Marianne Riksen-Walraven

Cortisol reactivity in young infants

In this systematic review on empirical studies of cortisol reactivity to acute stressors in infants, we specifically focus on the role of infant age in the early development of cortisol reactivity to stressors. Our findings indicate that many psychological stressors do not provoke a cortisol reaction, but in response to physical stressors, the infant HPA-axis mostly reacts with a moderate increase in post-stressor cortisol. Furthermore, for physical stressors only, cortisol reactivity effect sizes decrease with infant age, although relatively little is known for infants older than 6 months. These data provide more insight in the role of infant age in the development of cortisol reactivity in response to acute stressors. We discuss the role of caregivers in buffering the cortisol response to both psychological and physical stressors, and recommend extending the current knowledge on infant cortisol reactivity.

Need fulfillment in caring relationships: Its relation with well-being of residents in somatic nursing homes

Objectives: Quality of life and well-being in nursing homes are becoming more important in research and practice. Based on self-determination theory, the objective of this study is to examine the contribution of need fulfillment in the caring relationship to residents’ subjective well-being. It was expected that the relation of need fulfillment in the caring relationship with well-being is mediated by need fulfillment in general. Method: During interviews with 88 residents of somatic nursing homes (age 50–97, mean age 78.6), perceptions of need fulfillment in the caring relationship, need fulfillment in general, and two components of subjective well-being, i.e., depressive feelings and life satisfaction, were measured. The hypotheses were tested using hierarchical multiple regression analyses and mediational analysis. Results: As expected, the results indicated that need fulfillment in the caring relationship was related to lower levels of depressive feelings and more life satisfaction. Need fulfillment in general mediated the relation of need fulfillment in the caring relationship with depressive feelings. Conclusion: As suggested by the results, it can be concluded that high-quality caring relationships contribute to the need fulfillment of residents and their well-being. The quality of caring relationships is thus an important topic for further research. The field may especially benefit from longitudinal studies and studies that use observations of the caring relationship in addition to self-reports.

Need fulfillment, need importance, and depressive symptoms of residents over the first eight months of living in a nursing home

BACKGROUND Based on self-determination theory and adaptation theories, the study aim was to investigate the relationship between need fulfillment (of autonomy, relatedness, and competence), need importance, and depressive symptoms during the first months of living in a nursing home. METHODS Eight-month longitudinal questionnaire study in which 75 persons newly admitted to units for physically frail residents participated at baseline. Twenty-three longitudinal participants were remaining at the third and final measurement wave. RESULTS The results show a main effect of need fulfillment and an interaction effect of need fulfillment and need importance on depressive symptoms over time. A prototypical plot shows that residents with low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, regardless of their need importance. Residents with high need fulfillment had lower initial levels of depressive symptoms, but their trajectories differed for participants with low and high need importance. Residents with low need importance started with lower levels of depressive symptoms but remained stable over time, whereas residents with high need importance had more depressive symptoms at T1 that decreased slightly over time. CONCLUSIONS In general, depressive symptoms do not change over time. However, individual trajectories of depressive symptoms seem to depend on individual need fulfillment and need importance. The residents that consider need fulfillment to be highly important but experience low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, although the level of depressive symptoms remained higher as compared to the other residents.

Maternal late pregnancy anxiety and stress is associated with children’s health: a longitudinal study

Abstract Aim: Maternal prenatal anxiety and stress (PNS) have been positively associated to physical health prob lems in offspring in the first year of life. Whether these associations are transient, persistent, or even progressive over time, is as yet unknown. The goal of this study is to investigate associations between late pregnancy PNS and child health from 18 months to age 6. Methods: Mothers were recruited in late pregnancy, and had uncomplicated, singleton pregnancies without physical health problems. Around week 37 of pregnancy, mothers reported on their PNS by means of questionnaires, and provided saliva for determination of circadian cortisol concentrations. Children’s illnesses in the preceding year were assessed using maternal reports at 30, 48, 60, and 72 months. Antibiotic use was obtained from medical records between one and six years. Multilevel models (N¼174) showed a positive relation between maternal prenatal general and pregnancy-specific anxiety during late pregnancy and offspring respiratory illnesses and symptoms. Interaction effects with time indicated that more PNS was related to more respiratory illnesses until toddlerhood, but not later in life. Furthermore, maternal prenatal cortisol concentrations were related to child digestive illnesses. A steeper maternal cortisol decline over the day was related to more child digestive illnesses, until around three years of age. Finally, children of mothers who suffered more from daily hassles during pregnancy received more antibiotics between one and six years of age. PNS was not related to general and skin illnesses. Conclusion: Summarizing, this study showed that late pregnancy anxiety and cortisol was associated with children’s respiratory and digestive illnesses till the age of 3.0–3.5 years. Additionally, more daily hassles were related to more prescribed antibiotics between one and six years. These findings point in the direction of possible effects of PNS persisting beyond the first year of life and into toddlerhood, but disappearing at older ages.

Differential associations between behavioral and cortisol responses to a stressor in securely versus insecurely attached infants

HighlightsDo secure and insecure infants use different regulatory behaviors when stressed?Insecure infants fussed less when physiologically stressed.Secure infants showed more self‐soothing when physiologically stressed.29% explained variance in cortisol by regulatory behaviors in mother’s absence.Behavior and cortisol are differentially associated in secure and insecure infants. Abstract In this study we examined whether securely versus insecurely attached infants use different regulatory behaviors in absence of their mother and whether these regulatory behaviors are differentially associated with physiological stress responses in secure versus insecure infants. Participants were 193 one‐year‐olds and their mothers. During three 3‐min episodes of separation from the mother in the Strange Situation Procedure (SSP) [1], the following infant regulatory behaviors were observed: crying, fussing, self‐soothing, manipulation of toys, and manipulation of the door. Salivary cortisol was measured at baseline and 25, 40, and 60 min after the SSP to measure reactivity and recovery. Additionally, infants were classified as securely or insecurely attached to their mothers. During the mother’s absence, secure infants engaged more in manipulation of the door than insecure infants. Furthermore, in insecure (but not secure) infants less fussing was associated with higher cortisol reactivity, while in secure (but not insecure) infants more self‐soothing was associated with higher cortisol reactivity. In total, 29% of the variance in cortisol reactivity was explained by infant regulatory behaviors in the mother’s absence. Cortisol recovery was not predicted by infant regulatory behaviors in the mother’s absence. To conclude, the results show differential associations between behavioral and cortisol responses to a stressor in secure versus insecure infants. This might indicate that secure and insecure infants apply different behavioral regulatory strategies when physiologically stressed.