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2.  The Role of Language Ability and Self-Regulation in the Development of Inattentive-Hyperactive Behavior Problems 
Development and psychopathology  2014;27(1):221-237.
Previous research has found associations but not established mechanisms of developmental linkage between language ability and inattentive-hyperactive (I-H) behavior problems. The present study examined whether self-regulation mediates the effect of language ability on later I-H behavior problems among young children (N = 120) assessed at 30, 36, and 42 months of age. Cross-lagged panel models tested 1) the direction of effect between language ability and self-regulation and 2) longitudinal effects of language ability on later I-H problems mediated by self-regulation. Language ability was measured by children’s scores on the receptive and expressive language subtests of the Differential Ability Scales. Self-regulation was measured by three behavioral tasks requiring inhibitory control. I-H problems were reported by parents and secondary caregivers. Language ability predicted later self-regulation as measured by all three tasks. There was no association, however, between self-regulation and later language ability, suggesting that the direction of effect was stronger from language ability to later self-regulation. Moreover, the effect of language ability on later I-H behavior problems was mediated by children’s self-regulation in one of the tasks (for secondary caregivers’ but not parents’ ratings). Findings suggest that language deficits may explain later I-H behavior problems via their prediction of poorer self-regulatory skills.
PMCID: PMC4294999  PMID: 25025234
Language and verbal ability; attention deficit hyperactivity behavior problems; self-regulation; child; longitudinal
3.  [No title available] 
PMCID: PMC3898589  PMID: 24444174
4.  [No title available] 
PMCID: PMC3908929  PMID: 24280347
5.  [No title available] 
PMCID: PMC3946375  PMID: 24280373
6.  Mother-Infant Attachment and the Intergenerational Transmission of Posttraumatic Stress Disorder 
Evidence for the intergenerational transmission of posttraumatic stress disorder (PTSD) is documented in the literature, though the underlying mechanisms are poorly understood. Attachment theory provides a framework for elucidating the ways in which maternal PTSD may increase offspring PTSD vulnerability. The current study utilized two independent prospective datasets to test the hypotheses that (a) maternal PTSD increases the probability of developing an insecure mother-infant attachment relationship and (b) an insecure mother-infant attachment relationship increases the risk of developing PTSD following trauma exposure in later life. In the first study of urban, primarily low-income ethnic/racial minority mothers and infants (N = 45 dyads), elevated maternal PTSD symptoms at 6 months were associated with increased risk for an insecure, particularly disorganized, mother-infant attachment relationship at 13 months. In the second birth cohort of urban low-income mothers and children (N = 96 dyads), insecure (avoidant or resistant) attachment in infancy was associated in a dose-response manner with increased lifetime risk for a diagnosis of PTSD by adolescence. A history of disorganized attachment in infancy predicted severity of PTSD symptoms, including reexperiencing, avoidance, hyperarousal, and total symptoms, at 17.5 years. In both studies, associations between attachment and PTSD were not attributable to numerous co-occurring risk factors. The findings suggest that promoting positive mother-child relationships in early development, particularly in populations at high risk for trauma exposure, may reduce the incidence of PTSD.
PMCID: PMC4145695  PMID: 24059819
attachment; PTSD; intergenerational; maternal trauma; infant
7.  Parental Responsiveness Moderates the Association Between Early-life Stress and Reduced Telomere Length 
Development and psychopathology  2013;25(3):577-585.
Early-life stress, such as maltreatment, institutionalization, and exposure to violence, is associated with accelerated telomere shortening. Telomere shortening may thus represent a biomarker of early adversity. Previous studies have suggested that responsive parenting may protect children from the negative biological and behavioral consequences of early adversity. This study examined the role of parental responsiveness in buffering children from telomere shortening following experiences of early-life stress. We found that high-risk children had significantly shorter telomeres than low-risk children, controlling for household income, birth weight, gender, and minority status. Further, parental responsiveness moderated the association between risk and telomere length, with more responsive parenting associated with longer telomeres only among high-risk children. These findings suggest that responsive parenting may have protective benefits on telomere shortening for young children exposed to early-life stress. Accordingly, this study has important implications for early parenting interventions.
PMCID: PMC4312590  PMID: 23527512
early-life stress; telomeres; child maltreatment; maternal sensitivity; parental behavior
8.  Exposure to Maternal Pre- and Postnatal Depression and Anxiety Symptoms: Risk for Major Depression, Anxiety Disorders, and Conduct Disorder in Adolescent Offspring 
Development and psychopathology  2013;25(4 0 1):1045-1063.
This study evaluated whether exposure to maternal pre- or postnatal depression or anxiety symptoms predicted psychopathology in adolescent offspring. Growth mixture modeling was used to identify trajectories of pre- and postnatal depression and anxiety symptoms in 577 women of low socioeconomic status selected from a prenatal clinic. Logistic regression models indicated that maternal pre- and postnatal depression trajectory exposure was not associated with offspring major depression, anxiety, or conduct disorder but exposure to the high depression trajectory was associated with lower anxiety symptoms in males. Exposure to medium and high pre- and postnatal anxiety was associated with the risk of conduct disorder among offspring. Male offspring exposed to medium and high pre- and postnatal anxiety had higher odds of conduct disorder than males with low exposure levels. Females exposed to medium or high pre- and postnatal anxiety were less likely to meet conduct disorder criteria than females with lower exposure. To the best of our knowledge, this is the first study to examine the effect of pre- and postnatal anxiety trajectories on the risk of conduct disorder in offspring. These results suggest new directions for investigating the etiology of conduct disorder with a novel target for intervention.
PMCID: PMC4310683  PMID: 24229548
9.  Memory and representation in young children with Down syndrome: Exploring deferred imitation and object permanence 
Development and psychopathology  1995;7(3):393-407.
Deferred imitation and object permanence (OP) were tested in 48 young children with Down syndrome (DS), ranging from 20 to 43 months of age. Deferred imitation and high-level OP (invisible displacements) have long been held to be synchronous developments during sensory-motor “Stage 6” (18–24 months of age in unimpaired children). The results of the current study demonstrate deferred imitation in young children with DS, showing they can learn novel behaviors from observation and retain multiple models in memory. This is the first demonstration of deferred imitation in young children with DS. The average OP level passed in this sample was A-not-B, a task passed at 8–12 months of age in normally developing infants. Analyses showed that individual children who failed high-level OP (invisible displacements) could still perform deferred imitation. This indicates that deferred imitation and OP invisible displacements are not synchronous developments in children with DS. This asynchrony is compatible with new data from unimpaired children suggesting that deferred imitation and high-level OP entail separate and distinctive kinds of memory and representation.
PMCID: PMC4270267  PMID: 25530676
10.  Association between a marker for prenatal testosterone exposure and externalizing behavior problems in children 
Development and psychopathology  2012;24(3):771-782.
Prenatal androgen exposure has been associated with aggressive behavior in adults. It is less clear whether this association holds for childhood externalizing behavior. This study tests the hypothesis that increased prenatal androgen exposure is associated with aggressive behavior and attention problems in childhood. The ratio of the length of the second finger digit relative to the fourth digit, which is a marker for prenatal testosterone exposure, was assessed in 239 male and female fifth grade schoolchildren from Jintan, China, together with parent and teacher ratings of aggression and attention problems. Increased aggression and attention problems were both significantly associated with a lower ratio of the length of the second finger digit relative to the fourth digit ratios in boys but not girls. The effects remained significant after controlling for early adversity. These findings are the first to establish a relationship between an indirect indicator of fetal androgen exposure and any child psychopathology in Chinese children, and the observed effect size in boys was stronger than in male adults in Western studies. The results provide limited cross-cultural support for the importance of prenatal androgen exposure in contributing to the development of externalizing behavior problems in children, and they suggest that such effects may be specific to boys who may be relatively more vulnerable to early prenatal influences.
PMCID: PMC4247331  PMID: 22781854
11.  Maternal caregiving and girls’ depressive symptoms and antisocial behavior trajectories: An examination among high-risk youth 
Development and psychopathology  2014;26(0):1461-1475.
Past research has identified parental depression and family-of-origin maltreatment as precursors to adolescent depression and antisocial behavior. Caregiving experiences have also been identified as a factor that may ameliorate or accentuate adolescent psychopathology trajectories. Using the unique attributes of two geographically diverse, yet complementary longitudinal research designs, the present study examined the role of maternal caregiver involvement as a factor that promotes resilience-based trajectories related to depressive symptom and antisocial behaviors among adolescent girls. The first sample comprises a group of US-based adolescent girls in foster care (n = 100; mean age = 11.50 years), all of whom have had a history of childhood maltreatment and removal from the home of their biological parent(s). The second sample comprises a group of UK-based adolescent girls at high familial risk for depression (n = 145; mean age = 11.70 years), with all girls having a biological mother who has experienced recurrent depression. Study analyses examined the role of maternal caregiving on girls’ trajectories of depression and antisocial behavior, while controlling for levels of co-occurring psychopathology at each time point across the study period. Results suggest increasing trajectories of depressive symptoms, controlling for antisocial behavior, for girls at familial risk for depression, but decreasing trajectories for girls in foster care. A similar pattern of results was noted for antisocial behavior trajectories, controlling for depressive symptoms. Maternal caregiver involvement was differentially related to intercept and slope parameters in both samples. Results are discussed with respect to the identification of family level promotive factors aimed at reducing negative developmental trajectories among high-risk youth.
PMCID: PMC4244652  PMID: 25422973
Maternal caregiving; depression; antisocial behavior; foster care; trajectories
12.  Preventive Interventions and Sustained Attachment Security in Maltreated Children 
Development and psychopathology  2013;25(4 0 1):10.1017/S0954579413000278.
Thirteen-month-old maltreated infants (n = 137) and their mothers were randomly assigned to one of three conditions: child-parent psychotherapy (CPP), psychoeducational parenting intervention (PPI), and community standard (CS). A fourth group of nonmaltreated infants (n =52) and their mothers served as a normative comparison (NC) group. A prior investigation found that the CPP and PPI groups demonstrated substantial increases in secure attachment at post-intervention, whereas this change was not found in the CS and NC groups. The current investigation involved the analysis of data obtained at a follow-up assessment that occurred 12-months after the completion of treatment. At follow-up, children in the CPP group had higher rates of secure and lower rates of disorganized attachment than did children in the PPI or CS groups. Rates of disorganized attachment did not differ between the CPP and NC groups. Intention-to-treat analyses (ITT) also showed higher rates of secure attachment at follow-up in the CPP group relative to the PPI and CS groups. However, groups did not differ on disorganized attachment. Both primary and ITT analyses demonstrated that maternal reported child behavior problems did not differ among the four groups at the follow-up assessment. This is the first investigation to demonstrate sustained attachment security in maltreated children 12 months after the completion of an attachment theory-informed intervention. Findings also suggest that, while effective in the short term, parenting interventions alone may not be effective in maintaining secure attachment in children over time.
PMCID: PMC3857699  PMID: 24229539
13.  Patterns of Brain Activation in Foster Children and Nonmaltreated Children During an Inhibitory Control Task 
Development and psychopathology  2013;25(4 0 1):10.1017/S095457941300028X.
Children in foster care have often encountered a range of adverse experiences, including neglectful and/or abusive care and multiple caregiver transitions. Prior research findings suggest that such experiences negatively affect inhibitory control and the underlying neural circuitry. In the current study, event-related functional magnetic resonance imaging (fMRI) was employed during a go/no go task that assesses inhibitory control to compare the behavioral performance and brain activation of foster children and nonmaltreated children. The sample included two groups of 9- to 12-year-old children: 11 maltreated foster children and 11 nonmaltreated children living with their biological parents. There were no significant group differences on behavioral performance on the task. In contrast, patterns of brain activation differed by group. The nonmaltreated children demonstrated stronger activation than the foster children across several regions including the right anterior cingulate cortex, middle frontal gyrus, and right lingual gyrus during correct no go trials, whereas the foster children displayed stronger activation than the nonmaltreated children in the left inferior parietal lobule and right superior occipital cortex including the lingual gyrus and cuneus during incorrect no go trials. These results provide preliminary evidence that the early adversity experienced by foster children impacts the neural substrates of inhibitory control.
PMCID: PMC3831359  PMID: 24229540
foster children; functional magnetic resonance imaging (fMRI); brain activation; go/no go task; inhibitory control
14.  Stress physiology and developmental psychopathology: Past, present and future 
Development and psychopathology  2013;25(4 0 2):10.1017/S0954579413000667.
In the past 25 years research on the hypothalamic-pituitary-adrenocortical (HPA) axis has emerged as a vital area within the field of developmental psychopathology. Extensive animal research has provided knowledge of the substrates and physiological mechanisms that guide development of stress reactivity and regulation using methods that are not feasible in humans. Recent advances in understanding the anatomy and physiology of the HPA axis in humans and its interactions with other stress-mediating systems, including accurate assessment of salivary cortisol, more sophisticated neuroimaging methods, and a variety of genetic analyses, have led to greater knowledge of how psychological and biological processes impact functioning.A growing body of research on HPA axis regulation and reactivity in relation to psychopathology has drawn increased focus on the prenatal period, infancy, and the pubertal transition as potentially sensitive periods of stress system development in children. Theories such as the Allostatic Load Model have guided research by integrating multiple physiological systems and mechanisms by which stress can affect mental and physical health. However, almost none of the prominent theoretical models in stress physiology are truly developmental, and future work must incorporate how systems interact with the environment across the lifespan in both normal and atypical development. Our theoretical advancement will depend on our ability to integrate biological and psychological models. Researchers are increasingly realizing the importance of communication across disciplinary boundaries in order to understand how experiences influence neurobehavioral development. Importantly, knowledge gained over the past 25 years has been translated to both prevention and treatment interventions, and we look forward to the dissemination of interventions that promote recovery from adversity.
PMCID: PMC3869040  PMID: 24342845
Stress physiology; developmental psychopathology; HPA axis
15.  Origins of Children's Externalizing Behavior Problems in Low-Income Families: Toddlers’ Willing Stance toward their Mothers as the Missing Link 
Development and psychopathology  2013;25(4 0 1):10.1017/S0954579413000254.
Although children's active role in socialization has been long acknowledged, relevant research has typically focused on children's difficult temperament or negative behaviors that elicit coercive and adversarial processes, largely overlooking their capacity to act as positive, willing, even enthusiastic, active socialization agents. We studied the willing, receptive stance toward their mothers in 186 24-44-month-old children in a low-income sample. Confirmatory Factor Analysis supported a latent construct of willing stance, manifested as children's responsiveness to mothers in naturalistic interactions, responsive imitation in teaching contexts, and committed compliance with maternal prohibitions, all observed in the laboratory. Structural Equation Modeling analyses confirmed that ecological adversity undermined maternal responsiveness and responsiveness, in turn, was linked to children's willing stance. A compromised willing stance predicted externalizing behavior problems, assessed 10 months later, and fully mediated the links between maternal responsiveness and those outcomes. Ecological adversity had a direct, unmediated effect on internalizing behavior problems. Considering children's active role as willing, receptive agents capable of embracing parental influence can lead to a more complete understanding of detrimental mechanisms that link ecological adversity with antisocial developmental pathways. It can also inform research on the normative socialization process, consistent with the objectives of developmental psychopathology.
PMCID: PMC3887472  PMID: 24229537
16.  The Reformulation of Emotional Security Theory: The Role of Children’s Social Defense in Developmental Psychopathology 
Development and psychopathology  2013;25(4 0 2):1435-1454.
Although children’s security in the context of the interparental relationship has been identified as a key explanatory mechanism in pathways between family discord and child psychopathology, little is known about the inner workings of emotional security as a goal system. Accordingly, the objective of this paper is to describe how our reformulation of emotional security theory (EST-R) within an ethological and evolutionary framework may advance the characterization of the architecture and operation of emotional security and, in the process, cultivate sustainable growing points in developmental psychopathology. The first section of the paper describes how children’s security in the interparental relationship is organized around a distinctive behavioral system designed to defend against interpersonal threat. Building on this evolutionary foundation for emotional security, the paper offers an innovative taxonomy for identifying qualitatively different ways children try to preserve their security and its innovative implications for more precisely informing understanding of the mechanisms in pathways between family and developmental precursors and children’s trajectories of mental health. In the final section, the paper highlights the potential of EST-R to stimulate new generations of research on understanding how children defend against social threats in ecologies beyond the interparental dyad, including both familial and extrafamilial settings.
PMCID: PMC3918896  PMID: 24342849
17.  Trajectories of Multiple Adolescent Health Risk Behaviors in a Low-Income African American Population 
Development and psychopathology  2013;25(4 0 1):1155-1169.
This study examined interdependent trajectories of sexual risk, substance use, and conduct problems among 12–18 year-old African American youth who were followed annually as part of the Mobile Youth Study (MYS). We used growth-mixture modeling (GMM) to model the development of these three outcomes in the 1406 participants who met the inclusion criteria. Results indicate that there were four distinct classes: normative low risk (74.3% of sample); increasing high risk takers (11.9%); adolescent-limited conduct problems and drug risk with high risky sex (8.0%); and early experimenters (5.8%) The higher risk classes had higher rates of pregnancy and Sexually Transmitted Infections (STI) diagnoses than the normative sample at each of the ages we examined. Differing somewhat from our hypothesis, all of the non-normative classes exhibited high sexual risk behavior. While prevention efforts should be focused on addressing all three risk behaviors, the high rate of risky sexual behavior in the 25% of the sample that fall into the three non-normative classes, underscores an urgent need for improved sex education, including teen pregnancy and HIV/STI prevention, in this community.
PMCID: PMC4039413  PMID: 24229555
Adolescent; Conduct problems; Substance use; Risky sexual behavior; Growth mixture model
18.  Epigenetic mechanisms in the development of behavior: advances, challenges, and future promises of a new field 
Development and psychopathology  2013;25(4 0 2):1279-1291.
In the past decade, there have been exciting advances in the field of behavioral epigenetics that have provided new insights into a biological basis of neural and behavioral effects of gene-environment interactions. We now understand that changes in the activity of genes established through epigenetic alterations occur as a consequence of exposure to environmental adversity, social stress, and traumatic experiences. DNA methylation in particular has thus emerged as a leading candidate biological pathway linking gene-environment interactions to long-term and even multi-generational trajectories in behavioral development, including the vulnerability and resilience to psychopathology. To highlight advances concerning this theme I will first discuss what we have learned from studies using animal models with relevance to developmental psychopathology and from studies in which the translation of these findings has been made to humans. Second, I will highlight studies concerning the significance of DNA methylation alterations in outcomes associated with stress exposure later in life and dysfunction in the form of neuropsychiatric disorders. Finally, I will discuss several unanswered questions that once addressed, hold promise to advance our understanding of epigenetics both as a mechanism by which the environment can contribute to the development of psychiatric disorders and as an avenue for more effective intervention and treatment strategies.
PMCID: PMC4080409  PMID: 24342840
epigenetics; DNA methylation; psychopathology; early-life stress; trauma
19.  The developmental psychopathology of alcohol use and alcohol disorders: Research achievements and future directions 
Development and psychopathology  2013;25(4 0 2):1567-1584.
The last 25 years have seen significant advances in our conceptualization of alcohol use and alcohol use disorders within a developmental framework, along with advances in our empirical understanding that have been potentiated by advances in quantitative methods. These include advances in understanding the heterogeneity of trajectories of alcohol outcomes; new insights about early childhood antecedents, and adolescence and emerging adulthood as important developmental periods for alcohol outcomes; a more nuanced understanding of the influences of developmental transitions, and their timing and contexts; a greater appreciation for the importance of considering multiple levels of analysis (including an increasing number of genetically informative studies); a continuing focus on studying multiple pathways underlying alcohol outcomes; and an increasing focus on studying the effects of alcohol exposure on future development. The current paper reviews these advances and suggests directions for future study.
PMCID: PMC4080810  PMID: 24342856
20.  Contributions of Attachment Theory and Research: A Framework for Future Research, Translation, and Policy 
Development and psychopathology  2013;25(4 0 2):1415-1434.
Attachment theory has been generating creative and impactful research for almost half a century. In this article we focus on the documented antecedents and consequences of individual differences in infant attachment patterns, suggesting topics for further theoretical clarification, research, clinical interventions, and policy applications. We pay particular attention to the concept of cognitive “working models” and to neural and physiological mechanisms through which early attachment experiences contribute to later functioning. We consider adult caregiving behavior that predicts infant attachment patterns, and the still-mysterious “transmission gap” between parental AAI classifications and infant Strange Situation classifications. We also review connections between attachment and (a) child psychopathology, (b) neurobiology, (c) health and immune function, (d) empathy, compassion, and altruism, (e) school readiness, and (f) culture. We conclude with clinical-translational and public policy applications of attachment research that could reduce the occurrence and maintenance of insecure attachment during infancy and beyond. Our goal is to inspire researchers to continue advancing the field by finding new ways to tackle long-standing questions and by generating and testing novel hypotheses.
PMCID: PMC4085672  PMID: 24342848
21.  Coercive Family Process and Early-Onset Conduct Problems From Age 2 to School Entry 
Development and psychopathology  2014;26(4 0 1):917-932.
The emergence and persistence of conduct problems during early childhood is a robust predictor of behavior problems in school and future maladaptation. In this study we examined the reciprocal influences between observed coercive interactions between children and caregivers, oppositional and aggressive behavior, and growth in parent report of early childhood (ages 2–5) and school-age conduct problems (age 7.5 and 8.5). Participants were drawn from the Early Steps multisite randomized prevention trial that includes an ethnically diverse sample of male and female children and their families (N = 731). A parallel process growth model combining latent trajectory and cross-lagged approaches revealed the amplifying effect of observed coercive caregiver–child interactions on children's noncompliance, whereas child oppositional and aggressive behaviors did not consistently predict increased coercion. The slope and initial levels of child oppositional and aggressive behaviors and the stability of caregiver–child coercion were predictive of teacher-reported oppositional behavior at school age. Families assigned to the Family Check-Up condition had significantly steeper declines in child oppositional and aggressive behavior and moderate reductions in oppositional behavior in school and in coercion at age 3. Results were not moderated by child gender, race/ethnicity, or assignment to the intervention condition. The implications of these findings are discussed with respect to understanding the early development of conduct problems and to designing optimal strategies for reducing problem behavior in early childhood with families most in need.
PMCID: PMC4183745  PMID: 24690305
coercion; dynamic systems; microsocial analysis; oppositional defiant behavior
22.  A Matter of Timing: Developmental Theories of Romantic Involvement and Psychosocial Adjustment 
Development and psychopathology  2014;26(4 0 1):1149-1160.
The present study compared two theories of the association between romantic involvement and adjustment—a social timetable theory and a developmental task theory. We examined seven waves of longitudinal data on a community based sample of 200 participants (M age Wave 1 = 15 years, 10 months). In each wave, multiple measures of substance use, externalizing symptoms, and internalizing symptoms were gathered, typically from multiple reporters. Multilevel modeling revealed that greater levels of romantic involvement in adolescence were associated with higher levels of substance use and externalizing symptoms, but became associated with lower levels in adulthood. Similarly, having a romantic partner was associated with greater levels of substance use, externalizing symptoms, and internalizing symptoms in adolescence, but was associated with lower levels in young adulthood. The findings were not consistent with a social timetable theory, which predicts that nonnormative involvement is associated with poor adjustment. Instead, the findings are consistent with a developmental task theory which predicts that precocious romantic involvement undermines development and adaptation, but when romantic involvement becomes a salient developmental task in adulthood, it is associated with positive adjustment. Discussion focuses on the processes that may underlie the changing nature of the association between romantic involvement and adjustment.
PMCID: PMC4188828  PMID: 24703413
Romantic Relationships; Dating; Substance Use; Internalizing Symptoms; Externalizing Symptoms
23.  “I can, therefore I must”: Fragility in the upper-middle classes 
Development and psychopathology  2013;25(4 0 2):1529-1549.
We review evidence on a group recently identified as “at risk,” that is, youth in upwardly mobile, upper-middle class community contexts. These youngsters are statistically more likely than normative samples to show serious disturbance across several domains including drug and alcohol use, as well as internalizing and externalizing problems. Extant data on these problems are reviewed with attention to gender-specific patterns, presenting quantitative developmental research findings along with relevant evidence across other disciplines. In considering possible reasons for elevated maladjustment, we appraise multiple pathways, including aspects of family dynamics, peer norms, pressures at schools, and policies in higher education. All of these pathways are considered within the context of broad, exosystemic mores: the pervasive emphasis, in contemporary American culture, on maximizing personal status, and how this can threaten the well-being of individuals and of communities. We then discuss issues that warrant attention in future research. The paper concludes with suggestions for interventions at multiple levels, targeting youth, parents, educators, as well as policymakers, toward reducing pressures and maximizing positive adaptation among “privileged but pressured” youth and their families.
PMCID: PMC4215566  PMID: 24342854
24.  Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome 
Development and psychopathology  1997;9(3):473-489.
Maternal cocaine use during pregnancy can affect the infant directly through toxic effects or indirectly through cocaine’s influence on maternal psychological status. We followed 160 cocaine exposed and 56 nonexposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, infant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age of 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101 ± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychological distress was greater in cocaine using mothers. Hierarchical multiple regression was used to assess the relative effects of gestational age, maternal psychological distress, and cocaine and polydrug exposure on infant outcomes. Both psychological distress and cocaine and alcohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further support for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychological factors, which may increase child risk for poorer outcomes.
PMCID: PMC4213812  PMID: 9327234
25.  Normalizing the Development of Cortisol Regulation in Maltreated Infants Through Preventive Interventions 
Development and psychopathology  2011;23(3):789-800.
Longitudinal effects of child maltreatment on cortisol regulation in infants from age 1 to 3 years were investigated in the context of a randomized preventive intervention trial. Thirteen-month-old infants from maltreating families (N = 91) and their mothers were randomly assigned to one of three intervention conditions: 1. Child-Parent Psychotherapy (CPP); 2. Psychoeducational Parenting Intervention (PPI); and 3. a control group involving standard community services (CS). A fourth group of infants from nonmaltreating families (N = 52) and their mothers comprised a nonmaltreated comparison (NC) group. The two active interventions were combined into one maltreated intervention (MI) group for statistical analyses. Saliva samples were obtained from children at 10:00 a.m. before beginning a laboratory observation session with their mothers when the children were 13 months of age (pre-intervention), 19 months (mid-intervention), 26 months (post-intervention), and 38 months (one-year post-intervention follow-up). At the initial assessment, no significant differences among groups in morning cortisol were observed. Latent growth curve analyses examined trajectories of cortisol regulation over time. Beginning at mid-intervention, divergence was found among the groups. Whereas the MI group remained indistinguishable from the NC group across time, the CS group progressively evinced lower levels of morning cortisol, statistically differing from the MI and NC groups. Results highlight the value of psychosocial interventions for early child maltreatment in normalizing biological regulatory processes.
PMCID: PMC4191893  PMID: 21756432

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