Prenatal maternal transdiagnostic, RDoC-informed predictors of newborn neurobehavior: Differences by sex

We examined whether Research Domain Criteria (RDoC)-informed measures of prenatal stress predicted newborn neurobehavior and whether these effects differed by newborn sex. Multilevel, prenatal markers of prenatal stress were obtained from 162 pregnant women. Markers of the Negative Valence System included physiological functioning (respiratory sinus arrhythmia [RSA] and electrodermal [EDA] reactivity to a speech task, hair cortisol), self-reported stress (state anxiety, pregnancy-specific anxiety, daily stress, childhood trauma, economic hardship, and family resources), and interviewer-rated stress (episodic stress, chronic stress). Markers of the Arousal/Regulatory System included physiological functioning (baseline RSA, RSA, and EDA responses to infant cries) and self-reported affect intensity, urgency, emotion regulation strategies, and dispositional mindfulness. Newborns’ arousal and attention were assessed via the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. Path analyses showed that high maternal episodic and daily stress, low economic hardship, few emotion regulation strategies, and high baseline RSA predicted female newborns’ low attention; maternal mindfulness predicted female newborns’ high arousal. As for male newborns, high episodic stress predicted low arousal, and high pregnancy-specific anxiety predicted high attention. Findings suggest that RDoC-informed markers of prenatal stress could aid detection of variance in newborn neurobehavioral outcomes within hours after birth. Implications for intergenerational transmission of risk for psychopathology are discussed.

Childhood adversity moderates the influence of proximal episodic stress on the cortisol awakening response and depressive symptoms in adolescents

Childhood adversity (CA) is known to predict sensitization to proximal stressors. Researchers have suggested that disruptions in hypothalamus–pituitary–adrenal axis functioning may be a biological mechanism. If so, CA may predict altered associations between proximal life stress and markers of cortisol secretion. We examined whether CA moderates associations between recent episodic stress and (a) the cortisol awakening response (CAR), and (b) depressive symptoms, in 241 adolescents aged 14–17 years (cortisoln= 196). Salivary cortisol was sampled at 0, 30, and 60 min postawakening for 2 days. The CAR was calculated as the area under the curve with respect to increase and waking cortisol. CA and episodic stress were assessed using contextual-threat-method-coded objective interviews. CA significantly interacted with episodic stress to predict both the CAR and depression. Among those with low CA, episodic stress predicted increased CAR but did not predict depression. For adolescents with high CA, episodic stress predicted lower CAR and higher depression. These interactions were found only for independent (uncontrollable, fateful) events, and not for dependent (self-generated) stress. Increased allostatic load resulting from CA exposure may interfere with adolescents' ability to optimally regulate their CAR in relation to recent stress, contributing to increased depression risk.

Sensitivity to stress among the offspring of parents with bipolar disorder: a study of daytime cortisol levels

BackgroundIt is well known that the hypothalamic–pituitary–adrenal (HPA) axis is compromised in major depression and bipolar disorder. There is increasing evidence that subtle HPA abnormalities, such as elevated cortisol levels, precede the development of an affective disorder. Interpersonal stress is also associated with the development of affective disorders. The present study sought to determine whether interpersonal chronic and episodic stress moderated the relationship between cortisol levels in the natural environment and risk status, defined as having a parent with bipolar disorder.MethodSixty-two offspring of parents with bipolar disorder (OBD) and 60 offspring with no family history of affective disorders (OFH−), aged 19.48 years (s.d.=3.38, range 14–28), completed interviews assessing mental disorders and chronic and episodic stress, and provided saliva samples over 3 days.ResultsRegression analyses revealed that the OBD who experienced high interpersonal chronic stress displayed a larger cortisol rise following awakening than the OBD reporting low interpersonal chronic stress. The same relationship was also found for levels of non-interpersonal chronic stress. The OBD who reported experiencing severe interpersonal episodic stress exhibited higher levels of daytime cortisol than the OBD reporting interpersonal episodic stress of mild severity. Importantly, none of the above relationships were detected in the OFH−. Each of the interactions between family history of affective disorders and stress remained after controlling for age, gender and offspring lifetime affective disorders and current non-affective disorders.ConclusionsA biological sensitivity to stress may underlie the susceptibility to affective disorders among the OBD.

Psychological Support

Stress is an everyday experience that no one is exempt from experiencing, whether the stressor is positive or negative. Combine that reality with a medical condition, and there is a noticeable increase in the stress level that can easily become overwhelming. Like other diagnoses, aniridia has an impact on those living with the condition and their families. One of the reasons this condition is so complex is the lack of knowledge about it in both the public and medical communities. Too often people respond with a “What?” when they hear the word aniridia, and that leaves the families to be the educators, when they are the ones who still need to be educated. Their frustration can easily build. There is frustration with the diagnosis, with the life changes, and with the frustration itself. Without recognition or acceptance of this frustration, and an appropriate outlet to help ease the situation, negative effects are likely. It is vital for those touched by aniridia to prepare for the inevitable stress. Parents must identify and accept themselves as the supporting structures of their families. If they are weakened, they will be less likely to support their children. Individuals with aniridia have enough barriers to overcome and must learn to prevent future obstacles such as stress from affecting their lives. Although stress is unavoidable, it is at times preventable and, most often, manageable. By and large, there are three types of stress: acute, episodic, and chronic. Acute stress is defined as short-term stress that does not result in any permanent damage. One can describe this as the daily stress that can be lived with and is experienced by all individuals (such as taking tests and driving in heavy traffic). The second stress, episodic stress, is more intense because it is the frequent suffering of acute stress. The sufferer views life as chaotic and constantly in crisis, epitomized by the expression “if something can go wrong, it will.”