Person-centered methods to advance developmental psychopathology.

Dante Cicchetti's remarkable contributions to the field of developmental psychopathology include the advancement of key principles such as the interplay of typical and atypical development, multifinality and equifinality, the dynamic processes of resilience, and the integration of multiple levels of analysis into developmental theories. In this paper we assert that person-centered data analytic methods are particularly well-suited to advancing these tenets of developmental psychopathology. We illustrate their utility with a brief novel empirical study focused on underlying patterns of childhood neuroendocrine regulation and prospective links with emerging adult functioning. Results indicate that a childhood neuroendocrine profile marked by high diurnal cortisol paired with low diurnal DHEA was uniquely associated with more adaptive functioning in emerging adulthood. We discuss these findings, and person-centered methods more broadly, within the future of developmental psychopathology.

Profiles of diurnal cortisol and DHEA regulation among children: Associations with maltreatment experiences, symptomatology, and positive adaptation.

Person-centered methods represent an important advance in the simultaneous examination of multiple indicators of neuroendocrine functioning and may facilitate a more nuanced understanding of the impact of child maltreatment on hypothalamic-pituitary-adrenal axis dysregulation. The aims of the present study were threefold: (a) identify naturally occurring patterns of diurnal cortisol and dehydroepiandrosterone (DHEA) regulation among a sample of N = 1,258 children with and without histories of maltreatment, (b) investigate which neuroendocrine profiles characterize children with exposure to maltreatment, and (c) examine which profiles are related to adaptive outcomes and symptomatology among children. Cortisol and DHEA were sampled three times per day (9 a.m., 12 p.m., and 4 p.m.) across 5 and 2 days, respectively. Four profiles of cortisol and DHEA regulation were identified. Among females, a pattern marked by high cortisol and low DHEA was associated with more pervasive maltreatment experiences. Furthermore, we found evidence of adaptive interpersonal resilience such that children with maltreatment exposure who evidenced this pattern of high cortisol and low DHEA were viewed as more likeable than maltreated children with other neuroendocrine patterns. Finally, results pointed to higher levels of internalizing symptoms among children who displayed a profile marked by average cortisol and high DHEA.

Patterns of childhood maltreatment predict emotion processing and regulation in emerging adulthood.

Childhood maltreatment is a potent interpersonal trauma associated with dysregulation of emotional processes relevant to the development of psychopathology. The current study identified prospective links between patterns of maltreatment exposures and dimensions of emotion regulation in emerging adulthood. Participants included 427 individuals (48% Male; 75.9% Black, 10.8% White, 7.5% Hispanic, 6% Other) assessed at two waves. At Wave 1, children (10-12 years) from families eligible for public assistance with and without involvement with Child Protective Services took part in a research summer camp. Patterns of child maltreatment subtype and chronicity (based on coded CPS record data) were used to predict Wave 2 (age 18-24 years) profiles of emotion regulation based on self-report, and affective processing assessed via the Affective Go/No-Go task. Results identified associations between task-based affective processing and self-reported emotion regulation profiles. Further, chronic, multi-subtype childhood maltreatment exposure predicted difficulties with aggregated emotion dysregulation. Exposure to neglect with and without other maltreatment subtypes predicted lower sensitivity to affective words. Nuanced results distinguish multiple patterns of emotion regulation in a sample of emerging adults with high exposure to trauma and socioeconomic stress and suggest that maltreatment disrupts emotional development, resulting in difficulties identifying emotions and coping with emotional distress.

Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention.

Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.

Childhood maltreatment, psychiatric symptoms, and suicidal thoughts among adolescents receiving substance use treatment services.

INTRODUCTION: Childhood maltreatment experiences are associated with future suicidal thoughts and suicide attempts, yet the roles of specific psychiatric symptoms mediating this relation remain to be clarified. To clarify these relations, we tested a model incorporating multiple forms of childhood maltreatment (sexual abuse, physical punishment, emotional neglect), past year psychiatric disorder symptoms during adolescence (anxiety, mood, and conduct disorders) and recent suicidal thoughts. METHODS: We administered structured interviews to 394 adolescents receiving outpatient substance use treatment services in the Southeastern United States (280 males; Mage = 16.33; SDage = 1.15). Structural equation models (SEMs) were used to evaluate the degree to which relations between childhood maltreatment and suicidal thoughts were mediated by specific past-year psychiatric symptoms. RESULTS: Mood disorder symptoms significantly mediated the relation between neglect/negative home environment and suicidal thoughts. This path of influence did not vary by gender. CONCLUSIONS: Childhood maltreatment and subsequent psychopathology influence suicidal thoughts among adolescents receiving substance use treatment services. The findings of the present study have implications for the adaptation and delivery of substance use treatment services to adolescents to enhance treatment engagement and outcomes.

Daytime sleepiness underlies the link between adverse parenting and youth psychopathology among adolescent girls.

INTRODUCTION: Adverse parenting is associated with sleep problems in adolescence, including sleep quality, inadequate sleep, and daytime sleepiness. Adolescents who experience sleep problems are at greater risk for developing internalizing and externalizing problems. However, research on the intervening role of sleep in the link between adverse parenting and youth psychopathology remains limited. The present study aimed to examine the indirect effects of adverse parenting on youth internalizing and externalizing psychopathology via sleep problems, and to examine the moderating role of gender in associations between parenting and sleep. METHODS: Participants were 101 low-income youth aged 9-12 (52.5% female; 75.2% African-American) and their primary caregivers. Families were from a non-metropolitan region in the Southeastern United States. Data were collected at two time points (T1; Mage = 10.28, SD = 1.2; T2; Mage = 12.08, SD = 1.2). Adverse parenting was measured at T1, youth-reported sleep problems (inadequacy, disturbance) and daytime sleepiness were assessed at T2, and parent-reported internalizing and externalizing symptoms were measured at T2. RESULTS: Daytime sleepiness served as an intervening variable in associations between adverse parenting and internalizing and externalizing problems, but sleep problems did not. This indirect association was moderated by gender, such that the association between adverse parenting and daytime sleepiness only emerged as significant for girls. CONCLUSIONS: These findings suggest that daytime-related sleep behaviors may serve as a mechanism through which harsh or neglectful parenting is related to internalizing and externalizing psychopathology in adolescence, particularly for adolescent girls.

Heart Rate Variability Reactivity Moderates the Indirect Link Between Child Maltreatment and Young Adult Alcohol Use Problems Via Depressive Symptoms.

BACKGROUND AND OBJECTIVES: Young adults with childhood maltreatment (CM) histories are particularly vulnerable to depressive symptoms and alcohol use problems. Research suggests that maltreated youth may misuse alcohol in part to alleviate depressive symptoms. However, many youths with depressive symptoms exercise self-control and abstain from heavy alcohol use. The present study aimed to examine the influence of heart rate variability reactivity (HRV-R), a psychophysiological biomarker of self-regulation, in the indirect link between CM and alcohol-use problems via depressive symptoms among low socioeconomic-status rural young adults. METHODS: Two waves of data were collected from a community sample of 225 low socioeconomic-status nonmetropolitan young adults (Mage = 21.56, 52.9% female). HRV data were obtained with an electrocardiogram during a social stress task. CM was assessed through the Childhood Trauma Questionnaire. Alcohol use problems were measured using the Alcohol Use Disorders Identification Test. RESULTS: The indirect effect of CM on alcohol use problems via elevated depressive symptoms was positive and significant (α × ß = .159, P < .001). Self-regulation, indicated by high HRV-R (ie, vagal withdrawal), was found to significantly buffer the link between depressive symptoms and alcohol use problems (ß = .193, P = .022). DISCUSSION AND CONCLUSIONS: Adequate self-regulation capacities can protect maltreated youths from self-medicating alcohol use problems. SCIENTIFIC SIGNIFICANCE: This study will advance researchers' understanding of the development of alcohol use problems through unwrapping the risk and protective mechanisms underlying the association between young adults' early life stress and alcohol use behaviors. (Am J Addict 2020;29:141-150).

Childhood Neglect, Internalizing Symptoms and Adolescent Substance Use: Does the Neighborhood Context Matter?

Childhood neglect is associated with risk behaviors in adolescence, including substance use. There is evidence that internalizing behaviors may serve as a mechanism linking childhood neglect and substance use; however, further research is needed to examine this developmental pathway. According to developmental and ecological approaches, the neighborhood context and the developmental timing of maltreatment should both be considered when examining the sequelae of childhood neglect. Hence, the present study uses a longitudinal sample of youth (N = 965, 49.1% female, 59.2% African-American) to examine the influence of timing in the relationship between childhood neglect and adolescent psychopathology, and to examine the indirect effects of child neglect on substance use via internalizing symptoms in adolescence. Furthermore, the role of neighborhood disorder in this indirect effect was tested. Five data collection time points were used: Time 1(M age = 4.557, SD age = .701), Time 2 (M age = 6.422, SD age = .518), Time 3 (M age = 12.370, SD age = .443), Time 4 (M age = 14.359, SD age = .452), and Time 5 (M age = 16.316, SD age = .615). The findings showed that internalizing problems mediated the link between the severity of neglect in early childhood and adolescent substance use, and this pathway was moderated by neighborhood disorder. These results have implications for preventative interventions aimed toward reducing substance use for at-risk adolescents.

Interpersonal Mechanisms Between Child Maltreatment Timing and Young Adult Internalizing and Externalizing Symptomatology.

OBJECTIVE: Children who experience maltreatment are prone to exhibit interpersonal deficits and lack secure attachment, which can lead to internalizing and externalizing symptomatology. This study investigated timing and chronicity of maltreatment and its impacts on psychopathology outcomes in young adulthood. Two interpersonal mediators were examined: problems with peers and childhood attachment security. METHOD: Children with and without maltreatment exposure were recruited to take part in a 1-week research summer camp (N = 697; mean [SD] age = 11.29 [0.97] years; 71.3% Black or African American; 50.5% male). Participants were recontacted in young adulthood to complete a second wave of assessments (n = 427; mean [SD] age = 19.67 [1.16] years; 78.0% Black or African American; 48.9% male). Structural equation modeling was used to estimate indirect effects from child maltreatment timing to young adult internalizing and externalizing symptomatology via childhood attachment security and peer problems. RESULTS: Findings highlighted the detrimental impact of chronic maltreatment, which was associated with higher levels of peer problems (ß = .24, p < .001) and less secure attachment (ß = -.13, p < .01) in childhood. Also, lower attachment quality in childhood mediated the association between chronic maltreatment and self-reported internalizing (a × b = 0.02, p < .05) and externalizing symptomatology (a × b = 0.02, p < .05). Additionally, childhood peer problems mediated the association between chronic maltreatment and caregiver-reported internalizing problems (a × b = 0.04, p < .05). CONCLUSION: Chronic maltreatment is particularly harmful for interpersonal outcomes of children. Mediation findings differed by who reported on psychopathology, showing the importance of considering multireporter measures of psychopathology. PLAIN LANGUAGE SUMMARY: Child maltreatment is an interpersonal stressor that may impact developmental outcomes throughout a youth's life. In this study of 697 children who participated in a 1-week research summer camp and were contacted in young adulthood, the authors found that chronic maltreatment significantly increased the risk of difficulties in forming secure attachments as well as having problems with peers during childhood. In turn, these challenges were linked to emotional and behavioral symptomology in young adulthood. These findings emphasize the need to support children facing chronic maltreatment to improve their long-term mental health.

Building stronger bonds: The impact of family support and communication on suicidal behaviors among Black men who have sex with men.

INTRODUCTION: It has been well documented that men who identify with a sexual orientation other than heterosexual are at a greater risk for suicide-related outcomes. What is less known are the protective factors that can reduce such negative outcomes and contribute to their resilience. METHODS: This study used data collected between December 1, 2021, and January 2022 to understand how family factors contribute to or prevent depression symptoms and suicide outcomes among young Black men who have sex with men (BMSM) ages 18 to 29 (N = 400). A path analysis was conducted to explore the direct and indirect effects of suicide attempts. RESULTS: Surprisingly, there were nuanced findings that showed having a family member or friend die by suicide was indirectly associated with suicide planning and suicide attempts. It was also unexpectedly noted that there was a positive relationship between higher rates of depressive symptoms and higher levels of support from family members. CONCLUSIONS: The population focused on in this study is understudied and has unique needs. Identifying familial support may not automatically reduce the thoughts and plans of young BMSM, which is an example of why their intersecting marginalized identities must be considered when conducting further research, creating interventions, and providing therapeutic services.

A Longitudinal Examination of Child Maltreatment Dimensions, Emotion Regulation, and Comorbid Psychopathology.

Childhood maltreatment is a toxic stressor that occurs in the family context and is related to adverse outcomes including elevations in internalizing symptomology and externalizing symptomology. In the present study, we tested the role of threat and deprivation dimensions of child maltreatment in the etiology of comorbid psychopathology in emerging adulthood. Additionally, we investigated emotion regulation and emotion lability/negativity as mechanisms underlying the relationship between child maltreatment dimensions and emerging adult psychopathology. To address these aims, we used a longitudinal sample of emerging adults (N = 413, Mage = 19.67, 78.0% Black, 51.1% female) who had previously participated in research assessments at age 10-12. Using a person-centered approach with latent profile analysis, we identified three classes of emerging adulthood psychopathology characterized by different levels of symptom severity and comorbidity between internalizing and externalizing symptoms. Emerging adults who experienced deprivation only, compared to those who were not maltreated, were more likely to belong to a comorbid and severe psychopathology class versus the other identified psychopathology classes. There was also a significant indirect pathway from experiences of both threat and deprivation to a high externalizing class via emotion lability/negativity. Our results contribute to current models of childhood adversity and psychopathology and have implications for interventions to prevent psychopathology among emerging adults exposed to child maltreatment.

Individual and Contextual Risk and Protective Factors for Suicidal Thoughts and Behaviors among Black Adolescents with Arrest Histories.

Black adolescents in the United States have experienced an increase in suicidal thoughts and behaviors (STBs). Since Black adolescents are overrepresented in the youth punishment system, more research is needed to investigate correlates of STBs for this population. The purpose of this paper is to explore and establish correlates of individual, family, and community risk and protective factors and their relationship to lifetime STBs in a national sample of Black youth with arrest histories. Guided by an intersectional eco-behavioral lens, we investigated individual, family and contextual risk and protective factors for STBs among a national sample of justice-involved Black youth aged 12-17 with a history of arrest (n = 513). We used logistic regression models to test risk and protective factors for STBs. Among the sample, 9.78% endorsed suicidal ideation, and 7.17% endorsed a previous suicide attempt. Further, gender (female) and depression severity were risk factors for STBs, while positive parenting and religiosity were protective factors for STBs. School engagement was associated with lower levels of suicidal ideation. The findings suggest suicide prevention and intervention efforts should identify developmentally salient risk and protective factors to reduce mental health burden associated with STBs and concurrent alleged law-breaking activity of Black youth.

Child maltreatment, recent stressful life events, and suicide ideation: A test of the stress sensitivity hypothesis.

BACKGROUND: Exposure to child maltreatment is a well-known risk factor for suicide ideation among adolescents. Recent stressful life events may also contribute to this risk. However, the association between these risk factors is unclear in the etiology of suicide ideation for adolescents from socio-economically disadvantaged backgrounds. OBJECTIVE: The present study tested the stress generation and stress sensitivity hypotheses in relation to child maltreatment, recent stressful life events (in the past year), and suicide ideation (in the past two weeks). PARTICIPANTS AND SETTING: We utilized a sample of diverse, socioeconomically disadvantaged, depressed adolescent girls (N = 175) who were part of a depression treatment intervention. RESULTS: Child maltreatment was significantly associated with adolescent suicide ideation, ß = .40, p < .001. Results supported the stress sensitivity hypothesis, in that exposure to interpersonal stressors in the past year exacerbated the association between child maltreatment and adolescents' suicide ideation, ß = .18, p < .05. We found evidence for a protective factor, cognitive reappraisal, in the association between stressful life events and suicide ideation, ß = -.15, p < .05. CONCLUSIONS: These findings have several implications for clinical practice and suicide prevention with adolescent girls, and contribute to the extant literature on the role of chronic and acute stress in the etiology of adolescent suicide ideation.

Child maltreatment and the development of psychopathology: The role of developmental timing and chronicity.

BACKGROUND: The effects of child maltreatment (CM) on psychopathology are well-established, yet the complex effects of timing and chronicity of maltreatment exposure on the development of psychopathology are still unclear. OBJECTIVE: To elucidate developmental pathways from distinct dimensions of CM (chronicity and timing) to psychopathology during emerging adulthood using data from a longitudinal, multi-method study. PARTICIPANTS AND SETTING: Children with and without maltreatment exposure were recruited at wave 1 (ages 10-12) to participate in a research summer camp. At wave 2, participants were recontacted during emerging adulthood (ages 18-22). The current study includes 391 participants (51.3% female; 77.5% Black, 11.3% white, 7.4% Hispanic, 3.8% other race). METHODS: Timing and chronicity of maltreatment exposures were coded from child protective services records using the Maltreatment Classification System. Childhood internalizing and externalizing symptoms were assessed using child- and camp counselor-report. Emerging adults completed self-report questionnaires and were interviewed about their current and past symptoms of psychopathology. Structural equation modeling was used to estimate direct and indirect links between childhood maltreatment dimensions (chronicity and timing) to adult psychopathology via childhood internalizing and externalizing. RESULTS: Child maltreatment experiences that spanned several developmental periods, including both early and later childhood stages, predicted a cascade of both internalizing and externalizing symptoms in childhood that eventuated in greater symptoms of anxiety, depression, substance use disorder, and antisocial personality disorder in emerging adulthood. CONCLUSIONS: Results suggest that chronic childhood maltreatment exposure is associated with multifinality in psychopathology presentations that can be detected in childhood and extend into emerging adulthood. Early prevention and intervention efforts to promote positive and safe parenting are essential to decrease the burden of mental health symptoms conferred by chronic maltreatment exposures on individuals, families, and public health systems.

Harsh parenting and youth systemic inflammation: Modulation by the autonomic nervous system.

OBJECTIVE: The present study aimed to test the role of the autonomic nervous system (ANS) in modulating the impact of family stress induced by harsh parenting on youths' inflammation. First, we examined the direct effect of severity of adverse parenting behaviors on two serum biomarkers of systemic inflammation (C-reactive protein and interleukin-6) among youth. Second, we tested the moderating role of ANS reactivity in response to laboratory-induced stress in the association between harsh parenting and inflammation among these youth. METHOD: The sample included 101 low-income children (75.2% African American) between 9 and 12 years of age (Mage = 10.9; SDage = 1.2) who participated in a conflict task with their primary caregiver in a laboratory setting. Heart rate variability reactivity (HRV-R), skin conductance level reactivity (SCL-R), and preejection period reactivity (PEPr-R) were used to index parasympathetic and sympathetic nervous system reactivity. Markers of low-grade inflammation (C-reactive protein and interleukin-6) were obtained from serum. RESULTS: After adjusting for confounding variables, ANS activity moderated the associations between family stress and systemic inflammation. Specifically, elevated HRV-R buffered the effect of family stress on youths' inflammation, whereas elevated PEPr-R and SCL-R exacerbated the effect. CONCLUSION: These findings show that self-regulatory capacity and threat sensitivity, as indicated by ANS function, may have an impact on the associations between family stress and systemic inflammation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Alcohol Use and Depressive Symptoms Among a Nationally Representative Sample of Youth Investigated for Maltreatment.

OBJECTIVE: The relationships between depressive symptoms and alcohol use among maltreated youth have been well documented. However, the direction of these associations remains unclear. Two prevalent but contrasting perspectives on these associations-the self-medication and impaired-functioning hypotheses-have each received extensive support. The present study aims to test these hypotheses and to reconcile these theoretical and empirical inconsistencies by advancing a third integrative conceptualization, the bidirectional hypothesis, which considers developmental timing in the transactional associations between maltreated youth's depressive symptoms and alcohol use over time. METHOD: Data were drawn from the National Survey of Child and Adolescent Well-Being II, a longitudinal, nationally representative sample of youth involved with Child Protective Services because they have been maltreated. The current study included data from 657 youth followed over three equidistant time points for 3 years. Youth were aged 11-14 years at the first time point, with 52.7% female and 51.4% White. RESULTS: Autoregressive analyses within a structural equation modeling framework supported the impaired-functioning hypothesis during early adolescence and the self-medication hypothesis during mid- to late adolescence. The data were consistent with the bidirectional hypothesis in which depressive symptoms and alcohol use differentially predicted each other depending on the stage of adolescence. CONCLUSIONS: The bidirectional associations between alcohol use and depressive symptoms are influenced by developmental timing. Researchers should consider age when tailoring prevention programs that target maltreated youth. Depressive symptoms should be screened early and frequently to prevent adolescent substance use.

Growth patterns of future orientation among maltreated youth: A prospective examination of the emergence of resilience.

During adolescence, a positive outlook toward the future (i.e., future orientation) can protect youth from the risks conferred by childhood adversity. Research to date, however, has largely considered future orientation as a static attribute. Developmental systems perspectives suggest that future orientation, when considered across time, will exhibit dynamic trajectories with levels changing in response to the varying balance of risks and resources in youths' environments. Investigating the developmental course and consequences of future orientation is particularly germane to maltreated youth who may benefit from programs that target this protective mechanism. The present study tested hypotheses regarding the developmental course of future orientation, including the association of distinct future orientation trajectories with time-varying risk factors and resources, and the association of continuity and change in future orientation trajectories with young adult psychosocial functioning. Hypotheses were investigated with longitudinal (T1 Mage = 12.22, T2 Mage = 13.52, T3 Mage = 14.79, T4 Mage = 18.54), multireporter data from a nationally representative sample of maltreated youth (N = 1,461). Growth mixture modeling (GMM) identified three classes of growth trajectories in future orientation: high-persistent, low start/increasing, and high start/decreasing. Time-variant and -invariant risk factors and resources differentiated youths' future orientation trajectories. Youth in the high-persistent and low start/increasing trajectories were more likely to attain young adulthood developmental milestones-including independent living skills, social capital, employment, and higher weekly income. This study documents how an important component of resilient adaptation emerges and promotes positive outcomes among highly vulnerable youth. (PsycINFO Database Record

The Influence of Community Disadvantage and Masculinity Ideology on Number of Sexual Partners: A Prospective Analysis of Young Adult, Rural Black Men.

Young, rural Black men are disproportionately affected by sexually transmitted infections (STIs), a consequence, in part, of multiple sexual partnerships. We conducted a prospective study that examined the influence of masculinity ideology on changes in numbers of sexual partners in this population. We focused on a set of high-risk attitudes termed reputational masculinity. Community disadvantage during young adulthood was examined as a risk factor for reputational masculinity ideology, and vocational commitment was examined as a potential protective factor. The sample included 505 African American men ages 19 to 22 from high-poverty rural communities. Men reported their numbers of sexual partners during the past three months, masculinity ideology, community disadvantage, and vocational commitment. Follow-up data were collected 18 months after baseline assessment. Negative binomial modeling was used to test study hypotheses. Results indicated that community disadvantage was associated with increases in reputational masculinity during early adulthood, which in turn were linked to increases in numbers of sexual partners. Vocational commitment interacted with reputational masculinity to forecast numbers of sexual partners, attenuating the influence of reputational masculinity. Reputational masculinity and promotion of engagement with the workplace may be important targets for interventions designed to reduce sexual risk behavior.