Association of BMI trajectories with cardiometabolic risk among low-income Mexican American children.

BACKGROUND: The aim of this study was to identify distinct trajectories of BMI growth from 2 to 7.5 years and examine their associations with markers of cardiometabolic risk at age 7.5 years among a sample of low-income Mexican American children. METHODS: This longitudinal cohort study recruited 322 mother-child dyads to participate prenatally and at child age 2, 3, 4.5, 6, and 7.5 years. Child height/weight, waist circumference, and blood pressure were assessed at each time point. Blood was collected from child at 7.5 years. RESULTS: Covarying for birthweight, three BMI trajectories were identified: Low-Stable BMI (73% of the sample), High-Stable BMI (5.6% of the sample), and Increasing BMI over time (21.4% of the sample). The High-Stable and Increasing BMI classes had higher waist circumference and systolic blood pressure and lower HDL-c than the Low-Stable BMI class (ps < 0.05). Among children with BMIs below the 85th percentile, 16% had three or more cardiometabolic risk indicators. CONCLUSIONS: BMI classes were consistent with existing literature. For youth, standard medical practice is to examine cardiometabolic risk indicators when BMI is high; however, this practice would miss 16% of youth in our sample who exhibit cardiometabolic risk but do not screen in based on BMI. IMPACT: Research indicates Mexican American youth are at risk for cardiometabolic dysregulation relative to other ethnic groups, yet there is a paucity of longitudinal research. An Increasing BMI and a High-Stable BMI class were associated with larger waist circumference, higher systolic blood pressure, and lower HDL cholesterol than the Low-Stable BMI class. BMI trajectories in childhood predict cardiometabolic risk indicators. As the sole screener for deciding when to test cardiometabolic indicators, BMI alone will miss some children exhibiting cardiometabolic dysregulation.

Within-dyad bidirectional relations among maternal depressive symptoms and child behavior problems from infancy through preschool.

Although dyadic theory focuses on the impact of a mother's mental health on her own child and the impact of a child's mental health on their own mother, commonly used statistical approaches are incapable of distinguishing the desired within-dyad processes from between-dyad effects. Using autoregressive latent trajectory modeling with structured residuals, the current study evaluated within-dyad, bidirectional associations between maternal depressive symptoms and child behavior problems from child age 1-4.5 years among a sample of low-income, Mexican American women (N = 322, Mage = 27.8) and their children. Women reported on maternal depressive symptoms and child behavior problems during laboratory visits at child age 1, 1.5, 2, 3, and 4.5 years. Results provide novel evidence of child-driven bidirectional association between maternal depressive symptoms and child behavior problems at the within-dyad level as early as child age 1 year and within-person stability in child behavior problems emerging early in life.

Dispositional Active Coping Predicts Patterns of Adolescents' Cortisol Responsivity in the Context of School-related Stressors.

OBJECTIVE: The goal of this study was to examine the direct and conditional effects of active coping and prior exposure to school-related stressors on cortisol reactivity and recovery in response to an academically salient, social stress task. METHOD: Participants included N= 758 adolescents (50% male; M age = 12.03 years, SD = .49) enrolled in the 7th grade in Title 1 middle schools. Adolescents were predominantly ethnic minorities (62% Hispanic, 12% non-Hispanic White, 11% non-Hispanic Black, 7% Native American, and 8% "other"). Youth completed self-reported assessments of their dispositional use of active coping strategies, prior exposure to school hassles, pubertal status, medication use, and relevant demographic information. In addition, youth engaged in an academically salient group public speaking task adapted for adolescents and provided salivary cortisol sample pre-task, immediately post-task, 15-, and 30-minutes post-task. RESULTS: Results from piecewise latent growth curve modeling revealed that active coping independently predicted lower cortisol reactivity to the stress task. Furthermore, active coping was associated with slower cortisol recovery when adolescents reported not having experienced any school hassles in the past three months and faster recovery when having experienced several school hassles in the past three months. Results from multinomial logistic regressions revealed that greater use of active coping strategies was less likely to predict a hyper-reactive pattern of cortisol responding compared to other patterns. CONCLUSION: Findings provide support for active coping as a way to promote adaptive physiological responding to school-related stressors among ethnically diverse youth residing in low-income communities.

Intergenerational Consequences of Maternal Childhood Maltreatment on Infant Health Concerns.

INTRODUCTION: Childhood maltreatment is a well-established risk factor for health problems in adulthood and may also have intergenerational consequences for infant health. Childhood maltreatment may confer risk for infant health by undermining caregiver capacities for sensitive and responsive caregiving. However, associations among childhood maltreatment, maternal sensitivity, and infant health are not well understood. These processes may be of particular importance among low-income and ethnic minority populations for whom disparities in maltreatment exposure and poorer health outcomes are well-established. METHOD: The current study drew data from a sample of low-income, Mexican American families to examine whether maternal childhood maltreatment would be associated with more infant health concerns, and whether lower maternal sensitivity would explain their associations. Data were collected from 322 mother-infant dyads during home visits completed during pregnancy and when infants were 12, 18, and 24 weeks old. RESULTS: Maternal childhood maltreatment exposure and lower maternal sensitivity were both associated with more infant health concerns. Maternal childhood maltreatment was not associated with maternal sensitivity. DISCUSSION: These findings highlight potential intergenerational consequences of maternal childhood maltreatment for infant health and underscore a need for evaluating pre- and postnatal mechanisms through which these effects may be perpetuated. Furthermore, results indicate that maternal sensitivity may represent a promising target for interventions seeking to counteract intergenerational transmission processes. Clarification about underlying risk processes and potentiating resiliency characteristics may elucidate ways to better support mothers and infants across the lifespan.

Childhood maltreatment is associated with a variety of health outcomes across an individual's lifespan and may have intergenerational consequences as well. The present study is among the first to investigate maternal co-regulatory behaviors (i.e., sensitivity) as a potential mechanism through which maternal exposure to childhood maltreatment may influence infant health concerns. Results suggest that both maternal childhood maltreatment history and sensitivity may shape infant outcomes before 24 weeks of age. Increasing understanding of the mechanisms through which maternal childhood maltreatment may exert cascades of influence on infant health may help to inform the development of early intervention services.

The Interdependent Nature of Mother's and Children's Temperament and Eating Behaviors on Weight.

OBJECTIVES: The family environment is an important contextual factor for parent and child weight within families. Using an Actor-Partner Interdependence Model, the current study examined (1) the effect of child and mother temperament (i.e., negative affectivity, effortful control, and impulsivity) on mother and child weight, (2) the effect of mother eating behaviors on mother and child weight, and (3) how temperament might moderate the relationships between mother eating behaviors and mother and child weight. METHODS: The sample consisted of 220 mother-child dyads with children between 4 and 6 years of age (66.8% classified as low-, 25.9% middle-, and 5.5% high-income). Mothers completed questionnaires on their own temperament and eating behaviors as well as child temperament. Weight measures were assessed in the laboratory for both mother and child. RESULTS: Mother's negative affectivity and impulsivity were negatively related to mother's weight while children's impulsivity was positively related to children's and mother's weight. Mother's eating behaviors were also positively related to mother's weight. The interaction between child impulsivity and mother eating behaviors was significant; the association of mother eating behaviors with mother weight depended on child impulsivity. Specifically, when children had higher impulsivity, mothers had the highest weight. When children had average or lower impulsivity, mother weight was higher with higher endorsement of unhealthy eating behaviors. CONCLUSIONS: Findings suggest that after adjusting for the interdependent nature of temperament traits and weight, child impulsivity is an important factor associated with current weight for both mothers and children. Results also provide important implications for the impact children can have on their mothers.

Prenatal Programming of Behavior Problems via Second-by-Second Infant Emotion Dynamics.

Fetal adaptations to prenatal maternal stress may confer high risk for childhood behavior problems, potentially operating via dynamic fluctuations in infants' emotions during mother-infant interactions. These fluctuations over time may give rise to behavior problems. Among a sample of 210 low-income mothers of Mexican origin and their 24-week-old infants, dynamic structural equation modeling was used to examine whether within-infant second-by-second emotion processes were predicted by maternal prenatal stress and predicted behavior problems at 36 and 54 months. The mean level around which infant negative affect fluctuated was related to prenatal stress, but not to childhood behavior problems. The volatility in infant negative affect, reflecting greater ebb and flow in infant negative affect during playful interaction, was predicted by prenatal stress and predicted enduring behavior problems in childhood. Results highlight a potential child-driven pathway linking prenatal exposure with childhood behavior problems via infant negative emotional volatility.

Maternal Depressive Symptoms, Paternal Engagement, and Toddler Behavior Problems in Low-income Mexican-origin Families.

OBJECTIVE: Maternal postpartum depression (PPD) may influence fathers' engagement in childrearing; however, empirical studies have been equivocal as to whether these effects emerge in a compensatory (i.e., higher paternal engagement) or spillover (i.e., lower paternal engagement) manner. This study evaluated fathers' gender role attitudes as a moderator that shapes the association between maternal PPD and fathers' engagement during infancy, and also examined relations between father engagement and children's subsequent behavior problems. METHOD: In a prospective study of low-income, Mexican-origin families (N = 181 mothers and a subset of their partners, N = 92 fathers), maternal PPD symptoms and fathers' gender role attitudes were measured at 15-weeks postpartum, father engagement was measured at 21-weeks, and children's behavior problems were measured at 12 and 18 months. RESULTS: Higher maternal PPD symptoms were associated with lower father engagement and more child behavior problems when fathers endorsed more segregated gender role attitudes; however, this relation was not significant when fathers endorsed less segregated, more contemporary gender role attitudes. A mediational chain was evident, wherein the interaction of maternal PPD and fathers' gender role attitudes predicted paternal engagement, and lower paternal engagement subsequently predicted more child behavior problems at 12 months, which predicted more child behavior problems at 18 months. CONCLUSIONS: Results suggest the effects of maternal PPD on children's behavior problems may operate via paternal engagement, which is affected by fathers' traditional gender role attitudes. The study highlights the importance of examining fathering and children's behavior using a cultural-contextual lens among underrepresented ethnic minority families.

Prenatal Neighborhood Ethnocultural Context and the Mental Health of Mothers and Children in Low-Income Mexican American Families.

Socioeconomically disadvantaged neighborhoods increase the risk for poor mental health among residents, yet protective factors may operate alongside risk. This study evaluated the influence of the prenatal neighborhood ethnocultural context on child behavior problems and maternal depressive symptoms. Prenatal maternal role expectations, prenatal culture-specific stress, and postpartum depression (PPD) symptoms were evaluated as mediators. Participants included 322 low-income, Mexican American mother-child dyads. Women (Mage  = 27.8) reported on proposed mediators, maternal depressive symptoms, and child behavior problems at 4.5 years. Neighborhood Latinx concentration was obtained from census data. Higher Latinx concentration predicted fewer maternal depressive symptoms and child behavior problems, mediated through role expectations and PPD symptoms. Results suggest prenatal neighborhood context to impact later maternal and child mental health.

Infant Temperament Profiles, Cultural Orientation, and Toddler Behavioral and Physiological Regulation in Mexican-American Families.

This study sought to (a) replicate infant temperament profiles from predominantly White samples in a sample of low-income, predominantly first-generation Mexican-American families, (b) investigate associations between infant temperament profiles and toddler behavioral and physiological regulation, and (c) explore whether mothers' cultural orientation would moderate those associations. Mothers and infants (n = 322; 46% male) were assessed during pregnancy and at infant ages 9, 12, and 24 months. Latent profile analysis yielded three temperament profiles that were consistent with those from extant research. Compared to the high positive affect, well-regulated profile, the negative reactive, low regulated profile was associated with poorer behavioral and parasympathetic (i.e., respiratory sinus arrhythmia) regulation, but associations depended on mothers' Mexican and Anglo cultural orientation.

Second-by-second infant and mother emotion regulation and coregulation processes.

Context-appropriate infant physiological functioning may support emotion regulation and mother-infant emotion coregulation. Among a sample of 210 low-income Mexican-origin mothers and their 24-week-old infants, dynamic structural equation modeling (DSEM) was used to examine whether within-infant vagal functioning accounted for between-dyad differences in within-dyad second-by-second emotion regulation and coregulation during free play. Vagal functioning was captured by within-infant mean and variability (standard deviation) of respiratory sinus arrhythmia (RSA) during free play. Infant emotion regulation was quantified as emotional equilibria (within-person mean), volatility (within-person deviation from equilibrium), carryover (how quickly equilibrium is restored following a disturbance), and feedback loops (the extent to which prior affect dampens or amplifies subsequent affect) in positive and negative affect during free play; coregulation was quantified as the influence of one partner's affect on the other's subsequent affect. Among infants with lower RSA variability, positive affect fluctuated around a higher equilibrium, and negative affect fluctuated around a lower equilibrium; these infants exhibited feedback loops where their positive affect dampened their subsequent negative affect. As expected, infants with higher mean RSA exhibited more volatility in positive affect, feedback loops between their positive and negative affect, and stronger mother-driven emotion coregulation. The results highlight differences in simultaneously occurring biological and emotion regulation.

Infant Vagal Tone and Maternal Depressive Symptoms: A Bottom-Up Perspective.

Children vary in their susceptibility to environmental exposures such as maternal depression, but little is known about how children shape those same environments. When raising an infant with low arousal, mothers at risk of depression may experience decreased parenting self-efficacy and increased depressive symptoms. We evaluated a longitudinal mediated moderation model that hypothesized interactive effects of infant vagal tone (indexed by respiratory sinus arrhythmia [RSA]) and maternal postpartum depressive (PPD) symptoms on maternal depressive symptoms in early childhood via parenting self-efficacy. Among a sample of 322 very low-income Mexican American mother-infant dyads (46% male infants), infant RSA was assessed at 6 weeks of age; mothers (Mage = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 weeks to 6 months, parenting self-efficacy at 18 and 24 months, and depressive symptoms at 18 and 36 months. Higher PPD symptoms predicted higher maternal depressive symptoms at 36 months, especially among mothers whose infants had lower resting RSA. The interactive effect of PPD symptoms and infant RSA on 36-month depressive symptoms was partially mediated by lower parenting self-efficacy. Lower infant RSA may exacerbate the detrimental effects of PPD symptoms on subsequent maternal well-being via damage to mothers' beliefs in their ability to parent effectively.

Infant biological sensitivity to father engagement in low-income Mexican American families.

Despite a sizeable literature documenting meaningful contributions of father involvement to child health and development, researchers have paid little attention to biological characteristics that may render a child more or less sensitive to fathering behavior. The identification of child and paternal characteristics that promote child behavioral health is particularly critical in the context of sociocultural risk. We hypothesized that respiratory sinus arrhythmia (RSA) measured during infancy would moderate the impact of father engagement in caregiving activities on child behavioral health. In a sample of 181 Mexican American families, we evaluated the impact of infant RSA at 6 weeks, mother- and father-reported father engagement in caregiving activities at 15 and 21 weeks, and their interaction on toddler social or emotional behavior problems and competence at 2 years of age. Only infants with average or higher RSA exhibited more behavior problems in the context of low father engagement (p = .021). Neither RSA nor father engagement predicted behavioral competence. The results are consistent with a stress-diathesis process such that higher infant RSA increases vulnerability to suboptimal father involvement, but does not enhance the benefits of high father involvement.

Effects of maternal and paternal postnatal depressive symptoms on infants' parasympathetic regulation in low-income, Mexican American families.

Mothers and fathers are at elevated risk for developing depression during the first postnatal year, especially among families from marginalized communities. Although a number of studies demonstrate that exposure to maternal depressive symptoms can undermine infants' regulatory development, less is known about the extent to which paternal depressive symptoms may also contribute. The current study investigated whether maternal and paternal depressive symptoms were uniquely associated with infants' physiological regulation, and whether associations varied depending on infant sex. Participants included 90 low-income Mexican American families. Fathers and mothers self-reported their depressive symptoms when infants were 15 weeks old, and infants' resting parasympathetic activity (i.e., respiratory sinus arrhythmia [RSA]) was assessed at 6 and 24 weeks. Results indicated that, after controlling for infant 6-week RSA and depressive symptoms in the other parent, paternal depressive symptoms were associated with lower 24-week RSA for both girls and boys, but maternal depressive symptoms were only associated with lower 24-week RSA for boys. Findings highlight a potential mechanism through which the consequences of parent depressive symptoms may reverberate across generations, and suggest that considerations of both infants' and parents' sex may lend insight into how best to intervene.

Quantifying the dynamic nature of vagal responsivity in infancy: Methodological innovations and theoretical implications.

According to polyvagal theory, rapid modulation of the vagal brake develops early in infancy and supports social interactions. Despite being viewed as a dynamic system, researchers typically assess vagal regulation using global measures of respiratory sinus arrhythmia (RSA; an index of vagal tone). This study sought to capture the dynamic property of RSA and evaluate individual differences in within-infant RSA responsivity during mother-infant interaction. RSA was evaluated in a sample of 135 6-month-old Mexican-American infants during a 5-min free play task. Mothers reported on their children's behavioral problems and competence at 18 months using the Brief Infant-Toddler Social and Emotional Assessment. Time-varying estimates of infant RSA during the interaction were obtained using a multiple window technique and spectrogram analysis. Using structural equation modeling, we evaluated whether within-infant SD of RSA predicted infants' behavioral problems and competence at 18 months, after adjusting for infants' mean RSA and covariates. Greater within-infant SD of RSA predicted more behavior problems at 18 months. This study demonstrates that assessing intra-individual variability in RSA, or the extent to which infants fluctuate around their average level of RSA during a task, enhances our ability to test polyvagal theory's central tenet: vagal regulation supports well-regulated social interaction.

Reducing cultural mismatch: Latino students' neuroendocrine and affective stress responses following cultural diversity and inclusion reminder.

Cultural mismatch theory suggests that a poor fit between the cultural values endorsed by individuals and the institutions to which they belong results in emotional distress and activation of physiological stress processes, particularly for underrepresented groups. To test a novel paradigm for reducing perceptions of this cultural mismatch, the current experiment evaluated whether reminding first-year Latino university students (N = 84; Mage = 18.56; SD = 0.35; 63.1% female; 85.7% Mexican descent; 65.5% first-generation college students) about institutional support for cultural diversity and inclusion would reduce neuroendocrine and affective responses to psychosocial stress. Prior to completing a modified version of the Trier Social Stress Test, participants were randomly assigned to view either a video conveying university commitment to cultural diversity and inclusion (n = 45) or a control video (n = 39) depicting a campus tour. Five saliva samples assayed for cortisol and corresponding negative affect measures were collected to assess stress reactivity and recovery patterns (pre-task baseline, post-task +30 min, +45 min, +60 min, +75 min). Repeated measures data were analyzed using bilinear spline growth models. Viewing the culture video (compared to control) significantly reduced cortisol reactivity to the TSST and post-task negative affect levels, specifically for students endorsing higher Latino cultural values (e.g., familism, respect). Post-task cortisol levels were also reduced for students endorsing higher U.S. mainstream cultural values (e.g., self-reliance, competition). Results provide novel evidence for cultural diversity in stress responsivity and individual variation in approaches to reduce perceived cultural mismatch.

Interleukin-6 and Depressive Mood Symptoms: Mediators of the Association Between Childhood Abuse and Cognitive Performance in Middle-Aged Adults.

Background: Childhood abuse is a risk factor for the development of cognitive deficits in adulthood, a relation that is likely mediated by stress-sensitive psychological and physiological indicators. Purpose: To evaluate whether the link between exposure to childhood abuse and cognitive function in middle adulthood is mediated by interleukin-6 (IL-6), metabolic risk, and depressive mood symptoms. Methods: Participants were 770 adults aged 40-65 recruited from the community, who completed the following: (i) a questionnaire assessing exposure to abuse prior to age 18, (ii) a phone interview assessing current depressive mood symptoms, and (iii) a home visit that included blood sampling for evaluation of IL-6 and assessment of metabolic risk indices. A follow-up telephone assessment evaluating cognitive function was completed by 555 of the participants. Structural equation modeling was used to test study hypotheses. Results: Childhood abuse predicted higher levels of IL-6, depressive mood symptoms, and metabolic risk scores (p < .05). The relation between childhood abuse and poorer cognitive performance was mediated by IL-6 (p = .046) and depressive mood symptoms (p = .023), but not metabolic risk. IL-6 and depressive mood symptoms significantly mediated the relation between childhood abuse and adult cognitive function. Conclusions: Exposure to early abuse conveys enduring physiological and psychological effects, which may contribute to cognitive deficits that are evident by middle adulthood. Increased vulnerability for cognitive decline among adults with a history of early trauma and the mediating roles of IL-6 and depressive mood symptoms point to the potential value of interventions that address inflammation or depression, singly or together, to prevent cognitive decline in this at-risk population.

Biological Sensitivity to the Effects of Maternal Postpartum Depressive Symptoms on Children's Behavior Problems.

Resting respiratory sinus arrhythmia (RSA) may confer infant susceptibility to the postpartum environment. Among infants with higher RSA, there may be a positive relation between depressive symptoms across the first 6 months postpartum (PPD) and later behavior problems, and toddlers' dysregulation during mother-child interactions may partially explain the effects. Among a sample of low-income Mexican-American families, infant RSA (N = 322; 46% male) was assessed at 6 weeks of age; mothers (Mage  = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 to 24 weeks and infant behavior problems at 36 months. Dysregulation was observed at 24 months. PPD was positively associated with behavior problems only among infants with lower RSA; however, this relation was not mediated by dysregulation.

Infants' Biological Sensitivity to the Effects of Maternal Social Support: Evidence Among Mexican American Families.

The identification of infants who are most susceptible to both negative and positive social environments is critical for understanding early behavioral development. This study longitudinally assessed the interactive effects of infant vagal tone (respiratory sinus arrhythmia; RSA) and maternal social support on behavioral problems and competence among 322 low-income Mexican American mother-infant dyads (infants: 54.1% female) and explored sex differences. Infant RSA was calculated from resting HR data at 6 weeks of age. Mothers reported on general social support, partner support, and family support at 6 months, and infant behavioral problems and competence at 1 year. Two-way interactions (RSA × support source) were evaluated to predict behavioral problems and competence, adjusting for covariates. Results indicated higher competence among infants with lower RSA whose mothers reported higher general support or higher partner support. Interactive effects on behavior problems of RSA with maternal partner or family support were only found for female infants: Girls with higher RSA showed more behavior problems when mothers reported low support, but fewer problem levels in the context of high support. Our results suggest that infant RSA is an important moderator of the effects of the early social environment on early development.

Respiratory sinus arrhythmia: Modeling longitudinal change from 6 weeks to 2 years of age among low-income Mexican Americans.

Parasympathetically-mediated heart rate variability (HRV), commonly indexed via respiratory sinus arrhythmia (RSA), is theorized to support the physiological regulation of emotion; however, little is known about the trajectory of change in resting RSA across early development among high-risk populations for whom emotion regulation is crucial. This study characterized resting RSA change from 6 weeks to 2 years of age among 312 low-income Mexican American infants. RSA was assessed longitudinally at 6, 12, 18, 24, 52, 78, and 104 weeks of age. On average, resting RSA increased as infants aged, and this change accelerated over time. There was significant variance between infants in resting RSA at 6 weeks of age, and in the slope, and acceleration of resting RSA change. Intraclass correlation among infants' resting RSA measures was minimal, indicating that resting RSA may not be "trait-like" during infancy. Results characterize early RSA development among a high-risk sample, which can inform theoretical understanding of the development of emotional, and behavioral self-regulation in a high-risk population, as well as efforts to promote wellbeing across early childhood.

Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women.

BACKGROUND: Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age. PURPOSE: The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women. METHODS: Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year. RESULTS: Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain. CONCLUSIONS: Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.