Mother's affection at 8 months predicts emotional distress in adulthood.

BACKGROUND: Long-standing theory suggests that quality of the mother's (or primary caregiver's) interaction with a child is a key determinant of the child's subsequent resilience or vulnerability and has implications for health in adulthood. However, there is a dearth of longitudinal data with both objective assessments of nurturing behaviour during infancy and sustained follow-up ascertaining the quality of adult functioning. METHODS: We used data from the Providence, Rhode Island birth cohort of the National Collaborative Perinatal Project (mean age 34 at follow-up, final N=482) to conduct a prospective study of the association between objectively measured affective quality of the mother-infant interaction and adult mental health. Infant-mother interaction quality was rated by an observer when infants were 8 months old, and adult emotional functioning was assessed from the Symptom Checklist-90, capturing both specific and general types of distress. RESULTS: High levels of maternal affection at 8 months were associated with significantly lower levels of distress in adult offspring (1/2 standard deviation; b=-4.76, se=1.7, p<0.01). The strongest association was with the anxiety subscale. Mother's affection did not seem to be on the pathway between lower parental SES and offspring distress. CONCLUSION: These findings suggest that early nurturing and warmth have long-lasting positive effects on mental health well into adulthood.

Maternal transmission of nicotine dependence: psychiatric, neurocognitive and prenatal factors.

This paper reviews the literature on maternal influences on smoking behaviors of offspring from the perspective of neuropsychiatric deficits that may be transmitted from mother to child. In particular, we review what is known regarding associations between: (1) in-utero exposure to smoking, (2) adolescent neurocognitive functioning and psychiatric comorbidity, and (3) the patterns of smoking and progression of nicotine dependence. Furthering our knowledge of these differences in susceptibility to nicotine dependence among youth will provide additional avenues for prevention and intervention efforts targeted toward those at high risk for dependence.

Perinatal medication as a potential risk factor for adult drug abuse in a North American cohort.

The aim of this study was to explore perinatal exposures to medications as risk factors for adult drug abuse. We compared 69 drug abusing subjects and their 33 non-abusing siblings with regard to history of labor pain analgesia during birth and other obstetric variables. Three or more doses of opiates or barbiturates at birth yielded an OR of 4.7 (95% CI = 1.0-44.1) for becoming a drug abuser after multiple perinatal drug exposure.

Learning and emotion in infants.

The systematic study of the sensory and learning processes of infants is a rather recent science; indeed, infants far surpass what we "knew" about their capacity for learning a few decades ago. Emotion and learning are closely intertwined, because behaviors that elicit positive emotional response are repeated and learned. Understanding these processes can optimize care of newborns by both professionals and parents.

Risk-taking in preschool children.

This study was designed to characterize preschool-age children who engage in daring, risk-taking behaviors. Seventy-four children (39 males, 35 females) and their mothers from a wide range of socioeconomic strata participated. Children who described themselves as high in risk-taking were generally males, had higher accident and injury rates, and had parents whose assessments of their children's risk-taking activities were congruent with their own. Contrary to our expectations, however, risk-taking children did not appear to be more than ordinarily impulsive, which suggests that risk-taking is engaged in contemplatively (i.e., with some caution) by some youngsters and need not result in serious mishaps. Cognitive ability was found to be a codependent predictor of risk-taking for boys. Parents and clinicians will find it useful to know that risk-taking is a multidimensional phenomenon, not a unitary behavior or personality trait and that the Injury Behavior Checklist would be a valuable tool for screening selected populations.

Influence of sexual abuse on HIV-related attitudes and behaviors in adolescent psychiatric inpatients.

OBJECTIVE: To investigate the associations between sexual abuse and human immunodeficiency virus (HIV)-related attitudes and behaviors of adolescents with a psychiatric disorder. METHOD: HIV-related knowledge, attitudes, and behaviors were examined by self-report assessment of adolescents admitted to a psychiatric hospital (N = 100). A subsample (n = 30) completed a role-playing exercise regarding HIV-preventive behavior that was scored for the degree of effective communication by raters blind to the subjects' abuse history. RESULTS: HIV-related risk behaviors were prevalent, including unprotected sexual intercourse (67%) and multiple partners (27%) among the sexually active (71% of the total). Also frequent were alcohol and drug use (25%) and sharing cutting instruments (22%) among those engaged in self-cutting behavior (62%). The 38% of the sample identified as having a history of sexual abuse indicated significantly poorer self-efficacy concerning condom use than their peers. Abused females scored significantly lower on the self-efficacy of condom use scale and reported significantly more frequent alcohol use than nonabused females (p = .003). A hierarchical multiple regression that controlled for consistency of condom use and tolerance of people with acquired immunodeficiency syndrome found that abuse history uniquely accounted for 16% of the variance in condom use self-efficacy. Analysis of the videotaped role-play found that abused adolescents were significantly less competent and had more difficulty in effective communication than their peers (p = .003). CONCLUSION: A history of sexual abuse is associated with impaired safe sexual decision-making and HIV-preventive communication skills, even in this already at-risk group. This study also underscores the importance of actively addressing these issues in the context of clinical care.

Adolescent problem behaviors as predictors of adult alcohol diagnoses.

Young adult alcohol problems based on DIS/DSM III diagnoses were predicted from a number of adolescent risky/antisocial behaviors in a sample of 693 subjects. The number of times an individual was intoxicated before his/her sixteenth birthday was the best indicator of adult alcohol "abuse" and /or dependence, with adolescent fighting, arrests, and lack of participation in religious activities also serving as important problem behavior predictors. Results of correlational and principal-components analyses of adolescent problem behaviors are similar to previous work on Problem Behavior Theory. The results suggest that prevention efforts should begin before adolescence, prior to the time when individuals are exposed to, or begin practicing, adult health-threatening activities.

Representations of attachment in mothers and their one-year-old infants.

Attachment classifications in mothers and their 1-year-old infants were independently and concurrently assessed using the Adult Attachment Interview and the Strange Situation Procedure. Overall concordance was significant (k = 0.62), with strong links apparent between mothers classified dismissing and infants classified avoidant and between mothers classified autonomous and infants classified secure. Mothers' classified preoccupied were not more likely to have infants classified resistant. Mothers' perceptions and interpretations of the emotional distress of an infant observed in a 4-minute videotape were related to both infant and mother attachment classifications. These results are compatible with the suggestion that attachment classification reflect differences in internal working models of relationships. Other measures of maternal psychosocial adjustment were not related to infant attachment classifications.

Pregnancy/delivery complications and psychiatric diagnosis. A prospective study.

We examined the hypothesis that pregnancy and delivery complications result in increased risk for the development of psychiatric disorders. The study sample included 1068 pregnancies classified as chronic fetal hypoxia, other complications, preterm birth, or normal pregnancy/delivery that had initially been studied prospectively from the prenatal period through age 7 years. Subjects were recontacted (ages 18 to 27 years) and lifetime psychiatric diagnoses made with the Diagnostic Interview Schedule. Preterm subjects had significantly higher rates of cognitive impairment. Subjects with chronic fetal hypoxia had higher rates of both cognitive impairment and psychotic disorders, although these differences failed to reach statistical significance due to the small number of cases. With these exceptions, the data did not support the hypothesis that rates of psychiatric disorders are higher among subjects born with complications of pregnancy and delivery than among normal controls born without complications.

Young heavy drinkers and their drinking experiences: predictors of later alcohol use.

This study illustrated the impact of late adolescent and young adult alcohol experiences on current level of alcohol use. Additional factors investigated include reported age of problem onset, initial age of alcohol use, marital status, and life-span risk-taking behavior. A stepwise discriminant analysis was used to determine the importance of various subtypes of drinking experiences and combinations of these subtypes. Correct classification of current light and heavy alcohol drinkers by use of these experiences was 83.7% for late adolescent experiences and 77.5% for young adulthood experiences. The results suggest that early drinking experiences are useful predictors of future drinking patterns.

A retrospective study of risk-taking and alcohol-mediated unprotected intercourse.

The search for possible causal mechanisms leading to unprotected intercourse in males is the current focus of a great deal of psychosocial research. A retrospective questionnaire study of male undergraduate students (N = 332) examined the role of alcohol use and risk-taking behavior as a contributor to unprotected intercourse. Respondents' degree of risk-taking behavior during various periods of their life, and their alcohol use patterns and unprotected intercourse during their freshman and senior years of college were analyzed by a structural model. Results indicate a good model fit and suggest that older adolescent/young adult males may engage in riskier sexual behavior when using alcohol. Additionally, specific early behavior patterns appear to be the best predictor, from the variables in our model, of subsequent behavior. The findings of this study and other studies demonstrate that safe-sex instructional techniques designed for adolescents and young adults may benefit by focusing partly on responsible alcohol use.

Early identification of developmentally disabled and at-risk preschool children.

This study examined child-centered data (from birth to 7 years) and familial factors as possible predictors of disabilities in adolescence. The sample was taken from original participants in the National Collaborative Perinatal Project in Rhode Island who were also judged as handicapped after school entry. Results of the current study indicated that parental traits (i.e., maternal education) are more accurate predictors of adolescent status than the child's own behavior from birth to 3 years, whereas child-centered skills assessed at 4 and 7 years of age are better predictors than are familial factors. Overall, data suggest that early identification models which focus upon developmental delay or adverse medical events from birth to 3 years of age are inadequate in fully identifying children eventually judged to be handicapped. Screening initiatives must be developed that are multivariate (child and family focused) and account for differential weights of risk factors over time.

Learning processes in the human newborn. Sensitization, habituation, and classical conditioning.

Data have been presented to document that the human newborn is a conditionable organism. Babies in the first days of life possess sensitivity to stimulation in all sensory modalities, an unconditioned repertoire of responses to some of these sensory stimuli, and a capacity for associating simultaneously presented stimuli. Thus a perceived but previously neutral stimulus with respect to the elicitation of some particular behavior can itself become an effective stimulus through paired associations with an effective stimulus, and may now produce a response similar to the initially effective stimulus. For such a phenomenon to occur, the organism must be capable of remembering. The duration of memory is empirically demonstrable through probes or tests with the neutral stimulus, at various time intervals following the last experience of the pairing. Besides engaging in classical conditioning involving transfer of elicitability from an effective stimulus to a previously ineffective stimulus (or its converse, as in extinction), demonstrating that human newborns do learn, babies are also demonstrably capable habituators. They exhibit diminution of response intensity or frequency to repetitively presented, and particularly closely spaced and essentially innocuous, stimuli. Newborns also exhibit generalized sensitization to stimulation such that, when neonates are aroused, stimuli will nondiscriminatively elicit behaviors. It is thus important that appropriate controls for nonconditioning processes, which may also involve change in behavior through experience, be included in any demonstrations that purport to show the conditionability of the newborn.

Relationship of maternal and perinatal conditions to eventual adolescent suicide.

In an investigation of a possible relationship between falling perinatal mortality and rising rates of adolescent suicide, 46 risk factors from the prenatal, birth, and neonatal records of 52 adolescents who committed suicide before age 20 and 2 matched controls for each subject were analysed blind. The results showed statistically significant differences between the suicide victims and each of the controls and no difference between the controls. Three specific risk factors were shown to have a powerful capacity to differentiate the suicides from the controls: (i) respiratory distress for more than 1 h at birth; (ii) no antenatal care before 20 weeks of pregnancy; and (iii) chronic disease of the mother during pregnancy.