The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the "Prenatal to Preschool" study protocol.

Introduction: Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children's development and mental health are adversely impacted by their mothers' experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families. Methods: This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months. Results: Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children's development and mental health may be adversely impacted by their caregiver's experiences of racism. Discussion: This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.

The Disproportionate Burden of the COVID-19 Pandemic Among Pregnant Black Women.

The COVID-19 pandemic has disproportionately impacted the well-being of vulnerable populations in the US, including Black people. The impact on pregnant women is of special concern for the intrauterine and post-natal development of their offspring. We evaluated in an online survey a sample of 913 pregnant women, 216 Black, 571 White, 126 Other, during a 2-week stay-at-home mandate in the Philadelphia region. We applied logistic regression models and analysis of covariance to examine general and pregnancy-specific worries and negative consequences arising from the COVID-19 pandemic, symptoms of anxiety and depression, and resilience. Black pregnant women reported greater likelihood of having their employment negatively impacted, more concerns about a lasting economic burden, and more worries about their prenatal care, birth experience, and post-natal needs. In the full sample, 11.1% of women met screening criteria for anxiety and 9.9% met criteria for depression. Black women were more likely to meet criteria for depression than White women, but this difference was not significant accounting for covariates. Resilience factors including self-reliance and emotion regulation were higher in Black women. Racial disparities related to COVID-19 in pregnant women can advance the understanding of pregnancy related stressors and improve early identification of mental health needs.

Antisocial behavior with callous-unemotional traits is associated with widespread disruptions to white matter structural connectivity among low-income, urban males.

Antisocial behavior (AB), including violence, criminality, and substance abuse, is often linked to deficits in emotion processing, reward-related learning, and inhibitory control, as well as their associated neural networks. To better understand these deficits, the structural connections between brain regions implicated in AB can be examined using diffusion tensor imaging (DTI), which assesses white matter microstructure. Prior studies have identified differences in white matter microstructure of the uncinate fasciculus (UF), primarily within offender samples. However, few studies have looked beyond the UF or determined whether these relationships are present dimensionally across the range of AB and callous-unemotional (CU) traits. In the current study, we examined associations between AB and white matter microstructure from major fiber tracts, including the UF. Further, we explored whether these associations were specific to individuals high on CU traits. Within a relatively large community sample of young adult men from low-income, urban families (N = 178), we found no direct relations between dimensional, self-report measures of either AB or CU traits and white matter microstructure. However, we found significant associations between AB and white matter microstructure of several tracts only for those with high co-occurring levels of CU traits. In general, these associations did not differ according to race, socioeconomic status, or comorbid psychiatric symptoms. The current results suggest a unique neural profile of severe AB in combination with CU traits, characterized by widespread differences in white matter microstructure, which differs from either AB or CU traits in isolation and is not specific to hypothesized tracts (i.e., the UF).