Microbiome function and neurodevelopment in Black infants: vitamin B12 emerges as a key factor.

The early life gut microbiome affects the developing brain, and therefore may serve as a target to support neurodevelopment of children living in stressful and under-resourced environments, such as Black youth living on the South Side of Chicago, for whom we observe racial disparities in health. Microbiome compositions/functions key to multiple neurodevelopmental facets have not been studied in Black children, a vulnerable population due to racial disparities in health; thus, a subsample of Black infants living in urban, low-income neighborhoods whose mothers participated in a prenatal nutrition study were recruited for testing associations between composition and function of the gut microbiome (16S rRNA gene sequencing, shotgun metagenomics, and targeted metabolomics of fecal samples) and neurodevelopment (developmental testing, maternal report of temperament, and observed stress regulation). Two microbiome community types, defined by high Lachnospiraceae or Enterobacteriaceae abundance, were discovered in this cohort from 16S rRNA gene sequencing analysis; the Enterobacteriaceae-dominant community type was significantly negatively associated with cognition and language scores, specifically in male children. Vitamin B12 biosynthesis emerged as a key microbiome function from shotgun metagenomics sequencing analysis, showing positive associations with all measured developmental skills (i.e., cognition, language, motor, surgency, effortful control, and observed stress regulation). Blautia spp. also were identified as substantial contributors of important microbiome functions, including vitamin B12 biosynthesis and related vitamin B12-dependent microbiome functions, anti-inflammatory microbial surface antigens, competitive mechanisms against pathobionts, and production of antioxidants. The results are promising with respect to the potential for exploring therapeutic candidates, such as vitamin B12 nutritional or Blautia spp. probiotic supplementation, to support the neurodevelopment of infants at risk for experiencing racial disparities in health.

Phenotyping stress exposures related to perinatal health disparities.

Black American women living in low-resource environments are exposed to multiple stressors and are at high risk for perinatal complications. Stress exposure likely impacts pregnancy and birth complications via alterations in health systems that are engaged in regulating the stress response. Stressors may vary in terms of magnitude and pattern of effect on such health systems. In the present study, we test associations between three types of stress exposure: perceived stress, negative life events, and discrimination stress on neuroendocrine and cardiac response to a controlled laboratory stressor during the first trimester of pregnancy. In all, 100 pregnant Black women with Medicaid insurance completed a laboratory assessment during which salivary cortisol and heart rate variability (HRV) were used to measure stress response to the Trier Social Stress Test (TSST). Results revealed that only discrimination stress was significantly associated with cortisol and HRV in response to the TSST. High levels of discrimination stress were associated with lower levels of cortisol reactivity and higher levels of HRV across the visit. These results highlight the differential impact of domains of stress exposure on stress regulation during pregnancy and provide further evidence of the impact of discrimination stress on Black American women's health.

Differences in childhood body mass index between lesbian/gay and bisexual and heterosexual female adolescents: A follow-back study.

OBJECTIVE: To determine whether childhood body mass index (BMI), assessed in childhood, differs between lesbian/gay and bisexual (LGB) and heterosexual late adolescents, and whether childhood social stressors impact the association between sexual orientation and childhood BMI. METHODS: Participants included 2,070 late adolescents from the Pittsburgh Girls Study, of whom 233 (11.2%) identified as lesbian or bisexual and 1,837 (88.8%) as heterosexual at ages 17-20 years. Weight and height were used to calculate body mass index (BMI) at ages 10 through 14 years. Data were collected on child reported loneliness at ages 8 to 10 and peer victimization from 10 to 14 years. RESULTS: LGB females had higher BMIs and greater increases in BMI from ages 10-14 years compared to heterosexual females and reported higher levels of loneliness and peer victimization in childhood. Loneliness moderated the association between sexual identity and changes in BMI; for participants with loneliness scores in the upper quartile, the increase in BMI over time was approximately 30% higher for LGB females compared to heterosexual females. Child report of peer victimization mediated the association between sexual identity and changes in BMI, with nearly 18% of the total effect of sexual identity on BMI over time accounted for by peer victimization. CONCLUSIONS: Lesbian and bisexual adolescents report greater loneliness and peer victimization as children than heterosexual adolescents; these stressors confer risk for higher BMI among LGB females. These data underscore the importance of research on the social determinants of health. The hypothesis that the social stressors may partially account for differences in BMI and other cardiometabolic risk factors between LGB and heterosexual females should be addressed in future research.

Adolescent girls' neural response to reward mediates the relation between childhood financial disadvantage and depression.

BACKGROUND: Children who experience socioeconomic disadvantage are at heightened risk for developing depression; however, little is known about neurobiological mechanisms underlying this association. Low socioeconomic status (SES) during childhood may confer risk for depression through its stress-related effects on the neural circuitry associated with processing monetary rewards. METHODS: In a prospective study, we examined the relationships among the number of years of household receipt of public assistance from age 5-16 years, neural activation during monetary reward anticipation and receipt at age 16, and depression symptoms at age 16 in 123 girls. RESULTS: Number of years of household receipt of public assistance was positively associated with heightened response in the medial prefrontal cortex during reward anticipation, and this heightened neural response mediated the relationship between socioeconomic disadvantage and current depression symptoms, controlling for past depression. CONCLUSIONS: Chronic exposure to socioeconomic disadvantage in childhood may alter neural circuitry involved in reward anticipation in adolescence, which in turn may confer risk for depression.

Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls.

Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization.

The development of opposition-defiance during toddlerhood: a population-based cohort study.

OBJECTIVE: There is now emerging epidemiological evidence that a substantial proportion of toddlers in the general population may be experiencing a significant opposition-defiance problem before 2 years of age. This article describes the continuity and discontinuity in boys' and girls' opposition-defiance statuses during toddlerhood. METHOD: Data came from The Québec Longitudinal Study of Child Development, a survey of a representative birth cohort of children from the Canadian province of Québec. A time-specific latent variables (Markov) model was used to estimate the proportion of toddlers who cease or start to exhibit oppositional-defiant behaviors (ODBs) on a frequent basis between 17 and 29 months of age and to test for gender differences therein. RESULTS: A majority of toddlers who had exhibited ODBs on a frequent basis at 17 months of age were still doing so 1 year later. Also, a majority of toddlers who did exhibit ODBs on a frequent basis at 29 months of age had done so 1 year earlier. The results also show that there are more toddlers who start than stop exhibiting ODBs on a frequent basis during this period. Further, the continuity and discontinuity in toddlers' opposition-defiance statuses during this period did not vary between boys and girls, suggesting that gender differences in opposition-defiance have not yet emerged by the second half of the third year of life. CONCLUSION: The predictive accuracy of early opposition-defiance is very good, with a substantial proportion of toddlers experiencing a significant opposition-defiance problem throughout toddlerhood.

Race and sexual behavior predict uptake of the human papillomavirus vaccine.

OBJECTIVE: To identify predictors of human papillomavirus (HPV) vaccination initiation by girls at high risk for HPV infection. METHOD: Participants were 2,098 girls enrolled in the ongoing Pittsburgh Girls Study, who were between the ages of 12 and 15 years in 2008, and their primary caregivers. The study was conducted in the 2 years after the deployment of the first HPV vaccine approved by the U.S. Food and Drug Administration. Primary caregivers were asked about HPV vaccine uptake. Girls were interviewed about pubertal development and sexually intimate behavior. RESULTS: Approximately 60% of the girls had initiated the HPV vaccine in the past year. Among the hypothesized predictors of initiation, African-American race decreased the likelihood and level of sexually intimate behavior in the previous year increased the likelihood of uptake. Controlling for receipt of public assistance, African-American girls were close to 40% less likely to be vaccinated than European-American girls. CONCLUSION: Racial disparities in use of preventive interventions such as the HPV vaccine exist. Lack of information about public financing of the vaccine, timing of vaccination relative to sexual activity, and perceptions of preventive value may limit uptake among those at highest risk for infection and negative sequelae from infection. Further research to probe knowledge and attitudes toward HPV vaccination and the impact of the media on vaccine initiation and uptake may reveal specific targets of intervention.

Observational Assessment of Preschool Disruptive Behavior, Part II: validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS).

OBJECTIVE: To examine the validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), a new observational method for assessing preschool disruptive behavior. METHOD: A total of 327 behaviorally heterogeneous preschoolers from low-income environments comprised the validation sample. Parent and teacher reports were used to identify children with clinically significant disruptive behavior. The DB-DOS assessed observed disruptive behavior in two domains, problems in Behavioral Regulation and Anger Modulation, across three interactional contexts: Examiner Engaged, Examiner Busy, and Parent. Convergent and divergent validity of the DB-DOS were tested in relation to parent and teacher reports and independently observed behavior. Clinical validity was tested in terms of criterion and incremental validity of the DB-DOS for discriminating disruptive behavior status and impairment, concurrently and longitudinally. RESULTS: DB-DOS scores were significantly associated with reported and independently observed behavior in a theoretically meaningful fashion. Scores from both DB-DOS domains and each of the three DB-DOS contexts contributed uniquely to discrimination of disruptive behavior status, concurrently and predictively. Observed behavior on the DB-DOS also contributed incrementally to prediction of impairment over time, beyond variance explained by meeting DSM-IV disruptive behavior disorder symptom criteria based on parent/teacher report. CONCLUSIONS: The multidomain, multicontext approach of the DB-DOS is a valid method for direct assessment of preschool disruptive behavior. This approach shows promise for enhancing accurate identification of clinically significant disruptive behavior in young children and for characterizing subtypes in a manner that can directly inform etiological and intervention research.

Observational Assessment of Preschool Disruptive Behavior, Part I: reliability of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS).

OBJECTIVE: To examine the reliability of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), a new observational method for assessing preschool disruptive behavior. METHOD: The DB-DOS is a structured clinic-based assessment designed to elicit clinically salient behaviors relevant to the diagnosis of disruptive behavior in preschoolers. Child behavior is assessed in three interactional contexts that vary by partner (parent versus examiner) and level of support provided. Twenty-one disruptive behaviors are coded within two domains: problems in Behavioral Regulation and problems in Anger Modulation. A total of 364 referred and nonreferred preschoolers participated: interrater reliability and internal consistency were assessed on a primary sample (n = 335) and test-retest reliability was assessed in a separate sample (n = 29). RESULTS: The DB-DOS demonstrated good interrater and test-retest reliability. Confirmatory factor analysis demonstrated an excellent fit of the DB-DOS multidomain model of disruptive behavior. CONCLUSIONS: The DB-DOS is a reliable observational tool for clinic-based assessment of preschool disruptive behavior. This standardized assessment method holds promise for advancing developmentally sensitive characterization of preschool psychopathology.

Parsing the relations between SES and stress reactivity: examining individual differences in neonatal stress response.

In an effort to further delineate the reported relations between socioeconomic status (SES) and stress reactivity in children, associations between three domains of perinatal risk: socio-demographic, obstetrical complications, and maternal psychological factors during the perinatal period, and cortisol and behavioral reactivity were examined in 100 healthy African American neonates whose families resided in low-income environments. Behavioral and cortisol response to a heel stick and the Neonatal Behavioral Assessment Scale (NBAS) was measured within the first 2 days of life. Significant associations were found between socio-demographic risk, obstetrical complications, and maternal psychological factors and neonatal behavior and cortisol in the context of the NBAS; few significant associations were found in the context of the heel stick. Greater magnitude of perinatal risk was associated with both higher and lower than average neonatal stress reactivity. The results provide preliminary data on the types of perinatal experiences that may have significant effects on stress reactivity in humans, especially in the context of families living in poverty. Application of these data to the hypothesis that prenatal stress results in programming of the fetal/neonatal stress response system is discussed.

Gender differences in physical aggression: A prospective population-based survey of children before and after 2 years of age.

There has been much controversy over the past decades on the origins of gender differences in children's aggressive behavior. A widely held view is that gender differences emerge sometime after 2 years of age and increase in magnitude thereafter because of gender-differentiated socialization practices. The objective of this study was to test for (a) gender differences in the prevalence of physical aggression in the general population of 17-month-old children and (b) change in the magnitude of these differences between 17 and 29 months of age. Contrary to the differential socialization hypothesis, the results showed substantial gender differences in the prevalence of physical aggression at 17 months of age, with 5% of boys but only 1% of girls manifesting physically aggressive behaviors on a frequent basis. The results suggest that there is no change in the magnitude of these differences between 17 and 29 months of age.

Patterns of cortisol reactivity in African-American neonates from low-income environments.

Individual differences and stability in patterns of salivary cortisol reactivity were examined in 100 African-American neonates from low-income environments. A pattern of reactivity was defined by the change from prestressor to poststressor cortisol concentrations and the change following the poststressor during a recovery phase. Cortisol reactivity was measured in response to two stressors: the Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent) and the routine hospital heels-tick procedure. The use of two stressors allowed an examination of whether patterns of reactivity to different stimuli vary and whether there is individual stability in patterns of cortisol reactivity. Cortisol concentrations changed significantly across the three time points. The magnitude of change during the recovery period differed across stressors. Prestressor cortisol values were associated with cortisol reactivity. Both prestressor cortisol concentrations and pattern of cortisol response were significantly associated within individuals.