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Early Adversity, Socioemotional Development, and Stress in Urban 1-Year-Old Children - 23/11/13

Doi : 10.1016/j.jpeds.2013.08.030 
Frederick B. Palmer, MD 1, 2, , Kanwaljeet J.S. Anand, MBBS, DPhil 1, 3, 4, J. Carolyn Graff, PhD 2, 5, Laura E. Murphy, EdD 2, 6, Yanhua Qu, PhD 7, Eszter Völgyi, PhD 7, Cynthia R. Rovnaghi, MS 1, 4, Angela Moore, MPH 7, Quynh T. Tran, PhD 7, Frances A. Tylavsky, DrPH 7
1 Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 
2 Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, TN 
3 Department of Anatomy and Neurobiology, Memphis, TN 
4 Pain Neurobiology Laboratory, College of Medicine, Memphis, TN 
5 College of Nursing, University of Tennessee Health Science Center, Memphis, TN 
6 Departments of Psychiatry, University of Tennessee Health Science Center, Memphis, TN 
7 Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 

Reprint requests: Frederick B. Palmer, MD, Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, 711 Jefferson Ave, Memphis, TN 38105.

Abstract

Objective

To determine demographic, maternal, and child factors associated with socioemotional (SE) problems and chronic stress in 1-year-old children.

Study design

This was a prospective, longitudinal, community-based study, which followed mother-infant dyads (n = 1070; representative of race, education, and income status of Memphis/Shelby County, Tennessee) from midgestation into early childhood. Child SE development was measured using the Brief Infant-Toddler Social and Emotional Assessment in all 1097 1-year-olds. Chronic stress was assessed by hair cortisol in a subsample of 1-year-olds (n = 297). Multivariate regression models were developed to predict SE problems and hair cortisol levels.

Results

More black mothers than white mothers reported SE problems in their 1-year-olds (32.9% vs 10.2%; P < .001). In multivariate regression, SE problems in blacks were predicted by lower maternal education, greater parenting stress and maternal psychological distress, and higher cyclothymic personality score. In whites, predictors of SE problems were Medicaid insurance, higher maternal depression score at 1 year, greater parenting stress and maternal psychological distress, higher dysthymic personality score, and male sex. SE problem scores were associated with higher hair cortisol levels (P = .01). Blacks had higher hair cortisol levels than whites (P < .001). In the entire subsample, increased hair cortisol levels were associated with higher parenting stress (P = .001), lower maternal depression score (P = .01), lower birth length (P < .001), and greater length at 1 year of age (P = .003).

Conclusion

Differences in maternal education, insurance, mental health, and early stress may disrupt SE development in children. Complex relationships between hair cortisol level in 1-year-olds and maternal parenting stress and depression symptoms suggest dysregulation of the child's hypothalamic-pituitary-adrenal axis.

Le texte complet de cet article est disponible en PDF.

Keyword : BITSEA, BSI, CANDLE, EPDS, HPA, SE, TEMPS


Plan


 Supported by a grant from The Urban Child Institute to the University of Tennessee Health Science Center Department of Preventive Medicine. F.P., J.G., and L.M. were supported in part by the Health Resources and Services Administration's Maternal and Child Health Bureau (MC-00038-18) and the Administration on Intellectual and Developmental Disabilities (90DD0657). K.A. was supported in part by the European Commission (FP7 Programmed-2007-4.2-1) and the Oxnard Foundation. The authors declare no conflicts of interest.


© 2013  Mosby, Inc. Tous droits réservés.
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Vol 163 - N° 6

P. 1733 - décembre 2013 Retour au numéro
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