Kristin Bernard - US grants

? DESCRIPTION (provided by applicant): Depression and anxiety represent urgent public health problems, as these disorders are highly prevalent, chronically impairing for the affected individuals and their families, and very costly to society at large. Impaired functioning of core neural systems involved in reward processing and error monitoring may confer specific risk for depression and anxiety, respectively. In children, a reduced feedback negativity (FN), an ERP component sensitive to monetary rewards versus losses, predicts the first-onset of depressive disorders, whereas an increased error-related negativity (ERN), reflecting over-activation of an error-monitoring system, predicts the first-onset of anxiety disorders. Further, these biomarkers of risk for depression (i.e., FN) and anxiety (i.e., ERN) appear to be influenced by positive parenting and harsh parenting, respectively. The current proposal leverages a well-developed evidence-based parenting intervention to experimentally manipulate positive and harsh parenting in order to examine whether the FN and ERN can be altered in children and assess the specificity of these associations. This mechanism-focused approach has the potential to inform neurobiological models of developmental psychopathology and offer novel targets for intervention.

PROJECT SUMMARY/ ABSTRACT Many chronic, impairing, and costly adulthood health diseases, such as cardiovascular disease and type 2 diabetes, can be traced back to exposure to stress during childhood. One biological marker of physical health risk that may offer further insight into pathways by which chronic early stress leads to poor health outcomes is accelerated cellular aging, quantified as telomere length. Telomere shortening is already observable in young children who experience chronic exposure to stress, making telomere length an early biomarker of vulnerability to age-related diseases. Attachment theory offers an important framework for understanding the developmental origins of health and disease. Whereas sensitive parenting supports regulatory processes in early childhood, insensitive parenting may be a chronic stressor that undermines children?s physiological regulation, and subsequently the rate of children?s cellular aging. Adopting an intergenerational risk framework, the overarching aim of the proposed project is to examine whether mothers? attachment representations influence offspring?s telomere length through the quality of sensitive caregiving and children?s cortisol regulation. A total of 210 mothers and their young children will be drawn from two existing study samples: the first includes mothers and children from a diverse community sample, and the second includes mothers and children from a low-income community sample who previously participated in a randomized clinical trial of an attachment-based intervention. During infancy, we collected data on mothers? attachment representations, parental sensitivity, and children?s diurnal cortisol regulation. During follow-up visits conducted for the propose study when children are 4-5 years old, we will collect buccal cell samples to be assayed for telomere length. We will examine whether mothers? attachment representations affect children?s cellular aging (i.e., telomere length), whether parental sensitivity and children?s cortisol regulation mediate associations between mothers? attachment representations and children?s cellular aging, and whether the timing of sensitive parenting (manipulated via an attachment-based intervention) affects cellular aging.

PROJECT SUMMARY/ ABSTRACT Young children who have experienced neglect or abuse are at increased risk for poor behavioral and biological outcomes. However, this risk can be buffered if their parents behave in sensitive ways. Attachment and Biobehavioral Catch-up (ABC), a home visiting intervention, targets parental sensitivity among parents of high-risk infants. Through efficacy trials, the ABC intervention has been shown to engage the intervention mechanism, parental sensitivity, and enhance parental neural activity. In addition, children whose parents receive the ABC intervention show better outcomes in attachment, cortisol production, and behavioral regulation than children whose parents receive a control intervention. Pilot work suggests that some parents respond to the intervention within several sessions, suggesting that an abbreviated intervention could be optimal for them. The next critical step is demonstrating that the ABC intervention engages the intervention mechanism when implemented by community clinicians in a community context, and examining whether some parents can benefit from an abbreviated version of the intervention. This effectiveness trial leverages an existing partnership between a community-based organization and child welfare system to examine whether the ABC intervention engages the treatment mechanism, parental sensitivity, when implemented by community clinicians, whether changes in parental sensitivity mediate intervention effects on child outcomes, and whether parental cumulative risk moderates the effectiveness of varied dosages of the intervention. A total of 360 parents and their young children involved in the New York City child welfare system will be included as participants. Parents will be randomized to a screen-and-refer intervention with an established evidence base (Safe Environment for Every Kid; SEEK), to SEEK plus a 3-session version of ABC (ABC 3), or to SEEK plus the standard 10-session ABC intervention (ABC 10). Intervention effectiveness will be examined as changes in parental sensitivity (the intervention mechanism) at both behavioral and neural levels, as well as changes in child outcomes. Changes in parental sensitivity are expected to mediate intervention effects on child outcomes. Individual differences in response to treatment dosage will be explored.