During South Africa's first two decades as a democracy, the Western Cape Province has undergone radical changes to its healthcare system in an effort to address the extensive socioeconomic inequities that remain in the aftermath of the apartheid era. Although progress has been made, there is a clear need for interventions that support parents and children receiving health services in the public sector who are vulnerable to multiple psychosocial risks associated with extreme poverty. In this mixed-method study, we examined the feasibility and acceptability of adapting an evidence-based parenting intervention called Mothering from the Inside Out that was developed for mothers who are vulnerable to similar risks in the United States. Using qualitative methods, we documented the collaborative process that was guided by principles of community-based participatory research and examined themes in the Western Cape collaborators’ perspectives about the feasibility and acceptability of the intervention. Using quantitative methods, we tested the preliminary efficacy of the adapted version of Mothering from the Inside Out for improving maternal reflective functioning and mother–child interactions. Although findings from both study components indicated preliminary promise, a number of obstacles and challenges at multiple levels underscore the need for (a) flexibility and contextual support for intervention research conducted in under-resourced communities, (b) clinical sensitivity to the unique experiences of parents rearing children in highly stressful, under-resourced environments, and (c) equal partnerships that allow the expertise of local providers to inform the design proposals of consulting investigators.

Social anxiety disorder (SAD) is commonly diagnosed during adolescence and is associated with psychological stress reactivity and heightened physiological arousal. No study, however, has systematically examined which aspects of autonomic nervous system function mediate likely links between stress sensitivity and social anxiety symptoms in adolescents. Here, we assessed 163 adolescents (90 females; 12.29 ± 1.39 years) with respect to life stress and social anxiety symptoms, and measured respiratory sinus arrhythmia (RSA) and skin conductance levels (SCL) during a psychosocial stress paradigm. We operationalized stress sensitivity as the residual variance in subjective stress severity after accounting for objective severity and changes in autonomic regulation using standardized change scores in RSA and SCL. In females only, stress sensitivity and social anxiety symptoms were significantly correlated with each other (p < .001) and with autonomic regulation during both reactivity and recovery (all ps < 0.04). Further, sympathetic nervous system dominance during recovery specifically mediated associations between stress sensitivity and social anxiety symptoms (B = 1.06, 95% CI: 0.02–2.64). In contrast, in males, stress sensitivity, autonomic regulation during reactivity or recovery, and social anxiety symptoms were not significantly associated (all ps > 0.1). We interpret these results in the context of psychobiological models of SAD and discuss implications for interventions targeting autonomic processes.

Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.

The Goal-Corrected Partnership Adolescent Coding System (GPACS) has shown promise in assessing a secure as well as three atypical patterns of parent–adolescent interaction during a conflict discussion. The current study of 186 economically disadvantaged families examines the degree to which four GPACS patterns: secure/collaborative, hostile/punitive, role confused, and disoriented, prospectively predict adolescents’ social competence and maladaptive behavior (internalizing, externalizing, and risk behaviors) at age 15 years after controlling for these social behaviors at age 13 years and contemporaneous GPACS scores. Adolescents from secure/collaborative dyads at age 13 were more likely to have a secure state of mind in the Adult Attachment Interview at age 15 and showed higher levels of teachers’ ratings of empathy and lower levels of teachers’ ratings of externalizing behaviors at age 15 years. Adolescents in disoriented dyads showed higher levels of teacher-rated internalizing problems, while male adolescents in role confused dyads reported higher levels of involvement in risk behaviors, including unprotected sexual activity and substance use problems.

Building on Ellis et al.’s theorization for potent dimensions of environmental adversity, the present work sought to evaluate how environmental harshness and unpredictability might function directly and in interaction with child sensory processing sensitivity (SPS) to shape the development of child socioemotional functioning. Participants were 235 young children (Mage = 2.97 at the first measurement occasion) and their parents, who were followed for two consecutive annual measurement occasions. Child SPS was measured through behavioral observation across multiple tasks within the laboratory setting. Greater environmental unpredictability was significantly associated with the development of children’s externalizing problems over a year only for children with high SPS. Follow-up analyses indicated that the unpredictability-x-SPS interaction was consistent with differential susceptibility, such that high SPS children showed greater increases in externalizing problems under high unpredictability, but also lower increases/greater decreases in externalizing problems under low unpredictability. Such association did not apply to children with low SPS.

Adolescence is an important stage for the development of emotion regulation skills, especially for adolescent girls who are at elevated risk for the development of depression and anxiety. Although some emotion regulation strategies are more effective at helping adolescents regulate negative affect on average, research indicates strategy effectiveness varies with the context in which a strategy is deployed. Yet less work has been done examining which contextual factors are associated with adolescents switching emotion regulation strategies in their daily lives. This study examined individual and contextual factors related to negative interpersonal events that are associated with strategy effectiveness, including age, emotional intensity, perceived controllability, and co-regulatory support, and their association with adolescent emotion regulation strategy switching in daily life via ecological momentary assessment. Results indicated that adolescent girls differed in the degree to which they altered their emotion regulation strategies throughout their daily lives, and that switching strategies was associated with age as well as individual and within-person differences in perceived controllability, emotional intensity, and co-regulatory support. This study provides critical proof-of-concept of the utility of emotion regulation strategy switching as a measure of regulatory flexibility and highlights regulatory processes that may hold clues to the mechanisms of developmental psychopathology.

Impaired cognitive functioning constitutes an important symptom of major depressive disorder (MDD), potentially associated with elevated cortisol levels. Adverse childhood experiences (ACE) enhance the risk for MDD and can contribute to disturbances in the stress systems, including cortisol and cognitive functions. In healthy participants, cortisol administration as well as acute stress can affect cognitive performance. In the current study, we tested cognitive performance in MDD patients with (N = 32) and without (N = 52) ACE and healthy participants with (N = 22) and without (N = 37) ACE after psychosocial stress induction (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST). MDD predicted lower performance in verbal learning and both selective and sustained attention, while ACE predicted lower performance in psychomotoric speed and working memory. There were no interaction effects of MDD and ACE. After stress, MDD patients were more likely to show lower performance in working memory as well as in selective and sustained attention compared with participants without MDD. Individuals with ACE were more likely to show lower performance in verbal memory after stress compared with individuals without ACE. Our results indicate negative effects of MDD and ACE on distinct cognitive domains. Furthermore, MDD and/or ACE seem to enhance susceptibility for stress-related cognitive impairments.

The research domain criteria (RDoC) is an innovative approach designed to explore dimensions of human behavior. The aim of this approach is to move beyond the limits of psychiatric categories in the hope of aligning the identification of psychological health and dysfunction with clinical neuroscience. Despite its contributions to adult psychopathology research, RDoC undervalues ontogenetic development, which circumscribes our understanding of the etiologies, trajectories, and maintaining mechanisms of psychopathology risk. In this paper, we argue that integrating temperament research into the RDoC framework will advance our understanding of the mechanistic origins of psychopathology beginning in infancy. In illustrating this approach, we propose the incorporation of core principles of temperament theories into a new “life span considerations” subsection as one option for infusing development into the RDoC matrix. In doing so, researchers and clinicians may ultimately have the tools necessary to support emotional development and reduce a young child's likelihood of psychological dysfunction beginning in the first years of life.

Understanding differences in social-emotional behavior can help identify atypical development. This study examined the differences in social-emotional development in children at increased risk of an autism spectrum disorder (ASD) diagnosis (infant siblings of children diagnosed with the disorder). Parents completed the Brief Infant-Toddler Social-Emotional Assessment (BITSEA) to determine its ability to flag children with later-diagnosed ASD in a high-risk (HR) sibling population. Parents of HR (n = 311) and low-risk (LR; no family history of ASD; n = 127) children completed the BITSEA when their children were 18 months old and all children underwent a diagnostic assessment for ASD at age 3 years. All six subscales of the BITSEA (Problems, Competence, ASD Problems, ASD Competence, Total ASD Score, and Red Flags) distinguished between those in the HR group who were diagnosed with ASD (n = 84) compared to non-ASD-diagnosed children (both HR-N and LR). One subscale (BITSEA Competence) differentiated between the HR children not diagnosed with ASD and the LR group. The results suggest that tracking early social-emotional development may have implications for all HR children, as they are at increased risk of ASD but also other developmental or mental health conditions.

Parents’ comparisons of siblings have been understudied among sibling research, especially in Chinese societies where the government recently relaxed its one-child policy. This study, using a two-wave longitudinal design, explored how parents’ comparisons of siblings were associated with adolescents’ internalizing and externalizing problems. Study participants were 260 Chinese adolescents who had siblings and completed questionnaires that assessed their internalizing and externalizing problems, as well as their perceptions of parents’ critical comparisons of siblings. Cross-lagged modeling analysis showed that parents’ comparisons of siblings predicted more internalizing and externalizing problems in adolescents 6 months later. Moreover, adolescents’ externalizing problems but not internalizing problems predicted more parents’ comparisons of siblings over time. These findings underscore the importance of reciprocal relations between parents’ comparisons of siblings and adolescents’ externalizing problems and the implication of cultural context in understanding associations between parental practices and adolescents’ adjustment.

This article summarizes the results of an intervention study with approximately 4,000 Zambian children, in which risk of helminth infection and related health problems were ameliorated with medication and micronutrient and vitamin supplementation. The results of this intervention were tracked with a newly developed cognitive assessment battery for Zambian school children in Grades 3–7. The quantification of cognitive functioning manifested after the intervention indicated treatment-related improvements in the cognitive skill of following instructions. This skill is fundamental to success in school. It constitutes an important indicator of resilience in overcoming difficulties related to growing up and being educated under the pressure of the multiple risk factors characteristic of the developing world.

Previous studies of theory of mind abilities in young people with autism have found that their understanding of false belief is specifically impaired, but that simple aspects of desire are understood in line with mental age. We explored the possibility that more complex aspects of desire (in which comparison of goals with outcomes is not a sufficient strategy) are not understood by children with autism. In two experiments, we found that these children were specifically impaired in understanding desire satisfaction and desire change, when compared with children with mental handicap and normal 4-6-year-olds. Although there was some evidence that understanding of desires may be easier for individuals with autism than understanding false belief, it would appear that they have difficulties in understanding both epistemic and volitional mental states.

Prior theory and research have linked negative appraisals (NA), emotion reactivity (ER), and cognitive reactivity (CR) to depression; however, few studies have examined whether even two of these constructs simultaneously, but none have done so in child or adolescent populations. A total of 571 youths (ages 9–13) completed a novel procedure in which all three constructs were assessed in response to the same personally relevant, hypothetical, peer victimization events. Multilevel modeling enabled the extraction of dynamic, within-person, latent-variable measures of NA, ER, and CR. All three constructs were related to children's depressive symptoms in ways that were commensurate with most (but not all) theoretical frameworks. Gender and age differences also emerged. Support for an NA-predicts-ER-predicts-CR model suggests ways that these constructs can be integrated into a more complete, transtheoretical understanding of the cognitive-emotional substrate of depression in children.

Although infants less than 18 months old are capable of engaging in self-regulatory behavior (e.g., avoidance, withdrawal, and orienting to other aspects of their environment), the use of self-regulatory strategies at this age (as opposed to relying on caregivers) is associated with elevated behavioral and physiological distress. This study investigated infant dopamine-related genotypes (dopamine receptor D2 [DRD2], dopamine transporter solute carrier family C6, member 4 [SLC6A3], and catechol-O-methyltransferase [COMT]) as they interact with maternal self-reported history of maltreatment to predict observed infant independent emotion regulation behavior. A community sample (N = 193) of mother–infant dyads participated in a toy frustration challenge at infant age 15 months, and infant emotion regulation behavior was coded. Buccal cells were collected for genotyping. Maternal maltreatment history significantly interacted with infant SLC6A3 and COMT genotypes, such that infants with more 10-repeat and valine alleles of SLC6A3 and COMT, respectively, relative to infants with fewer or no 10-repeat and valine alleles, utilized more independent (i.e., maladaptive) regulatory behavior if mother reported a more extensive maltreatment history, as opposed to less. The findings indicate that child genetic factors moderate the intergenerational impact of maternal maltreatment history. The results are discussed in terms of potential mechanism of Gene × Environment interaction.

Adolescent psychopathology is commonly connected to marijuana use. How changes in these adolescent antecedents and in adolescent marijuana use are connected to patterns of marijuana use in the 20s is little understood. Another issue not clearly understood is psychopathology in the 30s as predicted by marijuana use in the 20s. This study sought to examine these two issues and the associations with marijuana disorder diagnoses using a longitudinal data set of 205 men with essentially annual reports. Individual psychopathology and family characteristics from the men's adolescence were used to predict their patterns of marijuana use across their 20s, and aspects of the men's psychopathology in their mid-30s were predicted from these patterns. Three patterns of marijuana use in the 20s were identified using growth mixture modeling and were associated with diagnoses of marijuana disorders at age 26 years. Parental marijuana use predicted chronic use for the men in adulthood. Patterns of marijuana use in the 20s predicted antisocial behavior and deviant peer association at age 36 years (controlling for adolescent levels of the outcomes by residualization). These findings indicate that differential patterns of marijuana use in early adulthood are associated with psychopathology toward midlife.

Guided by developmental psychopathology and dual-risk frameworks, the present study examined the interplay between childhood maltreatment and maternal major depression history in relation to neural reward responsiveness in youth. The sample consisted of 96 youth (ages 9–16; M = 12.29 years, SD = 2.20; 68.8% female) drawn from a large metropolitan city. Youth were recruited based on whether their mothers had a history of major depressive disorder (MDD) and were categorized into two groups: youth with mothers with a history of MDD (high risk; HR; n = 56) and youth with mothers with no history of psychiatric disorders (low risk; LR; n = 40). The reward positivity (RewP), an event-related potential component, was utilized to measure reward responsiveness and the Childhood Trauma Questionnaire measured childhood maltreatment. We found a significant two-way interaction between childhood maltreatment and risk group in relation to RewP. Simple slope analysis revealed that in the HR group, greater childhood maltreatment was significantly associated with reduced RewP. The relationship between childhood maltreatment and RewP was not significant among the LR youth. The present findings demonstrate that the association between childhood maltreatment and blunted reward responsiveness is dependent on whether offspring have mothers with histories of MDD.

Physiological response to stress has been linked to a variety of healthy and pathological conditions. The current study conducted a multilevel examination of interactions among environmental toxins (i.e., neighborhood crime and child maltreatment) and specific genetic polymorphisms of the endothelial nitric oxide synthase gene (eNOS) and GABA(A) receptor subunit alpha-6 gene (GABRA6). One hundred eighty-six children were recruited at age 4. The presence or absence of child maltreatment as well as the amount of crime that occurred in their neighborhood during the previous year were determined at that time. At age 9, the children were brought to the lab, where their physiological response to a cognitive challenge (i.e., change in the amplitude of the respiratory sinus arrhythmia) was assessed and DNA samples were collected for subsequent genotyping. The results confirmed that complex Gene × Gene, Environment × Environment, and Gene × Environment interactions were associated with different patterns of respiratory sinus arrhythmia reactivity. The implications for future research and evidence-based intervention are discussed.

The present study sought to unravel the psychological processes through which mass incarceration, specifically paternal incarceration, is negatively affecting the next generation of children. Data came from 4,327 families from 20 cities who participated in a 10-year longitudinal study. Parents and children reported on children’s rule-breaking behaviors and depressive symptoms when they were on average ages 5 (2003–2006), 9 (2007–2010), and 15 (2014–2017). Parental surveys and disposition information were combined to assess paternal incarceration at each age. Results showed that children who experienced paternal incarceration at age 5 also demonstrated more rule-breaking behaviors at age 15. Children’s age-9 depressive symptoms partially mediated our finding, such that children who experienced paternal incarceration at age 5 also showed greater depressive symptoms at age 9, which in turn predicted greater rule-breaking behaviors at age 15. Paternal incarceration predicted future rule-breaking behaviors more strongly than did other forms of father loss. Because we found paternal incarceration during childhood is associated with worsened adjustment into adolescence, we discussed the need for developmentally appropriate practices in the criminal justice system.

Early adversity has been shown to sensitize individuals to the effects of later stress and enhance risk of psychopathology. Using a longitudinal randomized trial of foster care as an alternative to institutional care, we extend the stress sensitization hypothesis to examine whether early institutional rearing sensitizes individuals to stressful events in adolescence engendering chronic low-grade inflammation. At baseline, institutionalized children in Romania (ages 6–31 months) were randomly assigned to foster care or to remain in usual care within institutions. A group of never-institutionalized children was recruited as an in-country comparison sample. At ages 12 and 16, participants reported stressful events. At age 16, Interleukin-6 (IL-6) and C-reactive protein (CRP) were derived from blood spots. Among children assigned to care as usual, more stressful events at age 12, but not age 16, were associated with higher IL-6. In the same group, stressful events at age 16 were associated with higher CRP, though these effects attenuated after adjusting for covariates. These associations were not observed in the foster care or never-institutionalized groups. The findings suggest that heightened inflammation following stress exposure is one pathway through which early neglect could compromise physical health. In contrast, early family care might buffer against these risks.

Based on findings that, like schizophrenic children, children with complex partial seizure disorder have illogical thinking, this study examined whether or not these same epileptic subjects had other thought processing impairments found in schizophrenic children. Compared to normal children (N = 38), both the epileptic (N = 27) and schizophrenic children (N = 31) underutilized discourse (cohesive) devices that make speech coherent. The severity of the discourse deficits and formal thought disorder of the schizophrenic children was associated with age, but not with IQ scores. Age, IQ, and seizure-related, not behavioral variables, were associated, however, with the severity of the discourse deficits of the epileptic subjects. The study' findings suggest that measures of impaired thought processing and communication in schizophrenic children could be a model to study the developmental impact of complex partial seizure disorder in middle childhood. The clinical implications of the study's findings are discussed.