Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017

Objective

After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression.

Method

Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60).

Results

A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time.

Conclusion

In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.

Examining the relationship between genetic risk for depression and youth episodic stress exposure

BACKGROUND

Offspring of depressed mothers have elevated risk of developing depression because they are exposed to greater stress. While generally assumed that youth's increased exposure to stress is due to the environmental effects of living with a depressed parent, youth's genes may influence stress exposure through gene-environment correlations (rGEs). To understand the relationship between risk for depression and stress, we examined the effects of polygenic risk for depression on youth stress exposure.

METHODS

We examined the relations of a polygenic risk score (PRS) for depression (DEP-PRS), as well as PRSs for 5 other disorders, with youth stress exposure. Data were from a longitudinal study of a community sample of youth and their parents (n = 377) focusing on data collected at youth's aged 12 and 15 assessments.

RESULTS

Elevated youth DEP-PRS was robustly associated with increased dependent stress, particularly interpersonal events. Exploratory analyses indicated that findings were driven by major stress and were not moderated by maternal nor paternal history of depression, and of the 5 additional PRSs tested, only elevated genetic liability for bipolar I was associated with increased dependent stress-particularly non-interpersonal events.

LIMITATIONS

Like other PRS studies, we focused on those of European ancestry thus, generalizability of findings is limited.

CONCLUSION

Polygenic risk contributes to youth experiencing stressful life events which are dependent on their behavior. This rGE appears to be specific to genetic risk for mood disorders.

Dead Labor: Mortality Inequities by Class, Gender, and Race/Ethnicity in the United States, 1986-2019

Objectives. To estimate social class inequities in US mortality using a relational measure based on power over productive property and workers' labor. Methods. We used nationally representative 1986-2018 National Health Interview Survey data with mortality follow-up through December 31, 2019 (n = 911 850). First, using business-ownership, occupational, and employment-status data, we classified respondents as incorporated business owners (IBOs), unincorporated business owners (UBOs), managers, workers, or not in the labor force (NLFs). Next, using inverse-probability-weighted survival curves, we estimated class mortality inequities overall, after subdividing workers by employment status and occupation, and by period, gender, race/ethnicity, and education. Results. UBOs, workers, and NLFs had, respectively, 6.3 (95% confidence interval [CI] = -8.1, -4.6), 6.6 (95% CI = -8.1, -5.0), and 19.4 (95% CI = -21.0, -17.7) per 100 lower 34-year survival rates than IBOs. Mortality risk was especially high for unemployed, blue-collar, and service workers. Inequities increased over time and were greater among male, racially minoritized, and less-educated respondents. Conclusions. We estimated considerable mortality inequities by class, gender, and race/ethnicity. We also estimated that class mortality inequities are increasing, threatening population health. Public Health Implications. Addressing class inequities likely requires structural, worker-empowering interventions. (Am J Public Health. 2023;113(6):637-646. https://doi.org/10.2105/AJPH.2023.307227).

Trends in Racial-Ethnic Disparities in Adult Mental Health Treatment Use From 2005 to 2019

OBJECTIVE

Although U.S. mental health treatment rates increased in the 2000s, gaps in treatment among racial-ethnic groups grew. Little is known, however, about national trends after 2012, when treatment access increased overall. This study assessed trends in racial-ethnic disparities in past-year treatment rates among people with a major depressive episode, serious psychological distress, or serious mental illness.

METHODS

National Survey on Drug Use and Health (2005-2019) data of adults with a past-year major depressive episode (N=49,791) or serious psychological distress (N=89,233) and of adults with past-year serious mental illness (N=24,944; 2008-2019) were analyzed. Linear risk regressions were used to model trends in past-year use of mental health treatment and included an interaction term between survey year and race-ethnicity.

RESULTS

Treatment use prevalence (2005-2019) among marginalized individuals with a major depressive episode remained lower than that among White people. The magnitude of the disparity in treatment use between White and Hispanic people with major depressive episode decreased slightly (percentage-point difference=-25.1% to -14.9%), whereas the disparity in treatment use between White people and American Indian/Alaska Native people with serious mental illness increased significantly (percentage-point difference=23.4% to -12.2%), from 2005 to 2019. The magnitude of the disparities for other marginalized racial-ethnic groups did not meaningfully change.

CONCLUSIONS

Racial-ethnic disparities in past-year mental health treatment use have persisted. Efforts to reduce disparities should consider structural barriers that hinder treatment use among marginalized groups.

Is adult separation anxiety associated with offspring risk for internalizing psychiatric problems?

BACKGROUND

Awareness of adult separation anxiety (ASA) is growing, but there is a dearth of knowledge about how separation anxiety aggregates in families. We examined the intergenerational associations of separation anxiety and other forms of internalizing problems in an American community sample of 515 predominantly white children and their parents.

METHODS

Children's separation anxiety (CSA), depression, and other anxiety disorders were modeled as latent factors using diagnoses from interviews and symptom scores from questionnaires completed by mothers, fathers, and children when children were 9 years old and again 3 years later. Parents' separation anxiety was assessed via a questionnaire and parents' other anxiety, depressive, and substance use disorders were assessed with a diagnostic interview when children were nine. Relationships between parents' and children's psychopathology were modeled using s.e.m.

RESULTS

Mothers' and fathers' ASA were related to all three psychopathology factors in offspring, over and above other parental disorders, in concurrent and prospective analyses. CSA was also related to maternal depression concurrently and prospectively and to maternal anxiety prospectively. Of all paternal psychopathology variables, only ASA was significantly related to children's psychopathology in either model.

CONCLUSIONS

Results indicate that parental separation anxiety is an important, but non-specific, risk factor for children's psychopathology. The pathway by which this risk is transmitted may be genetic or environmental, and the observed statistical associations likely also encompass child-to-parent effects.

Three-variable systems: An integrative moderation and mediation framework for developmental psychopathology

In this article, we consider an often overlooked model that combines mediation and moderation to explain how a third variable can relate to a risk factor-psychopathology relationship. We refer to it as moderation and mediation in a three-variable system. We describe how this model is relevant to studying vulnerability factors and how it may advance developmental psychopathology research. To illustrate the value of this approach, we provide several examples where this model may be applicable, such as the relationships among parental externalizing pathology, harsh parenting, and offspring psychopathology as well as between neuroticism, stressful life events, and depression. We discuss possible reasons why this model has not gained traction and attempt to clarify and dispel those concerns. We provide guidance and recommendations for when to consider this model for a given data set and point toward existing resources for testing this model that have been developed by statisticians and other methodologists. Lastly, we describe important caveats, limitations, and considerations for making this approach most useful for developmental research. Overall, our goal in presenting this information to developmental psychopathology researchers is to encourage testing moderation and mediation in a three-variable system with the aim of advancing analytic strategies for studying vulnerability factors.

Moderation effects in personality disorder research

Tests of statistical interactions (or tests of moderation effects) in personality disorder research are a common way for researchers to examine nuanced hypotheses relevant to personality pathology. However, the nature of statistical interactions makes them difficult to reliably detect in many research scenarios. The present study used a flexible, simulation-based approach to estimate statistical power to detect trait-by-trait interactions common to psychopathy research using the Triarchic model of Psychopathy and the Psychopathic Personality Inventory. Our results show that even above-average sample sizes in these literatures (e.g., N = 428) provide inadequate power to reliably detect trait-by-trait interactions, and the sample sizes needed to detect interaction effect sizes in realistic scenarios are extremely large, ranging from 1,300 to 5,200. The implications for trait-by-trait interactions in psychopathy are discussed, as well as how the present findings might generalize to other areas of personality disorder research. We provide recommendations for how to design research studies that can provide informative tests of interactions in personality disorder research, but also highlight that a more realistic option is to abandon the traditional approach when testing for interaction effects and adopt alternative approaches that may be more productive. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A multimethod, multiinformant study of early childhood temperament and depression and anxiety symptoms in adolescence

There is an extensive literature documenting associations between dimensions of temperament and depressive and anxiety disorders. However, much of the research in this area relies on cross-sectional and monomethod designs, uses samples of older youth and adults, and examines only the main effects of temperament. We examined longitudinal associations between temperamental positive emotionality (PE) and negative emotionality (NE) in early childhood and depressive and anxiety symptoms in adolescence. We assessed temperament using laboratory observations and parent reports, and symptoms using youth and parent report. We also examined potential moderators of these associations, including maternal and paternal history of depressive and anxiety disorders, youth experience of stressful life events, and parenting styles. Early childhood NE was associated with both adolescent depression and anxiety. Additionally, life events and psychological controlling and firm parenting moderated the associations between NE and depression symptoms, and maternal depression, paternal anxiety, and psychological controlling and firm parenting moderated the associations between NE and anxiety symptoms. Interaction effects were largely consistent with diathesis-stress interpretations. These findings show that temperamental NE, but not PE, is prospectively associated with risk for depressive and anxiety symptoms in adolescence, and that multiple additional factors potentiate these associations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Intergenerational transmission of depressive and anxiety disorders: Mediation via youth personality

Youth personality is hypothesized to mediate the intergenerational transmission of internalizing disorders. However, this has rarely been examined. We tested whether the intergenerational transmission of depressive and anxiety disorders is mediated by youth neuroticism and extraversion, and how parent personality influenced these relationships. Participants included 550 adolescent girls, aged 13-15 years at baseline (T1), and a coparticipating biological parent. Depressive and anxiety disorders were assessed by interview at T1, and adolescents were reinterviewed every 9 months for 3 years (T2-T5). Parent and youth personality was assessed at T1. Four path models examined direct and indirect effects of parent psychopathology and personality (neuroticism and extraversion) on youth outcomes, with youth neuroticism and extraversion as mediators in separate models. In the model examining the effects of parent psychopathology via T1 youth neuroticism, there were direct effects of parent depression on T2-T5 youth depressive disorders and indirect effects of parent anxiety disorders on T2-T5 youth depressive and anxiety disorders. When parent neuroticism was added, indirect effects of T1 parent anxiety disorders and neuroticism on T2-T5 youth depressive and anxiety disorders via T1 youth neuroticism were significant. In the model examining T1 youth extraversion as a mediator, there were significant direct effects of parent depressive and anxiety disorders on T2-T5 youth depressive and anxiety disorders, respectively. Finally, when adding parent extraversion, indirect effects of parent extraversion on T2-T5 youth depressive and anxiety disorders via youth extraversion were significant. Parent and youth personality play important roles in the intergenerational transmission of depressive and anxiety disorders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Adult separation anxiety: Personality characteristics of a neglected clinical syndrome

Over the past two decades, interest in the relationship between personality and psychopathology has resurged. However, the clinical problem of adult separation anxiety (ASA) has been largely excluded from this endeavor due to the age-of-onset criterion in older editions of the DSM that prohibited first-onset diagnoses in adulthood. This study tests relationships between ASA symptoms and higher- and lower-order personality traits in a community sample of 565 women. It accounts for systematic error by utilizing informant report, two personality inventories, and data from two time points over three years, and by adjusting for mood state. It also tests longitudinal ASA-personality models. Results indicate that ASA is robustly associated with negative emotionality and its facet of stress reaction, as well as with aggression, alienation, and absorption to somewhat lesser degrees. These relationships are not due to overlap with other traits (except in the case of alienation), or mood-state biases, and they are verified by informants. Moreover, negative temperament predicts greater levels of ASA three years later, adjusting for baseline ASA. Neither positive emotionality or temperament, nor positive emotionality's lower-order scales, were uniquely related to ASA in multitrait models, whereas relationships between ASA and disinhibition and constraint were inconsistent. These findings lay the groundwork for future research testing the mechanisms and causal links between these personality traits and ASA and may help clinicians anticipate traits that are associated with ASA in order to tailor treatments to patients' personalities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A person-centered approach to understanding child temperament at ages 3 and 6

Person-centered analyses, such as latent profile analysis, provide an approach to assessing individual differences in child temperament that aligns with typological theory and is well positioned for translation to applied settings. In a community sample, latent profile analysis was conducted using seven temperament traits assessed through laboratory observation when children were three- and six-years-old. At age 3, a four-class model fit best and subgroups were labeled “typical,” “sluggish,” “surgent,” and “dysregulated,” based on the pattern of class-specific means. A five-class model fit best at age 6 and subgroups were labeled “typical,” “sluggish,” “outgoing,” “active-impulsive” and “negative affect.” Associations between class membership and mother-reported temperament traits, concurrently assessed, were mostly consistent with the class identities. Comparison of subgroup membership across waves generally demonstrated patterns of continuity across groups characterized by similar trait patterns. This paper provides an illustrative guide for temperament researchers in the implementation of latent profile analysis, addressing important methodical considerations. Increased utilization of person-centered approaches like latent profile analysis could lead to important advances in the study of child temperament, such as improved understanding of the continuity of temperamental styles and more targeted risk assessment.

Early childhood temperament predicts intolerance of uncertainty in adolescence

Intolerance of uncertainty (IU) is the trait propensity to react negatively to uncertainty. To date, very few studies have explored early childhood predictors of IU. The current study identifies relations between child temperament assessed at age 3 (N = 559) and IU assessed at ages 12 (N = 432) and 15 (N = 415). Temperament was assessed through both laboratory observation (Laboratory Temperament Assessment Battery) and maternal report (Children's Behavior Questionnaire). IU was assessed through both maternal rating and child self-report using the 12-item Intolerance of Uncertainty Scale for Children. Higher levels of temperamental negative emotionality/neuroticism and lower levels of temperamental positive emotionality/extraversion assessed at age 3 predicted higher levels of IU in early-mid adolescence. Unique relationships were found at the trait facet level, and differences were observed between informants. These findings suggest that certain early child temperament traits can serve as markers of risk for difficulty dealing with uncertainty later in life. Future research should explore whether this relationship translates to increased risk for psychopathology.

Dimensions of irritability in adolescents: longitudinal associations with psychopathology in adulthood

BACKGROUND

There is an emerging consensus in developmental psychopathology that irritable youth are at risk for developing internalizing problems later in life. The current study explored if irritability in youth is multifactorial and the impact of irritability dimensions on psychopathology outcomes in adulthood.

METHODS

We conducted exploratory factor analysis on irritability symptom items from a semi-structured diagnostic interview administered to a community sample of adolescents (ages 14-19; 42.7% male; 89.1% white). The analysis identified two factors corresponding to items from the mood disorders v. the oppositional defiant disorder (ODD) (Leibenluft and Stoddard) sections of the interview. These factors were then entered together into regression models predicting psychopathology assessed at age 24 (N = 941) and again at age 30 (N = 816). All models controlled for concurrent psychopathology in youth.

RESULTS

The two irritability dimensions demonstrated different patterns of prospective relationships, with items from the ODD section primarily predicting externalizing psychopathology, items from the mood disorder sections predicting depression at age 24 but not 30, and both dimensions predicting borderline personality disorder symptoms.

CONCLUSIONS

These results suggest that the current standard of extracting and compositing irritability symptom items from diagnostic interviews masks distinct dimensions of irritability with different psychopathological outcomes. Additionally, these findings add nuance to the prevailing notion that irritability in youth is specifically linked to later internalizing problems. Further investigation using more sensitive and multifaceted measures of irritability are needed to parse the meaning and clinical implications of these dimensions.

Stressful life events moderate the effect of neural reward responsiveness in childhood on depressive symptoms in adolescence

BACKGROUND

Reward processing deficits have been implicated in the etiology of depression. A blunted reward positivity (RewP), an event-related potential elicited by feedback to monetary gain relative to loss, predicts new onsets and increases in depression symptoms. Etiological models of depression also highlight stressful life events. However, no studies have examined whether stressful life events moderate the effect of the RewP on subsequent depression symptoms. We examined this question during the key developmental transition from childhood to adolescence.

METHODS

A community sample of 369 children (mean age of 9) completed a self-report measure of depression symptoms. The RewP to winning v. losing was elicited using a monetary reward task. Three years later, we assessed stressful life events occurring in the year prior to the follow-up. Youth depressive symptoms were rated by the children and their parents at baseline and follow-up.

RESULTS

Stressful life events moderated the effect of the RewP on depression symptoms at follow-up such that a blunted RewP predicted higher depression symptoms in individuals with higher levels of stressful life events. This effect was also evident when events that were independent of the youth's behavior were examined separately.

CONCLUSIONS

These results suggest that the RewP reflects a vulnerability for depression that is activated by stress.

Effects of Maternal Depression and Mother-Child Relationship Quality in Early Childhood on Neural Reactivity to Rejection and Peer Stress in Adolescence: A 9-Year Longitudinal Study

Problems in mother-child relationships are thought to be key to intergenerational transmission of depression. To evaluate neural and behavioral processes involved in these pathways, we tested effects of maternal depression and maternal-child relationship quality in early childhood on neural and interviewer-based indicators of social processes in adolescence. At age 3, children and mothers (N=332) completed an observational parenting measure and diagnostic interviews with mothers. At age 12, adolescents completed a task in which event-related potentials (ERPs) were recorded to peer acceptance and rejection feedback and interviews to assess peer stress. Lower mother-child relationship quality at age 3 was associated with enhanced reactivity to rejection, as measured by N1, and greater peer stress at age 12. Indirect effects of maternal depression through mother-child relationship quality were observed for N1 and peer stress. Findings inform understanding of disruptions in social functioning that are likely relevant to the intergenerational transmission of depression.

Do simple slopes follow-up tests lead us astray? Advancements in the visualization and reporting of interactions

[Correction Notice: An Erratum for this article was reported online in Psychological Methods on Sep 24 2020 (see record 2020-72092-001). In the article "Do Simple Slopes Follow-Up Tests Lead Us Astray? Advancements in the Visualization and Reporting of Interactions," by Megan C. Finsaas and Brandon L. Goldstein (Psychological Methods, advance online publication. April 20, 2020. http://dx.doi.org/10.1037/ met0000266), Figure 5 contained an error. The second sentence of the caption of Figure 5 should read: "The left plot depicts the region of significance when life stress is acting as the moderator, and the right when neuroticism is acting as the moderator." All versions of this article have been corrected.] Statistical interactions between two continuous variables in linear regression are common in psychological science. As a follow-up analysis of how the moderator impacts the predictor-outcome relationship, researchers often use the pick-a-point simple slopes method. The simple slopes method requires researchers to make two decisions: (a) which moderator values should be used for plotting and testing simple slopes, and (b) which predictor should be considered the moderator. These decisions are meant to be driven by theory, but in practice researchers may use arbitrary conventions or theoretical reasons may not exist. Even when done thoughtfully, simple slopes analysis omits important information about the interaction. Consequently, it is problematic that the simple slopes approach is the primary basis for interpreting interactions. A more nuanced alternative is to utilize the Johnson-Neyman technique in conjunction with a regression plane depicting the interaction effect in three-dimensional space. This approach does not involve picking points but rather shows the slopes at all possible values of the predictor variables and gives both predictors equal weight instead of selecting a de facto moderator. Because this approach is complex and user-friendly implementation tools are lacking, we present a tutorial explaining the Johnson-Neyman technique and how to visualize interactions in 3-D space along with a new open-source tool that completes these procedures. We discuss how this approach facilitates interpretation and communication as well as its implications for replication efforts, transparency, and clinical applications. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Do simple slopes follow-up tests lead us astray? Advancements in the visualization and reporting of interactions

[Correction Notice: An Erratum for this article was reported online in Psychological Methods on Sep 24 2020 (see record 2020-72092-001). In the article "Do Simple Slopes Follow-Up Tests Lead Us Astray? Advancements in the Visualization and Reporting of Interactions," by Megan C. Finsaas and Brandon L. Goldstein (Psychological Methods, advance online publication. April 20, 2020. http://dx.doi.org/10.1037/ met0000266), Figure 5 contained an error. The second sentence of the caption of Figure 5 should read: "The left plot depicts the region of significance when life stress is acting as the moderator, and the right when neuroticism is acting as the moderator." All versions of this article have been corrected.] Statistical interactions between two continuous variables in linear regression are common in psychological science. As a follow-up analysis of how the moderator impacts the predictor-outcome relationship, researchers often use the pick-a-point simple slopes method. The simple slopes method requires researchers to make two decisions: (a) which moderator values should be used for plotting and testing simple slopes, and (b) which predictor should be considered the moderator. These decisions are meant to be driven by theory, but in practice researchers may use arbitrary conventions or theoretical reasons may not exist. Even when done thoughtfully, simple slopes analysis omits important information about the interaction. Consequently, it is problematic that the simple slopes approach is the primary basis for interpreting interactions. A more nuanced alternative is to utilize the Johnson-Neyman technique in conjunction with a regression plane depicting the interaction effect in three-dimensional space. This approach does not involve picking points but rather shows the slopes at all possible values of the predictor variables and gives both predictors equal weight instead of selecting a de facto moderator. Because this approach is complex and user-friendly implementation tools are lacking, we present a tutorial explaining the Johnson-Neyman technique and how to visualize interactions in 3-D space along with a new open-source tool that completes these procedures. We discuss how this approach facilitates interpretation and communication as well as its implications for replication efforts, transparency, and clinical applications. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychometric analysis of the adult separation anxiety symptom questionnaire: Item functioning and invariance across gender and time

The Adult Separation Anxiety Symptom Questionnaire (ASA-27) is the most widely used self-report assessment of adult separation anxiety (ASA). Despite its widespread use, relatively little is known about its psychometric properties, specifically whether it is unidimensional, its degree of precision (or information) across latent levels of ASA, the functioning of individual items in general and of DSM-derived versus non-DSM-derived items in particular, and whether the measure is invariant across gender and time. We addressed these issues in a sample of 509 adult women and 407 adult men from the local community participating in a longitudinal study of temperament and psychopathology in children. Two items from the ASA-27 were removed so that the measure met the item response theory (IRT) assumption of unidimensionality. Findings from a graded response model for categorical items suggested that the ASA-27 assesses ASA most reliably at moderate to high levels and that the DSM-derived items were more closely related to latent ASA than the non-DSM-derived items. Invariance tests employing single-factor confirmatory factor analysis models suggested that the measure is partially invariant across gender and time at the unique factor level, with fewer than 7% of parameters freed in both cases; this implies that the means and variances of the latent factors and differences in the observed responses are attributable to true differences in ASA. Future work should replicate these findings in a sample that includes individuals with a wider range of ASA severity and may consider removing additional items that provide little or redundant information. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Life stress moderates the effects of preschool behavioral inhibition on anxiety in early adolescence

BACKGROUND

Although a robust body of literature implicates temperamental behavioral inhibition (BI) as a prominent risk factor for anxiety disorders, many children with heightened BI do not develop anxiety. The current study examines the role of two forms of life stress (life events and natural disaster exposure) in moderating the relationship between BI in preschoolers and anxiety in early adolescence.

METHOD

A community sample of 392 3-year-old children was administered a laboratory observational assessment of temperament. When children were a mean age 10, the region was struck by a devastating hurricane and exposure to disaster-related stress was assessed. In early adolescence, youth and a parent were administered the UCLA Life Stress Interview (LSI) to assess behaviorally independent and dependent negative life events during the prior year and youth completed the Screen for Child Anxiety Related Emotional Disorders (SCARED).

RESULTS

The association between early childhood BI and anxiety symptoms in early adolescence was moderated by both independent life events and disaster-related stress. Children high in BI at age 3 reported greater anxiety symptoms at age 12 after exposure to higher levels of both forms of stress.

CONCLUSIONS

Stress moderated the association between early BI and later anxiety. Importantly, this was evident for two different kinds of stressors that were independent of the child's behavior that increases confidence in the causal role of stress in the development of anxiety in high BI children.

Early Childhood Parenting Predicts Late Childhood Brain Functional Connectivity During Emotion Perception and Reward Processing

Seventy-nine 3-year olds and their mothers participated in a laboratory-based task to assess maternal hostility. Mothers also reported their behavioral regulation of their child. Seven years later, functional magnetic resonance imaging data were acquired while viewing emotional faces and completing a reward processing task. Maternal hostility predicted more negative amygdala connectivity during exposure to sad relative to neutral faces with frontal and parietal regions as well as more negative left ventral striatal connectivity during monetary gain relative to loss feedback with the right posterior orbital frontal cortex and right inferior frontal gyrus. In contrast, maternal regulation predicted enhanced cingulo-frontal connectivity during monetary gain relative to loss feedback. Results suggest parenting is associated with alterations in emotion and reward processing circuitry 7-8 years later.

Early Childhood Psychopathology Prospectively Predicts Social Functioning in Early Adolescence

Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (N = 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.

Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence

BACKGROUND

Many preschool-age children meet criteria for psychiatric disorders, and rates approach those observed in later childhood and adolescence. However, there is a paucity of longitudinal research examining the outcomes of preschool diagnoses.

METHODS

Families with a 3-year-old child (N = 559) were recruited from the community. Primary caregivers were interviewed using the Preschool Age Psychiatric Assessment when children were 3 years old (n = 541), and, along with children, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version when children were 9 and 12 years old.

RESULTS

Rates of disruptive behavior disorders (DBD) decreased from preschool to middle childhood and early adolescence, whereas rates of attention-deficit/hyperactivity disorder (ADHD) increased. Rates of any psychiatric disorder and depression increased from preschool to early adolescence only. Preschoolers with a diagnosis were over twice as likely to have a diagnosis during later periods. Homotypic continuity was present for anxiety disorders from preschool to middle childhood, for ADHD from preschool to early adolescence, and for DBD through both later time points. There was heterotypic continuity between preschool anxiety and early adolescent depression, and between preschool ADHD and early adolescent DBD. Dimensional symptom scores showed homotypic continuity for all diagnostic categories and showed a number of heterotypic associations as well.

CONCLUSIONS

Results provide moderate support for the predictive validity of psychiatric disorders in preschoolers. Psychopathology in preschool is a significant risk factor for future psychiatric disorders during middle childhood and early adolescence.

Maternal executive function, infant feeding responsiveness and infant growth during the first 3 months

BACKGROUND

There is limited research in young infants, particularly <3 months of age, on maternal feeding practices in spite of increasing evidence that early weight gain velocity is a determinant of later obesity risk.

OBJECTIVE

To examine associations between maternal executive function (cognitive control over one's own behaviour), maternal feeding decisions and infant weight and adiposity gains.

METHODS

We used a checklist to assess cues mothers use to decide when to initiate and terminate infant feedings at 2 weeks and 3 months of age (N = 69). Maternal executive function was assessed using the NIH Toolbox Cognition Battery subtests for executive function and infant body composition using air displacement plethysmography.

RESULTS

Mothers with higher executive function reported relying on fewer non-satiety cues at 2 weeks of age (β = -0.29, p = 0.037) and on more infant hunger cues at 3 months of age (β = 0.31, p = 0.018) in their decisions on initiating and terminating feedings. Responsive feeding decisions, specifically the use of infant-based hunger cues at 3 months, in turn were associated with lower gains in weight-for-length (β = -0.30, p = 0.028) and percent body fat (β = -0.2, p = 0.091; non-covariate adjusted β = -0.27, p = 0.029).

CONCLUSIONS

These findings show both an association between maternal executive function and responsive feeding decisions and an association between responsive feeding decisions and infant weight and adiposity gains. The causal nature and direction of these associations require further investigation.

The Stony Brook Temperament Study: Early Antecedents and Pathways to Emotional Disorders

In this article, we summarize findings from the Stony Brook Temperament Study, which seeks to elucidate the early antecedents and pathways to later depressive and anxiety disorders. The study focuses on parents' internalizing disorders and children's early temperament as distal risk factors that operate, in part, through biobehavioral reward and threat systems. We summarize findings linking parents' emotional disorders and observations of children's early temperament to subsequent neural measures of children's affective processing. Next, we review findings showing that children's temperament and affective processing predict subsequent depression and anxiety. We also show that many of these associations are moderated by environmental factors, such as parenting and stress. Finally, we relate our findings to literature on the relationships of early temperament and affective processing to anxiety and depression in youth.