Buffering effects of safe, supportive, and nurturing relationships among women with childhood histories of maltreatment.

BACKGROUND: Adults who were victims of childhood maltreatment tend to have poorer health compared with adults who did not experience abuse. However, many are in good health. We tested whether safe, supportive, and nurturing relationships buffer women with a history of childhood maltreatment from poor health outcomes in later life. METHODS: Participants included women from the Environmental Risk (E-Risk) Longitudinal Twin Study who were involved in an intimate relationship at some point by the time their twin children were 10 years old. Women were initially interviewed in 1999-2000 (mean age = 33 years) and 2, 5, and 7 years later. They reported on their physical and mental health, and their health-risk behaviours. RESULTS: Compared with women who did not experience abuse in childhood, women with histories of maltreatment were at elevated risk for mental, physical, and health-risk behaviours, including major depressive disorder, sleep, and substance use problems. Cumulatively, safe, supportive, and nurturing relationships characterized by a lack of violence, emotional intimacy, and social support buffered women with a history of maltreatment from poor health outcomes. CONCLUSIONS: Our findings emphasize that negative social determinants of health - such as a childhood history of maltreatment - confer risk for psychopathology and other physical health problems. If, however, a woman's current social circumstances are sufficiently positive, they can promote good health, particularly in the face of past adversity.

Environmental risk, Oxytocin Receptor Gene (OXTR) methylation and youth callous-unemotional traits: a 13-year longitudinal study.

Youth with high callous-unemotional traits (CU) are at risk for early-onset and persistent conduct problems. Research suggests that there may be different developmental pathways to CU (genetic/constitutional vs environmental), and that the absence or presence of co-occurring internalizing problems is a key marker. However, it is unclear whether such a distinction is valid. Intermediate phenotypes such as DNA methylation, an epigenetic modification regulating gene expression, may help to clarify etiological pathways. This is the first study to examine prospective inter-relationships between environmental risk (prenatal/postnatal) and DNA methylation (birth, age 7 and 9) in the prediction of CU (age 13), for youth low vs high in internalizing problems. We focused on DNA methylation in the vicinity of the oxytocin receptor (OXTR) gene as it has been previously implicated in CU. Participants were 84 youth with early-onset and persistent conduct problems drawn from the Avon Longitudinal Study of Parents and Children. For youth with low internalizing problems (46%), we found that (i) OXTR methylation at birth associated with higher CU (age 13) as well as decreased experience of victimization during childhood (evocative epigenetic-environment correlation; birth-age 7), (ii) higher prenatal parental risks (maternal psychopathology, criminal behaviors, substance use) associated with higher OXTR methylation at birth and (iii) OXTR methylation levels were more stable across time (birth-age 9). In contrast, for youth with high internalizing problems, CU were associated with prenatal risks of an interpersonal nature (that is, intimate partner violence, family conflict) but not OXTR methylation. Findings support the existence of distinct developmental pathways to CU.

Interaction between serotonin transporter gene variants and life events predicts response to antidepressants in the GENDEP project.

There is substantial inter-individual variation in response to antidepressants, and genetic variation may, in part, explain these differences. For example, there is evidence to suggest that variation in the serotonin transporter gene (SLC6A4) predicts response to selective serotonin reuptake inhibitors (SSRIs). Environmental factors such as the occurrence of stressful life events before treatment may also be important. One prior report suggests that both factors interact in predicting response to antidepressants. GENDEP, a prospective part-randomized pharmacogenomics trial, collected longitudinal data on the outcome of 811 patients with major depression undergoing treatment with either an SSRI (escitalopram) or a tricyclic antidepressant (nortriptyline). Life events experienced over 6 months preceding treatment were measured using a List of Threatening Experiences Questionnaire, and several polymorphisms in the serotonin transporter gene (SLC6A4) have been genotyped including the serotonin transporter-linked polymorphic region (5-HTTLPR). Stressful life events were shown to predict a significantly better response to escitalopram but had no effect on response to nortriptyline. Variation in the 5-HTTLPR and another polymorphism in the gene, STin4, significantly modified these effects. Gene-environment interactions including life events may therefore be important not only in the aetiology of depression, but also in predicting response to antidepressant medication.

Gender differences in moral orientation: a meta-analysis.

C. Gilligan's (1982) critique of L. Kohlberg's theory of moral reasoning and her assertion that two modes of moral reasoning (justice and care) exist have been the subject of debate within the field of psychology for more than 15 years. This meta-analysis was conducted to review quantitatively the work on gender differences in moral orientation. The meta-analysis revealed small differences in the care orientation favoring females (d = -.28) and small differences in the justice orientation favoring males (d = .19). Together, the moderator variables accounted for 16% of the variance in the effect sizes for care reasoning and 17% of the variance in the effect sizes for justice reasoning. These findings do not offer strong support for the claim that the care orientation is used predominantly by women and that the justice orientation is used predominantly by men.

Plasma concentrations of lidocaine resulting from instillation of lidocaine jelly into genitourinary tract prior to cystoscopy.

Plasma concentrations of lidocaine were measured over a period of three hours following the instillation of lidocaine jelly (Xylocaine 2% Jelly) into the genitourinary tract of 30 patients (15 male, 15 female) scheduled for cystoscopy. The mean quantity of jelly instilled was 21.4 Gm (11-27.5 Gm) and of lidocaine HCl administered thereby 428 mg (218-550 mg). Plasma concentration reached measurable levels in only 5 cases, never exceeding 0.2 microgram/ml.

Child-rearing antecedents of intergenerational relations in young adulthood: a prospective study.

Data gathered from mothers on parenting and family climate when almost 1,000 children in the Dunedin, New Zealand, longitudinal study were 3, 5, 7, 9, 13, and 15 years of age were used to predict intergenerational relations between young adult children (age 26) and their middle-aged parents. Analyses focused on distinct developmental epochs revealed greater prediction from the middle-childhood and early-adolescent periods than from the early-childhood years: most indicated that more supportive family environments and child-rearing experiences in the family of origin forecasted more positive and less negative parent-child relationships (in terms of contact, closeness, conflict, reciprocal assistance) in young adulthood, though associations were modest in magnitude. Some evidence indicated that (modestly) deleterious effects on intergenerational relations of experiencing relatively unsupportive child-rearing environments in 1 but not 2 (of 3) developmental periods studied could be offset by relatively supportive family environments in the remaining developmental periods.

Gene-environment correlations: a review of the evidence and implications for prevention of mental illness.

Family studies have demonstrated genetic influences on environmental exposure: the phenomenon of gene-environment correlation (rGE). A few molecular genetic studies have confirmed the results, but the identification of rGE in studies that measure genes and environments faces several challenges. Using examples from studies in psychology and psychiatry, we integrate the behavioral and molecular genetic literatures on rGE, describe challenges in identifying rGE and discuss the implications of molecular genetic findings of rGE for future research on gene-environment interplay and for attempts to prevent disease by reducing environmental risk exposure. Genes affect environments indirectly, via behavior and personality characteristics. Associations between individual genetic variants and behaviors are typically small in magnitude, and downstream effects on environmental risk are further attenuated by behavioral mediation. Genotype-environment associations are most likely to be detected when the environment is behaviorally modifiable and highly specified and a plausible mechanism links gene and behavior. rGEs play an important causal role in psychiatric illness. Although research efforts should concentrate on elucidating the genetic underpinnings of behavior rather than the environment itself, the identification of rGE may suggest targets for environmental intervention even in highly heritable disease. Prevention efforts must address the possibility of confounding between rGE and gene-environment interaction (G x E).

Predicting early fatherhood and whether young fathers live with their children: prospective findings and policy reconsiderations.

This prospective study of a birth cohort addressed three questions. Which individual and family-of-origin characteristics predict the age at which young men make the transition to fatherhood? Do these same characteristics predict how long young men live with their child? Are individual differences in the amount of time fathers spend living with their child associated with the father's psychosocial characteristics in young adulthood? In this unique study, it was found that by age 26, 19% of the 499 study men had become fathers. Individual and family-of-origin characteristics were assessed from birth until age 15 and contemporaneous characteristics were assessed at age 26. Young men who experienced a stressful rearing environment and a history of conduct problems were more likely to become fathers at an early age and to spend less time living with their child. Of those who experienced none of the risk factors, fewer than 10% had become fathers by age 26 compared to more than 60% of those who experienced five risk factors. Fathers who lived apart from their child reported the most social and psychological difficulties in young adulthood. These findings point to individual and family-of-origin characteristics that might be targeted in order to delay fatherhood and increase levels of paternal involvement. However, given their troubled life histories and poor social-psychological adjustment in young adulthood, some absent fathers might have difficulties providing positive parenting and partnering unless policy initiatives to promote intact families also support young fathers.

Why are children born to teen mothers at risk for adverse outcomes in young adulthood? Results from a 20-year longitudinal study.

This 20-year longitudinal study showed that the young adult offspring of teen mothers are at risk for a range of adverse outcomes including early school leaving, unemployment, early parenthood, and violent offending. We tested how much the effect of teen childbearing on offspring outcomes could be accounted for by social selection (in which a woman's characteristics that make her an inadequate parent also make her likely to bear children in her teens) versus social influence (in which the consequences of becoming a teen mother also bring harm to her children, apart from any characteristics of her own). The results provided support for both mechanisms. Across outcomes, maternal characteristics and family circumstances together accounted for approximately 39% of the effect of teen childbearing on offspring outcomes. Consistent with a social-selection hypothesis, maternal characteristics accounted for approximately 18% of the effect of teen childbearing on offspring outcomes; consistent with a social-influence hypothesis, family circumstances accounted for 21% of the teen childbearing effect after controlling for maternal characteristics. These results suggest that public policy initiatives should be targeted not only at delaying childbearing in the population but at supporting individual at-risk mothers and their children.