Maternal sensitivity and infant autonomic and endocrine stress responses.

BACKGROUND: Early environmental exposures may help shape the development of the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis, influencing vulnerability for health problems across the lifespan. Little is known about the role of maternal sensitivity in influencing the development of the ANS in early life. AIMS: To examine associations among maternal sensitivity and infant behavioral distress and ANS and HPA axis reactivity to the Repeated Still-Face Paradigm (SFP-R), a dyadic stress task. STUDY DESIGN: Observational repeated measures study. SUBJECTS: Thirty-five urban, sociodemographically diverse mothers and their 6-month-old infants. OUTCOME MEASURES: Changes in infant affective distress, heart rate, respiratory sinus arrhythmia (RSA), and T-wave amplitude (TWA) across episodes of the SFP-R were assessed. A measure of cortisol output (area under the curve) in the hour following cessation of the SFP-R was also obtained. RESULTS: Greater maternal insensitivity was associated with greater infant sympathetic activation (TWA) during periods of stress and tended to be associated with greater cortisol output following the SFP-R. There was also evidence for greater affective distress and less parasympathetic activation (RSA) during the SFP-R among infants of predominantly insensitive mothers. CONCLUSIONS: Caregiving quality in early life may influence the responsiveness of the sympathetic and parasympathetic branches of the ANS as well as the HPA axis. Consideration of the ANS and HPA axis systems together provides a fuller representation of adaptive versus maladaptive stress responses. The findings highlight the importance of supporting high quality caregiving in the early years of life, which is likely to promote later health.

Examining aggression in male Vietnam veterans who receive VA services: the role of traumatic events and combat exposure.

We examined the relationship between trauma exposure and the perpetration of aggression by male Vietnam veterans (N = 1,328) using archival data from a multisite study conducted by the Cooperative Studies Program of the Department of Veteran Affairs (CSP-334) in the early 1990s. Both traumatic events in civilian life and combat exposure were examined as correlates of aggression. Results indicated that pre- and postmilitary traumatic events and combat exposure were all related to perpetration of aggression at the bivariate level; r = .07, r = .20, and r = .13, respectively. When these variables were examined simultaneously, only combat exposure (ß = .14, p < .001) and postmilitary traumatic events (ß = .20, p < .001) were associated with aggression. No interaction effects were found for civilian traumatic events and combat in relation to aggression. Results highlight the importance of attending to the psychological aftermath of exposure to traumatic events experienced during and following deployment before aggressive patterns develop.

Race/ethnicity as a predictor of change in working alliance during cognitive behavioral therapy for intimate partner violence perpetrators.

Despite evidence that the working alliance (WA) is an important factor in psychotherapy outcome and that race/ethnicity plays an important role in the processes of therapy, few studies have directly examined associations between WA and race/ethnicity. These relationships may be particularly salient for difficult-to-engage populations, such as men participating in treatment for intimate partner violence. The current study examined WA ratings in a sample of 107 male intimate partner violence perpetrators attending a 16-week cognitive-behavioral group program. Approximately 50% of these participants were Caucasian and 50% were members of a racial/ethnic minority group (African American, Asian American, Hispanic, and American Indian). Growth curve modeling was used to assess changes in both therapist and client WA ratings across four time points during therapy. Findings indicated that there was no mean level of change in therapist WA ratings over time. However, clients' WA ratings demonstrated a reliable, steady increase across sessions. A significant interaction between WA and race/ethnicity emerged such that Caucasian participants reported a significant increase in WA over time, whereas members of racial/ethnic minority group did not report a consistent pattern of change. The interaction between client race/ethnicity and WA was also a significant predictor of treatment outcome at 6-month follow-up.