Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors

Parenting practices and trajectories of proactive coping assets among emerging adult Black men

Positive youth development (PYD) frameworks suggest that a critical response to investigating the challenges young Black men living in resource poor communities experience involves identifying contextual resources in young men's lives and personal assets that promote success. The following study examines heterogeneity in proactive coping assets trajectories, parental practices as predictors of developmental trajectories, and associated outcomes of each trajectory. The study sample consisted of Black emerging adult men living in rural Georgia (N = 504). At baseline, men were between the ages of 19 and 22 (Mage = 20.29; SD = 1.10). At wave four, the participants' mean age was 27.67 (SD = 1.39). Results of growth mixture modeling from waves 1 to 3 discerned three developmental trajectory classes of emerging adults' proactive coping assets: a high and increasing class (n = 247, 49%), a low and stable class (n = 212, 42%), and a moderate and decreasing class (n = 45, 9%). Trajectory classes were linked to baseline levels of parental support, coaching, and expectations. Analysis revealed that parental support and parental coaching predicted proactive coping asset trajectory class identification. Links were then investigated between emerging adults' proactive coping asset trajectory classes and wave four physical health, depression, and alcohol use. Results revealed significant associations between class identification, alcohol use, and physical health. Study findings provide evidence supporting the impact of parenting on emerging adult Black men, underscoring the need to expand resources that support parenting and emerging adult relationships.

Racial Discrimination and Metabolic Syndrome in Young Black Adults

Importance

Metabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored.

Objective

To evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways.

Design, Setting, and Participants

This longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023.

Exposures

Youths reported exposure to racial discrimination annually from ages 19 to 21 years.

Main Outcomes and Measures

MetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, >150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, <40 mg/dL in men and <50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators.

Results

In 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P < .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged.

Conclusions and Relevance

This study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.

Exposure to parental depression in adolescence and proinflammatory phenotypes 20 years later

Although the biological embedding model of adversity proposes that stressful experiences in childhood create a durable proinflammatory phenotype in immune cells, research to date has relied on study designs that limit our ability to make conclusions about whether the phenotype is long-lasting. The present study leverages an ongoing 20-year investigation of African American youth to test research questions about the extent to which stressors measured in childhood forecast a proinflammatory phenotype in adulthood, as indicated by exaggerated cytokine responses to bacterial stimuli, monocyte insensitivity to inhibitory signals from hydrocortisone, and low-grade inflammation. Parents reported on their depressive symptoms and unsupportive parenting tendencies across youths' adolescence. At age 31, youth participants (now adults) completed a fasting blood draw. Samples were incubated with lipopolysaccharide and doses of hydrocortisone to evaluate proinflammatory processes. Additionally, blood samples were tested for indicators of low-grade inflammation, including IL-6, IL-8, IL-10, and TNF-α, and soluble urokinase plasminogen activator receptor. Analyses revealed that parental depression across youths' adolescence prospectively predicted indicators of proinflammatory phenotypes at age 31. Follow-up analyses suggested that unsupportive parenting mediated these associations. These findings suggest that exposure to parental depression in adolescence leaves an imprint on inflammatory activity that can be observed 20 years later.

Attention Bias and Anxiety: The Moderating Effect of Sociocultural Variables in Rural Latinx Youth

Attention bias confers risk for anxiety development, however, the influence of sociodemographic variables on the relationship between attention bias and anxiety remains unclear. We examined the association between attention bias and anxiety among rural Latinx youth and investigated potential moderators of this relationship. Clinical symptoms, demographic characteristics, and a performance-based measure of attention bias were collected from 66 rural Latinx youth with clinical levels of anxiety (33.3% female; Mage = 11.74; 92.4% Latinx, 7.6% Mixed Latinx). No moderating effects for age or gender were found. Youth below the poverty line displayed an attention bias away from threat in comparison to youth above the poverty line, who displayed an attention bias towards threat. Among youth below the poverty line, this bias away from threat was associated with increased anxiety. Findings highlight the importance of economic adversity in understanding the relationship between attention bias and anxiety.

Family-Centered Prevention to Reduce Discrimination-Related Depressive Symptoms Among Black Adolescents: Secondary Analysis of a Randomized Clinical Trial

Importance

Racial discrimination undermines the mental health of Black adolescents. Preventive interventions that can attenuate the effects of exposure to racial discrimination are needed.

Objective

To investigate whether participation in the Strong African American Families (SAAF) program moderates Black adolescents' depressive symptoms associated with experience of racial discrimination.

Design, Setting, and Participants

This secondary analysis used data from a community-based randomized clinical trial of SAAF (SAAF vs no treatment control). Participants were followed up at 10, 22, and 34 months after the baseline assessment. Assessment staff were blind to participant condition. Participants in this trial lived in 7 rural counties in Georgia. SAAF was delivered at local community centers. Eligible families had a child aged 11 to 12 years who self-identified as African American or Black. The joint influence of random assignment to SAAF and exposure to racial discrimination was investigated. Data were analyzed from September 2022 to March 2023.

Intervention

SAAF is a 7-session (14 hours) family skills training intervention that occurs over 7 weeks. Small groups of caregivers and their adolescents participate in a structured curriculum targeting effective parenting behavior, adolescent self-regulation, and Black pride.

Main Outcomes and Measures

The main outcome was adolescent-reported depressive symptoms, assessed at 34 months via the 20-item Center for Epidemiologic Studies Depression Scale for Children.

Results

Of 825 families screened randomly from public school lists, 472 adolescents (mean [SD] age, 11.6 years; 240 [50.8%] female) were enrolled and randomized to SAAF (252 participants) or a no treatment control (220 participants). Exposure to racial discrimination at age 13 years was associated with increased depressive symptoms at age 14 years (β = 0.23; 95% CI, 0.13 to 0.34; P < .001). Interaction analyses indicated that the experimental condition significantly moderated the association of racial discrimination with depressive symptoms: (β = -0.27; 95% CI, -0.47 to -0.08; P = .005). Probing the interaction with simple slopes at ±SD revealed that for the control group, racial discrimination was significantly associated with depressive symptoms (β = 0.39; 95% CI, 0.23 to 0.54; P < .001), while for the SAAF group, there was no association between racial discrimination and depressive symptoms (β = 0.12; P = .09).

Conclusions and Relevance

This randomized clinical trial found that the SAAF intervention reduced the incidence of racism-associated mental health symptoms among Black adolescents. SAAF is recommended for dissemination to health care practitioners working with rural Black adolescents.

Trial Registration

ClinicalTrials.gov Identifier: NCT03590132.

Allostatic load in early adolescence: gene / environment contributions and relevance for mental health

Background

Allostatic load is the cumulative "wear and tear" on the body due to chronic adversity. We aimed to test poly-environmental (exposomic) and polygenic contributions to allostatic load and their combined contribution to early adolescent mental health.

Methods

We analyzed data on N = 5,035 diverse youth (mean age 12) from the Adolescent Brain Cognitive Development Study (ABCD). Using dimensionality reduction method, we calculated and overall allostatic load score (AL) using body mass index [BMI], waist circumference, blood pressure, blood glycemia, blood cholesterol, and salivary DHEA. Childhood exposomic risk was quantified using multi-level environmental exposures before age 11. Genetic risk was quantified using polygenic risk scores (PRS) for metabolic system susceptibility (type 2 diabetes [T2D]) and stress-related psychiatric disease (major depressive disorder [MDD]). We used linear mixed effects models to test main, additive, and interactive effects of exposomic and polygenic risk (independent variables) on AL (dependent variable). Mediation models tested the mediating role of AL on the pathway from exposomic and polygenic risk to youth mental health. Models adjusted for demographics and genetic principal components.

Results

We observed disparities in AL with non-Hispanic White youth having significantly lower AL compared to Hispanic and Non-Hispanic Black youth. In the diverse sample, childhood exposomic burden was associated with AL in adolescence (beta=0.25, 95%CI 0.22-0.29, P<.001). In European ancestry participants (n=2,928), polygenic risk of both T2D and depression was associated with AL (T2D-PRS beta=0.11, 95%CI 0.07-0.14, P<.001; MDD-PRS beta=0.05, 95%CI 0.02-0.09, P=.003). Both polygenic scores showed significant interaction with exposomic risk such that, with greater polygenic risk, the association between exposome and AL was stronger. AL partly mediated the pathway to youth mental health from exposomic risk and from MDD-PRS, and fully mediated the pathway from T2D-PRS.

Conclusions

AL can be quantified in youth using anthropometric and biological measures and is mapped to exposomic and polygenic risk. Main and interactive environmental and genetic effects support a diathesis-stress model. Findings suggest that both environmental and genetic risk be considered when modeling stress-related health conditions.

Association Between Individual Differences in Dichotomous Thinking and Current and Childhood High-Crime Environments

The way people perceive the things around them is closely related to living in a complex and challenging social environment. Dichotomous thinking (preference for dichotomy, dichotomous belief, and profit-and-loss thinking), which classifies things in a simple way, can be useful in dangerous and resource-limited environments. However, based on prior studies, people's manner of perceiving things may have developed as a response to the harshness of their childhood environment, and may not be related to their current environment. Therefore, we examined the relationship between individual differences in dichotomous thinking and high-crime environments as indicators of environmental harshness. We assessed dichotomous thinking in 41,284 Japanese residents using large-scale data from the Human Information Database FY19 compiled by NTT DATA Institute of Management Consulting, Inc. The fixed effects regression model showed that, after controlling for age, high-crime environment of the residents' childhood was associated with dichotomous thinking, with the exception of dichotomous belief. On the other hand, their current environment of crime was not associated. In sum, our research suggests that people's dichotomous thinking tendency may be a form of adaptation to the harshness of their childhood environment rather than their current one.

Longitudinal links between early adolescent temperament and inflammation among young black adults

A large body of research demonstrates that inflammation is involved in physical health problems that cause substantial morbidity and early mortality. Given inflammation's role in the etiology of chronic diseases, pediatric scientists have begun to study childhood factors that presage elevation of inflammatory biomarkers later in life. The purpose of this study was to test hypotheses designed to determine whether early adolescent emotionally intense and low attention temperaments forecast (a) inflammation at ages 25 and 29 years and (b) worsening levels of inflammation between these two data points. Toward this end, 307 Black children from the rural southeastern United States participated in an 18-year longitudinal study (mean age at baseline, 11.2 years) to determine whether and how early adolescent's behavioral styles or emotionally intense and low attention temperaments may be associated with absolute and worsening levels of inflammation in young adulthood. When children were 11-13 years of age, different teachers at each age provided assessments of emotionally intense and low attention temperaments. Thus, multiple measures of the same temperament constructs were obtained across 3 years for each participant. At age 25, participants provided data on their self-regulation abilities. Peripheral blood was collected at ages 25 and 29 years from which inflammation was quantified, using soluble urokinase plasminogen activator (suPAR), the proinflammatory cytokines interleukin (IL) IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α). Covariates associated with inflammation in prior studies were also assessed; these included socioeconomic risk, gender, cigarette smoking, body mass index (BMI), adverse childhood experiences (ACEs), depressive symptoms, and medication use. An early adolescent emotionally intense temperament was associated directly with higher suPAR and cytokine levels at age 29, and with worsening cytokine levels between ages 25 and 29. A low attention temperament was associated with suPAR levels at age 29. Collectively, these observations highlight pathways that could underlie health risks associated with early adolescent temperaments. The findings suggest that emotionally intense and low-attention early adolescent temperaments forecast higher and worsening inflammation levels across young adulthood.

Family-level antecedents of children's patterns of reactivity to interparental conflict: Testing the reformulation of emotional security theory

Guided by emotional security theory, this study examined the family-level antecedents of children's reaction patterns to interparental conflict in a sample of 243 preschool children (M age = 4.60 years; 48% Black; 16% Latinx; 56% girls) and their parents in the Northeastern United States. Behavioral observations of children's responses to interparental conflict over two annual measurement occasions assessed their tendencies to exhibit four patterns of defending against threat: secure (i.e., efficiently address direct threats), mobilizing (i.e., high reactivity to potential threat and social opportunities), dominant (i.e., directly defeat threat), and demobilizing (i.e., reduce salience as a target of hostility). Latent profile analyses of interparental, coparental, and parent characteristics derived from multiple methods at the first wave yielded four profiles corresponding with harmonious, enmeshed, compensatory, and detouring patterns of family-level functioning. Additional analyses revealed that children in harmonious and compensatory family profiles exhibited more secure patterns of reactivity over a 1-year period than children in the enmeshed family profile. In contrast, subsequent mobilizing reactivity was most pronounced for children in the enmeshed family profile. Finally, children in the detouring profile exhibited substantially higher levels of demobilizing reactivity to interparental conflict. Results are discussed in the context of how they inform and refine emotional security theory. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research

BACKGROUND

Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods.

METHODS

This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews.

RESULTS

The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden.

CONCLUSIONS

The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.

Measuring allostatic load: Approaches and limitations to algorithm creation

OBJECTIVE

Allostatic load literature has proliferated over the past three decades, and a growing body of research demonstrates that higher levels of allostatic load are associated with a wide range of negative physical and mental health outcomes. However, there remain significant challenges with operationalization of the concept. A scoping review of the methods employed to create an allostatic load algorithm was conducted and recommendations for future research with an orientation towards advancing clinical application of the theory are discussed.

METHODS

A search of seven electronic databases (PubMed, PsycINFO, Social Work Abstracts, Social Service Abstracts, Social Sciences Citation Index (Web of Science), Sociological Abstracts, Scopus) was completed with the search term "allostatic load." Studies were reviewed, and if they met the inclusion criteria, data was extracted, complied, and presented in the narrative, table, and figures.

RESULTS

The initial searches yielded 5280 results with the final sample of 395 non-duplicate articles that met the inclusion criteria. More than half (52.5%) of all included publications employed biomarker cutoffs based on the high-risk quartiles of the sample distribution, 11.1% employed the sum of at-risk clinical scores, and the remainder of studies utilized a range of different algorithms.

CONCLUSION

Allostatic load literature has grown at an exponential rate in recent years, but researchers continue to operationalize the concept via algorithms that may have limited utility moving forward. More nuanced statistical approaches are emerging and should be considered, as should a shift towards an approach that can provide additional clinical utility.

Risk and Resilience Pathways, Community Adversity, Decision-making, and Alcohol Use Among Appalachian Adolescents: Protocol for the Longitudinal Young Mountaineer Health Study Cohort

BACKGROUND

Alcohol use impairs psychosocial and neurocognitive development and increases the vulnerability of youth to academic failure, substance use disorders, and other mental health problems. The early onset of alcohol use in adolescents is of particular concern, forecasting substance abuse in later adolescence and adulthood. To date, evidence suggests that youth in rural areas are especially vulnerable to contextual and community factors that contribute to the early onset of alcohol use.

OBJECTIVE

The objective of the Young Mountaineer Health Study is to investigate the influence of contextual and health behavior variables on the early onset of alcohol use among middle school-aged youth in resource-poor Appalachian rural communities.

METHODS

This is a program of prospective cohort studies of approximately 2200 middle school youth from a range of 20 rural, small town, and small city (population <30,000) public schools in West Virginia. Students are participating in 6 waves of data collection (2 per year) over the course of middle school (sixth to eighth grades; fall and spring) from 2020 to 2023. On the basis of an organizational arrangement, which includes a team of local data collection leaders, supervising contact agents in schools, and an honest broker system to deidentify data linked via school IDs, we are able to collect novel forms of data (self-reported data, teacher-reported data, census-linked area data, and archival school records) while ensuring high rates of participation by a large majority of youth in each participating school.

RESULTS

In the spring of 2021, 3 waves of student survey data, 2 waves of data from teachers, and a selection of archival school records were collected. Student survey wave 1 comprised 1349 (response rate 80.7%) participants, wave 2 comprised 1649 (response rate 87%) participants, and wave 3 comprised 1909 (response rate 83.1%) participants. The COVID-19 pandemic has had a negative impact on the sampling frame size, resulting in a reduced number of eligible students, particularly during the fall of 2020. Nevertheless, our team structure and incentive system have proven vitally important in mitigating the potentially far greater negative impact of the pandemic on our data collection processes.

CONCLUSIONS

The Young Mountaineer Health Study will use a large data set to test pathways linking rural community disadvantage to alcohol misuse among early adolescents. Furthermore, the program will test hypotheses regarding contextual factors (eg, parenting practices and neighborhood collective efficacy) that protect youth from community disadvantage and explore alcohol antecedents in the onset of nicotine, marijuana, and other drug use. Data collection efforts have been successful despite interruptions caused by the COVID-19 pandemic in 2020 and 2021.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40451.

Childhood poverty and psychological well-being: The mediating role of cumulative risk exposure

The current study assessed whether the proportion of childhood (age 0-9 years) in poverty altered the developmental trajectories (ages 9-24) of multimethodological indicators of psychological well-being. In addition, we tested whether exposure to cumulative risk over time mediated the association between poverty exposure and psychological well-being. Measures of psychological well-being included internalizing and externalizing symptoms, a behavioral index of learned helplessness (task persistence), and chronic physiological stress (allostatic load). Exposure to poverty during childhood predicted the trajectory of each development outcome: individuals with more poverty exposure during childhood showed (a) relatively high levels of internalizing symptoms that diminished more slowly with maturation, (b) relatively high levels of externalizing symptoms that increased faster over time, (c) less task persistence indicative of greater learned helplessness, and (d) higher levels of chronic physiological stress which increased faster over time relative to persons with less childhood poverty exposure. Trajectories of cumulative risk exposure from physical and psychosocial surroundings from 9-24 years accounted for the association between childhood poverty and the growth curves of internalizing and externalizing symptoms but not for learned helplessness or chronic physiological stress. Additional sensitivity analyses indicate that early childhood disadvantage is particularly problematic for each outcome, except for internalizing symptoms which seem sensitive to the combination of early and lifetime poverty exposure. We also explored whether domains of cumulative risk as well as two alternatives, maternal sensitivity or family cohesion, functioned as mediators. Little evidence emerged for any of these alternative mediating constructs.

Early socioeconomic adversity and young adult diabetic risk: an investigation of genetically informed biopsychosocial processes over the life course

The present study investigated a comprehensive model that integrates contributions of early socioeconomic adversity (ESA) and multiple polygenic scores (PGSs) through different mechanisms leading to diabetic risk in early adulthood. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. The results showed that both ESA and PGSs were involved in different mechanisms. ESA contributed additively to educational failures, BMI, depressive symptoms, and diabetes risk over the life course (an additive process). Also, ESA launched a cascading process that connected these outcomes in a successively contingent manner. In addition to ESA, youths' multiple PGSs directly contributed to educational, psychological, and BMI outcomes. Multiple PGSs for education, BMI, and type 2 diabetes influenced not only youth outcomes that they were supposed to predict directly but also additional youth outcomes showing biological pleiotropy. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental and health outcomes.

Early experience unpredictability in child development as a model for understanding the impact of the COVID-19 pandemic: A translational neuroscience perspective

Extensive evidence links adverse experiences during childhood to a wide range of negative consequences in biological, socioemotional, and cognitive development. Unpredictability is a core element underlying most forms of early adversity; it has been a focus of developmental research for many years and has been receiving increasing attention recently. In this article, we propose a conceptual model to describe how unpredictable and adverse early experiences affect children's neurobiological, behavioral, and psychological development in the context of the COVID-19 pandemic. We first highlight the critical role of unpredictability in child development by reviewing existing conceptual models of early adversity as they relate to subsequent development across the lifespan. Then, we employ a translational neuroscience framework to summarize the current animal- and human-based evidence on the neurobiological alterations induced by early experience unpredictability. We further argue that the COVID-19 pandemic serves as a global "natural experiment" that provides rare insight to the investigation of the negative developmental consequences of widespread, clustered, and unpredictable adverse events among children. We discuss how the pandemic helps advance the science of unpredictable early adverse experiences. As unpredictability research continues to grow, we highlight several directions for future studies and implications for policymaking and intervention practices.

Discrimination and Inflammation in Adolescents of Color

Background

This study examined how experiences with discrimination relate to inflammation, a key biological pathway in mental and physical illnesses, and whether associations are moderated by gender across two samples of adolescents of color.

Methods

Study 1 was a longitudinal study of 419 African American adolescents assessed on discrimination (ages 19-20), with trajectories of biomarkers of low-grade inflammation (C-reactive protein and soluble urokinase plasminogen activator receptor) measured from ages 25 to 29. Study 2 was a cross-sectional study of 201 eighth graders of color assessed on discrimination and mechanistic indicators of a proinflammatory phenotype: 1) in vitro studies of immune cells' inflammatory cytokine responses to stimuli; 2) in vitro studies of cells' sensitivity to anti-inflammatory agents; 3) circulating numbers of classical monocytes, key cellular drivers of low-grade inflammation; and 4) a composite of six biomarkers of low-grade inflammation.

Results

Interactions of discrimination by gender were found across both studies. In study 1, African American males experiencing high discrimination showed increasing trajectories of soluble urokinase plasminogen activator receptor over time (p < .001). In study 2, adolescent boys of color experiencing greater discrimination evinced a more proinflammatory phenotype: larger cytokine responses to stimuli (p = .003), lower sensitivity to anti-inflammatory agents (p = .003), higher numbers of classical monocytes (p = .008), and more low-grade inflammation (p = .003). No such associations were found in females.

Conclusions

Discrimination is a pressing societal issue that will need to be addressed in efforts to promote health equity. This study suggests that adolescent males of color may be particularly vulnerable to its effects on mental health-relevant inflammatory processes.

Adverse childhood experiences and low socioeconomic status with respect to allostatic load in adulthood: A systematic review

Early-life psychosocial stress primes a number of health risk behaviors, and contributes to the development of various mental and somatic disorders in adulthood. It has been reported that adverse childhood experiences (ACEs) and low socioeconomic status (SES) might be associated with allostatic load (AL) in adulthood. In turn, elevated AL index has been found to predict a number of unfavorable health outcomes. Therefore, we aimed to perform a systematic review of studies investigating the association of ACEs and childhood SES with AL in adult populations. Independent online searches covered the publication period up to 20th Jun 2021. A total of 27 studies were included in qualitative synthesis. The majority of eligible studies showed that ACEs (14 out of 19 studies recording ACEs, 73.7%) and low childhood SES (11 out of 12 studies recording childhood SES, 91.7%) are associated with elevated AL in adults. However, several processes were found to mediate or moderate this association. These include educational attainments, social support, health behaviors, adult stress, post-traumatic stress disorder, coping strategies and aging. Moreover, a substantial methodological heterogeneity of approaches to calculating the AL index was observed. Apart from reports from overlapping samples, none of eligible studies used the same set of biomarkers. Findings from this systematic review imply that early-life psychosocial stress might have a lasting impact on biological dysregulations captured by the AL index. Future studies need to explore whether the association between early-life stress and the AL index accounts for the development of specific health outcomes.

Parents' Maltreatment Histories, Dimensions of Emotion Regulation, and Connections to Offspring Self-Regulation: A Sex-Specific Transmission Pathway

Introduction

Parents with childhood maltreatment histories are at risk for emotion regulation (ER) problems, which are associated with reduced self-regulation among their offspring. However, gaps remain in the literature regarding this indirect transmission pathway. First, ER consists of multiple dimensions and it is unclear which dimension is most affected by childhood maltreatment. Second, less is known regarding which parental ER dimension is linked to offspring self-regulation. Thus, the present study aimed to examine the direct and indirect associations between parental maltreatment histories and child self-regulatory capacity via dimensions of parental ER.

Methods

In this cross-sectional study, 101 youth (75% African American/Black; 53% female; M _age = 10.28; SD = 1.19) and their primary caregivers were recruited from a low-income community in the Southeastern United States. Structural equation modeling was used to model the effect of parents' self-reported childhood maltreatment on youth physiological self-regulation (measured by heart rate variability reactivity [HRV-R]), via parents' self-reported ER.

Results

Parental maltreatment history was significantly associated with five of the six components of ER. Further, the indirect effect of parents' childhood maltreatment on child HRV-R was significant when parents reported more difficulty engaging goal-directed behaviors. Moderation analyses by sex showed that daughters had greater dysregulation regardless of parental maltreatment histories, while parents' ER was found to play a more significant role in the intergenerational transmission of dysregulation to sons.

Conclusions

The current study extends the literature on self-regulation development in children of low-income, maltreatment-exposed parents. Our study may inform parent-child interventions for improving self-regulation.

Trajectories of adolescent stressful life events and young adults' socioeconomic and relational outcomes: Weight and depressive symptoms as mediators

Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed.

Vulnerability pathways to mental health outcomes in children and parents during COVID-19

We examined pathways from pre-existing psychosocial and economic vulnerability to mental health difficulties and stress in families during the COVID-19 pandemic. Data from two time points from a multi-cohort study initiated during the COVID-19 pandemic were used. Parents of children 6-18 years completed questionnaires on pre-COVID-19 socioeconomic and demographic factors in addition to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning. Youth 10 years and older also completed their own measures of mental health and stress. Using structural equation modelling, pathways from pre-existing vulnerability to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning, including reciprocal pathways, were estimated. Pre-existing psychosocial and economic vulnerability predicted higher material deprivation due to COVID-19 restrictions which in turn was associated with parent and child stress due to restrictions and mental health difficulties. The reciprocal effects between increased child and parent stress and greater mental health difficulties at Time 1 and 2 were significant. Reciprocal effects between parent and child mental health were also significant. Finally, family functioning at Time 2 was negatively impacted by child and parent mental health and stress due to COVID-19 restrictions at Time 1. Psychosocial and economic vulnerability is a risk factor for material deprivation during COVID-19, increasing the risk of mental health difficulties and stress, and their reciprocal effects over time within families. Implications for prevention policy and parent and child mental health services are discussed.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02459-z.

Early life course processes leading to educational and economic attainment in young adulthood: Contributions of early socioeconomic adversity and education polygenic score

The present study investigated an integrated life course model, drawn from the life course theoretical perspective, to elucidate youth’s additive, cascading, and cumulative life course processes stemming from early socioeconomic adversity and education polygenic score (education PGS) as well as potential interactions between them (GxE), which contribute to subsequent young adult socioeconomic outcomes. Additionally, the independent, varying associations among social and genetic predictors, life-stage specific educational outcomes (educational achievement in adolescence and educational attainment, in later stages), and young adult economic outcomes were examined. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. Early family socioeconomic adversity and individual education PGS were associated with life stage-specific educational outcomes through additive and cascading processes linked to young adults’ economic outcomes (personal earnings) through a cumulative process. A GxE moderation existed between individuals’ education PGS and early socioeconomic adversity at multiple life stages, explaining variation in adolescent educational outcomes. Both early socioeconomic adversity and education PGS were persistently associated with youth’s educational and economic outcomes throughout the early life course. In sum, the findings based on the integrated life course model showed how additive, cascading, and cumulative processes were related and conditioned one another, generating specific life course patterns and outcomes. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental characteristics.

Evaluating measures of allostatic load in adolescents: A systematic review

BACKGROUND

Adolescents can experience heightened stress due to biopsychosocial changes that occur during this developmental stage. The 'wear and tear' of the physiological systems responsible for managing our stress response can lead to dysregulation of these systems, known as allostatic load (AL). AL is commonly measured within adult populations, however, inconsistencies exist across measures used to quantify the effects of stress on health. The aim of this review was to identify variations in measures across AL studies, and to consider how specific measures may be more appropriate for use within adolescent populations.

METHOD

Pubmed, PsycINFO, PsycARTICLES, Academic Search Complete, were searched in July 2020, using search terms 'allostatic load' and 'adolescence'. AL studies (1988-2020) with an adolescent population (age 10-24 years) were included. 354 records were screened by two reviewers and 41 full-text articles were assessed for eligibility.

RESULTS

25 studies were included in final synthesis. Biomarkers of AL ranged from 1 to 14. The most common index of AL consisted of 6 biomarkers; cortisol, epinephrine, norepinephrine, systolic blood pressure, diastolic blood pressure, and body-mass index.

FINDINGS

Defining measures of AL during adolescence may help to identify vulnerabilities specific to adolescents, which may shape their lifelong health trajectories.

How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood

Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.

Temperament as a moderator of the association of cumulative risk with preadolescent appraisal and coping style

BACKGROUND

Children exposed to cumulative risk (CR) are more likely to have poor physical and psychological health across the lifespan. CR may contribute to children's adjustment, in part through its effects on appraisal and coping. Further, child temperament may alter the effects of CR on appraisal and coping.

OBJECTIVE

This study investigated the interactive and prospective effects of CR and temperament on children's appraisal and coping strategies.

DESIGN AND METHOD

In this secondary data analysis using a community sample (N=306) of preadolescents (M age = 9.5 at T1), structural equations models were conducted to examine temperament negative emotionality (NE) and effortful control (EC) as moderators of the effect of CR on both levels and proportional use of positive and threat appraisals, and active and avoidant coping.

RESULTS

Children higher in NE used more threat appraisal and avoidant coping, whereas children higher in EC used less threat appraisal concurrently and decreased in their use of threat appraisal across 1 year. Both NE and EC altered the prospective effect of CR on appraisal and coping.

CONCLUSIONS

Findings suggest temperament alters the effect of CR on appraisal and coping, implicating EC as a resource and NE as a vulnerability in changes in appraisal and coping during preadolescence.

Deconstructing Cumulative Risk: Poverty and Aspects of Instability Relate Uniquely to Young Children's Basal Cortisol

This study deconstructs cumulative risk to probe unique relations to basal cortisol for family income and four distinct aspects of poverty-related instability. Participants were 288 children aged 3-5 years who attended Head Start preschool. Parents reported on poverty risks. Children provided samples of salivary cortisol at four times of day on 6 days. Results of hierarchical linear modeling with piecewise latent growth curves representing basal cortisol indicated unique relations for family income, household chaos, neighborhood risk, attachment-disruptive residential changes, and non-attachment changes. The findings support an equifinality implied by cumulative risk models in demonstrating that multiple risks relate to cortisol dysregulation yet also suggest the utility of considering unique effects of different risks for neurophysiological stress response functioning.

The southern rural health and mortality penalty: A review of regional health inequities in the United States

Rural-urban differences in morbidity and mortality across the United States have been well documented and termed the "rural mortality penalty". However, research studies frequently treat rural areas as homogeneous and often do not account for geospatial variability in rural health risks by both county, state, region, race, and sex within the United States. Additionally, people living in the rural South of the US have higher rates of morbidity and mortality compared to both their urban counterparts and other rural areas. Of those living in southern rural communities, people of color experience higher rates of death and disease compared to white populations. Although there is a wealth of research that uses individual-level behaviors to explain rural-urban health disparities, there is less focus on how community and structural factors influence these differences. This review focuses on the "southern rural health penalty", a term coined by the authors, which refers to the high rate of mortality and morbidity in southern rural areas in the USA compared to both urban areas and non-southern rural places. We use macrosocial determinants of health to explain possible reasons for the "southern rural health penalty". This review can guide future research on rural health between southern and non-southern populations in the US and examine if macrosocial determinants of health can explain health disparities within southern rural populations.

Contextual risks and psychosocial outcomes among rural African American emerging adults: A latent profile analysis

African American emerging adults face unique contextual risks that place them at heightened risk for poor psychosocial outcomes. The purpose of this study was to identify profiles of contextual risks among rural African American emerging adults and determine how risk profiles relate to psychosocial outcomes. Our representative sample included 667 fifth graders who live in the rural South and were followed from preadolescence into emerging adulthood. Contextual risks were assessed at ages 19-21 years via six indicators: perceived stress, daily stress, community disadvantage, parent-child conflict, racial discrimination, and childhood trauma. Four psychosocial variables were also assessed at ages 19-21 years: self-regulation, racial identity, parent support, and friend support. Psychosocial outcomes were assessed at age 25 years: education, substance use, future orientation, depressive symptoms, and externalizing behaviors. Latent profile analysis results indicated that the sample could be characterized by three patterns of contextual risk: low contextual risk, high contextual risk, and high contextual risk-childhood trauma. Risk profiles were associated with psychosocial outcomes, with the childhood trauma and high-risk profiles faring worse than the low-risk profile. Further, childhood trauma was particularly predictive of worse outcomes for emerging adults. Findings highlight the need for research and prevention programs that mitigate the effects of contextual risks on psychosocial outcomes for African American emerging adults in rural areas.

Apolipoprotein E genotype and in vivo amyloid burden in middle-aged Hispanics

OBJECTIVE

To examine in vivo amyloid burden in relation to APOEε4 genotype in middle-aged Hispanics. We hypothesize higher amyloid levels among APOE ε4 carriers vs APOE ε4 noncarriers.

METHODS

This is a cross-sectional study in a community-based sample of 249 middle-aged Hispanics in New York City who underwent a 3T brain MRI and PET with the amyloid radioligand 18F-florbetaben. APOE genotype was the primary exposure. The primary outcome was amyloid positivity. The secondary outcome was subthreshold amyloid levels examined as a continuous variable.

RESULTS

APOE ε4 carriers (n = 85) had a higher frequency (15.3%) of amyloid positivity compared to APOE ε4 noncarriers (n = 164, 1.8%). In the subthreshold group of amyloid-negative participants (n = 233), APOE ε4 carriers (n = 72) had a 0.02 (95% confidence interval [CI] 0.01-0.04) higher global brain amyloid standardized uptake value ratio (SUVR) compared to APOE ε4 noncarriers (n = 161). Compared to participants with the ε3/ε3 genotype, participants with ε4/ε4 had the highest frequency of amyloid positivity (28.6%), followed by those with ε3/ε4 (11%). Among amyloid-negative participants (n = 233), compared to participants with ε3/ε3 (n = 134), those with ε4/ε4 (n = 5) had a 0.12 (95% CI 0.07-0.17) higher global brain amyloid SUVR, and those with ε3/ε4 had a 0.02 higher SUVR (95% CI 0.003-0.04). Results were similar when a median split was used for elevated amyloid, when continuous amyloid SUVR was analyzed in all participants, and in nonparametric Mann-Whitney comparisons.

CONCLUSION

Middle-aged Hispanic APOE ε4 carriers have higher in vivo brain amyloid burden compared with noncarriers, as reported in non-Hispanics.

Association between prolonged separation from parents and allostatic load among children in China

OBJECTIVE

To capture the association of exposure to prolonged separation from both parents early in life and allostatic load (AL), a measure of biological multi-system dysregulation.

METHODS

We used data from 557 7-12-year-old children enrolled in rural area of Chizhou city, Anhui Province, China. We computed an AL score based on eleven biomarkers representing four regulatory systems: immune/inflammatory system (high sensitivity C-reactive protein); metabolic system (body mass index; high density lipoprotein; low density lipoprotein, total cholesterol; triglycerides; fasting glucose; glycated hemoglobin; insulin) and cardiovascular system (systolic and diastolic blood pressure). Child's experiences of parent-child separation were collected a brief online questionnaire by parents of children.

RESULTS

More than 1 in 3 of our participants separated with both parents at age 6 or younger and nearly 1 in 10 persistently separated from both parents after birth. The AL score was significantly higher among children separated from both parents during early childhood (3.25 ± 1.98) or persistently since birth (3.48 ± 1.92), compared with those who did not separated from both parents (2.34 ± 1.53, F = 12.992, P<0.001). After adjustment of demographic covariates, body mass index as well as parent frequency of communication and parental warmth, children who separated from both parents in early childhood (β = 0.84, 95%CI:0.40, 1.28, P < 0.001) or persistently into adolescence (β = 1.27, 95%CI:0.43, 2.12, P = 0.003) evinced the highest levels of AL.

CONCLUSION

This study is the first to show an association between prolonged parent-child separation and physiological wear-and-tear as measured by AL, which provides potential insights into the biological mechanisms underpinning long-term health outcomes in contexts of parent-child separation.

Persistence of skin-deep resilience in African American adults

OBJECTIVE

The skin-deep resilience pattern suggests that, for low-socioeconomic-status African American youths, the ability to maintain high self-control and to persist with efforts to succeed may act as a double-edged sword, facilitating academic success and adjustment while undermining physical health. We extend research by following a sample of rural African Americans, asking whether the skin-deep resilience pattern, evident during adolescence, persists into adulthood by increasing susceptibility to metabolic syndrome (MetS) and insulin resistance (IR).

METHODS

The sample included 368 11-year-old African Americans, their parents, and their teachers. Parents provided data on family poverty across ages 11-18 years. Teachers provided data on youths' planful self-control across ages 11-13 years. At age 27 years, participants completed questionnaires about educational attainment and psychological adjustment and provided a fasting blood sample from which MetS and IR were assessed.

RESULTS

Regardless of years spent living in poverty, planful self-control during childhood was associated with college graduation (p < .001) and with low levels of depressive symptoms (p = .016) and antisocial behavior (p = .028). For participants exhibiting high levels of self-control, however, living more years in poverty across adolescence was associated with a greater number of MetS components that met clinical cutoff criteria (p = .018) and greater IR (p = .016) during adulthood.

CONCLUSIONS

The skin-deep resilience pattern persists into adulthood, particularly among those who spent more of their adolescence living in poverty, and increases vulnerability to MetS and IR while it also promotes college graduation and positive psychological adjustment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Contribution of Neighborhood Socioeconomic Disadvantage to Depressive Symptoms Over the Course of Adult Life: A 32-Year Prospective Cohort Study

The association between socioeconomic disadvantage and increased risk of depressive symptoms in adulthood is well established. We tested 1) the contribution of early exposure to neighborhood socioeconomic disadvantage to later depressive symptoms throughout life, 2) the persistence of the potential association between early exposure and depressive symptoms, and 3) the contributions of other known risk factors to the association. Data were collected from the Young Finns Study, a prospective, population-based 32-year follow-up study that included participants aged 3-18 years at baseline in 1980. Participants were followed up with repeated measurements of depressive symptoms between 1992 and 2012 (n = 2,788) and linked to national grid data on neighborhood disadvantage via residential addresses. We examined the associations in mixed models separately for the 5-, 10-, 15-, and 20-year follow-ups. Living in a disadvantaged neighborhood during childhood and adolescence was associated with a higher level of depressive symptoms in adulthood during all follow-up periods (β = 0.07, P = 0.001) than living in a nondisadvantaged area. Individual adulthood socioeconomic status mediated the associations. These findings suggest that living in a socioeconomically disadvantaged area during childhood and adolescence has a long-lasting negative association with mental health irrespective of family-related risks, partially due to socioeconomic adversity later in life.

Why now? Examining antecedents for substance use initiation among African American adolescents

Current adolescent substance use risk models have inadequately predicted use for African Americans, offering limited knowledge about differential predictability as a function of developmental period. Among a sample of 500 African American youth (ages 11-21), four risk indices (i.e., social risk, attitudinal risk, intrapersonal risk, and racial discrimination risk) were examined in the prediction of alcohol, marijuana, and cigarette initiation during early (ages 11-13), mid (ages 16-18), and late (ages 19-21) adolescence. Results showed that when developmental periods were combined, racial discrimination was the only index that predicted initiation for all three substances. However, when risk models were stratified based on developmental period, variation was found within and across substance types. Results highlight the importance of racial discrimination in understanding substance use initiation among African American youth and the need for tailored interventions based on developmental stage.

Childhood socioeconomic hardship, family conflict, and young adult hypertension: The Santiago Longitudinal Study

OBJECTIVE

Stress derived from socioeconomic disadvantage can be damaging to mental and physical health. This study uses longitudinal data on a large prospectively studied cohort to examine how socioeconomic hardship during childhood leads to hypertension in young adulthood by its effects on family conflict, anxiety-depression, and body mass.

METHOD

Data are from 1,039 participants of the Santiago Longitudinal Study who were studied in childhood (M age 10 years), adolescence (14-17 years), and young adulthood (21-26 years). As young adults, 26% had elevated blood pressure or hypertension.

RESULTS

Children from more economically disadvantaged families experienced higher levels of family conflict, which related to significant increases in anxiety-depression and body mass over time, both of which were directly linked to hypertension in young adulthood.

CONCLUSIONS

Findings provide an understanding of how early-life adversity associated with socioeconomic hardship manifests as stress-related health problems in adulthood. Intervention efforts that target overweight/obesity and anxiety and depression that stem from childhood poverty might be useful for reducing the socioeconomic disparities in adult health.

Neighborhood crime, socioeconomic status, and suspiciousness in adolescents and young adults at Clinical High Risk (CHR) for psychosis

INTRODUCTION

Contextual factors representing chronic stressors, such as neighborhood crime characteristics, have been repeatedly linked to compromised mental and physical health, and may contribute to the pathologizing of normative/non-clinical experiences. However, the impact of such structural factors has seldom been incorporated in Clinical High Risk (CHR) for psychosis research. Understanding how context can influence the presence or severity of symptoms such as suspiciousness/paranoia may have important relevance for promoting valid and reliable assessment, as well as for understanding ways in which environment may be related to illness development and expression.

METHODS

A total of 126 adolescents and young adults (nCHR = 63, ncontrol = 63) underwent clinical interviews for Clinical High-Risk syndromes. Neighborhood crime indices and socioeconomic status were calculated through geocoding and extracting of publicly available Census and Federal Bureau of Investigation (FBI) data. Analyses examined presence of associations between neighborhood crime indices, socioeconomic status, suspiciousness and total symptoms.

RESULTS

Greater neighborhood crime was related to increased suspiciousness in CHR individuals, even after controlling for neighborhood socioeconomic status, r = 0.27, p = .03. Neighborhood crime was not related to total symptoms, and neither was neighborhood socioeconomic status.

DISCUSSION

Results suggest neighborhood crime uniquely related to suspiciousness symptoms in CHR individuals, while this was not the case for healthy volunteers (HV). Future work will be critical for determining the extent to which assessors are pathologizing experiences that are normative for a particular context, or rather, if a stressful context is serving as a sufficient environmental stressor to unmask emerging psychosis.

Higher Peripheral Inflammatory Signaling Associated With Lower Resting-State Functional Brain Connectivity in Emotion Regulation and Central Executive Networks

BACKGROUND

Researchers document bidirectional pathways linking peripheral inflammation and neural circuitries subserving emotion processing and regulation. To extend this work, we present results from two independent studies examining the relationship between inflammation and resting-state functional connectivity (rsFC), as measured by functional magnetic resonance imaging.

METHODS

Study 1 involved 90 rural African American young adults, 25 years of age (52% female), and study 2 involved 82 urban African American youths, 13 to 14 years of age (66% female). Both studies measured circulating inflammatory biomarkers (C-reactive protein, interleukin 6, interleukin 10, tumor necrosis factor alpha), and the measures were averaged to form a composite. Study 2 also enumerated classical monocytes, a key leukocyte subpopulation involved in immune-to-brain signaling. All participants completed a resting-state functional magnetic resonance imaging scan.

RESULTS

Consistent with our prediction, higher scores on the inflammatory composite were associated with lower rsFC within an emotion regulation network in study 1, controlling for sex. Study 2 replicated study 1, showing that higher scores on the inflammatory composite were associated with lower rsFC within the emotion regulation network, controlling for sex, age, and pubertal status, and found a similar pattern for rsFC within a central executive network. Study 2 also found that higher numbers of classical monocytes were associated with lower rsFC within both the emotion regulation and central executive networks. There was no relationship between rsFC in the anterior salience or default mode networks with inflammation in either study.

CONCLUSIONS

With these findings, we document relationships between peripheral inflammation and rsFC within an emotion regulation and central executive network and replicate these associations with the emotion regulation network across two independent samples.

Assessing Developmental Environmental Risk Factor Exposure in Clinical High Risk for Psychosis Individuals: Preliminary Results Using the Individual and Structural Exposure to Stress in Psychosis-Risk States Scale

INTRODUCTION

Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder.

METHODS

CHR individuals (n = 35) and healthy volunteers (n = 28) completed structured clinical interviews as well as our group's newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined.

RESULTS

Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11-13 age range, and significant group differences for the 14-18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed.

DISCUSSION

Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations.

The Protective Effects of Supportive Parenting on the Relationship Between Adolescent Poverty and Resting-State Functional Brain Connectivity During Adulthood

Children growing up in poverty are vulnerable to negative changes in the developing brain; however, these outcomes vary widely. We tested the hypothesis that receipt of supportive parenting would offset the association between living in poverty during adolescence and the connectivity of neural networks that support cognition and emotion regulation during young adulthood. In a sample of African American youths (N = 119) living in the rural South, poverty status and receipt of supportive parenting were assessed when youths were 11 to 13 and 16 to 18 years old. At age 25, resting-state functional connectivity of the central-executive and emotion-regulation neural networks was assessed using functional MRI. The results revealed that more years spent living in poverty presaged less connectivity in both neural networks among young adults who received low levels of supportive parenting but not among those who received high levels of such parenting.

Socioeconomic Adversity, Social Resources, and Allostatic Load Among Hispanic/Latino Youth: The Study of Latino Youth

OBJECTIVE

We examined associations among socioeconomic adversity, social resources, and allostatic load in Hispanic/Latino youth, who are at high risk for obesity and related cardiometabolic risks.

METHODS

Participants were 1343 Hispanic/Latino youth (51% male; ages 8-16 years) offspring of Hispanic Community Health Study/Study of Latinos participants. Between 2012 and 2014, youth underwent a fasting blood draw and anthropometric assessment, and youth and their enrolled caregivers provided social and demographic information. A composite indicator of allostatic load represented dysregulation across general metabolism, cardiovascular, glucose metabolism, lipid, and inflammation/hemostatic systems. Socioeconomic adversity was a composite of caregiver education, employment status, economic hardship, family income relative to poverty, family structure, and receipt of food assistance. Social resources were a composite of family functioning, parental closeness, peer support, and parenting style variables.

RESULTS

Multivariable regression models that adjusted for sociodemographic factors, design effects (strata and clustering), and sample weights revealed a significant, positive, association between socioeconomic adversity and allostatic load (β = .10, p = .035), and a significant, inverse association between socioeconomic adversity and social resources (β = -.10, p = .013). Social resources did not relate to allostatic load and did not moderate or help explain the association of adversity with allostatic load (all p values > .05).

CONCLUSIONS

Statistically significant, but small associations of socioeconomic adversity with both allostatic load and social resources were identified. The small effects may partially reflect range restriction given overall high socioeconomic adversity and high social resources in the cohort.

The Profundity of the Everyday: Family Routines in Adolescence Predict Development in Young Adulthood

PURPOSE

The current study was designed to investigate the unique, long-term effects of family routines during adolescence on multiple developmental domains in young adulthood for rural African-Americans.

METHODS

Prospective data were collected annually for 6 years from 504 rural African-American youth and their parents, beginning when the youth were 16 years of age.

RESULTS

Results indicated that youth whose primary caregivers reported more family routines during adolescence (e.g., regularly eating together as a family, consistent bedtime) reported less alcohol use, greater emotional self-regulation, lower epinephrine levels, and higher rates of college/university enrollment in young adulthood. These effects were evident for all outcomes controlling for socioeconomic risk, sex, and available baseline (age 16 years) measures; for a subset of outcomes, the effects of family routines persisted even after taking into account levels of supportive parenting, harsh parenting, and household chaos.

CONCLUSIONS

Findings substantiate the benefits of consistent, predictable family environments for healthy development and suggest that family routines constitute an important, yet understudied, factor for adolescents' long-term development.

Reports of perceived racial discrimination among African American children predict negative affect and smoking behavior in adulthood: A sensitive period hypothesis

We examined the prospective relations between a cultural risk factor, perceived racial discrimination (PRD), and subsequent negative affect and health behavior (smoking) in a panel of 889 African American children (part of the Family and Community Health Study). Cultural moderators (protective factors) of these relations were also examined. PRD was assessed six times from ages 10.5 (Wave 1) to 24.5 (Wave 6), and negative affect (anger and depressive symptoms) was assessed at Wave 2 (age 12.5) and Wave 6 (age 24.5). Results indicated that Wave 1 PRD predicted Wave 6 smoking, controlling for multiple factors related to smoking and/or PRD, including smoking at age 15.5. Structural equation models indicated that these relations between Wave 1 PRD and smoking were mediated by both early and later negative affect. The models also indicated that Wave 1 PRD had a direct impact on Wave 6 anger (assessed 14 years later), controlling for the effects of PRD on early affect. Cultural socialization was associated with lower rates of adolescent smoking, and it buffered the relation between PRD and Wave 6 anger. The impact of early PRD experiences along with suggestions for culturally informed interventions and preventive interventions that might buffer against early PRD effects are discussed.

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

Trauma-Informed Care Education in Baccalaureate Nursing Curricula in the United States: Applying the American Association of Colleges of Nursing Essentials

The practice of trauma-informed care (TIC) allows nurses in any setting to identify and intervene with traumatized individuals and to create a continuum of care when forensic nursing services are needed. The purpose of this article is to suggest ways to incorporate TIC content into baccalaureate nursing programs. We begin with an overview of baccalaureate nursing curricula and common types of traumatic experience important for students to understand. We then propose specific strategies for inclusion of TIC content in baccalaureate nursing education, using the American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice. With a solid foundation in TIC, baccalaureate-prepared nursing students can provide effective patient care and better support forensic nursing practice. This will increase the capacity of the nursing profession in general to meet the needs of those affected by trauma, violence, and abuse.

Substance Use and Obesity Trajectories in African Americans Entering Adulthood

INTRODUCTION

The transition to adulthood can be stressful for minority adolescents, and many may cope through unhealthy behaviors, including substance use and obesity-related behaviors. This study tested substance use and obesity trajectories over time in African American youth, longitudinal associations of trajectories with mental and physical health in adulthood, and whether self-control and sex predict trajectories.

METHODS

Two longitudinal studies of 516 and 992 African American adolescents. In Study 1, substance use and obesity trajectories were assessed from ages 19 to 25 years. At age 25 years, internalizing and externalizing problems, metabolic syndrome, and inflammatory biomarkers were measured. In Study 2, substance use and obesity trajectories were assessed from ages 17 to 29 years. Depression, delinquency, diabetes, blood pressure, and inflammatory biomarkers were measured at age 29 years. Data analyses were conducted in 2017.

RESULTS

Across both studies, the majority of African American adolescents evinced poor health behavior trajectories (latent class growth analyses), with 23%-27% showing increasing substance use over time, 18%-27% showing increasing obesity over time, and 9%-11% showing increases in both. ANCOVAs for trajectory analyses revealed that males were more likely to evince increasing substance use, with females more likely to show increasing obesity. Substance use trajectories were associated with poorer mental health in adulthood; obesity trajectories with poorer physical health in adulthood. Those with good health behavior trajectories had higher self-control in early adolescence.

CONCLUSIONS

The transition to adulthood is a vulnerable period for many African Americans. Given the commonalities of substance use and obesity in their rewarding/stress-relieving properties, similar prevention efforts may help stem the rise of both in these youth.

Adjustment disorder diagnosis: Improving clinical utility

OBJECTIVES

Adjustment disorder (AD) is a frequent diagnosis in clinical practice worldwide. After long neglect in mental health research, the new DSM definition and in particular the ICD-11 model of AD is about to create a fresh impulse for research on AD and for refined clinical use of the diagnosis.

METHODS

This paper outlines the clinical features of AD according to the ICD-10, ICD-11 and DSM-5 definitions, and provides case vignettes of patients with AD with clinical presentations of dominating anxiety, depressed mood or mixed symptom presentations. The available clinical assessments and diagnostic tools are described in detail, together with findings on their psychometric properties.

RESULTS

The current AD definitions are consistent with a new nosological grouping of AD with posttraumatic stress disorder in the chapter on trauma- and stressor-related disorders, or stress response syndromes.

CONCLUSIONS

This nosological specification opens new avenues for neurobiological and psychological research on AD and for developing novel therapies.

Peer influence, Frontostriatal connectivity, and delay discounting in African American emerging adults

Prior research has demonstrated the importance of delay discounting in adverse health behaviors, such as addiction, attention deficit hyperactivity disorder, risk taking, and obesity. Nevertheless, the functional connectivity of neural circuitry associated with delay discounting and the ways in which the social environment may influence frontostriatal connectivity remain largely unknown, particularly in African Americans. Building on recent literature implicating frontostriatal connectivity during active delay discounting decision making and at rest, we used functional magnetic resonance imaging to assess the association between delay discounting and frontostriatal resting state connectivity (rsFC). We also examined the capacity of social relationships with parents and peers to longitudinally predict frontostriatal rsFC. The study cohort was composed of 91 rural African American emerging adults followed over a 6-year period. Greater (i.e., more positive) frontostriatal rsFC was associated with decreased delay discounting (i.e., less impulsive decision making). In addition, peer relationships at ages 20 and 21 significantly predicted frontostriatal rsFC at age 25 above and beyond parental influence. A significant indirect effect of peer affiliation on delay discounting through frontostriatal rsFC also emerged. These results indicate a role of frontostriatal connectivity in delay discounting decision making and highlight peers' unique influence on decision making behaviors through frontostriatal rsFC during emerging adulthood.

Racial discrimination, body mass index, and insulin resistance: A longitudinal analysis

OBJECTIVE

To examine prospective relations of perceived racial discrimination at ages 16-18 with body mass index (BMI) at ages 19-21 and insulin resistance (IR) at ages 25 and 27 among Black youth in the rural South, and to determine whether BMI connected discrimination to IR as a mediator.

METHOD

Participants were 315 African American adolescents in rural counties in Georgia who provided data on their perceptions of discrimination during adolescence. BMI was measured during a yearly home visit, and a certified phlebotomist drew a fasting blood sample from which IR was measured.

RESULTS

The data analysis, with all confounding variables controlled, revealed that, over time, (a) discrimination was associated positively with both BMI and IR; (b) BMI was associated positively with IR; and (c) BMI acted as a mediator connecting discrimination with IR.

CONCLUSIONS

The findings are consistent with the hypothesis that exposure to discrimination presages IR through its effects on BMI. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Parenting and Salience Network Connectivity Among African Americans: A Protective Pathway for Health-Risk Behaviors

BACKGROUND

Supportive parenting during childhood has been associated with many positive developmental outcomes for offspring in adulthood, including fewer health-risk behaviors. Little is known about the neural mechanisms underlying these associations.

METHODS

The present study followed rural African Americans (n = 91, 52% female) from late childhood (11-13 years of age) to emerging adulthood (25 years of age). Parent-child communication was assessed at 11, 12, and 13 years of age. Functional magnetic resonance imaging was used at 25 years of age to measure resting-state functional connectivity of the anterior salience network (ASN). Harmful alcohol use and emotional eating were also assessed at 25 years of age. Structural equation modeling was used to test pathways from parent-child communication at 11 to 13 years of age to harmful alcohol use and emotional eating at 25 years of age via resting-state functional connectivity of the ASN.

RESULTS

Greater parent-child communication between 11 and 13 years of age forecast greater resting-state functional connectivity of the ASN at 25 years of age which, in turn, was associated with lower harmful alcohol use and emotional eating at 25 years of age. Significant indirect effects through the ASN were present for both outcomes.

CONCLUSIONS

These findings indicate the importance of parenting in late childhood for adaptive behaviors and suggest a pathway via higher ASN coherence. This network was implicated in both harmful alcohol use and emotional eating, corroborating evidence of overlap in brain regions for dysregulated substance use and eating behaviors and revealing divergent pathways. These findings support the value of prevention and intervention efforts targeting parenting skills in childhood toward fostering long-term, adaptive neurocognitive development.

Trajectory classes of cannabis use and heavy drinking among rural African American adolescents: multi-level predictors of class membership

AIMS

To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi-level assessments of risk factors.

DESIGN

A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors.

SETTING

Rural communities in the southeastern United States.

PARTICIPANTS

African American youth (n = 518).

MEASUREMENTS

Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors.

FINDINGS

Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years.

CONCLUSIONS

Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.

Early socioeconomic adversity and cardiometabolic risk in young adults: mediating roles of risky health lifestyle and depressive symptoms

The study examined the mediating roles of risky health lifestyle and depressive symptoms in relation to childhood/adolescence adversity and young adult cardiometabolic risk with data from the National Longitudinal Study of Adolescent to Adult Health (n = 9421). Four classes of youth emerged from a latent class analysis with varying early adversity patterns: (a) both low disadvantaged SES and stressful experience (54.8%), (b) high disadvantaged SES and low stressful experience (31.0%), (c) low disadvantaged SES and high stressful experience (10.9%), and (d) both high disadvantaged SES and stressful experience (3.3%). Early adversity had multiple direct and indirect effects on CM risk for those experiencing SES-related adversities. Instead, early adversity generated mediational processes between adversity and CM risks through risky health lifestyle and depressive symptoms for those experiencing stressful experience. Implications for intervention when dealing with youths who have experienced multiple forms of early adversity are discussed.