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The study assessed conduct and emotional difficulties in a group of Romanian adoptees at age 11, and serves as a follow-up to assessments made when the children were 6 years old. It was found that there was a significant increase in emotional difficulties, but not conduct problems, for the Romanian sample since age 6. It was also found that emotional difficulty was significantly more prevalent at age 11 in the Romanian group than in a within-UK adoptee group. Emotional difficulties in the Romanian adoptee group were found to be significantly and strongly related to previous deprivation-specific problems (disinhibited attachment, cognitive impairment, inattention/overactivity and quasi-autism); however, the presence of such early problems did not account fully for the onset of later emotional problems. Five contrasting hypotheses concerning possible mediators for later onset of emotional difficulties for the Romanian group were examined. No links were found to duration of deprivation or other deprivation-related indices, stresses/difficulties in the postadoption family environment, or educational attainment and self-esteem. There was some evidence that emotion recognition might play a role in the emergence of these problems, but other measures of social competence and theory of mind showed no associations with the onset of emotional problems.

Family processes have a substantial impact on children's social and emotional well-being, but little is known about the effects of family stress on children's physical health. To begin to identify potential links between family stress and health in children, we examined associations between specific aspects of family psychosocial stress and the frequency of illnesses in children, measures of innate and adaptive immune function, and human herpesvirus 6 (HHV-6) reactivation.Prospective study of 169 ambulatory school-age children and parents. Parents completed multiple assessments of stress at 7 sequential six-month visits and maintained weekly illness diaries for their children over three years using a thermometer to record fever. Children had blood obtained for HHV-6 and immune function studies at each visit including natural killer (NK) cell function and the percentage of CD4 and CD8 cells associated with immune control of cytomegalovirus (CMV).Parental psychiatric symptoms were associated with a higher frequency of illnesses: for each 1 U increase in symptom score children had an increased 1-year rate of total illnesses of 40% (rate ratio, 1.40; 95% CI, 1.06-1.85) and febrile illnesses of 77% (rate ratio, 1.77, 95% CI, 1.00-3.13). Parental psychiatric symptom scores were also associated with enhanced NK cell function (estimate, 0.15; 95% CI, 0.05-0.26) and increased percentages of CD8+CD28-CD57+ cells in the blood of CMV seropositive children (estimate, 2.57; 95% CI, 0.36-4.79). HHV-6 reactivation was not detected.There is an association between specific psychosocial stress exposure and rates of illness and immune function in normally developing children.

Maternal stress or anxiety during pregnancy can lead to neurodevelopmental and other problems in the child, and cortisol is one possible mediator. Animal models show that maternal prenatal stress can affect placental function, including regulation of placental 11beta-HSD2, the main barrier to the placental passage of cortisol. It is not known whether a parallel process exists in humans. The aim of the current study was to determine whether maternal anxiety increases the association between maternal plasma cortisol and amniotic fluid cortisol. The sample consisted of 262 women having amniocentesis, with normal pregnancies, who completed Spielberger State and Trait anxiety scales, from whom a plasma sample and an aliquot of amniotic fluid was obtained. The correlation between maternal and amniotic fluid cortisol was strongly dependent on both State and Trait maternal anxiety; in the most anxious State quartile r(62)=.59, p

Threatening intrusive images are central to posttraumatic stress disorder. It has been suggested that intrusive imagery in the context of a sense of threat leads to the development and persistence of posttraumatic stress symptoms. This study investigates London school children's (N=76; age 10-11 years) self-reported posttraumatic stress symptoms in response to viewing the attacks of September 11, 2001 on television. Assessments were made at two time points. A minority of participants reported moderate-severe symptoms with functional impairment at 2 months (14.5%) and 6 months (9.2%) after viewing the September 11 events. After controlling for symptom stability, persistent symptoms were associated with peri-traumatic factors, notably perceiving that one's life was in danger. The combined effect of intrusive imagery and peri-traumatic life threat was associated with symptom persistence. Assessments of intrusive image content via checklist and free-report indicated that the images were directly related to September 11 and were fairly stable over time. Implications for treating children's intrusive images following stressful events are explored.

To examine the effects of prenatal stress on cognition and behavioral fearfulness in infants.Mothers were recruited at amniocentesis at Queen Charlotte's and Chelsea Hospital, London, between 2001 and 2005, and recalled when their children were 14 to 19 months to assess cognitive development using the Bayley Scales and fearfulness using the Lab-TAB. Measures of prenatal and postnatal life events and current psychological state were collected at the postnatal visit.Prenatal stress predicted both mental development (rs = -0.39, n = 123 p.0001) and observed fearfulness (rs = 0.33, n = 106, p.001); the magnitude of effect was essentially unchanged after covarying postnatal stressors, maternal education and psychological state, exposures to medications and substances during pregnancy, and birth outcomes. Prenatal stress accounted for 17% of the variance in cognitive ability and 10% of the variance in observed fearfulness. The correlation between mental development and fearfulness was minimal (r = -0.06, not significant). Prenatal partner relationship strain accounted for 73.5% and 75.0% of the prenatal stress related variance on infant cognitive and fearfulness scores, respectively.These findings strengthen previous research that suggests that fetal programming can be important for neurodevelopmental and psychiatric outcomes. They imply that the mechanisms by which mental development and fearfulness are affected are different and that prenatal stress due to relationship strain may warrant particular attention.

This study addressed the basis for the intergenerational transmission of psychosocial risk associated with maternal childhood abuse in relation to offspring adjustment. The study tested how far group differences in individual change in adjustment over time were explained by differences in exposure to specific environmental risk experiences. Data are drawn from the Avon Longitudinal Study of Parents and Children. Information on mothers' own experience of childhood abuse, offspring adjustment at ages 4 and 7 years, and hypothesized mediators was available for 5,619 families. A residuals scores analysis was used to track children's adjustment over time. Maternal childhood abuse was associated with poorer behavioral trajectories between ages 4 and 7 years. Children of abused mothers were more likely to experience a range of negative life events between ages 4 and 7 years, including changes in family composition, separations from parents, "shocks and frights" and physical assaults. Interim life events, together with antecedent psychosocial risk (maternal antenatal affective symptoms, age 4 parental hostility, age 4 family type) fully mediated the association between maternal childhood abuse and offspring prognosis.The authors express their gratitude to the families who participated in the study. Support for these analyses was provided by a grant from the Medical Research Council. The Avon Longitudinal Study of Parents and Children (ALSPAC) is part of the World Health Organisation initiated European Study of Pregnancy and Childhood, and is supported, among others, by the Wellcome Trust, The Department of Health, The Department of the Environment, and the Medical Research Council. The ALSPAC study team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers, and managers who continue to make the study possible.

Background: disinhibited attachment is an important sequel of an institutional rearing, but questions remain regarding its measurement, its persistence, the specificity of the association with institutional rearing and on whether or not it constitutes a meaningful disorder. Method: children initially reared in profoundly depriving institutions in Romania and subsequently adopted into UK families were compared with respect to findings at 11 years with children who had not experienced institutional deprivation and who had been adopted within the UK before the age of 6 months. Measures included parental reports, a Strange Situation procedure modified for use in the home and systematic standardised investigator ratings of the children's behaviour. Results: disinhibited attachment, as reported by parents, showed a high degree of persistence from 6 to 11, but also a reduction over time in its frequency. Investigator ratings validated the parental reports but suggested that much of the fall in rate of disinhibited attachment was a function of the parental measure being less developmentally appropriate at 11 than it had been at 6. Disinhibited attachment was strongly associated with institutional rearing but there was not a significant increase in relation to duration of institutional deprivation beyond the age of 6 months. Mild, but not marked, disinhibited attachment was quite frequent in non-institutionalised adopted children but both the course and correlates indicated that its meaning was probably quite different. In the institution-reared children, disinhibited attachment was associated with a marked increase in service usage and associations with other forms of psychopathology. Conclusions: disinhibited attachment constitutes a valid, and handicapping, clinical pattern that is strongly associated with an institutional rearing.

Change in maternal report of sibling negativity was investigated in 313 sibling dyads from 171 families taking part in a longitudinal, general population survey in the United Kingdom. The inclusion of multiple dyads per family allowed for the emergence of 3 novel elements for sibling research: an examination of within-family similarity on sibling relationship quality, modeling within-family similarity as a function of the shared environment and the differentiation of family-wide and dyad-specific predictors. Moderate similarity on sibling negativity was found across different sibling dyads and similarity was higher in 2 versus lone-parent families. Maternal negativity, genetic relatedness, age of the oldest child in the dyad, and the interaction between lone-parent status and maternal differential treatment were found to predict change in sibling negativity.

Recent studies provide a wealth of findings on the mechanisms by which early stress exposure, particularly within the early child-parent attachment relationship, may influence long-term adaptation. Translating these findings to clinical practice and social policy is now underway. In this review, some key considerations in this translational task are examined, specifically, the conceptual bases underlying the research designs, the putative mechanisms involved, and the degree to which currently available findings might shape interventions. Although the primary focus is on depression, a broader range of phenotypes associated with poor early caregiving environments is also considered.

Background Previous studies suggest that separation is a major stressful life event that is linked with marked increases in depressive symptoms. Little is known, however, about the sources of variation in depressive symptoms following separation. Method This study examines factors moderating the effect of separation on depressive symptoms in women participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, longitudinal study of a large community sample in the west of England. Data on marital/partner status, depression, and hypothesized moderating factors were available on women (n = 8264), assessed on two occasions approximately 12 months apart. Results Over this 1-year period, 2.7% of women experienced a separation. As expected, those who experienced a separation between assessment periods reported, on average, a significant increase in depressive symptoms, approximately 0.25 of a S.D. However, there were marked individual differences in response to separation, with 56.1% showing a increase of 0.5 S.D. or more and 21.0% showing an decrease of 0.5 S.D. or more in depressive symptoms following separation. Regression analyses identified several factors that moderated response to separation; specifically, the effect of separation on depressive symptoms was less for women who were in a cohabiting (non-marital) relationship and for women who experienced elevated marital conflict prior to separation. Conclusion The results underscore the wide variation in responses to separation and document the need to consider context in interpreting the effects of major life events on depressive symptoms.

Children who have experienced parental separation have potentially 3 sets of parents whose relationships may impact on them: mother and former partner, mother and stepfather, and father and new partner. Children's accounts of their response to conflict between these different parental dyads were studied, in relation to the quality of their relationships with these parents assessed with child interviews and questionnaires, and to maternal reports of the children's adjustment, in a sample of 159 children growing up in different family settings. Involvement in conflict within 1 parental dyad was chiefly unrelated to such involvement in conflict between the other parental dyads. In contrast, there was evidence for "spillover" effects in relationships within families; for instance, high frequencies of conflict between parents were linked to more troubled parent-child relationships. Children were more likely to side with the parent to whom they were biologically related than with stepparents. Involvement in mother-nonresident father conflict and in mother-stepfather conflict were both associated with adjustment problems, independent of the qualities of positivity and conflict in the relationship between child and parent. Implications for views on "family boundaries" are considered.

Background: The area of child custody assessments continues to fail to meet the evidence-based threshold now established in clinical practice. This is despite the existence, for many years, of published guidelines governing the practice of custody assessments available from a number of professional bodies. Methods: This article reviews the potential of attachment theory to contribute to the conceptualization of custody evaluations, clinical assessment, and the development of evidence-based practice. Particular attention is paid to specific instruments used to assess attachment in clinic and non-clinic settings. Results: Guidelines concerning child custody assessments highlight the particular importance of assessing attachment and parent‐child relationship quality. However, measures often used in the course of a custody assessment are not backed up with empirical research, and the measures that are supported by empirical research have been slow to influence practice. There may be conceptual and measurement advantages of considering an attachment research-informed custody assessment. Discussion: Attachment theory has obvious conceptual relevance for the child custody context. Further clinical research is needed to demonstrate the usefulness of attachment research measures; research of this kind may shed important light on the development and resilience of affectional bonds. Keywords: Attachment, custody evaluation, assessment. Evidence-based practice has come to be accepted as a standard to be achieved in the practice of psychiatry and psychology. Application to child and adolescent mental health services is no exception, although it is recognized that progress in this area is just beginning (Ramchandani, Joughlin, & Zwi, 2001). Progress in achieving the evidence-based standard in forensic child and adolescent mental health has been slower still. In particular, despite many years of clinical experience and despite the existence of practice guidelines from many professional bodies, most clinicians would readily accept thatthereisapaucityofrelevantresearchevidenceon which to base the practice of child custody evaluations. 1 This is all the more relevant given that the courts are moving from a sociologically based view of truth (‘Truth is what experts in the field believe’) towards a method-based view (‘Truth is what is discovered through the appropriate application of scientific methods’; Galatzer-Levy & Ostrov, 1999). The aims of this article are to 1) review briefly guidelines concerning custody (or residence) determination and the role that attachment theory has come to play, 2) discuss the factors that may determine the custody decision, particularly the role of psychological input, 3) consider the potential of attachment theory for informing practice by reviewing clinical and research assessment strategies and evaluating how attachment theory has been integrated so far, and 4) provide practical recommendations for developing an attachment-oriented evidence-based model of custody evaluation.

It is clear that postnatal maternal depression can impair maternal care and may be associated with delayed social, behavioral, cognitive, and physical development in growing children. There also is evidence that adolescent children of depressed fathers are likelier to experience psychopathology. This longitudinal cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), postulated that paternal depression postnatally would be associated with a heightened risk of behavioral and emotional problems at age 3.5 years. Participants included 13,351 mothers and 12,884 fathers, all of them evaluated 8 weeks postnatally using the Edinburgh Postnatal Depression Scale (EPDS). The fathers were again assessed when their children were 21 months old. The Ruttter revised preschool scales served to measure children's emotional and behavioral development. Relevant information was available for 8431 fathers, 11,833 mothers, and 10,024 children. The likelihood of remaining in the study after 42 months was lessened by a high degree of symptomatic depression in mothers but not in fathers. EPDS scores for mothers and fathers correlated to a significant degree. Paternal depression correlated closely with higher total problem scores on the Rutter preschool scales. Emotional, conduct, and hyperactivity scores exhibited this association but prosocial behavior scores did not. Significant associations remained after adjusting for social class, degree of education, and maternal depression. Controlling for paternal depression at 21 months postnatally, postnatal paternal depression correlated with later conduct problems and also with hyperactivity. Maternal depression was associated with increased total scores on the Rutter preschool scales. The association between paternal depression and later behavioral problems was stronger in boys than in girls. Paternal depression correlated only with increased problems in boys. Apart from postpartum maternal depression, paternal depression in the postnatal period is associated with a higher risk of behavioral problems at age 3.5 years. It seems likely that effective interventions for paternal depression would lessen its adverse effects on subsequent childhood development, particularly in boys.

Readers will now be familiar with the notion of 'translational research'. According to its generally acknowledged progenitor, the National Institutes of Health (NIH) in the US, this is a kind of research agenda focused on translating or applying the research findings from basic/preclinical studies to human studies and perhaps most especially treatment trials; and, the translation of clinical research findings to the community so that evidence-based best practice is adopted.

Studies showing the effectiveness of cognitive behavioural therapy (CBT) for children have proliferated in recent years. Findings from these investigations provide clear evidence that CBT is an effective clinical tool for treating some of the more common psychological disorders in children and adolescence, principally anxiety and depression (Kendall, 1985; Harrington et al., 1998). Given that this first essential hurdle has been cleared, attention can now be directed towards two follow-on questions: what are the mechanisms underlying effective treatment and how do we understand the inevitable variation in treatment response? This chapter addresses these latter questions by appealing to developmental theory and research relevant to social cognitions and psychological disorders in children and adolescence. The aims of the chapter are to outline why a developmental model of CBT is needed and how one might be constructed; to review illustrative findings from research on children's social cognitions and the extent to which CBT with children is informed by this research; to identify some of the obstacles blocking greater synthesis of developmental and clinical research relevant to CBT with children; and to draw implications for assessment and interventions.

Animal studies suggest that prenatal stress is associated with long-term disturbance in hypothalamic-pituitary-adrenal (HPA) axis function, but evidence in humans is lacking. This study examined the long-term association between prenatal anxiety and measures of diurnal cortisol at age 10 years.Measures of cortisol were collected at awakening, 30 min after awakening, and at 4 pm and 9 pm on 3 consecutive days in a sample of 10-year-olds (n = 74) from the Avon Longitudinal Study of Parents and Children, a prospective longitudinal cohort study of mothers and children on whom measures of anxiety and depression were collected in pregnancy and the postpartum period. Analyses examined the links between symptoms of prenatal anxiety and multiple indicators of cortisol, an index of HPA axis functioning.Prenatal anxiety was significantly associated with individual differences in awakening and afternoon cortisol after accounting for obstetric and sociodemographic risk (partial correlations were .32 and .25, p.05). The effect for awakening cortisol remained significant after controlling for multiple postnatal assessments of maternal anxiety and depression.This study provides the first human evidence that prenatal anxiety might have lasting effects on HPA axis functioning in the child and that prenatal anxiety might constitute a mechanism for an increased vulnerability to psychopathology in children and adolescents.

Research findings show that there is marked variability in children's response to parental separation, but few studies identify the sources of this variation. This prospective longitudinal study examines the factors modifying children's adjustment to parental separation in a community sample of 5,635 families in England. Children's behavioral/emotional problems were assessed when children were aged 47 and 81 months; marital quality, maternal depression, socioeconomic circumstances, and demographic variables were assessed prior to the separation from maternal report. Results indicated that 346 mothers separated from their partners in the 3-year period. Preseparation differences were found for measures of family process and parent risk factors, with effect sizes ranging from small to trivial. Parental separation was associated with a significant but modest increase in behavioral/emotional problems, independent of marital quality, maternal depression, socioeconomic circumstances, and demographic variables. Moderation analyses showed that children of cohabiting parents had a greater increase in adjustment problems following parental separation than children of married parents. Further research elucidating the factors that moderate children's adjustment to parental separation is needed to improve our understanding of who may most likely benefit from preventive interventions.

Objective To examine the etiologies of covariation of childhood sleep problems and other behavioral/emotional problems in young children. Method The parents of more than 6,000 twin pairs provided information on their twins’ anxiety, conduct, and hyperactivity at ages 3, 4, and 7 by completing the Strengths and Difficulties Questionnaire. Information on sleep problems was obtained at age 3/4. Results Phenotypic correlations in preschool years between sleep problems and anxiety, conduct, and hyperactivity ranged from 0.17 to 0.22. These correlations were largely due to shared environmental factors (0.72–0.96) and less to heredity (0.05–0.26) and nonshared environment (0.00–0.06). Sleep problems at age 3/4 years predicted at age 7 years anxiety (β = .12, p < .001), conduct problems (β = .09, p < .001), and hyperactivity (β = .07, p < .001), after accounting for stability of these problems. These predictive associations were also mainly mediated by shared environment (0.16–0.91), although genetic (0.02–0.84) and nonshared environmental (−0.03–0.09) factors were also influential. Conclusions The modest associations between early sleep problems and later behavioral/emotional problems are largely accounted for by common psychosocial risk factors. Further research on which specific risks may mediate these connections is needed.

Background: Children’s relationships with their nonresident fathers, and associations between these relationships, children’s relationships with mothers and stepfathers, and the children’s adjustment were studied in 162 children from single-parent and stepfamilies, selected from a representative community sample in the UK, studied at 2 time points two years apart. Method: Children were interviewed about their relationships with their nonresident fathers, mothers and stepfathers; mothers reported on children’s adjustment, and other family variables. Results: Positive child–nonresident father relationships were correlated with (a) contact between child and father, (b) the quality of the mother–child relationship, and (c) the frequency of contact between the mother and her former partner. Conflict between child and father was correlated with conflict between child and mother, and child and stepfather. Child–nonresident father contact and relationships were stable over 2 years, and related to children’s adjustment; these associations were stronger for children from single-parent families than for those with stepfathers, and for those whose mothers had been first pregnant as teenagers. Conclusions: Associations between the quality of children’s relationships with nonresident fathers and their adjustment need to be considered within the framework of the larger family system; child–father relationships are particularly important for children from high risk families. Keywords: Child Behavior Checklist, divorce, fathers, mothers, parent–child relationships, separation. Abbreviations: ALSPAC: Avon Longitudinal Study of Parents and Children; CBCL: Child Behavior Checklist. Increasing numbers of children experience separation of their parents; the great majority of these children then live primarily with their mothers, and may subsequently live with a stepfather as a result of their mothers new partnership. The risks of problems in children’s adjustment following these family transitions is substantially increased; however, individual variation in children’s outcomes following parental separation and stepfamily formation is great. The family factors and socio-economic adversities associated with these individual differences in adjustment outcome have been investigated widely (for reviews see Pryor & Rodgers, 2001; Hetherington & Stanley-Hagan, 1999). One feature of children’s family lives which may contribute to this variation concerns their relationships with the fathers who do not live with them. What are the links between the children’s accounts of their relationships with their nonresident fathers, and their experiences and relationships with their mothers and stepfathers? Does the quality of their relationships with their

From middle childhood onwards, substantial evidence points to phenotypic differentiation between anxiety diagnostic categories such as generalised anxiety, separation anxiety, specific phobia, and obsessive-compulsive disorders. However, little is known about the genetics of these categories and especially about the phenotypic and genetic structure of related behaviours in pre-school children.We examined the phenotypic differentiation and genetics of mother-reported anxiety-related behaviours in 4,564 four-year-old twin pairs, from a population-based sample.Confirmatory factor analyses provided support for five correlated factors: General Distress, Separation Anxiety, Fears, Obsessive-Compulsive Behaviours, and Shyness/Inhibition. Genetic influences were found on all five factors, but the pattern of influences differed considerably across them, with particularly high heritability estimates for Obsessive-Compulsive Behaviours and Shyness/Inhibition, and substantial shared environmental influence on Separation Anxiety. Multivariate genetic analyses revealed moderate genetic correlations between the five factors. Genetic overlap was particularly pronounced between General Distress and the other anxiety-related behaviours, accounting for about half of their covariance. Genetic variance on Obsessive-Compulsive Behaviours was the least correlated with the other scales. The shared environmental influences correlated highly across the factors, accounting for the greatest proportion of covariation between Separation Anxiety, Fears and Obsessive-Compulsive Behaviours. The non-shared environment influences were largely variable specific.These data provide evidence for phenotypic and genetic overlap as well as differentiation between aspects of anxiety-related behaviours in young children. We conclude that research with young children will benefit from more specific assessments of anxiety-related behaviours in addition to less differentiated assessments of 'internalising' symptoms.

Understanding the processes by which genetic risks lead to psychopathology is a key conceptual and methodological task for research. The current study, based on an at-risk adoption design, examines the hypothesis that the effect of genetic risk on children's behavioral/emotional problems and social adjustment is moderated by psychosocial risk, specifically parental separation.Data are based on the Colorado Adoption Project. One hundred and seventy-one adoptees, all of whom were placed in the adoptive home in early infancy, were assessed using a multi-method strategy at 12 years of age. Adoptees' adjustment was measured using parent and 'teacher reports on the Child Behavioral Checklist as well as observer ratings of social competence; all raters were blind to the biological background of the adoptee. Genetic risk was indexed by biological parents' self-reports of negative emotionality, which was completed prior to the adoption.By age 12 years, 23 of the 171 adoptees experienced a separation in the adoptive home. Correlation and regression analyses indicated that the association between genetic risk and child adjustment was moderated by parental separation. In the absence of parental separation, genetic risk was uncorrelated with adoptee adjustment; however, there were substantial and significant associations between individual differences in genetic diathesis and poor adjustment among the adoptees who experienced parental separation.The association between parental separation and children's behavioral/ emotional and social adjustment may not be entirely environmental in origin. Genetic vulnerability is accentuated by major psychosocial stresses, and this may partly explain the wide individual differences in children's adjustment to family transitions.

The aim of this special issue is to examine methods for assessing and treating attachment disorders. This target article outlines existing strategies for assessment and considers which aspects of severe attachment disturbances and disorders may be core features of the disturbance(s). The usefulness of alternative methodologies for assessment are discussed, with particular emphasis on the need for the development of clinical protocol. The applications and implications for treatment are then discussed, with particular emphasis on the nature of the underlying disturbances that should be a focus for intervention. An absence of established treatment guidelines or consensus regarding the mechanisms of change are highlighted as barriers to further progress.

(2003). Current perspectives on attachment disorders: Rejoinder and synthesis. Attachment & Human Development: Vol. 5, No. 3, pp. 321-326.

This article examines the role of the shared family context in understanding differential parental treatment of children. Child-specific and family-context predictors of differential parental positivity and negativity were examined using multilevel modeling in a population of 8,476 children nested in 3,762 families. Child age was the strongest child-specific predictor of positivity and differential positivity. Lower socioeconomic status (SES), marital dissatisfaction, and larger family size were associated with higher levels of differential positivity. There was evidence of potentiation when risks were combined. Children's temperament was associated with parental negativity and differential negativity. The strength of this association was moderated by SES. Mixed-gender sibships in families with marital dissatisfaction and children in single-parent families received the highest levels of differential negativity. The findings are discussed in the context of shared and nonshared environmental influences on development.

Objective: To investigate links between child sexual abuse (occurring before 13 years), later mental health, family organization, parenting behaviors, and adjustment in offspring. Method: The present study investigates a subsample of the Avon Longitudinal Study of Parents and Children an ongoing study of women and their families in the area of Avon, England. A sample of 8292 families met inclusion criteria for identifiable family type and completed self-report data on prior sexual assault. Further data were collected on life course variables, socioeconomic variables, psychological well-being, relationship quality, parent-child relationship quality, and children’s adjustment. Results: After adjustment for other childhood adversity, prior child sexual abuse was associated with a range of outcomes in adulthood, including current membership of a nontraditional family type (single mother and stepfather) poorer psychological well-being, teenage pregnancy, parenting behaviors, and adjustment problems in the victim’s later offspring. The relationship of child sexual abuse with aspects of the parent-child relationship in later life and with the offspring’s adjustment difficulties were mediated in part by mother’s mental health—chiefly anxiety. Conclusion: Findings indicate that child sexual abuse has long-term repercussions for adult mental health, parenting relationships, and child adjustment in the succeeding generation.

Animal experiments suggest that maternal stress and anxiety during pregnancy have long-term effects on the behaviour of the offspring.To test the hypothesis that antenatal maternal anxiety predicts behavioural problems at age 4 years.Data were collected on multiple antenatal and postnatal assessments of maternal anxiety and depression, antenatal and obstetric risks, psychosocial risks and children's behavioural/emotional problems (n=7448).Antenatal maternal anxiety predicted behavioural/emotional problems in boys (OR=2.14, 95% CI 1.48-3.10) and girls (OR=1.88, 95% CI 1.3-2.69) after accounting for covariates. When covarying maternal anxiety up to 33 months postnatally, antenatal anxiety continued to predict total problems in boys (OR=1.56, 95% CI 1.02-2.41) and girls (OR=1.51, 95% CI 1.22-2.81).There could be a direct effect of maternal mood on foetal brain development, which affects the behavioural development of the child.

Observed parent–adolescent autonomy struggles were assessed as potential predictors of the development of peer-rated hostility over a decade later in young adulthood in both normal and previously psychiatrically hospitalized groups of adolescents. Longitudinal, multireporter data were obtained by coding family interactions involving 83 adolescents and their parents at age 16 years and then obtaining ratings by close friends of adolescents' hostility at age 25 years. Fathers' behavior undermining adolescents' autonomy in interactions at age 16 years were predictive of adolescents-as-young-adults' hostility, as rated by close friends at age 25 years. These predictions contributed additional variance to understanding young adult hostility even after accounting for concurrent levels of adolescent hostility at age 16 years and paternal hostility at this age, each of which also significantly contributed to predicting future hostility. Results are discussed as highlighting a pathway by which difficulties attaining autonomy in adolescence may presage the development of long-term difficulties in social functioning.

Introduction Pregnancy may cause somatic alterations and possible transformation in women's behaviour, emotions and cognition. Objective To analyse monthly somatic and cognitive changes in pregnancy. Aims To examine the pattern of cognitive (depressed mood, lack of self-esteem, guilt, lack of concentration, sensitivity to criticism, thoughts of death) and somatic (decreased energy, feelings of heavy limbs and feeling worse in the morning) symptoms throughout the 9 months of pregnancy. Methods N=374 women were interviewed once (6 weeks postnatal) using a modified version of the Structured Clinical Interview for DSM IV. Women were asked whether they had experienced each symptom at any time during pregnancy and if they said yes, the monthly symptom occurrence was assessed. Repeated measures General Linear Model analysis was used. Results There were both linear (a) and quadratic (b) significant changes over time for sensitivity to criticism (Fa=20.9(1), Fb=7.02(1), pa,b=0.00), lack of concentration (Fa=37.0(1); Fb=10.3(1); pa,b=0.00), decreased energy (Fa=13.4(1), Fb=62.6(1); pa,b=0.00) and feelings of heavy limbs(Fa=92.9(1), Fb=67.7(1) pa,b=0.00). Guilt (F=0.00(1); p=0.93) showed no change over pregnancy, lack of self-esteem (F=10.15(1); p= 0.00) showed linear significance while depressed mood (F=5.15(1); p= 0.02) showed quadratic significance. After controlling for covariates, no significant interactions between them and all symptoms were found. Conclusion Cognitive symptoms changed throughout pregnancy as much as somatic symptoms. Most symptoms showed a different pattern from depressed mood (Figure 1). Sensitivity to criticism, lack of concentration, feelings of heavy limbs and decreased energy were especially high during late pregnancy. Download : Download full-size image Figure 1 . Depression pattern through 9 months of pregnancy

BackgroundChildren in stepfamilies and single-parent families exhibit elevated levels of behavioural and emotional problems compared with children in intact (biological) families, but there is variation within and across these family types.AimsTo examine the sources of variation in children's behavioural and emotional problems across diverse family settings.MethodLevels of behavioural and emotional problems in children from diverse stepfamilies and single-parent families were compared with children living with both biological parents. Psychosocial risks were measured at the individual child and family levels.ResultsBehavioural and emotional problems were elevated in children in stepmother/complex stepfamilies and single-parent families, but not in simple stepfather families, relative to ‘biological’ families. Psychopathology associated with family type was explained by compromised quality of the parent–child relationship, parental depression and socio-economic adversity. Sibling similarity in behavioural and emotional problems was most pronounced in high-risk family settings.ConclusionsFamily type is a proxy for exposure to psychosocial risks; the extent of family-wide influence on children's development may be strongest in high-stress settings.

Importance Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention. Objective To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. Design, Setting, and Participants Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring. Main Outcomes and Measures Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision . Results Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression. Conclusions and Relevance The findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.

Parent-child dyadic mutuality (shared positive affect, responsiveness, and cooperation) is an important component of family socialization processes. This study sought to extend previous research on mutuality by using a quantitative genetic design to examine between- and within-family variations (e.g., sibling differences) and gene-environment processes. The first study included 125 pairs of identical and same-sex fraternal 3-year-old twins. Observations of mutuality and parents' and observers' ratings of family environment and child behavior were gathered. Greater mutuality was associated with higher socioeconomic status. Moderate sibling similarity in parent-child mutuality was accounted for by child genetic similarity, suggesting evocative gene-environment correlation and nonshared environmental processes. These findings were replicated in a 2nd study of 102 pairs of adoptive and biological siblings.

Recent reviews of research on child and adolescent psychopathology have highlighted the consistently high rates of co-occurring dimensions of psychopathology, particularly between internalizing and externalizing disorders, and have suggested that further research examining the causes of co-occurring syndromes is needed. The authors examined this question in a national sample of 720 same-sex adolescent siblings between 10 and 18 years of age consisting of monozygotic and dizygotic twins, full siblings, half siblings, and unrelated siblings. Composite measures of adolescent and parent reports and observational measures of depressive symptoms and antisocial behavior were subjected to behavioral genetic models that examine the genetic and environmental influences on individual differences in each dimension as well as in the co-occurrence between dimensions. Results indicated that approximately half of the variability in depressive symptoms and antisocial behavior is attributed to genetic factors; shared and nonshared environmental influences were also significant. The co-occurrence of depressive and antisocial symptoms was explained by genetic and shared and nonshared environmental influences. Specifically, approximately 45% of the observed covariation between depressive and antisocial symptoms could be explained by a common genetic liability. Results are interpreted in light of contribution of genetic studies to debates on child and adolescent psychopathology.

This study examined links between processes of establishing autonomy and relatedness in adolescent-family interactions and adolescents' psychosocial development. Adolescents in 2-parent families and their parents were observed in a revealed-differences interaction task when adolescents were 14, and adolescents' ego development and self-esteem were assessed at both 14 and 16. Developmental indices were strongly related to autonomy and relatedness displayed by both parents and adolescents. Significant variance was explained even after accounting for the number and quality of speeches of each family member as rated by a different, well-validated family coding system. Increases in adolescents' ego development and self-esteem over time were predicted by fathers' behaviors challenging adolescents' autonomy and relatedness, but only when these occurred in the context of fathers' overall display of autonomous-relatedness with the adolescent. The importance of the mutually negotiated process of adolescents' exploration from the secure base of parental relationships is discussed.

In a large twin study Minnis et al ([2007][1]) have demonstrated that attachment disorder behaviours can be differentiated from other common childhood emotional and behavioural disorders and appear to be strongly genetically influenced, particularly in boys. The authors also point out that, even in

Introduction: There is growing evidence that prenatal maternal stress is associated with poorer behavioural [1] and cognitive [2] development in the child. What has not been established is whether this is because antenatal stress has a direct effect on the fetus. Animal models indicate that prenatal stress can have a long-term effect on the neuroendocrine stress response in the offspring, specifically the HPA axis [3], although other possible mechanisms include genetic predisposition or postnatal effects mediated by parenting. What is also unclear is the nature of the antenatal stress that is most harmful for child outcomes. We are conducting a study aiming to examine the association between maternal antenatal and postnatal stress and infant cognitive and behavioural development, and to explore possible mediating hormonal mechanisms. Here we present infant outcomes in relation to maternal stress during pregnancy and in the postnatal period. Methods: Women were originally recruited from an amniocentesis clinic, after obtaining written consent. Mothers completed a 26-item questionnaire relating to antenatal and postnatal stressful life events [4]. A trained developmental researcher administered the Bayley Scales of Infant Development (Second Edition) assessing mental (MDI) and motor (PDI) development. The study was approved by the local research ethics committee and is funded by the March of Dimes. Results: Seventy women returned for assessments when their child was about 18 months old ([mean±S.D.] 17.4± 1.1 months). English was the first language in the family and the children (32 girls and 36 boys) were all born at full term (>37 weeks; [mean±S.D.] 39.49±1.26 weeks) and had no clinical problems. Two mothers and babies were excluded because of insufficient English. There was a significant correlation between the total number of stressful life events in the antenatal period and infant MDI [Spearman's correlation (rs)=−0.43, p

Objective. To investigate whether family type and psychosocial risks indexed by family type were systematically associated with differences in health outcomes in children. Design and Subjects. The study is based on a longitudinal, prospective study of a large (n = ∼10 000) community sample of families, the Avon Longitudinal Study of Pregnancy and Childhood. Main Outcome Measures. Frequency of accidents, illnesses, and medical interventions. Results. At 2 years of age, children in single-parent and stepfamilies were disproportionately likely to experience accidents and receive medical treatment for physical illnesses. In addition, children in single-parent families and stepfamilies were more likely to be hospitalized or receive attention from a hospital doctor for an injury or illness. Exposure to psychosocial risks also were elevated in single-parent families and stepfamilies, compared with intact or nonstepfamilies, and these factors primarily accounted for the connection between family type and children's physical health. Conclusions. The consequences of family transitions on children's health extend beyond traditional mental health and behavioral outcomes and include accident proneness, illness, and receipt of medical attention. The mediating processes are not entirely attributable to social class differences connected to family type and may instead be associated with a range of psychosocial risks that are more frequently found in single-parent families and stepfamilies, compared with intact or nonstepfamilies. Prevention and intervention efforts directed toward children at risk for poor behavioral and mental health adjustment secondary to family disruption should consider children's physical health and health-related behaviors.

The rate of severe depression among women in single-parent and biological families and in a variety of stepfamilies was examined in a large community sample of 13,088 pregnant women in the United Kingdom. Compared with women in biological families and published population rates, women in single-parent families and step-families reported significantly elevated rates of depression. Family-type differences in several risk factors were examined, including cohabiting (vs. married) status, relationship history, and socioeconomic and psychosocial risks, such as crowding, social support, and stressful life events. Family-type differences in depression were mediated partly by differences in social support, stressful life events, and crowding, but a main effect of family type in predicting depression remained after statistically controlling for these risks.