Objectives The specific study objectives were: 1) to identify perceived common stressors among pa... more Objectives The specific study objectives were: 1) to identify perceived common stressors among parents in refugee settlements, 2) to analyze the associations of perinatal depression and early initiation of breastfeeding and 3) to analyze the associations between perinatal depression and exclusive breastfeeding. Methods Qualitative study participants were mothers (n = 66) and fathers (n = 49) who compromised eight focus group discussions (FGDs): four mothers FGDs, two fathers FGDs, two mothers and fathers FGDs. Two FGDs with Village Health Team and six individual interviews with key informants also were conducted. Thematic analysis was used in NVivo, v. 12. Quantitative study participants (n = 390) were pregnant mothers who were enrolled in a community-based randomized control study. Perinatal depression was measured using Patient Health Questionnaire-9 during 3rd trimester and postpartum. Early initiation and exclusive breastfeeding were assessed using WHO guidelines. SAS, v. 9.4, w...
Current treatments for chronic pain have limited benefit. We describe a resilience intervention f... more Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention (n = 38) or control (n = 37). Fifty-eight Veterans completed pre- and post-testing (intervention n = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well val...
Building Early Social and Emotional Relationships with Infants and Toddlers, 2018
Attachment to caregivers plays a critical role in the social and emotional development of childre... more Attachment to caregivers plays a critical role in the social and emotional development of children. The foundation of the caregiver-infant relationship begins before birth and continues to develop after birth. There are both threats to prenatal and neonatal attachment and factors that promote early bonding and social and emotional development during this time. This chapter focuses on the early relationships between infants and caregivers and is divided into three sections reflecting distinct periods (prenatal, childbirth, and postnatal). Descriptions of social and emotional development and attachment, contextual influences, and assessments are highlighted in each section.
Pregnancy loss (i.e., miscarriage, stillbirth) is a relatively common and often traumatic experie... more Pregnancy loss (i.e., miscarriage, stillbirth) is a relatively common and often traumatic experience. Although prior research has examined mental health consequences of pregnancy loss, to our knowledge, none have examined how the experience of pregnancy loss affects how women perceive or value the importance of motherhood. Using longitudinal data from the National Survey of Fertility Barriers, we applied change-score regression analysis to examine how a pregnancy loss that occurred between survey waves was associated with a change in importance of motherhood scores, controlling for sociodemographic and pregnancy-specific characteristics. We found that women who experienced a pregnancy loss reported an increase in importance of motherhood compared to women without a pregnancy loss. The findings suggest that an increase in the importance of motherhood following a pregnancy loss could be a grief response. Health care professionals should consider validating maternal identity following ...
This chapter will address health disparities in pregnancy and birth outcomes among racial and eth... more This chapter will address health disparities in pregnancy and birth outcomes among racial and ethnic minorities, including preterm birth, low birthweight, and infant mortality, as well as maternal morbidity and mortality during the perinatal period. This chapter will also address racial disparities in infant and early childhood development, including cognitive and social-emotional development, and early academic achievement. Taking a life course perspective that includes the intergenerational transmission of race-related trauma and stress, this chapter will specifically examine the role of chronic stress and its influence on biological and psychosocial processes. Cultural and environmental protective factors will also be addressed, as well as discussion about potential interventions. Intersectionality with other demographic variables including gender, socioeconomic status, and education will also be discussed.
Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in re... more Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n = 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n = 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4+ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4+ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4+ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This article proposes a model for understanding the effects of adverse childhood experiences (ACE... more This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
SummaryBackgroundAdverse childhood experiences (ACEs) and obesity are independently associated wi... more SummaryBackgroundAdverse childhood experiences (ACEs) and obesity are independently associated with brain/neurocognitive health. Despite a growing emphasis on the importance of early life adversity on health, the relationship between ACEs and neurocognition in adults with overweight/obesity is unclear. The objective was to examine associations between self‐reported ACEs and measured neurocognitive domains in a sample of adults with overweight/obesity.MethodsParticipants were 95 predominantly white, highly educated adult women (76% female, 81% Caucasian, and 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self‐regulatory Mechanisms of Obesity Study. ACEs and fluid/crystallized neurocognitive domains were measured at baseline using the Adverse Childhood Experiences Scale and the NIH Toolbox Cognition Battery and Automated Neuropsychological Assessment Metric, respectively.ResultsHigher ACEs scores were negatively correlated with fluid cognition (r = −....
Parenting stress and children's behavior problems have frequently been linked, with bidirecti... more Parenting stress and children's behavior problems have frequently been linked, with bidirectional relations spanning from early childhood through adolescence. However, this association has not been well studied in infancy or toddlerhood, and prospective mediators have not been thoroughly explored. This prospective, longitudinal study utilized two transactional models to examine bidirectional relations between parenting stress and children's behavior problems and explore perceived family conflict and parental supportiveness as potential mediators. Data were taken from the Early Head Start Family and Child Experiences Study, where 835 parent-child dyads were assessed at 1, 2, and 3 years. Parenting stress and behavior problems were measured at all 3 time points, while family conflict and observed parental supportiveness were measured at ages 2 and 3. Results indicated that parenting stress and children's behavior problems were relatively stable over time and had bidirectional or cross-lagged associations. Family conflict mediated the relation between children's behavior problems at age 1 and parenting stress at age 3, while parental supportiveness mediated the relation between parenting stress at age 1 and behavior problems at age 3, suggesting both "child" and "parent" effects that function through two different mechanisms. These findings suggest that early prevention programs should focus on both children's behavior and parenting stress in the first year and work to reduce family conflict and increase parental supportiveness in order to disrupt this negative cycle. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
The mechanisms underlying the depression-obesity relationship are unclear. Food attentional bias ... more The mechanisms underlying the depression-obesity relationship are unclear. Food attentional bias (FAB) represents one candidate mechanism that has not been examined. We evaluated the hypothesis that greater depressive symptoms are associated with increased FAB. Participants were 89 normal weight or overweight adults (mean age = 21.2 ± 4.0 years, 53% female, 33% non-white, mean body mass index in kg/m = 21.9 ± 1.8 for normal weight; 27.2 ± 1.5 for overweight). Total, somatic, and cognitive-affective depressive symptom scores were computed from the Patient Health Questionnaire-8 (PHQ-8). FAB scores were calculated using reaction times (RT) and eye-tracking (ET) direction and duration measures for a food visual probe task. Age, gender, race/ethnicity, and body fat percent were covariates. Only PHQ-8 somatic symptoms were positively associated with RT-measured FAB (β = 0.23, p = .04). The relationship between somatic symptoms and ET direction (β = 0.18, p = .17) and duration (β = 0.23, ...
Objectives The specific study objectives were: 1) to identify perceived common stressors among pa... more Objectives The specific study objectives were: 1) to identify perceived common stressors among parents in refugee settlements, 2) to analyze the associations of perinatal depression and early initiation of breastfeeding and 3) to analyze the associations between perinatal depression and exclusive breastfeeding. Methods Qualitative study participants were mothers (n = 66) and fathers (n = 49) who compromised eight focus group discussions (FGDs): four mothers FGDs, two fathers FGDs, two mothers and fathers FGDs. Two FGDs with Village Health Team and six individual interviews with key informants also were conducted. Thematic analysis was used in NVivo, v. 12. Quantitative study participants (n = 390) were pregnant mothers who were enrolled in a community-based randomized control study. Perinatal depression was measured using Patient Health Questionnaire-9 during 3rd trimester and postpartum. Early initiation and exclusive breastfeeding were assessed using WHO guidelines. SAS, v. 9.4, w...
Current treatments for chronic pain have limited benefit. We describe a resilience intervention f... more Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention (n = 38) or control (n = 37). Fifty-eight Veterans completed pre- and post-testing (intervention n = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well val...
Building Early Social and Emotional Relationships with Infants and Toddlers, 2018
Attachment to caregivers plays a critical role in the social and emotional development of childre... more Attachment to caregivers plays a critical role in the social and emotional development of children. The foundation of the caregiver-infant relationship begins before birth and continues to develop after birth. There are both threats to prenatal and neonatal attachment and factors that promote early bonding and social and emotional development during this time. This chapter focuses on the early relationships between infants and caregivers and is divided into three sections reflecting distinct periods (prenatal, childbirth, and postnatal). Descriptions of social and emotional development and attachment, contextual influences, and assessments are highlighted in each section.
Pregnancy loss (i.e., miscarriage, stillbirth) is a relatively common and often traumatic experie... more Pregnancy loss (i.e., miscarriage, stillbirth) is a relatively common and often traumatic experience. Although prior research has examined mental health consequences of pregnancy loss, to our knowledge, none have examined how the experience of pregnancy loss affects how women perceive or value the importance of motherhood. Using longitudinal data from the National Survey of Fertility Barriers, we applied change-score regression analysis to examine how a pregnancy loss that occurred between survey waves was associated with a change in importance of motherhood scores, controlling for sociodemographic and pregnancy-specific characteristics. We found that women who experienced a pregnancy loss reported an increase in importance of motherhood compared to women without a pregnancy loss. The findings suggest that an increase in the importance of motherhood following a pregnancy loss could be a grief response. Health care professionals should consider validating maternal identity following ...
This chapter will address health disparities in pregnancy and birth outcomes among racial and eth... more This chapter will address health disparities in pregnancy and birth outcomes among racial and ethnic minorities, including preterm birth, low birthweight, and infant mortality, as well as maternal morbidity and mortality during the perinatal period. This chapter will also address racial disparities in infant and early childhood development, including cognitive and social-emotional development, and early academic achievement. Taking a life course perspective that includes the intergenerational transmission of race-related trauma and stress, this chapter will specifically examine the role of chronic stress and its influence on biological and psychosocial processes. Cultural and environmental protective factors will also be addressed, as well as discussion about potential interventions. Intersectionality with other demographic variables including gender, socioeconomic status, and education will also be discussed.
Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in re... more Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n = 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n = 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4+ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4+ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4+ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This article proposes a model for understanding the effects of adverse childhood experiences (ACE... more This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
SummaryBackgroundAdverse childhood experiences (ACEs) and obesity are independently associated wi... more SummaryBackgroundAdverse childhood experiences (ACEs) and obesity are independently associated with brain/neurocognitive health. Despite a growing emphasis on the importance of early life adversity on health, the relationship between ACEs and neurocognition in adults with overweight/obesity is unclear. The objective was to examine associations between self‐reported ACEs and measured neurocognitive domains in a sample of adults with overweight/obesity.MethodsParticipants were 95 predominantly white, highly educated adult women (76% female, 81% Caucasian, and 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self‐regulatory Mechanisms of Obesity Study. ACEs and fluid/crystallized neurocognitive domains were measured at baseline using the Adverse Childhood Experiences Scale and the NIH Toolbox Cognition Battery and Automated Neuropsychological Assessment Metric, respectively.ResultsHigher ACEs scores were negatively correlated with fluid cognition (r = −....
Parenting stress and children's behavior problems have frequently been linked, with bidirecti... more Parenting stress and children's behavior problems have frequently been linked, with bidirectional relations spanning from early childhood through adolescence. However, this association has not been well studied in infancy or toddlerhood, and prospective mediators have not been thoroughly explored. This prospective, longitudinal study utilized two transactional models to examine bidirectional relations between parenting stress and children's behavior problems and explore perceived family conflict and parental supportiveness as potential mediators. Data were taken from the Early Head Start Family and Child Experiences Study, where 835 parent-child dyads were assessed at 1, 2, and 3 years. Parenting stress and behavior problems were measured at all 3 time points, while family conflict and observed parental supportiveness were measured at ages 2 and 3. Results indicated that parenting stress and children's behavior problems were relatively stable over time and had bidirectional or cross-lagged associations. Family conflict mediated the relation between children's behavior problems at age 1 and parenting stress at age 3, while parental supportiveness mediated the relation between parenting stress at age 1 and behavior problems at age 3, suggesting both "child" and "parent" effects that function through two different mechanisms. These findings suggest that early prevention programs should focus on both children's behavior and parenting stress in the first year and work to reduce family conflict and increase parental supportiveness in order to disrupt this negative cycle. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
The mechanisms underlying the depression-obesity relationship are unclear. Food attentional bias ... more The mechanisms underlying the depression-obesity relationship are unclear. Food attentional bias (FAB) represents one candidate mechanism that has not been examined. We evaluated the hypothesis that greater depressive symptoms are associated with increased FAB. Participants were 89 normal weight or overweight adults (mean age = 21.2 ± 4.0 years, 53% female, 33% non-white, mean body mass index in kg/m = 21.9 ± 1.8 for normal weight; 27.2 ± 1.5 for overweight). Total, somatic, and cognitive-affective depressive symptom scores were computed from the Patient Health Questionnaire-8 (PHQ-8). FAB scores were calculated using reaction times (RT) and eye-tracking (ET) direction and duration measures for a food visual probe task. Age, gender, race/ethnicity, and body fat percent were covariates. Only PHQ-8 somatic symptoms were positively associated with RT-measured FAB (β = 0.23, p = .04). The relationship between somatic symptoms and ET direction (β = 0.18, p = .17) and duration (β = 0.23, ...
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