Jaclyn A. Ludmer

Cumulative Risk, Cumulative Outcome: A 20-Year Longitudinal Study

Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a “mediated net of adversity” model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

Stress Physiology in Infancy and Early Childhood: Cortisol Flexibility, Attunement, and Coordination

Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic‐pituitary‐adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within‐subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of “flexibility,” the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregivers physiological function. Infant‐mother “attunement” is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the “coordination” of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between‐subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model..

Dopamine receptor D2 ( DRD2 ), dopamine transporter solute carrier family C6, member 4 ( SLC6A3 ), and catechol- O -methyltransferase ( COMT ) genes as moderators of the relation between maternal history of maltreatment and infant emotion regulation

Although infants less than 18 months old are capable of engaging in self-regulatory behavior (e.g., avoidance, withdrawal, and orienting to other aspects of their environment), the use of self-regulatory strategies at this age (as opposed to relying on caregivers) is associated with elevated behavioral and physiological distress. This study investigated infant dopamine-related genotypes (dopamine receptor D2 [DRD2], dopamine transporter solute carrier family C6, member 4 [SLC6A3], and catechol-O-methyltransferase [COMT]) as they interact with maternal self-reported history of maltreatment to predict observed infant independent emotion regulation behavior. A community sample (N = 193) of mother-infant dyads participated in a toy frustration challenge at infant age 15 months, and infant emotion regulation behavior was coded. Buccal cells were collected for genotyping. Maternal maltreatment history significantly interacted with infant SLC6A3 and COMT genotypes, such that infants with more 10-repeat and valine alleles of SLC6A3 and COMT, respectively, relative to infants with fewer or no 10-repeat and valine alleles, utilized more independent (i.e., maladaptive) regulatory behavior if mother reported a more extensive maltreatment history, as opposed to less. The findings indicate that child genetic factors moderate the intergenerational impact of maternal maltreatment history. The results are discussed in terms of potential mechanism of Gene × Environment interaction.

Association between maternal childhood maltreatment and mother-infant attachment disorganization: Moderation by maternal oxytocin receptor gene and cortisol secretion

ABSTRACT This study examined maternal oxytocin receptor (OXTR, rs53576) genotype and cortisol secretion as moderators of the relation between maternal childhood maltreatment history and disorganized mother‐infant attachment in the Strange Situation Procedure (SSP). A community sample of 314 mother‐infant dyads completed the SSP at infant age 17 months. Self‐reported maltreatment history more strongly predicted mother‐infant attachment disorganization score and disorganized classification for mothers with more plasticity alleles of OXTR (G), relative to mothers with fewer plasticity alleles. Maltreatment history also more strongly predicted mother‐infant attachment disorganization score and classification for mothers with higher SSP cortisol secretion, relative to mothers with lower SSP cortisol secretion. Findings indicate that maltreatment history is related to disorganization in the next generation, but that this relation depends on maternal genetic characteristics and cortisol. HighlightsModerators of maternal maltreatment history‐infant disorganized attachment relationMaltreatment‐disorganization relation stronger for mothers with OXTR G alleles.Maltreatment‐disorganization relation stronger for mothers with high cortisol.

Comparing the Multicomponent Coping Power Program to Individualized Parent–Child Treatment for Improving the Parenting Efficacy and Satisfaction of Parents of Children with Conduct Problems

This study compared the multicomponent Coping Power (group) program to individualized parent–child treatment with respect to changing the parenting efficacy and satisfaction of parents of children with conduct problems. One hundred fourteen parents of 9–12-year-old children with conduct problems were randomized to Coping Power or individualized treatment at an urban children’s mental health clinic. Parents reported their pre- and post-treatment parenting efficacy and parenting satisfaction (Parent Sense of Competence Scale). Mixed effect models revealed that parenting efficacy and satisfaction significantly increased from pre- to post-treatment, and there was no evidence that this effect is different between Coping Power and individualized treatment, even after controlling for initial severity of child symptomatology. Findings support the effectiveness of Coping Power as an intervention for parenting efficacy and satisfaction among parents of children aged 9–12 years with conduct problems.

Mothers' personal and interpersonal function as potential mediators between maternal maltreatment history and child behavior problems

This study examined maternal depressive symptoms, social support, parenting, and adult attachment as mediators explaining the relation between maternal childhood maltreatment and child behavior in offspring. We assessed a community sample of 96 mother–child dyads. At child age 16 months, mothers self-reported maltreatment history, adult attachment, depressive symptoms, and social support, and maternal sensitivity was assessed via 2 hr of direct behavioral observation. Maternal reports of child behavior were collected at 5 years. Single and parallel mediation models were constructed. Only maternal depressive symptoms mediated the relation between maternal maltreatment history and children’s internalizing problems. Maternal sensitivity emerged as a suppressor variable. With respect to the relation between maternal maltreatment history and children’s externalizing problems, when entered singly, maternal depressive symptoms, social support, and avoidant attachment emerged as mediators. When examined in parallel, only maternal depressive symptoms and avoidant attachment accounted for unique mediating variance. Findings have implications with respect to important maternal factors that might be targeted to reduce the probability of maladaptive child behavior.

Maternal DRD2, SLC6A3, and OXTR genotypes as potential moderators of the relation between maternal history of care and maternal cortisol secretion in the context of mother-infant separation

A mothers cortisol secretion is importantly associated with her own mental health and her infants cortisol secretion. This study investigated the influences of maternal history of care and maternal DRD2, SLC6A3, and OXTR genotypes on maternal cortisol in the context of infant stress. A community sample of 296 mother-infant dyads completed a maternal separation at infant age 17 months. Maternal salivary cortisol, buccal cells, and self-reported history of care were collected. Multilevel models revealed that history of care had a greater influence on maternal baseline cortisol (but not cortisol trajectory) for mothers with more plasticity alleles of SLC6A3 (10R) and OXTR (G), relative to mothers with fewer or no plasticity alleles. Findings indicate that a mothers history of care is related to her cortisol secretion in anticipation of infant stress, but that this relation depends on her genetic characteristics. Findings are discussed in relation to the maternal protective system and anticipatory cortisol secretion.

Accounting for the impact of parent internalizing symptoms on Parent Training benefits: The role of positive parenting

Parent Training (PT) is not as effective for parents with histories of internalizing symptoms as it is for other parents. This study aimed to determine which dimensions of parenting, notably parenting efficacy, positive parenting, inconsistent discipline, and poor supervision, mediate the association between parent lifetime internalizing symptoms and post-PT child emotional and behavioral difficulties. One hundred fourteen parents (82% biological mothers) of children aged 9-12 years received PT at an urban childrens mental health clinic. Parents reported their lifetime internalizing symptoms, pre- and post- PT parenting skills, and pre- and post- PT child difficulties. Positive parenting fully mediated the relation between parent lifetime internalizing symptoms and elevated child post-PT emotional and behavioral difficulties. Specifically, parents higher in internalizing symptoms reported lower positive parenting post-PT, which in turn predicted more child difficulties post-PT. Findings suggest that fostering positive parenting in PT may be particularly important for parents with histories of internalizing symptoms.