Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity

The current study examined the role of hypothalamic‐pituitary‐adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at‐risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers’ depression was measured five times during the infants’ first 18 months. Infant cortisol was collected during a social stressor (the still‐face paradigm) when infants were 6 months old, and mothers reported on toddlers’ internalizing and externalizing symptoms at 18 months. Among this sample of high‐risk mother–infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.     

Co-development of internalizing and externalizing behavior problems during early childhood among child welfare-involved children

Using parallel-process latent growth curve modeling, we examine developmental trajectories of internalizing and externalizing behavior problems and identify early risk factors for behavior problems among 329 child welfare-involved children followed from age 2 years to 5 years. Data are drawn from the National Survey of Child and Adolescent Well-Being II. On average, internalizing behavior problems remained stable, while externalizing behavior problems decreased over time. Higher initial levels of internalizing behavior problems were associated with higher initial levels of externalizing behavior problems. Rates of change also had positive cross-domain relationships. Child neglect, exposure to intimate partner violence (IPV), insecure caregiver-child attachment, and caregiver mental health problems were associated with higher initial levels of internalizing and externalizing behavior problems. Exposure to IPV, out-of-home care, and caregiver drug use predicted rates of change in behavior problems. Our findings highlight the importance of comprehensive assessment and treatment for co-occurring internalizing and externalizing behavior problems in young children involved in the child welfare system. Results also indicate the need for identifying and addressing early risk factors to prevent early onset and continued development of behavior problems in high-risk children.     

Beyond talk: Contributions of quantity and quality of communication to language success across socioeconomic strata

Infants from low-socioeconomic status (SES) households hear a projected 30 million fewer words than their higher-SES peers. In a recent study, Hirsh-Pasek et al. (Psychological Science, 2015; 26: 1071) found that in a low-income sample, fluency and connectedness in exchanges between caregivers and toddlers predicted child language a year later over and above quantity of talk (Hirsh-Pasek et al., Psychological Science, 2015; 26: 1071). Here, we expand upon this study by examining fluency and connectedness in two higher-SES samples. Using data from the NICHD Study of Early Child Care and Youth Development, we sampled 20 toddlers who had low, average, and high language outcomes at 36 months from each of 2 groups based on income-to-needs ratio (INR; middle and high) and applied new coding to the mother–toddler interaction at 24 months. In the high-INR group, the quality of mother–toddler interaction at 24 months accounted for more variability in language outcomes a year later than did quantity of talk, quality of talk, or sensitive parenting. These results could not be accounted for by child language ability at 24 months. These effects were not found in the middle-INR sample. Our findings suggest that when the quality of interaction, fluency and connectedness, predicts language outcomes, it is a robust relation, but it may not be universal.     

Effect of Environmental Risk and Externalizing Comorbidity on Internalizing Problems Among Economically Disadvantaged African American Youth

This study examined the effects of racial discrimination, community violence, and stressful life events on internalizing problems among African American youth from high‐poverty neighborhoods (N = 607; 293 boys; M_age = 16.0 years, SD = 1.44 years). Mediated effects via externalizing problems on these relations were also examined, given the high comorbidity rate between internalizing and externalizing problems. Externalizing problems partially mediated the effect of stressful life events on internalizing problems and fully mediated the effect of racial discrimination for boys but not for girls. Exposure to violence had a significant indirect effect on internalizing problems via externalizing problems. The findings call for greater attention to internalizing problems among African American youth and pathways to internalizing problems via externalizing problems.     

Mother–Toddler Cortisol Synchrony Moderates Risk of Early Internalizing Symptoms

Cortisol synchrony is the degree to which mother–toddler cortisol levels are mutually regulated within a dyad. Synchrony's impact on toddler development is not well understood, so this study investigated how synchronous cortisol levels (reactivity and total concentration) in mother–toddler dyads moderate the association between risk factors (i.e., maternal worry, toddler inhibition) and early internalizing symptoms. Seventy mothers and their 2‐year‐old toddlers provided interpretable saliva samples. Behavioral observations were made to assess the toddler's temperament at age 2, and mothers reported on their toddler's internalizing symptoms when toddlers were 2 and 3 years old. Results suggest that mother–toddler synchrony in total cortisol concentration moderates the relation between risk factors and internalizing symptoms. Specifically, toddler inhibition and maternal worry were less associated with concurrent toddler internalizing symptoms when dyads demonstrated greater cortisol synchrony in total concentration. Further, synchrony in total cortisol levels marginally moderated the association between toddler inhibition and future internalizing symptoms, such that inhibited toddlers were less likely to demonstrate internalizing symptoms at age 3 when dyads demonstrated more cortisol synchrony. This suggests that cortisol synchrony may serve as an advantageous context that reduces the risk of developing of internalizing symptoms and augments the field's understanding of the implications of shared physiological responses within mother–toddler dyads.     

Maternal dynamic respiratory sinus arrhythmia during toddlers’ interactions with novelty

Maternal psychophysiological responses to toddlers’ distress to novelty may have important implications for parenting during early childhood that are relevant to children's eventual development of social withdrawal and anxiety. Likely, these responses depend on intrapersonal, interpersonal, and contextual factors. The current study investigated the time course of respiratory sinus arrhythmia (RSA) across two laboratory novelty episodes, one low threat and one moderate threat, in 120 mothers of 2-year-old toddlers. Growth models tested context differences in and correlates of dynamic patterns of RSA. Dynamic patterns differed between tasks and according to mothers’ perceptions of and distress about toddler shyness. Thus, changes in mothers’ RSA across toddlers’ interactions with novelty seem to depend on the context as well as how mothers perceive and respond to their toddlers’ shyness.     

Does Child Sex Moderate Vulnerability to Postpartum Risk among Infants of Mothers at Risk for Psychopathology?

Early childhood behavior problems may indicate risk for subsequent psychopathology (Shaw, Gilliom, Ingoldsby, & Nagin, Developmental Psychology, 39, 2003, 189). There is some evidence to suggest that boys and girls may be differentially susceptible to postpartum risk factors that predict problem behaviors in early childhood (Kochanska, Coy, & Murray, Child Development, 72, 2001, 1091; Martel, Klump, Nigg, Breedlove, & Sisk, Hormones and Behavior , 55, 2009, 465). The main aim of this study is to examine whether child sex moderates the effect of infant and maternal predictors of toddler problem behaviors in a unique sample of high‐risk mother–child dyads. Analyses were based on data collected for 198 mother–child dyads (52% male offspring) followed longitudinally from birth to 18 months. Maternal and infant variables, including maternal PTSD and depression symptoms, maternal maltreatment history, observed maternal parenting quality, demographic risk, and infant negative emotionality and night waking, were used to predict toddler behavior problems. Although boys and girls displayed similar levels of total problem behaviors at 18 months overall, the specific set of infant and maternal variables that predicted toddler problems varied by child sex. The significant predictor for boys was maternal PTSD symptoms, whereas significant predictors for girls were infant negative emotionality and sleep problems. Results suggest that sex‐differentiated transmission of risk can be identified as early as 18 months postpartum. These differences suggest a gender‐specific biological sensitivity to maternal psychopathology, or alternatively, a gender‐specific reporting bias among mothers with childhood maltreatment histories.     

Changes in Externalizing and Internalizing Problems of Adolescents in Foster Care

Using a developmental psychopathology framework, this study aimed to examine changes in externalizing and internalizing problems of adolescents in foster care and to determine whether type of maltreatment, gender, and age influenced trajectories. Authors used 3 waves of data from the National Survey of Child and Adolescent Well‐Being. Growth‐curve analyses of 106 adolescents aged 13–16 in foster care revealed that externalizing and internalizing problems decreased over time. Adolescents, particularly boys, placed in foster care as a result of sexual abuse, physical abuse, or neglect demonstrated faster decreases in externalizing problems and, similarly but to a weaker degree, internalizing problems than did those placed in foster care as a result of other forms of maltreatment.     

A longitudinal study of the differential social-cognitive foundations of early prosocial behaviors

A growing body of work has documented the emergence of instrumental helping and sharing in the second year of life; however, less is known about mechanisms that underlie development and production of prosocial behavior. The current study took a longitudinal approach to explore whether the origins of prosocial behaviors can be traced back to foundational social-cognitive capacities emerging in infancy. In a sample of 90 children, longitudinal relations were examined between intention understanding and joint attention measured in infancy (8–12 months) and later instrumental helping and sharing behavior assessed in the toddler years (18–25 months). We expected social-cognitive capacities supporting infants’ understanding of others to be positively related to their prosocial behaviors as toddlers. Measured variable path analyses revealed two distinct developmental pathways from infant social cognition to later prosocial behavior: 1) Instrumental helping in the toddler years was positively predicted by intention understanding in infancy; 2) sharing in the toddler years was positively predicted by infants’ initiating joint attention. These results lend support to proposals on the multidimensional nature of early prosocial behavior and offer the first longitudinal evidence that the origins of toddlers' prosocial behavior can be traced to social-cognitive capacities emerging in infancy.     

The Effects of a Family Systems Intervention on Co‐Occurring Internalizing and Externalizing Behaviors of Children with Substance Abusing Mothers: A Latent Transition Analysis

Children of substance abusing parents are at heightened risk to develop problem behaviors, yet little is known about the co‐occurring patterns of internalizing and externalizing behaviors among this population. With 183 children (M age = 11.54 years, SD = 2.55, range 8–16) whose mothers were diagnosed with a substance use disorder, the current study identified subgroups/classes of children that were clinically distinct in their co‐occurring patterns of internalizing and externalizing behaviors, and examined how children in different clinical subgroups responded to a family systems intervention. Latent class analyses identified four classes of internalizing and externalizing behaviors: internalizing only, externalizing only, comorbid, and normative. Latent transition analyses showed that participation in family systems therapy resulted in an increased likelihood of transitioning from the externalizing class at baseline to the normative class at 18 months post‐baseline, and from the comorbid class at baseline to the internalizing class at 18 months post‐baseline as well. The findings support the effectiveness of family systems therapy in interrupting the stability of children's problem behaviors and improving children's behavioral outcomes.     

The association between perception of relationship with caregivers and behaviours of youth in foster care: a child and caregiver perspective

The transition into foster care can be difficult for children. Research has consistently shown an increased risk for children in foster care to exhibit higher levels of problem behaviours in comparison to youth in the general population. The purpose of this study was to analyse the associations between the youths' perception of their relationship with their caregiver on their perception of their own internalizing and externalizing behaviours as well as the youths' perception of the relationships with caregivers and how caregivers report of youths' internalizing and externalizing behaviours. This study utilized the secondary data from the general release version of the National Survey of Child and Adolescent Well-Being [National Survey of Child and Adolescent Well-Being (2009) Introduction to the wave 1 general and restricted use releases, Nation Data Archive on Child Abuse and Neglect, Ithaca, NY]. Significant relationships between youths' perception of relationship with their caregiver were found with both youth perception of internalizing behaviours and caregiver perception of internalizing and externalizing behaviours. Results are explained with implications for practice, training, research and policy.     

Briefly Noted

Internalizing and externalizing problems predicted onset of any tobacco use in youth; however, findings differed for internalizing and externalizing problems across tobacco products, researchers found in analyzing the Population Assessment of Tobacco and Health Study of 12‐ to 24‐year‐old never‐users. Self‐reported internalizing and externalizing symptoms were assessed at wave 1 (45,971 subjects), and past‐12‐month use of tobacco products was assessed at wave 2 (38,443 subjects). The researchers found that high‐severity internalizing symptoms at wave 1 increased the risk by 1.5 times of using tobacco by wave 2, and that high‐severity externalizing problems increased the risk of tobacco use by 1.3 times at wave 2. Low‐ and moderate‐severity problems did not predict tobacco onset. The study was funded by the National Institute on Drug Abuse and the Food and Drug Administration. Several authors declared conflicts of interest — one as an expert witness in a lawsuit against the tobacco industry. The article, “Mental Health Problems and Onset of Tobacco Use Among 12‐ to 24‐Year‐Olds in the PATH Study,” was published in the December 2018 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.     

Caregiver qualities,family closeness,and the well-being of adolescents engaged in the child welfare system

Children who come into contact with the child welfare system are at greater risk of experiencing internalizing and externalizing behaviors. This secondary analysis of the National Survey of Child and Adolescent Well-Being explored how caregiver characteristics and behaviors, and caregiver–child closeness influence these outcomes over time. The final sample was 877 caregiver and adolescent (11–17 years old) dyads. Weighted multivariate regression analyses were performed. Caregiver characteristics associated with depressive symptoms included age and education; caregiver health was not associated with internalizing and externalizing behaviors. For adolescents, being female, older, or Hispanic was associated with internalizing behaviors. Although not significant for externalizing behaviors, caregiver–adolescent closeness was protective against internalizing behaviors. Understanding factors that contribute to the mental health of child-welfare-exposed adolescents has far-reaching implications for family-based interventions with child-welfare-involved youth.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Sequences of toddler negative emotion and parent–toddler verbal communication during a waking day

Although the second year of life is characterized by dramatic changes in expressive language and by increases in negative emotion expression, verbal communication and emotional communication are often studied separately. With a sample of twenty‐five one‐year‐olds (12–23 months), we used Language Environment Analysis (LENA; Xu, Yapanel, & Gray, 2009, Reliability of the LENA? language environment analysis system in young children’s natural home environment. LENA Foundation) to audio‐record and quantify parent–toddler communication, including toddlers’ vocal negative emotion expressions, across a full waking day. Using a multilevel extension of lag‐sequential analysis, we investigated whether parents are differentially responsive to toddlers’ negative emotion expressions compared to their verbal or preverbal vocalizations, and we examined the effects of parents’ verbal responses on toddlers’ subsequent communicative behavior. Toddlers’ negative emotions were less likely than their vocalizations to be followed by parent speech. However, when negative emotions were followed by parent speech, toddlers were most likely to vocalize next. Post hoc analyses suggest that older toddlers and toddlers with higher language abilities were more likely to shift from negative emotion to verbal or preverbal vocalization following parent response. Implications of the results for understanding the parent–toddler communication processes that support both emotional development and verbal development are discussed.     

Residential Mobility and Adolescent Achievement and Behavior: Understanding Timing and Extent of Mobility

Residential mobility is generally viewed as an adverse event for adolescents' development. Less is known about whether moving during adolescence, childhood, or both periods explains this connection and whether the extent of mobility matters. Analytic shortcomings with much of the research call into question extant findings. We examined associations between childhood, adolescent, and child–adolescent mobility and adolescents' achievement (math and reading) and behavior problems (internalizing and externalizing). With a multisite, longitudinal sample (N = 1,056), we employed propensity score methods, which mitigate concerns about selection bias on observed variables, to investigate relationships. Results suggest that multiple, child–adolescent movers had more internalizing problems in adolescence than their stable peers, but did not differ on externalizing problems or achievement.     

Toddlers’ Duration of Attention Toward Putative Threat

Although individual differences in reactions to novelty in the toddler years have been consistently linked to risk of developing anxious behavior, toddlers’ attention toward a novel, putatively threatening stimulus while in the presence of other enjoyable activities has rarely been examined as a precursor to such risk. The current study examined how attention toward an angry‐looking gorilla mask in a room with alternative opportunities for play in 24‐month‐old toddlers predicted social inhibition when children entered kindergarten. Analyses examined attention to threat above and beyond and in interaction with both proximity to the mask and fear of novelty observed in other situations. Attention to threat interacted with proximity to the mask to predict social inhibition, such that attention to threat most strongly predicted social inhibition when toddlers stayed furthest from the mask. This relation occurred above and beyond the predictive relation between fear of novelty and social inhibition. Results are discussed within the broader literature of anxiety development and attentional processes in young children.     

Caregiver Protective Behavior,Toddler Fear and Sadness,and Toddler Cortisol Reactivity in Novel Contexts

Previous research has shown that caregiver protective behavior may exacerbate toddler distress in specific contexts. This study sought to extend this work to examine associations between these variables and toddler cortisol reactivity. Ninety‐three 24‐month‐old toddlers were observed across six novel contexts designed to elicit distress. Toddlers were asked to give saliva samples at the beginning and end of the laboratory procedure. Toddler sadness, toddler fear and caregiver protective behavior were coded. Results indicate that caregiver protective behavior accounted for the association between toddler sadness and cortisol reactivity where higher levels of protective behavior were associated with higher cortisol reactivity. This study showed that caregiver protective behavior, which functions to prevent a child from interacting with a novel stimulus, is an important mechanism to consider when understanding toddler stress responses during novel contexts.     

Exploring Gender Differences on Internalizing and Externalizing Behavior Among Maltreated Youth: Implications for Social Work Action

This purpose of this study was to explore the moderating influence of gender on the relationship between child maltreatment and internalizing symptoms (e.g., affective and somatic problems) and externalizing behavior (e.g., rule breaking behavior and aggression) among children aged 7–12 years old. Using a longitudinal comparison group design and a sample of 300 youth of which 56% (n = 168) had substantiated cases of child maltreatment, results of a structural equation modeling revealed that internalizing symptoms exerted a mediating influence that was conditioned by gender. Only girls’ internalizing symptoms were found to mediate the link between child maltreatment and externalizing behavior while a direct relationship between maltreatment and externalizing behavior was found among boys. These findings provide evidence for gender differences in the pathways between being child maltreatment and maladaptive thoughts, feelings, and behaviors. Thus, adapting evidence-based strategies that target gender specific internalizing behaviors and externalizing behaviors among maltreated youth may significantly reduce the risk of short and long-term maladaptive behavior.     

Self-esteem: A mediator between peer relationships and behaviors of adolescents in foster care

Youth in foster care have been shown to be at risk for a range of negative behaviors. Developmental research has highlighted the important role that peer relationships can play in an adolescent's development. For youth in foster care, peer relationships can also play an important role in both youths' internal perception of themselves and their enacted behaviors. This study utilized National Survey of Child and Adolescent Wellbeing, a national secondary dataset to analyze the connection between peer relationships for youths in long-term foster care and their report of internalizing, externalizing, and delinquent behaviors (n = 188). Additionally, the self-esteem of adolescents was explored as a potential mediator between peer relationships and these behaviors. Preliminary analyses indicated that peer relationships had a significant association with all three of the identified behaviors: internalizing, externalizing, and delinquent behaviors of youths in foster care. Self-esteem was found to be a significant mediator between peer relationships and adolescents' report of their internalizing, externalizing, and delinquent behaviors. Clinical implications for therapeutic services that focuses on the adolescent's self-image and potential policy implications are discussed.