Childhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan.

BACKGROUND: Parent-child relationship quality can have long-term impacts on child mental health into adulthood. The impact of parental behaviors on the future mental health of children has been understudied in South Asia, where parenting approaches differ from the dominant western approaches often represented in the literature. METHODS: Mothers in rural Pakistan (N = 828) reported on their own mothers' parenting behaviors using the Parental Bonding Instrument (PBI) and were assessed for depression using the Structured Clinical Interview for DSM Disorders (SCID). The PBI includes scales for warmth (care scale) and over-control (protection scale), as well as subscales for behavioral control and psychological control. We used structural equation modeling to test the associations between depression and all PBI scales/subscales. RESULTS: Increased parental care was associated with lower probability of depression (B = -0.19, SE = 0.09). Parental protection was associated with higher probability of depression (B = 0.25, SE = 0.11). Among the protection subscales, behavioral control was associated with increased risk of depression (B = 0.24, 95 % SE = 0.11) and psychological control was associated with decreased risk of depression (B = -0.28, SE = 0.12). LIMITATIONS: This cross-sectional study used retrospective self-reports of parenting experiences. Participants only reported on their mothers, not fathers or other caregivers. CONCLUSIONS: In a rural Pakistani sample, maternal warmth was protective against adulthood depression. The association between maternal control and depression varied based on the type of control (behavioral or psychological), emphasizing the importance of nuanced measures of parental control in this context.

Longitudinal pathways between maternal depression, parenting behaviors, and early childhood development: a mediation analysis.

Maternal depression is a global public health concern with far-reaching impacts on child development, yet our understanding of mechanisms remains incomplete. This study examined whether parenting mediates the association between maternal depression and child outcomes. Participants included 841 rural Pakistani mother-child dyads (50% female). Maternal depression was measured at 12 months postpartum, parenting behaviors (warmth, stimulation, and harsh parenting) were measured at 24 months, and child outcomes (mental health, socioemotional development, and cognitive skills) were measured at 36 months. Maternal depression predicted increased harsh parenting, child mental health difficulties, and child socioemotional concerns; however, there was little evidence for parenting as a mediator between maternal depression and child outcomes. Sex-stratified results are discussed, and findings are situated in context.

Enhancing early parenting in the community: Preliminary results from a learning collaborative approach to scale up Attachment and Biobehavioral Catch-up.

Attachment and Biobehavioral Catch-up (ABC) is a promising home-visiting intervention promoting sensitive caregiving and secure parent-child attachment in families with young children. The goal of this study was to examine a learning collaborative approach to disseminating ABC in a community setting. Training outcomes (e.g., trainee completion, satisfaction, effectiveness of training methods) and intervention outcomes (e.g., parent behavior, parent beliefs, child socioemotional development) were examined. Eighteen practitioners participated in the ABC learning collaborative; 13 completed training. Quantitative and qualitative measures indicated that trainees were satisfied with their experience and valued the unique collaboration opportunities offered by the learning collaborative. In addition, trainees served 67 families in the community, 37 of whom completed all sessions of ABC. The study was conducted in the United States. Racial demographics of the children in the sample included: 56.7% White, 22.4% Black/African-American, 17.9% Bi- or Multi-racial, and 3.0% unknown. Regarding ethnicity, 80.6% were Non-Hispanic/Latino, 10.4% were Hispanic/Latino, and 9.0% were unknown. Caregivers who completed ABC showed more sensitive parenting behavior and reported positive changes in their perceived self-efficacy and their beliefs around infant crying. Children who received ABC showed increased socioemotional functioning. Results demonstrate successful dissemination of ABC in the community using a learning collaborative approach.

El Alcance de Afectividad y Bio-comportamiento (ABC) es una prometedora intervención de visita a casa que promueve el cuidado sensible y una relación progenitor-niño segura en familias con niños pequeños. El propósito de este estudio fue examinar un acercamiento de aprendizaje colaborativo para diseminar el ABC en un escenario comunitario. Se examinaron los resultados de entrenamiento (v.g. que el entrenado completó el proceso, satisfacción, efectividad de los métodos de entrenamiento) y los resultados de intervención (v.g. comportamiento del progenitor, creencias del progenitor, desarrollo socioemocional del niño). Dieciocho profesionales en la práctica participaron en el proceso de aprendizaje colaborativo; 13 completaron el entrenamiento, Las medidas cuantitativas y cualitativas indicaron que quienes se entrenaban estaban satisfechos con su experiencia y valoraron las oportunidades de colaboración que el proceso de aprendizaje colaborativo ofrecía de manera única. Adicionalmente, quienes se entrenaban les sirvieron a 67 familias en la comunidad, 37 de las cuales completaron todas las sesiones del ABC. El estudio se llevó a cabo en los Estados Unidos. Los perfiles demográficos raciales de los niños incluyen: 56.7% de raza blanca, 22.4% de raza negra o Afroamericanos, 17.9% birraciales o multirraciales, con un 3.0% cuya raza se desconoce. En cuanto a la etnicidad, 80.6% no eran hispanos o latinos, 10.4% eran hispanos o latinos, con un 9.0% cuya etnicidad se desconoce. Los cuidadores que completaron el ABC mostraron una conducta de crianza más sensible y reportaron cambios positivos en cuanto a su percepción de auto efectividad y su creencia acerca del llanto del infante. Los niños que recibieron el ABC mostraron un aumento en su funcionamiento socioemocional. Los resultados demuestran una exitosa diseminación del ABC en la comunidad usando un acercamiento de aprendizaje colaborativo.

L'attachement et le rattrapage bio-comportemental (en anglais Attachment and Biobehavioral Catch-up, soit ABC) est une intervention prometteuse de visite à domicile promouvant des soins sensibles et un attachement parent-enfant sécure chez les familles avec de jeunes enfants. Le but de cette étude est d'examiner une approche collaborative d'apprentissage à la dissémination de l'ABC dans le contexte d'une communauté. Les résultats de la formation (par exemple le fait de terminer le stage, la satisfaction, l'efficacité des méthodes de formation) et les résultats de l'intervention (par exemple le comportement du parent, les croyances parentales, le développement socio-émotionnel de l'enfant) ont été examinés. Dix-huit praticiens ont participé à la collaboration d'apprentissage ABC; 13 ont terminé la formation. Les mesures quantitatives and qualitatives ont indiqué que les stagiaires étaient satisfaits de leur expérience et avaient apprécié la chance d'une collaboration unique offerte par la collaboration d'apprentissage. De plus les stagiaires ont aidé 67 familles dans la communauté, 37 d'entre elles ayant terminé toutes les séances de l'ABC. L'étude a été faite aux Etats-Unis d'Amérique. Les données démographiques raciales des enfants dans l'échantillon ont inclus: 56,7% blancs, 22,4% noirs américains, 17,9% métisses ou multi-ethniques, et 3,0% de race inconnue. Concernant l'ethnicité, 80,6% était Non-Hispaniques/Non-Latinos, 10,4% étaient Hispaniques/Latinos et 9,0% étaient d'une ethnicité inconnue. Les personnes prenant soin des enfants qui ont complété l'ABC ont fait preuve d'un comportement de parentage plus sensible et fait état de changements positifs dans leur auto-efficacité perçue et leurs croyances concernant les pleurs des bébés. Les enfants ayant reçu l'ABC ont démontré un fonctionnement socio-émotionnel plus élevé. Les résultats démontrent une dissémination réussie de l'ABC dans une communauté en utilisant une approche collaborative d'apprentissage.

Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan.

Hypothalamic pituitary adrenal (HPA) axis activity may be a mechanism linking early adversity to child mental health difficulties. However, there is a dearth of longitudinal evidence for the association between HPA axis activity and mental health among children in low-resource contexts. The goal of this study is to examine linear and curvilinear associations between HPA axis activity during infancy and mental health difficulties in early childhood among children in rural Pakistan. Participants included 104 children (46% male) from the Bachpan study, a longitudinal cohort embedded within a maternal depression trial in Pakistan. We examined the associations between hair-derived cortisol and dehydroepiandosterone (DHEA) at 12 months old and mental health difficulties, measured with the Strengths and Difficulties Questionnaire (SDQ), at 36 months old. There was a significant quadratic association between hair cortisol and SDQ scores, with results showing a U-shaped relationship (i.e., having relatively high or low cortisol predicted increased mental health difficulties). DHEA showed a quadratic association with SDQ scores with an inverted U-shaped relationship (i.e., high and low DHEA was associated with decreased mental health difficulties). Results provide evidence of longitudinal and curvilinear effects of cortisol and DHEA during infancy on mental health difficulties in early childhood.

Mother-in-law childcare and perinatal depression in rural Pakistan.

BACKGROUND: Mothers-in-law often provide key childcare support to daughters-in-law during the perinatal period that may enhance maternal mental health. Yet, poor mother-in-law/daughter-in-law relationships may be associated with maternal depression. The extent to which mother-in-law childcare involvement affects perinatal depression may differ across contexts of family conflict. OBJECTIVE: We explored the relationship between mother-in-law childcare and daughter-in-law perinatal depression in rural Pakistan across contexts of family conflict. METHODS: Data on 783 women came from the Bachpan Cohort, a birth cohort in Pakistan. Maternally-reported mother-in-law childcare was assessed at 3 and 12 months postpartum using a 24-h recall and categorized into no, low, and high involvement. Major depression was captured at 3 and 12 months using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV. Family conflict was captured using three items from the Life Events Checklist. Log-Poisson models were used to estimate cross-sectional associations between mother-in-law childcare and perinatal depression, stratified by family conflict. RESULTS: Mother-in-law childcare was common in the first year postpartum. The association between mother-in-law childcare and perinatal depression differed by the presence of family conflict and postpartum timing. At 3 months postpartum, low and high mother-in-law childcare (vs no involvement) were associated with a lower prevalence of depression regardless of family conflict. At 12 months postpartum, among families with no conflict, low mother-in-law childcare (vs no involvement) was associated with lower perinatal depression; however, among families with conflict, high mother-in-law childcare was associated with increased perinatal depression. CONCLUSION: Our findings highlight the complexities of associations between mother-in-law childcare support and perinatal depression in the first year after birth. Mother-in-law childcare in the immediate postpartum period was beneficial for mothers. Understanding the source, amount, timing, and context of social support is necessary to inform research and interventions that aim to improve maternal mental health.

The physiology of maternal sensitivity to distress: An exploratory study of mothers' electrocortical and sympathetic nervous system reactivity.

Maternal sensitivity in response to infant distress is related to a number of physiological processes, including electrocortical activity and activation of the sympathetic nervous system. Several studies have examined these systems in isolation, but limited work to date has investigated how they may moderate one another in relation to maternal behavior. The current exploratory study aimed to investigate the interactive effect of the late positive potential (LPP) and skin conductance level (SCL) on observed maternal sensitivity to distress. Ninety-five mothers of 6- to 12-month-old infants participated in two reactivity tasks measuring their LPP and SCL responses to child crying stimuli. Maternal sensitivity to distress was coded from video-recorded mother-infant interactions. Results showed a significant interaction effect, such that LPP reactivity to infant crying was positively related to maternal sensitivity to distress among mothers with relatively low SCL reactivity. The findings highlight the importance of examining multiple systems when characterizing the physiological basis of maternal behavior.

Stressful life events, intimate partner violence, and perceived stress in the postpartum period: longitudinal findings in rural Pakistan.

PURPOSE: While the association between intimate partner violence (IPV) and stress is well documented, the directionality of this relationship is unclear. We use an adjusted longitudinal study design to better understand if stressful life events in the home precipitate or exacerbate intimate partner violence (IPV) and if experiences of IPV, in turn, increase levels of perceived stress. METHODS: Longitudinal data were collected among married women in rural Pakistan at 12 and 24 months postpartum (N = 815). Adjusted Poisson and linear regression models were used to examine stressful life events, past year IPV and severity (number and frequency of violent acts), and perceived stress (Cohen Perceived Stress Scale). RESULTS: At 12 months postpartum, the prevalence of past year physical, psychological, and sexual IPV was 8.5%, 25.7%, and 25.1%, respectively, with 42.6% experiencing any IPV. After adjustment, stressful life events were associated with a subsequent increased likelihood of all IPV types and increased severity of all but physical IPV. Any past year IPV (versus none) and greater IPV severity were associated with 3.43 (95% CI 2.33-4.52) and 2.57 (95% CI 1.87-3.27) point subsequent increases in perceived stress. Physical, psychological, and sexual IPV and their respective severities were all independently associated with increased perceived stress. CONCLUSIONS: Among postpartum women in Pakistan, stressful life events increase the likelihood of IPV and, in turn, experiences of IPV increase stress levels. Support to families undergoing stressful circumstances may be critical to reducing women's IPV exposure and resulting elevated stress.

Adverse childhood experiences and implications of perceived stress, anxiety and cortisol among women in Pakistan: a cross-sectional study.

OBJECTIVES: Adverse childhood experiences (ACEs) are linked to poor maternal mental health. The goal of this study is to examine the associations between ACEs and multiple manifestations of stress (including perceived stress, anxiety and cortisol) among mothers in rural Pakistan. DESIGN: This study used a cross-sectional design. Mothers were originally recruited during their third trimester of pregnancy and followed until 36 months post partum. Cortisol was collected at 12 months post partum, and self-report data were collected at 36 months post partum. SETTING: All participants reside in rural villages in Rawalpindi, Pakistan. The measures were administered at home visits by field interviewers. PARTICIPANTS: Data were collected from 889 mothers. All mothers in the sample provided data on ACEs and perceived stress, 623 provided data on anxiety and 90 provided hair cortisol. PRIMARY AND SECONDARY OUTCOMES MEASURES: ACEs were captured retrospectively using an adapted version of the ACE International Questionnaire, and represented as a continuous variable and subdomains (neglect, home violence, family psychological distress, community violence). Primary outcomes included perceived stress measured with the Cohen Perceived Stress Scale (PSS) and anxiety measured with the Generalised Anxiety Disorder-7 scale (GAD-7). Hair-derived cortisol was included as a secondary outcome. Generalised linear models with cluster-robust SEs were used to estimate associations between ACEs and the outcome variables. RESULTS: All models featured positive associations between ACE items and PSS. The continuous total ACE score (B=0.4; 95% CI 0.0 to 0.8) was associated with higher anxiety symptoms on the GAD-7. Home violence (B=6.7; 95% CI 2.7 to 10.8) and community violence (B=7.5; 95% CI 1.4 to 13.6) were associated with increased hair cortisol production. CONCLUSIONS: All four ACE domains were associated with elevated levels of perceived stress, anxiety and cortisol, with varying precision and strength of estimates, indicating that the type of ACE has a differential impact. This study informed our understanding of the differential impact of specific ACEs on perceived stress, anxiety and hypothalamic pituitary adrenal-axis functioning, providing implications for future clinical intervention and research development.

Effects of a maternal psychosocial intervention on hair derived biomarkers of HPA axis function in mothers and children in rural Pakistan.

Objective: Disruptions in the hypothalamic-pituitary-adrenal (HPA) axis are thought to be key neuroendocrine mechanisms involved in psychopathology and may have intergenerational impacts. Hair-derived HPA hormones offer a measure of long-term HPA axis activity that may be useful in assessing maternal and infant health. Building on a community-based randomized control trial of a perinatal depression intervention in Pakistan, we examine intervention effects on HPA axis activity in a subsample of mothers and infants. Methods: HPA axis activity was assessed using hair-derived cortisol, cortisone, and dehydroepiandosterone (DHEA). Hair samples were collected from mother-child dyads at one year postpartum from prenatally depressed women randomized to a cognitive-behavioral intervention (n = 35 dyads) or to enhanced usual care (n = 37 dyads), and from a comparison sample of women who screened negative for depression in pregnancy (n = 35 dyads). Results: The intervention group had 38 percent (p=0.01) lower maternal cortisol levels and 45 percent (p < 0.01) lower maternal cortisone compared to the EUC group. Maternal DHEA levels were higher among women in the intervention group compared to the EUC group by 29 percent (p = 0.02). Intergenerational intervention effects show higher DHEA levels in infants by 43% (p = 0.03). Infant cortisol and cortisone did not differ across groups. Conclusions: Results suggest that the perinatal depression intervention has effects on HPA axis activity in both mothers and children, providing evidence that treating maternal depression may impact physiological stress system functioning intergenerationally. In addition, utilizing hair-derived biomarkers of HPA-axis activity is a potentially useful clinical indicator of intervention impacts on the neuroendocrine system.

Early Adverse Experiences and Repeated Wheezing From 6 to 30 Months of Age: Investigating the Roles of Hypothalamic-Pituitary-Adrenal Axis Functioning, Child Sex, and Caregiving Sensitivity.

This study examined associations among early adversity, diurnal cortisol, child sex, and caregiver sensitivity at age 6 months in relation to wheezing in children (47% male) followed to 30 months. Analyses included 676 mother-child dyads, 393 of whom completed an observational caregiver sensitivity measure. Participants were primarily ethnic minorities (42.7% Black, 25.4% Hispanic); 22.1% of children had ≥ 1 wheezing episode. Higher adversity was associated with increased wheeze frequency and blunted diurnal cortisol slope. The indirect effect of adversity on wheezing through cortisol slope was significant for females, but not males. Higher caregiver sensitivity was protective against wheezing for males, but not females, with high cortisol. Findings suggest complex associations among adversity, cortisol, child sex, and caregiver sensitivity in predicting wheezing.

Indicators of deprivation predict diurnal cortisol regulation during infancy.

Dysregulation of diurnal cortisol rhythms is often seen among children exposed to early adversity and has been associated with a variety of negative physical and mental health outcomes. The present study examined whether two indicators of deprivation, sociodemographic burden and observed parental insensitivity, were associated with child diurnal cortisol rhythms among a diverse community sample of 250 infants ages 5 to 22 months (M = 12.68 months, 47.2% male). The sample was diverse in terms of socioeconomic status as assessed by household income (M = $59,163, SD = $57,775, range = $0-230,000) and infant race/ethnicity (41.6% African American, 19.2% White, 17.2% multiracial, 14.0% Hispanic/Latin, 2.8% Caribbean, 2.8% other, 1.2% American Indian/Alaska Native, and 1.2% Asian). Sociodemographic burden indicators were assessed through questionnaires completed by the parent. Parental sensitivity was assessed through observations of parents' interactions with their infants during a play interaction task. Cortisol was assayed from infant saliva samples collected at waking and bedtime across 3 days. Structural equation modeling revealed that higher sociodemographic burden, but not parental insensitivity, was associated with blunted diurnal cortisol slopes. Neither sociodemographic burden nor parental insensitivity were associated with the cortisol awakening response. These findings suggest that sociodemographic burden may be an important early predictor of diurnal cortisol slope dysregulation, highlighting the importance of interventions providing support to individuals who experience sociodemographic burden and promoting reduction of these early stressors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Externalizing behavior and stress system functioning in infants exposed to early adversity: A multi-system exploration.

Children who experience early adversity often show alterations across multiple stress response systems, including the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Changes in the diurnal rhythm of salivary cortisol (a marker of HPA axis functioning) and alpha-amylase (a marker of ANS functioning) may increase their probability of developing behavior problems. The goal of this study is to examine how these analytes may interact to predict externalizing behavior in infants exposed to early stress. Participants included 179 parents and their 6- to 20-month old infants recruited from a low-income neighborhood. Parents reported on their infants' externalizing behaviors and collected saliva samples from their children at wake-up and bedtime over three days. Diurnal cortisol and alpha-amylase were modeled using latent difference scores. Four models were tested examining the effects of cortisol and alpha-amylase morning values and slopes, as well as their interactions, on externalizing behavior. Results showed a significant interaction effect of cortisol and alpha-amylase morning values, such that low morning cortisol was associated with decreased externalizing behavior when morning alpha-amylase was high but not low. These findings highlight the importance of examining multiple systems when characterizing the physiological correlates of externalizing behavior among infants experiencing adversity.

Developmental pathways from preschool irritability to multifinality in early adolescence: the role of diurnal cortisol.

BACKGROUND: Early irritability predicts a broad spectrum of psychopathology spanning both internalizing and externalizing disorders, rather than any particular disorder or group of disorders (i.e. multifinality). Very few studies, however, have examined the developmental mechanisms by which it leads to such phenotypically diverse outcomes. We examined whether variation in the diurnal pattern of cortisol moderates developmental pathways between preschool irritability and the subsequent emergence of internalizing and externalizing symptoms 9 years later. METHOD: When children were 3 years old, mothers were interviewed about children's irritability and completed questionnaires about their children's psychopathology. Six years later, children collected saliva samples at wake-up and bedtime on three consecutive days. Diurnal cortisol patterns were modeled as latent difference scores between evening and morning samples. When children were approximately 12 years old, mothers again completed questionnaires about their children's psychopathology. RESULTS: Among children with higher levels of irritability at age 3, a steeper diurnal cortisol slope at age 9 predicted greater internalizing symptoms and irritability at age 12, whereas a blunted slope at age 9 predicted greater externalizing symptoms at age 12, adjusting for baseline and concurrent symptoms. CONCLUSION: Our results suggest that variation in stress system functioning can predict and differentiate developmental trajectories of early irritability that are relatively more internalizing v. those in which externalizing symptoms dominate in pre-adolescence.

Adult processing of child emotional expressions: A meta-analysis of ERP studies.

Numerous event-related potential (ERP) studies have examined adults' neural responses to child emotional expressions to understand the neurobiological mechanisms contributing to caregiving. It is unclear, however, whether one emotion evokes an enhanced response across components, and whether this pattern differs based on parent status or other sample characteristics. This meta-analysis quantified adult responses to child emotional expressions at the N170 and the late positive potential (LPP) components. Cohen's d reflected the difference between crying and neutral (CN), crying and laughing (CL), and laughing and neutral (LN) N170 and LPP amplitudes. Crying expressions elicited slightly enhanced N170 and LPP amplitudes relative to neutral and laughing expressions (N170 CN: k = 24, d = -0.09, p < 0.001; N170 CL: k = 30, d = -0.07, p = .004; LPP CN: k = 20, d = 0.12, p = .027; LPP CL: k = 27, d = 0.10, p < .001), and laughing expressions elicited slightly enhanced N170 amplitudes relative to neutral expressions (N170 LN: k = 21, d = -0.05, p = .02). Parental status, child age, risk factors for insensitive caregiving, and measurement characteristics moderated some effect sizes, with reference electrode emerging as the most consistent moderator. Results shed light on the typical pattern of neural response to child emotions and characteristics that may moderate this response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Latent profiles of maternal neural response to infant emotional stimuli: Associations with maternal sensitivity.

In the current study, we examined how latent profiles reflecting maternal neural response to infant emotional expressions predict observed parenting behavior. Participants included 86 mothers of infants. Maternal sensitivity was coded from video-recorded distress and play interactions; mothers' event-related potentials (ERPs) to child emotional expressions were measured from EEG activity recorded during a categorization task. Latent profile analysis of mothers' P200 and late positive potential (LPP) responses to crying and laughing child expressions identified three latent profiles, characterized by enhanced or attenuated responses to crying and laughing expressions at early and late stages of processing. Mothers' probability of being assigned to the "attenuated to distress" profile, characterized by undifferentiated early and late response to infant emotional expressions, was associated with reduced maternal sensitivity. Probability of being assigned to this profile was also correlated with sociodemographic risk. Profiles of maternal neural response to infant emotional expressions may enhance our understanding of the phenomenology of insensitive caregiving.

Secure attachment predicts lower body mass index in young children with histories of child protective services involvement.

BACKGROUND: Children who experience early adversity are at risk for obesity; secure attachment may be a protective factor as it has been linked to reduced obesity risk. OBJECTIVE: To evaluate whether (1) participation in a parenting intervention and (2) secure attachment were associated with body mass index (BMI) among young children with histories of child protective services (CPS) involvement. METHODS: A total of 105 parent-child dyads referred following CPS involvement were randomly assigned to receive Attachment and Biobehavioral Catch-up (ABC), which was designed to increase parental sensitivity, or a control intervention. Attachment security was assessed during infancy, and BMI was assessed at annual follow-up visits until children were 4 years old. RESULTS: Children in the ABC group were more likely to have secure attachments (52%) than children in the control intervention group (32%). Although the ABC intervention did not have a direct effect on children's BMI, secure attachment was associated with a steeper decline in BMI from age 2 to age 4, with secure children showing significantly lower BMI (M = 15.4, SD = 2.08; 16.6% overweight/obese) than insecure children (M = 17.6, SD = 3.81; 35.7% overweight/obese) at age 4. CONCLUSIONS: Secure attachment was associated with reduced BMI among CPS-referred children; thus, secure attachment may be a novel target of early obesity prevention efforts.

Homotypic and heterotypic continuity of internalizing and externalizing symptoms from ages 3 to 12: The moderating role of diurnal cortisol.

Psychological symptoms that arise in early childhood can follow a multitude of patterns into adolescence, including homotypic continuity (i.e., similar symptoms over time) and heterotypic continuity (i.e., a shift in symptoms over time). However, we know very little about the factors that distinguish homotypic vs. heterotypic continuity of early internalizing and externalizing symptoms over development. In a separate line of research, diurnal cortisol has been shown to predict later internalizing and externalizing problems. In the current study, we tested whether diurnal cortisol patterns moderated the course of internalizing and externalizing symptoms from preschool to early adolescence. 554 children (54% male) and parents participated in a longitudinal study. Parents reported on their children's internalizing and externalizing symptoms at ages 3 and 12, and children collected diurnal saliva samples at age 9. Results showed that a steeper cortisol decline at age 9 combined with high internalizing or externalizing problems at age 3 predicted higher internalizing problems at age 12. A more blunted cortisol decline combined with early internalizing or externalizing problems predicted higher externalizing problems in early adolescence. These results illustrate the moderating role of stress system functioning in homotypic and heterotypic patterns of psychopathology from preschool to early adolescence.

Longitudinal associations between low morning cortisol in infancy and anger dysregulation in early childhood in a CPS-referred sample.

Children who experience early adversity are at increased risk for developing psychopathology, and dysfunction of the hypothalamic pituitary adrenal (HPA) axis is a possible mechanism conferring this risk. This study sought to characterize the association between morning cortisol during different developmental periods and deficits in children's emotion regulation, a core feature of many psychological disorders. Morning cortisol was collected at two time points (i.e., during infancy, M = 13.0 months old, and during early childhood, M = 36.8 months old) from 120 children with histories of child protective services (CPS) involvement. Children completed a lab visit during early childhood (M = 38.6 months old) that involved an observational measure of anger regulation. Results showed that low morning cortisol during infancy, but not early childhood, predicted increased anger dysregulation during early childhood. These results highlight the importance of developmental timing in assessing the effects of HPA axis functioning and suggest that low cortisol during infancy is a risk factor for later emotion regulation difficulties.

Parental depressive history, parenting styles, and child psychopathology over 6 years: The contribution of each parent's depressive history to the other's parenting styles.

The link between parental depressive history and parenting styles is well established, as is the association of parenting with child psychopathology. However, little research has examined whether a depressive history in one parent predicts the parenting style of the other parent. As well, relatively little research has tested transactional models of the parenting-child psychopathology relationship in the context of parents' depressive histories. In this study, mothers and fathers of 392 children were assessed for a lifetime history of major depression when their children were 3 years old. They then completed measures of permissiveness and authoritarianism and their child's internalizing and externalizing symptoms when children were 3, 6, and 9 years old. The results showed that a depressive history in one parent predicted the other parent's permissiveness. Analyses then showed that child externalizing symptoms at age 3 predicted maternal permissiveness and authoritarianism and paternal permissiveness at age 6. Maternal permissiveness at age 6 predicted child externalizing symptoms at age 9. No relationships in either direction were found between parenting styles and child internalizing symptoms. The results highlight the importance of considering both parents' depressive histories when understanding parenting styles, and support transactional models of parenting styles and child externalizing symptoms.