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1.  Examination of concordance between maternal and youth reports in the diagnosis of pediatric bipolar disorder 
Bipolar disorders  2009;11(3):10.1111/j.1399-5618.2009.00671.x.
While concordance between mother and child report continues to be the gold standard in the assessment of pediatric bipolar disorder, uncertainty develops when a mother’s report is not endorsed by the youth. To this end we compared discordant (mother positive and youth negative) and concordant (mother and youth positive) cases.
Subjects were 98 adolescents (12–19 years of age) derived from family studies of bipolar disorder in youth who had both self-reported and mother-reported assessments. Comparisons were made between discordant (n = 35) and concordant (n = 59) cases on a wide range of clinical correlates.
Mothers in both groups reported similar rates of symptoms of mania and depression. Within the concordant group, mothers and youth reported similar rates of symptoms of mania. There were no differences between the concordant and discordant groups in onset, duration, or impairment of mania, rates of psychiatric hospitalization, cognitive variables, or rates of disorders in family members.
The similarities between discordant and concordant reports in symptomatology of mania and depression, rates of comorbidities, treatment needs, and other clinical correlates suggest that a mother-based diagnosis of mania should not be discounted in discrepant cases in which the youth fails to endorse the diagnosis.
PMCID: PMC3815595  PMID: 19419387
maternal report; pediatric bipolar disorder
2.  Neighborhood Violence and its Association with Mothers’ Health: Assessing the Relative Importance of Perceived Safety and Exposure to Violence 
This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers’ health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother’s age, child’s age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children.
PMCID: PMC2704268  PMID: 19343500
Neighborhood violence; Women’s health; Measurement
3.  Family Boundary Ambiguity and the Measurement of Family Structure: The Significance of Cohabitation 
Demography  2009;46(1):85-101.
We used data from the first wave of the National Longitudinal Study of Adolescent Health to examine family boundary ambiguity in adolescent and mother reports of family structure and found that the greater the family complexity, the more likely adolescent and mother reports of family structure were discrepant. This boundary ambiguity in reporting was most pronounced for cohabiting stepfamilies. Among mothers who reported living with a cohabiting partner, only one-third of their teenage children also reported residing in a cohabiting stepfamily. Conversely, for those adolescents who reported their family structure as a cohabiting stepfamily, just two-thirds of their mothers agreed. Levels of agreement between adolescents and mothers about residing in a two-biological-parent family, single-mother family, or married stepfamily were considerably higher. Estimates of the distribution of adolescents across family structures vary according to whether adolescent, mother, or combined reports are used. Moreover, the relationship between family structure and family processes differed depending on whose reports of family structure were used, and boundary ambiguity was associated with several key family processes. Family boundary ambiguity presents an important measurement challenge for family scholars.
PMCID: PMC2831266  PMID: 19348110
4.  Active and passive maternal smoking during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study 
In Western countries, active maternal smoking during pregnancy is recognized as the most important preventable risk factor for adverse birth outcomes. However, the effect of passive maternal smoking is less clear and has not been extensively studied. In Japan, there has been only one epidemiological study which examined the effects of active smoking during early pregnancy on birth outcomes although the effects of passive smoking were not assessed.
Study subjects were 1565 mothers with singleton pregnancies and the babies born from these pregnancies. Data on active maternal smoking status in the first, second, and third trimesters and maternal environmental tobacco smoke (ETS) exposure at home and work were collected with self-administered questionnaires.
Compared with children born to mothers who had never smoked during pregnancy, children born to mothers who had smoked throughout their pregnancy had a significantly increased risk of small-for-gestational-age (SGA) (adjusted odd ratio [OR] = 2.87; 95% confidence interval: 1.11 − 6.56). However, active maternal smoking only in the first trimester and active maternal smoking in the second and/or third trimesters but not throughout pregnancy were not significantly associated with SGA. With regard to the risk of preterm birth, the adjusted ORs for the above-mentioned three categories were not significant; however, the positive linear trend was significant (P for trend = 0.048). No significant association was found between active maternal smoking during pregnancy and the risk of low birth weight. There was a significant inverse relationship between active maternal smoking during pregnancy and birth weight; newborns of mothers who had smoked throughout pregnancy had an adjusted mean birth weight reduction of 169.6 g. When classifying babies by gender, a significant positive association between active maternal smoking throughout pregnancy and the risk of SGA was found only in male newborns, however, the interaction was not significant. Maternal ETS exposure at home or work was not significantly associated with any birth outcomes.
This is the first study in Japan to show that active maternal smoking throughout pregnancy, but not during the first trimester, is significantly associated with an increased risk of SGA and a decrease in birth weight. Thus, women who smoke should quit smoking as soon as possible after conception.
PMCID: PMC3750375  PMID: 23919433
5.  Parenting Knowledge: Experiential and Sociodemographic Factors in European American Mothers of Young Children 
Developmental psychology  2010;46(6):1677-1693.
Knowledge of childrearing and child development is relevant to parenting and the well-being of children. In a sociodemographically heterogeneous sample of 268 European American mothers of 2-year-olds, we assessed the state of mothers’ parenting knowledge, compared parenting knowledge in groups of mothers who varied in terms of parenthood and social status, and identified principal sources of mothers’ parenting knowledge in terms of social factors, parenting supports, and formal classes. On the whole, European American mothers demonstrated a fair but less than complete basic parenting knowledge, and mothers’ age, education, and rated helpfulness of written materials each uniquely contributed to their knowledge. Adult mothers scored higher than adolescent mothers, and mothers improved in their knowledge of parenting from their first to their second child (and were stable across time). No differences were found between mothers of girls and boys, mothers who varied in employment status, or between birth and adoptive mothers. The implications of variation in parenting knowledge and its sources for parenting education and clinical interactions with parents are discussed.
PMCID: PMC3412549  PMID: 20836597
6.  Emotion Regulation and Attachment: Unpacking Two Constructs and Their Association 
This study examined the association between the security of attachment and processes influencing the development of emotion regulation in young children. A sample of 73 4 1/2-year-olds and their mothers were observed in an emotion regulation probe involving mild frustration for children, and mothers and children were later independently interviewed about how the child had felt. Fewer than half the mothers agreed with children’s self-reports in the emotion they attributed to children (a lower rate than the concordance of observer ratings with children’s self-reports), and higher mother-child concordance was associated with secure attachment and mother’s beliefs about the importance of attending to and accepting their own emotions. Mother-child conversations about recent events evoking children’s negative emotion were also analyzed. Children were less likely to avoid conversing about negative feelings when they were in secure attachments and when mothers were more validating of the child’s perspective. Children’s greater understanding of negative emotions was also significantly associated with higher mother-child concordance and less child conversational avoidance. Taken together, these findings underscore the multiple influences of attachment on emotion regulation and the importance of children’s emotion understanding to these processes.
PMCID: PMC2821505  PMID: 20174446
Emotion regulation; Security of attachment; Sensitivity; Emotion understanding
7.  Smoking in Pregnancy and Parenting Stress: Maternal Psychological Symptoms and Socioeconomic Status as Potential Mediating Variables 
Nicotine & Tobacco Research  2011;13(7):532-539.
The purpose of this study was to examine the impact of smoking in pregnancy on parenting stress. Maternal psychological symptoms and socioeconomic status (SES) were evaluated as potential mediating factors between prenatal cigarette use and later parenting stress.
The sample included 218 mothers who were recruited at the hospital after birth and completed a 6-month visit with their infants at a university laboratory. Based on the mothers’ responses to interviews at the hospital on tobacco use during pregnancy, the sample included 77 nonsmokers and 141 smokers. Information on sociodemographic variables, prenatal care, and other substance use during pregnancy was collected at the hospital interview. At the 6-month visit, the mothers completed measures of parenting stress and psychological symptoms. Cotinine levels were assessed at both timepoints.
Regression analysis showed that maternal smoking during pregnancy predicted parenting stress in infancy. Maternal symptoms of psychological distress and SES were evaluated simultaneously to determine whether they functioned as mediating variables between smoking in pregnancy and parenting stress. A multiple mediation analysis (Preacher & Hayes, 2008a) showed that maternal psychological symptoms functioned as a mediating variable but that SES did not.
Results suggest that mothers who smoke in pregnancy are likely to experience higher levels of psychological symptoms, which, in turn, predict higher levels of parenting stress. Smoking in pregnancy may be a marker for symptoms of psychological distress in mothers.
PMCID: PMC3129237  PMID: 21436299
8.  Does maternal smoking during pregnancy predict the smoking patterns of young adult offspring? A birth cohort study 
Tobacco Control  2006;15(6):452-457.
To examine the association between maternal smoking during pregnancy and the development of smoking behaviour patterns among young adult offspring.
Data were from the Mater‐University of Queensland Study of Pregnancy (MUSP), a birth cohort of 7223 mothers and children enrolled in Brisbane, Australia, in 1981. The development of smoking behaviours (early or late onset, or combination of onset and prevalence patterns) among offspring at age 21 years with different patterns of maternal smoking (never smoked, smoked before or after pregnancy but not during pregnancy, or smoked during pregnancy) were compared. Maternal smoking information was derived from the prospectively collected data from the beginning of pregnancy until the child was 14 years of age. Analyses were restricted to the 3058 mothers and children whose smoking status was reported.
The proportion of young adults who smoked regularly, either with early onset or late onset, was greater among those whose mothers had smoked during pregnancy compared with those whose mothers had never smoked. The smoking patterns among those adolescent offspring whose mothers stopped smoking during pregnancy, but who then smoked at other times during the child's life, were similar to those whose mothers had never smoked. This association was robust to adjustment for a variety of potential covariates.
The findings provide some evidence for a direct effect of maternal smoking in utero on the development of smoking behaviour patterns of offspring and provide yet another incentive to persuade pregnant women not to smoke.
PMCID: PMC2563674  PMID: 17130374
9.  Maternal Smoking During Pregnancy and Intellectual Performance in Young Adult Swedish Male Offspring 
Smoking during pregnancy has been linked to an increased risk of several adverse birth outcomes. Associations with deficits in cognitive development have also been suggested. It is unclear if these associations are due to genetic and/or environmental confounding. In a population-based Swedish cohort study on 205 777 singleton males born to Nordic mothers between 1983 and 1988, we examined the association between maternal smoking during pregnancy and the risk of poor intellectual performance in young adult male offspring. In the cohort analyses, the risk of poor intellectual performance was increased in sons of smoking mothers compared to sons of non-smokers. Stratifying for maternal smoking habits across two pregnancies, there was an increased risk of poor intellectual performance for both sons if the mother was only smoking in the first pregnancy, but in neither son if the mother was only smoking in the second pregnancy. The effect of smoking during pregnancy on intellectual performance was not present when the association was evaluated within sibling pairs. Thus, the association between prenatal smoking exposure and offspring risk of low intellectual performance appears to be completely confounded by familial (genetic and early environmental) factors.
PMCID: PMC3653250  PMID: 20078833
10.  Mothers’ perceived physical health during early and middle childhood: Relations with child developmental delay and behavior problems 
The self-perceived physical health of mothers raising children with developmental delay (DD; n = 116) or typical development (TD; n = 129) was examined across child ages 3–9 years, revealing three main findings. First, mothers of children with DD experienced poorer self-rated physical health than mothers of children with TD at each age. Latent growth curve analyses indicated that mothers in the DD group experienced poorer health from age 3 but that the two groups showed similar growth across ages 3–9 years. Second, cross-lagged panel analyses supported a child-driven pathway in early childhood (ages 3–5) by which early mother-reported child behavior problems predicted poorer maternal health over time, while the reversed, health-driven path was not supported. Third, this cross-lagged path was significantly stronger in the DD group, indicating that behavior problems more strongly impact mothers’ health when children have developmental delay than when children have typical development. The health disparity between mothers of children with DD versus TD stabilizes by child age 5 and persists across early and middle childhood. Early interventions ought to focus on mothers’ well-being, both psychological and physical, in addition to child functioning.
PMCID: PMC3563844  PMID: 23306002
Children with developmental delays; maternal health; early childhood
11.  Parent-child communication and substance use among adolescents: Do father and mother communication play a different role for sons and daughters? 
Addictive behaviors  2009;35(5):426-431.
The purpose of this study was to investigate gender-specific variations in the associations between communication with father and mother, cigarette smoking, alcohol drinking and marijuana use in male and female adolescents. Cross-sectional data were collected from a national sample of 1308 tenth graders who participated in the 2005/06 U.S. HBSC. Outcome variables were self-reported substances used in the past 30 days. Logistic regression analyses controlling for race/ethnicity, family structure and socioeconomic status showed that the association of mother and father communication with adolescent substance use varied by substance and gender. Among sons, father communication was protective against marijuana use and mother communication was protective against smoking. Neither father nor mother communication were protective against substance use by daughters. Research is needed to understand gender-specific differences in correlates of adolescent substance use and the implications for prevention and intervention.
PMCID: PMC2830386  PMID: 20060651
Substance use; parent-child communication; gender difference; adolescent; risk behavior; HBSC
12.  Resemblance in dietary intakes between urban low-income African American adolescents and their mothers: The HEALTH-KIDS Study 
To examine the association and predictors of dietary intake resemblance between urban low-income African American adolescents and their mothers.
Detailed dietary data collected from 121 child-parent pairs in Chicago in Fall 2003 were used. The association was assessed using correlation coefficients, kappa, and percentage of agreement, and logistic regression models.
Overall, the association was weak as indicated by correlations and other measures. None of the mother-son correlations for nutrients and food groups were greater than 0.20. Mother-daughter pairs had stronger correlations (0.26 for energy and 0.30 for fat). The association was stronger in normal weight- than overweight or obese mothers. Logistic models showed that mother being a current smoker, giving child more pocket money, and allowing child to eat or purchase snacks without parental permission or presence predicted a higher probability of resemblance in undesirable eating patterns, such as high-energy, high-fat, and high-snack intakes (p<0.05).
Mother-child diet association was generally weak, and varied considerably across groups and intake variables in this homogenous population. Some maternal characteristics seem to affect the association.
PMCID: PMC2643250  PMID: 19103323
child; adolescent; mother; diet; African American; association; correlation
13.  Brief Report: Problem Solving and Maternal Distress at the Time of a Child's Diagnosis of Cancer in Two-Parent Versus Lone-Parent Households 
Journal of Pediatric Psychology  2009;34(8):817-821.
Objective To examine negative affectivity and problem-solving abilities for lone mothers and those who are married/partnered subsequent to a child's diagnosis with cancer. Methods Negative affectivity and problem-solving strategies were assessed for 464 mothers (87 lone and 377 married/partnered) within 2–16 weeks of their child's diagnosis with cancer. Results The two groups of mothers did not differ significantly on measures of perceived posttraumatic stress or problem-solving; lone mothers reported significantly more symptoms of depression. This difference was no longer significant when maternal education was taken into account. Conclusions Negative affectivity and problem-solving abilities were similar for lone mothers and those that are married/partnered shortly after their child has been diagnosed with cancer. Findings are discussed within the context of contemporary strategies to assess marital status as proxy variable for various underlying constructs.
PMCID: PMC2729682  PMID: 19129268
cancer; quality of life; parent stress
14.  Maternal Smoking during Pregnancy and Neonatal Behavior: A Large-Scale Community Study 
Pediatrics  2009;123(5):e842-e848.
To investigate the influence of prospectively-measured smoking during pregnancy on aspects of neonatal behavior in a large, community sample.
Patients and Methods
Participants were mothers and infants from the Providence Cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or low birthweight were excluded. The final sample included 962 mother-infant pairs, of whom 23% were African-American. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to three subscales: irritability, muscle tone, response to respiratory challenge.
Sixty-two percent of the sample reported smoking during pregnancy with 24% of smokers reporting smoking a pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than a pack per day, heavy/pack a day or more) on irritability and muscle tone in the neonate (p's<.005), with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age and race, and infant birthweight and age (p's<.001). Post hoc tests suggested particular effects of heavy smoking on increased infant irritability, but both moderate and heavy smoking exposure on increased muscle tone.
In a large, community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.
PMCID: PMC2872509  PMID: 19403478
smoking; pregnancy; infant; neonate; behavior; irritability; muscle tone
15.  Information Management Strategies Within Conversations About Cigarette Smoking: Parenting Correlates and Longitudinal Associations With Teen Smoking 
Developmental psychology  2012;49(8):1565-1578.
The present study examined smoking-specific and general parenting predictors of in vivo observed patterns of parent–adolescent discussion concerning adolescents’ cigarette smoking experiences and associations between these observed patterns and 24-month longitudinal trajectories of teen cigarette smoking behavior (nonsmokers, current experimenters, escalators). Parental solicitation, adolescent disclosure, and adolescent information management were coded from direct observations of 528 video-recorded parent–adolescent discussions about cigarette smoking with 344 teens (M age = 15.62 years) with a history of smoking experimentation (321 interactions with mothers, 207 interactions with fathers). Adolescent initiation of discussions concerning their own smoking behavior (21% of interactions) was predicted by lower levels of maternal observed disapproval of cigarette smoking and fewer teen-reported communication problems with mothers. Maternal initiation in discussions (35% of interactions) was associated with higher levels of family rules about illicit substance use. Three categories of adolescent information management (full disclosure, active secrecy, incomplete strategies) were coded by matching adolescents’ confidential self-reported smoking status with their observed spontaneous disclosures and responses to parental solicitations. Fully disclosing teens reported higher quality communication with their mothers (more open, less problematic). Teens engaged in active secrecy with their mothers when families had high levels of parental rules about illicit substance use and when mothers expressed lower levels of expectancies that their teen would smoke in the future. Adolescents were more likely to escalate their smoking over 2 years if their parents initiated the discussion of adolescent smoking behavior (solicited) and if adolescents engaged in active secrecy.
PMCID: PMC3737289  PMID: 23148939
adolescent–parent communication; disclosure; secrecy; cigarette smoking; observational research
16.  Fathers and Maternal Risk for Physical Child Abuse 
Child maltreatment  2009;14(3):277-290.
This study set out to examine father-related factors predicting maternal physical child abuse risk in a national birth cohort of 1,480 families. In-home and phone interviews were conducted with mothers when index children were 3 years old. Predictor variables included the mother–father relationship status; father demographic, economic, and psychosocial variables; and key background factors. Outcome variables included both observed and self-reported proxies of maternal physical child abuse risk. At the bivariate level, mothers married to fathers were at lower risk for most indicators of maternal physical child abuse. However, after accounting for specific fathering factors and controlling for background variables, multivariate analyses indicated that marriage washed out as a protective factor, and on two of three indicators was linked with greater maternal physical abuse risk. Regarding fathering factors linked with risk, fathers’ higher educational attainment and their positive involvement with their children most discernibly predicted lower maternal physical child abuse risk. Fathers’ economic factors played no observable role in mothers’ risk for physical child maltreatment. Such multivariate findings suggest that marriage per se does not appear to be a protective factor for maternal physical child abuse and rather it may serve as a proxy for other father-related protective factors.
PMCID: PMC2832926  PMID: 19581432
fathers; physical child abuse; marital status; maternal risk
17.  Maternal Depressive Symptoms and Child Behavior Problems among Latina Adolescent Mothers: The Buffering Effect of Mother-reported Partner Child Care Involvement 
We examined the relations between maternal depressive symptoms and child internalizing and externalizing problems in a sample of 125 adolescent Latina mothers (primarily Puerto Rican) and their toddlers. We also tested the influence of mother-reported partner child care involvement on child behavior problems and explored mother-reported partner characteristics that related to this involvement. Results suggested that maternal depressive symptoms related to child internalizing and externalizing problems when accounting for contextual risk factors. Importantly, these symptoms mediated the link between life stress and child behavior problems. Mother-reported partner child care interacted with maternal depressive symptoms for internalizing, not externalizing, problems. Specifically, depressive symptoms related less strongly to internalizing problems at higher levels of partner child care than at lower levels. Participants with younger partners, co-residing partners, and in longer romantic relationships reported higher partner child care involvement. Results are discussed considering implications for future research and interventions for mothers, their children, and their partners.
PMCID: PMC3856902  PMID: 24339474
maternal depression; child behavior; adolescent mothers; Latina; partner involvement
18.  The Effect of the Home Environment on Physical Activity and Dietary Intake in Preschool Children 
The effects of the home environment on child health behaviors related to obesity are unclear.
To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.
Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors (“junk” and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental timepoint, maternal education/work status, child body mass index and accelerometer wear-time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data was collected in North Carolina from 2007–2011.
Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced “junk” food intake scores while parental policies supporting family meals increased “junk” food intake scores.
To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child’s food intake.
PMCID: PMC3786032  PMID: 23736357
Childhood obesity; home environment; parenting; physical activity; dietary intake
19.  Adjustment Trade-Offs of Co-Rumination in Mother-Adolescent Relationships 
Journal of adolescence  2009;33(3):487-497.
The current study examined co-rumination (i.e., extensively discussing, rehashing, and speculating about problems) in the context of mother-adolescent relationships. Fifth-, eighth-, and eleventh-graders (N = 516) reported on co-rumination and more normative self-disclosure with mothers, their relationships with mothers, and their own internalizing symptoms. A subset of mothers (N = 200) reported on mother-adolescent co-rumination and self-disclosure. Results from the adolescent-report data indicated greater mother-adolescent co-rumination with daughters than sons and also adjustment trade-offs of mother-adolescent co-rumination. Mother-adolescent co-rumination was related to positive relationship quality but also to enmeshment in the relationship. Whereas the relation with positive relationship quality appeared to be due in part to normative self-disclosure, the relation with enmeshment was unique to co-rumination. Mother-adolescent co-rumination also was related to youth anxiety/depression. The relations with enmeshment and internalizing symptoms were strongest when co-rumination focused on the mothers' problems. Implications of mother-adolescent co-rumination for promoting appropriate relationship boundaries and youth well-being are discussed.
PMCID: PMC2862851  PMID: 19616839
20.  Role of Parenting Relationship Quality in Communicating about Maternal BRCA1/2 Genetic Test Results with Children 
Journal of genetic counseling  2008;17(3):283-287.
It is known that many mothers rapidly share the results of their BRCA1/2 genetic testing with their children, especially adolescent children. What is less known is the extent to which these mothers may engage fathers in a discussion concerning genetic counseling and the anticipated disclosure of genetic test results to children, or seek shared decision making in this context. This short communication addresses this issue by first examining mothers' and fathers' discussions concerning a research study of family communication. In our view, this conversation likely served as a precursor to, and proxy indicator of, maternal receptivity to partner input regarding the genetic counseling/testing-results disclosure process. We further evaluated how the quality of the parenting relationship is associated with mothers' decisions to include or not include the child's father in this study. Finally, this report addresses potential ways in which the genetic counselor may be able to facilitate parental communication regarding the evolving process of disclosure of genetic information to children and adolescents.
PMCID: PMC2495773  PMID: 18288593
BRCA1/2 testing; cancer; family communication; men; children
21.  Interactions Between the COMT Val108/158Met Polymorphism and Maternal Prenatal Smoking Predict Aggressive Behavior Outcomes 
Biological psychology  2011;87(1):99-105.
The purpose of the current study is to examine the moderating influence of the catechol O methyltransferase gene (COMT) on the maternal prenatal smoking/offspring externalizing disorder relationship. The sample consisted of 430 young adults born between 1981 and 1984 at the Mater Misericordiae Mother’s Hospital in Brisbane, Australia, as well as their mothers and peers. Mothers reported their prenatal smoking status during pregnancy, and genetic data was obtained from the youth at a later follow-up in adulthood. The outcome measures in this study were mother and teacher reports of youth attention problems and aggression at age 15, and youth, mother and peer reports of youth attention problems and aggression at age 20 (combined to create latent factors of attention problems and aggression at each age). The COMT Val108/158Met polymorphism (rs4680) significantly interacted with maternal cigarette smoking during pregnancy to predict youth aggressive behavior at ages 15 and 20. This gene-environment interaction was not significant for youth attention problems.
PMCID: PMC3081881  PMID: 21356266
prenatal; smoking; aggression; gene-environment interaction
22.  Factors influencing mother-child reports of depressive symptoms and agreement among clinically referred depressed youngsters in Hungary 
Journal of affective disorders  2006;100(1-3):143-151.
Psychiatric assessments of children typically involve two informants, the child and the parent. Understanding discordance in their reports has been of interest to clinicians and researchers. We examine differences between mothers’ and children’s report of children’s depressive symptom severity, and factors that may influence their reports and level of agreement. We hypothesized that agreement between mother and child would improve if (1) the mother is depressed, due to improved recall of mood congruent symptoms, (2) the child is older, due to better social-cognitive and communication skills, and (3) the child is a female.
Subjects were 354 children (158 girls; mean age 11.69 years, s.d.: 2.05 years) with Major Depressive Disorder. Depressive symptoms were evaluated by a semi-structured interview separately with the mother and the child. Agreement on symptom severity was based on concordance of the presence and extent of symptoms.
Maternal reports were significantly higher than their son’s but not daughters’. Girls, particularly with increasing age, reported higher levels of symptoms; however mothers’ reports were not affected by child sex or age. Maternal depression predicted more severe symptom reports for both children and mothers. Agreement between the mother and the child increased as children got older.
The same clinician interviewed the mother and the child, which might inflate rates of agreement. However, this method mirrors clinical evaluation.
During a clinical interview one must consider the age and sex of the child and the depressive state of the mother in assimilating information about the child.
PMCID: PMC2909647  PMID: 17125844
mother-child agreement; depressive symptoms; maternal depression; age; sex of child
23.  Mother’s environmental tobacco smoke exposure during pregnancy and externalizing behavior problems in children 
Neurotoxicology  2012;34:167-174.
While the impact of active maternal smoking during pregnancy on child health has been well investigated, the association between maternal passive smoking, or environmental tobacco smoke (ETS), or second-hand smoke, and behavioral development of offspring is less clear. This study examines the association between maternal ETS exposure during pregnancy and child behavior problems.
Cross-sectional data of 646 mother–child pairs from the Jintan China Cohort Study were used in the analyses. Mother’s exposure to tobacco smoking at home, the workplace, and other places during pregnancy (for the determination of maternal ETS exposure) and children’s behaviors (via Child Behavior Checklist) were assessed when the children were 5–6 years old. Logistic regression models were constructed to examine associations between maternal exposure to ETS during pregnancy and internalizing and externalizing behavior problems, adjusting for potential cofounders including child sex and parental characteristics.
37% of mothers reported ETS during pregnancy. Children of mothers exposed to ETS during pregnancy had higher scores for externalizing and total behavior problems, with 25% of children whose mothers were exposed to ETS compared to 16% of children of unexposed mothers. After adjusting for potential confounders, ETS exposure was associated with a higher risk of externalizing behavior problems in offspring of exposed mothers (OR = 2.08, 95% confidence interval [CI] 1.27–3.43). Analysis after multiple imputations and sensitivity analysis further verified the association, but no dose–response relationship was found. ETS exposure, however, was not associated with internalizing or total behavior problems.
This study suggests that maternal ETS exposure during pregnancy may impact child behavioral development, particularly externalizing behaviors.
PMCID: PMC3587028  PMID: 23178460
Environmental tobacco exposure; Second-hand smoke; Child behavior problem; Externalizing behavior; Pregnancy exposure
24.  Maternal Depressive Symptoms in Pediatric Major Depressive Disorder: Relationship to Acute Treatment Outcome 
In the present study, we assess maternal depressive symptoms at the beginning and end of treatment to investigate the possible reciprocal relationship of maternal illness with the child’s depressive illness and treatment.
We present data on 146 children and their mothers who were participating in a pediatric acute treatment study of fluoxetine. Patients were assessed with the Children’s Depression Rating Scale-Revised at baseline and at each treatment visit. Mothers completed the Quick Inventory of Depressive Symptomatology-Self Report at baseline and end of acute treatment.
Thirty percent of mothers had moderate to severe levels of depressive symptoms at the child’s baseline assessment. Overall, mothers reported improvement in maternal depressive symptoms at the end of their child’s acute treatment, although maternal depression was not specifically targeted for intervention. Furthermore, mother’s depressive symptoms appear to be associated with the child’s depression severity both at the beginning and end of treatment. Mothers with higher levels of depressive symptoms had children with higher levels of depression severity at baseline and over the course of treatment. However, maternal depressive symptoms at baseline had no association with the rate of improvement of child depression severity.
This study indicates a positive relationship between the depression severity of mothers and their children. These findings highlight potential areas of intervention in the acute treatment of childhood depression.
PMCID: PMC2826141  PMID: 18434919
maternal depressive symptoms; pediatric depression; acute treatment of pediatric depression
25.  Maternal Sadness and Adolescents' Responses to Stress in Offspring of Mothers with and without a History of Depression 
This study examined maternal sadness and adolescents' responses to stress in the offspring (n = 72) of mothers with and without a history of depression. Mothers with a history of depression reported higher levels of current depressive symptoms and exhibited greater sadness during interactions with their adolescent children than mothers without a history of depression. Similarly, adolescent children of mothers with a history of depression experienced higher rates of internalizing and externalizing symptoms than adolescents of mothers without a history of depression. Regression analyses indicated that adolescents' use of secondary control coping mediated the relationship between observed maternal sadness and adolescents' internalizing and externalizing symptoms, in that higher levels of secondary control coping (e.g., cognitive reframing) were related to fewer symptoms. Results have implications for preventive interventions with children of mothers with a history of depression.
PMCID: PMC2600864  PMID: 18991125

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