Risk avoidance and social anxiety in adolescence: Examination of event-related potentials and theta-dynamics on the Balloon Risk Avoidance Task.

Adolescents are at relatively high-risk for developing anxiety, particularly social anxiety. A primary hallmark of social anxiety is the impulse to avoid situations that introduce risk. Here, we examined the neural and behavioral correlates of risk avoidance in adolescents (N=59) 11 to 19 years of age. The Balloon Risk Avoidance Task was used with concurrent electroencephalography to measure event-related potentials (frontal P2; late slow-wave; N2, feedback-related negativity, FRN; posterior P3) and oscillatory dynamics (midfrontal theta, 4-7 Hz) in response to unsuccessful and successful risk avoidance conditions. Social anxiety was measured using the Social Phobia and Anxiety Inventory for Children. Results indicated that, across the whole sample, youth exhibited smaller P3, larger FRN, and larger theta responses to unsuccessful risk avoidance. Youth reporting high (compared to low) levels of social anxiety exhibited larger P2, slow-wave, and FRN responses to unsuccessful, compared to successful, risk avoidance. Further, greater social anxiety was associated with reduced theta responses to successful avoidance. Youth with higher levels of social anxiety showed smaller theta responses to both conditions compared to those with low levels of social anxiety. Taken together, the ERP-component differences and weakened theta power in socially anxious youth following unsuccessful avoidance are informative neural correlates for socially anxious youth during risk avoidance.

Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis.

Maternal psychological factors, including anxiety, depression, and substance use, may negatively affect parenting. Previous works with mothers have often assessed each of these factors in isolation despite their frequent co-occurrence. Psychological factors have also been associated with neural processing of facial stimuli, specifically the amplitude (i.e., size) and latency (i.e., timing) of the face-specific N170 event-related potential. In the current study, 106 mothers completed measures assessing maternal psychological factors-anxiety, depression, and substance use. A latent profile analysis was used to identify profiles of psychological factors and assess profile associations with the N170 elicited by infant faces and with parental reflective functioning (PRF) as a measure related to caregiving. Two profiles (termed high and low psychological risk) were identified, with the higher risk profile associated with delayed N170 latency responses to infant faces. An exploratory analysis evidenced an indirect effect between the higher psychological risk profile and lower PRF through delayed N170 latency responses to infant faces. Taken together, maternal psychological risk across multiple indicators may together shape neural processing of infant faces, which may have downstream consequences for caregiving.

Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults.

Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.

Assessing the Efficacy of Large Language Models in Health Literacy: A Comprehensive Cross-Sectional Study.

Enhanced health literacy in children has been empirically linked to better health outcomes over the long term; however, few interventions have been shown to improve health literacy. In this context, we investigate whether large language models (LLMs) can serve as a medium to improve health literacy in children. We tested pediatric conditions using 26 different prompts in ChatGPT-3.5, ChatGPT-4, Microsoft Bing, and Google Bard (now known as Google Gemini). The primary outcome measurement was the reading grade level (RGL) of output as assessed by Gunning Fog, Flesch-Kincaid Grade Level, Automated Readability Index, and Coleman-Liau indices. Word counts were also assessed. Across all models, output for basic prompts such as "Explain" and "What is (are)," were at, or exceeded, the tenth-grade RGL. When prompts were specified to explain conditions from the first- to twelfth-grade level, we found that LLMs had varying abilities to tailor responses based on grade level. ChatGPT-3.5 provided responses that ranged from the seventh-grade to college freshmen RGL while ChatGPT-4 outputted responses from the tenth-grade to the college senior RGL. Microsoft Bing provided responses from the ninth- to eleventh-grade RGL while Google Bard provided responses from the seventh- to tenth-grade RGL. LLMs face challenges in crafting outputs below a sixth-grade RGL. However, their capability to modify outputs above this threshold, provides a potential mechanism for adolescents to explore, understand, and engage with information regarding their health conditions, spanning from simple to complex terms. Future studies are needed to verify the accuracy and efficacy of these tools.

Long-term neurocognitive outcomes in 204 single-suture craniosynostosis patients.

PURPOSE: Craniosynostosis, which describes premature fusion of one or more cranial sutures, has been associated with a variety of neurocognitive deficits. We sought to explore the cognitive profiles of the various types of single-suture, non-syndromic craniosynostosis (NSC). METHODS: A retrospective review of children 6-18 years old with surgically corrected NSC who underwent neurocognitive testing (Weschler Abbreviated Scale of Intelligence, Beery-Buktenica Developmental Test of Visuomotor Integration) from the years 2014-2022 was conducted. RESULTS: 204 patients completed neurocognitive testing (139 sagittal, 39 metopic, 22 unicoronal, 4 lambdoid suture). 110 (54%) of the cohort was male, and 150 (74%) were White. Mean IQ was 106.10±14.01 and mean age at surgery and testing were 9.0±12.2 months and 10.9±4.0 years, respectively. Sagittal synostosis was associated with higher scores than metopic synostosis, with significant differences in verbal IQ (109.42±15.76 vs 101.37±10.41), full-scale IQ (108.32±14.44 vs 100.05±11.76), visuomotor integration (101.62±13.64 vs 92.44±12.07), visual perception (103.81±12.42 vs 95.87±11.23), and motor coordination (90.45±15.60 vs 84.21±15.44). Sagittal synostosis was associated with significantly higher scores for visuomotor integration (101.62±13.64 vs 94.95±10.24) and visual perception (103.81±12.42 vs 94.82±12.75) than unicoronal synostosis. CONCLUSIONS: Compared to patients with sagittal synostosis, patients with metopic synostosis exhibited lower scores in verbal IQ, full-scale IQ, visuomotor integration, visual perception, and motor control after surgical correction. Despite surgical correction for premature metopic suture fusion, the effect on the adjacent frontal lobe and white matter connections to other regions of the brain may have a lasting functional impact. Patients with unicoronal synostosis exhibited lower visuomotor integration and visual perception scores.

Adult attachment is related to maternal neural response to infant cues: an ERP study.

Maternal attachment security is an important predictor of caregiving . However, little is known regarding the neurobiological mechanisms by which attachment influences processing of infant cues, a critical component of caregiving. We examined whether attachment security, measured by the Adult Attachment Interview, might relate to neural responses to infant cues using event-related potentials. Secure (n=35) and insecure (n=24) mothers viewed photographs of infant faces and heard recordings of infant vocalizations while electroencephalography was recorded. We examined initial processing of infant faces (N170) and cries (N100), and attentional allocation to infant faces and cries (P300). Secure mothers were significantly faster than insecure mothers to orient to infant cries (N100), structurally encode their own infant's face (N170), and attend to infant faces (P300). These differences may elucidate mechanisms underlying how attachment may shape neural processing of infant cues and highlight the use ofsocial neuroscientific approaches in examining clinically relevant aspects of attachment.

Reframing caring for parents who struggle with substance-use disorders.

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent-child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.

Nancy Suchman y los colegas sobre quienes ella ha ejercido influencia han producido un trabajo innovador y de reto a las actitudes sobre la comprensión de cómo la crianza y el uso de sustancias conviven juntas. La doctora Suchman y sus colegas insisten en el hecho de que no hay nada acerca del trastorno de uso de sustancias que no permita el cuidado eficaz y sensible para niños, especialmente con intervenciones que se enfocan en la relación progenitor-niño. El legado de Suchman es enfatizar cómo el uso de sustancias como enfermedad aleja a los individuos de relaciones importantes y afectuosas y les limita en el proceso de entregarse a tales relaciones. Restaurar la importancia de relaciones afectuosas y de la habilidad del individuo para mantener una relación afectuosa pudiera ser tan impactante en su uso de sustancias como un enfoque estricto para reducir el uso de drogas y lograr el estado de abstinencia.

Nancy Suchman, et les collègues qu'elle a influencés, a fait un travail novateur et généreusement combatif pour la compréhension de la manière dont le parentage et la toxicomanie se rassemblent. Le docteur Suchman et ses collègues soutiennent qu'il n'y a rien dans un trouble lié à l'usage d'une substance qui empêche le soin efficace et sensible aux enfants, surtout avec des interventions qui se focalisent sur la relation parent-enfant. L'héritage légué par Suchman consiste à mettre en lumière la façon dont la toxicomanie en tant que maladie détache les individus de relations importantes et attentionnées et limite le don qu'ils font d'eux-mêmes à ces relations. Le fait de restaurer la prépondérance de relations attentionnées et la capacité de l'individu à prendre soin peut avoir autant d'impact sur leur toxicomanie qu'une attention stricte à la réduction d'utilisation des drogues et l'atteinte de l'abstinence.

School age effects of Minding the Baby-An attachment-based home-visiting intervention-On parenting and child behaviors.

Multiple interventions have been developed to improve the caregiver-child relationship as a buffer to the effects of early life adversity and toxic stress. However, relatively few studies have evaluated the long-term effects of these early childhood interventions, particularly on parenting and childhood behaviors. Here we describe the early school-age follow-up results of a randomized controlled trial of Minding the Baby ® (MTB), a reflective, attachment-based, trauma-informed, preventive home-visiting intervention for first-time mothers and their infants. Results indicate that mothers who participated in MTB are less likely to show impaired mentalizing compared to control mothers two to eight years after the intervention ended. Additionally, MTB mothers have lower levels of hostile and coercive parenting, and their children have lower total and externalizing problem behavior scores when compared to controls at follow-up. We discuss our findings in terms of their contribution to understanding the long-term parenting and childhood socio-emotional developmental effects of early preventive interventions for stressed populations.

Exploring resting frontal EEG and reflective functioning in maternal substance use.

Maternal substance use is associated with altered neural activity and poor offspring outcomes, which may be facilitated by suboptimal caregiving in the form of impaired parental reflective functioning (PRF). To investigate these associations, the resting-state frontal electroencephalography (EEG) power of 48 substance-using mothers and 37 non-substance-using mothers were examined, specifying seven frequency bands: delta, theta, alpha, alpha1, alpha2, beta, and gamma. Substance-using mothers exhibited enhanced beta and gamma spectral power compared to non-substance-using mothers, potentially reflecting higher arousal states in substance-using mothers. There were no between-group differences in any component of PRF (i.e., levels of pre-mentalizing, certainty, and interest and curiosity). Whole-sample analyses revealed significant positive correlations between pre-mentalizing and delta spectral power. Taken together, these findings suggest potential neural correlates of maternal substance use and PRF, providing an important next step into examining associations between maternal substance use and poor child outcomes.

Se asocia el uso materno de sustancias con la actividad neural alterada y el débil resultado en los hijos, lo cual pudiera ser favorecido por una prestación de cuidado subóptima en forma de un impedido funcionamiento con reflexión (PRF) en el progenitor. Para investigar estas asociaciones, se examinó la fuerza de la electroencefalografía frontal en estado de descanso de 48 madres que usaban sustancia y 37 madres que no usaban sustancias, especificando siete bandas de frecuencia: delta, theta, alpha, alpha 1, alpha 2, beta y gamma. Las madres que usaban sustancias mostraron una fuerza espectral aumentada en beta y gamma, tal como se les comparó con las madres que no usaban sustancias, lo que potencialmente refleja estados más altos de agitación en las madres que usaban sustancias. No se dieron diferencias entre grupos en ninguno de los componentes de PRF (v.g. niveles de pre-mentalización, opacidad e interés y curiosidad). Los análisis de todas las muestras revelaron correlaciones positivas significativas entre pre-mentalización y la fuerza espectral delta. Tomándolos en conjunto, estos resultados indican posibles correlaciones neurales entre del uso materno de sustancias y PRF, lo cual aporta un importante próximo paso para examinar las asociaciones entre el uso materno de sustancias y los débiles resultados en el niño.

La toxicomanie maternelle est liée à une activité neuronale altérée et de mauvais résultats sur les enfants de la personne, ce qui peut être facilité par un mode de soin suboptimal sous la forme d'un fonctionnement de réflexion parentale (PRF en anglais) altéré. Pour enquêter sur ces liens, l'électroencéphalographie frontale au repos (EEG) de 48 mères toxicomanes et de 37 mères non-toxicomanes a été examiné, plus spécifiquement sur quatre bandes de fréquences : delta, thêta, alpha, alpha1, alpha2, béta, et gamma. Les mères toxicomanes ont fait preuve d'une puissance spectrale de béta et gamma importante comparées aux mères non-toxicomanes, ce qui reflète peut-être de plus d' états d'excitation chez les mères toxicomanes. Nous n'avons observé aucune différence entre les groupes pour ce qui concerne les composantes de la PRF (soit, niveaux de pré-mentalisation, d'opacité, d'intérêt et de curiosité). Des analyses sur tout l'échantillon ont révélé des corrélations positives importantes entre la puissance spectrale de pré-mentalisation et la puissance spectrale delta. Considérés dans l'ensemble, ces résultats suggèrent un corrélat neural potentiel de la toxicomanie maternelle et de la PRF, ce qui présente une nouvelle étape importante dans l'examen des liens entre la toxicomanie maternelle et les mauvais résultats sur l'enfant.

The Application of Connectome-Based Predictive Modeling to the Maternal Brain: Implications for Mother-Infant Bonding.

Maternal bonding early postpartum lays an important foundation for child development. Changing brain structure and function during pregnancy and postpartum may underscore maternal bonding. We employed connectome-based predictive modeling (CPM) to measure brain functional connectivity and predict self-reported maternal bonding in mothers at 2 and 8 months postpartum. At 2 months, CPM predicted maternal anxiety in the bonding relationship: Greater integration between cerebellar and motor-sensory-auditory networks and between frontoparietal and motor-sensory-auditory networks were associated with more maternal anxiety toward their infant. Furthermore, greater segregation between the cerebellar and frontoparietal, and within the motor-sensory-auditory networks, was associated with more maternal anxiety regarding their infant. We did not observe CPM prediction of maternal bonding impairments or rejection/anger toward the infant. Finally, considering 2 and 8 months of data, changes in network connectivity were associated with changes in maternal anxiety in the bonding relationship. Our results suggest that changing connectivity among maternal brain networks may provide insight into the mother-infant bond, specifically in the context of anxiety and the representation of the infant in the mother's mind. These findings provide an opportunity to mechanistically investigate approaches to enhance the connectivity of these networks to optimize the representational and behavioral quality of the caregiving relationship.

Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention.

BACKGROUND: Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism. OBJECTIVE: The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention. METHODS: Ninety-seven maternal-child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention. RESULTS: Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels. DISCUSSION: Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.

Long-Term Neurocognitive Outcomes in Sagittal Synostosis: The Impact of Reoperation.

INTRODUCTION: Optimal age at surgery in nonsyndromic sagittal craniosynostosis continues to be debated. Previous reports suggest that earlier age at whole vault cranioplasty more frequently requires reoperation. It is unknown, however, whether reoperation affects neurocognitive outcome. This study examined the impact of reoperation on neurocognitive outcome in children with nonsyndromic sagittal craniosynostosis using comprehensive neurocognitive testing. METHODS: Forty-seven school-age children (age 5-16 years) with nonsyndromic sagittal craniosynostosis who underwent whole-vault cranioplasty were included in this analysis. Participants were administered a battery of standardized neuropsychological testing to measure neurocognitive outcomes. RESULTS: Thirteen of the 47 participants underwent reoperation (27.7%); 11 out of the 13 reoperations were minor revisions while 2 reoperations were cranioplasties. Reoperation rate was not statistically different between patients who had earlier surgery (at age ≤6 months) versus later surgery (at age >6 months) (P > 0.05). Nonreoperated patients who had only one later-in-life surgery did not perform statistically better than reoperated patients on any outcome measure of neurocognitive function, including IQ, academic achievement, visuomotor integration, executive function, and behavior. Comparing reoperated earlier surgery patients with nonreoperated later surgery patients, reoperated earlier surgery patients had higher full-scale and verbal IQ (P < 0.05), scored higher on word reading, reading comprehension, spelling, numerical operations, and visuomotor integration (P < 0.05), and had fewer indicators of suspected learning disabilities (P < 0.01) compared to nonreoperated later surgery patients. CONCLUSION: Reoperation rate after whole vault cranioplasty was 27.7%, with few cases of repeat cranioplasty (4.2% of all patients). Reoperation was not associated with worse neurocognitive outcome. Reoperated earlier surgery patients in fact performed better in IQ, academic achievement and visuomotor integration when compared to nonreoperated later surgery patients.

Minding the Baby®: Enhancing parental reflective functioning and infant attachment in an attachment-based, interdisciplinary home visiting program.

In this article, we describe the results of the second phase of a randomized controlled trial of Minding the Baby (MTB), an interdisciplinary reflective parenting intervention for infants and their families. Young first-time mothers living in underserved, poor, urban communities received intensive home visiting services from a nurse and social worker team for 27 months, from pregnancy to the child's second birthday. Results indicate that MTB mothers' levels of reflective functioning was more likely to increase over the course of the intervention than were those of control group mothers. Likewise, infants in the MTB group were significantly more likely to be securely attached, and significantly less likely to be disorganized, than infants in the control group. We discuss our findings in terms of their contribution to understanding the impacts and import of intensive intervention with vulnerable families during the earliest stages of parenthood in preventing the intergenerational transmission of disrupted relationships and insecure attachment.

Alexithymia, Emotion-Regulation Strategies, and Traumatic Experiences in Prenatally Cocaine-Exposed Young Adults.

BACKGROUND AND OBJECTIVES: Exposure to early-life trauma may lead to maladaptive characteristics such as alexithymia, and thus to poorer emotional regulation. This relationship may also be influenced by exposure to substances prenatally. We hypothesized that increased alexithymia would be seen in those with prenatal cocaine exposure (PCE). Additionally, we hypothesized that early-life trauma would be associated with alexithymia, and that alexithymia would be associated with poor emotional reappraisal and emotional suppression. METHODS: A moderated mediation model was developed to examine whether the hypothesized indirect relationship between trauma and emotional reappraisal through alexithymia was different in young adults with and without PCE (Total N = 57). Thirty-seven young adults with PCE and 20 with no such exposure, all of whom were members of a longitudinal cohort, were recruited for the study, and data concerning childhood trauma, alexithymia, and emotional regulation were collected. Intercorrelations were performed between the scores on each measure and moderated mediation models were constructed separately with emotional neglect or emotional abuse as the independent variable and emotional reappraisal or emotional suppression as the dependent variable. RESULTS: PCE status was associated with alexithymia, and alexithymia mediated the relationship between emotional neglect and emotional reappraisal in individuals with PCE but not those without. DISCUSSION AND CONCLUSIONS: The data suggest that alexithymia is a mechanism underlying poor use of emotional reappraisal in PCE individuals. SCIENTIFIC SIGNIFICANCE: Individuals with early-life trauma and substance exposure may represent a vulnerable population, and alexithymia may play a key role in the development of emotional regulation skills in this population. (Am J Addict 2020;29:492-499).

Getting to the heart of food craving with resting heart rate variability in adolescents.

BACKGROUND: There is an epidemic of obesity in children and adolescents. Research into the self-regulatory factors that drive eating behavior is of critical importance. Food craving contributes to overeating and difficulty with weight loss and is strongly correlated with self-regulation. High-frequency heart rate variability (HF HRV) reflects parasympathetic activity and is positively associated with self-regulation. Few studies of HF HRV and food craving have been conducted in adolescents. The current study examined the association between HF HRV and food craving in a large-scale sample of healthy adolescents. METHOD: Electrocardiogram (ECG) was recorded in 134 healthy adolescents aged 10-17 during a 7-min resting state. Participants also completed the Food Craving Questionnaire-Trait (FCQ-T). The relative power of HF HRV was calculated. Association between HF HRV and food craving was examined in the context of sex and age. Next, the relative significance of all food craving subscales was considered in relation to HF HRV. RESULTS: HF HRV was inversely correlated with food craving, taking into account sex and age. Considering all the subscales of FCQ-T in relation to HF HRV, the "lack of control over eating" subscale accounted for the most significant variance. CONCLUSION: This was the first study to evaluate resting HRV and eating behaviors in a large-scale adolescent sample. HF HRV was negatively associated with food craving, with lower HF HRV correlating with higher food craving, especially in the context of diminished control over eating. HF HRV could be a potential biomarker for food craving and food-related self-regulation capacity, and therefore may aid weight management interventions.

Acceptability and Feasibility of Hair and Salivary Biomarker Collection Among Multiethnic School-Age Children.

OBJECTIVE: As noninvasive biological markers gain increasing popularity in pediatric research, it is critical to understand how study participants perceive these measures, especially among groups underrepresented in biobehavioral research, like children and people of color. The purpose of this study was to examine acceptability and feasibility of hair and salivary biomarker collection in an urban community sample of ethnically diverse children (age 4 to 10 years). METHODS: Ninety-seven mother-child dyads were recruited for a cross-sectional follow up study of the Minding the Baby® home visiting intervention. Children were Hispanic (63%), Black (34%), and multi-racial (3.1%). A conventional content analysis was conducted using two sources of data: (1) mothers' responses to open-ended interview questions on their views and suggestions regarding biomarker collection, and (2) field notes recorded by investigators. RESULTS: Forty-four percent of mothers reported biomarker-related questions or concerns, including questions about the purpose of biomarker testing, and concerns about cosmetic issues, child discomfort, and future use of biomarker data. Mothers also offered positive feedback and advice for collection. Issues affecting feasibility included children's hair length and style, refusal to participate, and behavioral or developmental issues. CONCLUSIONS: Hair and salivary biomarker collection was largely acceptable and feasible in this sample. Strategies for promoting ethical and sensitive biomarker collection include respectful explanations and parental involvement, creating a comfortable and safe environment for the child, flexible collection strategies, and attention to development, cultural preferences and perspectives.

Substance use and mothers' neural responses to infant cues.

Substance use may influence mothers' responsiveness to their infants and negatively impact the parent-infant relationship. Maternal substance use may co-opt neural circuitry involved in caregiving, thus reducing the salience of infant cues and diminishing the sense of reward experienced by caring for infants. Gaps in understanding exist with regard to the mechanisms by which substance use operates to influence mothers' processing of infant cues and how this translates to caregiving. Therefore, we examined how substance use might relate to maternal neural responses to infant cues using event-related potentials (ERPs). Substance-using (n = 29) and nonsubstance-using (n = 29) mothers viewed photographs of infant faces and heard recordings of infant vocalizations while electroencephalography was recorded simultaneously. Three specific ERP components were used to examine initial processing of infant faces (N170) and cries (N100), and attentional allocation to infant faces and cries (P300). Substance-using mothers did not discriminate facial affect at early encoding stages (N170), were generally slower to orient to infant cries (N100), showed heightened responses to neutral faces (P300), and failed to adaptively differentiate between high-distress versus low-distress cries (P300). These differences may be important to caregiving behaviors associated with the formation of mother-child attachment. Implications are discussed, as are limitations and future directions.

Childhood trauma moderates inhibitory control and anterior cingulate cortex activation during stress.

OBJECTIVE: The anterior cingulate cortex (ACC) is critical for both stress and inhibitory control processes and has been implicated in childhood trauma. This prospective study tested the hypothesis that early trauma moderates the association between inhibitory control during late childhood and ACC stress reactivity during adolescence. METHOD: Sixty-four adolescents were stratified into higher- or lower-childhood-trauma groups. Inhibitory control was indicated by fewer errors on a Stroop Color-Word task. Personalized stress cues during functional magnetic resonance imaging assessed neural correlates of stress in adolescents. RESULTS: Using a priori-defined anterior (rCZa) and posterior rostral cingulate zones of the ACC, associated with Stroop Color-Word task performance in prior meta-analyses, Stroop errors correlated inversely with activation in the rCZa during stress-cue exposure (r = -.23, p = .04). Childhood trauma moderated the association between Stroop errors and rCZa stress reactivity (interaction = -1.26, p = .02, 95%CI = -2.33,-0.20), where Stroop errors were inversely associated with brain activation among those with higher childhood trauma (simple slopes = -.83, p = .007, 95%CI = -1.40,-0.25). Low stress-related rCZa activation inversely (R2 = 0.19, b = -0.43, p = .001, 95%CI = -4.11,-1.06) and Stroop errors directly (R2 = 0.09, b = 0.27, p = .048, 95%CI = 0.02, 5.8) associated with baseline subjective anxiety while controlling for childhood trauma. CONCLUSIONS: This is the first study to demonstrate a moderating role of childhood trauma on the relationship between inhibitory control and stress-related ACC activation. Childhood trauma may portend neurodevelopmental changes that impede recruitment of control-associated ACC-functioning during distress, which may relate to dysregulation of stress-induced affective responses. Further work is needed to elucidate relationships between childhood trauma and addictive behaviors precipitated by stress.

Maternal Adverse Childhood Experiences, Family Strengths, and Chronic Stress in Children.

BACKGROUND: Researchers have demonstrated that maternal adverse childhood experiences (ACEs), such as abuse and neglect, are associated with prenatal risk factors and poor infant development. However, associations with child physiologic and health outcomes, including biomarkers of chronic or "toxic" stress, have not yet been explored. OBJECTIVES: The purpose of this study was to examine the associations among past maternal experiences, current maternal posttraumatic stress disorder (PTSD) symptoms, and children's indicators of exposure to chronic stress in a multiethnic sample of mothers and children at early school age (4 to 9 years). METHODS: This cross-sectional study included maternal-child dyads (N = 54) recruited from urban community health centers in New Haven, Connecticut. Mothers reported history of ACEs, family strengths, and current PTSD symptoms. Child measures included biomarkers and health and developmental outcomes associated with chronic stress. Correlational and regression analyses were conducted. RESULTS: Childhood trauma in mothers was associated with higher systolic blood pressure percentile (ρ = .29, p = .03) and behavioral problems (ρ = .47, p = .001) in children, while maternal history of family strengths was associated with lower salivary interleukin (IL)-1ß (ρ = -.27, p = .055), salivary IL-6 (ρ = -.27, p = .054), and body mass index z-scores (ρ = -.29, p = .03) in children. Maternal PTSD symptoms were associated with more child behavioral problems (ρ = .57, p < .001) and higher odds of asthma history (ρ = .30, p = .03). DISCUSSION: Results indicate that past maternal experiences may have important influences on a child's health and affect his or her risk for experiencing toxic stress.

Associations Between Maternal Experiences of Discrimination and Biomarkers of Toxic Stress in School-Aged Children.

OBJECTIVE: To examine associations between maternal experiences of discrimination and child biomarkers of toxic stress in a multiethnic, urban sample of mothers and children (4-9 years). METHODS: Data were drawn from a cross-sectional study of maternal-child dyads (N = 54) living in low-income neighborhoods in New Haven, Connecticut, USA. Mothers reported experiences of discrimination. Noninvasive biomarkers of toxic stress were collected to assess neuroendocrine (hair cortisol), immune (salivary cytokines, c-reactive protein), and cardiovascular (blood pressure) functioning in children. RESULTS: Maternal experiences of discrimination were associated with increased log-transformed salivary interleukin-6 (IL-6) levels in children (ß = 0.15, p = 0.02). CONCLUSIONS: Vicarious racism, or indirect exposure to discrimination experienced by caregivers, is associated with poor health outcomes for children. Immune pathways may be a biological mechanism through which racial discrimination "gets under the skin," but additional research is needed to fully understand these relationships. Uncovering the physiological mechanisms linking vicarious racism with child health is an important step towards understanding possible early roots of racial and ethnic health inequities.