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Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective
Journal of Child Psychology and Psychiatry
Abstract
If a mother is stressed or anxious while pregnant her child is more likely to show a range of symptoms such as those of attention deficit hyperactivity disorder, conduct disorder, aggression or anxiety. While there remains some debate about what proportion of these effects are due to the prenatal or the postnatal environment, and the role of genetics, there is good evidence that prenatal stress exposure can increase the risk for later psychopathology. Why should this be? In our evolutionary history it is possible that some increase in these characteristics in some individuals was adaptive in a stressful environment, and that this type of fetal programming prepared the child or group for the environment in which they were going to find themselves. Anxiety may have been associated with increased vigilance, distractible attention with more perception of danger, impulsivity with more exploration, conduct disorder with a willingness to break rules, and aggression with the ability to fight intruders or predators. This adaptation for a future dangerous environment may explain why stress and anxiety, rather than depression, seem to have these programming effects; why there is a dose-response relationship with prenatal stress from moderate to severe and it is not only toxic stress that has consequences; why not all children are affected and why individual children are affected in different ways; and why the outcomes affected can depend on the sex of the offspring. An evolutionary perspective may give a different understanding of children in our society with these symptoms, and suggest new directions for research. For example, there is some evidence that the type of cognitive deficits observed after prenatal stress have specific characteristics; these may be those which were adaptive in a past environment.
... For example, elevated cortisol and sympathetic nervous system activity may communicate to an unborn child that their mother lives in a highly stressful environment. Consequently, these features of a pregnant individual's biology may prompt fetal neurodevelopmental changes, such as lower birthweight, preterm delivery, and greater distractibility in infancy [22,23]. According to evolutionary theory, if the postnatal environment were to be aligned with the experience of the fetus in utero, these adaptations could help a child navigate stressful early-life circumstances (e.g., distractibility could help one mitigate risk of multiple threats) [24]. ...
... However, these neurodevelopmental changes can be detrimental in the long term, especially when the postnatal environment is misaligned with the one for which the fetus was adapting. This can result in increased risk for psychopathology, developmental delays, and neurocognitive deficits across the lifespan [21,22,25]. One challenge that researchers have encountered is that prenatal maternal health features and correlates are highly interrelated, making it difficult to choose which to include as independent variables in a model. ...
... Pregnant people's mental and physical health is also shaped by their social and cultural context. Stress experienced during the prenatal period can "get under the skin" and alter fetal neurodevelopment [22]. Social determinants of health, such as socioeconomic disadvantage, crime exposure, and poverty, are often related to infant health at birth through biological embedding of stress during pregnancy [48][49][50]. ...
Background
Newborns are shaped by prenatal maternal experiences. These include a pregnant person’s physical health, prior pregnancy experiences, emotion regulation, and socially determined health markers. We used a series of machine learning models to predict markers of fetal growth and development—specifically, newborn birthweight and head circumference (HC).
Methods
We used a pre-registered archival data analytic approach. These data consisted of maternal and newborn characteristics of 594 maternal-infant dyads in the western U.S. Participants also completed a measure of emotion dysregulation. In total, there were 22 predictors of newborn HC and birthweight. We used regularized regression for predictor selection and linear prediction, followed by nonlinear models if linear models were overfit.
Results
HC was predicted best with a linear model (ridge regression). Newborn sex (male), number of living children, and maternal BMI predicted a larger HC, whereas maternal preeclampsia, number of prior preterm births, and race/ethnicity (Latina) predicted a smaller HC. Birthweight was predicted best with a nonlinear model (support vector machine). Occupational prestige (a marker similar to socioeconomic status) predicted higher birthweight, maternal race/ethnicity (non-White and non-Latina) predicted lower birthweight, and the number of living children, prior preterm births, and difficulty with emotional clarity had nonlinear effects.
Conclusions
HC and birthweight were predicted by a variety of variables associated with prenatal stressful experiences, spanning medical, psychological, and social markers of health and stress. These findings may highlight the importance of viewing prenatal maternal health across multiple dimensions. Findings also suggest that assessing difficulties with emotional clarity during standard obstetric care (in the U.S.) may help identify risk for adverse newborn outcomes.
... Accumulating evidence suggests that prenatal and postnatal MDS are both associated with heightened negative affect during infancy (see Spry et al., 2020 for review and meta-analysis). Several mechanisms have been suggested to explain these associations, including in utero exposure to stress hormones, pro-inflammatory cytokines, or microbiota (Chan et al., 2018;Glover, 2011;Gustafsson et al., 2018;Van den Bergh et al., 2020) as well as postnatal exposure to less optimal parent-infant interactions and broader relational environments (Goodman et al., 2011). However, these direct associations are modest in size and there is also substantial variability in these links across studies (Spry et al., 2020). ...
... Distinguishing between these two emotional responses is crucial, given their distinct associations with subsequent empathy and prosocial behavior abilities (Eisenberg et al., 2014;Spinrad et al., 2022). Traditional developmental theories of empathy-related responding have suggested that affective concern surfaces during the second year of life, whereas in early infancy the affective responses to others' distress (Glover, 2011) are limited to self-distress or emotion contagion (Hoffman, 1975(Hoffman, , 2001. However, growing evidence challenges this developmental timeline (Abramson et al., 2019;Davidov et al., 2021;Liddle et al., 2015;Roth-Hanania et al., 2011;Spinrad et al., 2022;Vaish & Grossmann, 2022). ...
Exposure to maternal depressive symptoms (MDS) may have a pertinent role in shaping children’s emotional development. However, little is known about how these processes emerge in the early postpartum period. The current study examined the direct and interactive associations between MDS and cry-processing cognitions in the prediction of infant negative emotionality and affective concern. Participants were 130 mother-child dyads (50% female) assessed at three time points. During the second trimester of pregnancy, expectant mothers completed a procedure to assess responses to video clips of distressed infants and reported about MDS. Mothers also reported about MDS at 1- and 3-months postpartum. At age 3 months, infants’ negative emotionality and affective concern responses were observed and rated. We found no direct associations between MDS and both measures of infant emotional reactivity. However, MDS interacted with cry-processing cognitions to predict affective concern and negative emotionality. Overall, MDS were related to increased affective concern and decreased negative emotionality when mothers held cognitions that were more focused on their own emotions in the face of the infant’s cry rather than the infant’s emotional state and needs. Clinical implications for early screening and intervention are discussed.
... Concurrently, Urie Bronfenbrenner's Ecological Systems Theory (1979) frames maternal mental health within a broader social and environmental context, highlighting its potential to influence fetal development. Additionally, the Psychobiological Theory, as proposed by Glover (2011), delves into the direct effects of a mother's psychological state on the fetus via the endocrine system. These theories collectively suggest that maternal mental health and psychological changes substantially affect fetal growth through both biological and psychosocial mechanisms, emphasizing the paramount importance of maternal well-being and supportive social systems during pregnancy. ...
... These theories collectively suggest that maternal mental health and psychological changes substantially affect fetal growth through both biological and psychosocial mechanisms, emphasizing the paramount importance of maternal well-being and supportive social systems during pregnancy. This perspective not only advocates for in-depth research in this area but also aligns with the growing body of evidence suggesting that pregnancy is a critical period of adaptation, marked by significant physiological, psychological, and social changes (Bronfenbrenner, 1979;Glover, 2011;Wadhwa et al., 1993). ...
Objective
This study investigates the impact of both maternal psychopathological factors and adaptive psychological changes within the couple on fetal growth, emphasizing the importance of evaluating pregnancy from the perspectives of the couple, the mother, and the fetus collectively. A “couple” in this context refers to heterosexual partners engaged in the pregnancy process together, whether married or in a stable relationship.
Methods
We included 189 pregnant women in their first trimester, tracking maternal depression, anxiety, body appreciation, prenatal attachment, and the couple’s adjustment level across each trimester. Fetal growth parameters measured include biparietal diameter, femur length, humerus length, abdomen circumference, head circumference, β-HCG, and amniotic fluid levels, with relationships between these variables being modeled accordingly.
Results
Our findings indicate stable levels of maternal depression, anxiety, body appreciation, and couple’s adjustment throughout the pregnancy, with a significant increase in prenatal attachment levels in each subsequent trimester. Prenatal attachment in the first trimester and maternal depression levels in the second and third trimesters were found to directly influence fetal growth, while other variables exhibited indirect effects.
Conclusions
Fetal growth is influenced by a myriad of biopsychosocial factors. Ensuring healthy pregnancy and fetal development necessitates close monitoring and support of the mother’s adaptive psychological changes, early identification and treatment of potential psychopathologies, and maintenance of the psychosocial health of the couple.
... Much of the work that has explored the transmission of adversity across generations in AAs and NAs has examined the impact of parental prenatal stress (stress during pregnancy) on offspring health and utilized multi-ethnic/racial samples. These studies demonstrate that maternal exposure to prenatal stress is negatively associated with infant mental health (Glover, 2011) through neuroendocrine immune circuitry and epigenetic alterations in the mother (Conching & Thayer, 2019). As populations that have experienced historical trauma, AAs and NAs disproportionately face adversities known to induce these biological changes (APA, 2017). ...
... Because we were interested in the role of parental preconception adversity in potentially shaping offspring's health, studies were required to include at least two generations of participants from the same family. In addition, studies were required to measure preconception adversity because much research has already been devoted to examining the link between prenatal adversity and offspring mental health (Glover, 2011). Finally, measuring adversity exposure and mental health at the individual level was essential for included studies to avoid the use of neighborhood or county measures that cannot be accurately designated to any individual or linked between family members. ...
This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web of Science were searched for studies that included at least two generations of AAs or NAs from the same family, measured parental preconception adversity and their offspring’s mental health, and examined the association between these variables. Over 3,200 articles were screened, and 18 articles representing 13 unique studies were included in this review. Among the studies with samples that included AAs ( n = 12, 92%), 10 (83%) reported a significant association between parental preconception adversity and adverse offspring mental health. The only study with a sample of NAs ( n = 1, 8%) also reported a significant association between these variables. Although the literature suggests that parental preconception adversity is associated with offspring mental health among AAs and NAs, it must be interpreted in the context of the small number of studies on this topic and the less-than-ideal samples utilized—just one study included a sample of NAs and several studies ( n = 6, 46%) used multi-ethnic/racial samples without testing for ethnic/racial disparities in their results. A more rigorous body of literature on this topic is needed as it may help explain an important factor underlying ethnic/racial mental health disparities, with important implications for interventions and policy.
... Psychosocial stress during pregnancy is a known risk factor for altered neurodevelopment and risk for psychiatric disorders in later life. 1 In addition, psychosocial stress is also related to higher susceptibility to contracting infections and generally lower quality of physical health. [2][3][4] Examining the effects of maternal prenatal psychosocial stress and infection on infant outcomes is particularly timely in the context of the COVID-19 pandemic. ...
... 25 These cortical connections are thus vulnerable to shaping by environmental signals even before birth. 1 Increasing evidence shows associations between prenatal stress and phenotypic alterations in infant attentional processing using both maternal report measures 26,27 and measurement of infant looking behavior. 28,29 Recent findings point to inflammatory processes as one mechanistic pathway through which maternal prenatal stress may impact fetal development. ...
Background:
The COVID-19 pandemic dramatically altered the psychosocial environment of pregnant women and new mothers. In addition, prenatal infection is a known risk factor for altered fetal development. Here we examine joint effects of maternal psychosocial stress and COVID-19 infection during pregnancy on infant attention at 6 months postpartum.
Method:
One-hundred and sixty-seven pregnant mothers and infants (40% non-White; n = 71 females) were recruited in New York City (n = 50 COVID+, n = 117 COVID-). Infants' attentional processing was assessed at 6 months, and socioemotional function and neurodevelopmental risk were evaluated at 12 months.
Results:
Maternal psychosocial stress and COVID-19 infection during pregnancy jointly predicted infant attention at 6 months. In mothers reporting positive COVID-19 infection, higher prenatal psychosocial stress was associated with lower infant attention at 6 months. Exploratory analyses indicated that infant attention in turn predicted socioemotional function and neurodevelopmental risk at 12 months.
Conclusions:
These data suggest that maternal psychosocial stress and COVID-19 infection during pregnancy may have joint effects on infant attention at 6 months. This work adds to a growing literature on the effects of the COVID-19 pandemic on infant development, and may point to maternal psychosocial stress as an important target for intervention.
Impact:
This study found that elevated maternal psychosocial stress and COVID-19 infection during pregnancy jointly predicted lower infant attention scores at 6 months, which is a known marker of risk for neurodevelopmental disorder. In turn, infant attention predicted socioemotional function and risk for neurodevelopmental disorder at 12 months. These data suggest that maternal psychosocial stress may modulate the effects of gestational infection on neurodevelopment and highlight malleable targets for intervention.
... Youth with lower-risk mothers may reap the salutary benefits of maternal sensitivity and emotional availability on internalizing problems. However, close attunement to depressed mothers, who tend to be less sensitive and responsive (Goodman et al., 2020) and may exhibit more volatile physiological signals (Somers et al., 2021b), may lead children to adapt to a harsh or unpredictable environment in ways that heighten their vigilance to threat cues, distractibility, and impulsivity and increase risk for children's externalizing problems (Glover, 2011;Monk et al., 2019;Sandman et al., 2012) and in turn for poorer maternal wellbeing. The results of the present study suggest that the effects of dyadic synchrony may be context-and domain-specific; yet, we were only able to reliably assess internalizing and externalizing problems in childhood, and earlier assessments of child internalizing and externalizing problems are needed to inform the timing of these effects, including both the duration of effects on maternal mental health and the emergence of differential effects on child internalizing and externalizing problems. ...
Coordination in mothers’ and their infants’ parasympathetic nervous system functioning (i.e., respiratory sinus arrhythmia [RSA] synchrony) specifically during playful interactions may promote resilience against exposure to postpartum depressive symptoms (PPD), for both members of the dyad. To test biobehavioral synchrony theory-derived hypotheses, we evaluated whether positive mother-infant RSA synchrony during play attenuated associations between maternal PPD symptoms and future child behavior problems and maternal depressive symptoms. 322 low-income, Mexican-origin mothers and their children participated in 5-min resting baseline and free play interaction tasks when children were 24 weeks of age; mothers reported on their PPD symptoms and on child behavior problems and maternal depressive symptoms at 12- and 36-months child age. Results of multilevel structural equation models demonstrated that, though the associations between maternal PPD symptoms and future child behavior problems and maternal depressive symptoms differed depending on levels of RSA synchrony during play and non-interactive tasks, the protective benefits of positive RSA synchrony on 12-month maternal depressive symptoms and 36-month child internalizing problems were specific to its assessment during a playful interaction. Results suggest that the dyadic coordination of physiological capacities during playful interactions is an active mechanism that promotes resilience to emotional distress for mothers and their children.
... AWT poses challenges by diminishing the crucial mother-fetal bond essential for fetal health. Research highlights the significance of hormonal exchanges, sensory experiences, and the mother's voice and heartbeat in fetal development [10][11][12][13][14][15]. These factors, integral to the natural uterine environment, provide essential biochemical signals supporting organ development and stress management, aspects that AWT may struggle to replicate fully. ...
... The perinatal period, from conception to 2 years postpartum, represents a time of normative transition that can be experienced as stressful or cause anxiety for some women. Stress and anxiety are highly related, yet distinct concepts (Glover 2011). Stress is defined as occurring when external demands are perceived to exceed a person's capacity to cope with those demands (Lazarus 1966;Lazarus and Folkman 1984). ...
Objectives:Perinatal stress and anxiety from conception to two years postpartum have important adverse outcomes for women and infants. This study examined (i) women’s perception of sources and experiences of perinatal stress and anxiety, (ii) women’s attitudes to and experiences of available supports, and (iii) women’s preferences for perinatal stress and anxiety supports in Ireland.
Methods:An online mixed-methods cross-sectional survey was conducted with 700 women in Ireland. Participants were pregnant women (n = 214) or mothers of children ≤ 2 years old (n = 486). Participants completed closed-ended questionnaires on sociodemographic, birth and child factors, and on stress, anxiety, perceived social support, and resilience. Participants completed open-ended questions about experiences of stress and anxiety and the supports available for stress and anxiety during pregnancy and/or postpartum. Quantitative data were analysed descriptively and using correlations; qualitative data were analysed using thematic analysis.
Results:Quantitative data indicated significant relationships between perinatal stress and/or anxiety and women’s perceived social support, resilience, having a previous mental health disorder diagnosis (both p < 0.001), and experiencing a high-risk pregnancy or pregnancy complications (p < 0.01). Themes developed in qualitative analyses included: ‘perceived responsibilities’; ‘self-care’; ‘care for maternal health and well-being’; ‘social support’; and ‘access to support and information’.
Conclusions:Women’s stress and anxiety are impacted by multiple diverse factors related to the individual, to interpersonal relationships, to perinatal health and mental health outcomes, and to available services and supports. Development of support-based individual-level interventions and increased peer support, coupled with improvements to service provision is needed to provide better perinatal care for women in Ireland.
... . Particularly for the child, women (hereafter also referred to as "mother/maternal") mental health in pregnancy hosts intergenerational cascading in uences, including prenatal programming processes building the infant neurobiological systems (Glover, 2011;Glover et al., 2018) and the parental brain changes that contribute to shape the quality of postnatal caregiving functioning (Hoekzema et al., 2017;Swain et al., 2017). Whilst being so powerfully implicated in the psychobiology that sets for the offspring generation, women's perinatal mental health is extremely sensitive to the quality of the social environment, with signi cant stressors, including psychosocial ones, placing the risk of a two-generation impact of maternal maladaptive adjustment and stress response to such exposure. ...
Perinatal mental health is fundamental to a healthy society. The aim of this study was to describe the trajectories of women’s posttraumatic stress disorder (PTSD) symptoms during the perinatal period to assess their association with child behavior problems at 12 months. We designed an observational longitudinal study. Women were recruited through social media posting during the Coronavirus Disease 2019 (COVID-19) pandemic Italian national lockdown from April 8 to May 4, 2020, and contacted again at 6 and 12 months after the expected delivery date, collecting PTSD scores each time. Child behaviors were reported at 12 months postpartum. Inclusion criteria were residence in Italy, age over 18 years, and fluency in Italian. A total of 327 mother-child dyads were eligible for inclusion in the study. Clustering analysis suggested five groups of PTSD trajectories: a very low and stable (VL) group, 2 groups with decreasing PTSD symptoms over time (one high and decreasing (H-), one low and decreasing (L-)), and 2 groups with positive PTSD trajectories (one high and increasing (H+), one low and increasing (L+)). The H + and H- clusters had significantly higher risks (+ 58% and + 76% for H + and H-, respectively) for total child behavioral outcomes compared with the VL cluster, and higher risk for internalizing problems. Although many women had PTSD scores below the cut-off, we envision a significant risk for the children of mothers with elevated symptoms in pregnancy. Longitudinal modeling of perinatal PTSD symptoms is warranted for sensitive two-generation risk detection.
... Maternal depressive symptoms could impact sleep problems in early childhood through several mechanisms. In the prenatal period, the association between maternal depression and sleep problems in early childhood has been explained by the prenatal programming that adversely influences fetal development [29]. It was shown that depressive symptoms during pregnancy could expose the fetus to high levels of maternal glucocorticoids and pro-inflammatory cytokines, and program an adverse offspring phenotype which could explain why maternal depressive symptoms during pregnancy predicts increased risk of sleep problems in children [16,43,54]. ...
Both prenatal and postnatal maternal depression have been associated with increased sleep problems in early childhood. However, this association is less consistent for postnatal depression, and the strength of the association remains unclear. The aim of the current study was to provide a quantitative synthesis of the literature to estimate the magnitude of the association between maternal depression and sleep problems in early childhood. Medline, PsycINFO, PsycARTICLES, Web of Science, and Scopus were searched for prospective longitudinal studies from 1970 to December 2022. Of 117 articles screened, 22 studies met the inclusion criteria. Both prenatal depression (OR = 1.82; 95% CI = 1.28–2.61) and postnatal depression (OR = 1.65; 95% CI = 1.50–1.82) were associated with increased likelihood of sleep problems in early childhood. The heterogeneity between the studies was significant and high both for prenatal (Q = 432.323; I² = 97.456, P < .001) and postnatal depression (Q = 44.902, I² = 65.594, P < .001), which mean that conclusions are tentative and need to be considered within the possible influence of unmeasured confounding. However, mitigating depression symptoms in mothers both during pregnancy and in the postnatal period would be an effective strategy for reducing sleep problems in children.
... These findings, alongside other epigenetic research, suggest that the act of immigrating may impose a stress on the mother that initiates key epigenetic changes that have been impli- cated in the emergence of autism in offspring. These findings agree with a large body of other research on the impact of stress on epigenetic processes (e.g., Glover, 2011). ...
Over the past decade, findings from cultural neuroscience have demonstrated that functional neural processes vary significantly across populations. These findings add a new dimension to the well-established literature describing cultural differences in human behavior. Although these findings are informative for understanding complex relationships between social and neurobiological processes, they also have significant implications for psychiatric research. Neuropsychiatry already co-considers the relationship between brain and social world; however, its research findings notoriously underrepresent diverse cultural, ethnic, and gender groups. Considering that psychiatric patients across cultures exhibit different behavioral presentations and symptom distributions, they may exhibit equally different functional neural processes as well. Increasing representation of diverse patient groups in neuropsychiatric research would allow potential differences to be investigated and understood. Although cross-cultural comparisons may be the most direct means of accomplishing this goal, such studies must be carefully constructed to avoid reinforcing stigmas or stereotypes when working with sensitive patient populations. For example, hypotheses and inclusion criteria must avoid reliance on stereotypes or conflation of geographic boundaries with cultural boundaries. These pitfalls point to deeper problems with current approaches to culture-brain research, which lack operational definitions of ‘culture’ more generally. After outlining these issues, solutions to these methodological problems will be presented and an operational definition of culture for neuropsychiatry will be proposed.
... The study adds to a corpus of knowledge that emphasises the relevance of the perinatal period as critical for the foundation of woman's health, parental functioning, and child development (Glover, 2011;Grote et al., 2010;Khashan et al., 2011;Liu & Tronick, 2013;Maxson et al., 2016;O'Donnell et al., 2009;Seckl & Holmes, 2007). Also, the study points at maternal experience of pregnancy and delivery as highly concerning as a key concept to address into perinatal health services. ...
... These adaptive traits in challenging environments suggest that prenatal programming readies the child or group for their circumstances. For instance, heightened alertness may connect to anxiety, distractible attention to increased perceptions of danger, impulsivity to increased exploration, and aggression to enhanced defense capacities [162]. ...
This paper explores the concept of historical trauma (HT) as an extension of post-traumatic stress disorder (PTSD), expanding the definition to encompass the accumulated emotional and psychological trauma across generations and lifespans. Coined by Lakota social work professor Maria Yellow Horse Brave Heart, HT refers to the enduring impact of abuse and displacement on marginalized groups, such as enslaved African Blacks, Native Americans, Indigenous people in Canada, and others globally. HT becomes ingrained in cultural memory, impacting individuals with symptoms including depression, survivor guilt, anger, substance abuse, hypervigilance, and more.Examining the distinction between history and collective memory, the paper delves into the effects of persecution and oppression on specific groups, emphasizing chronic and severe stress. The focus extends to genocides worldwide, exploring maternal stress's impact on fetal development, drawing insights from events like the Ice Storm in Quebec, the Leningrad siege, and the Dutch famine. The paper concludes by questioning whether interventions can mitigate the maternal/paternal transmission of stress-induced pathologies, providing avenues for further research and potential solutions to alleviate the enduring effects of historical trauma.
... It is possible that in our evolutionary history, some increase in these characteristics in certain individuals was adaptive in response to a stressful environment, and that fetal programming prepared the child or group for the environment in which they were going to find themselves (Glover, 2011). However, it is important to note that the stressors faced by humans today are often very different from those in our evolutionary past. ...
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction, repetitive behaviors, and narrow interests. People with ASD often experience additional mental health issues such as depression and anxiety. While genetics have long been considered a significant factor in the development of ASD, recent research indicates that the interplay between genes and the environment is crucial in understanding its underlying causes. This chapter aims to discuss the relationship between prenatal stress and the characteristics of ASD in countries within the Asia-Pacific region. The findings indicate a connection between prenatal stress and the traits of ASD in China, South Korea, and Japan. Further investigation is required to fully comprehend the specific mechanisms involved in this relationship. Genetic consultation can provide insights into potential risk factors, genetic counseling, and guidance on personalized interventions.
... Several studies have explored the adverse influence of prenatal maternal depression on neurodevelopment in childhood, highlighting increased reactivity [57], more difficult temperament [58], greater negative affectivity [59,60], and high cry reactivity [61]. Furthermore, elevated temperamental domains of activity and emotional reactivity have been linked to depression, anxiety, attention deficit hyperactivity disorder, and conduct disorder later in childhood [62][63][64]. ...
Simple Summary
Trauma-informed care (TIC) is an approach which has been utilised in human psychology for many years now. TIC considers how important early experience is in determining lifelong responses to challenging situations, how individuals respond to stress, how they overcome it, and their ability to develop and sustain resilience. There are a number of scientific publications which consider the importance of early experience in animals, both in utero and during their early development. This paper considers aspects of TIC approaches for humans which might be applied in dogs, focusing on both prevention of behavioural problems, by protecting puppies from adverse early experiences, and also, assessment of shelter dogs or those presented for problematic behaviours. A TIC approach for dogs would result in the following: the realisation that adverse early experience has significant consequences for canine welfare; recognising that where dogs respond in an apparently irrational or over the top manner, it may be the result of previous trauma; people involved in the care of these dogs must respond with empathy, understanding, and practical solutions to improve the welfare of the dog, while avoiding the need to re-traumatise them in as part of the diagnostic or treatment processes.
Abstract
Dog caregiver reporting on the spectrum of fearful–aggressive behaviours often describes ‘unpredictable’ or ‘exaggerated’ responses to a situation/animal/person. A possible explanation for these behavioural responses considers that the dog is reacting to triggered memories for which the dog has a negative association. For many dogs undergoing veterinary behavioural treatment or rehabilitation through a canine rescue organisation, the assessing clinician relies on “proxy” reporting of the history/background by a caregiver (dog owner, foster carer, or shelter personnel). Detailed information on the event or circumstances resulting in this negative association may be limited or absent altogether. Consideration of a trauma-informed care (TIC) approach, currently applied in a wide range of human psychology and social care fields, may be helpful in guiding the clinical approach taken. The literature relating to adverse early experience (AEE) and trauma-informed care (TIC) in puppies/dogs compared to children/adults was evaluated to identify common themes and conclusions identified across both species. In the absence of known/identifiable trauma, behavioural assessment and management should consider that a ‘problem’ dog may behave as it does, as the result of previous trauma. The dog can then be viewed through a lens of empathy and understanding, often lacking for dogs presenting with impulsive, reactive, or aggressive behaviours. Assessment must avoid re-traumatising the animal through exposure to triggering stimuli and, treatment options should include counselling of caregivers on the impact of adverse early experiences, consideration of the window of tolerance, and TIC behavioural modification techniques.
... Our findings extend both studies by inclusion of diagnostic measures of maternal depression and child anxiety disorders, accounting for the timing of depression by inclusion of measure concurrently in childhood as well as in pregnancy and by examining the interaction of birth weight and gestational age instead of the consideration of these separately. Increased vulnerability to later anxiety disorders has been postulated to be increased through early life influences on HPA axis, such as cortisol and maternal stress, during the development of stress regulation [39,40]. In understanding any potential relationship between earlier birth and later anxiety, it could be hypothesised through neurodevelopmental impacts on the developing stress response either directly from early birth and/or associated with the indication that led to early birth, as well as through subsequent influences on parenting behaviours, such as overprotection, together with maternal stress, that may result in an increased vulnerability to later anxiety. ...
This study examines whether gestational age, birth weight, and early term birth is associated with childhood mental disorders in 342 pregnant women recruited at less than 20 weeks gestation and were then followed up until 4 years postpartum, including 93 children born at early term. Women were assessed at recruitment using the Structured Clinical Interview for DSM. At 4 years of age their children were assessed using the Preschool Age Psychiatric Assessment (PAPA) and the Child Behavior Checklist (CBCL). This study found earlier birth predicted an increased risk for anxiety disorders and demonstrated a significant interaction between gestational age and lower birthweight. The risk for ADHD increased with lower gestational age independent of birthweight. In contrast, gestational age was not associated with Oppositional Defiant Disorder, Conduct Disorder, internalizing or externalizing symptoms. These findings highlight the important differences in the association of early term birth and vulnerability for specific mental disorders.
... Important events that occur during this period can change the connectivity between these regions to prepare the fetus for future events (as cited in Babineau et al., 2015). The impact of prenatal events on behavioural regulation has been reported as early as the first days of life (Glover, 2011;O'Connor et al., 2003). The role of emotional symptoms and stressors experienced by mothers during the prenatal period in explaining 4-month-old infants' negative behavioural reactivity to novel situations has been demonstrated (Davis et al., 2011). ...
According to the fetal programming hypothesis, early experiences and environmental factors shape human development as early as the fetal period. Emotional arousal due to changes and requirements in the transition to parenthood negatively affects emotion regulation skills of parents, and as a result, increased emotion regulation difficulties play a negative role on children's development. The present study aimed to investigate the predictive role of prenatal parental emotion regulation difficulties on communication skills of infants. A total of 97 first-time parent couples and their infants (57 girls, 40 boys) participated in the study. A convenience sampling method was used and the data was collected at two different times. Time 1 and Time 2 were representing the third trimester of pregnancy and the 12th postnatal month, respectively. Prenatal parental emotion regulation difficulties were measured by having first-time parent couples complete the Difficulties in Emotion Regulation Scale-16 at T1. In addition, parents were requested to fill out Communication subscale of Ages and Stages Questionnaires and a demographic form containing gender of infants, socioeconomic status and birth history at T2. The relationships between the obtained study variables were examined with Pearson correlation coefficient. The correlation-based findings revealed that higher prenatal maternal and paternal emotion regulation difficulties were associated with lower communication skills of infants, supporting the hypotheses. This study is thought to be a resource for preventive programmes by identifying protective and risk factors for infants' communication skills and emphasizing the potential role of the prenatal period on child development. Keywords: Maternal prenatal emotion regulation difficulties, paternal prenatal emotion regulation difficulties, infancy, communication skills, preventive studies
... In fact, while major depression is present in up to 11.9% of pregnant women, the prevalence of subclinical depressive symptomatology is higher, although it often remains undetected (Woody et al., 2017;Yonkers et al., 2009). Depression during pregnancy has been associated with an increased risk of adverse birth and child outcomes, including prematurity, low birth weight, neurodevelopmental delays and adult psychiatric disorders (Davis et al., 2007;Deave et al., 2008;Glover, 2011;Grigoriadis et al., 2013;Osborne et al., 2022;Plant et al., 2015). A key potential mediator linking maternal depression and offspring's developmental alterations is the flow of abnormally high levels of maternal cortisol, which can cross the placental barrier and compromise fetal development (Buss et al., 2012;Reynolds, 2013;Vlenterie et al., 2022). ...
Background: Depression during pregnancy is a common complication that can negatively affect fetal health and birth outcomes. Cortisol is believed to be a key mediator of this association. Although pregnancy entails a natural increase in cortisol levels, preclinical depression could alter its circadian rhythm, producing excessively high overall diurnal cortisol levels that might be harmful for the fetus and future offspring development. Objectives: Using a prospective longitudinal design, we aimed to study (i) trimestral cortisol circadian rhythm and its overall levels throughout pregnancy in healthy women, (ii) the extent to which maternal depressive symptoms influence both cortisol rhythmicity and overall levels, and (iii) the possible adverse consequences of elevated maternal cortisol on the offspring's weight and gestational age at birth. Study design: 112 healthy pregnant women from the general Spanish population were recruited before their first pregnancy. To assess cortisol circadian rhythm, participants provided four saliva samples at each trimester of pregnancy (at awakening, 30 min after awakening, before lunch and before going to bed). Overall cortisol levels were calculated with AUCg approximation. Depressive symptoms were evaluated in each trimester and defined according to EPDS cutoff values (1st trimester, EPDS ≥ 11; 2nd and 3rd trimesters, EPDS ≥ 10). At birth, the risk for low weight, prematurity and weight birth percentile was retrieved for 100 infants. Mixed models and simple effects were employed to study changes of maternal cortisol circadian rhythm and overall levels throughout pregnancy and the possible influence of maternal depressive symptoms. Finally, logistic regressions were performed to assess the associations between maternal overall cortisol levels in each trimester of pregnancy and birth anthropometrics. Results: Although overall diurnal cortisol levels increase throughout pregnancy, cortisol circadian rhythm is preserved in all trimesters [1st (F(3110)= 92.565, p < .001), 2nd (F(3,85)= 46.828, p < .001) and 3rd (F(3,90)= 65.555, p < .001)]. However, women with depressive symptoms showed a flattened cortisol circadian pattern only during the second trimester, characterized by a blunted awakening peak and reduced evening decline (F (3,85)= 4.136, p = .009), but not during the first (F(3,11)= 1.676, p = .176) or the third (F(3,90)= 1.089, p = .358) trimesters. Additionally, they did not show a cortisol increase from second to third trimester (p = .636). higher maternal cortisol levels in second and third trimesters seemed to be associated with increased risk of prematurity (adjusted OR − 0.371, 95% CI 0.490-0.972, p = .034) and low birth weight percentile (adjusted OR − 0.612, 95% CI 0.348-0.846, p = .007) respectively. Conclusion: Maternal cortisol levels increased throughout pregnancy, although cortisol circadian rhythm was preserved in all trimesters of pregnancy. However, prenatal depressive symptoms were associated with flattened maternal cortisol circadian rhythm in mid-pregnancy. Therefore, it seems that women with depressive symptoms tended to increase less gradually their cortisol levels from mid to late pregnancy. Finally, higher maternal cortisol levels in mid and late-pregnancy seem to be associated with poorer birth anthropometrics Early detection of depressive symptoms in general population could help to prevent putative obstetrical and birth adverse outcomes.
... Prenatal stress, anxiety, and depression are estimated to be experienced by 22-37% of women (Fisher et al., 2012;Leach et al., 2017). Prenatal stress, anxiety and depression are distinct yet related constructs (Glover, 2011) that can be conceptualised and measured as psychological (e.g. perceived, self-reported stress and anxiety), physiological (e.g. ...
... Este tipo de programación fetal prepara al niño para el entorno en que se van a encontrar ellos mismos. Esta adaptación lo hace mucho más pronto a reaccionar, ser más vigilante, distraído en su atención con mayor percepción de peligro, impulsivo con mayor exploración, tener desórdenes de conducta con deseo de romper las reglas, y agresivo para luchar contra intrusos (16) . Suelen ser niños más susceptibles a llorar, a estresarse, a sentir ansiedad. ...
La manera en que el feto se desarrolla en el útero depende del estado de la madre, de su alimentación, de su entorno y también de sus emociones. Estudios realizados en animales de laboratorio demuestran que el estrés prenatal ocasiona serias perturbaciones en el desarrollo del SNC, particularmente del eje hipotálamo adrenal (HPA); en la respuesta hormonal al estrés. Diferentes estudios, incluyendo varios experimentos naturales, han encontrado una asociación significativa entre ansiedad o estrés materno antenatal y diferentes problemas cognitivos, conductuales, de lenguaje y emocionales en los hijos. Entre los factores de riesgo para presentar alteraciones psicológicas durante el embarazo se encuentran una historia personal o familiar de enfermedades psiquiátricas o uso de drogas, historia personal pasada de abuso sexual, físico o emocional, y una historia pasada de depresión, el cual es el factor que más fuertemente predice síntomas depresivos antenatales. El estrés y la ansiedad materna pueden afectar al feto durante todo el embarazo pero lo hacen de manera distinta de acuerdo a la etapa de gestación en que se encuentra y de qué áreas del cerebro se están desarrollando. Por ello es tan necesario investigar y desarrollar programas de prevención, de intervención y de apoyo para reducir los niveles de estrés, ansiedad o depresión durante el embarazo y prevenir sus efectos adversos en una proporción clínicamente significativa de niños.
... Essa população vivencia um ciclo gravídico-puerperal, marcado por inúmeras mudanças físicas, psíquicas e sociais, tornando gestantes e puérperas mais vulneráveis ao sofrimento psíquico, como o estresse. Estudos mostram que o tipo e a intensidade do estresse na gestação têm impacto no desenvolvimento fetal, com consequências para o desenvolvimento do bebê (Charil, Laplante, Vaillancourt & King, 2010;Glover, 2011;Franke et al, 2017) e também para a mãe, aumentando as chances de depressão pós-parto (Rodrigues & Schiavo, 2011;Arrais & Araujo, 2017;Kliemann, Böing & Crepaldi, 2017). ...
A pandemia da COVID-19 resultou em grande estresse, especialmente para populações mais vulneráveis, como mulheres grávidas e no pós-parto. Devido ao isolamento social, durante o início do período pandêmico, as redes sociais tornaram-se recursos importantes para informar e promover saúde e bem-estar. O objetivo deste estudo é apresentar uma proposta psicoeducativa de intervenção positiva na forma de posts para o Instagram e sua validade de conteúdo para o enfrentamento do estresse provocado pela pandemia por gestantes e puérperas no ano de 2020. A validade de conteúdo foi avaliada por 64 juízas, que analisaram 29 posts adotando uma escala Likert de 5 pontos para validar linguagem, relevância, pertinência e apresentação da proposta. Observou-se coeficientes de validade de conteúdo acima do ponto de corte (≥ 0.80) para todos os critérios, o que indica a adequação da proposta para enfrentar os estressores da pandemia pela população alvo. Dessa forma, confirmou-se a possibilidade de utilização das mídias sociais visando o aumento no acesso a materiais de qualidade que promovem a democratização do cuidado à saúde mental.
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
De acuerdo con el Programa de Naciones Unidas para el Desarrollo, en América Latina, alrededor de 1.5 millones de personas se encuentran privadas de su libertad, lo que la coloca como una de las regiones con mayor sobrepoblación en prisiones del mundo. Ante este panorama, el objetivo de esta obra es coadyuvar a la reflexión y puesta en acción de prácticas e intervenciones que promuevan la adaptación y reintegración social de esta población. Bajo este marco, las y los autores analizan lo que implica la privación de la libertad, desde distintas disciplinas como Psicología, Derecho, Ciencias Políticas y Trabajo Social. Esta variedad de perspectivas permite que la condición de perder la libertad se estudie en procesos específicos, tales como: maternidad, atención a la salud mental, vínculos familiares, educación en centros penitenciarios, sexualidad, consumo de sustancias, distinciones de la privación de libertad en centros penitenciarios para mujeres, experiencias de víctimas del crimen organizado y vivencias de adolescentes en conflicto con la ley. Se espera que el esfuerzo cristalizado en esta obra, contribuya a sensibilizar a más profesionales y se involucren en intervenciones dirigidas a atender a esta población vulnerable.
http://www.librosoa.unam.mx/handle/123456789/3650
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
Los factores familiares, sociales y criminológicos serán la base principal para que el diseño del instrumento de evaluación en Trabajo Social propuesto en este trabajo, se convierta en una herramienta útil para la impartición y ejecución de justicia, en específico, en el campo de la reinserción social y reeducación de las personas privadas de su libertad por el delito de robo.
... These distinct research literatures share a common notion that mothers' adverse experiences can influence offspring development (Roubinov et al., 2021). However, the former focuses on biopsychosocial mechanisms underlying associations between maternal pre-conception adversity and offspring development (Bowers & Yehuda, 2016;Scorza et al., 2018) whereas the latter explores how in utero stress exposure affects fetal development (Glover, 2011). Despite evidence that a woman's exposures to adversity prior to adulthood and while pregnant are each associated with offspring outcomes, few studies have tested these associations simultaneously, and no studies have tested the simultaneous effects of these variables on childbirth and newborn neurobehavioral outcomes. ...
Separate literatures have demonstrated that mothers' experiences with trauma during childhood or pregnancy are associated with maternal prenatal health risks, adverse childbirth outcomes, and offspring internalizing and externalizing disorders. These literatures largely align with the intergenerational transmission or fetal programming frameworks, respectively. However, few studies have tested the effects of maternal childhood and prenatal trauma simultaneously on mothers' and infants' health outcomes, and no studies have examined these effects on newborn neurobehavioral outcomes. Thus, in the present study, we examined how the developmental timing of pregnant women's traumatic life experiences associated with their physical health and psychopathology (Aim 1) as well as their newborns' birth and neurodevelopmental outcomes (Aim 2; for pre-registered aims and hypotheses, see https://osf.io/ygnre/?view_only=cbe17d0ac7f24af5a4d3e37e24eebead). One hundred and fifty-two 3rd trimester pregnant women (Mage = 29 years; 17.1% Hispanic/Latina) completed measures of trauma history and psychopathology. Then, 24-48 h after birth, trained clinicians conducted newborn neurobehavioral exams (n = 118 newborns; 52.6% female). Results indicated that lifetime traumatic experiences associated with multiple prenatal maternal health outcomes, including depression, anxiety, emotion dysregulation, and pregnancy complications. Pregnant women's experiences with childhood trauma, but not adulthood or prenatal trauma, predicted higher neurobehavioral attention scores among female newborns. Our discussion highlights the importance of considering the developmental timing of maternal trauma on perinatal outcomes and contextualizes our findings within the intergenerational transmission and fetal programming literatures. DATA AVAILABILITY: Data pertaining to R01MH119070 (MPIs Crowell & Conradt) and that support these findings are uploaded to the NIMH repository.
... For the mother, there is a high risk for the onset of psychological distress, including depression, state anxiety, and pregnancy-related anxiety [1][2][3]. Poor maternal mental health can result in downstream consequences for fetal development and infant health, including preterm birth, low-birth weight, cognitive developmental deficits, and lifelong non-communicable chronic disease risk [4][5][6][7][8][9][10][11][12][13]. Thus, investigating maternal mental health during pregnancy can have intergenerational public health implications. ...
Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled β = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled β = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled β = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.
... Worldwide the societal burden of mental health problems is increasing (Vigo et al., 2016). Although early stage prevention is more cost-efficient than treatment (Bauer et al., 2016), prenatal origins of mental health problems that are often preventable remain understudied (Browne et al., 2020;Glover, 2011;Monk et al., 2019;van den Heuvel, 2022). In a UK-based study, it has been estimated that perinatal anxiety and depression combined costs the society about £8500 per woman giving birth. ...
Background
The connectome, constituting a unique fingerprint of a person’s brain, may be influenced by its prenatal environment, potentially affecting later-life resilience and mental health.
Methods
We conducted a prospective resting-state functional Magnetic Resonance Imaging study in 28-year-old offspring (N = 49) of mothers whose anxiety was monitored during pregnancy. Two offspring anxiety subgroups were defined: “High anxiety” (n = 13) group versus “low-to-medium anxiety” (n = 36) group, based on maternal self-reported state anxiety at 12–22 weeks of gestation. To predict resting-state functional connectivity of 32 by 32 ROIs, maternal state anxiety during pregnancy was included as a predictor in general linear models for both ROI-to-ROI and graph theoretical metrics. Sex, birth weight and postnatal anxiety were included as covariates.
Results
Higher maternal anxiety was associated with weaker functional connectivity of medial prefrontal cortex with left inferior frontal gyrus (t = 3.45, pFDR < 0.05). Moreover, network-based statistics (NBS) confirmed our finding and revealed an additional association of weaker connectivity between left lateral prefontal cortex with left somatosensory motor gyrus in the offspring. While our results showed a general pattern of lower functional connectivity in adults prenatally exposed to maternal anxiety, we did not observe significant differences in global brain networks between groups.
Conclusions
Weaker (medial) prefrontal cortex functional connectivity in the high anxiety adult offspring group suggests a long-term negative impact of prenatal exposure to high maternal anxiety, extending into adulthood. To prevent mental health problems at population level, universal primary prevention strategies should aim at lowering maternal anxiety during pregnancy.
El embarazo es una etapa llena de retos, que pueden conllevar estrés y ansiedad en la adaptación de la madre. En este sentido, la teoría de la programación fetal de Barker hipotetiza que las experiencias vividas durante el embarazo dejan una huella en la descendencia. Varios estudios han encontrado relación entre las experiencias adversas maternas durante el embarazo y un peor desarrollo del niño. El objetivo del estudio es conocer si existe relación entre el estrés, depresión, ansiedad y obsesión de la madre en el embarazo y la posterior psicopatología del hijo a los dos años.
Identifying proximal and multigenerational distal risk mechanisms through which adversity exposure may shape neuroendocrine dysregulation among children is critical to advancing effective preventive interventions for adversity-exposed individuals. Utilizing longitudinal data ( N = 247), the current study examined maternal and offspring history of childhood maltreatment (CM) as predictors of offspring cortisol/DHEA ratios, and, in exploratory analyses, extended this longitudinally to offspring depressive symptoms in young adulthood. Youth (ages 8–13 years) initially attended a research camp, then were followed up approximately eight years later (ages 18–22 years). Maternal history of CM significantly predicted their offspring’s childhood cortisol/DHEA ratio over and above the effects of the offspring’s history of CM. Offspring CM was not a significant predictor of the ratio. The cortisol/DHEA ratio did not mediate the relationship between maternal history of CM and offspring emerging adulthood depression. Results highlight an intergenerational cascade of CM and negative outcomes and support inclusion of maternal experiences in screening for at-risk youth.
There are competing theoretical hypotheses regarding the consequences of early adversity, such as childhood maltreatment, for individuals’ autonomic nervous system activity. Research examining potential implications of child maltreatment for sympathetic nervous system activity, specifically, is scarce. In this preregistered study, we examined whether childhood maltreatment history is associated with pregnant adults’ sympathetic responses to different stressors. This population is particularly relevant, given potential intergenerational consequences of pregnant individuals’ physiological responses to stress. Pregnant women's ( N = 162) electrodermal levels were recorded while completing the Trier Social Stress Test (TSST), which elicits social‐evaluative threat, and while watching a video of an unfamiliar infant crying, which was intended to activate the attachment system. Pregnant women's retrospective reports of childhood maltreatment were negatively associated with their electrodermal reactivity to the TSST and to the video of the infant crying. Follow‐up analyses indicated that these associations were specific to reported experiences of childhood abuse and not childhood neglect. Altogether, these findings indicate that self‐reported childhood maltreatment experiences, and childhood abuse in particular, may result in blunted activity of the sympathetic nervous system in response to multiple types of stressors.
This review summarizes recent findings on stress-related programming of brain development in utero, with an emphasis on situating findings within the mothers’ broader psychosocial experiences. Meta-analyses of observational studies on prenatal stress exposure indicate that the direction and size of effects on child neurodevelopment are heterogeneous across studies. Inspired by lifespan and topological frameworks of adversity, we conceptualize individual variation in mothers’ lived experience during and prior to pregnancy as a key determinant of these heterogeneous effects across populations. We structure our review to discuss experiential categories that may uniquely shape the psychological and biological influence of stress on pregnant mothers and their developing children, including current socioeconomic resources, exposure to chronic and traumatic stressors, culture and historical trauma, and the contours of prenatal stress itself. We conclude by identifying next steps that hold potential to meaningfully advance the field of fetal programming.
A crescente preocupação com a saúde mental, especialmente em relação à ansiedade e depressão, motiva pesquisas para compreender os fatores de risco e as formas de tratamento. Este estudo objetivou investigar associações entre fatores de risco para doenças cardiovasculares (DCV), estado mental e escores de risco cardiovascular em estudantes e funcionários de uma universidade pública. Realizou-se um estudo observacional e descritivo na Universidade Federal de Viçosa, envolvendo questionários sobre dados demográficos, hábitos de vida, sintomas de depressão e ansiedade, além de exames laboratoriais. A amostra incluiu voluntários de ambos os sexos, entre 18 e 70 anos. Os resultados revelaram uma maior resposta das mulheres aos questionários, bem como maiores escores de ansiedade, depressão e sofrimento mental em comparação com os homens. O índice de massa corporal (IMC) mostrou influência nos escores de saúde mental, com valores mais elevados associados a pontuações mais altas. A prática regular de atividades físicas foi associada a escores mais baixos nos testes de ansiedade, depressão e sofrimento mental. Além disso, a idade avançada foi associada a maiores escores de depressão. Esses resultados destacam a alta prevalência de ansiedade e depressão, especialmente entre mulheres e jovens, ressaltando a importância de estratégias de suporte e acompanhamento para essa população. Estudos adicionais são necessários para direcionar essas intervenções de forma mais eficaz.
Natural Disasters cause huge damage to human capital and lead to loss of productivity. A higher degree of socioeconomic vulnerability, inadequate mitigation measures, and low levels of economic development lead to an increased risk of fatalities and infrastructure damage. The risk increases initially with development before it starts to decline. Natural disasters, besides causing huge loss of life and property, also severely damage human capital and its development owing to physical and mental trauma. These further affect the other dimensions of society, such as crimes against women and children, domestic violence, food security, and the enhanced burden of care. The government, therefore, plays an important role in disaster risk mitigation and fatality control. The disaster risk mitigation policies should account for the disproportionate effects of natural calamities on the marginalized sections, which include people with low incomes, women, and young children.
Over the past few decades, there has been accumulating evidence that prenatal exposure to risk is negatively related to child self-regulation. However, the mechanisms underlying this relationship are unclear. The present study used a multimethod approach to simultaneously examine the mediating role of the developmental trajectories of observed parenting quality (support, stimulation, and structure) and children’s functional brain networks (small-worldness) from infancy into the preschool period in a sample of 233 children and their biological mothers. The results revealed a potential sleeper effect: Prenatal exposure to risk was negatively related to child self-regulation during the preschool period, but not during infancy. Parenting quality remained relatively stable over time, whereas small-worldness showed an increase during infancy, followed by a decrease into the preschool age period. These developmental changes did not mediate the relation between prenatal risk and child self-regulation. Prenatal exposure to risk was related to lower levels of maternal support during infancy, but did not affect the development of parenting quality over time. Prenatal risk was also not related to the growth rate of small-worldness in young children. However, the developmental changes in small-worldness predicted individual differences in child self-regulation. These findings suggest that children generally have the potential to benefit from positive postnatal parenting environments, regardless of the levels of prenatal risk. A potential target for intervention efforts based on the current findings might be related to postnatal experiences that impact the development of functional brain networks, which in turn could affect the development of child self-regulation.
High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10 hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy.
Although the causes of neurodevelopmental disorders remain unknown, several environmental risk factors have attracted considerable attention. We conducted a retrospective, longitudinal, population-based cohort study using data from infant health examinations of children born to mothers with pregnancies between April 1, 2014 and March 31, 2016 in Kobe City to identify the perinatal factors associated with neurodevelopmental referrals in 3-year-old children. There were 15,223 and 1283 children in the normal and referral groups, respectively. Neurodevelopmental referrals at the health checkup for 3-year-old children were significantly associated with the lack of social support during pregnancy (adjusted odds ratio [aOR] 1.99, 99% CI 1.14–3.45, p = 0.001), history of psychiatric consultation (aOR 1.56, 99% CI 1.10–2.22, p = 0.001), no social assistance post-delivery (aOR 1.49, 99% CI 1.03–2.16, p = 0.006), Edinburgh Post-natal Depression Scale (EPDS) score ≥ 9 (aOR 1.36, 99% CI 1.01–1.84, p = 0.008), infant gender (male) (aOR 2.51, 99% CI 2.05–3.06, p < 0.001), and cesarean delivery (aOR 1.39, 99% CI 1.11–1.75, p < 0.001). In conclusion, this exploratory study in the general Japanese population identified six perinatal factors associated with neurodevelopmental referrals in 3-year-old children: infant gender (male), cesarean section, maternal history of psychiatric consultation, EPDS score ≥ 9, lack of social support during pregnancy, and no social assistance post-delivery.
Latar belakang: Hipertensi kehamilan ialah penyakit klinis umum yang sering terjadi pada kehamilan meliputi hipertensi gestasional, dan pre-eklampsia. Diketahui bahwa 5-10%, hipertensi gestasional terjadi pada ibu hamil di seluruh dunia. Hipertensi gestasional menyebabkan kerusakan organ pada ibu, kelahiran prematur dan kecemasan pada masa anak-anak hingga dewasa. Tujuan penelitian: Mereview dan memetakan penelitian terkait distres psikologi pada ibu hamil dengan hipertensi gestasional. Metode: Scoping Review menggunakan PRISMA-ScR Checklis, Framework PEOS, data base ScienceDirect, Pubmed, Wiley dan Research Rabbit dengan kriteria inklusi kriteria eksklusi. Seleksi dan penilaian artikel menggunakan Prisma Flowchart dan Critical Appraisal. Hasil: Ditemukan 10 artikel dari 1423 yang relevan dengan tujuan Scoping Review terdiri 2 kualitatif dan 8 kuantitatif. Ditemukan 3 tema utama yaitu faktor yang berhubungan dengan kejadian distres psikologis pada ibu hamil dengan hipertensi gestasional, dampak yang berhubungan dengan kejadian distres psikologi pada ibu hamil dengan hipertensi gestasional dan mekanisme Coping kejadian distres psikologis pada ibu hamil dengan hipertensi gestasional. Simpulan: Faktor lingkungan menyebabkan ibu hamil mengalami hipertensi gestasional, hipertensi gestasional meningkatkan stres pada ibu hamil, distres psikologi pada ibu hamil dengan hipertensi gestasional berdampak pada ibu dan anak dan pemilihan Coping didasari hubungan antara ibu dengan pasangan dan orang-orang terdekatnya.
Gebelik bireyin yaşam döngüsünde fizyolojik, psikolojik ve sosyal değişimlerin yaşandığı, birey için annelik kimliğinin kazanıldığı özel bir deneyimdir. Kadın hamilelik başlangıcından itibaren gebeliğin kendisi, günlük yaşam aktivitelerinin değişen yönleri ve bebeğe bakmanın sorumlulukları ile psikolojik sorunlara karşı artan duyarlılık dönemi yaşamaktadır. Psikolojik sorunlar stresli yaşam koşullarına verilen olumsuz bir psikolojik tepkidir ve küresel sağlık sorunlarından biri olarak tanımlamaktadır. Psikolojik sorunlar olarak adlandırılan depresyon, stres ve anksiyete gebelik ve doğum sonu dönemde yaygın olarak görülmektedir. Gebelik ve yaşanan psikolojik sorunlarla ilişkili faktörler arasında yaşanmış psikiyatrik hastalık öyküsü, yetersiz sosyal destek, eş ve aile ile yaşanılan sorunlar, planlanmamış veya istenmeyen gebelik, primipar olma, riskli gebelik, sosyodemografik ve/veya ekonomik faktörler olarak belirtilmiştir. Kadınların en az %20'si prenatal dönemde depresif semptomlar yaşamaktadır. Anksiyete, doğum öncesi ve doğum sonrası dönemlerde daha az çalışılmış olmasına rağmen, doğum öncesi dönemde %13-21 oranında yaşandığı belirtilmektedir. Gebelik döneminde yaşanan psikolojik sorunların her birinin, düşük doğum ağırlığı ve erken doğum dahil olumsuz doğum sonuçları ve ilerleyen dönemde duygusal, davranışsal ve bilişsel sorunlar dahil olumsuz sonuçları ile ilişkileri olduğu belirtilmektedir. Bu nedenle, bu yaygın durumların tanımlanması ve tedavi edilmesi anne ve bebek sağlığı için son derece önemlidir. Bu çalışma prenatal dönemde en çok görülen ruhsal bozukluklar içerisinde yer alan stres, anksiyete ve depresyonu incelemek amacıyla yapılmıştır.
Accumulating evidence suggests that psychological distress during pregnancy is linked to offspring risk for externalizing outcomes (e.g., reactive/aggressive behaviors, hyperactivity, and impulsivity). Effect sizes across studies have varied widely, however, due to differences in study design and methodology, including control for the confounding continuation of distress in the postnatal period. Clarifying these inconsistencies is necessary to guide the precision of prevention efforts and inform public health policies. A meta-analysis was conducted with 55 longitudinal studies to investigate the association between prenatal psychological distress (anxiety, depression, and perceived stress) and offspring externalizing behaviors. Results revealed a significant but small effect (r = .160) of prenatal distress on externalizing behaviors. The magnitude of the prenatal effect size remained largely unchanged after adjusting for postnatal distress (r = .159), implicating a unique effect of psychological distress during the prenatal period in the etiology of externalizing behaviors. Moderation tests showed that prenatal effects did not vary based on type and timing of psychological distress during pregnancy. Greater instability of distress from prenatal to postnatal periods predicted larger effects. Prenatal effects were comparable across most externalizing outcomes, consistent with the common comorbidity of externalizing spectrum disorders, although effects appeared smaller for nonaggressive rule-breaking (vs. aggressive) behaviors. Significant associations persisted across all developmental periods, appearing slightly larger in early childhood. We discuss these results in the context of developmental and psychobiological theories of externalizing behavior, offer preliminary clinical and public health implications, and highlight directions for future research including the need for longitudinal studies with more racially and socioeconomically diverse families.
Objectives
The objective is to to explore the longitudinal change trajectories of postpartum stress and its related factors.
Design
A longitudinal study with follow-ups from 42 days to 6 months after delivery.
Settings and participants
A total of 406 postpartum women were recruited at baseline (42 days after delivery) from 6 hospitals in Nantong, Jiangsu Province, China, and followed up at 3 and 6 months. After the follow-ups, 358 postpartum women were retained for further analysis.
Methods
Postpartum stress was evaluated using the Maternal Postpartum Stress Scale (MPSS) at baseline (42 days) and 3 and 6 months after delivery. MPSS has three dimensions, such as: personal needs and fatigue, infant nurturing and body changes and sexuality. Postpartum depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the short-form Depression, Anxiety and Stress Scale, respectively. The MPSS scores were normalised using a rank-based inverse normal transformation.
Results
Postpartum stress decreased significantly after 3 months, and postpartum stress reduced further after 6 months. Additionally, the scores for all three dimensions reduced after 6 months, while infant nurturing reduced after both 3 and 6 months. Older age (β=0.028, p=0.049), higher education level (β=0.153, p=0.005) and higher body mass index (BMI) (β=0.027, p=0.008) of the postpartum women were significantly associated with higher postpartum stress levels in corresponding dimensions at 42 days. Older age was also associated with higher postpartum stress at 3 (β=0.030, p=0.033) and 6 months (β=0.050, p<0.001) in the dimension of personal needs and fatigue. Postpartum stress levels were significantly higher in women with depression or anxiety symptoms.
Conclusions
Postpartum stress continuously declined from 42 days to 6 months after delivery. Postpartum women with older age, higher education levels, higher BMI and anxiety or depression symptoms should be the target population for early intervention.
Prenatal maternal stress (PNMS)—characterized by exposure to stress, anxiety, depression, or intimate partner violence—has been linked to biological alterations in infants, including disruptions to their intestinal microbiota, which have long‐term implications for children's developmental outcomes. Significant research has been done examining the effects of PNMS on the microbiome in animals, but less is known about these effects in human research. The current systematic review aimed to synthesize current findings on the association between PNMS and mother and infant microbiomes. Medline, Embase, PsycInfo, Web of Science, and Eric databases were searched through to February 2022. A total of eight studies ( n = 2219 infants, 2202 mothers) were included in the qualitative synthesis. Findings provided promising evidence of the role that PNMS plays in altering the microbial composition, diversity, and gut immunity in mothers and infants. Notably, majority of included studies found that higher PNMS was linked to increases in genera from the phylum Proteobacteria . The factors influencing these effects are explored including nutrition, birth mode, and parenting behaviors. Potential interventions to mitigate the adverse effects of PNMS are discussed, along with recommendations for future studies with longitudinal designs to better understand the appropriate type and timing of interventions needed to promote “healthy” maternal and infant microbial functioning.
Purpose: There are conflicting data about the effects of fetal echocardiography (fECHO) on the psychiatric symptoms of the mother and cardiac evaluation of the fetus. Methods: This study included 119 pregnant women who evaluated using fECHO as the study group and 65 healthy pregnant women who evaluated using ultrasonography for routine screening as the control group. All participants filled out State and Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) before assessment. Results: Mitral flow velocity, Tricuspid flow velocity, Aorta flow velocity (AFV), Pulmonary artery flow velocity, Fetal heart rate (FHR) was evaluated by fECHO. STAI-S, STAI-T and PSS scores of women who evaluated by using fECHO were higher than the control group. In fECHO group, AFV values of pregnant women with high STAI-S scores were higher than those with low STAI-S scores. FHR was higher in pregnant women with low STAI-T scores compared to pregnant women with high STAI-T scores. Correlation analyses showed that STAI-S scores and AFV values and number of pregnancies were positively correlated. FHR was found to be negatively correlated with STAI-S, STAI-T and PSS scores. Conclusion: fECHO can cause anxiety and stress in pregnant women and may have negative effects on fetal cardiac evaluation.
The authors investigated the association between maternal psychological and fetal neurobehavioral functioning. Data were provided by 52 maternal-fetal pairs at 24, 30, and 36 weeks gestation. The relations between maternal measures and fetal heart rate, variability, and motor activity were statistically modeled. Fetuses of women who were more affectively intense, appraised their lives as more stressful, and reported more frequent pregnancy-specific hassles were more active across gestation. Fetuses of women who perceived their pregnancy to be more intensely and frequently uplifting and had positive emotional valence toward pregnancy were less active. Associations with fetal heart-rate measures were detected at 36 weeks gestation. These data provide evidence for proximal effects of maternal psychological functioning on fetal neurobehavior.
How often has anyone said after reading a textbook, “Wow, what a great read!”? That is what I just did. Peter Gluckman, along with Alan Beedle and Mark Hanson, have written a wonderful introduction to the principles of evolutionary biology and defined ways in which these principles can be applied to understanding human disease. I would recommend the first part of the book, “Fundamentals of Evolutionary Biology” (150 pp) to any reader, whether medical professional or layperson, interested in a clear, concise, complete, yet eminently readable introduction to modern evolutionary theory. The authors not only manage to give the reader a sense of how human beings are inextricably linked to their evolutionary past—hairless apes, as it were—but also provide examples of traits, such as menstruation, menopause, having unusually fat infants and an unusually short intestinal tract, needing vitamins C and D, that are unique to humans and a few of their ape relatives, and how these create exciting medical puzzles for evolutionary biologists to explain and physicians to treat.
This article reviews the evolutionary origins and functions of the capacity for anxiety, and relevant clinical and research issues. Normal anxiety is an emotion that helps organisms defend against a wide variety of threats. There is a general capacity for normal defensive arousal, and subtypes of normal anxiety protect against particular kinds of threats. These normal subtypes correspond somewhat to mild forms of various anxiety disorders. Anxiety disorders arise from dysregulation of normal defensive responses, raising the possibility of a hypophobic disorder (too little anxiety). If a drug were discovered that abolished all defensive anxiety, it could do harm as well as good. Factors that have shaped anxiety-regulation mechanisms can explain prepotent and prepared tendencies to associate anxiety more quickly with certain cues than with others. These tendencies lead to excess fear of largely archaic dangers, like snakes, and too little fear of new threats, like cars. An understanding of the evolutionary origins, functions, and mechanisms of anxiety suggests new questions about anxiety disorders.
Like humans engaged in risky activities, group members of some animal societies take turns acting as sentinels. Explanations
of the evolution of sentinel behavior have frequently relied on kin selection or reciprocal altruism, but recent models suggest
that guarding may be an individual's optimal activity once its stomach is full if no other animal is on guard. This paper
provides support for this last explanation by showing that, in groups of meerkats (Suricata suricatta), animals guard from safe sites, and solitary individuals as well as group members spend part of their time on guard. Though
individuals seldom take successive guarding bouts, there is no regular rota, and the provision of food increases contributions
to guarding and reduces the latency between bouts by the same individual.
Problems with language and symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence are often strongly linked to low scholastic performance. Early recognition of children who are at increased risk is necessary. Our objective was to determine whether mixed-handedness, which is associated with atypical cerebral laterality, is associated with language, scholastic, and ADHD symptoms in childhood and adolescence.
Prospective data come from the Northern Finland Birth Cohort 1986, a longitudinal, population-based birth cohort with assessments when children were 7 to 8 and 16 years of age (N = 7871). Teacher, parent, and/or adolescent reports were used to assess language difficulties, scholastic performance, and mental health, including ADHD symptoms.
Mixed-handed children, relative to right-handed, had approximately a twofold increase in odds of having difficulties with language and scholastic performance at the age of 8 years. Eight years later, as 16-year-olds, adolescents had twofold increase in odds concerning difficulties in school with language and with ADHD symptoms. Mixed-handed children were more likely to have scores indicating probable psychiatric disturbance, including ADHD symptoms. As adolescents, mixed-handed children with previous behavioral problems were at considerably higher risk for scoring within the range of probable ADHD-inattention or ADHD-combined case. Mixed-handedness was associated with greater symptom severity in children and adolescents (P = .01) concerning psychiatric disturbance and ADHD inattention but not ADHD hyperactivity.
The results indicate that mixed-handed children have a greater likelihood of having language, scholastic, and mental health problems in childhood and that these persist into adolescence. Thus, these results suggest that mixed-handedness, particularly in the presence of difficulties, could aid in the recognition of children who are at risk for stable problems. Additional research is needed to understand the connections between neural substrates related to atypical cerebral asymmetry, mixed-handedness, and mental health problems including ADHD symptoms.
"Barker's hypothesis" emerged almost 25 years ago from epidemiological studies of birth and death records that revealed a high geographic correlation between rates of infant mortality and certain classes of later adult deaths as well as an association between birthweight and rates of adult death from ischemic heart disease. These observations led to a theory that undernutrition during gestation was an important early origin of adult cardiac and metabolic disorders due to fetal programming that permanently shaped the body's structure, function, and metabolism and contributed to adult disease. This theory stimulated interest in the fetal origins of adult disorders, which expanded and coalesced approximately 5 years ago with the formation of an international society for developmental origins of health and disease (DOHaD). Here we review a few examples of the many emergent themes of the DOHaD approach, including theoretical advances related to predictive adaptive responses of the fetus to a broad range of environmental cues, empirical observations of effects of overnutrition and stress during pregnancy on outcomes in childhood and adulthood, and potential epigenetic mechanisms that may underlie these observations and theory. Next, we discuss the relevance of the DOHaD approach to reproductive medicine. Finally, we consider the next steps that might be taken to apply, evaluate, and extend the DOHaD approach.
The aim of the present study was to examine the association between prenatal psychosocial stress exposure and subsequent prefrontal cortex-dependent working memory performance in human adults. Working memory performance was assessed using an item-recognition task under 10 mg hydrocortisone (cortisol) and placebo conditions in a sample of 32 healthy young women (mean age = 25 +/- 4.34 years) whose mothers experienced a major negative life event during their pregnancy (Prenatal Stress, PS group), and in a comparison group of 27 healthy young women (mean age = 24 +/- 3.4 years). The two groups did not differ in the placebo condition, however, subjects in the PS group showed longer reaction times after hydrocortisone administration compared with subjects in the comparison group (p = .02). These findings provide support for an association between prenatal stress exposure and the potential modulatory effect of cortisol on working memory performance in young adults, which may reflect compromised development of the prefrontal cortex in prenatal life.
Exposure to prenatal stress is associated with later adverse health and adjustment outcomes. This is generally presumed to arise through early environmentally mediated programming effects on the foetus. However, associations could arise through factors that influence mothers' characteristics and behaviour during pregnancy which are inherited by offspring.
A 'prenatal cross-fostering' design where pregnant mothers are related or unrelated to their child as a result of in vitro fertilization (IVF) was used to disentangle maternally inherited and environmental influences. If links between prenatal stress and offspring outcome are environmental, association should be observed in unrelated as well as related mother-child pairs. Offspring birth weight and gestational age as well as mental health were the outcomes assessed.
Associations between prenatal stress and offspring birth weight, gestational age and antisocial behaviour were seen in both related and unrelated mother-offspring pairs, consistent with there being environmental links. The association between prenatal stress and offspring anxiety in related and unrelated groups appeared to be due to current maternal anxiety/depression rather than prenatal stress. In contrast, the link between prenatal stress and offspring attention deficit hyperactivity disorder was only present in related mother-offspring pairs and therefore was attributable to inherited factors.
Genetically informative designs can be helpful in testing whether inherited factors contribute to the association between environmental risk factors and health outcomes. These results suggest that associations between prenatal stress and offspring outcomes could arise from inherited factors and post-natal environmental factors in addition to causal prenatal risk effects.
Human aggression is viewed from four explanatory perspectives, derived from the ethological tradition. The first consists of its adaptive value, which can be seen throughout the animal kingdom, involving resource competition and protection of the self and offspring, which has been viewed from a cost-benefit perspective. The second concerns the phylogenetic origin of aggression, which in humans involves brain mechanisms that are associated with anger and inhibition, the emotional expression of anger, and how aggressive actions are manifest. The third concerns the origin of aggression in development and its subsequent modification through experience. An evolutionary approach to development yields conclusions that are contrary to the influential social learning perspective, notably that physical aggression occurs early in life, and its subsequent development is characterized by learned inhibition. The fourth explanation concerns the motivational mechanisms controlling aggression: approached from an evolutionary background, these mechanisms range from the inflexible reflex-like responses to those incorporating rational decision-making.
Dermatoglyphic asymmetry of fingertip ridge counts is more frequent in schizophrenia patients than normal controls, and may reflect disruptions in fetal development during Weeks 14-22 when fingerprints develop. However, there are no data in humans linking specific adverse events at specific times to dermatoglyphic asymmetries. Our objective was to determine whether prenatal exposure to a natural disaster (1998 Quebec ice storm) during Weeks 14-22 would result in increased dermatoglyphic asymmetry in children, and to determine the roles of maternal objective stress exposure, subjective stress reaction, and postdisaster cortisol. Ridge counts for homologous fingers were scored for 77 children (20 target exposed [Weeks 14-22] and 57 nontarget exposed [exposed during other gestation weeks]). Children in the target group had more than 0.50 SD greater asymmetry than the nontarget group. Within the target group, children whose mothers had high subjective ice storm stress had significantly greater asymmetry than those with lower stress mothers, and maternal postdisaster cortisol had a significant negative correlation with the children's dermatoglyphic asymmetry (r = -.56). Prenatal maternal stress during the period of fingerprint development results in greater dermatoglyphic asymmetry in their children, especially in the face of greater maternal distress.
Maternal care influences hypothalamic-pituitary-adrenal (HPA) function in the rat through epigenetic programming of glucocorticoid receptor expression. In humans, childhood abuse alters HPA stress responses and increases the risk of suicide. We examined epigenetic differences in a neuron-specific glucocorticoid receptor (NR3C1) promoter between postmortem hippocampus obtained from suicide victims with a history of childhood abuse and those from either suicide victims with no childhood abuse or controls. We found decreased levels of glucocorticoid receptor mRNA, as well as mRNA transcripts bearing the glucocorticoid receptor 1F splice variant and increased cytosine methylation of an NR3C1 promoter. Patch-methylated NR3C1 promoter constructs that mimicked the methylation state in samples from abused suicide victims showed decreased NGFI-A transcription factor binding and NGFI-A-inducible gene transcription. These findings translate previous results from rat to humans and suggest a common effect of parental care on the epigenetic regulation of hippocampal glucocorticoid receptor expression.
Emotions research is now routinely grounded in evolution, but explicit evolutionary analyses of emotions remain rare. This article considers the implications of natural selection for several classic questions about emotions and emotional disorders. Emotions are special modes of operation shaped by natural selection. They adjust multiple response parameters in ways that have increased fitness in adaptively challenging situations that recurred over the course of evolution. They are valenced because selection shapes special processes for situations that have influenced fitness in the past. In situations that decrease fitness, negative emotions are useful and positive emotions are harmful. Selection has partially differentiated subtypes of emotions from generic precursor states to deal with specialized situations. This has resulted in untidy emotions that blur into each other on dozens of dimensions, rendering the quest for simple categorically distinct emotions futile. Selection has shaped flexible mechanisms that control the expression of emotions on the basis of an individual's appraisal of the meaning of events for his or her ability to reach personal goals. The prevalence of emotional disorders can be attributed to several evolutionary factors.
The current study sought to determine whether prenatal 3,4-methylenedioxy-N-methamphetamine (MDMA) exposure from E14-20 in the rat resulted in behavioral sequelae in adult offspring. Prenatal MDMA exposure results in increased dopaminergic fiber density in the prefrontal cortex, striatum and nucleus accumbens of young rats. Since these areas are critical in response to novelty, reward, attention and locomotor activity, we hypothesized that prenatal MDMA exposure would produce significant changes in the performance of tasks that examine such behaviors in adult rats. Adult rats prenatally exposed to MDMA exhibited greater activity and spent more time in the center during a novel open field test as compared to controls. This increased activity was not reflected in normal home cage activity. Prenatal exposure to MDMA did not affect feeding or food reward. It did not alter cocaine self-administration behaviors, nor did it have an effect on the locomotor response to amphetamine challenge. Finally, while prenatal MDMA did not affect performance in the radial arm maze or the Morris water maze (MWM), these animals demonstrated altered performance in a cued MWM paradigm. Prenatal MDMA exposure resulted in perseverative attendance to a hanging cue when the platform in the MWM was removed as compared to controls. Together, these data demonstrate that prenatal exposure to MDMA results in a behavioral phenotype in adult rats characterized by reduced anxiety, a heightened response to novelty, and "hyperattentiveness" to environmental cues during spatial learning.
Postpartum depression (PPD) is considered a major public health problem that conveys risk to mothers and offspring. Yet PPD typically occurs in the context of a lifelong episodic illness, and its putative effects might derive from the child's exposure to other episodes, in pregnancy or later childhood. The aim of the study is to test two hypotheses: (1) that the effects of PPD on adolescent outcomes are partly explained by antepartum depression (APD) and (2) that the effects of APD and PPD are both explained by later exposure to the mother's depression.
A random sample of 178 antenatal patients was drawn from two general medical practices in South London; 171 gave birth to live infants, and 150 (88%) were assessed at 3 months post partum, with 121 of their offspring (81%) assessed for emotional disorders (ED), disruptive behaviour disorders (DBD) and IQ, at 11 and 16 years of age.
When APD and subsequent episodes of depression were taken into account, PPD had a significant effect on adolescent IQ, especially for boys, but did not predict psychopathology. ED and DBD in adolescence were predicted by the extent of exposure to maternal depression after 3 months post partum; a significant effect of APD on ED in girls was accounted for by later exposure to the mother's illness. Mothers' symptoms of anxiety, smoking and alcohol use in pregnancy did not predict adolescent outcomes, once maternal depression was taken into account.
Some effects attributed to mothers' mental health problems in pregnancy or post partum may be mediated by cumulative exposure to maternal illness, probably reflecting genetic influence and gene-environment correlation. However, PPD has a direct effect on cognition. Clinicians should endeavour to identify women with depression in pregnancy (31% of this sample) and help them to manage their lifelong illness.
Prenatal stress is associated with an increased vulnerability to neurodevelopmental disorders, including autism and schizophrenia. To determine the critical time window when fetal antecedents may induce a disease predisposition, we examined behavioral responses in offspring exposed to stress during early, mid, and late gestation. We found that male offspring exposed to stress early in gestation displayed maladaptive behavioral stress responsivity, anhedonia, and an increased sensitivity to selective serotonin reuptake inhibitor treatment. Long-term alterations in central corticotropin-releasing factor (CRF) and glucocorticoid receptor (GR) expression, as well as increased hypothalamic-pituitary-adrenal (HPA) axis responsivity, were present in these mice and likely contributed to an elevated stress sensitivity. Changes in CRF and GR gene methylation correlated with altered gene expression, providing important evidence of epigenetic programming during early prenatal stress. In addition, we found the core mechanism underlying male vulnerability may involve sex-specific placenta responsivity, where stress early in pregnancy significantly increased expression of PPARalpha (peroxisome proliferator-activated receptor alpha), IGFBP-1 (insulin-like growth factor binding protein 1), HIF3alpha (hypoxia-inducible factor 3a), and GLUT4 (glucose transporter 4) in male placentas but not females. Examination of placental epigenetic machinery revealed basal sex differences, providing further evidence that sex-specific programming begins very early in pregnancy, and may contribute to the timing and vulnerability of the developing fetus to maternal perturbations. Overall, these results indicate that stress experience early in pregnancy may contribute to male neurodevelopmental disorders through impacts on placental function and fetal development.
Current knowledge about early plasticity and children's responsiveness to environmental modifications as well as the atheoretical nature of current nosological systems necessitate alternative models to explain the phenomena of childhood behavioral and emotional disturbances. Evolutionary biology provides one such framework. It organizes data from the behavioral and cognitive sciences and parallels similar efforts in other areas of medicine and biology. Through an evolutionary biological lens, some mental disorders are better viewed as an adaptive response to early pathogenic environments and/or reflect the optimization of brain function to some environments at the cost of poorer response to the demands of other environments. As an example, the authors examine attention-deficit/hyperactivity disorder (ADHD) in relation to evolutionary theories of psychology and biology and clarify the potentially adaptive nature of characteristics of inattention, impulsivity, and motoric hyperactivity, depending on the nature of child's environments. Reframing ADHD characteristics according to evolutionary theory has important treatment implications for clinicians and offers researchers opportunities for novel scientific discoveries.
Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. A new vision of optimal early human development is emerging which takes account of both short and long-term outcomes.
Animal studies suggest that psychological factors may interfere with the development of brain asymmetry during gestation. We evaluated whether psychological exposure in pregnancy was associated with mixed-handedness in the offspring. In a follow-up design study, 824 Danish-speaking women with singleton pregnancies provided information on psychological distress and the occurrence of life events in the early second and third trimesters of pregnancy. Handedness of the children was based on maternal reports when the children were 3 years of age. Among the 419 males and 405 females, 7% and 5% respectively were mixed-handed whereas mixed-handedness was found in 3% of the parents. Psychological distress in the third trimester as well as higher levels of stressful life events were related to a higher prevalence of mixed-handedness in the offspring. About 16% of the women reported more than one life event in the third trimester of pregnancy and among the offspring of these women 11% were mixed-handed (odds ratio=2.3; 95% confidence interval 1.2 to 4.4). Women who at the same time reported a high level of distress and stressful life events, had a three- to four-fold higher prevalence of mixed-handedness in their offspring.
We review a significant body of evidence from independent prospective studies that if a mother is stressed while pregnant, her child is substantially more likely to have emotional or cognitive problems, including an increased risk of attentional deficit/hyperactivity, anxiety, and language delay. These findings are independent of effects due to maternal postnatal depression and anxiety. We still do not know what forms of anxiety or stress are most detrimental, but research suggests that the relationship with the partner can be important in this respect. The magnitude of these effects is clinically significant, as the attributable load of emotional/behavioral problems due to antenatal stress and/or anxiety is approximately 15%. Animal models suggest that activity of the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end-product cortisol are involved in these effects in both mother and offspring. The fetal environment can be altered if stress in the mother changes her hormonal profile, and in humans, there is a strong correlation between maternal and fetal cortisol levels. However, many problems remain in understanding the mechanisms involved in this interaction. For example, maternal cortisol responses to stress decline over the course of pregnancy, and earlier in pregnancy, the link between maternal and fetal cortisol is less robust. It is possible that the effects of maternal anxiety and stress on the developing fetus and child are moderated by other factors such as a maternal diet (e.g., protein load). It is suggested that extra vigilance or anxiety, readily distracted attention, or a hyper-responsive HPA axis may have been adaptive in a stressful environment during evolution, but exists today at the cost of vulnerability to neurodevelopmental disorders.
Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. A new vision of optimal early human development is emerging which takes account of both short and long-term outcomes.
Human social interaction is rarely guided by pure reason. Instead, in situation in which humans have the option to cooperate, to defect, or to punish non-cooperative behavior of another person, they quite uniformly tend to reciprocate “good” deeds, reject unfair proposals, and try to enforce obedience to social rules and norms in non-cooperative individuals (“free-riders”), even if the punishment incurs costs to the punisher. Abundant research using various game theoretical approaches has examined these apparently irrational human behaviors. This article reviews the evolutionary rationale of how such behavior could have been favored by selection. It explores the cognitive mechanisms required to compute possible scenarios of cooperation, defection, and the detection of cheating. Moreover, the article summarizes recent research developments into individual differences in behavior, which suggest that temperament and character as well as between- and within-sex differences in hormonal status influence behavior in social exchange. Finally, we present an overview over studies that have addressed the question of how neuropsychiatric disorders may alter performance in game theoretical paradigms, and propose how empirical approaches into this fascinating field can advance our understanding of human nature.
Experimental animal studies suggest that early glucocorticoid exposure may have lasting effects on the neurodevelopment of the offspring; animal studies also suggest that this effect may be eliminated by positive postnatal rearing. The relevance of these findings to humans is not known.
We prospectively followed 125 mothers and their normally developing children from pregnancy through 17 months postnatal. Amniotic fluid was obtained at, on average, 17.2 weeks gestation; infants were assessed at an average age of 17 months with the Bayley Scales of Infant Development, and ratings of infant-mother attachment classification were made from the standard Ainsworth Strange Situation assessment.
Prenatal cortisol exposure, indexed by amniotic fluid levels, negatively predicted cognitive ability in the infant, independent of prenatal, obstetric, and socioeconomic factors. This association was moderated by child-mother attachment: in children with an insecure attachment, the correlation was [r(54) = -.47, p < .001]; in contrast, the association was nonexistent in children who had a secure attachment [r(70) = -.05, ns].
These findings mimic experimental animal findings and provide the first direct human evidence that increased cortisol in utero is associated with impaired cognitive development, and that its impact is dependent on the quality of the mother-infant relationship.
There is extensive evidence in rats that prenatal environmental stress (PES) exposure and early postnatal altered maternal care, as a consequence of stress during gestation, can detrimentally affect the brain and behavioral development of the offspring. In order to separate the effect of PES on the fetuses from that on the behavior of the mother, in the present study, we used a cross-fostering procedure in which PES-fetuses were raised by non-stressed mothers and non PES-fetuses were raised by stressed mothers. In Experiment 1, non-stressed mothers showed significantly more maternal behavior than stressed mothers. In Experiment 2, when the female offspring from Experiment 1 reached maturity, they were tested for: (1) induced maternal behavior (MB), (2) plasma levels of corticosterone (Cpd B), progesterone (P), and estradiol (E2), (3) number of accessory olfactory bulb (AOB) mitral cells, and (4) c-fos expression measured in AOB and medial preoptic area (MPOA) neurons. We replicated our previous findings that the PES group reared by their own stressed mothers, when adult, attacked the young, expressed disorganized MB and showed altered Cpd B, P and E2 levels, plus a male-like neuro-morphological pattern in the AOB, by comparison with the non-PES group, reared by their own non-stressed mothers. By contrast, when adult, the PES group reared by non-stressed mothers showed hormonal and morphological neuronal alterations, but they displayed appropriate (full) MB. The non-PES group raised by stressed mothers also showed altered hormone levels, but showed full MB and no morphological neuronal changes. Significant differences in the AOB and MPOA c-fos activity, related to whether or not MB was expressed, were found in the non-PES groups, but not in the PES group reared by non-stressed mothers.
Exposure to stress during critical periods of an organism's maturation can result in permanent behavioral changes and induced hyper-responsive to aversive stimuli as adult. Hippocampus is a plastic and vulnerable brain structure that is susceptible to damage during aging and repeated stress. The present study examines the effect of maternal restraint stress on the level of GAP-43, pGAP-43 and synaptophysin in the hippocampus of rat pups. Prenatal stress (PS) causes a significant increase of GAP-43 and pGAP-43 (p<or=0.001) in the pup's hippocampus during postnatal days 7 and 14, but not at later ages. Up-regulation of GAP-43 and pGAP-43 may alter the pattern of axonal growth and synapses' formation in the pup's brain since the first two postnatal weeks are correlated with peak period of synaptogenesis in the rat brain. We also examined the level of synaptophysin, a synaptic vesicle membrane protein, in the pup's brain. Our finding revealed that, PS causes a significant decrease of synaptophysin in the pup's hippocampus as compared to control (p<or=0.001). These changes are due to the direct effects of maternal stress hormone since repeated injection with corticosterone (CORT, 40 mg/kg) to pregnant rat during gestation days (GDs) 14-21 also gave the same results. Abnormal axonal sprouting and reorganization together with the alterations in synaptic vesicle membrane protein during the critical period of synaptogenesis may lead to a defect in synapse formation and axonal pruning in the hippocampus. These changes may be associated with stress-induced impairment of hippocampal function that occurs in later life of the offspring.
There are several independent prospective studies showing that a wide variety of forms of prenatal stress can have long-term effects on the behavioural and cognitive outcome for the child. Animal studies have shown that prenatal stress, as well as affecting behaviour, can also reprogram the function of the HPA axis in the offspring. However, the effects on the HPA axis are very variable depending on the nature of the stress, its timing in gestation, the genetic strain of the animal, the sex and age of the offspring and whether basal or stimulated HPA axis responses are studied. There are also several recent studies showing long-term effects of prenatal stress on basal cortisol levels, or cortisol responses to stress, in humans. The designs of these studies differ considerably, many are small, and the effects on outcome are also varied. There is little evidence, so far, that altered function of the HPA axis in the child mediates the behavioural or cognitive alterations observed to be associated with prenatal stress.
It is well established in animal models that the prenatal environment can have a major impact on stress axis function throughout life. These changes can predispose to various metabolic, cardiovascular, and neurobiological pathophysiologies. Emerging evidence indicates that the same programming effects occur in humans. It is now becoming clear that the pathophysiological effects are not confined to the first-generation offspring and that there is transgenerational memory of fetal experience that can extend across multiple generations. The complex mechanisms by which transgenerational transmission of stress responsiveness occur are rapidly becoming a focus of investigation. Understanding these fundamental biological processes will allow for development of intervention strategies that prevent or reverse adverse programming of the stress response.
The goal of our study was to characterise the relationships between trait anxiety symptoms of women during their pregnancies and birth outcomes of their offspring using a longitudinal cohort from the Maternal Health Practices and Child Development Project. We used the State‐Trait Personality Index anxiety measure that is based on Spielberger's State‐Trait Anxiety Inventory to measure self‐reported trait anxiety at two gestational assessments (fourth and seventh months, representing the first and second trimesters, respectively) and at a third assessment shortly after delivery (representing the third trimester). Demographic, social, psychological, substance use and medical factors were assessed prenatally, and outcomes of the 763 live, singleton births were determined at delivery.
In regression models, trait anxiety at the second and third trimesters predicted lower birthweight and shorter birth length, controlling for confounders. Anxiety reported at the third trimester predicted shortened gestational age, controlling for confounders. At the first and second trimesters, the relationship of birthweight and birth length to maternal trait anxiety was only significant for severe anxiety. Women whose anxiety reached severe levels for at least two trimesters were significantly more likely to deliver offspring of lower birthweight and shorter birth length than those women who reported severe anxiety at none or only one of the trimesters. Additionally, offspring of women who experienced severe anxiety during all three trimesters had shorter mean gestational age than offspring of women who did not report severe anxiety at any trimester. Women who report chronic, severe trait anxiety are at the highest risk of having shorter gestations and delivering smaller babies.
Because the brain undergoes dramatic changes during fetal development it is vulnerable to environmental insults. There is evidence that maternal stress and anxiety during pregnancy influences birth outcome but there are no studies that have evaluated the influence of stress during human pregnancy on brain morphology. In the current prospective longitudinal study we included 35 women for whom serial data on pregnancy anxiety was available at 19 (+/-0.83), 25 (+/-0.9) and 31 (+/-0.9) weeks gestation. When the offspring from the target pregnancy were between 6 and 9 years of age, their neurodevelopmental stage was assessed by a structural MRI scan. With the application of voxel-based morphometry, we found regional reductions in gray matter density in association with pregnancy anxiety after controlling for total gray matter volume, age, gestational age at birth, handedness and postpartum perceived stress. Specifically, independent of postnatal stress, pregnancy anxiety at 19 weeks gestation was associated with gray matter volume reductions in the prefrontal cortex, the premotor cortex, the medial temporal lobe, the lateral temporal cortex, the postcentral gyrus as well as the cerebellum extending to the middle occipital gyrus and the fusiform gyrus. High pregnancy anxiety at 25 and 31 weeks gestation was not significantly associated with local reductions in gray matter volume.This is the first prospective study to show that a specific temporal pattern of pregnancy anxiety is related to specific changes in brain morphology. Altered gray matter volume in brain regions affected by prenatal maternal anxiety may render the developing individual more vulnerable to neurodevelopmental and psychiatric disorders as well as cognitive and intellectual impairment.
Although postnatal psychologic distress has been widely studied for many years, particularly with a focus on postpartum depression, symptoms of maternal depression, stress, and anxiety are not more common or severe after childbirth than during pregnancy. This paper reviews the newer body of research aimed at identifying the effects of women's antenatal psychologic distress on fetal behavior and child development, and the biologic pathways for this influence. These studies are in line with the growing body of literature supporting the "fetal origins hypothesis" that prenatal environmental exposures--including maternal psychologic state-based alterations in in utero physiology--can have sustained effects across the lifespan.
Maternal stress and anxiety during pregnancy are related to negative developmental outcomes for offspring, both physiological and psychological, from the fetal period through early adolescence. This robust relationship is likely to be partly explained by alterations in fetal neurodevelopmental programming, calling for further examination of neurophysiologically-based cognitive markers that may be related to the altered structure-function relationships that contribute to these negative developmental outcomes. The current investigation examined the relationship between perinatal maternal anxiety and neonatal auditory evoked responses (AERs) to mother and stranger voices. Results indicated that neonates of low-anxiety mothers displayed more negative frontal slow wave amplitudes in response to their mother's voice compared to a female stranger's voice, while neonates of high-anxiety mothers showed the opposite pattern. These findings suggest that neonates of perinatally anxious mothers may demonstrate neurophysiologically-based differences in attentional allocation. This could represent one pathway to the negative psychological outcomes seen throughout development in offspring of anxious mothers.
Among young children who demonstrate high levels of conduct problems, less than 50% will continue to exhibit these problems into adolescence. Such developmental heterogeneity presents a serious challenge for intervention and diagnostic screening in early childhood. The purpose of the present study was to inform diagnostic screening and preventive intervention efforts by identifying youths whose conduct problems persist. The authors examined 1) the extent to which early-onset persistent versus childhood-limited trajectories can be identified from repeated assessments of childhood and early-adolescent conduct problems and 2) how prenatal and early postnatal risks differentiate these two groups.
To identify heterogeneity in early-onset conduct problems, the authors used data from a large longitudinal population-based cohort of children followed from the prenatal period to age 13. Predictive risk factors examined were prenatal and postnatal measures of maternal distress (anxiety, depression), emotional and practical support, and family and child characteristics (from birth to 4 years of age).
Findings revealed a distinction between early-onset persistent versus childhood-limited conduct problems in youths. Robust predictors of the early-onset persistent trajectory were maternal anxiety during pregnancy (32 weeks gestation), partner cruelty to the mother (from age 0 to 4 years), harsh parenting, and higher levels of child undercontrolled temperament. Sex differences in these risks were not identified.
Interventions aiming to reduce childhood conduct problems should address prenatal risks in mothers and early postnatal risks in both mothers and their young children.
Recent human studies have shown that a wide variety of prenatal stressors, from anxiety and partner relationship problems, to natural disasters, increase the risk for a diverse range of adverse neurodevelopmental outcomes in the child. These include impaired cognitive development and behavioral problems, autism and schizophrenia. However, many questions remain about the underlying processes. Much of the research, based on animal studies, has focussed on the maternal HPA axis, with mixed results. Maternal stress or anxiety during pregnancy has been found to be weakly associated with raised maternal cortisol, if at all. The placenta may be a more promising programming vector, because it controls fetal exposure to the maternal environment. Animal studies indicate that prenatal stress can affect the activity of the placental barrier enzyme 11-betaHSD2, which metabolises cortisol. We review the evidence for a similar mechanism in humans and how maternal stress may cause other changes in the placenta which affect fetal neurodevelopment.
To assess the association between maternal anxiety during pregnancy and the brain activity of 17 year old adolescents performing two cognitive control tasks.
Twenty-three 17 year old boys of mothers whose level of anxiety was measured during pregnancy were investigated using ERP while performing a Go/Nogo paradigm assessing exogenous cognitive control and a Gambling paradigm requiring endogenous cognitive control.
No effects of antenatal maternal anxiety were observed in the Go/Nogo paradigm. However, in the Gambling paradigm adolescents of the high anxiety group (n=8) showed a less efficient pattern of decision making compared to the adolescents in the low-average anxiety group (n=15). Moreover, only for this task the ERP data showed an enlarged early frontal P2a component in the high anxiety group.
The brain activity of adolescents during an endogenous cognitive control task is associated to the level of anxiety experienced by their mother during pregnancy. This association was not observed during an exogenous cognitive control task.
This study indicates that a child's brain functionality is related to its mother's anxiety during pregnancy. Endogenous cognitive control is regarded the cognitive function most affected by the level of antenatal maternal anxiety.
Prenatal stress has been linked to several adverse neurobehavioral outcomes, which may share a common pathophysiology with autism. We aimed to examine whether prenatal stress exposure after maternal bereavement is associated with an increased risk of autism later in life.
We conducted a nationwide population-based cohort study of all 1492709 singletons in Denmark born from 1978 to 2003. A total of 37275 children were born to women who lost a close relative during pregnancy or up to 1 year before pregnancy. These children were included in the exposed group, and the remaining children were in the unexposed group. All children were followed up from birth until their death, migration, onset of autism, or the end of 2006. Information on autism was obtained from the Danish Psychiatric Central Register. We used Cox regression models to estimate hazard ratios in the exposed group compared with those in the unexposed group.
Maternal bereavement during the prenatal period was not associated with an increased risk of autism in the offspring. The hazard ratios did not differ by the nature of the exposure (maternal relationship to the deceased or cause of death). The hazard ratios were comparable between the 5 prenatal exposure periods under study (7-12 months before pregnancy, 0-6 months before pregnancy, first trimester, second trimester, and third trimester).
This is the first population-based cohort study to examine the effect of prenatal stress on autism in childhood. Our data do not support any strong association between prenatal stress after maternal bereavement and the risk of autism.
The concept of fetal programming states that changes in the fetal environment during sensitive periods of organ development may cause long-lasting changes in the structure and functioning of these organs later in life and influence the risk for chronic diseases such as coronary heart disease and type 2 diabetes. Fetal growth is a summary marker of the fetal environment and is reflected by relatively easy-to-obtain measures of size at birth such as birth weight. In the last two decades, a body of evidence emerged linking fetal growth with behavioural and mental health outcomes later in life. Cognitive functioning and behavioural problems in childhood, in particular inattention/hyperactivity, have been shown to be inversely related to fetal growth. Although results are mixed, risk for personality disorders and schizophrenia seems to be linked with fetal growth and adversity, while the evidence for mood disorders is weak. Vulnerability for psychopathology may also be influenced by prenatal adversity. There is evidence for associations of fetal growth with temperament in childhood as well as stress reactivity and distress. The associations of fetal growth with mental health later in life are potentially caused by specific prenatal factors such as maternal smoking, alcohol, toxins/drugs, nutrition, psychosocial stress and infection during pregnancy. The mechanisms likely involve changes in neurodevelopment and in the set point of neuroendocrine systems, and there is evidence that prenatal adversity interacts with genetic and postnatal environmental factors. Future studies should examine the effects of specific prenatal factors and attempt to disentangle genetic and prenatal environmental effects.
Sex differences are found in animal studies concerning the relationship between prenatal maternal stress and outcome of the offspring. Most human studies in this field have not addressed sex differences, although differences between boys and girls may elucidate the biochemical as well as psychological processes involved. Associations between prenatal maternal emotional complaints and behavioural problems of toddlers and preschoolers as assessed by both mothers and fathers are studied separately for boys and girls.
Healthy Dutch Caucasian singleton, pregnant women (N=444) answered questionnaires about anxiety and depression in every trimester of pregnancy. When their children (227 boys, 217 girls) were between 14 and 54 months old, both parents reported on their current feelings of depression and anxiety and on the behavioural problems of their children.
Prenatal maternal emotional complaints were found to be associated with child behavioural problems both in boys and in girls, but in different ways. Prenatal maternal emotional complaints during the first trimester were associated with total and internalizing behavioural problems for boys. Emotional complaints during the third trimester were associated with total, internalizing, as well as externalizing behavioural problems for girls.
Differentiation according to sex and information on timing of emotional complaints during pregnancy is needed in studies concerning the relation between prenatal maternal emotional complaints and child outcome.
Epidemiological studies have reported associations between measures of size and weight at birth and disease risk in later life. Alteration in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis in response to prenatal stress has been proposed as one underlying mechanism. The present study investigated in humans the association of prenatal psychosocial stress exposure with subsequent HPA axis regulation in adult life, with a focus on measures of response to challenge and feedback sensitivity. Healthy young adults whose mothers experienced severe stress during their pregnancy in form of major negative life events (e.g. death of someone close; prenatal stress (PS) group, n=31) and an age-matched comparison group (CG, n=30) underwent the Trier Social Stress Test (TSST) and a 1 microg ACTH(1-24) stimulation test. In addition, a diurnal cortisol profile was assessed. ACTH concentrations following a standardized behavioural challenge paradigm (TSST) were marginally significantly higher in PS subjects than in CG subjects (p=.06). Pre-TSST adrenocortical (cortisol) levels were lower (p=.007), whereas the increase in cortisol in response to the TSST was higher (p=.03) in PS subjects compared to CG subjects. Cortisol concentrations following a pharmacological stimulation test simulating pituitary activity (ACTH(1-24) test) were significantly lower in PS than in CG subjects (p=.006). No differences emerged between the two groups in basal diurnal cortisol levels. This study provides first evidence in humans of an association between prenatal psychosocial stress exposure and subsequent alterations in the regulation of the HPA axis.
Animal studies have shown that prenatal stress has persisting effects on several aspects of offspring development; more recent studies show that this effect may be eliminated by positive postnatal rearing. Human studies of prenatal anxiety/stress are now also beginning to document links between antenatal stress/anxiety and behavioural and cognitive development of the child; however, there is no human evidence as to whether the early caregiving environment moderates the effect of antenatal anxiety/stress on child outcomes.
Antenatal and postnatal measures of stress were collected on 123 women who were recruited from an antenatal clinic. Laboratory-based assessment of the children's cognitive development and fearfulness were assessed when the children were aged 17 months. In addition, child-parent attachment quality was assessed using the Strange Situation.
Attachment classification moderated the link between antenatal stress and observed fearfulness. The effect of antenatal stress on fearfulness was most accentuated in children with an Insecure/Resistant attachment classification; the significant antenatal stress x attachment classification interaction held after controlling for postnatal stress and obstetric, social and demographic factors. Attachment did not moderate the effects of antenatal anxiety on cognitive development.
These findings provide the first human evidence that postnatal parenting may moderate the adverse effects of antenatal stress. These results raise developmental questions about the timing and effect of interventions to reduce the adverse effects of antenatal stress exposure.
Prenatal maternal stress (PNMS) has been linked with adverse health outcomes in the offspring through experimental studies using animal models and epidemiological studies of human populations. The purpose of this review article is to establish a parallel between animal and human studies, while focusing on methodological issues and gaps in knowledge. The review examines the quality of recent evidence for prevailing PNMS theoretical models, namely the biopsychosocial model for adverse pregnancy outcomes and the fetal programming model for chronic diseases. The investigators used PubMed (2000–06) to identify recently published original articles in the English language literature. A total of 103 (60 human and 43 animal) studies were examined.
Most human studies originated from developed countries, thus limiting generalisability to developing nations. Most animal studies were conducted on non‐primates, rendering extrapolation of findings to pregnant women less straightforward. PNMS definition and measurement were heterogeneous across studies examining similar research questions, thus precluding the conduct of meta‐analyses. In human studies, physical health outcomes were often restricted to birth complications while mental health outcomes included postnatal developmental disorders and psychiatric conditions in children, adolescents and adults. Diverse health outcomes were considered in animal studies, some being useful models for depression, schizophrenia or attention deficit hyperactivity disorder in human populations. The overall evidence is consistent with independent effects of PNMS on perinatal and postnatal outcomes. Intervention studies and large population‐based cohort studies combining repeated multi‐dimensional and standardised PNMS measurements with biomarkers of stress are needed to further understand PNMS aetiology and pathophysiology in human populations.
This was a prospective study designed to determine the extent to which the degree of exposure to prenatal maternal stress due to a natural disaster explains variance in the intellectual and language performance of offspring at age 5(1/2) while controlling for several potential confounding variables.
Subjects were eighty-nine 5(1/2)-year-old children whose mothers were pregnant during a natural disaster: the January 1998 ice storm crisis in the Canadian province of Québec that resulted in power losses for 3 million people for as long as 40 days. In June 1998, women completed several questionnaires including those about the extent of objective stress (Storm 32) and subjective distress (Impact of Events Scale-Revised) experienced due to the storm. Their children were assessed with the Wechsler Preschool and Primary Scale of Intelligence-Revised (IQ) and Peabody Picture Vocabulary Test-Revised (language) at 5(1/2) years of age, and mothers completed assessments of recent life events and psychological functioning.
Children exposed in utero to high levels of objective stress had lower Full Scale IQs, Verbal IQs, and language abilities compared to children exposed to low or moderate levels of objective prenatal maternal stress; there were no effects of subjective stress or objective stress on Performance IQs. Trend analyses show that for all outcome variables except Block Design, there was a significant curvilinear association between objective stress and functioning.
Prenatal exposure to a moderately severe natural disaster is associated with lower cognitive and language abilities at 5(1/2) years of age.
Sexually dimorphic rough-and-tumble play patterns were compared in male and female rats derived from control mothers and mothers stressed from days 14-21 of pregnancy. Animals were weaned into groups of 8 consisting of 2 males and 2 females from each treatment. Play in the home cage was recorded at 25, 28, 31, 34, 37 and 45 days of age and was most intense on day 31. The overall level of play was significantly higher in control males than in females or stressed males. Control males showed higher levels of the pinning component of rough-and-tumble play than females or stressed males. No play partner preferences were detected in any group. In adulthood, a higher percentage of stressed than control males displayed the female lordotic pattern. No deficits in ejaculatory behavior occurred in the stressed males. Since maternal stress alters patterns of plasma testosterone in male fetuses, the data suggest that the sexual differentiation of social play begins during prenatal ontogeny in the rat. The present results show that sexually dimorphic behaviors displayed before puberty are incompletely masculinized in prenatally stressed males, a finding similar to that reported for a number of adult behaviors.
This study compared hyperactive and normal girls and boys on their mother-child interactions, family psychiatric status and ratings on the Personality Inventory for Children (PIC). Hyperactive children were less compliant and more negative, and their mothers responded more negatively to their compliance than mothers of normal children. Mothers of hyperactive children reported more depression, marital discord and psychiatric problems in their relatives, and rated their children more deviant on 15 of 16 PIC scales than normal children. Hyperactive boys received more direction and praise, and had greater maternal concern about their adjustment than hyperactive girls or normal children.
A genetical mathematical model is described which allows for interactions between relatives on one another's fitness. Making use of Wright's Coefficient of Relationship as the measure of the proportion of replica genes in a relative, a quantity is found which incorporates the maximizing property of Darwinian fitness. This quantity is named “inclusive fitness”. Species following the model should tend to evolve behaviour such that each organism appears to be attempting to maximize its inclusive fitness. This implies a limited restraint on selfish competitive behaviour and possibility of limited self-sacrifices.
Special cases of the model are used to show (a) that selection in the social situations newly covered tends to be slower than classical selection, (b) how in populations of rather non-dispersive organisms the model may apply to genes affecting dispersion, and (c) how it may apply approximately to competition between relatives, for example, within sibships. Some artificialities of the model are discussed.
On the basis of Western studies suggesting that infants with difficult temperaments are at greater risk for behavioral and physical disorders, the author postulated that Masai infants with difficult temperaments would be at greater risk in the harsh environment created by the sub-Saharan drought in 1974, which disrupted the life of the Masai people of East Africa and resulted in increased infant mortality. Two groups of infants with difficult and easy temperaments were defined and followed. Contrary to expectations, mortality was greater for the infants with easy temperaments. The infant's contribution, child-rearing orientation, and feeding practices were factors influencing survival.
J. C. Wakefield (1992a, 1992b, 1993) recently proposed that mental disorder is best conceptualized as a "harmful dysfunction," whereby "harm" is a value judgment regarding the undesirability of a condition, and "dysfunction" is the failure of a system to function as designed by natural selection. The authors maintain, however, that (a) many mental functions are not direct evolutionary adaptations, but rather adaptively neutral by-products of adaptations, (b) Wakefield's concept of the evolutionarily designed response neglects the fact that natural selection almost invariably results in substantial variability across individuals, and (c) many consensual disorders represent evolutionarily adaptive reactions to danger or loss. The authors propose that mental disorder is a Roschian concept characterized by instrinsically fuzzy boundaries and that Wakefield's analysis may only prolong scientific debate on a fundamentally nonscientific issue.
This review looks at the mechanisms for distinguishing kin. Initially two theories for explaining kin recognition are outlined: inclusive fitness; and optimal outbreeding theory. Next, how organisms distinguish their relatives, is covered. Two mechanisms are involved: physical features (phenotypes); cues related to time or place; or a combination of the two. For instance bank swallows (Riparia riparia) use both direct and indirect methods, whereas Sea squirts (Botryllus schlosseri) rely exclusively on genetic labels. The authors then discuss how organisms use recognition cues to assess relatedness. Finally, one reasons for kin recognition is advanced, viz cannibalistic kin. It has been shown that cannibalistic spadefoot toad tadpoles (Scaphiopus bombifrons) avoid eating kin (depending on hunger level). They manage this avoidance by taking an exploratory bite, either then eating, or releasing if the tadpole is a sibling. -S.R.Harris
The aim was to test a model of the influence of maternal prenatal psychosocial stress on birth outcomes after controlling for biomedical risk.
In a prospective study a sociodemographically homogeneous sample of 90 women was assessed during the third trimester with standard, reliable questionnaires that measured episodic and chronic stress, strain (response to stress), and pregnancy-related anxiety. Birth outcomes included infant birth weight, gestational age at birth, and intrapartum complications. Parity and biomedical (antepartum) risk was also coded. Bivariate and multivariate analyses were performed after controlling for the effects of biomedical risk factors.
Independent of biomedical risk, each unit increase of prenatal life event stress (from a possible sample range of 14.7 units) was associated with a 55.03 gm decrease in infant birth weight and with a significant increase in the likelihood of low birth weight (odds ratio 1.32), and each unit increase of prenatal pregnancy anxiety (from a possible sample range of 5 units) was associated with a 3-day decrease in gestational age at birth.
Independent of biomedical risk, maternal prenatal stress factors are significantly associated with infant birth weight and with gestational age at birth.
Immune alterations in schizophrenia have been described for decades. However, modern immunological methods and new insights into the highly developed and functionally differentiated immune system allows an integrative view of both, the older and also recent findings of immunological abnormalities in schizophrenia. Both, the unspecific and the specific arm of the immune system seem to be involved in the dysfunction of the immune system in schizophrenia. The unspecific "innate" immune system shows signs of an overactivation in unmedicated schizophrenic patients, as increased monocytes and gamma delta-cells point to. Increased levels of Interleukin-6 (IL-6) and the activation of the IL-6 system in schizophrenia might also be the result of the activation of monocytes/macrophages. On the contrary, several parameters of the specific cellular immune system are blunted, e.g. the decreased T-helper-1 (TH-1) related immune parameters in schizophrenic patients both, in vitro and in vivo. It seems that a TH-1-TH-2 imbalance with a shift to the TH-2 system is associated with schizophrenia. During antipsychotic therapy with neuroleptics, the specific TH-1 related immune answer becomes activated, but also the B-cell system and the antibody production increases.