Maltreatment type differences in cortisol stress response trajectories across adolescence.

This study examined cortisol stress response trajectories across adolescence in 454 maltreated and comparison youth recruited from Los Angeles County between 2002 and 2005 (66.7% maltreated; 46.7% girls; 39.0% Latino; 37.7% Black; 12.3% Mixed or Biracial; 11.0% White; Mage = 10.9 years, SD = 1.2). Adolescents' peak activation and cortisol reactivity and recovery slopes following the Trier Social Stress Test for Children were calculated at four waves, then used to model peak activation and cortisol reactivity and recovery trajectories arrayed by age. Maltreated youth had blunted cortisol reactivity at age 9 relative to comparison youth (b = -.19, p = .02). Sexually and physically abused youth showed blunted cortisol reactivity and recovery trajectories relative to emotionally abused and neglected youth.

Psychologically aggressive parenting and later aggression: Salivary alpha-amylase reactivity and sex as moderators.

Psychologically aggressive parenting (PAP) exposure negatively affects children's development of aggression. Nevertheless, not all children exposed to PAP display aggressive behaviors. Sympathetic nervous system (SNS) activity may influence the impact of early adversity on aggression. This study examines whether SNS reactivity and sex moderate the link between psychologically aggressive parenting (PAP) during childhood and later aggression. Emerging adults (N = 182, mean age = 19.03 years, 53 % female) retrospectively reported on their childhood PAP and current aggression. Salivary alpha-amylase (sAA) collected from a social stress task indexed SNS reactivity to stress. Childhood PAP was associated with emerging adulthood anger, hostility, physical, and verbal aggression. Moreover, males were more likely to exhibit anger, verbal, and physical aggression and had higher levels of sAA reactivity than females. A significant three-way interaction between childhood PAP, sAA reactivity, and sex accounted for participants' current verbal aggression. The link between childhood PAP and later verbal aggression was stronger for males at higher levels of sAA reactivity. Females with higher levels of sAA reactivity displayed lower levels of verbal aggression regardless of PAP exposure. Males and females with lower levels of sAA reactivity were at elevated risk for verbal aggression regardless of PAP exposure. Moreover, we found a significant two-way interaction between PAP and sex on anger, such that higher levels of PAP exposure were associated with more anger among males, but not females. These findings highlight the importance of examining interactions between biological and environmental factors and sex in accounting for later aggression.

A Systematic Review of Systems Science Approaches to Understand and Address Domestic and Gender-Based Violence.

Purpose: We aimed to synthesize insights from systems science approaches applied to domestic and gender-based violence. Methods: We conducted a systematic review of systems science studies (systems thinking, group model-building, agent-based modeling [ABM], system dynamics [SD] modeling, social network analysis [SNA], and network analysis [NA]) applied to domestic or gender-based violence, including victimization, perpetration, prevention, and community responses. We used blinded review to identify papers meeting our inclusion criteria (i.e., peer-reviewed journal article or published book chapter that described a systems science approach to domestic or gender-based violence, broadly defined) and assessed the quality and transparency of each study. Results: Our search yielded 1,841 studies, and 74 studies met our inclusion criteria (45 SNA, 12 NA, 8 ABM, and 3 SD). Although research aims varied across study types, the included studies highlighted social network influences on risks for domestic violence, clustering of risk factors and violence experiences, and potential targets for intervention. We assessed the quality of the included studies as moderate, though only a minority adhered to best practices in model development and dissemination, including stakeholder engagement and sharing of model code. Conclusions: Systems science approaches for the study of domestic and gender-based violence have shed light on the complex processes that characterize domestic violence and its broader context. Future research in this area should include greater dialogue between different types of systems science approaches, consideration of peer and family influences in the same models, and expanded use of best practices, including continued engagement of community stakeholders. Supplementary Information: The online version contains supplementary material available at 10.1007/s10896-023-00578-8.

Racial differences in sympathetic nervous system indicators: Implications and challenges for research.

Growing evidence indicates the presence of racial differences in sympathetic nervous system (SNS) functioning, yet the nature of these differences is unclear and appears to vary across different indices of SNS activity. Moreover, racial differences among commonly used indices of SNS activity are under-investigated. This systematic review examines racial differences among widely used resting SNS indices, such as electrodermal activity (EDA), pre-ejection period (PEP), and salivary alpha-amylase (sAA). Our review reveals that Black participants have consistently been found to display lower resting EDA compared to White participants. The few studies that have investigated or reported racial differences in PEP and sAA yield mixed findings about whether racial differences exist. We discuss potential reasons for racial differences in SNS activity, such as index-specific factors, lab confounds, psychosocial environmental factors, and their interactions. We outline a framework characterizing possible contributors to racial differences in SNS functioning. Lastly, we highlight the implications of several definitional, analytic, and interpretive issues concerning the treatment of group differences in psychophysiological activity and provide future recommendations.

Associations between HPA axis reactivity and PTSD and depressive symptoms: Importance of maltreatment type and puberty.

The functioning of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in the etiology and maintenance of depressive and posttraumatic stress disorder (PTSD) symptoms. However, different maltreatment experiences as well as the increased sensitivity of the HPA axis during puberty may alter associations between the HPA axis and mental health. To address these gaps, the current study examined the potential bidirectional associations between cortisol reactivity to a stressor, PTSD symptoms, and depressive symptoms among early adolescents across two time points, 1 year apart (n = 454; Mage = 10.98 at Time 1 and Mage = 12.11 at Time 2). Multiple-group path models tested the pathways between cortiol reactivity and mental health prior to and during puberty, for different types of maltreatment . Overall, the results showed that associations between cortisol output and symptoms of PTSD and depression were driven by those in the midst of puberty. Specifically, higher cortisol output at Time 1 was linked with higher levels of subsequent PTSD and depressive symptoms for neglected youth who had reached puberty. However, depressive symptoms predicted subsequent lower cortisol output for the physical abuse and emotional abuse groups. These findings demonstrate longitudinal links between cortisol, depressive symptoms, and PTSD symptoms among youth with different types of maltreatment histories and highlight the need to consider the reorganization of the stress system during puberty in order to advance our understanding of the HPA axis and mental health.

Applications of agent-based modeling in trauma research.

OBJECTIVE: Trauma, violence, and their consequences for population health are shaped by complex, intersecting forces across the life span. We aimed to illustrate the strengths of agent-based modeling (ABM), a computational approach in which population-level patterns emerge from the behaviors and interactions of simulated individuals, for advancing trauma research; Method: We provide an overview of agent-based modeling for trauma research, including a discussion of the model development process, ABM as a complement to other causal inference and complex systems approaches in trauma research, and past ABM applications in the trauma literature; Results: We use existing ABM applications to illustrate the strengths of ABM for trauma research, including incorporating interactions between individuals, simulating processes across multiple scales, examining life-course effects, testing alternate theories, comparing intervention strategies in a virtual laboratory, and guiding decision making. We also discuss the challenges of applying ABM to trauma research and offer specific suggestions for incorporating ABM into future studies of trauma and violence; Conclusion: Agent-based modeling is a useful complement to other methodological advances in trauma research. We recommend a more widespread adoption of ABM, particularly for research into patterns and consequences of individual traumatic experiences across the life course and understanding the effects of interventions that may be influenced by social norms and social network structures. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Childhood violence exposure and externalizing behaviors: A systematic review of the role of physiological biomarkers.

Childhood exposure to violence has been consistently linked to externalizing behaviors like delinquency and aggression. Growing evidence indicates that physiological biomarkers from the parasympathetic and sympathetic nervous systems (PNS and SNS) and hypothalamic-pituitary-adrenal (HPA) axis may moderate or mediate the relation between childhood violence exposure and externalizing behaviors. We conducted a systematic review to synthesize recent findings on physiological biomarkers as mediators and/or moderators of this association across the life course, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search yielded 3878 articles, of which 44 met inclusion criteria (describing a total of 46 independent studies). We found consistent evidence for blunted HPA-axis reactivity as a mediator of the relation between childhood violence exposure and subsequent externalizing behaviors, and for non-reciprocal PNS/SNS activation as moderators exacerbating this relation. However, the results of the majority of included studies that demonstrated significant moderating effects of physiological biomarkers varied by participant sex, type of childhood violence exposure, and type of stimuli used to induce physiological reactivity. The observed mixed findings are consistent with some theories that emphasize that both high and low stress reactivity can be adaptive depending on one's early environment. These findings highlight the need for systematic explorations of heterogeneity, theory-driven research questions, and longitudinal studies that span multiple developmental periods and multiple biological systems. Clinical implications include the need to assess physiological biomarkers in treatment and intervention studies and the potential to target interventions based on both autonomic functioning and environmental contexts.

Savoring Moderates the Link between Marijuana Use and Marijuana Problems.

Background: The changing legal landscape for marijuana requires concerted efforts toward minimizing the potential harms related to use of the plant. Purpose/Objectives: Identifying buffers against negative consequences in regular users could help researchers fashion prevention efforts that could appeal to those who are uninterested in messages related to abstinence. Savoring, a positively-focused, mindful approach to making the most of positive experiences, appears to overlap with facets of treatment that have proven successful with problem users. The present study examined the role of savoring in the development of marijuana-related problems. Methods: We examined the potential role of savoring as a buffer against marijuana problems in 195 participants (27.3% female). Results: Participants in this sample used cannabis 3.06 days per week on average. Correlations revealed that problems decreased as savoring increased. In addition, a significant interaction revealed that savoring moderated the impact of frequent use on problems. As savoring increased, the positive association between frequency of use and negative consequences decreased, suggesting that those who are high on savoring experience fewer negative consequences than those who are low on savoring even when they use marijuana as frequently. Conclusions: These data support the idea of incorporating savoring into the prevention of marijuana problems.

The Young Adolescent Project: A longitudinal study of the effects of maltreatment on adolescent development.

The Young Adolescent Project (YAP) is an ongoing longitudinal study investigating the effects of abuse and neglect on adolescent development. It is a multidisciplinary study guided by a developmental, ecological perspective, and designed to consider the physical, social, and psychological effects of childhood maltreatment through the transition from childhood to adolescence. Four waves of data collection have been completed, ranging from early (Mean age = 10.95) to late adolescence (Mean age = 18.24). Members of the maltreated group (n = 303) were selected from new cases that had been opened by the Department of Child and Family Services, whereas the comparison group (n = 151) were not involved with child welfare but lived in the same neighborhoods as the maltreated group. The study assessed a wide variety of domains including physical development (e.g., height, weight, body mass, pubertal development); physiological reactivity (e.g., cortisol); cognitive abilities; mental health (e.g., symptoms of depression, anxiety, trauma, and aggression); risk behavior (e.g., sexual activity, delinquency, or substance use); social development (e.g., self-esteem, competence, and social support); family environment; and exposure to community violence. Overall, our findings demonstrated the pervasive and persistent adverse effects of child maltreatment both within and across domains, but they also identified maltreated youth with positive functioning. Our hope is that this work will help move us toward identifying targets for intervention to cultivate resilience and positive adaptation after early maltreatment experiences.

The Moderating Role of Cortisol Reactivity on the Link Between Maltreatment and Body Mass Index Trajectory Across Adolescence.

PURPOSE: Child maltreatment increases risk for obesity, yet differential effects of maltreatment type remain unclear. Cortisol reactivity may help clarify these effects, given links among cortisol reactivity, maltreatment, and obesity. We examined these associations in boys and girls across adolescence. METHODS: We collected data from 454 adolescents (212 girls) across four waves (aged 8-13 years at Time 1), including 303 maltreated youth. We modeled body mass index (BMI) percentile trajectories arrayed by age separately for boys and girls and tested whether cortisol reactivity at Time 1 moderated the association between maltreatment type and BMI growth. RESULTS: In girls, cortisol reactivity moderated the association between maltreatment type and quadratic change in BMI. At low levels of cortisol, sexually abused girls had a steeper quadratic increase in BMI compared with comparison (-.65, 95% confidence interval [CI] -1.09 to -.22) and physically abused (-.76, 95% CI -1.29, -.24) girls. At high levels of cortisol, sexually abused girls did not differ from comparison (.15, 95% CI -.40 to .70) or physically abused (.21, 95% CI -.38 to .80) girls in quadratic change in BMI. In boys, cortisol reactivity did not moderate the association between maltreatment type and BMI growth. CONCLUSIONS: The combination of lower cortisol reactivity and sexual abuse may put girls at risk for BMI increase during later adolescence. Given the negative consequences of high BMI, identifying and intervening with these girls could lead to better health and well-being among this group. Cortisol reactivity may not play the same role among boys.

Evaluating the role of repetitive negative thinking in the maintenance of social appearance anxiety: An experimental manipulation.

Social appearance anxiety (SAA), or fear of having one's appearance negatively evaluated by others, is a risk factor for eating pathology and social anxiety, but maintenance processes for SAA remain unclear. The current study evaluated repetitive negative thinking (RNT) as a process through which SAA is maintained over time. Undergraduates (N = 126) completed self-report measurements, made an impromptu speech task to induce SAA, and were randomized to either engage in RNT or distraction following the speech task. Participants then attended a second appointment one day later and were asked to make a second speech. Results indicated positive associations between self-reported trait SAA and RNT. Individuals asked to engage in RNT following the appointment 1 speech task reported significantly higher state SAA than those who engaged in distraction. Findings indicated no significant effect of group on appointment 2 SAA, but post-hoc analyses suggested that naturally-occurring RNT may have accounted for increases in SAA across appointments. Overall, results provide support for the importance of RNT in maintaining various internalizing symptoms.

Relation between aggression exposure in adolescence and adult posttraumatic stress symptoms: Moderating role of the parasympathetic nervous system.

The present study examines the impact of the parasympathetic nervous system (PNS), as measured by respiratory sinus arrhythmia (RSA), on the link between family aggression experienced during adolescence and posttraumatic stress symptoms during young adulthood. Participants completed retrospective self-report measures of interparental aggression and harsh parenting exposure during adolescence and measures of current posttraumatic stress symptoms. RSA indexed PNS activity. Among females, the three-way interaction between harsh parenting, interparental aggression, and resting RSA was significant in accounting for young adulthood PTSD symptoms. At higher values of resting RSA and higher levels of interparental aggression exposure, harsh parenting experienced during adolescence was positively associated with adulthood PTSD symptoms. Among males, adolescent aggression exposure and resting RSA did not significantly account for variation in adulthood PTSD symptoms. Thus, this study suggests that resting PNS activity may play an important role in the relationship between stressors during adolescence and later PTSD in females.

Stress reactivity in maltreated and comparison male and female young adolescents.

The purpose of the present report was to examine the association of recent maltreatment experiences with cortisol reactivity in young adolescents. The ethnically diverse sample consisted of boys and girls 9 to 12 years of age. The maltreatment group (N = 303) all had recent, substantiated reports to protective services for neglect, physical abuse, sexual abuse, and/or emotional maltreatment. The comparison group (N = 151) was recruited from the same neighborhoods and was demographically similar to the maltreatment group. Cortisol reactivity was assessed by a laboratory stressor, a modified version of the Trier Social Stress Test for Children. Statistical analyses indicated that the maltreated young adolescents showed a blunted or attenuated response to the stressor as compared with those in the comparison group. This attenuated response was especially pronounced for those whose maltreatment included physical and/or sexual abuse. A main effect for gender was also found with boys having higher cortisol than girls. Implications for treatment of mental and physical health problems associated with child maltreatment and for prevention of developmental problems across the life span are discussed.

Adolescents' cortisol reactivity and subjective distress in response to family conflict: the moderating role of internalizing symptoms.

PURPOSE: Internalizing symptoms have been associated with both higher and blunted cortisol responses in adolescents. Little attention has been paid to subjective experiences of distress in conjunction with internalizing symptoms in hypothalamic-pituitary-adrenal axis responses to laboratory stressors. The present study examines whether adolescents' internalizing symptoms moderate the association between cortisol responses and distress in response to a common stressor in adolescence: family conflict. Differences are also examined between adolescents with current, past only, and no history of internalizing symptoms. METHODS: Adolescents (N = 70) discussed areas of conflict with their parents and subsequently reported on distress experienced during the discussion. Baseline and five poststressor saliva samples were collected. Adolescents' internalizing symptoms were assessed concurrently with the discussion and at three previous time-points. RESULTS: Internalizing symptoms moderated the association between distress reported by the adolescents and cortisol reactivity in response to family conflict. Adolescents with current and past internalizing symptoms had a blunted cortisol response, whereas adolescents with no history of internalizing symptoms showed greater cortisol reactivity when reporting greater distress. CONCLUSIONS: This study expands the understanding of how current and remitted internalizing symptoms are related to adolescents' responses to everyday family conflicts. Adolescents with current and past internalizing symptoms demonstrated a lack of correspondence between psychological and physiological stress, whereas adolescents with no history of internalizing symptoms showed the anticipated correspondence. This study has important implications for understanding the link between internalizing symptoms and adolescents' hypothalamic-pituitary-adrenal functioning in response to common social stressors.

Changes in Physiology before, during, and after Yawning.

The ultimate function of yawning continues to be debated. Here, we examine physiological measurements taken before, during, and after yawns in humans, in an attempt to identify key proximate mechanisms associated with this behavior. In two separate studies we measured changes in heart rate, lung volume, eye closure, skin conductance, ear pulse, respiratory sinus arrhythmia, and respiratory rate. Data were depicted from 75 s before and after yawns, and analyzed at baseline, during, and immediately following yawns. Increases in heart rate, lung volume, and eye muscle tension were observed during or immediately following yawning. Patterns of physiological changes during yawning were then compared to data from non-yawning deep inhalations. In one study, respiration period increased following the execution of a yawn. Much of the variance in physiology surrounding yawning was specific to the yawning event. This was not the case for deep inhalation. We consider our findings in light of various hypotheses about the function of yawning and conclude that they are most consistent with the brain cooling hypothesis.

Does cognitive behavioral therapy for youth anxiety outperform usual care in community clinics? An initial effectiveness test.

OBJECTIVE: Most tests of cognitive behavioral therapy (CBT) for youth anxiety disorders have shown beneficial effects, but these have been efficacy trials with recruited youths treated by researcher-employed therapists. One previous (nonrandomized) trial in community clinics found that CBT did not outperform usual care (UC). The present study used a more stringent effectiveness design to test CBT versus UC in youths referred to community clinics, with all treatment provided by therapists employed in the clinics. METHOD: A randomized controlled trial methodology was used. Therapists were randomized to training and supervision in the Coping Cat CBT program or UC. Forty-eight youths (56% girls, 8 to 15 years of age, 38% Caucasian, 33% Latino, 15% African-American) diagnosed with DSM-IV anxiety disorders were randomized to CBT or UC. RESULTS: At the end of treatment more than half the youths no longer met criteria for their primary anxiety disorder, but the groups did not differ significantly on symptom (e.g., parent report, eta-square = 0.0001; child report, eta-square = 0.09; both differences favoring UC) or diagnostic (CBT, 66.7% without primary diagnosis; UC, 73.7%; odds ratio 0.71) outcomes. No differences were found with regard to outcomes of comorbid conditions, treatment duration, or costs. However, youths receiving CBT used fewer additional services than UC youths (χ(2)(1) = 8.82, p = .006). CONCLUSIONS: CBT did not produce better clinical outcomes than usual community clinic care. This initial test involved a relatively modest sample size; more research is needed to clarify whether there are conditions under which CBT can produce better clinical outcomes than usual clinical care. CLINICAL TRIAL REGISTRY INFORMATION: Community Clinic Test of Youth Anxiety and Depression Study, URL: http://clinicaltrials.gov, unique identifier: NCT01005836.

Violence exposure in multiple interpersonal domains: cumulative and differential effects.

PURPOSE: To examine dose-response effects of cumulative violence exposure including parent-to-youth aggression, marital physical aggression, and community violence, and to explore whether separate interpersonal domains of exposure differentially influence adverse outcomes. METHODS: The present study uses parent-reports and child-reports of youth violence exposure from the first three waves of a prospective, longitudinal study of 103 community-based families. Outcomes were criterion levels (T score >or= 60) of somatic complaints, depressive symptoms, anxiety, over-arousal, aggression, delinquent behaviors, and presence versus absence of academic failure. RESULTS: After controlling for initial symptoms, income and parents' psychopathology, adjusted relative risks showed that marital aggression contributed uniquely to anxiety, and parent-to-youth aggression contributed uniquely to somatic complaints and aggression. All three domains significantly contributed to academic failure. With each one-point increase on the cumulative violence exposure index that summed across interpersonal domains and across time, there was an increased risk of more than 50% for meeting criterion levels of depressive symptoms and anxiety, and a 10%-25% increased risk for somatic complaints, delinquent behaviors, and academic failure. Significant curvilinear effects showed high cumulative violence increased risk of comorbid symptoms; 76% of youth with higher cumulative violence met thresholds on 3+ adverse outcomes, compared to 36% and 7% for youth with moderate and low violence exposure. CONCLUSIONS: These data highlight the importance of assessing violence exposure across multiple interpersonal domains and across time. Awareness of the contributions of violence exposure to common symptoms and particularly comorbid symptoms can inform interventions for wide-ranging adolescent problems.

Interparental aggression and parent-adolescent salivary alpha amylase symmetry.

The present study examined salivary alpha amylase (sAA), a putative marker of adrenergic activity, in family members engaging in family conflict discussions. We examined symmetry among family members' sAA levels at baseline and in response to a conflict discussion. The relation between a history of interparental aggression on parent-adolescent sAA symmetry also was examined. Participants were 62 families with a mother, father, and biological child age 13-18 (n=29 girls). After engaging in a relaxation procedure, families participated in a 15-minute triadic family conflict discussion. Participants provided saliva samples at post-relaxation/pre-discussion, immediately post-discussion, and at 10 and 20 min post-discussion. Participants also reported on interparental physical aggression during the previous year. Across the sample we found evidence of symmetry between mothers' and adolescents' sAA levels at baseline and around the discussion. Interparental aggression was associated with lower sAA levels among fathers. Interparental aggression also affected patterns of parent-child sAA response symmetry such that families reporting interparental aggression exhibited greater father-adolescent sAA symmetry than did those with no reports of interparental aggression. Among families with no interparental aggression history, we found consistent mother-adolescent symmetry. These differences suggest different patterns of parent-adolescent physiological attunement among families with interparental aggression.

Skin conductance reactivity and respiratory sinus arrhythmia among maltreated and comparison youth: relations with aggressive behavior.

OBJECTIVE: The goal of this study was to examine respiratory sinus arrhythmia (RSA), an indicator of parasympathetic nervous system-linked cardiac activity, and skin conductance level (SCL), a sympathetic indicator, as moderators of the link between child maltreatment and adolescent aggression. METHOD: Participants were 234 maltreated (48.3% male) and 128 (57.8% male) comparison youth aged 9-16 years participating in wave 2 of a longitudinal study. RESULTS: Regression analyses suggest that among boys, high RSA may be protective against the effects of maltreatment on aggressive behavior. Among girls, the moderating effect of RSA was further moderated by SCL reactivity such that low levels of both baseline RSA and SCL reactivity, or conversely high levels of both baseline RSA and SCL reactivity, exacerbated the link between maltreatment and aggression. CONCLUSIONS: High RSA may protect against the effects of maltreatment on aggressive behavior, though this effect may be moderated by SCL reactivity among girls.

Sex differences in salivary cortisol in response to acute stressors among healthy participants, in recreational or pathological gamblers, and in those with posttraumatic stress disorder.

Sex differences in incidence and severity of some stress-related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic-pituitary-adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or posttraumatic stress disorder (PTSD). Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress-related experiences, will be the subject of future investigation.