Infant DNA methylation: an early indicator of intergenerational trauma?

Exposure to adverse childhood experiences (ACEs) increases risk for mental and physical health problems. Intergenerationally, mothers' ACEs predict children's health problems including neurodevelopmental and behavioural problems and poorer physical health. Theories of intergenerational trauma suggest that ACEs experienced in one generation negatively affect the health and well-being of future generations, with DNA methylation (DNAm) being one of several potential biological explanations. To begin exploring this hypothesis, we tested whether infant DNA methylation associated with intergenerational trauma. Secondary analysis employed data from the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Subsample data were collected from mothers during pregnancy and postpartum on measures of distress, stress and ACEs and from infants at 3 months of age on DNAm from blood (n = 92) and buccal epithelial cells (BECs; n = 124; primarily nonoverlapping individuals between tissues). Blood and BECs were examined in separate analyses. Preliminary associations identified in blood and BECs suggest that infant DNAm patterns may relate to maternal ACEs. For the majority of ACE-related DNAm sites, neither maternal perinatal distress, nor maternal cortisol awakening response (CAR; a measure of hypothalamic-pituitary-adrenocortical axis function), substantially reduced associations between maternal ACEs and infant DNAm. However, accounting for maternal perinatal distress and cortisol substantially changed the effect of ACEs in a greater proportion of blood DNAm sites than BEC DNAm sites in the top ACEs-associated correlated methylated regions (CMRs), as well as across all CMRs and all remaining CpGs (that did not fall into CMRs). Possible DNAm patterns in infants, thus, might capture a signature of maternal intergenerational trauma, and this effect appears to be more dependent on maternal perinatal distress and CAR in blood relative to BECs.

Parenting Interacts With Plasticity Genes in Predicting Behavioral Outcomes in Preschoolers.

BACKGROUND: Public health and pediatric nurses typically focus on supporting parenting to reduce the likelihood of children's behavioral problems. Studies have identified interactions between early exposures to stress in caregiving and child genotype in predicting children's behavioral problems, such that certain genotypes connote greater differential susceptibility or plasticity to environmental stressors. We sought to uncover the interaction between observational measures of parent-child relationship quality and genotype in predicting early-onset behavioral problems in 24-month-olds, using prospective methods. METHODS: We conducted a secondary analysis of data collected on a subsample of 176 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study. Inclusion criteria required mothers to be ≥18 years of age, English speaking and ≤22 weeks gestational age at enrollment. Genetic data were obtained from blood leukocytes and buccal epithelial cell samples, collected from infants at three months of age. For each child, the presence of plasticity alleles was determined for BDNF, CNR1, DRD2/ANKK1, DRD4, DAT1, 5-HTTLPR, and MAOA and an overall index was calculated to summarize the number of plasticity alleles present. Observational assessments of parent-child relationship quality (sensitivity, controlling, and unresponsiveness) were conducted at six months of age. Children's internalizing (e.g., emotionally reactive, anxious/depressed, somatic complaint, withdrawn) and externalizing (e.g., aggression, inattention) behaviors were assessed at 24 months of age. After extracting genetic data, a maximum likelihood method for regressions was employed with Akaike Information Criterion (AIC) for model selection. RESULTS: When parents were less responsive and children possessed more plasticity alleles, children were more likely to be emotionally reactive, anxious/depressed, report somatic complaints, and withdrawn, while when parents were less responsive and children possessed fewer plasticity alleles, children were less likely to display these internalizing behaviors, in a differentially susceptible manner. Furthermore, when parents were more responsive, and children possessed more plasticity alleles, children were less likely to display internalizing behaviors (P = 0.034). Similarly, children who possessed either the CNR1-A plasticity allele (P = 0.010) or DAT1 9-repeat plasticity allele (P = 0.036) and experienced more/less parental control displayed more/fewer externalizing problems, respectively, in a differentially susceptible manner. CONCLUSIONS: The plasticity index score interacted with parental unresponsiveness in predicting anxiety and depressive behavioral problems in children, while individual genetic variants interacted with parental controlling behavior in predicting aggression and inattention in children, suggestive of differential susceptibility to caregiving. Especially in the context of nursing interventions designed to support childrearing and children's development, nurses need to be aware of the interactions between child genotype and parenting in understanding how well interventions will work in promoting optimal child behavior.

Concept Analysis of Posttraumatic Stress Disorder.

PURPOSE: Mental health nursing is not the same as psychiatry, so it is important for nurses to have an understanding of the defining attributes, antecedents, consequences, model cases, and empirical referents of post-traumatic stress disorder (PTSD). METHOD: Walker and Avant's (2005) method is used to guide this concept analysis of PTSD. FINDINGS: Four attributes arise from this concept analysis, which are addressed through both the DSM-IV and DSM-5 (American Psychiatric Association, /): triggering event or events, re-experiencing, fear, and helplessness. Though a majority of the defining attributes are addressed through both versions of the DSM, a key fifth attribute arises through this concept analysis: a disruption of meaning. CONCLUSIONS: A better understanding of PTSD from a nursing perspective will help inform appropriate nursing interventions and prevention strategies, while expanding the knowledge synthesis and contribution of the nursing profession. PRACTICE IMPLICATIONS: A model case, borderline case, and contrary case of PTSD are provided. Discussion of the importance of a lack or loss of meaning in PTSD is included, along with exploration of transformative learning theory to inform clinical practice for nurses addressing a disruption of meaning.