Controlling contamination in child maltreatment research: Impact on effect size estimates for child behavior problems measured throughout childhood and adolescence.

Contamination, when members of a comparison or control condition are exposed to the event or intervention under scientific investigation, is a methodological phenomenon that downwardly biases the magnitude of effect size estimates. This study tested a novel approach for controlling contamination in observational child maltreatment research. Data from The Longitudinal Studies of Child Abuse and Neglect (LONGSCAN; N = 1354) were obtained to estimate the risk of confirmed child maltreatment on trajectories of internalizing and externalizing behaviors before and after controlling contamination. Baseline models, where contamination was uncontrolled, demonstrated a risk for greater internalizing (b = .29, p < .001, d = .40) and externalizing (b = .14, p = .040, d = .19) behavior trajectories. Final models, where contamination was controlled by separating the comparison condition into subgroups that did or did not self-report maltreatment, also demonstrated risks for greater internalizing (b = .37, p < .001, d = .51) and externalizing (b = .22, p = .028, d = .29) behavior trajectories. However, effect size estimates in final models were 27.5%-52.6% larger compared to baseline models. Controlling contamination in child maltreatment research can strengthen effect size estimates for child behavior problems, aiding future child maltreatment research design and analysis.

Epigenetic Age Acceleration and Risk for Posttraumatic Stress Disorder following Exposure to Substantiated Child Maltreatment.

OBJECTIVE: Child maltreatment is among the strongest predictors of posttraumatic stress disorder (PTSD). However, less than 40% of children who have been maltreated are ever diagnosed with PTSD, suggesting that exposure to child maltreatment alone is insufficient to explain this risk. This study examined whether epigenetic age acceleration, a stress-sensitive biomarker derived from DNA methylation, explains variation in PTSD diagnostic status subsequent to child maltreatment. METHOD: Children and adolescents (N = 70; 65.7% female), 8-15 years of age (M = 12.00, SD = 2.37) and exposed to substantiated child maltreatment within the 12 months prior to study entry, were enrolled. Participants provided epithelial cheek cells via buccal swab for genotyping and quantification of epigenetic age acceleration within a case-control design. PTSD diagnostic status was determined using the Child PTSD Symptoms Scale according to the DSM-IV-TR algorithm. RESULTS: Epigenetic age acceleration predicted current PTSD status, revealing an effect size magnitude in the moderate range, OR = 2.35, 95% CI: 1.22- 4.51, after adjusting for sample demographics, polygenic risk for PTSD, and lifetime exposure to other childhood adversities. Supplemental analyses demonstrated that epigenetic age acceleration was related to a greater severity of PTSD arousal symptoms (r =.29, p =.015). There were no differential effects for child maltreatment subtype on epigenetic age acceleration or PTSD status. CONCLUSIONS: The biological embedding of child maltreatment may explain variation in PTSD diagnostic status and serve as a novel approach for informing selective prevention or precision-based therapeutics for those at risk for PTSD.

History of Maltreatment in Childhood and Subsequent Parenting Stress in At-Risk, First-Time Mothers: Identifying Points of Intervention During Home Visiting.

Home visiting is an effective preventive intervention that can improve parenting outcomes for at-risk, new mothers, thereby optimizing subsequent child development. A history of maltreatment in childhood is common in mothers participating in home visiting, yet the extent to which such a history is related to parenting outcomes during home visiting is unknown. The current study evaluated whether mothers with a history of maltreatment in childhood respond less favorably to home visiting by examining the direct and indirect pathways to subsequent parenting stress, a key parenting outcome affecting child development. First-time mothers (N = 220; age range = 16-42) participating in one of two home visiting programs, Healthy Families America or Nurse Family Partnership, were evaluated at enrollment and again at 9-and 18-month post-enrollment assessments. Researchers administered measures of maternal history of maltreatment in childhood, depressive symptoms, social support, and parenting stress. Maternal history of maltreatment in childhood predicted worsening parenting stress at the 18-month assessment. Mediation modeling identified two indirect pathways, one involving social support at enrollment and one involving persistent depressive symptoms during home visiting, that explained the relation between a history of maltreatment in childhood and parenting stress at the 18-month assessment. Ways to improve the preventive effects of home visiting for mothers with a history of maltreatment in childhood through the identification of relevant intervention targets and their ideal time of administration are discussed.

Child maltreatment and adolescent externalizing behavior: Examining the indirect and cross-lagged pathways of prosocial peer activities.

BACKGROUND: There is a well-established relation between child maltreatment and externalizing behaviors in adolescence. A gap in this scientific literature is the identification of pathways, particularly protective pathways, explaining this relation prior to the transition to adulthood. OBJECTIVE: This study examined the indirect and cross-lagged pathways of peer engagement in prosocial activities to explain the relation between child maltreatment and adolescent externalizing behaviors. PARTICIPANTS AND SETTINGS: Children and their caregivers (N = 1354) participated in a multi-site, multi-wave, prospective cohort study of child maltreatment in the U.S. METHODS: Child maltreatment, peer engagement in prosocial activities, and externalizing behaviors were assessed at ages twelve, fourteen, and sixteen. A cross-lagged path model evaluated whether peer engagement in prosocial activities was an indirect pathway of the relation between prior child maltreatment and subsequent externalizing behaviors. Cross-lagged relations were examined to determine directionality of risk among these variables during adolescence. RESULTS: The path model did not support peer engagement in prosocial activities as an indirect or cross-lagged pathway to externalizing behaviors in adolescence. Instead, prior child maltreatment had a direct relation with greater externalizing behaviors, which had indirect and cross-lagged effects with less peer engagement in prosocial activities at multiple points later in adolescence. CONCLUSIONS: The degree of peer engagement in prosocial activities may not be a risk or protective pathway to externalizing behaviors in adolescence for those exposed to child maltreatment. In fact, externalizing behaviors appear to limit subsequent engagement with peers in prosocial activities, providing an opportunity for future research and intervention.

The impact of negative affect on attention patterns to threat across the first 2 years of life.

The current study examined the relations between individual differences in attention to emotion faces and temperamental negative affect across the first 2 years of life. Infant studies have noted a normative pattern of preferential attention to salient cues, particularly angry faces. A parallel literature suggests that elevated attention bias to threat is associated with anxiety, particularly if coupled with temperamental risk. Examining the emerging relations between attention to threat and temperamental negative affect may help distinguish normative from at-risk patterns of attention. Infants (N = 145) ages 4 to 24 months (M = 12.93 months, SD = 5.57) completed an eye-tracking task modeled on the attention bias "dot-probe" task used with older children and adults. With age, infants spent greater time attending to emotion faces, particularly threat faces. All infants displayed slower latencies to fixate to incongruent versus congruent probes. Neither relation was moderated by temperament. Trial-by-trial analyses found that dwell time to the face was associated with latency to orient to subsequent probes, moderated by the infant's age and temperament. In young infants low in negative affect longer processing of angry faces was associated with faster subsequent fixation to probes; young infants high in negative affect displayed the opposite pattern at trend. Findings suggest that although age was directly associated with an emerging bias to threat, the impact of processing threat on subsequent orienting was associated with age and temperament. Early patterns of attention may shape how children respond to their environments, potentially via attention's gate-keeping role in framing a child's social world for processing. (PsycINFO Database Record

Psychometric Evaluation of the Comprehensive Trauma Interview PTSD Symptoms Scale Following Exposure to Child Maltreatment.

The current study evaluated the psychometric properties of the Comprehensive Trauma Interview Post-Traumatic Stress Disorder (PTSD) Symptoms Scale (CTI-PSS), a novel method of assessing PTSD symptoms following exposure to a range of child adversities in the child maltreatment population. A sample of female adolescents ( n = 343) exposed to substantiated child sexual abuse and a nonmaltreated comparison condition completed the CTI-PSS and other established measures to assess internal consistency, factor structure, test discriminability as well as convergent, discriminant, and incremental validities. Results demonstrated that the CTI-PSS is a reliable and valid measure of PTSD symptoms with good discriminability and a factor structure that fits existing conceptualizations of the PTSD construct. It also demonstrated strong convergence with an established measure of PTSD symptoms and explained unique variance in the prediction of child sexual abuse status. Overall, the CTI-PSS appears to be a useful instrument for assessing PTSD symptoms in the child maltreatment population.

Comparison of AS03 and Alum on immune responses elicited by A/H3N2 split influenza vaccine in young, mature and aged BALB/c mice.

INTRODUCTION: There is great interest in developing more effective influenza vaccines for the elderly. Oil-in-water adjuvants can boost humoral responses to seasonal vaccines in elderly subjects but relatively little is known about their mechanism of action. METHODS: We compared humoral and cellular immune profiles in young adult (2 months), mature (11-12 months) or aged (16-17 month) female BALB/c mice following two doses of Alum or AS03-adjuvanted A/H3N2 split-virus antigen (A/Uruguay/716/2007) at 0.75 or 3 µg hemagglutinin (HA) per dose intramuscularly versus 3 µg HA without adjuvant. RESULTS: Overall, hemagglutination inhibition (HAI), microneutralization (MN) and end-point ELISA titres were higher in the young mice and when an adjuvant was used. Both adjuvants increased humoral responses in older animals but the highest titres across all groups were observed in the AS03-adjuvanted groups. Neither IgG avidity nor A/H3N2-specific splenocyte proliferation was influenced by age, antigen dose or adjuvant. In contrast, cytokine production by ex vivo-stimulated splenocytes differed widely between groups. Most cytokine levels in older mice vaccinated with antigen alone (3 µg HA/dose) were ≤ 50% of those in young animals. In young mice, cytokine levels increased modestly with Alum and significantly with AS03. Increases tended to be greatest at the lower antigen dose (0.75 µg versus 3 µg HA). In the older animals, Alum had little impact on cytokine production but responses in the AS03 groups paralleled those of the young mice (broad activation of Th1, Th2, and Th17-type cytokines) and the greatest increases were seen with the higher antigen dose (3 µg HA). CONCLUSIONS: In both young and aged mice, Alum and AS03 increased the magnitude of humoral and cellular responses to split influenza virus vaccination. Overall, these effects were most pronounced in the younger animals and the groups receiving AS03. These data support the use of oil-in-water adjuvants in influenza vaccines targeting the elderly.

When failure isn't an option.

Some teams, by the very nature of their work, must consistently perform at the highest levels. How do you--as a team leader, a supervisor, a trainer, or an outside coach--ensure that this happens? To answer this question, Harvard Business Review asked six people who work with high-performance teams to comment on developing and managing these teams. The result is a collection of commentaries from Michael Hillmann, deputy chief of the Los Angeles Police Department and commander of its Special Operations Bureau, which includes the SWAT team; Philippe Dongier, who headed up a joint United Nations/World Bank/Asian Development Bank reconstruction team in Afghanistan after the fall of the Taliban; the National Fire Academy's Robert Murgallis, who trains firefighting teams; Mary Khosh, former career coach for players with the Cleveland Browns; Elizabeth Allen, a planner of society weddings, charity galas, and corporate events; and Ray Evernham, who, as a stock-car-racing crew chief, helped driver Jeff Gordon win three NASCAR championships. The types of teams represented in these commentaries are very different. Some are ad hoc, formed for a specific task, while others are ongoing, typically improving their performance with each task they undertake. For all of them, the stakes are high. Despite their differences, some similarities emerge in the ways they achieve top performance. For example, selection of team members is crucial-as is a willingness to get rid of members who don't consistently deliver. A leader who supports and builds confidence in members is also key, and high-performance teams without such a leader will often informally create one. Finally, the stress that defines the work of these teams helps generate peak short-term performance--and poses the constant risk of members burning out.

Riboflavin-responsive trimethylaminuria in a patient with homocystinuria on betaine therapy.

A 17-year-old female patient with pyridoxine non-responsive homocystinuria, treated with 20 g of betaine per day, developed a strong body odour, which was described as fish-like. Urinary trimethylamine (TMA) was measured and found to be markedly increased. DNA mutation analysis revealed homozygosity for a common allelic variant in the gene coding for the TMA oxidising enzyme FMO3. Without changing diet or betaine therapy, riboflavin was given at a dose of 200 mg per day. An immediate improvement in her odour was noticed by her friends and family and urinary TMA was noted to be greatly reduced, although still above the normal range.Gradual further reductions in TMA (and odour) have followed whilst receiving riboflavin. Throughout this period, betaine compliance has been demonstrated by the measurement of dimethylglycine (DMG) excretion, which has been consistently increased. Marked excretions of DMG when the odour had subsided also demonstrate that DMG was not the source of the odour.This patient study raises the possibility that betaine may be converted to TMA by intestinal flora to some degree, resulting in a significant fish odour when oxidation of TMA is compromised by FMO3 variants. The possibility exists that the body odour occasionally associated with betaine therapy for homocystinuria may not be related to increased circulating betaine or DMG, but due to a common FMO3 mutation resulting in TMAU. Benefits of riboflavin therapy for TMAU for such patients would allow the maintenance of betaine therapy without problematic body odour.

Psychopathy in a mixed gender sample of adult stalkers.

The authors present data on a mixed gender sample of 78 adult stalking perpetrators, each of whom was assessed with the Psychopathy Checklist:Screening Version (PCL:SV). Results indicate a generally low frequency of psychopathy in this group, although 15% of the sample was composed of psychopaths. Comparisons between this sample and other forensic samples indicate that both the frequency and degree of psychopathy were lower in the stalking group. The findings support previous theory and empirical findings, including the concept that underlying attachment pathology among stalkers and psychopaths is quite different, and psychopathy--in contrast to other areas of violence risk assessment--is usually not relevant when evaluating dangerousness among stalkers.