Anne Tharner

Dopaminergic, Serotonergic, and Oxytonergic Candidate Genes Associated with Infant Attachment Security and Disorganization? In Search of Main and Interaction Effects.

BACKGROUND AND METHODS In two birth cohort studies with genetic, sensitive parenting, and attachment data of more than 1,000 infants in total, we tested main and interaction effects of candidate genes involved in the dopamine, serotonin, and oxytocin systems (DRD4, DRD2, COMT, 5-HTT, OXTR) on attachment security and disorganization. Parenting was assessed using observational rating scales for parental sensitivity (Ainsworth, Bell, & Stayton, 1974), and infant attachment was assessed with the Strange Situation Procedure. RESULTS We found no consistent additive genetic associations for attachment security and attachment disorganization. However, specific tests revealed evidence for a codominant risk model for COMT Val158Met, consistent across both samples. Children with the Val/Met genotype showed higher disorganization scores (combined effect size d = .22, CI = .10-.34, p < .001). Gene-by-environment interaction effects were not replicable across the two samples. CONCLUSIONS This unexpected finding might be explained by a broader range of plasticity in heterozygotes, which may increase susceptibility to environmental influences or to dysregulation of emotional arousal. This study is unique in combining the two largest attachment cohorts with molecular genetic and observed rearing environment data to date.

Breastfeeding and its relation to maternal sensitivity and infant attachment.

Objective: To examine the association of breastfeeding with maternal sensitive responsiveness and infant-mother attachment security and disorganization. Methods: We included 675 participants of a prospective cohort study. Questionnaires about breastfeeding practices were administered at 2 and 6 months postpartum. At 14 months, maternal sensitive responsiveness was assessed in a 13-minute laboratory procedure using Ainsworths sensitivity scales, and attachment quality was assessed with the Strange Situation Procedure. Mothers were genotyped for oxytocin receptor genes OXTR rs53576 and OXTR rs2254298. Linear regressions and analyses of covariance adjusted for various background variables were conducted. We tested for mediation and moderation by maternal sensitive responsiveness and maternal oxytocin receptor genotype. Results: Continuous analyses showed that longer duration of breastfeeding was associated with more maternal sensitive responsiveness (B = 0.11, 95% confidence interval [CI] 0.02; 0.20, p < .05), more attachment security (B = 0.24, 95% CI = 0.02; 0.46, p < .05), and less attachment disorganization (B = −0.20, 95% CI −0.36; −0.03, p < .05). Duration of breastfeeding was not related to the risk of insecure-avoidant or insecure-resistant versus secure attachment classification, but longer duration of breastfeeding predicted a lower risk of disorganized versus secure attachment classification (n = 151; odds ratio [OR] = 0.81, 95% CI 0.66 to 0.99, p = .04). Maternal sensitive responsiveness did not mediate the associations, and maternal oxytocin receptor genotype was not a significant moderator. Conclusions: Although duration of breastfeeding was not associated with differences in infant-mother attachment classifications, we found subtle positive associations between duration of breastfeeding and sensitive responsiveness, attachment security, and disorganization.

FKBP5 and resistant attachment predict cortisol reactivity in infants: Gene—environment interaction

Quality of the parent-infant attachment relationship influences physiological stress regulation. Genetic factors also contribute to the stress regulatory HPA-axis. Quality of attachment as an index of the rearing environment (measured with the Strange Situation Procedure, SSP), and HPA-axis related SNPs (BclI, rs41423247; TthIIII, rs10052957; GR-9β, rs6198; N363S, rs6195; ER22/23EK, rs6189 and 6190; and FKBP5, rs1360780) were hypothesized to be related to cortisol reactivity in the stressful SSP. In this large population based sample, FKBP5 rs1360780, but not GR haplotype, was related to cortisol reactivity. Moreover, we found a significant interaction effect for insecure-resistant attachment and FKBP5 rs1360780, indicating a double-risk for heightened cortisol reactivity levels in infants with one or two T-alleles of the FKBP5 SNP and an insecure-resistant attachment relationship with their mother. Findings are discussed from the perspective of gene-environment interaction.

Trajectories of picky eating during childhood: A general population study

OBJECTIVE This cohort study describes the prevalence of picky eating and examines prognostic factors for picky eating trajectories during childhood. METHODS 4,018 participants of a population-based cohort with measurements from pregnancy onwards were included. Picky eating was assessed by maternal report when children were 1.5, 3, and 6 years old. The associations of child and family characteristics with trajectories of picky eating were examined using logistic regression. Never picky eaters were used as the reference group. RESULTS Prevalence of picky eating was 26.5% at 1.5 years of age, 27.6% at the age of 3 and declined to 13.2% at 6 years. Four main picky eating trajectories were defined: (1) never picky eating at all three assessments (55% of children), (2) remitting (0-4 years, 32%), (3) late-onset (6 years only, 4%), and (4) persistent (all ages, 4%). This implies that almost two thirds of the early picky eaters remitted within 3 years. Male sex, lower birth weight, non-Western maternal ethnicity, and low parental income predicted persistent picky eating. More often late-onset picky eaters were children of parents with low income and non-Western ethnicity. DISCUSSION We found that nearly half (46%) of children were picky eaters at some point during early childhood. Remittance was very high. This suggests that picky eating is usually a transient behavior and part of normal development in preschool children. However, a substantial group of persistent picky eaters, often from a socially disadvantaged background, continues to have problems beyond the preschool age.

Feeding practices and child weight: is the association bidirectional in preschool children?

BACKGROUND Parental feeding practices are associated with childrens body mass index (BMI). It has been generally assumed that parental feeding determines childrens eating behaviors and weight gain, but feeding practices could equally be a parents response to child weight. OBJECTIVE In longitudinal analyses, we assessed the directionality in the relation between selected controlling feeding practices and BMI in early childhood. DESIGN Participants were 4166 children from the population-based Generation R Study. BMI was measured at ages 2 and 6 y. With the use of the Child Feeding Questionnaire, parents reported on restriction, monitoring, and pressure to eat (child age: 4 y). BMI and feeding-behavior scales were transformed to SD scores. RESULTS With the use of linear regression analyses, there was an indication that a higher BMI at age 2 y predicted higher levels of parental restriction (adjusted β = 0.07; 95% CI: 0.04, 0.10) and lower levels of pressure to eat (adjusted β = -0.20; 95% CI: -0.23, -0.17) 2 y later. Restriction at age 4 y positively predicted child BMI at 6 y of age, although this association attenuated to statistical nonsignificance after accounting for BMI at age 4 y (β = 0.01; 95% CI: -0.01, 0.03). Pressure to eat predicted lower BMI independently of BMI at age 4 y (β = -0.02; 95% CI: -0.04, -0.01). For both restriction and pressure to eat, the relation from BMI to parenting was stronger than the reverse (Walds test for comparison: P = 0.03 and < 0.001, respectively). Monitoring predicted a lower child BMI, but this relation was explained by confounding factors. CONCLUSIONS Although the feeding-BMI relation is bidirectional, the main direction of observed effects suggests that parents tend to adapt their controlling feeding practices in response to their childs BMI rather than the reverse. Therefore, some components of current programs aimed at preventing or treating unhealthy child weight may need to be carefully scrutinized, especially those targeting parental food-related restriction and pressure to eat.

The prevalence of child sexual abuse in out-of-home care: a comparison between abuse in residential and in foster care

We investigated the 2010 year prevalence of child sexual abuse (CSA) in residential and foster care and compared it with prevalence rates in the general population. We used two approaches to estimate the prevalence of CSA. First, 264 professionals working in residential or foster care (sentinels) reported CSA for the children they worked with (N = 6,281). Second, 329 adolescents staying in residential or foster care reported on their own experiences with CSA. Sentinels and adolescents were randomly selected from 82 Dutch out-of-home care facilities. We found that 3.5 per 1,000 children had been victims of CSA based on sentinel reports. In addition, 248 per 1,000 adolescents reported having experienced CSA. Results based on both sentinel report and self-report revealed higher prevalence rates in out-of-home care than in the general population, with the highest prevalence in residential care. Prevalence rates in foster care did not differ from the general population. According to our findings, children and adolescents in residential care are at increased risk of CSA compared to children in foster care. Unfortunately, foster care does not fully protect children against sexual abuse either, and thus its quality needs to be further improved.

Maternal Psychopathology Influences Infant Heart Rate Variability : Generation R Study

Objective: To assess the determinants of heart rate (HR) and heart rate variability (HRV) in children. The autonomic nervous system as measured by HR and HRV is considered a biological marker of psychopathology in children. Methods: We examined the relationship of maternal psychopathology with infant HR and HRV. HR was recorded at 14 months in 528 infants. The high-frequency component of HRV was used as an indicator of cardiac vagal modulation. The presence of a lifetime maternal psychiatric diagnosis was assessed with the Composite International Diagnostic Interview. Presence of maternal psychiatric symptoms during pregnancy and 2 months after birth was assessed, using the Brief Symptom Inventory. Results: A maternal history of a psychiatric disorder was associated with a 0.24-standard deviation (SD) higher mean HR in the infant (&bgr; = 0.24, 95% Confidence Interval (CI) = 0.03, 0.4, p = .025) and a 0.14-SD lower high-frequency power (&bgr; = −0.14, 95% CI = −0.6, −0.03, p = .003). Likewise, postnatal maternal anxiety and depression symptoms were associated with infant mean HR. A 1-point increase in the mean anxiety symptom score was associated with 0.14-SD higher mean HR in the infant (&bgr; = 0.14, 95% CI = 0.05, 0.2, p = .004), and a 1-point increase in mean depression score with a 0.11-SD increase (&bgr; = 0.11, 95% CI = 0.01, 0.2, p = .025). No significant associations of prenatal maternal affective symptoms with infants autonomic functioning were found. Conclusion: Maternal lifetime psychiatric diagnosis and postnatal psychiatric symptoms are associated with infant autonomic functioning, namely, higher mean HR and lower vagal modulation. ANS = autonomic nervous system; BSI = Brief Symptom Inventory; CIDI = Composite International Diagnostic Interview; HF = high frequency; HR = heart rate; HRV = heart rate variability; IBQ = Infant Behavior Questionnaire; WHO = World Health Organization.

Infant Attachment, Parenting Stress, and Child Emotional and Behavioral Problems at Age 3 Years

SYNOPSIS Objective. To examine the role of infant attachment classification and parenting stress for toddler emotional and behavior problems. Design. Participants were 606 infant–mother dyads who took part in a population-based cohort study in the Netherlands. Infant–mother attachment classification was assessed using the Strange Situation Procedure when the children were 14 months old. At 18 months, parenting stress was measured with the Dutch version of the Parenting Stress Index. When the children were 3 years old, both mothers and fathers completed the Child Behavior Checklist. Results. Infant attachment moderated the effect of parenting stress on child emotional and behavior problems. Parenting stress was related to more aggression and attention problem behaviors in insecurely attached children, but not in securely attached children. Moreover, higher parenting stress was associated with more withdrawal problem behaviors in insecurely attached children, in particular in insecure-resistant and in disorganized children. Conclusion. In the presence of an insecure attachment relationship, more parenting stress is related to more (internalizing) withdrawal problem behavior and to more (externalizing) aggression and attention problems. Attachment security in infancy buffers the influence of parenting stress on child emotional and behavior problems.

Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children

OBJECTIVE To examine bidirectional associations between a childs fussy eating behavior and functional constipation. STUDY DESIGN Participants were 4823 children enrolled in a prospective cohort study from pregnancy onward. We assessed fussy eating at age 4 years with the Child Eating Behavior Questionnaire, and assessed functional constipation using ROME II and III criteria with parental questionnaires at age 2, 3, 4, and 6 years. RESULTS Higher food fussiness at age 4 years was associated with a greater risk of functional constipation at both 4 years (OR, 1.30; 95% CI, 1.20-1.42; P < .001 per 1 SD increase) and 6 years (OR, 1.12; 95% CI, 1.03-1.23; P < .05 per 1 SD increase). The converse was also observed; previous constipation predicted a greater risk of being a fussy eater at age 4 years (constipation at 2 years: OR, 2.05; 95% CI 1.43-2.94; P < .001; constipation at 3 years: OR, 1.72; 95% CI, 1.26-2.35, P < .001). Path analyses confirmed that the association between fussy eating and functional constipation was indeed bidirectional, showing that functional constipation at age 3 years predicted fussy eater classification at age 4 years (β = 0.06; P < .001), which in turn predicted functional constipation at age 6 years (β = 0.08: P < .001) independent of each other. CONCLUSION A vicious cycle might develop in which children with functional constipation develop unhealthy eating behavior, which in turn increases the risk of functional gastrointestinal disease.

The association between parenting and attachment security is moderated by a polymorphism in the mineralocorticoid receptor gene: evidence for differential susceptibility.

Maternal sensitive responsiveness and extreme insensitivity only partly explain the variance in attachment security. Differences in attachment security may well be rooted in the interplay of genetic variations and environmental factors. The association between parenting (observed sensitive responsiveness and extreme insensitivity) and attachment security (assessed with the Strange Situation Procedure) was hypothesized to be moderated by genes involved in the regulation of the stress response: the glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) genes. A significant G×E interaction was found: infants carrying the minor MR allele (G) were significantly more securely attached if their mothers showed more sensitive responsiveness and significantly less securely attached if their mothers showed more extremely insensitive behaviors. These associations were not significant for carriers of the AA genotype of MR. Findings are discussed from a differential susceptibility perspective.