Linda Luecken - US grants

DESCRIPTION (provided by applicant): Early life adversity in the form of inadequate caregiving has been linked to greater risk of physical and psychological illness over the lifespan. Self-regulatory ability in response to stress has been proposed as a mechanism linking early family experiences to long-term health. Although well-studied in children, little is known about the extent to which caregiving experiences affect self-regulatory ability into adulthood. In addition, individual differences in cognitive and affective self-regulatory responses to stress may mediate or moderate physiological responses. The current study will address this important potential cognitive pathway linking early caregiving experiences to stress-responding in adulthood. Participants will include 60 young adult men and women; half from high conflict/low affection family environments, and half from low conflict/high affection family environments. A social interaction task will be conducted in which participants role-play making a request from a difficult neighbor (a confederate from the research team). Blood pressure will be taken continuously, and salivary cortisol will be measured before and at 3 timepoints following the role-play. The task will be videotaped and analyzed for negative verbal and nonverbal behavior, and coping styles. Emotional responses and cognitive appraisals of the situation and the confederate will be assessed following the task. We hypothesize that participants from high conflict/low affection family environments will display greater negative affectivity during the role-play, maladaptive coping responses, greater negative cognitive appraisals, and elevated cortisol and blood pressure responses relative to those from low conflict/high affection backgrounds. We also hypothesize that cognitive/affective responses will mediate physiological reactivity. This study will provide important information regarding the role of cognitive and emotional responses to stress as a mechanism linking early caregiving experiences to physiological reactivity and long-term health. An understanding of cognitive and emotional mechanisms underlying psychological and physiological vulnerability will help to articulate and define appropriate targets for psychotherapeutic intervention with individuals rendered vulnerable by inadequate early caregiving.

DESCRIPTION (provided by applicant): The consequences of postpartum depression (PPD) extend far beyond the mother's mental health, and can have severe detrimental effects on marital relationships, parenting abilities, mother-infant bonding, and infant health and development. Although Latinos are the fastest growing population group in the US, few studies of PPD have been conducted with Latina women. Existing studies suggest a significantly elevated vulnerability to PPD for low income ethnic minority women. However, the trajectories of onset and recovery have not been well- described, and little is known about the influence of cultural-ecological risk and protective factors. Further, most research has failed to consider the fundamental role of the newborn baby and the ability of mother-infant interactions to influence the onset and course of PPD. This study will evaluate a community sample of 330 low-income Mexican American first- time mothers from the prenatal period through the first postpartum year. The development of PPD and the process of recovery will be examined using well-validated symptom and clinically diagnostic measures. Culturally-ecological factors will be examined that may either confer risk or offer protection from PPD. Repeated home observations of mother-infant interactions will be collected in the critical first 6 months following childbirth. The bio-psychosocial process by which mothers and infants co-regulate each other's emotions, behavior, and physiology will be analyzed and used to predict the longitudinal course of PPD over the first year. Findings will significantly enhance understanding of the impact of culturally-relevant risk and protective factors on the onset and course of PPD in a highly vulnerable population, and will identify innovative targets (e.g., mother-infant interactions) for future interventions. PUBLIC HEALTH RELEVANCE: Postpartum mood disorders, primarily depression, affect a large number of new mothers. Estimates range from 10-15 percent in general population samples. However, striking health disparities are evident in studies evaluating low-income and/or ethnic minority mothers, for whom prevalence rates from 24-49 percent have been reported. A large research literature documents the substantial detrimental public health impact of postpartum depression, not just for women, but for their partners and children as well. According to the World Health Organization (2007), depression is the leading cause of disability worldwide, and the fourth leading contributor to worldwide burden of disease. Infants and children of mothers who are depressed, especially those experiencing social disadvantage, face considerable short and long-term disadvantage, including lower birth weight, poorer cognitive development, higher rates of behavioral and social problems, and more frequent emotional problems. In Arizona, the largest percentages of new births are to Hispanic women, of whom the majority is classified as low-income. Population birth trends in Arizona (and the US as a whole), the magnitude of the public health impact of postpartum mood disorders, and the significant mental health disparities new Hispanic mothers experience argue for the critical need for further understanding of processes affecting the development of postpartum mood disorders in low-income Mexican American women.

DESCRIPTION (provided by applicant): The consequences of postpartum depression (PPD) extend far beyond the mother's mental health, and can have severe detrimental effects on parenting abilities, mother-infant bonding, and infant health and development. Although Latinos are the fastest growing population group in the U.S., few studies of PPD have been conducted with Latina women. Existing studies suggest a significantly elevated vulnerability to PPD for low income ethnic minority women, which translates into an elevated risk for their children. However, most research has failed to consider the fundamental role of the newborn baby and the ability of mother-infant interactions to influence the onset and course of PPD, as well as the consequences for infant and child development. The parent grant for this supplemental proposal is evaluating a community sample of 330 low-income Mexican American new mothers from the prenatal period through the first postpartum year to assess the development of PPD, cultural-ecological factors that may either confer risk or offer protection from PPD, and the biopsychosocial process by which maternal depression influences and is influenced by mother-infant co-regulation of each other's emotions, behavior, and physiology. We propose to extend these aims by the addition of comprehensive measurement of infant temperament, attachment, and cognitive, emotional, and behavioral functioning through 2 years of age. This project takes the dynamic perspective that PPD influences infant development at the same time that infant development influences PPD. In short, a culturally-informed understanding of the impact of PPD on infant functioning has important reciprocal implications for the health and well-being of Mexican American new mothers. Collection of this additional data will enable a better understanding of the underlying mechanisms of PPD and its effects on mothers and infants, but also allows an extra year of data collection to better support the future submission of a proposal to longitudinally follow of this critical population with documented health disparity for PPD. PUBLIC HEALTH RELEVANCE: A large research literature documents the substantial detrimental public health impact of postpartum depression. Infants and children of mothers who are depressed, especially those experiencing social disadvantage, face considerable short and long-term disadvantage, including lower birth weight, poorer cognitive development, higher rates of behavioral and social problems, and more frequent emotional problems. Population birth trends and the significant mental health disparities new Hispanic mothers and their infants experience argue for the critical need for further understanding of processes affecting the development of postpartum mood disorders in low-income Mexican American women and the consequences for their children.

DESCRIPTION (provided by applicant): The identification of early life precursors to psychopathology in a high risk population has considerable promise for efforts to mitigate the public health burden of mental disorders. Hispanic children, members of the fastest growing ethnic group in the US, are more than twice as likely as non-Hispanic white children to be raised in poverty, and considerable research documents deleterious effects of poverty and ethnic minority status on brain development, stress physiology, development of social and emotional regulatory capacity, and lifespan mental and physical health. To better understand developmental precursors to psychopathology in very low- income ethnic minority children, we propose to capitalize on data collected by an NIMH-funded longitudinal study of Mexican American mothers and infants (Las Madres Nuevas) that addressed maternal mental health and mother-infant coregulation across the first two postpartum years. The proposed project will focus on the children from Las Madres Nuevas as they approach a critical developmental transition period (ages 3-6). We will chart trajectories of cognitive, emotional, social, and behavioral competence, with the goal of early identification and predication of points at which elevated risk for disorder emerges. Our project will focus on the emergence of self-regulatory skills from early life mother-infant coregulation as a central mechanism by which early life risk factors translate into lifespan health outcomes for low-income children. The development of self- regulatory ability is a critical foundation for lifespan mental health, but Hispanic children and children from disadvantaged environments are at risk of impaired self-regulatory skills as they enter kindergarten. Our scientific approach emphasizes the cultural embeddedness of development, with the view that child outcomes must be examined with attention to cultural forces that shape and give meaning to self-regulation and mental health. We also address the role of early life biological susceptibility in shaping children's developing regulatory skills. In combination, this project holds great potential to address central questions about cultural, biological, and environmental contributions to adaptive regulatory capacity; identify early precursors to psychopathology in a high risk ethnic group; and enhance opportunities for translation to treatment and prevention.

Project Summary Although childhood obesity is a national health problem reaching epidemic proportions, Hispanic children are nearly twice as likely as non-Hispanic white children to be obese, and Mexican Americans have higher risk of obesity than other Hispanic subgroups. Weight-associated health problems are also increasing at alarming rates. If contemporary obesity prevalence rates persist, ?the current generation of children will be the first generation in US history to be sicker and die earlier than their parents? (Robert Wood Johnson Foundation, 2012). Because the challenges of intervention are multiplied after a child has already reached obesity status, it is imperative to understand the processes of developing risk in the earliest years of life. The identification of risk and resiliency predictors of the development of obesity during critical formative years of childhood will provide specific targets amenable to preventive public health interventions. We propose to capitalize on longitudinal data collected by an NIMH and NICHD-funded study of very low income Mexican American mothers and infants (Las Madres Nuevas) that assesses a multitude of cultural and environmental risk and protective factors from the prenatal period through six years of age. We propose to leverage this existing longitudinal dataset, and collect physical health and markers of cardiometabolic risk at ages 7.5 and 9. In combination, we will: 1) Use advanced statistical procedures to chart trajectories of weight gain using objective measures of weight and growth measured at 13 time points from birth through age 9; 2) Identify critical periods from birth to age 9 at which children diverge from healthy weight gain trajectories; 3) Evaluate early life biological susceptibility as a moderator of the impact of environmental influences on child weight gain trajectories and obesity; 4) Evaluate the consequences of cultural, economic, maternal and child factors, and weight gain trajectories for emerging physical health and cardiometabolic risk. The proposed longitudinal study, with data drawn from biological measures, anthropometric measures, parent report, medical records, and observational sessions, is ideally situated to answer key questions related to weight disparities among low- income MA children, and delineate mechanistic pathways in the emergence of MA child obesity. Our scientific approach emphasizes the cultural embeddedness of obesity development, with the view that the reduction of child obesity disparities can best be accomplished by understanding sociocultural and economic forces that shape eating behavior and weight gain. This project holds great potential to address central questions about early life contributors to weight gain and obesity risk in a high risk ethnic group, and enhance opportunities for prevention of obesity and associated health problems.