Longitudinal change in symptoms of depression, anxiety and post-traumatic stress disorder during the COVID-19 pandemic among Mexican college students.

Longitudinal studies suggest the psychological difficulties precipitated by the COVID-19 pandemic have gradually declined, but our understanding of the factors that predict change in mental health is limited. We evaluated the mental health of Mexican college students during the early stage of the pandemic and 4 months later, as well as predictors of change in students' mental health. Participants were 648 students (71% women, Mage = 21.46) from a private University in Northern Mexico who completed online surveys from May 2020 to September 2020. Students' self-reported levels of mental health symptoms (depression, anxiety and post-traumatic stress disorder) significantly decreased from May to September. Poor physical health, more COVID-related worry and higher initial levels of peer social support predicted less change in psychological symptoms. On the other hand, more hours of sleep per night and a pre-existing mental health diagnosis predicted steeper decreases in symptoms. Findings suggest reductions in mental health difficulties that are consistent with theoretical frameworks of resilience among Mexican college students. In addition, results underscore the interplay between physical, psychological and social functioning, and the need for continued monitoring of mental health and intervention efforts that address physical health, sleep and pandemic-related worry in University settings.

The effects of IPV and mental health symptoms on HPA axis functioning during early pregnancy.

Maternal HPA axis dysregulation during early pregnancy can negatively affect maternal functioning. However, findings are mixed regarding how intimate partner violence (IPV), a common traumatic stressor, impacts HPA axis regulation during pregnancy. Interactions between IPV and mental health symptoms as they influence cortisol production are rarely examined, especially among pregnant women. Therefore, this study examined the impact of IPV, mental health symptoms, and their interactions on the maternal HPA axis during early pregnancy; 255 pregnant women, oversampled for experiences of IPV, completed a laboratory stressor and measures of depressive and post-traumatic stress symptoms (PTSS) at 15-18 weeks of pregnancy. Participants provided saliva samples following the Trier Social Stress Test that were assayed for cortisol; the area under the curve with respect to ground (AUCg) was computed as a measure of cortisol reactivity. The interactive effects of IPV, depressive symptoms, and PTSS on AUCg were significant, but the main effects were not. At low levels of depressive symptoms, the association between IPV and AUCg was negative; at moderate levels of depressive symptoms, it was not significant, and at high levels, it was positive. At low and moderate levels of PTSS, the effects of IPV on cortisol AUCg were not significant, but at high levels, the association was positive. IPV during early pregnancy was associated with both hyperactive and blunted stress reactivity, depending on the type and severity of mental health symptoms. These patterns of dysregulation of the HPA axis may have differential effects both for women's functioning throughout pregnancy as well as for the offspring.

COVID-19 related psychosocial problems among university students in Mexico - a longitudinal qualitative examination.

Research on the impact of the COVID-19 pandemic among college students around the world has primarily focused on their mental health symptoms and COVID-specific worry. However, contextually specific understanding of outbreak impacts is key to inform directed public health messaging and programming to improve wellbeing and coping. The current study aimed to identify the main psychosocial problems college students experienced during the first 6 months of the COVID-19 pandemic in Monterrey, Mexico. Participants were 606 college students (71% female) enrolled in a private university. Participants described COVID-related problems in an open-ended prompt as part of a longitudinal online survey: initially in May 2020, and then every 2 weeks for 3 months. Thematic analyses were conducted within a longitudinal inductive qualitative approach to rank responses by frequency across themes. Five major categories emerged. At baseline, over 75% of participants noted the outbreak negatively impacted their daily activities and responsibilities, 73% their mental health, 50% their physical health, 35% their interpersonal relationships, and 22% their economic situation. Concerns remained relatively stable throughout the follow-up period, with interpersonal and economic concerns becoming more prevalent as the pandemic progressed. Problems identified in this study can inform preventative measures for future health crises, including tailoring public health messaging and expanding access to contextually sensitive mental and behavioral health programming.

Validation of the Children’s Inventory of Anger (ChIA) with a Mexican sample / Validación del Cuestionario del Enojo para Niños (ChIA) con una muestra mexicana

The Children’s Inventory of Anger (ChIA) is a self-report measure that assesses the level of anger experienced by children and youth. Anger is asignificant predictor of aggression, peer relationships difficulties and antisocial behavior; therefore, is crucial to have a valid and reliable measure toevaluate it. The purpose of this study was to validate the ChIA for the Mexican children (ChIA-M). Participants were 638 students (M = 9.8 years; SD= 1.51), 49% were females from primary and secondary Mexican public schools. The exploratory factor analysis supported the four-factor structurewith a shared variance of 47.60%, but a different distribution of items. The confirmatory factor analysis indicated the model to be an acceptable fitwith the data χ 2 (338) = 1089.75, p ≤ .001, NFI = .82; IFI = .907, CFI = .906, RMSEA = .047. Good internal consistency was obtained for Totalscore α = .94 and subscales: Frustration α = .90, Aggression α = .88 , Peer Relationships α = .76 and Authority Relations α = .81. Convergentand divergent validity was supported through positive and significant correlations with the Anger Inventory for Mexican Children and the negligiblecorrelations with the Children Questionnaire of Positive Emotions. Results suggest that the Spanish version of the ChIA for Mexican population isa valid and reliable measure of child anger. However, attention should be paid to the cultural differences related to the experience of anger. Furtherresearch should continue evaluating the ChIA with clinical samples and children from different ages and regions in Mexico. (AU)

El Cuestionario del Enojo para Niños (ChIA) es un instrumentode autoinforme que evalúa el nivel de enojo experimentado por niños y jóvenes. El enojo es un predictor de la agresión, los problemas con pares yel comportamiento antisocial; por lo tanto, es crucial tener un instrumento válido y fiable. El propósito de este estudio fue validar el ChIA para niñosmexicanos (ChIA-M). Los participantes fueron 638 estudiantes (M = 9.8 años; SD = 1.51), 49 % eran mujeres de escuelas primarias y secundariaspúblicas mexicanas. El análisis factorial exploratorio apoyó la estructura de cuatro factores con una varianza compartida de 47.60 %, pero una distribución diferente de ítems. El análisis factorial confirmatorio indicó que el modelo ajusta aceptablemente χ 2 (338) = 1089.75, p ≤ .001, NFI = .82;IFI = .907, CFI = .906, RMSEA = .047. Se obtuvo buena consistencia interna para Puntaje total α = .94 y subescalas: Frustración α = .90, Agresiónα = .88, Relaciones con pares α = .76 y Relaciones con autoridad α = .81. Obtuvo evidencias de validez convergente y divergente con correlacionespositivas y significativas con el Inventario de Ira para Niños Mexicanos y correlaciones insignificantes con el Cuestionario de Emociones Positivaspara Niños. Los resultados sugieren que la versión en español del ChIA para población mexicana es un instrumento válido y fiable del enfado infantil.Sin embargo, se debe prestar atención a las diferencias culturales relacionadas con la experiencia de enojo. Se sugiere seguir investigando el ChIAcon muestras clínicas y niños de diferentes edades y regiones de México. (AU)

Conflict Appraisals and Trauma Symptoms in Children Exposed to Intimate Partner Violence.

Children exposed to intimate partner violence (IPV) are at risk for posttraumatic stress symptoms (PTSS) and alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated children's threat and self-blame appraisals about parental conflict as potential mechanisms leading to these adverse outcomes. Parent-child relationships were also examined. The sample consisted of 119 10-year-olds and their mothers who were recruited from the community as part of a larger study of IPV. Children's reports of IPV directed at their mother in the past year were not associated with PTSS; however, IPV exposure was associated with attenuated cortisol output in response to a social stressor. IPV exposure was also associated with greater threat appraisals and poorer quality parent-child relationships. These results provide further evidence that witnessing IPV is threatening for children, has negative consequences for parent-child relationships, and can impact children's HPA axis functioning.

Local clinician perspectives on cause, impact, and treatment of key expressions of distress in Cambodian children.

Child trauma and posttraumatic stress in Cambodia is highly prevalent, perpetuated within a postwar sociocultural context. The examination of locally meaningful expressions of distress is needed to provide culturally sensitive assessment and treatment of trauma-affected Cambodian children. The acceptable, feasible, and sustainable incorporation of expressions of distress into assessment and intervention development relies on key mental health professionals operating in Cambodia, who can provide invaluable perspectives on child trauma experiences in this particular sociocultural context. In this study, qualitative interviews were conducted with 15 Cambodian mental health professionals (MHPs) who work directly with trauma-affected Cambodian children. MHPs were presented with seven key posttraumatic problems derived from previous qualitative interviews with Cambodian children and caregivers, and discussed 1) the causes of these problems, 2) the impact of the problem on the child or those around them, 3) the current treatment for the problem in Cambodia, and 4) recommended treatment. MHPs provided unique insights and perspectives of trauma-affected children in the Cambodian context regarding key target problems, including palpitations, difficulties in school, headache, and thinking too much, and highlighted future directions for assessment and intervention. Recommendations are discussed in regard to programming design and organizational training development to promote culturally salient, feasible, and sustainable mental health service provision in Cambodia.

Key expressions of trauma-related distress in Cambodian children: A step toward culturally sensitive trauma assessment and intervention.

More than half of all children in Cambodia experience direct abuse and over 70% experience other traumatic events, which significantly increase their risks for a range of physical and mental health problems. Additionally, Cambodian children face longstanding sociopolitical, intergenerational, and cultural factors that compound the impact of other trauma. As a result, rates of posttraumatic stress symptoms among Cambodian youth are high. However, care providers often rely on Western-based nosology that does not account for culturally specific expressions of trauma. A greater understanding of culturally-salient expressions of distress can help inform diagnostic assessment accuracy and treatment effectiveness and monitoring. The current study utilized a qualitative design to interview 30 Cambodian caregivers of children with trauma experiences and 30 Cambodian children (ages 10-13 years) with trauma experiences to identify key local expressions of trauma. Findings reveal certain PTSD symptoms and culturally-specific frequent and severe trauma-related problems for Cambodian children and domains of functioning impacted by trauma. Certain symptoms seem particularly important to evaluate in this group, such as anger, physical complaints (e.g., headache and palpitations), and cognitive-focused complaints (in particular, "thinking too much"). All caregivers and children reported physical health as impacted by trauma-related problems, highlighting a particularly salient domain of functioning for this population. Expressions of distress explored in the current study are discussed in the context of assessment and intervention development to inform diagnostic and clinical efforts for those working with trauma-exposed Cambodian children.

Charting a Course towards Resilience Following Adverse Childhood Experiences: Addressing Intergenerational Trauma via Strengths-Based Intervention.

Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, the study of childhood adversity has blossomed, with expanded conceptualizations and assessments of ACEs. This review brings together various biological, psychological, and sociological principles that inform our understanding of ACEs and our approach to treatment. Specifically, we document the evolution of ACEs research, focusing on the intergenerational impact of ACEs, the importance of incorporating a resilience framework when examining ACEs, and implementing interventions that address adversity across generations and at multiple levels of the social ecology. Evidence is provided to support the evolving perspective that ACEs have long-lasting effects beyond the ACE(s)-exposed individual, with significant attention to the impact of parental ACEs on child development. An intergenerational and multilevel approach to understanding and addressing ACEs offers specific areas to target in interventions and in public policy.

Parent Cultural Stress and Internalizing Problems in Latinx Preschoolers: Moderation by Maternal Involvement and Positive Verbalizations.

Parent cultural stress has a pervasive and significant impact on family functioning and increases risk for socioemotional problems among Latinx children. Identifying factors that can protect against the negative influence of cultural stressors and enhance the developmental trajectories of Latinx children early in life is key as these children experience disproportionate risk for psychosocial adversity and internalizing mental health problems. The present study evaluated the effect of maternal cultural stress on young children´s internalizing problems, and the moderating role of maternal parenting behaviors. Participants were 65 Latinx children (3 to 5 years old, 50% female) and their mothers (21 to 47 years old, 68% immigrants) recruited from three Head Start Centers in the Chicagoland Area. Mother-reported cultural stress predicted young children's internalizing problems. In addition, maternal self-reported involvement and observed maternal positive verbalizations during one-on-one interactions with the child moderated the effect of cultural stress on child internalizing symptoms. Findings are discussed in the context of efforts to promote family and child resilience and implications for culturally sensitive measurement and intervention.

Child Appraisals of Interparental Conflict: The Effects of Intimate Partner Violence and Parent-Child Relationship Quality.

Children's appraisals of interparental violence, including appraisals of high threat and low coping efficacy, are robust predictors of behavioral and emotional problems. However, few studies have examined the factors that account for children's use of these maladaptive appraisals, particularly among children exposed to more severe forms of interparental conflict. The current study examines parent-child relationship quality as a mediator of the effect of intimate partner violence (IPV) exposure on children's appraisals of conflict. Participants were 118 mother-child dyads (54 girls and 64 boys), recruited from three Midwestern counties. Consistent with previous reports, child exposure to IPV, as reported by children's mothers, predicted higher threat and lower coping efficacy appraisals. In addition, mediation analyses showed child reports of parent-child relationship quality mediated the association between IPV and coping efficacy, but not the effects of IPV on threat appraisals. The role of parent-child relationships in shaping cognitive appraisals in the context of IPV exposure can have implications for prevention and intervention efforts as well as public policy.

Heterogeneous Trajectories of Depression Symptoms in Latino Youth.

Latino youth are at greater risk for depression relative to youth of other ethnic groups. The course of depression among Latino children and adolescents, however, remains largely unexamined, along with family and cultural factors that can help explain dissimilar symptom paths. The present study used growth mixture modeling to map trajectories of depression symptoms and to examine youth and parent familism as predictors of these trajectories. Participants were 133 Latino 5th- to 7th-grade students (Mage = 12.4 years, SD = 0.91; 55.6% boys) and a subsample of their parents (n = 89). Youth reported on their depression symptoms at four time points, including two surveys (Time 1 and Time 3) and two in-person interviews (Time 2 and Time 4) over the course of 2 years. Familism reports were obtained from youth at Time 1 and from parents at Time 2. The trajectories identified include stable-low, recovery, and escalating, and only youth familism predicted membership in these trajectories. Relative to those in the recovery trajectory, youth reporting higher familism were more likely to belong to the stable-low trajectory. This study helps to highlight the heterogeneous course of depression among Latino youth and illustrates the importance of incorporating youth perspectives on family cultural values when considering their well-being.

Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity.

The current study examined the role of hypothalamic-pituitary-adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at-risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers' depression was measured five times during the infants' first 18 months. Infant cortisol was collected during a social stressor (the still-face paradigm) when infants were 6 months old, and mothers reported on toddlers' internalizing and externalizing symptoms at 18 months. Among this sample of high-risk mother-infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.

Prenatal intimate partner violence exposure predicts infant biobehavioral regulation: Moderation by the brain-derived neurotrophic factor (BDNF) gene.

The ability to regulate stress is a critical developmental milestone of early childhood that involves a set of interconnected behavioral and physiological processes and is influenced by genetic and environmental stimuli. Prenatal exposure to traumatic stress and trauma, including intimate partner violence (IPV), increases risk for offspring biobehavioral regulation problems during childhood and adolescence. Although individual differences in susceptibility to prenatal stress have been largely unexplored, a handful of studies suggest children with specific genetic characteristics are most vulnerable to prenatal stress. We evaluated the brain-derived neurotrophic factor Val66Met gene (BDNF) as a moderator of the effect of prenatal IPV exposure on infant temperamental and cortisol regulation in response to a psychosocial challenge. Ninety-nine mother-infant dyads recruited from the community were assessed when infants (51% female) were 11 to 14 months. Maternal reports of IPV during pregnancy and infant temperament were obtained, and infant saliva was collected for genotyping and to assess cortisol reactivity (before and after the Strange Situation Task). Significant genetic moderation effects were found. Among infants with the BDNF Met allele, prenatal IPV predicted worse temperamental regulation and mobilization of the cortisol response, while controlling for infant postnatal exposure to IPV, other maternal traumatic experiences, and infant sex. However, prenatal IPV exposure was not associated with temperamental or cortisol outcomes among infant carriers of the Val/Val genotype. Findings are discussed in relation to prenatal programming and biological susceptibility to stress.

Postpartum depression and resilience predict parenting sense of competence in women with childhood maltreatment history.

This study examines the effect of a history of childhood maltreatment (CM) on parenting sense of competence, taking into account the influence of resilience and postpartum depressive symptoms as moderators of this relationship. Participants (N = 131) were a community sample of women recruited into a larger study of maternal childhood maltreatment. Women completed questionnaires over the phone at 4 months postpartum and parenting sense of competence (PSOC) was assessed during a home visit at 6 months postpartum. A three-way interaction emerged; women with low depression and high resilience factors maintained high levels of PSOC, even when they had a CM history. In contrast, among women with one postpartum risk factor (depression or low resilience) CM was associated with decreased PSOC. Results suggest that a mother's well-being postpartum moderates the effect of a childhood maltreatment history on her parenting sense of competence. Reducing postpartum depressive symptoms and enhancing resilience may be important components for interventions that address parenting confidence with maltreated women.

Maternal insightfulness protects against the detrimental effects of postpartum stress on positive parenting among at-risk mother-infant dyads.

The current study evaluated whether maternal insightfulness can buffer the negative influence of postpartum stressful life events on maternal parenting behaviors. Participants were 125 mother-infant dyads (55% boys) who present a subsample of a larger longitudinal study on maternal maltreatment during childhood and its impact on peripartum maternal adjustment. Women were primarily white and middle class. At 4 months postpartum, mothers reported on the stressful life events experienced after the child's birth and current depressive symptoms. At 6 months postpartum, maternal parenting quality was assessed using videotaped mother-infant interactions and maternal insightfulness was evaluated using the Insightfulness Assessment. Insightfulness significantly moderated the effect of postpartum stressful events on maternal parenting behaviors. Mothers who were insightful displayed high levels of positive parenting during interactions with their infant regardless of the amount of stressful life events experienced. In contrast, mothers classified as non-insightful showed less positive parenting as they experienced more stressful life events. Findings highlight the protective role of maternal insightfulness in the face of postpartum stress, and suggest that efforts to enhance insightfulness during the early postpartum period may be particularly relevant for women in high-risk contexts.

Social-ecological predictors of externalizing behavior trajectories in at-risk youth.

Extant research consistently links youth externalizing problems and later maladaptive outcomes, and these behaviors are particularly detrimental given their relative stability across development. Although an array of risk and protective factors for externalizing problems have been identified, few studies have examined factors reflecting the multiple social-ecological levels that influence child development and used them to predict longitudinal trajectories of externalizing problems. The current study examined externalizing behavior trajectories in a sample of 1,094 at-risk youth (539 boys, 555 girls) from the Longitudinal Studies in Child Abuse and Neglect multisite longitudinal study of child maltreatment. Normed Child Behavior Checklist externalizing scores were used to estimate group trajectories via growth-based trajectory modeling at ages 10, 12, 14, and 16 using the SAS PROC TRAJ procedure. Model fit was assessed using the Bayes information criterion and the Akaike information criterion statistics. Analyses revealed optimal fit for five distinct behavioral trajectories: low stable, mid-increasing, mid-decreasing, medium high, and high stable. Multinomial logistic regressions revealed that a combination of risk and protective factors at individual, family, school, and neighborhood levels contribute to distinct trajectories of externalizing problems over time. Predictors of low and decreasing trajectories can inform interventions aimed at addressing externalizing problems among high-risk adolescents.

Exposure to intimate partner violence in utero and infant internalizing behaviors: Moderation by salivary cortisol-alpha amylase asymmetry.

Guided by the main tenets of contemporary models of the developmental origins of health and disease, this study evaluated whether individual differences in reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and Sympathetic Nervous System (SNS) moderate the effect of prenatal exposure to trauma on internalizing and externalizing behaviors during infancy. Participants were a community sample of 182 mothers (M age=25years, 43% Caucasian, 33% Black/African American, 24% Biracial/Other) and their infants (59% girls; M age=11.8months). Each mother completed questionnaires that assessed IPV experienced during pregnancy and also reported on her infant's behavior problems. Infant saliva samples (later assayed for cortisol and sAA) were collected before and after a frustrating task (i.e., arm restraint). Results revealed that the association between in utero IPV and infant internalizing behaviors was most pronounced for infants with asymmetrical HPA-SNS (i.e., high-cortisol and low-sAA) reactivity to frustration, and least pronounced for infants with symmetrical HPA-SNS (i.e., low-cortisol and low-sAA or high-cortisol and high-sAA) reactivity to frustration. Higher levels of externalizing behavior, in contrast, were associated with higher levels of prenatal IPV but unrelated to either cortisol or sAA reactivity to stress. Findings replicate documented associations between maternal IPV exposure during pregnancy and offspring risk. Moreover, findings advance our understanding of individual differences in the developmental origins of health and disease and provide additional evidence that assessing multiple stress biomarkers contributes to a more comprehensive understanding of individual vulnerability to adversity.

Direct and Indirect Effects of Maltreatment and Social Support on Children's Social Competence Across Reporters.

Children's social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children's social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n = 783 caregiver-child dyads. CPS report history (age 0-8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity.

Profiles of Adaptation Among Child Victims of Suspected Maltreatment.

This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.