Erika Hohm

Maternal bond and mother-child interaction in severe postpartum psychiatric disorders: is there a link?

SummaryMothers in the puerperium are vulnerable to a wide spectrum of postpartum psychiatric disorders. One of the central psychological processes of the puerperium is the development of an emotional relationship with the baby. The bond to the infant as well as the interaction with the baby are two aspects of the mother–infant relationship that can be disturbed by mothers with postpartum psychiatric disorders. Dysfunctional maternal cognitions may also influence the development of an emotional bonding and the establishment of a positive interaction with the child. The aim of this study is to investigate differences in the self-perceived experience of bonding and the observed mother–child interaction of severely ill postpartum depressive and psychotic mothers. In addition the association between subjective experience of bonding and objective measurement of mother–child interaction will be described. Results show that depressive mothers perceived their bonding to the baby more negatively than psychotic mothers. No differences could be found in the objective interactional behaviour of the mothers in both groups, with the exception that the infants of psychotic mothers showed more eye contact avoidance towards their mothers. The subjective experience of motherhood clearly influences the maternal interactional behaviour with depressive mothers as well as with psychotic mothers.

Negative association between plasma cortisol levels and aggression in a high-risk community sample of adolescents

In this study, the association of aggressive behavior and personality traits with plasma cortisol levels was investigated in a high-risk community sample of adolescents. Plasma cortisol levels were collected in 245 fifteen-year-olds (118 males, 127 females) from an epidemiological cohort study of children at risk for psychopathology. Additionally, measures of reactive and proactive aggression, externalizing behavior and callous-unemotional together with impulsive personality features were assessed. Both subtypes of aggression as well as delinquent behavior and impulsive personality traits showed significant negative correlations with plasma cortisol levels. This association was observed in males, but not in females. In both gender groups, callous-unemotional traits were unrelated to plasma cortisol levels. This result suggests that the association between cortisol levels and aggression in adolescents is mediated rather by impulsivity than by unemotional or psychopathic traits.

Association between ADHD and smoking in adolescence: shared genetic, environmental and psychopathological factors

SummaryThe present study aimed to examine the extent to which the co-occurrence of ADHD and smoking in adolescents could be attributed to common genetic, environmental and psychopathological factors. Data are from an ongoing prospective study of the outcome of early risk factors. At age 15 years, 305 adolescents completed self-report questionnaires measuring tobacco consumption and deviant peer affiliations. Lifetime psychiatric diagnoses were obtained using standardized interviews. DNA was genotyped for the dopamine D4 receptor (DRD4) gene exon III polymorphism. Adolescents with a lifetime diagnosis of ADHD displayed significantly higher smoking activity than non-ADHD controls. A major component of this association could be accounted for by deviant peer affiliations and the comorbidity with oppositional-defiant and conduct disorder, while a minor part was attributable to DRD4 in males but not in females. These findings suggest that the association of ADHD with smoking relies on risk factors shared by the two behaviors.

Effect of Prenatal Exposure to Tobacco Smoke on Inhibitory Control: Neuroimaging Results From a 25-Year Prospective Study

IMPORTANCE There is accumulating evidence relating maternal smoking during pregnancy to attention-deficit/hyperactivity disorder (ADHD) without elucidating specific mechanisms. Research investigating the neurobiological underpinnings of this disorder has implicated deficits during response inhibition. Attempts to uncover the effect of prenatal exposure to nicotine on inhibitory control may thus be of high clinical importance. OBJECTIVE To clarify the influence of maternal smoking during pregnancy (hereafter referred to as prenatal smoking) on the neural circuitry of response inhibition and its association with related behavioral phenotypes such as ADHD and novelty seeking in the mothers offspring. DESIGN, SETTING, AND PARTICIPANTS Functional magnetic resonance imaging was performed for the offspring at 25 years of age during a modified Eriksen flanker/NoGo task, and voxel-based morphometry was performed to study brain volume differences of the offspring. Prenatal smoking (1-5 cigarettes per day [14 mothers] or >5 cigarettes per day [24 mothers]) and lifetime ADHD symptoms were determined using standardized parent interviews at the offsprings age of 3 months and over a period of 13 years (from 2 to 15 years of age), respectively. Novelty seeking was assessed at 19 years of age. Analyses were adjusted for sex, parental postnatal smoking, psychosocial and obstetric adversity, maternal prenatal stress, and lifetime substance abuse. A total of 178 young adults (73 males) without current psychopathology from a community sample followed since birth (Mannheim, Germany) participated in the study. MAIN OUTCOMES AND MEASURES Functional magnetic resonance imaging response, morphometric data, lifetime ADHD symptoms, and novelty seeking. RESULTS Participants prenatally exposed to nicotine exhibited a weaker response in the anterior cingulate cortex (t168 = 4.46; peak Montreal Neurological Institute [MNI] coordinates x = -2, y = 20, z = 30; familywise error [FWE]-corrected P = .003), the right inferior frontal gyrus (t168 = 3.65; peak MNI coordinates x = 44, y = 38, z = 12; FWE-corrected P = .04), the left inferior frontal gyrus (t168 = 4.09; peak MNI coordinates x = -38, y = 36, z = 8; FWE-corrected P = .009), and the supramarginal gyrus (t168 = 5.03; peak MNI coordinates x = 64, y = -28, z = 22; FWE-corrected P = .02) during the processing of the NoGo compared to neutral stimuli, while presenting a decreased volume in the right inferior frontal gyrus. These findings were obtained irrespective of the adjustment of confounders, ADHD symptoms, and novelty seeking. There was an inverse relationship between inferior frontal gyrus activity and ADHD symptoms and between anterior cingulate cortex activity and novelty seeking. CONCLUSIONS AND RELEVANCE These findings point to a functional involvement of prenatal exposure to tobacco smoke in neural alterations similar to ADHD, which underlines the importance of smoking prevention treatments.

The long-term impact of early life poverty on orbitofrontal cortex volume in adulthood: results from a prospective study over 25 years

Converging evidence has highlighted the association between poverty and conduct disorder (CD) without specifying neurobiological pathways. Neuroimaging research has emphasized structural and functional alterations in the orbitofrontal cortex (OFC) as one key mechanism underlying this disorder. The present study aimed to clarify the long-term influence of early poverty on OFC volume and its association with CD symptoms in healthy participants of an epidemiological cohort study followed since birth. At age 25 years, voxel-based morphometry was applied to study brain volume differences. Poverty (0=non-exposed (N=134), 1=exposed (N=33)) and smoking during pregnancy were determined using a standardized parent interview, and information on maternal responsiveness was derived from videotaped mother–infant interactions at the age of 3 months. CD symptoms were assessed by diagnostic interview from 8 to 19 years of age. Information on life stress was acquired at each assessment and childhood maltreatment was measured using retrospective self-report at the age of 23 years. Analyses were adjusted for sex, parental psychopathology and delinquency, obstetric adversity, parental education, and current poverty. Individuals exposed to early life poverty exhibited a lower OFC volume. Moreover, we replicated previous findings of increased CD symptoms as a consequence of childhood poverty. This effect proved statistically mediated by OFC volume and exposure to life stress and smoking during pregnancy, but not by childhood maltreatment and maternal responsiveness. These findings underline the importance of studying the impact of early life adversity on brain alterations and highlight the need for programs to decrease income-related disparities.

Association of norepinephrine transporter (NET, SLC6A2) genotype with ADHD-related phenotypes: Findings of a longitudinal study from birth to adolescence

Variation in the gene encoding for the norepinephrine transporter (NET, SLC6A2) has repeatedly been linked with ADHD, although there is some inconsistency regarding the association with specific genes. The variants for which most consistent association has been found are the NET variants rs3785157 and rs28386840. Here, we tested for their association with ADHD diagnosis and ADHD-related phenotypes during development in a longitudinal German community sample. Children were followed from age 4 to age 15, using diagnostic interviews to assess ADHD. Between the ages of 8 and 15 years, the Child Behavior Checklist (CBCL) was administered to the primary caregivers. The continuous performance task (CPT) was performed at age 15. Controlling for possible confounders, we found that homozygous carriers of the major A allele of the functional promoter variant rs28386840 displayed a higher rate of ADHD lifetime diagnosis. Moreover, homozygous carriers of the minor T allele of rs3785157 were more likely to develop ADHD and showed higher scores on the CBCL externalizing behavior scales. Additionally, we found that individuals heterozygous for rs3785157 made fewer omission errors in the CPT than homozygotes. This is the first longitudinal study to report associations between specific NET variants and ADHD-related phenotypes during the course of development.

Intrauterine Exposure to Cigarette Smoke Is Associated with Increased Ghrelin Concentrations in Adulthood

Background: The appetite-stimulating hormone ghrelin is a fundamental regulator of human energy metabolism. A series of studies support the notion that long-term appetite and weight regulation may be already programmed in early life and it could be demonstrated that the intrauterine environment affects the ghrelin system of the offspring. Animal studies have also shown that intrauterine programming of orexigenic systems persists even until adolescence/adulthood. Methods: We hypothesized that plasma ghrelin concentrations in adulthood may be associated with the intrauterine exposure to cigarette smoke. We examined this hypothesis in a sample of 19-year-olds followed up since birth in the framework of the Mannheim Study of Children at Risk, an ongoing epidemiological cohort study of the long-term outcome of early risk factors. Results: As a main finding, we found that ghrelin plasma concentrations in young adults who had been exposed to cigarette smoke in utero were significantly higher than in those without prenatal smoke exposure. Moreover, individuals with intrauterine nicotine exposure showed a significantly higher prevalence of own smoking habits and lower educational status compared to those in the group without exposure. Conclusion: Smoking during pregnancy may be considered as an adverse intrauterine influence that may alter the endocrine-metabolic status of the offspring even until early adulthood.

Soziale und individuelle Determinanten des Tabakkonsums im frühen Jugendalter

Zusammenfassung: Fragestellung: Der Tabakkonsum von Jugendlichen soll hinsichtlich des Wirkungsgefuges individueller und sozialer Einflussfaktoren untersucht werden. Methodik: In einer prospektiven Langsschnittstudie an einer Geburtskohorte von 384 Kindern mit Risiken fur die Entwicklung psychischer Auffalligkeiten wurden im Alter von 15 Jahren der jugendliche Tabakkonsum, mit dem Rauchen verbundene Erwartungen bezuglich Instrumentalitat und Selbstwirksamkeit sowie der Tabakkonsum im Elternhaus und Freundeskreis erhoben. Ergebnisse: Etwa 60% der 15-Jahrigen gaben an, jemals Zigaretten konsumiert zu haben, ca. 16% rauchten taglich. Eine geringe rauchbezogene Selbstwirksamkeit und eine hohe Anzahl tabakkonsumierender Freunde waren bei beiden Geschlechtern am engsten mit dem jugendlichen Zigarettenkonsum verbunden. Besonders gefahrdet waren Jugendliche mit einem hohen Tabakkonsum im Freundeskreis, die sich als wenig selbstwirksam beschrieben. Wahrend elterliches Rauchen einen direkten, aber geringen Einfluss...

Lower cortisol level in response to a psychosocial stressor in young females with self-harm

BACKGROUND Self-harm is highly prevalent in adolescence, often serving an emotion regulation function. Social stressors such as bullying are associated with self-harm. The neurobiological background of the relationship between social stressors and self-harm needs to be further understood to inform prevention and therapy. METHODS Participants were members of an epidemiological cohort study. 130 female participants underwent the Trier Social Stress Test (TSST) at age 19. Of them, 21 reported a history of self-harm as assessed by the Youth Self Report. Psychiatric diagnoses were recorded. RESULTS Participants with a history of self-harm showed significantly lower blood cortisol levels throughout the TSST. Early psychosocial adversity did not significantly differ between groups with and without self-harm, with self-harming participants reporting more childhood adversities. CONCLUSION These results add to the limited field of studies showing an altered HPA axis activity in females with self-harm. Future studies need to address the causal mechanisms behind this association.

Effekte, Verlauf und Erfolgsbedingungen unterschiedlicher erzieherischer Hilfen

Zusammenfassung. Die Ergebnisse der ersten prospektiven Langsschnittstudie zu Beziehungen zwischen Effekten unterschiedlicher erzieherischer Hilfen und Daten aus der Hilfeplanung wird vorgelegt. Sie beruht auf 180 von insgesamt 233 Verlaufen fur die Erhebungen an drei Zeitpunkten angestellt werden konnten. Befunde aus dem Hilfeplanungsprozes, nach dem halben Hilfeverlauf (langstens nach einem Jahr) und am Ende (nach maximal zwei Jahren) wurden berucksichtigt. Als Ergebnisdaten galten die Reduktion der Symptomatik, das erreichte Funktionsniveau und das Ausmas abnormer psychosozialer Bedingungen im Umfeld des Kindes, die an den drei Zeitpunkten erhoben worden waren. Die postulierten Beziehungen zwischen Ausgangsproblematik, Ausgangsbelastung und Potential von Kind und Familie mit den drei Ergebnisvariablen wurden bestatigt. Sie blieben stabil, wenn die Strukturqualitat der Einrichtung, die Qualitat des einzelnen Hilfeprozesses, die Hilfeart und das Geschlecht kontrolliert wurden. Die Diskussion erorterte da...