Lenneke R. A. Alink

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.

Longitudinal Associations among Child Maltreatment, Social Functioning, and Cortisol Regulation

Child maltreatment increases the risk for impaired social functioning and cortisol regulation. However, the longitudinal interplay among these factors is still unclear. This study aimed to shed light on the effect of maltreatment on social functioning and cortisol regulation over time. The sample consisted of 236 children (mean age 7.64 years, SD = 1.36; 125 maltreated children and 111 nonmaltreated children, 128 boys and 108 girls) who attended a week-long summer camp for 2 consecutive years. Saliva was collected during 5 days at 9:00 a.m. and 4:00 p.m. Means of morning and afternoon cortisol levels and cortisol change (difference between morning and afternoon levels, controlled for morning levels) were used to group the children into low-, medium-, and high-cortisol groups. Prosocial, disruptive/aggressive, and withdrawn behaviors were assessed using information from peers and counselors. Maltreated children showed less prosocial and more disruptive/aggressive and withdrawn behavior. Results of structural equation modeling analyses indicated that there were indirect effects of maltreatment on Year 2 morning cortisol via prosocial and disruptive/aggressive behavior: Lower levels of prosocial behavior and higher levels of disruptive/aggressive behavior were related to lower morning cortisol levels 1 year later. Withdrawn behavior was related to higher afternoon cortisol values 1 year later. Results of this study suggest that maltreated children are more likely to experience difficulties in social functioning, which in turn is related to cortisol regulation 1 year later. This altered hypothalamic-pituitary-adrenocortical (HPA) axis functioning may put children at risk for later psychopathology.

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.

Cultural–geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence

Our comprehensive meta-analysis combined prevalence figures of child physical abuse reported in 111 studies, including 168 independent samples with a total of 9,698,801 participants. The overall estimated prevalence was 3/1000 for studies using informants and 226/1000 for studies using self-report measures of child physical abuse, with no apparent gender differences. Methodological factors partly explained the vast variation of self-reported prevalence rates in individual studies. The highest prevalence rates were found for studies using a broad definition of child physical abuse, studies measuring physical abuse over the longest period of 0-18 years, studies using college samples, studies in which adults served as respondents, and studies using more questions on physical abuse. Cultural-geographical factors did not seem to affect prevalence rates of physical abuse, which may be partly due to procedural factors. More crosscultural research on physical abuse is badly needed, especially in Africa and South America. We conclude that child physical abuse is a widespread, global phenomenon affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nations Convention on the Rights of the Child.

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.

The Universality of Childhood Emotional Abuse: A Meta-Analysis of Worldwide Prevalence

This comprehensive meta-analysis combined prevalence figures of child emotional abuse reported in 29 studies, including 46 independent samples with a total of 7,082,279 participants. The overall estimated prevalence was 3/1,000 for studies using informants and 363/1,000 for studies using self-report measures of child emotional abuse. Procedural factors seem to exert a greater influence on the prevalence of childhood emotional abuse than sample characteristics and definitional issues, without fully explaining the vast variation of prevalence rates reported in individual studies. We conclude that child emotional abuse is a universal problem affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nations Convention on the Rights of the Child.

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.

Infants' responsiveness, attachment, and indiscriminate friendliness after international adoption from institutions or foster care in China: application of Emotional Availability Scales to adoptive families.

In a short-term longitudinal design we investigated maternal sensitivity, child responsiveness, attachment, and indiscriminate friendliness in families with children internationally adopted from institutions or foster care in China. Ninety-two families with 50 postinstitutionalized and 42 formerly fostered girls, aged 11-16 months on arrival, were studied 2 and 6 months after adoption. Maternal sensitivity and child responsiveness were observed with the Emotional Availability Scales, attachment was assessed with the Strange Situation procedure, and mothers reported on childrens indiscriminate friendliness. The postinstitutionalized children showed less secure attachment, whereas the former foster children did not differ from the normative distribution of attachment security. However, at both assessments the two groups of adopted children showed more disorganized attachments compared to normative data. Adoptive mothers of postinstitutionalized and former foster children were equally sensitive and their sensitivity did not change over time. Postinstitutionalized and former foster children did not differ on indiscriminate friendliness, but children with more sensitive adoptive mothers showed less indiscriminate friendliness. The former foster children showed a larger increase in responsiveness over time than the postinstitutionalized children, suggesting that childrens responsiveness is more sensitive to change than attachment, and that preadoption foster care is more beneficial for the development of childrens responsiveness after adoptive placement than preadoption institutional care.

The impact of oxytocin administration on charitable donating is moderated by experiences of parental love-withdrawal

Oxytocin has been implicated in a variety of prosocial processes but most of this work has used laboratory tasks (such as the ultimatum game or the dictator game) to evaluate oxytocin’s prosocial effects. In a double blind randomized trial we examined the influence of intranasal administration of oxytocin on real, high-cost donating money to a charity without any expectation for reciprocation. Participants in the current study were 57 female undergraduate students, aged 18–30 years, who received a nasal spray containing either 24 IU of oxytocin or a placebo, and were then given the opportunity to make a charitable donation. The participants reported how often their parents used love-withdrawal as a disciplinary strategy involving withholding love and affection after a failure or misbehavior. Oxytocin appeared to increase the participants’ willingness to donate money to a charity but only in participants who experienced low levels of parental love-withdrawal. In contrast, oxytocin administration was ineffective in enhancing donating behavior in individuals who experienced high levels of parental love-withdrawal. We conclude that the positive effect of oxytocin administration on prosocial behavior may be limited to individuals with supportive backgrounds.