Physiological Stress Response Reactivity Mediates the Link Between Emotional Abuse and Youth Internalizing Problems.

Youth who are raised in emotionally abusive families are more likely to have poor mental health outcomes such as depression and anxiety. However, the mechanisms of this association are unclear. The present study utilized a longitudinal sample of low-SES youth (N = 101, MageT1 = 10.24) to examine stress response reactivity (i.e. vagal withdrawal, sympathetic activation, and hypothalamic-pituitary-adrenal [HPA] axis activation) as mediators between emotional abuse and prospective youth internalizing symptoms. Results indicated that blunted HPA reactivity to a laboratory social stress task mediated the association between emotional abuse and youth internalizing symptoms. Emotional abuse was also associated with blunted parasympathetic nervous system activity (i.e. less vagal withdrawal than average). In sum, emotional abuse is a potent risk factor for youth internalizing symptoms, and this link may be mediated via dysregulation in physiological stress response systems. Primary prevention of childhood emotional abuse and secondary prevention programs that target self-regulation skills may reduce rates of youth internalizing symptoms and disorders.

Developmental pathways from child maltreatment to adolescent suicide-related behaviors: The internalizing and externalizing comorbidity hypothesis.

Child maltreatment is a robust risk factor for suicidal ideation and behaviors during adolescence. Elevations in internalizing and externalizing symptomology have been identified as two distinct developmental pathways linking child maltreatment and adolescent risk for suicide. However, recent research suggests that the co-occurrence of internalizing and externalizing symptomology may form a distinct etiological pathway for adolescent risk behaviors. Using the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) sample (N = 1,314), the present study employed a person-centered approach to identify patterns of concurrent change in internalizing and externalizing psychopathology over five time points from early childhood to adolescence in relation to previous experiences of child maltreatment and subsequent suicidal ideation and behaviors. Results indicated four distinct bivariate externalizing and internalizing growth trajectories. Group membership in a heightened comorbid internalizing and externalizing symptom trajectory mediated the association between childhood abuse and adolescent suicidal ideation and suicidal behaviors. These findings suggest that the concurrent development of externalizing and internalizing symptoms in childhood and adolescence may constitute a unique developmental trajectory that confers risk for suicide-related outcomes.

Child Maltreatment, Delayed Reward Discounting, and Alcohol and Other Drug Use Problems: The Moderating Role of Heart Rate Variability.

BACKGROUND: Child maltreatment (CM) is robustly associated with youth risk for addictive behaviors, and recent findings suggest that this may be mediated through impulsive discounting of future rewards. However, research indicates that youth self-regulation (emotional and cognitive), particularly in peer contexts, is critical to consider in the study of decision making. This study aimed to examine the indirect link between CM and alcohol and other drug use problems, through delayed reward discounting (DRD), among a community sample of emerging adults. Further, this investigation aimed to examine whether this indirect link was moderated by heart rate variability (HRV), a physiological proxy for regulation of stress reactivity. METHODS: A sample of emerging adults (N = 225; Mage  = 21.56; SDage  = 2.24; 52.9% female) was assessed at 2 time points, with 1 year between assessments. The sample was comprised of rural emerging adults from lower socioeconomic backgrounds. DRD was examined using a monetary choice task, and HRV reactivity was derived during a social stress task. RESULTS: Increased CM experiences were significantly linked to riskier DRD. HRV reactivity amplified the indirect effect between CM and alcohol use problems via riskier DRD. CONCLUSIONS: The results demonstrate that the connection between CM and alcohol use problems via impulsive decision making is modulated by acute stress response reactivity, as indexed by HRV.

Child Abuse and Neglect, Callous-Unemotional Traits, and Substance Use Problems: the Moderating Role of Stress Response Reactivity.

Young adults who experienced child abuse and neglect (CAN) are at significant risk for callous-unemotional traits and substance use problems. Research shows that compromised self-regulation may increase risk for these maladaptive outcomes. In the present cross-sectional study, we examined the moderating role of self-regulation, indexed by heart rate variability reactivity, in the indirect link between CAN and alcohol and other drug use problems via callous-unemotional traits. We utilized a sample of mostly female undergraduate students (N = 130, 81% Female; M age = 20.72). We hypothesized that (a) CAN and alcohol or other drug use problems would be associated indirectly via elevations in callous-unemotional traits, and (b) that this indirect association would be exacerbated by elevated heart rate variability reactivity. Results indicated that increased callous-unemotional traits underlain in the link between CAN and alcohol or other drug use problems. Further, this indirect link was exacerbated among youth with elevated heart rate variability reactivity. These findings have significant implications for prevention by demonstrating that physiological self-regulation is important to target in substance use prevention among collegiate samples.

A longitudinal investigation of protective factors for bereaved maltreated youth.

BACKGROUND: Maltreated youth are at an elevated risk for the development of problem behaviors. Coping with the death of a family member or close friend during adolescence, referred to as bereavement, is a stressful event that could potentiate risk linked to maltreatment. However, developmental research suggests that youth adjustment is a product of multiple risk and protective factors. Although maltreated youth who experience loss may be particularly vulnerable to behavior problems, personal and contextual factors may attenuate or exacerbate youths' risk for internalizing and externalizing psychopathology. OBJECTIVE: The overarching goal of this study is to examine individual, family, and community-level protective factors for maltreated youth who experience bereavement. Specifically, we aim to examine the effect of age 12 bereavement on age 16 internalizing and externalizing psychopathology, and to investigate the moderating role of multi-level protective factors at ages 14 and 16. METHODS: The study consisted of a sample of 800 youth (52.4% female, 45.1% African-American) drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), collected from 1998 to 2011. RESULTS: Maltreated youth who experienced significant loss were at increased risk for externalizing symptoms, compared to non-bereaved maltreated youth (ß = 0.085, p < .05). Individual future orientation (ß = 0.103, p < .05) family future orientation (ß = -0.120, p < .05), parental monitoring (ß = -0.123, p< .01), and neighborhood collective efficacy (ß = -0.126, p < .01) each significantly moderated the association between bereavement and externalizing symptoms. CONCLUSIONS: These results have implications for future interventions aimed towards reducing problem behaviors in adolescents with a history of child maltreatment and who experience bereavement.

Childhood Maltreatment, Self-esteem, and Suicidal Ideation in a Low-SES Emerging Adult Sample: The Moderating Role of Heart Rate Variability.

Childhood maltreatment is associated with risk for suicidal ideation later in life, yet more research is needed on the indirect effects and bioregulatory protective factors in this association. The present study aimed to investigate the indirect influence of childhood maltreatment on suicidal ideation in emerging adulthood via level of self-esteem, and examine the moderating role of heart rate variability (HRV; a proxy for emotion regulation) in this indirect association. The study included a sample of 167 non-metropolitan emerging adults (Mage = 21.17, 55.8% female) of low-socioeconomic status (low-SES). HRV data were obained using an electrocardigram, whereas childhood maltreatment, suicidal ideation, and self-esteem data were obtained via self-report. Childhood maltreatment was indirectly associated with suicidal ideation via reduced self-esteem. HRV buffered this indirect association. Childhood maltreatment poses a risk for the development of suicidal ideation. Interventions that bolster self-esteem and emotion regulation may reduce suicide risk for emerging adults with a history of childhood maltreatment.

Adverse Childhood Experiences and Amygdalar Reduction: High-Resolution Segmentation Reveals Associations With Subnuclei and Psychiatric Outcomes.

The aim of the present study was 2-fold: (1) to utilize improved amygdala segmentation and exploratory factor analysis to characterize the latent volumetric structure among amygdala nuclei and (2) to assess the effect of adverse childhood experiences (ACEs) on amygdalar morphometry and current psychiatric symptoms. To investigate these aims, structural (T1) MRI and self-report data were obtained from 119 emerging adults. Regression analysis showed that higher ACE scores were related to reduced volume of the right, but not the left, amygdalar segments. Further, exploratory factor analysis yielded a two-factor structure, basolateral and central-medial nuclei of the right amygdala. Stractual equation modeling analyses revealed that higher ACE scores were significantly related to a reduced volume of the right basolateral and central-medial segments. Furthermore, reduction in the right basolateral amygdala was associated with increased anxiety, depressive symptoms, and alcohol use. This association supports an indirect effect between early adversity and psychiatric problems via reduced right basolateral amygdalar volume. The high-resolution segmentation results reveal a latent structure among amygdalar nuclei, which is consistent with prior work conducted in nonhuman mammals. These findings extend previous reports linking early adversity, right amygdala volume, and psychopathology.