Ashley Wazana

• Doctor of Medicine
• McGill University

Background: Neuroimaging has contributed considerably to our understanding of brain development and its relationship to cognition and behavior. However, despite advancements in neuroimaging, replicability in research remains a key issue and there are no gold standard models that quantify neuroanatomical correlates of cognition, behavior and their i...

This study explored the interactions among prenatal stress, child sex, and polygenic risk scores (PGS) for attention‐deficit/hyperactivity disorder (ADHD) on structural developmental changes of brain regions implicated in ADHD. We used data from two population‐based birth cohorts: Growing Up in Singapore Towards healthy Outcomes (GUSTO) from Singap...

We investigated the longitudinal associations among maternal pre- and postnatal depression, maternal anxiety, and children’s language and cognitive development followed from 15 to 61 months. Furthermore, we assessed the protective role of children’s early print experiences with books against the adverse effect of maternal depression on language dev...

Parenting is a key contributor to child development. The effects of parenting, however, also depend on child characteristics, including genetic factors. A more complete appraisal of the role of parenting thus requires a comprehensive developmental model which explores questions about parenting behavior, child susceptibility to parenting, and child...

Dysregulation is a combination of emotion, behavior, and attention problems associated with lifelong psychiatric comorbidity. There is evidence for the stability of dysregulation from childhood to adulthood, which would be more fully characterized by determining the likely stability from infancy to childhood. Early origins of dysregulation can furt...

Early life environments program developmental processes that determine later life disease risk and resiliency. To understand how early life circumstances shape health trajectories, it is critical to consider how environmental adversity and enrichment interact with constitutional factors, such as one’s genetic makeup, to produce lasting changes to t...

Background Secure attachment reflects caregiver-child relationship in which the caregiver is responsive when support and comforting are needed by the child. This pattern of bond has an important buffering role in the response to stress by the reduction of the negative experience and its associated physiological response. Disruption of the physiolog...

Purpose of review: Attachment represents an aspect of the parent-child relationship by encapsulating behaviours and stress management strategies. Although attachment is not considered a measure of psychopathology, some attachment styles place children at higher risk for psychopathologies. The origins of attachment have historically thought to be e...

Data sharing is key to advancing our understanding of human health and well-being. While issues related to pediatric research warrant strong ethical protections, overly protectionist policies may serve to exclude minors from data sharing initiatives. Pediatric data sharing is critical to scientific research concerning health and well-being, to say...

The development of mental health disorders is a complex process that includes biological (e.g., genetic) and environmental influences interacting over the lifespan. Although there is a strong main effect of genetics on psychopathology, nor genes nor the environment alone can development of psychopathology [1]. Differential susceptibility is a gene-...

Negative emotionality (NE) was evaluated as a candidate mechanism linking prenatal maternal affective symptoms and offspring internalizing problems during the preschool/early school age period. The participants were 335 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment project. A Confirmatory Bifactor Analysis (CFA...

Re-contacting minors enrolled in research upon their reaching the age of majority or maturity to seek their autonomous consent to continue their participation is considered an ethical requirement. This issue has generally been studied in the context of minors who are actively involved in the research. However, what becomes of this issue when the mi...

Suicide was the second‑leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome o...

The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how early life exposures shape lifecycle health. To date, no comprehensive list of these exposures and their interactions has been developed, which limits our ability to predict trajectories of risk and resiliency in humans. To address this gap, we developed a mode...

Background Polygenic risk scores (PRSs) operationalize genetic propensity toward a particular mental disorder and hold promise as early predictors of psychopathology, but before a PRS can be used clinically, explanatory power must be increased and the specificity for a psychiatric domain established. To enable early detection, it is crucial to stud...

Background : Few studies have explored the complex gene-by-prenatal environment-by-early postnatal environment interactions that underlie the development of attentional competence. Here, we examined if variation in dopamine-related genes interacts with prenatal adversity to influence toddler attentional competence and whether this influence is buff...

We are writing this Introduction at a time of unprecedented population-wide stress and uncertainty associated with the COVID-19 pandemic. Beyond the actual infection itself, this world crisis affects us all, and not surprisingly, the most vulnerable remain disproportionately affected by the many of the unintended social, economic and health consequ...

Depression during pregnancy, with the often-accompanying anxiety and stress, carries risks for mothers and their infants, and while antidepressant medications (ADM) are used to treat these disorders (and presumably reduce risks to mothers and their children), prenatal exposure to these medications is also associated with adverse developmental outco...

As widely discussed in this volume, mounting evidence traces the developmental origins of psychopathology to the perinatal period (Hughes et al. 2013), yet studies continue to yield small to moderate effect sizes (Stein et al. 2014). Moreover, to date there has been little evidence that early interventions during pregnancy lead to a reduction in th...

Objective: In this study, we aimed to (1) assess the effectiveness of an intensive multimodal day treatment program in improving externalizing problems and function in elementary-age children and (2) examine 3 predictors of the treatment outcome (i.e., family functioning, baseline severity, and comorbid disorders). Methods: The sample included 2...

This book examines the complex impact of prenatal stress and the mechanism of its transmission on children’s development and well-being, including prenatal programming, epigenetics, inflammatory processes and the brain-gut microbiome. It analyzes current findings on prenatal stressors affecting pregnancy, including preconception stress, prenatal ma...

Background Polygenic risk scores (PRSs) are increasingly used in psychiatric research to operationalize genetic propensity towards a particular mental disorder. PRSs hold promise as early predictors of psychiatric symptoms in clinical settings, but, before a PRS can be clinically used, their specificity towards a psychiatric domain needs to be eval...

Purpose of review: Understanding variability in developmental outcomes following exposure to early life adversity (ELA) has been an area of increasing interest in psychiatry, as resilient outcomes are just as prevalent as negative ones. However, resilient individuals are understudied in most cohorts and even when studied, resilience is typically d...

The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure–outcome relationships are complex and poorly defined. We, therefo...

Objective Few studies have attempted to identify how distinct dimensions of maternal prenatal affective symptoms relate to offspring psychopathology. We defined latent dimensions of women’s prenatal affective symptoms and pregnancy-specific worries to examined their association with early offspring psychopathology in three prenatal cohorts. Method...

Parental care has a strong impact on neurodevelopment and mental health in the offspring. While a multitude of animal studies has revealed that the parental brain is a highly complex system involving many brain structures and neuroendocrine systems, human maternal parenting as a multi‐dimensional construct with cognitive, emotional, and behavioral...

Background Internalising and externalising problems commonly co‐occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into s...

Motivated by the goal of expanding currently existing genotype x environment interaction (GxE) models to simultaneously include multiple genetic variants and environmental exposures in a parsimonious way, we developed a novel method to estimate the parameters in a GxE model, where G is a weighted sum of genetic variants (genetic score) and E is a w...

Currently, two main approaches exist to distinguish differential susceptibility from diathesis-stress and vantage sensitivity in genotype × environment interaction (G×E) research: Regions of significance (RoS) and competitive-confirmatory approaches. Each is limited by their single-gene/single-environment foci given that most phenotypes are the pro...

Currently, two main approaches exist to distinguish differential susceptibility from diathesis-stress and vantage sensitivity in genotype x environment interaction (GxE) research: Regions of significance (RoS) and competitive-confirmatory approaches. Each is limited by their single-gene/single-environment foci given that most phenotypes are the pro...

Currently, two main approaches exist to distinguish differential susceptibility from diathesis-stress and vantage sensitivity in genotype × environment interaction (G×E) research: Regions of significance (RoS) and competitive-confirmatory approaches. Each is limited by their single-gene/single-environment foci given that most phenotypes are the pro...

Background: Efforts to understand the developmental pathways for disorganized attachment reflect the importance of disorganized attachment on the prediction of future psychopathology. The inconsistent findings on the prediction of disorganized attachment from the dopamine D4 receptor (DRD4) gene, birth weight, and maternal depression as well as th...

Objective: An attachment model was used to understand how maternal sensitivity and adverse childhood experiences are related to somatization. Methods: We examined maternal sensitivity at 6 and 18 months and somatization at 5 years in 292 children in a longitudinal cohort study. We next examined attachment insecurity and somatization (health anxi...

Background: Efforts to understand the developmental pathways for disorganized attachment reflect the importance of disorganized attachment on the prediction of future psychopathology. The inconsistent findings on the prediction of disorganized attachment from the dopamine D4 receptor (DRD4) gene, birth weight, and maternal depression as well as the...

Background: Recent evidence suggests that early exposure to low maternal sensitivity is a risk factor for obesity in children and adolescents. A separate line of study shows that the seven-repeat (7R) allele of the dopamine-4 receptor gene (DRD4) increases susceptibility to environmental factors including maternal sensitivity. The current study in...

Prenatal maternal depression and a multilocus genetic profile of two susceptibility genes implicated in the stress response were examined in an interaction model predicting negative emotionality in the first 3 years. In 179 mother–infant dyads from the Maternal Adversity, Vulnerability, and Neurodevelopment cohort, prenatal depression (Center for E...

Disorganized attachment is an important early risk factor for socioemotional problems throughout childhood and into adulthood. Prevailing models of the etiology of disorganized attachment emphasize the role of highly dysfunctional parenting, to the exclusion of complex models examining the interplay of child and parental factors. Decades of researc...

Background: The current paper aimed to explore the effects of birth weight and the 7-repeat allele in Exon III of the dopamine D4 receptor (DRD4) gene on the development of disorganized attachment, a potential endophenotype of depression. Infants born with low birth weight have been shown to be at higher risk for later neurological impairments, ps...

Research findings are inconclusive when it comes to whether breastfeeding is associated with the mother-infant relationship or infant temperament.. We examined the association between breastfeeding at three months postpartum and infant temperament at 18 months postpartum and whether this link was affected by the mothers' anxiety and mediated by her...

We examined transgenerational effects of maternal childhood adversity on child temperament and a functional promoter polymorphism, 5-HTTLPR, in the serotonin transporter gene (SLC6A4) as potential moderators of such maternal influences in 154 mother-child dyads, recruited into a longitudinal birth cohort study. We examined the interactive effects o...

Background Poor inhibitory control is associated with overeating and/or obesity in school-age children, adolescents and adults. The current study examined whether an objective and reliable marker of response inhibition, the Stop-Signal Reaction Time (SSRT), is associated with BMI z-scores and/or food intake during a snack test in pre-school childre...

To describe the theory and methodology of the multi-wave, prospective Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) study. The goal of MAVAN is to examine the pre- and postnatal influences, and their interaction, in determining individual differences in mental health. MAVAN is a community-based, birth cohort study of pregnant Canad...

Background Childhood dysregulation, which reflects deficits in the capacity to regulate or control one's thoughts, emotions and behaviours, is associated with psychopathology throughout childhood and into adulthood. Exposures to adversity during the prenatal period, including prenatal depression, can influence the development of dysregulation, and...

Identify children at-risk of having mental health problems is of value to prevent injury. But the limited agreement between informants might jeopardize prevention initiatives. The aims of the present study were 1) to test the concordance between parents and children reports, and 2) to investigate their relationships with parental reports of childre...

Introduction: Sleep problems are frequent in young children and more so among children with difficult temperament. Although temperament had a strong hereditary component, it is also affected by early life experiences. Relations between polymorphisms of monoamine transporter genes and temperament /personality traits are documented. Serotonin also re...

Introduction and Objectives: Maternal well-being associates with children temperament. For instance, children of women who suffer from depression and/or anxiety tend to display behavioural, social, and emotional impairments such as increased negative emotionality. Children with difficult temperament also show an increased prevalence of parasomnias...

Headaches are common in childhood and significantly impact children's quality of life. On the contrary to the adolescent and adult population, there are few data on the associations between headaches and psychopathology in young children. The aim of this study was to examine the relationships between child headaches, emotional and behavioral diffic...

To examine the psychometric properties of the Dominic Interactive (DI) in school-aged children in a different cultural environment than Quebec. In a large French region, 100 schools and 25 children (aged 6 to 11 years) per school were randomly selected. Data were collected using self-administered questionnaires to children (DI), parents (sociodemog...

To examine the psychometric properties of the French version of the strengths and difficulties questionnaire (SDQ), compare estimates of child mental health problems and SDQ scores across France, US and UK. The French version of the parent-reported SDQ was administered to the parents of a representative sample of 1,348 French children aged 6-11 yea...

To estimate the prevalence of peer victimization among primary school-aged children, to identify mental health and social correlates, and to assess health care services use. One hundred schools and 25 children (6-11 years old) per school were randomly selected in a large French region. Data were collected using standardized self-administered questi...

The aim of this study was to estimate the prevalence of child overweight in a regional sample of primary school-aged children, and to examine the relationships among child overweight, psychopathology, and social functioning. A cross-sectional survey was conducted in 2004 in 100 primary schools of a large French region, with 2,341 children aged 6-11...

We provide an illustration of how changes in methodological factors may produce variations in the frequency of autistic disorder (AD) over time and project how much of the observed increase in the frequency of AD may be explained by methodological factors. Using a prediction analysis, we calculate how broadening diagnostic criteria, younger age at...

Evidence suggests that the pharmaceutical industry exerts a large influence on residents' education and practice. Yet existing guidelines by professional bodies do not cover the specifics of residents' interactions with the pharmaceutical industry. At the psychiatry residency program of the McGill University Health Center, the authors set out to sy...

Two physicians assert that pharmaceutical companies' sponsorship of clinical conferences for residents and physicians represent a conflict of interest. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.

Persuasion, influence, and change are familiar domains in psychiatry. Frequently, therapists attempt to identify and understand the cognitions, affects, and perceptions their patients have developed or acquired and then, by a number of means, trigger therapeutic changes. Whereas they spend much work in the therapeutic setting attempting to delineat...

Persuasion, influence, and change are familiar domains in psychiatry. Frequently, therapists attempt to identify and understand the cognitions, affects, and perceptions their patients have developed or acquired and then, by a number of means, trigger therapeutic changes. Whereas they spend much work in the therapeutic setting attempting to delineat...

Purpose. Post Traumatic Stress Disorder (PTSD) is a disorder with important prevalence, morbidity, co-morbidity as well as economic cost. This study examines the comparative efficacy and effectiveness of pharmacotherapy and psychotherapy. Data sources. (1) MEDLINE search from 1966 to present using both McSH terms and related keywords; (2) reference...

To compare child pedestrian injury rates on one-way versus two-way streets in Hamilton, and examine whether the characteristics of child pedestrian injuries differ across street types. The rates of injury per child population, per kilometre, per year were calculated by age, sex and socio-economic status (SES). Child, environment and driver characte...

Controversy exists over the fact that physicians have regular contact with the pharmaceutical industry and its sales representatives, who spend a large sum of money each year promoting to them by way of gifts, free meals, travel subsidies, sponsored teachings, and symposia. To identify the extent of and attitudes toward the relationship between phy...

Context Controversy exists over the fact that physicians have regular contact with the pharmaceutical industry and its sales representatives, who spend a large sum of money each year promoting to them by way of gifts, free meals, travel subsidies, sponsored teachings, and symposia.Objective To identify the extent of and attitudes toward the relat...

To identify modifiable risk factors for child pedestrian injuries. (1) MEDLINE search from 1985 to 1995; search term used was traffic accidents; (2) review of reference lists from retrieved articles and books; (3) review of reference lists from three systematic reviews on childhood injuries and (4) consultation with 'key informants'. All studies th...

To review the evidence of general injury and pedestrian injury studies to determine if there are child behavioural, emotional, developmental, or physical characteristics that put children at higher risk for injury and, if there are such proneness risk factors, to determine their importance relative to other risk factors. This paper critically asses...