The effects of IPV and mental health symptoms on HPA axis functioning during early pregnancy.

Maternal HPA axis dysregulation during early pregnancy can negatively affect maternal functioning. However, findings are mixed regarding how intimate partner violence (IPV), a common traumatic stressor, impacts HPA axis regulation during pregnancy. Interactions between IPV and mental health symptoms as they influence cortisol production are rarely examined, especially among pregnant women. Therefore, this study examined the impact of IPV, mental health symptoms, and their interactions on the maternal HPA axis during early pregnancy; 255 pregnant women, oversampled for experiences of IPV, completed a laboratory stressor and measures of depressive and post-traumatic stress symptoms (PTSS) at 15-18 weeks of pregnancy. Participants provided saliva samples following the Trier Social Stress Test that were assayed for cortisol; the area under the curve with respect to ground (AUCg) was computed as a measure of cortisol reactivity. The interactive effects of IPV, depressive symptoms, and PTSS on AUCg were significant, but the main effects were not. At low levels of depressive symptoms, the association between IPV and AUCg was negative; at moderate levels of depressive symptoms, it was not significant, and at high levels, it was positive. At low and moderate levels of PTSS, the effects of IPV on cortisol AUCg were not significant, but at high levels, the association was positive. IPV during early pregnancy was associated with both hyperactive and blunted stress reactivity, depending on the type and severity of mental health symptoms. These patterns of dysregulation of the HPA axis may have differential effects both for women's functioning throughout pregnancy as well as for the offspring.

Longitudinal change in symptoms of depression, anxiety and post-traumatic stress disorder during the COVID-19 pandemic among Mexican college students.

Longitudinal studies suggest the psychological difficulties precipitated by the COVID-19 pandemic have gradually declined, but our understanding of the factors that predict change in mental health is limited. We evaluated the mental health of Mexican college students during the early stage of the pandemic and 4 months later, as well as predictors of change in students' mental health. Participants were 648 students (71% women, Mage = 21.46) from a private University in Northern Mexico who completed online surveys from May 2020 to September 2020. Students' self-reported levels of mental health symptoms (depression, anxiety and post-traumatic stress disorder) significantly decreased from May to September. Poor physical health, more COVID-related worry and higher initial levels of peer social support predicted less change in psychological symptoms. On the other hand, more hours of sleep per night and a pre-existing mental health diagnosis predicted steeper decreases in symptoms. Findings suggest reductions in mental health difficulties that are consistent with theoretical frameworks of resilience among Mexican college students. In addition, results underscore the interplay between physical, psychological and social functioning, and the need for continued monitoring of mental health and intervention efforts that address physical health, sleep and pandemic-related worry in University settings.

Conflict Appraisals and Trauma Symptoms in Children Exposed to Intimate Partner Violence.

Children exposed to intimate partner violence (IPV) are at risk for posttraumatic stress symptoms (PTSS) and alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated children's threat and self-blame appraisals about parental conflict as potential mechanisms leading to these adverse outcomes. Parent-child relationships were also examined. The sample consisted of 119 10-year-olds and their mothers who were recruited from the community as part of a larger study of IPV. Children's reports of IPV directed at their mother in the past year were not associated with PTSS; however, IPV exposure was associated with attenuated cortisol output in response to a social stressor. IPV exposure was also associated with greater threat appraisals and poorer quality parent-child relationships. These results provide further evidence that witnessing IPV is threatening for children, has negative consequences for parent-child relationships, and can impact children's HPA axis functioning.

Heterogeneous Trajectories of Depression Symptoms in Latino Youth.

Latino youth are at greater risk for depression relative to youth of other ethnic groups. The course of depression among Latino children and adolescents, however, remains largely unexamined, along with family and cultural factors that can help explain dissimilar symptom paths. The present study used growth mixture modeling to map trajectories of depression symptoms and to examine youth and parent familism as predictors of these trajectories. Participants were 133 Latino 5th- to 7th-grade students (Mage = 12.4 years, SD = 0.91; 55.6% boys) and a subsample of their parents (n = 89). Youth reported on their depression symptoms at four time points, including two surveys (Time 1 and Time 3) and two in-person interviews (Time 2 and Time 4) over the course of 2 years. Familism reports were obtained from youth at Time 1 and from parents at Time 2. The trajectories identified include stable-low, recovery, and escalating, and only youth familism predicted membership in these trajectories. Relative to those in the recovery trajectory, youth reporting higher familism were more likely to belong to the stable-low trajectory. This study helps to highlight the heterogeneous course of depression among Latino youth and illustrates the importance of incorporating youth perspectives on family cultural values when considering their well-being.

Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity.

The current study examined the role of hypothalamic-pituitary-adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at-risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers' depression was measured five times during the infants' first 18 months. Infant cortisol was collected during a social stressor (the still-face paradigm) when infants were 6 months old, and mothers reported on toddlers' internalizing and externalizing symptoms at 18 months. Among this sample of high-risk mother-infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.

Social-ecological predictors of externalizing behavior trajectories in at-risk youth.

Extant research consistently links youth externalizing problems and later maladaptive outcomes, and these behaviors are particularly detrimental given their relative stability across development. Although an array of risk and protective factors for externalizing problems have been identified, few studies have examined factors reflecting the multiple social-ecological levels that influence child development and used them to predict longitudinal trajectories of externalizing problems. The current study examined externalizing behavior trajectories in a sample of 1,094 at-risk youth (539 boys, 555 girls) from the Longitudinal Studies in Child Abuse and Neglect multisite longitudinal study of child maltreatment. Normed Child Behavior Checklist externalizing scores were used to estimate group trajectories via growth-based trajectory modeling at ages 10, 12, 14, and 16 using the SAS PROC TRAJ procedure. Model fit was assessed using the Bayes information criterion and the Akaike information criterion statistics. Analyses revealed optimal fit for five distinct behavioral trajectories: low stable, mid-increasing, mid-decreasing, medium high, and high stable. Multinomial logistic regressions revealed that a combination of risk and protective factors at individual, family, school, and neighborhood levels contribute to distinct trajectories of externalizing problems over time. Predictors of low and decreasing trajectories can inform interventions aimed at addressing externalizing problems among high-risk adolescents.

Prenatal intimate partner violence exposure predicts infant biobehavioral regulation: Moderation by the brain-derived neurotrophic factor (BDNF) gene.

The ability to regulate stress is a critical developmental milestone of early childhood that involves a set of interconnected behavioral and physiological processes and is influenced by genetic and environmental stimuli. Prenatal exposure to traumatic stress and trauma, including intimate partner violence (IPV), increases risk for offspring biobehavioral regulation problems during childhood and adolescence. Although individual differences in susceptibility to prenatal stress have been largely unexplored, a handful of studies suggest children with specific genetic characteristics are most vulnerable to prenatal stress. We evaluated the brain-derived neurotrophic factor Val66Met gene (BDNF) as a moderator of the effect of prenatal IPV exposure on infant temperamental and cortisol regulation in response to a psychosocial challenge. Ninety-nine mother-infant dyads recruited from the community were assessed when infants (51% female) were 11 to 14 months. Maternal reports of IPV during pregnancy and infant temperament were obtained, and infant saliva was collected for genotyping and to assess cortisol reactivity (before and after the Strange Situation Task). Significant genetic moderation effects were found. Among infants with the BDNF Met allele, prenatal IPV predicted worse temperamental regulation and mobilization of the cortisol response, while controlling for infant postnatal exposure to IPV, other maternal traumatic experiences, and infant sex. However, prenatal IPV exposure was not associated with temperamental or cortisol outcomes among infant carriers of the Val/Val genotype. Findings are discussed in relation to prenatal programming and biological susceptibility to stress.

Postpartum depression and resilience predict parenting sense of competence in women with childhood maltreatment history.

This study examines the effect of a history of childhood maltreatment (CM) on parenting sense of competence, taking into account the influence of resilience and postpartum depressive symptoms as moderators of this relationship. Participants (N = 131) were a community sample of women recruited into a larger study of maternal childhood maltreatment. Women completed questionnaires over the phone at 4 months postpartum and parenting sense of competence (PSOC) was assessed during a home visit at 6 months postpartum. A three-way interaction emerged; women with low depression and high resilience factors maintained high levels of PSOC, even when they had a CM history. In contrast, among women with one postpartum risk factor (depression or low resilience) CM was associated with decreased PSOC. Results suggest that a mother's well-being postpartum moderates the effect of a childhood maltreatment history on her parenting sense of competence. Reducing postpartum depressive symptoms and enhancing resilience may be important components for interventions that address parenting confidence with maltreated women.

Maternal insightfulness protects against the detrimental effects of postpartum stress on positive parenting among at-risk mother-infant dyads.

The current study evaluated whether maternal insightfulness can buffer the negative influence of postpartum stressful life events on maternal parenting behaviors. Participants were 125 mother-infant dyads (55% boys) who present a subsample of a larger longitudinal study on maternal maltreatment during childhood and its impact on peripartum maternal adjustment. Women were primarily white and middle class. At 4 months postpartum, mothers reported on the stressful life events experienced after the child's birth and current depressive symptoms. At 6 months postpartum, maternal parenting quality was assessed using videotaped mother-infant interactions and maternal insightfulness was evaluated using the Insightfulness Assessment. Insightfulness significantly moderated the effect of postpartum stressful events on maternal parenting behaviors. Mothers who were insightful displayed high levels of positive parenting during interactions with their infant regardless of the amount of stressful life events experienced. In contrast, mothers classified as non-insightful showed less positive parenting as they experienced more stressful life events. Findings highlight the protective role of maternal insightfulness in the face of postpartum stress, and suggest that efforts to enhance insightfulness during the early postpartum period may be particularly relevant for women in high-risk contexts.

Profiles of Adaptation Among Child Victims of Suspected Maltreatment.

This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.

Direct and Indirect Effects of Maltreatment and Social Support on Children's Social Competence Across Reporters.

Children's social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children's social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n = 783 caregiver-child dyads. CPS report history (age 0-8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity.

Infant adrenocortical reactivity and behavioral functioning: relation to early exposure to maternal intimate partner violence.

Prenatal stress negatively affects fetal development, which in turn may affect infant hypothalamic-pituitary-adrenal (HPA) axis regulation and behavioral functioning. We examined effects of exposure to a traumatic stressor in families [intimate partner violence (IPV)] on both infants' HPA axis reactivity to stress and their internalizing and externalizing behaviors. Infants (n = 182, 50% girls, x age = 11.77 months) were exposed to a laboratory challenge task designed to induce frustration and anger (i.e. arm restraint). Saliva samples were taken pre-task and 20 and 40 min post-task and then assayed for cortisol. Mothers reported on their pregnancy and postpartum IPV history, current mental health, substance use and their infants' behaviors. Structural equation modeling revealed that prenatal, but not postnatal, IPV was independently associated with infant cortisol reactivity and problem behavior. Maternal mental health predicted infant behavioral functioning but not infant HPA axis reactivity. These findings are consistent with the prenatal programing hypothesis; that is, early life stress affects later risk and vulnerability for altered physiological and behavioral regulation.

The influence of prenatal intimate partner violence exposure on hypothalamic-pituitary-adrenal axis reactivity and childhood internalizing and externalizing symptoms.

This prospective longitudinal study examines the long-term influence of intimate partner violence (IPV) exposure in utero. We hypothesized that (a) prenatal IPV increases risk for internalizing and externalizing problems as well as for a profile of dysregulated cortisol reactivity, and (b) patterns of cortisol hyper- and hyporeactivity are differentially associated with internalizing and externalizing problems. The participants were 119 10-year-old children. Their mothers reported their IPV experiences and distress during pregnancy. Child and maternal reports of internalizing and externalizing problems as well as lifetime IPV exposure were obtained. Salivary cortisol was assessed at baseline, 20 min, and 40 min after challenge. The results partially supported our hypotheses: Exposure to IPV during pregnancy predicted child-reported internalizing and externalizing problems, mother ratings of child externalizing problems, and a profile of high cortisol secretion before and after stress challenge. The results were significant above and beyond the influence of maternal distress during pregnancy and IPV that occurred during the child's life. In addition, a profile of high cortisol secretion was associated with maternal reports of child internalizing behaviors. Findings support the growing consensus that prenatal stress can lead to lasting disruptions in adaptation and highlight the need for more longitudinal examinations of prenatal IPV exposure.

Longitudinal examination of infant baseline and reactivity cortisol from ages 7 to 16 months.

This study characterized the longitudinal evolution of HPA axis functioning from 7 to 16 months of age and identified individual and environmental factors that shape changes in HPA axis functioning over time. Participants were 167 mother-infant dyads drawn from a larger longitudinal study, recruited based on maternal history of being maltreated during childhood. Salivary cortisol levels were assessed before and after age-appropriate psychosocial stressors when infants were 7 and 16 months old. Maternal observed parenting and maternal reports of infant and environmental characteristics were obtained at 7 months and evaluated as predictors of changes in infant baseline cortisol and reactivity from 7 to 16 months. Results revealed that infants did not show a cortisol response at 7 months, but reactivity to psychosocial stress emerged by 16 months. Individual differences in cortisol baseline and reactivity levels over time were related to infant sex and maternal overcontrolling behaviors, underscoring the malleable and socially informed nature of early HPA axis functioning. Findings can inform prevention and intervention efforts to promote healthy stress regulation during infancy.

Maternal parenting predicts infant biobehavioral regulation among women with a history of childhood maltreatment.

Early biobehavioral regulation, a major influence of later adaptation, develops through dyadic interactions with caregivers. Thus, identification of maternal characteristics that can ameliorate or exacerbate infants' innate vulnerabilities is key for infant well-being and long-term healthy development. The present study evaluated the influence of maternal parenting, postpartum psychopathology, history of childhood maltreatment, and demographic risk on infant behavioral and physiological (i.e., salivary cortisol) regulation using the still-face paradigm. Our sample included 153 women with high rates of childhood maltreatment experiences. Mother-infant dyads completed a multimethod assessment at 7 months of age. Structural equation modeling showed that maternal positive (i.e., sensitive, warm, engaged, and joyful) and negative (i.e., overcontrolling and hostile) behaviors during interactions were associated with concurrent maternal depressive symptoms, single parent status, and low family income. In turn, positive parenting predicted improved infant behavioral regulation (i.e., positive affect and social behaviors following the stressor) and decreased cortisol reactivity (i.e., posttask levels that were similar to or lower than baseline cortisol). These findings suggest increased risk for those women experiencing high levels of depressive symptoms postpartum and highlight the importance of maternal positive interactive behaviors during the first year for children's neurodevelopment.

COVID-19 related psychosocial problems among university students in Mexico - a longitudinal qualitative examination.

Research on the impact of the COVID-19 pandemic among college students around the world has primarily focused on their mental health symptoms and COVID-specific worry. However, contextually specific understanding of outbreak impacts is key to inform directed public health messaging and programming to improve wellbeing and coping. The current study aimed to identify the main psychosocial problems college students experienced during the first 6 months of the COVID-19 pandemic in Monterrey, Mexico. Participants were 606 college students (71% female) enrolled in a private university. Participants described COVID-related problems in an open-ended prompt as part of a longitudinal online survey: initially in May 2020, and then every 2 weeks for 3 months. Thematic analyses were conducted within a longitudinal inductive qualitative approach to rank responses by frequency across themes. Five major categories emerged. At baseline, over 75% of participants noted the outbreak negatively impacted their daily activities and responsibilities, 73% their mental health, 50% their physical health, 35% their interpersonal relationships, and 22% their economic situation. Concerns remained relatively stable throughout the follow-up period, with interpersonal and economic concerns becoming more prevalent as the pandemic progressed. Problems identified in this study can inform preventative measures for future health crises, including tailoring public health messaging and expanding access to contextually sensitive mental and behavioral health programming.

Local clinician perspectives on cause, impact, and treatment of key expressions of distress in Cambodian children.

Child trauma and posttraumatic stress in Cambodia is highly prevalent, perpetuated within a postwar sociocultural context. The examination of locally meaningful expressions of distress is needed to provide culturally sensitive assessment and treatment of trauma-affected Cambodian children. The acceptable, feasible, and sustainable incorporation of expressions of distress into assessment and intervention development relies on key mental health professionals operating in Cambodia, who can provide invaluable perspectives on child trauma experiences in this particular sociocultural context. In this study, qualitative interviews were conducted with 15 Cambodian mental health professionals (MHPs) who work directly with trauma-affected Cambodian children. MHPs were presented with seven key posttraumatic problems derived from previous qualitative interviews with Cambodian children and caregivers, and discussed 1) the causes of these problems, 2) the impact of the problem on the child or those around them, 3) the current treatment for the problem in Cambodia, and 4) recommended treatment. MHPs provided unique insights and perspectives of trauma-affected children in the Cambodian context regarding key target problems, including palpitations, difficulties in school, headache, and thinking too much, and highlighted future directions for assessment and intervention. Recommendations are discussed in regard to programming design and organizational training development to promote culturally salient, feasible, and sustainable mental health service provision in Cambodia.

Key expressions of trauma-related distress in Cambodian children: A step toward culturally sensitive trauma assessment and intervention.

More than half of all children in Cambodia experience direct abuse and over 70% experience other traumatic events, which significantly increase their risks for a range of physical and mental health problems. Additionally, Cambodian children face longstanding sociopolitical, intergenerational, and cultural factors that compound the impact of other trauma. As a result, rates of posttraumatic stress symptoms among Cambodian youth are high. However, care providers often rely on Western-based nosology that does not account for culturally specific expressions of trauma. A greater understanding of culturally-salient expressions of distress can help inform diagnostic assessment accuracy and treatment effectiveness and monitoring. The current study utilized a qualitative design to interview 30 Cambodian caregivers of children with trauma experiences and 30 Cambodian children (ages 10-13 years) with trauma experiences to identify key local expressions of trauma. Findings reveal certain PTSD symptoms and culturally-specific frequent and severe trauma-related problems for Cambodian children and domains of functioning impacted by trauma. Certain symptoms seem particularly important to evaluate in this group, such as anger, physical complaints (e.g., headache and palpitations), and cognitive-focused complaints (in particular, "thinking too much"). All caregivers and children reported physical health as impacted by trauma-related problems, highlighting a particularly salient domain of functioning for this population. Expressions of distress explored in the current study are discussed in the context of assessment and intervention development to inform diagnostic and clinical efforts for those working with trauma-exposed Cambodian children.

Parent Cultural Stress and Internalizing Problems in Latinx Preschoolers: Moderation by Maternal Involvement and Positive Verbalizations.

Parent cultural stress has a pervasive and significant impact on family functioning and increases risk for socioemotional problems among Latinx children. Identifying factors that can protect against the negative influence of cultural stressors and enhance the developmental trajectories of Latinx children early in life is key as these children experience disproportionate risk for psychosocial adversity and internalizing mental health problems. The present study evaluated the effect of maternal cultural stress on young children´s internalizing problems, and the moderating role of maternal parenting behaviors. Participants were 65 Latinx children (3 to 5 years old, 50% female) and their mothers (21 to 47 years old, 68% immigrants) recruited from three Head Start Centers in the Chicagoland Area. Mother-reported cultural stress predicted young children's internalizing problems. In addition, maternal self-reported involvement and observed maternal positive verbalizations during one-on-one interactions with the child moderated the effect of cultural stress on child internalizing symptoms. Findings are discussed in the context of efforts to promote family and child resilience and implications for culturally sensitive measurement and intervention.