Judi Mesman

Experimental Evidence for Differential Susceptibility: Dopamine D4 Receptor Polymorphism (DRD4 VNTR) Moderates Intervention Effects on Toddlers' Externalizing Behavior in a Randomized Controlled Trial.

In a randomized controlled trial we tested the role of genetic differences in explaining variability in intervention effects on child externalizing behavior. One hundred fifty-seven families with 1- to 3-year-old children screened for their relatively high levels of externalizing behavior participated in a study implementing Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), with six 1.5-hr intervention sessions focusing on maternal sensitivity and discipline. A moderating role of the dopamine D4 receptor (DRD4) variable-number tandem repeat (VNTR) exon III polymorphism was found: VIPP-SD proved to be effective in decreasing externalizing behavior in children with the DRD4 7-repeat allele, a polymorphism that is associated with motivational and reward mechanisms and Attention Deficit Hyperactivity Disorder (ADHD) in children. VIPP-SD effects were largest in children with the DRD4 7-repeat allele whose parents showed the largest increase in the use of positive discipline. The findings of this first experimental test of (measured) gene by (observed) environment interaction in human development indicate that children may be differentially susceptible to intervention effects depending on genetic differences.

Cortisol and externalizing behavior in children and adolescents: mixed meta-analytic evidence for the inverse relation of basal cortisol and cortisol reactivity with externalizing behavior.

An inverse relation between cortisol (re)activity and externalizing behavior has been hypothesized, but research findings seem equivocal. We tested this hypo(re)activity hypothesis in two meta-analyses, one for basal cortisol (k = 72 studies, N = 5,480) and one for cortisol reactivity to a stressor (k = 29 studies, N = 2,601). No association was found between cortisol reactivity and externalizing behaviors (r = -.04, 95% CI = -.11, .02). However, the relation between basal cortisol and externalizing behavior was significant but small (r = -.05, 95% CI = -.10, -.002). The age of the children significantly moderated this relation: Externalizing behavior was associated with higher basal cortisol (hyperactivity) in preschoolers (r = .09, 95% CI = .002, .17), and with lower basal cortisol (hypoactivity) in elementary school-aged children (r = -.14, 95% CI = -.19, -.08). There was no significant relation between cortisol and externalizing behavior in adolescents.

Attachment-Based Intervention for Enhancing Sensitive Discipline in Mothers of 1- to 3-Year-Old Children at Risk for Externalizing Behavior Problems: A Randomized Controlled Trial.

The home-based intervention program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) was tested in a randomized controlled trial with 237 families screened for their 1- to 3-year-old childrens relatively high scores on externalizing behavior. VIPP-SD, based on attachment theory and coercion theory, focuses on mirroring and discussing actual parent-child interactions in six 1.5-hr sessions with individual families at home. VIPP-SD proved to be effective in enhancing maternal attitudes toward sensitivity and sensitive discipline and in promoting sensitive discipline interactions in the intervention group as compared with the control group. Moreover, in families with more marital discord and in families with more daily hassles, the intervention resulted in a decrease of overactive problem behaviors in the children. The authors conclude that VIPP-SD should become an important module in attachment-based interventions.

Early Preschool Predictors of Preadolescent Internalizing and Externalizing DSM-IV Diagnoses

OBJECTIVE To investigate the independent predictive value of parent-reported psychopathology and family risk factors in early preschool in relation to parent-reported internalizing and externalizing psychopathology in preadolescence. METHOD Subjects were participants in a longitudinal study of 420 two- to three-year-olds from the general population of Zuid-Holland, the Netherlands, which started in 1989. At a second follow-up 8 years later (ages 10-11 years), 358 children participated. For this study, 332 children were included for whom DSM-IV diagnoses (derived from the Diagnostic Interview Schedule for Children-Version 4-Parent Version) were obtained at age 10 to 11 years. Preschool risk factors were obtained through the Child Behavior Checklist for ages 2 to 3 years and a parent interview. RESULTS Early preschool internalizing and externalizing problems were predictive of their DSM-IV counterparts 8 years later, independent of the influence of early parent-reported family risk factors. Preschool child physical problems were independently predictive of both internalizing and externalizing diagnoses in preadolescence. Of the environmental risk factors, only stressful life events contributed independently to the prediction of later externalizing problems. CONCLUSION Early adverse family circumstances and parenting characteristics do not contribute to the prediction of later psychopathology once child characteristics are accounted for.

Child-Reported Depression and Anxiety in Preadolescence: I. Associations With Parent- and Teacher-Reported Problems

OBJECTIVE To examine a wide range of parent- and teacher-reported behaviors in relation to child-reported depression and anxiety in preadolescence. METHOD Subjects were participants in a longitudinal study of 420 preschool children from the general population that started in 1989. At second follow-up 8 years later (ages 10-11 years), usable parent information was obtained for 358 children. For this study, 274 children for whom complete child, parent, and teacher reports were obtained at age 10 to 11 years were included. Measures included the Dimensions of Depression Profile for Children, the State-Trait Anxiety Inventory for Children, the Child Behavior Checklist/4-18, and the Teachers Report Form. RESULTS Of 120 parent-reported problem items, only 11 and 9 were associated with child-reported depression and anxiety, respectively. For teachers, 33 and 20 items (of 120) were significantly associated with child-reported depression and anxiety, respectively, including items referring to withdrawal, anxiety, depression, social problems, and academic problems. CONCLUSIONS Teachers are more likely than parents to notice internalizing problems and related problems such as social and academic problems in children reporting depression or anxiety.

Effects of an attachment-based intervention on daily cortisol moderated by dopamine receptor D4: A randomized control trial on 1- to 3-year-olds screened for externalizing behavior

The effect of the Video-Feedback Intervention to Promote Positive Parenting and Sensitive Discipline (VIPP-SD) on daily cortisol production was tested in a randomized controlled trial with 130 families with 1- to 3-year-old children screened for their relatively high levels of externalizing behavior. Six 1.5-hr intervention sessions focusing on maternal sensitivity and discipline were conducted with individual families at their homes. Children in the intervention group showed lower cortisol levels, with a moderating role of the dopamine receptor D4 (DRD4) VNTR exon III polymorphism. The VIPP-SD program proved to be effective in decreasing daily cortisol production in children with the DRD4 7-repeat allele, but not in children without the DRD4 7-repeat allele. Our findings indicate that children are differentially susceptible to intervention effects dependent on the presence of the 7-repeat DRD4 allele.

Dopamine system genes associated with parenting in the context of daily hassles

The current study examined the molecular genetic foundations of sensitive parenting in humans and is the first to test the interaction between genes and environment in modulating parental sensitive responses to children. In a community sample of 176 Caucasian, middle class mothers with their 23‐month‐old toddlers at risk for externalizing behavior problems, the association between daily hassles and sensitive parenting was investigated. We tested whether two dopamine‐related genes, dopamine D4 receptor (DRD4) and catechol‐O‐methyltransferase (COMT) gene polymorphisms, modulate parents’ vulnerability to the negative influence of daily hassles on sensitive parenting behavior to their offspring. Sensitive parenting was observed in structured settings, and parents reported on their daily hassles through a standard questionnaire. In parents with the combination of genes leading to the least efficient dopaminergic system functioning (COMT val/val or val/met, DRD4‐7Repeat), more daily hassles were associated with less sensitive parenting, and lower levels of daily hassles were associated with more sensitive parenting d = 1.12. The other combinations of COMT and DRD4 polymorphisms did not show significant associations between daily hassles and maternal sensitivity, suggesting differential susceptibility to hassles depending on parents’ dopaminergic system genes. It is concluded that the study of (multiple) gene–environment interactions (in the current case: gene by gene by environment interaction, G × G × E) may explain why some parents are more and others less impacted by daily stresses in responding sensitively to their offspring’s signals.

Differential susceptibility to discipline: The moderating effect of child temperament on the association between maternal discipline and early childhood externalizing problems

This study investigated the interaction of child temperament and maternal discipline in the prediction of externalizing problems in early childhood. Interaction effects were evaluated in a sample of 227 one- to three-year-old children with relatively high externalizing problems scores on the Child Behavior Checklist/1 1/2-5. Child temperament was reported by the mothers, maternal discipline was observed in a laboratory session, and child outcome measures included both mother-reported externalizing problems and observed physical aggression. Results indicate that children with difficult temperaments are more susceptible to negative discipline (i.e., they showed more externalizing problems) as well as more susceptible to positive discipline (i.e., they showed fewer externalizing problems and less physical aggression), as compared with children with relatively easy temperaments. These findings provide empirical evidence for the differential susceptibility hypothesis and suggest directions for enhancing the effectiveness of interventions aimed at reducing early childhood externalizing problems.

Maternal sensitivity to infants in various settings predicts harsh discipline in toddlerhood.

In a longitudinal study with 73 mothers and their second-born child, stability and main-level differences between measures of maternal sensitivity across settings and over time were examined. Furthermore, the predictability of harsh discipline by these different maternal sensitivity measures was studied. Maternal sensitivity was assessed at three and six months during bathing, free play on mothers lap and the baseline and reunion episode of the Still Face Paradigm (SFP; Tronick, Als, Adamson, Wise, & Brazelton, 1978). Harsh discipline was observed during three home visits in the second year of life. Results showed a single underlying factor for all maternal sensitivity settings at both time points and significant stability over time. Harsh discipline was predicted by maternal sensitivity at three months, which was fully mediated by maternal sensitivity at six months. Early failure to respond appropriately to infant signals is an important indicator of risk for future harsh parenting.

Mary Ainsworth’s legacy: a systematic review of observational instruments measuring parental sensitivity

Since Mary Ainsworth’s formulation of the Sensitivity-Insensitivity to Infant Signals and Communications observational scale, new instruments have been developed to observe parental sensitivity. In this paper, we provide an overview of eight commonly used observational instruments to measure parental sensitivity. Their similarities and differences in comparison to the original Ainsworth sensitivity construct and its applications will be discussed. Consistent with the search criteria, each of the instruments clearly includes the key elements of Ainsworth’s definition of sensitivity. Notable deviations from the original scale are the use of composite scales rather than a single global scale and the related inclusion of new elements, and specifically the inclusion of positive affect as an indicator of sensitivity. Further, most of the instruments have a wider scope than Ainsworth’s sensitivity scale in terms of target age groups and the assessment of sensitivity in fathers. We discuss the interpretation of the sensitivity construct depending on variations in how the construct is defined in different observational instruments, and advances in the application of the construct.