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1.
Dev Sci ; 27(3): e13456, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37902111

RESUMEN

Pregnant women in poverty may be especially likely to experience sleep and circadian rhythm disturbances, which may have downstream effects on fetal neurodevelopment. However, the associations between sleep and circadian rhythm disturbances, social disadvantage during pregnancy, and neonatal brain structure remains poorly understood. The current study explored the association between maternal sleep and circadian rhythm disturbances during pregnancy and neonatal brain outcomes, examining sleep and circadian rhythm disturbances as a mediator of the effect of social disadvantage during pregnancy on infant structural brain outcomes. The study included 148 mother-infant dyads, recruited during early pregnancy, who had both actigraphy and neuroimaging data. Mothers' sleep was assessed throughout their pregnancy using actigraphy, and neonates underwent brain magnetic resonance imaging in the first weeks of life. Neonatal structural brain outcomes included cortical gray matter, subcortical gray matter, and white matter volumes along with a measure of the total surface area of the cortex. Neonates of mothers who experienced greater inter-daily deviations in sleep duration had smaller total cortical gray and white matter volumes and reduced cortical surface areas. Neonates of mothers who had higher levels of circadian misalignment and later sleep timing during pregnancy showed smaller subcortical gray matter volumes. Inter-daily deviations in sleep duration during pregnancy mediated the association between maternal social disadvantage and neonatal structural brain outcomes. Findings highlight the importance of regularity and rhythmicity in sleep schedules during pregnancy and bring to light the role of chronodisruption as a potential mechanism underlying the deleterious neurodevelopmental effects of prenatal adversity. RESEARCH HIGHLIGHTS: Social disadvantage was associated with sleep and circadian rhythm disturbances during pregnancy, including later sleep schedules, increased variability in sleep duration, circadian misalignment, and a higher proportion of the sleep period spent awake. Maternal sleep and circadian rhythm disturbances during pregnancy were associated with decreased brain volume and reduced cortical surface area in neonates. Maternal inter-daily deviations in sleep duration during pregnancy mediated the association between social disadvantage and neonatal brain volume and cortical surface area.


Asunto(s)
Sueño , Sustancia Blanca , Recién Nacido , Lactante , Humanos , Embarazo , Femenino , Ritmo Circadiano , Encéfalo , Sustancia Gris
2.
Dev Psychopathol ; : 1-16, 2023 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-37340976

RESUMEN

Difficulties with emotion regulation are integral to borderline personality disorder (BPD) and its hypothesized developmental pathway. Here, we prospectively assess trajectories of emotion processing across childhood, how BPD symptoms impact these trajectories, and whether developmental changes are transdiagnostic or specific to BPD, as major depressive (MDD) and conduct disorders (CD) are also characterized by emotion regulation difficulties. This study included 187 children enriched for those with early symptoms of depression and disruptive behaviors from a longitudinal study. We created multilevel models of multiple components of emotional processing from mean ages 9.05 to 18.55 years, and assessed the effect of late adolescent BPD, MDD, and CD symptoms on these trajectories. Linear trajectories of coping with sadness and anger, and quadratic trajectories of dysregulated expressions of sadness and anger were transdiagnostic, but also exhibited independent relationships with BPD symptoms. Only inhibition of sadness was related to BPD symptoms. The quadratic trajectories of poor emotional awareness and emotional reluctance were also independently related to BPD. Findings support examining separable components of emotion processing across development as potential precursors to BPD, underscoring the importance of understanding these trajectories as not only a marker of potential risk but also potential targets for prevention and intervention.

3.
Proc Natl Acad Sci U S A ; 117(36): 22015-22023, 2020 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-32839328

RESUMEN

There is robust evidence that early poverty is associated with poor developmental outcomes, including impaired emotion regulation and depression. However, the specific mechanisms that mediate this risk are less clear. Here we test the hypothesis that one pathway involves hormone mechanisms (testosterone and DHEA) that contribute to disruption of hippocampal brain development, which in turn contributes to perturbed emotion regulation and subsequent risk for depression. To do so, we used data from 167 children participating in the Preschool Depression Study, a longitudinal study that followed children from preschool (ages 3 to 5 y) to late adolescence, and which includes prospective assessments of poverty in preschool, measures of testosterone, DHEA, and hippocampal volume across school age and adolescence, and measures of emotion regulation and depression in adolescence. Using multilevel modeling and linear regression, we found that early poverty predicted shallower increases of testosterone, but not DHEA, across development, which in turn predicted shallower trajectories of hippocampal development. Further, we found that early poverty predicted both impaired emotion regulation and depression. The relationship between early poverty and self-reported depression in adolescence was explained by serial mediation through testosterone to hippocampus to emotion dysregulation. There were no significant interactions with sex. These results provide evidence about a hormonal pathway by which early poverty may contribute to disrupted brain development and risk for mental health problems later in life. Identification of such pathways provide evidence for potential points of intervention that might help mitigate the impact of early adversity on brain development.


Asunto(s)
Depresión/economía , Depresión/psicología , Hipocampo/crecimiento & desarrollo , Testosterona/sangre , Niño , Preescolar , Depresión/sangre , Depresión/fisiopatología , Emociones , Femenino , Humanos , Estudios Longitudinales , Masculino , Pobreza , Estudios Prospectivos
4.
Eur Child Adolesc Psychiatry ; 32(12): 2491-2501, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36216984

RESUMEN

Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) effectively treats depression and improves functioning in preschoolers. Parental depression has been associated with inconsistent parenting, depression onset and maintenance in offspring, and decreased treatment efficacy for youth. Given the intensity of parent involvement in PCIT-ED, this secondary data analysis aimed to evaluate parental depression severity (i.e., Beck Depression Inventory-II Total Score; BDI-II) as a moderator and predictor of child, parenting, and engagement outcomes, within the context of a randomized trial. Children (N = 229; ages 3-6.11) with early childhood depression and a consenting caregiver were randomly assigned to receive PCIT-ED or Waitlist (WL). Moderation results supported the superiority of PCIT-ED over WL on child and parenting outcomes, independent of parent-reported BDI-II at baseline (p ≥ 0.684 and p ≥ 0.476, respectively). BDI-II did not significantly predict child (p ≥ 0.836), parenting (p ≥ 0.114) or engagement (p ≥ 0.114) outcomes. Finally, BDI-II did not surpass chance in predicting whether children would maintain a depression diagnosis after PCIT-ED (AUC = 0.530) or prematurely terminate treatment (AUC = 0.545). Our results suggest that PCIT-ED is not contraindicated by minimal-to-moderate symptoms of depression in parents. Taken together with previous reports, PCIT-ED may indeed be a particularly beneficial treatment choice for this population. Further research in samples with more severe parental depression is needed. ClinicalTrials.gov identifier: NCT02076425.


Asunto(s)
Depresión , Responsabilidad Parental , Humanos , Preescolar , Adolescente , Responsabilidad Parental/psicología , Depresión/terapia , Depresión/psicología , Psicoterapia/métodos , Emociones , Padres/psicología , Relaciones Padres-Hijo
5.
Eur Child Adolesc Psychiatry ; 32(11): 2303-2311, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36063216

RESUMEN

Deficits in emotion intelligence (EI) are a key component of early-childhood callous-unemotional (CU) traits. Children's EI may be influenced by their mother's EI through both familial genetic and environmental mechanisms; however, no study has directly tested the role of maternal EI in the development of CU traits. This study investigated whether maternal EI had a direct relationship with children's CU traits when controlling for the potential influence of parenting affect and other psychiatric diagnoses. Mothers and their 3- to 5-year-old preschoolers (N = 200) were recruited as part of a parent-child interaction-emotion development therapy treatment trial for preschool clinical depression and comorbid psychopathology. Using data collected prior to treatment, regression models tested whether maternal EI was related to children's CU traits, which specific aspects of maternal EI were most strongly associated with CU traits, and whether associations held after accounting for observed parenting affect. Maternal EI (p < 0.005), specifically the ability to understand others' emotions (p < 0.01), was significantly associated with children's CU traits. This relationship was specific, as maternal EI did not predict depression or oppositional defiant disorder. Both maternal EI and observed negative parenting affect were independently and significantly related to CU traits (p < 0.05) in a combined model. Given that maternal EI and observed negative parenting affect were independent predictors of CU traits in preschoolers with comorbid depression, findings suggest that current treatments for CU traits that focus solely on improving parenting could be made more effective by targeting maternal EI and helping mothers better model emotional competence.


Asunto(s)
Trastorno de la Conducta , Niño , Preescolar , Femenino , Humanos , Trastorno de la Conducta/psicología , Inteligencia Emocional , Emociones , Empatía , Relaciones Padres-Hijo , Responsabilidad Parental/psicología
6.
Curr Psychol ; 42(5): 3991-4000, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37009263

RESUMEN

Obesity is a major public health problem and cause of significant burden across the lifespan. Longitudinal samples, beginning in early childhood offer an advantageous approach to studying obesity, given the potential to observe within-individual changes over time. Yet among the many available longitudinal studies of children, particularly those studying psychological disorders, do not assess for overweight/obesity status or related constructs necessary to compute BMI. We offer a unique thin slice approach for assessing obesity/overweight status using previously collected video data. The current study observationally coded overweight/obesity status in a clinically enriched sample of preschoolers oversampled for depression (N=299). Preschoolers (ages 3-6 years) completed 1-8 structured observational tasks with an experimenter. Overweight/obesity was coded using a "thin slice" technique with 7,820 unique ratings available for analysis. Parent-reported physical health problems were assessed throughout the study and BMI percentiles were available from ages 8-19 years. Thin-slice ratings of overweight/obesity were reliably observed in preschoolers' ages 3-6 years. Thin-slice ratings of overweight/obesity during preschool significantly predicted adolescent BMI percentiles at six separate assessments spanning ages 8-19 years. Further, preschool overweight/obese thin-slice ratings were associated with more physical health problems over time and less sport/activity participation during preschool. Overweight/obesity can be observationally identified in preschool-age children and offers a reliable estimate of future BMI percentile. Study findings highlight how previously collected data could be utilized to study the developmental trajectories of overweight/obesity to inform this critical public health problem.

7.
Dev Sci ; 25(3): e13196, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34802176

RESUMEN

The reward positivity (RewP) is a widely studied measure of neural response to rewards, yet little is known about normative developmental characteristics of the RewP during early childhood. The present study utilized a pooled community sample of 309 4- to 6-year-old children who participated in the Doors guessing game to examine the latency and amplitude of the RewP. Peak detection of the gain-loss difference waveform was conducted for electrodes Fz, Cz, Pz, Oz and the mean activity in a 100 ms window centered around this peak was analyzed. There was a significant decrease in RewP latency (RewP was earlier) and increase in RewP amplitude (RewP magnitude was larger) with advancing age in this cross-sectional analysis. Further, these were independent effects, as both RewP latency and RewP amplitude were uniquely associated with children's age. Moreover, our results indicate that the RewP latency in 4- to 6-year-olds falls outside the 250-350 ms window typically used to quantify the RewP (RewP latency in our sample = 381 ms; SD = 60.15). The internal consistency for latency (.64) and amplitude (.27) of the RewP were characterized by moderate to low reliability, consistent with previous work on the reliability of difference scores. Overall, results demonstrate RewP differences in both timing and amplitude across age in early childhood, and suggest that both amplitude and latency of the RewP might function as individual difference measures of reward processing. These findings are discussed in the context of methodological considerations and the development of reward processing across early childhood.


Asunto(s)
Electroencefalografía , Potenciales Evocados , Niño , Preescolar , Estudios Transversales , Potenciales Evocados/fisiología , Humanos , Reproducibilidad de los Resultados , Recompensa
8.
J Pediatr ; 236: 164-171, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33930406

RESUMEN

OBJECTIVES: To evaluate the Preschool Feeling Checklist (PFC) utility for predicting later mental disorders and functioning for children and assess whether the PFC's predictive utility differs as a function of childhood poverty. STUDY DESIGN: We analyzed data from a prospective longitudinal study of preschoolers in St Louis. Preschoolers (N = 287) were recruited from primary care sites and were assessed annually for 10-15 years. The PFC screened for depressive symptoms. Later age-appropriate psychiatric diagnostic interviews were used to derive Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnoses. Regression and moderation analyses, and multilevel modeling were used to test the association between the PFC and later outcomes, and whether this relationship was moderated by income-to-needs. RESULTS: The PFC predicted major depressive disorder (OR 1.13, P < .001), attention deficit hyperactivity disorder (OR 1.16, P < .001), and mania (OR 1.18, P < .05) in adolescence and early adulthood. Income-to-needs was a moderator in the predictive pathway between the PFC and later major depressive disorder (OR 1.10, P < .05) and mania (OR 1.19, P < .001) with the measure less predictive for children living in poverty. The PFC predicted worse functioning by the final assessment (b = 1.71, SE = 0.51, P = .001). CONCLUSIONS: The PFC served as an indicator of risk for later attention deficit hyperactivity disorder and impairment in all children. It has predictive utility for later mood disorders only in children living above the poverty line. Predicting depression in children living below the poverty line may require consideration of risk factors not covered by the PFC.


Asunto(s)
Emociones , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Pobreza/psicología , Atención Primaria de Salud , Adolescente , Factores de Edad , Lista de Verificación , Niño , Preescolar , Femenino , Humanos , Estudios Longitudinales , Masculino , Valor Predictivo de las Pruebas , Estudios Prospectivos , Medición de Riesgo
9.
J Child Psychol Psychiatry ; 62(1): 86-96, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32469454

RESUMEN

BACKGROUND: Parenting in early childhood exerts substantial influence over children's emotional health and development. Using data from a randomized controlled trial of a novel treatment for early childhood depression, Parent-Child Interaction Therapy Emotion Development (PCIT-ED), we explored two broad dimensions of parenting (behavior and affect) to determine whether any changes could be detected following treatment when compared to those in a waitlist control condition. METHOD: 229 caregiver-child dyads, 114 randomly assigned to PCIT-ED for preschool-onset depression, and 115 assigned to a waitlist completed two structured interaction tasks at baseline and post-treatment. Interactions were later coded by observer's blind to diagnostic and treatment status. RESULTS: Greater reductions were found in self-reported negative parenting behaviors and observed negative affect and greater increases in self-reported positive parenting behaviors and observed positive affect among the caregivers in the treatment group. Increases in the overall positivity of the observed interactional style of caregivers, but no observed parenting behavior change was found following treatment. Discrepancies between self-reported and observed parenting were greater among caregivers on the waitlist. CONCLUSIONS: Following PCIT-ED treatment, caregivers self-reported improvements in parenting practices and declines in punitive practices along with observed increases in positive affect and decreases in negative affect when interacting with their child. Moreover, coherence between self-reported and observed parenting was higher in the treatment group. These findings highlight the efficacy of PCIT-ED in improving parenting behaviors and the need to use multiple methods to assess parenting in treatment studies.


Asunto(s)
Depresión , Responsabilidad Parental , Preescolar , Emociones , Humanos , Relaciones Padres-Hijo , Autoinforme
10.
Eur Child Adolesc Psychiatry ; 30(9): 1463-1474, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32935261

RESUMEN

In school-aged children, adolescents, and adults, more than 72% of individuals diagnosed with major depression report co-occurring sleep problems, but little is known about sleep problems in the context of preschool-onset major depressive disorder (PO-MDD). The current study examined the prevalence of various sleep problems in a sample of young children diagnosed with PO-MDD and explored how the treatment of depression, using a modification of parent-child interaction therapy focused on emotional development (PCIT-ED), affects sleep problems. Participants included 229 preschoolers (ages 3-6 years) who met criteria for PO-MDD and participated a single-blind, randomized control trial comparing PCIT-ED to a waitlist control condition. Children were randomly assigned to either PCIT-ED (n = 114) or the waitlist condition (n = 115). Children were assessed at baseline, immediately after PCIT-ED, and 3 months after treatment completion for parent-reported sleep problems across the domains of insomnia, hypersomnia, daytime fatigue, and a total sleep problem index. In our sample, 45% of children had at least one subthreshold sleep problem, 38.4% had at least one threshold sleep problem, and 72.5% had at least one sleep problem (either threshold or subthreshold). Treatment with PCIT-ED significantly reduced sleep problems, including insomnia, daytime fatigue, and total sleep problems, compared to a waitlist condition, even when controlling for child depression. This reduction was maintained at a 3-month follow-up. Sleep problems are a prevalent co-occurring condition with PO-MDD. Interventions such as PCIT-ED that also effectively reduce sleep problems may be particularly beneficial for recovery from PO-MDD.Clinical trial registration information: a randomized control trial of PCIT-ED for preschool depression; https://clinicaltrials.gov/NCT02076425 .


Asunto(s)
Trastorno Depresivo Mayor , Trastornos del Sueño-Vigilia , Adolescente , Adulto , Niño , Preescolar , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/terapia , Emociones , Humanos , Relaciones Padres-Hijo , Instituciones Académicas , Método Simple Ciego , Trastornos del Sueño-Vigilia/terapia
11.
J Pers Assess ; 103(2): 214-223, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32013574

RESUMEN

A large literature assessing personality across the lifespan has used the Big Five as an organizing framework, with evidence that variation along different dimensions predicts aspects of psychopathology. Parent reports indicate that these dimensions emerge as early as preschool, but there is a need for objective, observational measures of personality in young children, as parent report can be confounded by the parents' own personality and psychopathology. The current study observationally coded personality dimensions in a clinically enriched sample of preschoolers. A heterogeneous group of preschoolers oversampled for depression (N = 299) completed 1-8 structured observational tasks with an experimenter. Big Five personality dimensions of extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience were coded using a "thin slice" technique with 7,820 unique ratings available for analysis. Thin slice ratings of personality dimensions were reliably observed in preschoolers ages 3-6 years. Within and across-task, consistency was also evident, with consistency estimates higher than found in adult samples. Divergent validity was limited, with coders distinguishing between three (extraversion/openness; agreeableness/conscientiousness; and neuroticism) rather than five dimensions. Personality dimensions can be observationally identified in preschool-age children and offer reliable estimates that stand across different observational tasks. Study findings highlight the importance of observational approaches to assessing early personality dimensions, as well as the utility of the thin slice approach for meaningful secondary data analysis.


Asunto(s)
Extraversión Psicológica , Neuroticismo , Determinación de la Personalidad/normas , Desarrollo de la Personalidad , Personalidad , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Inventario de Personalidad , Psicometría/estadística & datos numéricos
12.
Child Psychiatry Hum Dev ; 51(2): 321-329, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31625000

RESUMEN

The ability to identify and label emotions may represent an early-life risk factor that relates to excess weight gain during childhood. The current study investigates the relationships between preschool emotion identification and early adolescent body mass index (BMI), as well as the mediating role of two variables: depressive symptoms and peer relations. In a longitudinal study, preschoolers completed an emotion identification task, and parents completed psychiatric assessments and a peer-relations questionnaire about their child. BMI percentile was measured at later time points in early adolescence. Poor emotion identification during preschool predicted increases in BMI percentile over time, with greater deficits in emotion identification ability relating to steeper increases in BMI percentile across early adolescence. Peer relations in preschool partially mediated the relationship between preschool emotion identification ability and adolescent BMI. This study provides novel information about potential targets for early interventions in the service of obesity prevention.


Asunto(s)
Índice de Masa Corporal , Depresión/psicología , Emociones/fisiología , Relaciones Interpersonales , Percepción Social , Adolescente , Preescolar , Escolaridad , Femenino , Humanos , Estudios Longitudinales , Masculino , Obesidad/psicología , Grupo Paritario , Factores de Riesgo , Instituciones Académicas
13.
Curr Psychiatry Rep ; 21(12): 128, 2019 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-31748851

RESUMEN

PURPOSE OF REVIEW: We review findings related to predictors, correlates, outcomes, and treatment of preschool depression that have been published in the last 3 years. RECENT FINDINGS: Preschool depression displays a chronic course through late adolescence and is associated with temperamental and personality traits, poorer physical health, and negative parenting practices. Preschool depression predicts deficits into adolescence, including social difficulties and blunted neural response to rewards. Depressed preschoolers can experience suicidal ideation and behaviors and display an accurate understanding of the finality of death. A treatment for preschool depression has now been validated that uses the parent-child relationship to enhance emotion development and reduce depressive symptoms. Preschool depression is homotypic with depression that occurs later in life. Future work elucidating mechanisms through which preschool depression develops and informs the sub-groups for which particular treatments may be most effective will have considerable implications for prevention and early intervention.


Asunto(s)
Discapacidades del Desarrollo/psicología , Emociones/fisiología , Relaciones Padres-Hijo , Temperamento , Adolescente , Niño , Preescolar , Trastorno Depresivo , Discapacidades del Desarrollo/diagnóstico , Humanos , Apego a Objetos , Responsabilidad Parental , Inventario de Personalidad , Pobreza
14.
Child Dev ; 89(3): 734-745, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29222816

RESUMEN

High shyness during early adolescence is associated with impaired peer relationships and risk for psychiatric disorders. Little is known, however, about the relation between shyness and trajectories of brain development over early adolescence. The current study longitudinally examined trajectories of resting-state functional connectivity (rs-fc) within four brain networks in 147 adolescents. Subjects underwent functional magnetic resonance imaging at three different time points, at average ages 10.5 (range = 7.8-13.0), 11.7 (range = 9.3-14.1), and 12.9 years (range = 10.1-15.2). Multilevel linear modeling indicated that high shyness was associated with a less steep negative slope of default mode network (DMN) rs-fc over early adolescence relative to low shyness. Less steep decreases in DMN rs-fc may relate to increased self-focus in adolescents with high shyness.


Asunto(s)
Conducta del Adolescente/fisiología , Encéfalo/fisiología , Conducta Infantil/fisiología , Conectoma/métodos , Red Nerviosa/fisiología , Timidez , Adolescente , Encéfalo/diagnóstico por imagen , Encéfalo/crecimiento & desarrollo , Niño , Femenino , Humanos , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/crecimiento & desarrollo
15.
J Child Psychol Psychiatry ; 58(2): 151-159, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27616560

RESUMEN

BACKGROUND: Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early-onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children - (i) Sleep onset latency, (ii) Refusal to sleep alone, and (iii) Nighttime awakenings - measured during preschool, and investigated whether these sleep problems predicted anxiety and/or depression across the next 6 years until school age (ages 9-13). METHODS: Data were analyzed from N = 292 participants from a prospective longitudinal study of preschool-age children (ages 3-6). At baseline, parent-reported clinical interviews of psychiatric symptoms, as well as sleep problems were conducted using the Preschool-Age Psychiatric Assessment (PAPA). Follow-up clinical interviews were also conducted annually through school age using the Childhood and Adolescent Psychiatric Assessment (CAPA). RESULTS: Parent-reported sleep onset latency and refusal to sleep alone were significant independent predictors of MDD and anxiety severity, but not ADHD severity across time, even after controlling for family income-to-needs ratio and maternal internalizing psychopathology. In exploratory analyses using only healthy preschoolers, parent-reported sleep onset latency and refusal to sleep alone also predicted anxiety severity. CONCLUSIONS: We demonstrate that specific, yet relatively common sleep problems predict diagnostic severity of depression and anxiety across time, but not ADHD. Increased clinical attention to and screening for sleep onset latency and refusal to sleep alone during preschool may be warranted.


Asunto(s)
Ansiedad/fisiopatología , Depresión/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatología , Adolescente , Niño , Preescolar , Femenino , Humanos , Estudios Longitudinales , Masculino , Pronóstico , Índice de Severidad de la Enfermedad
16.
Psychosom Med ; 78(9): 1008-1018, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27749744

RESUMEN

OBJECTIVE: The purpose of the present report was to describe the longitudinal trajectories of physical health beginning during preschool and continuing into early adolescence; explore whether these trajectories were predicted by psychosocial adversity, family income-to-needs ratio, and psychiatric disorders occurring during the preschool period; and determine whether psychiatric disorders mediated these relations. METHODS: Participants included 296 children participating in a longitudinal study of early-onset psychopathology spanning 10 years. Semistructured clinical interviews were conducted with caregivers to determine children's psychiatric diagnoses between ages 3 and 6 years. Caregivers also completed annual assessments of their child's physical health problems (ages 3-13) and reported on the family's income and indicators of psychosocial adversity. RESULTS: Growth mixture modeling revealed 2 trajectories of physical health problems: a stable, low group (n = 199) and a high, increasing group (n = 57) indicating linear increases in physical health problems from ages 3 to 13. Preschool psychiatric diagnoses (Estimate [Est] = 0.05, p < .001), family income-to-needs ratio (Est = -0.01, p = .012), and psychosocial adversity (Est = 0.02, p = .015) predicted membership in the high, increasing trajectory of physical health problems. Early-onset psychopathology mediated relations between psychosocial adversity and physical health problems (αß = 0.31, p = .050) and between income-to-needs ratio and physical health problems (αß = -0.29, p < .021). CONCLUSIONS: These findings indicate the importance of early indicators of risk: low income-to-needs ratios, high psychosocial adversity, and psychiatric disorders occurring during the preschool period for contributing to increasing physical health problems from preschool through early adolescence. Early-onset psychiatric disorders also mediated relations between psychosocial adversity, income-to-needs ratio, and physical health problems.


Asunto(s)
Desarrollo del Adolescente/fisiología , Maltrato a los Niños/psicología , Desarrollo Infantil/fisiología , Estado de Salud , Trastornos Mentales/fisiopatología , Clase Social , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Trastornos Mentales/psicología
17.
J Child Psychol Psychiatry ; 57(7): 794-804, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26748606

RESUMEN

BACKGROUND: There has been little available data to inform the predictors and outcomes of latent class trajectories of depressive symptoms beginning during preschool and continuing throughout school age. Further, the extant literature in this domain has been limited by the use of parent report checklists of nonspecific 'internalizing' psychopathology rather than diagnostic interviews for depression. METHODS: To address these gaps in the literature, this study applied growth mixture modeling to depressive symptom severity endorsed by children and/or their caregivers (N = 348) during a structured clinical interview in a 10-year longitudinal dataset spanning from preschool into late school age. RESULTS: Three distinct trajectories of depressive symptom severity were found in boys and girls. For boys, but not girls, the high depression severity latent class increased in depressive symptoms from preschool through school age, followed by a decline in depressive symptom severity during later school age. For girls, the high depression severity latent class remained stable across time. Early childhood social adversity, familial history of affective disorder, preschool-onset ODD/CD, and school age functional impairment differentiated high-risk trajectory classes among both boys and girls. CONCLUSIONS: Extending the literature on trajectories of depressive symptoms to the preschool period, these findings incorporate structured clinical interviews of depressive symptom severity and indicate gender differences as well as psychosocial predictors and functional outcomes among children in high severity latent classes. The findings from this study suggest that increased attention to screening for depressive symptoms in early childhood is of significant public health importance.


Asunto(s)
Déficit de la Atención y Trastornos de Conducta Disruptiva/fisiopatología , Depresión/clasificación , Depresión/fisiopatología , Progresión de la Enfermedad , Índice de Severidad de la Enfermedad , Adolescente , Factores de Edad , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Niño , Preescolar , Comorbilidad , Depresión/epidemiología , Femenino , Humanos , Masculino , Factores Sexuales
18.
Dev Psychopathol ; 28(1): 213-24, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25925083

RESUMEN

Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multimethod approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across 3 years (ages 16-18) in a diverse, at-risk sample of adolescent girls (N = 113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: self-report, emotion ratings to stressors from ecological assessments across 1 week, and observer-rated negative affectivity during a mother-daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. The results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. In addition, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms.


Asunto(s)
Trastorno de Personalidad Limítrofe/psicología , Emociones , Conflicto Familiar/psicología , Relaciones Madre-Hijo , Pobreza/psicología , Familia Monoparental/psicología , Adolescente , Femenino , Humanos , Análisis de Regresión , Factores de Riesgo
19.
J Pediatr ; 167(4): 821-828.e4, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26227437

RESUMEN

OBJECTIVE: To examine the rate of change in body mass index (BMI) percentile across 3 years in relation to emotion identification ability and brain-based reactivity in emotional processing regions. STUDY DESIGN: A longitudinal sample of 202 youths completed 3 functional magnetic resonance imaging-based facial processing tasks and behavioral emotion differentiation tasks. We examined the rate of change in the youth's BMI percentile as a function of reactivity in emotional processing brain regions and behavioral emotion identification tasks using multilevel modeling. RESULTS: Lower correct identification of both happiness and sadness measured behaviorally predicted increases in BMI percentile across development, whereas higher correct identification of both happiness and sadness predicted decreases in BMI percentile, while controlling for children's pubertal status, sex, ethnicity, IQ score, exposure to antipsychotic medication, family income-to-needs ratio, and externalizing, internalizing, and depressive symptoms. Greater neural activation in emotional reactivity regions to sad faces also predicted increases in BMI percentile during development, also controlling for the aforementioned covariates. CONCLUSION: Our findings provide longitudinal developmental data demonstrating links between both emotion identification ability and greater neural reactivity in emotional processing regions with trajectories of BMI percentiles across childhood.


Asunto(s)
Índice de Masa Corporal , Encéfalo/fisiopatología , Emociones , Imagen por Resonancia Magnética , Antipsicóticos/química , Niño , Preescolar , Depresión/diagnóstico , Depresión/fisiopatología , Expresión Facial , Femenino , Humanos , Estudios Longitudinales , Masculino , Madres , Pobreza , Análisis de Regresión
20.
J Adolesc ; 41: 157-61, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25889821

RESUMEN

Despite findings of an association between adolescent psychopathology and perceived parental criticism, the relation between adolescent borderline personality disorder (BPD) symptoms and perceived parental criticism has not been examined. Given the centrality of interpersonal sensitivity to BPD (relative to other forms of psychopathology), we hypothesized that adolescent BPD symptoms would be uniquely related to perceived caregiver criticism, above and beyond other forms of psychopathology and general emotion dysregulation. Adolescents (N = 109) in a residential psychiatric treatment facility completed self-report measures of BPD symptoms, perceived caregiver criticism, emotion dysregulation, and symptoms of depression, anxiety, and posttraumatic stress disorder. Results revealed a unique relation of adolescent BPD symptoms to perceived caregiver criticism, above and beyond age, gender, and other forms of psychopathology. Findings suggest that adolescent BPD symptoms may have unique relevance for adolescents' perceptions of caregivers' attitudes and behaviors, increasing the likelihood of negative perceptions.


Asunto(s)
Desarrollo del Adolescente , Trastorno de Personalidad Limítrofe/psicología , Cuidadores/psicología , Juicio , Responsabilidad Parental/psicología , Psicología del Adolescente , Adolescente , Factores de Edad , Ansiedad/psicología , Mecanismos de Defensa , Depresión/psicología , Emociones , Conflicto Familiar/psicología , Femenino , Humanos , Masculino , Psicopatología , Medio Social , Trastornos por Estrés Postraumático
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