Does HPA-Axis Dysregulation Account for the Effects of Income on Effortful Control and Adjustment in Preschool Children?

Playgrounds are for children: Investigating developmentally-specific "Green Space" and child mental health

"Green space" effects on health have been amply demonstrated, but whether specific features of green space exert differential effects remains unknown. Driven by developmental psychology theory highlighting the importance of play for young children, we investigated the association between parks with playgrounds, as a subtype of "green space", and young child mental health. After adjusting for individual race, sex, income, and cumulative risk as well as neighborhood disadvantage, we find that children (N=95) living near parks with playgrounds have better mental health than those near parks without playgrounds (β ˆ = - 1.22 (95% CI: -3.82 - 1.38, p=0.36) Child Behavior Checklist scale). While not statistically significant, the observed difference, which is equivalent to 11% of the baseline mean score, is meaningful. Our results, while only suggestive, indicate that moving beyond "green space" to investigate developmentally-specific features may be worthwhile.

Maternal Psychological Problems During Pregnancy and Child Externalizing Problems: Moderated Mediation Model with Child Self-regulated Compliance and Polygenic Risk Scores for Aggression

A potential pathway underlying the association between prenatal exposure to maternal psychological problems and childhood externalizing problems is child self-regulation. This prospective study (N = 687) examined whether self-regulated compliance mediates the relation between maternal affective problems and hostility during pregnancy and childhood externalizing problems, and explored moderation by child polygenic risk scores for aggression and sex. Self-regulated compliance at age 3 was observed in mother-child interactions, and externalizing problems at age 6 were reported by mothers and teachers. Polygenic risk scores were calculated based on a genome-wide association study of aggressive behavior. Self-regulated compliance mediated the associations between maternal psychological problems and externalizing problems. Aggression PRS was associated with higher externalizing problems reported by mothers. No evidence was found of moderation by aggression PRS or sex. These findings support the hypothesis that maternal psychological problems during pregnancy might influence externalizing problems through early self-regulation, regardless of child genetic susceptibility or sex.

Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study

A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child's birth and children's adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child's development and health.

The Mediating Effect of Self-Regulation in the Association Between Poverty and Child Weight: A Systematic Review

Deficits in self-regulation (SR) have been proposed as a potential contributor to child overweight/obesity, a public health concern that disproportionately affects children living in poverty. Although poverty is known to influence SR, SR has not been considered as a potential mechanism in the association between poverty and child obesity. The aim of the current paper was to systematically review the current literature to determine whether SR is a viable mechanism in the relationship between child exposure to poverty and later risk of overweight/obesity. We systematically review and summarize literature in three related areas with the aim of generating a developmentally informed model that accounts for the consistent association between poverty and child weight, specifically how: (1) poverty relates to child weight, (2) poverty relates to child SR, and (3) SR is associated with weight. To quantify the strength of associations for each pathway, effect sizes were collected and aggregated. Findings from the studies included suggest small but potentially meaningful associations between poverty and child SR and between SR and child weight. The conceptualization and measurement of SR, however, varied across literature studies and made it difficult to determine whether SR can feasibly connect poverty to child obesity. Although SR may be a promising potential target for obesity intervention for low-income children, additional research on how SR affects risk of obesity is crucial, especially based on the lack of success of the limited number of SR-promoting interventions for improving children's weight outcomes.

Pathways from early adversity to later adjustment: Tests of the additive and bidirectional effects of executive control and diurnal cortisol in early childhood

Additive and bidirectional effects of executive control and hypothalamic-pituitary-adrenal (HPA) axis regulation on children's adjustment were examined, along with the effects of low income and cumulative risk on executive control and the HPA axis. The study utilized longitudinal data from a community sample of preschool age children (N = 306, 36-39 months at Time 1) whose families were recruited to overrepresent low-income contexts. We tested the effects of low income and cumulative risk on levels and growth of executive control and HPA axis regulation (diurnal cortisol level), the bidirectional effects of executive control and the HPA axis on each other, and their additive effects on children's adjustment problems, social competence and academic readiness. Low income predicted lower Time 4 executive control, and cumulative risk predicted lower Time 4 diurnal cortisol level. There was little evidence of bidirectional effects of executive control and diurnal cortisol. However, both executive control and diurnal cortisol predicted Time 4 adjustment, suggesting additive effects. There were indirect effects of income on all three adjustment outcomes through executive control, and of cumulative risk on adjustment problems and social competence through diurnal cortisol. The results provide evidence that executive control and diurnal cortisol additively predict children's adjustment and partially account for the effects of income and cumulative risk on adjustment.

"Food" and "non-food" self-regulation in childhood: a review and reciprocal analysis

BACKGROUND

In developmental science, there is an extensive literature on non-food related self-regulation in childhood, where several domains relating to emotions, actions and cognitions have been identified. There is now growing attention to food related self-regulation in childhood, especially difficulties with ASR, and the consequences for weight gain and adiposity. The aim of this narrative review was to conduct a reciprocal analysis of self-regulation in the food and non-food domains in childhood (referred to as appetite self-regulation (ASR) and general self-regulation (GSR) respectively). The focus was on commonalities and differences in key concepts and underpinning processes.

METHODS

Databases and major journals were searched using terms such as self-regulation, appetite self-regulation, or self-regulation of energy intake, together with associated constructs (e.g., Executive Function, Effortful Control, delay-of-gratification). This was followed by backward and forward snowballing.

RESULTS AND DISCUSSION

The scholarship on GSR in childhood has had a focus on the role of the cognitively-oriented Executive Function (EF), the temperamentally-based Effortful Control (EC) and the recursive interplay between bottom-up (reactive, emotion driven, approach or avoidance) and top-down (cognitive, conscious decision-making) processes. "Hot" and "cool/cold" EF and self-regulation situations have been distinguished. There were some parallels between GSR and ASR in these areas, but uncertainty about the contribution of EF and EC to ASR in young children. Possible differences between the contribution to ASR-related outcomes of delay-of-gratification in food and non-food tasks were apparent. Unique elements of ASR were identified; associated with psychological, biological and neurological responses to food and bottom-up processes. A diverse number of situations or elements connected to ASR exist: for example, energy balance homeostasis, caloric compensation, hunger regulation, satiation, satiety, energy density of food, eating in the absence of hunger, emotional eating, etc. CONCLUSIONS: Self-regulation in food and non-food domains are amenable to a reciprocal analysis. We argue that self-regulation of appetite should be added as a domain under the umbrella of self-regulation in childhood along with the other non-food related domains. This could lead to a broader understanding of self-regulation in childhood, and generate novel lines of enquiry.

Associations between Effortful Control, Cortisol Awakening Response, and Depressive Problems in Latino Preadolescents

The present study examined associations between effortful control, a trait marker of self-regulation, adaptive HPA system functioning (as reflected by the CAR), and concurrent and longitudinal depressive problems, in a sample of preadolescent Latino youth (N = 119, mean age = 11.53 years, 59% female). We hypothesized that trait readiness for self-regulation (e.g., effortful control) could be related to physiological state readiness for self-regulation (e.g., CAR), and that both may counter depressive problems. We found that youth's CAR was positively associated with effortful control, and negatively with youth depressive problems. Effortful control and youth depressive problems were also negatively associated. Longitudinal relations of CAR and effortful control on depressive problems at T2 were not significant in the structural equation model after controlling for T1 depressive problems, although these variables were significant in the bivariate correlations. Results suggest that both trait-regulation and physiological regulation may counter depressive problems in Latino youth.

Maternal witness to intimate partner violence during childhood and prenatal family functioning alter newborn cortisol reactivity

Witnessing intimate partner violence (IPV) during childhood is a risk factor for mental health problems across the lifespan. Less is known about the intergenerational consequences of witnessing IPV, and if the current family climate buffers intergenerational effects of witnessing violence. The mother's experience of witnessing IPV against her own mother during childhood, prenatal family dysfunction, and prenatal perceived stress were examined as predictors of offspring cortisol in the first month of life (N = 218 mother-infant dyads). Mothers reported on witnessing IPV in their childhoods, prenatal family dysfunction, and prenatal perceived stress in pregnancy. At 2 days and again at 1 month postpartum, infants engaged in a neurobehavioral exam to assess infant cortisol reactivity. Infants whose mothers witnessed IPV in childhood exhibited alterations in their baseline cortisol and their cortisol reactivity at 1 month of age, whereas family dysfunction during pregnancy was associated with baseline cortisol and cortisol reactivity at 2 days of age. Prenatal perceived stress was not associated with infant cortisol at 2 days or 1 month. Prenatal family dysfunction and perceived stress did not moderate effects of the mother's experience of witnessing IPV. Results support the view that maternal experiences in childhood and during pregnancy exert intergenerational effects on the HPA stress response system.

Children's cortisol response to the transition from preschool to formal schooling: A review

This review examines the current state of knowledge regarding children's biological stress response during the transition from preschool to compulsory formal schooling, focusing on longitudinal studies that include repeated measures of cortisol concentrations in saliva or scalp hair. In all, eight independent studies (ten publications) were found and their results support the hypothesis that the transition from preschool to formal schooling coincides with an increase in cortisol concentration in both saliva and hair. Evidence of recovery (i.e. decrease in stress response over time) is more limited and suggests that it could take as many as 3-6 months before kindergarten children's cortisol concentration returns to baseline levels. However, important individual differences are observed. Potential predictors that have received some empirical support include child temperament (fearfulness/inhibition or surgency/extroversion) and prenatal maternal stress or anxiety. Very few studies, however, have examined whether there are actual functional consequences of individual differences in children's cortisol response associated with this transition. Finally, current methodological limitations and avenues for future studies are discussed.

Featured Article: Community Crime Exposure and Risk for Obesity in Preschool Children: Moderation by the Hypothalamic-Pituitary-Adrenal-Axis Response

Objective

Identification of early risk factors related to obesity is critical to preventative public health efforts. In this study, we investigated links between the Hypothalamic-Pituitary-Adrenal (HPA)-axis activity (diurnal cortisol pattern), geospatially operationalized exposure to neighborhood crime, and body mass index (BMI) for a sample of 5-year-old children. Greater community crime exposure and lower HPA-axis activity were hypothesized to contribute to higher BMI, with child HPA-axis moderating the association between crime exposure and BMI.

Method

Families residing within the boundaries of the City of Seattle (N = 114) provided information concerning demographic/psychosocial risk factors, used to calculate a Cumulative Risk Index, indicating the number of contextual adversities present. Child BMI and diurnal cortisol pattern (derived from assays of saliva samples) were examined, along with neighborhood crime indices computed with publically available information, based on participants' locations.

Results

Hierarchical multiple regression analyses, adjusted for covariates (cumulative risk, age, and sex), indicated that crime proximity made a unique contribution to child BMI, in the direction signaling an increase in the risk for obesity. Consistent with our hypothesis, a significant interaction was observed, indicative of moderation by diurnal cortisol pattern. Follow-up simple slope analyses demonstrated that crime exposure was significantly related to higher BMI for children with low-flat (blunted) diurnal cortisol patterns, where community crime and BMI were not significantly associated at higher levels of cortisol.

Conclusion

Community crime exposure contributes to higher BMI as early as the preschool period, and blunted diurnal cortisol patterns may place children experiencing neighborhood adversity at greater risk for obesity.

Parenting matters: Moderation of biological and community risk for obesity

Contributions of parental limit setting, negativity, scaffolding, warmth, and responsiveness to Body Mass Index (BMI) were examined. Parenting behaviors were observed in parent-child interactions, and child BMI was assessed at 5 years of age. Mothers provided demographic information and obtained child saliva samples used to derive cortisol concentration indicators (N = 250). Geospatial crime indices were computed based on publically available information for a subsample residing within the boundaries of a Pacific Northwest city (N = 114). Maternal warmth and limit setting moderated the association between child HPA-axis regulation and BMI. BMI was higher for children at lower cortisol concentrations with greater maternal warmth and lower for youngsters with mid-range cortisol values under high maternal limit setting. Maternal scaffolding moderated the effects of crime exposure, so that lower scaffolding translated into higher child BMI with greater neighborhood crime exposure. These parenting behaviors could be leveraged in obesity prevention/intervention efforts.

The Nexus Between Nutrition and Early Childhood Development

This article looks at both nutrition and early childhood stimulation interventions as part of an integrated life cycle approach to development. We build on recent systematic reviews of child development, which are comprehensive in regard to what is currently known about outcomes reported in key studies. We then focus particularly on implementation, scaling, and economic returns, drawing mainly on experience in low- and middle-income countries where undernutrition and poor child development remain significant public health challenges with implications across the life course.

Vagal Tone and Children's Delay of Gratification: Differential Sensitivity in Resource-Poor and Resource-Rich Environments

Children from different socioeconomic backgrounds have differing abilities to delay gratification, and impoverished children have the greatest difficulties in doing so. In the present study, we examined the role of vagal tone in predicting the ability to delay gratification in both resource-rich and resource-poor environments. We derived hypotheses from evolutionary models of children's conditional adaptation to proximal rearing contexts. In Study 1, we tested whether elevated vagal tone was associated with shorter delay of gratification in impoverished children. In Study 2, we compared the relative role of vagal tone across two groups of children, one that had experienced greater impoverishment and one that was relatively middle-class. Results indicated that in resource-rich environments, higher vagal tone was associated with longer delay of gratification. In contrast, high vagal tone in children living in resource-poor environments was associated with reduced delay of gratification. We interpret the results with an eye to evolutionary-developmental models of the function of children's stress-response system and adaptive behavior across varying contexts of economic risk.

Intergenerational transmission of self-regulation: A multidisciplinary review and integrative conceptual framework

This review examines mechanisms contributing to the intergenerational transmission of self-regulation. To provide an integrated account of how self-regulation is transmitted across generations, we draw from over 75 years of accumulated evidence, spanning case studies to experimental approaches, in literatures covering developmental, social, and clinical psychology, and criminology, physiology, genetics, and human and animal neuroscience (among others). First, we present a taxonomy of what self-regulation is and then examine how it develops--overviews that guide the main foci of the review. Next, studies supporting an association between parent and child self-regulation are reviewed. Subsequently, literature that considers potential social mechanisms of transmission, specifically parenting behavior, interparental (i.e., marital) relationship behaviors, and broader rearing influences (e.g., household chaos) is considered. Finally, evidence that prenatal programming may be the starting point of the intergenerational transmission of self-regulation is covered, along with key findings from the behavioral and molecular genetics literatures. To integrate these literatures, we introduce the self-regulation intergenerational transmission model, a framework that brings together prenatal, social/contextual, and neurobiological mechanisms (spanning endocrine, neural, and genetic levels, including gene-environment interplay and epigenetic processes) to explain the intergenerational transmission of self-regulation. This model also incorporates potential transactional processes between generations (e.g., children's self-regulation and parent-child interaction dynamics that may affect parents' self-regulation) that further influence intergenerational processes. In pointing the way forward, we note key future directions and ways to address limitations in existing work throughout the review and in closing. We also conclude by noting several implications for intervention work.

Relations of growth in effortful control to family income, cumulative risk, and adjustment in preschool-age children

The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50 % girls, 50 % boys) from families representing a range of income (29 % at- or near-poverty; 28 % lower-income; 25 % middle-income; 18 % upper-income), with 4 assessments starting at 36-40 month. Income was directly related to levels of executive control and delay ability. Cumulative risk accounted for the effects of income on delay ability but not executive control. Higher initial executive control and slope of executive control and delay ability predicted academic readiness, whereas levels, but not growth, of executive control and delay ability predicted social competence and adjustment problems. Low income is a marker for lower effortful control, which demonstrates additive or mediating effects in the relation of income to children's preschool adjustment.