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Background Early life stress (ELS) has been linked to poor mental and physical health outcomes in adolescence and adulthood. Mindfulness reduces symptoms of depression and anxiety and improves cognitive and social outcomes in both youth and adults. However, little is known whether mindfulness can mitigate against the adverse neurobiological and psychological effects of ELS. This study aimed to examine the feasibility of conducting a group mindfulness intervention in adolescents with ELS and provide preliminary indication of potential effects on stress-related biomarkers and mental health symptoms. Methods Forty adolescents were randomized to receive either eight sessions of Mindfulness-Based Stress Reduction for Teens in group format (MBSR-T; n = 21) or Treatment as Usual Control group (CTRL; n = 17). Outcomes were assessed at baseline and follow-up and included measures associated with neurobiological functioning (immune and endocrine biomarkers) and self-reported mental health (depressive) symptoms. Linear mixed effects models were used to assess the effects of group and time on these outcome measures. Results Sixteen of the 21 adolescents completed the intervention, attending an average of 6.5 sessions. The model examining cortisol responses to stress induction revealed medium effects trending toward significance (Cohen’s d = .56) for anticipatory cortisol levels in the MBSR-T relative to CTRL groups. No significant effects were found in models examining C-reactive protein or interleukin 6 inflammatory markers. The model examining depressive symptoms revealed a medium effect for symptom reduction (Cohen’s d = .69) in the MBSR-T relative to CTRL groups. Conclusions This study demonstrated feasibility of conducting a group-based MBSR-T intervention for adolescents with ELS. There was some evidence for efficacy on a symptom level with potential subtle changes on a biological level. Future larger studies are needed to determine the efficacy of group-based mindfulness interventions in this population. Trial registration Identifier #NCT03633903, registered 16/08/2018.

Theory and research indicate that adverse childhood experiences (ACEs) are linked to negative parenting attitudes and behaviors. We posit that protective and compensatory experiences (PACEs) in childhood buffer the negative effects of ACEs on later parenting. To test this premise, the present study examined associations between ACEs, PACEs, and attitudes towards nurturing and harsh parenting in an ethnically diverse sample of parents with children of various ages (N = 109; 65% mothers, 35% fathers; M age = 38). Parents completed a widely used parenting attitudes questionnaire and the ACEs and PACEs surveys. PACEs were negatively correlated with ACEs and positively correlated with nurturing parenting attitudes and parent income and education levels. Linear regression models indicate that higher PACEs, ACEs, and family income and less harsh parenting attitudes predict nurturing parenting attitudes. In contrast, higher ACEs and less nurturing attitudes were correlated with harsh parenting attitudes. As expected, moderation analyses indicated that the association between ACEs and harsh parenting attitudes was conditional upon the level of PACEs. When PACE scores were low (M - 1 SD), but not when PACE scores were average or high (M + 1 SD), ACEs were associated with harsh parenting attitudes, suggesting a buffering effect of PACEs on negative parenting attitudes. These findings support the importance of including protective as well as adverse childhood experiences when assessing the role of childhood experiences on parenting attitudes and practices. Implications of these findings for researchers and practitioners are discussed, as well as new directions for PACEs research using a cumulative protection approach.

This study investigated the associations between maternal depression when infants were 3 to 11 months old (M= 6 months), and positive parenting behaviors when children were between 12 and 22 months (M= 17 months) and the home language environment assessed when children were 18 to 28 months old (M= 23.5 months) in a sample of 29 low-income mother–child dyads. After controlling for maternal education, only teaching behaviors remained a moderate and significant predictor of adult word counts. Observed teaching behaviors significantly predicted conversational turns and marginally predicted child vocalizations; effects sizes were small. Encouraging behaviors were a small and significant predictor of conversational turns and a marginally significant predictor of adult word counts. Maternal depression was a moderate and significant predictor of children's vocal productivity scores and a small, marginal predictor of conversational turns. These findings have important implications for parenting and children's language outcomes.

The relationship between adverse childhood experiences (ACEs) and negative physical and mental health outcomes is well established (Felitti et al. [1998]. Relationship of childhood abuse and househ...

This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Childhood exposure to adversity may increase an individual’s reactivity to subsequent stressors. In this paper, we examine how adverse childhood experiences (ACEs) are associated with experiencing greater perceived distress during the pandemic. In this volunteer clinical cohort study, 177 pregnant women (ages 16–38) were recruited from two university-affiliated perinatal clinics located in a small metropolitan city between October 2017 and May 2018. Longitudinal data collection is ongoing. The current study includes the 101 women who participated through the eighth and most recent survey conducted in mid-April 2020. OLS regression analyses were used to examine the association between childhood adversity and pandemic-related distress. We found that ACE scores were associated with higher levels of distress (b = .08; se = .03; p

Adverse childhood experiences (ACEs) are widely recognized as predictors of early onset of alcohol and other drug use, problematic substance use, and addiction (Anda et al., Eur Arch Psych Clin Neurosci 256(3):174–186, 2006; Campbell et al., Am J Prev Med 50(3):344–352, 2016; Merrick et al., J Am Med Assoc Pediat 172:1038–1044, 2018). ACEs can have profound and enduring effects on neurological development, and immune and metabolic systems, resulting in behavioral and epigenetic changes that can persist across generations. Research with animal models and humans indicates that early exposure to abuse, neglect, and other stressors alters brain development, decreasing the individual’s ability and capacity to manage stress and emotions and increasing the likelihood of dependence on mood-altering substances (Kirsch et al., Adver Resil Sci, 1–19, 2020). There are growing bodies of evidence that environments enriched in nurturing relationships and resources can buffer the effects of early adversity (Blaze and Roth 2015; Morris et al. 2018). Interventions such as Attachment Biobehavioral Catch-up (ABC) that promote secure attachment show promise for interrupting the intergenerational cycle of adversity and addiction. Policies and programs that ensure access to Protective and Compensatory Experiences (PACEs) may also promote resilience in families who have experienced ACEs and addiction (Hays-Grudo and Morris, Adverse and protective childhood experiences: A developmental perspective. American Psychological Association, Washington, DC, 2020).

Background Early life stress (ELS) has been linked to poor mental and physical health outcomes in adolescence and adulthood. Mindfulness reduces symptoms of depression and anxiety and improves cognitive and social outcomes in both youth and adults. However, little is known whether mindfulness can mitigate against the adverse neurobiological and psychological effects of ELS. This study aimed to examine the feasibility of conducting a group mindfulness intervention in adolescents with ELS and provide preliminary indication of potential effects on stress-related biomarkers and mental health symptoms. Methods Forty adolescents were randomized to receive either eight sessions of Mindfulness-Based Stress Reduction for Teens in group format (MBSR-T; n = 21) or Control (CTRL; n = 17). Outcomes were assessed at baseline and follow-up and included measures associated with neurobiological functioning (immune and endocrine biomarkers) and self-reported mental health symptoms. Linear mixed effects models were used to assess the effects of group and time on these outcome measures. ResultsSixteen of the 21 adolescents completed the intervention, attending an average of 6.5 sessions. The model examining depressive symptoms revealed a medium effect for symptom reduction [Cohen’s d = .69] in the MBSR-T relateive to CTRL groups.ConclusionsThis study demonstrated feasibilility of conducting a group-based MBSR intervention for adolescents with ELS. There was some evidence for efficacy on a symptom level with potential subtle changes on a biological level. Future larger studies are needed to determine the efficacy of group-based mindfulness interventions in this population.

This study explored whether parents’ ability to regulate their behaviour and attention, assessed as components of everyday executive function (EF), was influenced by their past adverse experiences ...

Parent adverse childhood experiences (ACEs) and caregiver reports of harsh parenting were examined in relation to the executive function (EF) abilities in young low-income children. Data were collected from 55 mother–child dyads; 17–40 months of age. Parent measures included the ACEs questionnaire and harsh parenting items from the Adult Adolescent Parenting Inventory-2. Children’s EF was assessed using game-like tasks to measure working memory, cognitive flexibility, and inhibitory control. Harsh parenting attitudes were marginally correlated with children’s cognitive flexibility. In regression analyses controlling for child age, harsh parenting attitudes predicted lower inhibitory control in children, and parent-reported ACEs predicted lower working memory scores. Findings suggest that parent ACEs and parenting attitudes may be important factors in the development of young children’s EF skills.

In this chapter we provide an overview of the theoretical perspectives informing research and practice in early relationships, including attachment theory, psychodynamic theory, sociocultural theory, infant mental health, synchrony, the biopsychosocial model, and risk and resilience. This overview is followed by future directions for research and practice in building early relationships. We present an integrated model of infant mental health that incorporates current knowledge about the effects of early experiences on development (e.g., toxic stress, adverse childhood experiences, protective and compensatory experiences, and neurobiological research). We describe challenges and opportunities that may arise when applying infant mental health within other disciplines, such as early childhood education, pediatrics, psychiatry, psychology, and developmental science. We end with an example of an integrated set of interventions developed and implemented at the state and community level, providing practical suggestions for including infant mental health in practice, research, and policy.

Based on evidence that strong and nurturing relationships between children and caregivers can be improved through evidence-based interventions, the Tulsa Children’s Project (TCP) was designed as a highly integrated set of programs for parents, teachers, and administrators at three high-quality early childhood centers serving low-income children from 8 weeks to 5 years. Three groups of interventions were coordinated into an integrated model, including physical health promotion programs (nutrition, exercise, increased access to care), teacher and administrative professional development and curriculum support, and a parent workforce training and development program. To address the stress associated with poverty and a documented history of individual trauma and adversity, mental health and socioemotional development concepts and activities were featured in each of the components.

In this article, the authors posit that programs promoting nurturing parent–child relationships influence outcomes of parents and young children living in poverty through two primary mechanisms: (a) strengthening parents' social support and (b) increasing positive parent–child interactions. The authors discuss evidence for these mechanisms as catalysts for change and provide examples from selected parenting programs that support the influence of nurturing relationships on child and parenting outcomes. The article focuses on prevention programs targeted at children and families living in poverty and closes with a discussion of the potential for widespread implementation and scalability for public health impact.

Studies of weight and health-related quality of life (HRQOL) generally focus on white populations. This analysis examines the association between clinical weight categories and physical HRQOL in five racial/ethnic groups of older women and determines the extent to which emotional/psychological (social support, caregiver burden) and physical health (diabetes, osteoarthritis) factors modify this relationship.The cross-sectional analysis, completed in 2007, used baseline data from postmenopausal women enrolled in the Women's Health Initiative (WHI) during the 5-year recruitment period (1993-1998).Of 161,393 women, 83% were non-Hispanic white, 9% were African American, 4% were Hispanic/Latina, 3% were Asian/Pacific Islander, and1% were American Indian/Alaska Native. Obesity (body mass index [BMI]or =30 kg/m(2)) was most common in non-Asian minority groups. Regression modeling showed higher odds of poor physical HRQOL with increasing weight category in all groups. In the total sample, these odds were at least 6 times as high in women with class 3 obesity as in women of normal weight and were only mildly attenuated after the analysis adjusted for emotional/psychological factors. Further adjustment for physical health factors made odds ratio (OR) estimates drop from 2.36 to 1.59 for class 1 obesity and from 6.96 to 3.71 for class 3 obesity. This pattern generally persisted within each racial/ethnic group.Heavier weight negatively affects physical HRQOL in postmenopausal women across diverse racial/ethnic backgrounds. Weight-relevant physical health factors have a greater impact on this weight-HRQOL association than do emotional/psychological factors.

Objectives Prompt and successful cardiopulmonary resuscitation during a sudden cardiac arrest can be hindered by multiple variables, ie, ineffective communication, stress, lack of training, and an unfamiliar environment, such as a new hospital facility. The main objective of the study was to use high-fidelity simulations to orient Code Blue Teams (CBTs) to critical events in a new hospital facility. A secondary objective was to elucidate factors that may have contributed to responses by debriefing teams. Methods Mock Code Blue exercises using high-fidelity simulation were implemented in real workplace settings to orient CBTs to critical events. We measured arrival time of first responder, crash cart to code site, first six CBT responders, first chest compression, and first electrical shock. After each mock code, participants were debriefed to assess any barriers to effective response and decision making. Results Twelve mock codes were conducted at different locations of the new facility. Sixty-nine percent of the participants reported that the training was beneficial. The median time of arrival of the first responders was 42 seconds and the first CBT member was 66 seconds. The median time to initiation of chest compressions was 80 seconds, crash cart arrival was 68 seconds, and first electrical shock was 341 seconds. An additional outcome of the study was the identification of facility and systems issues that had the potential to impact patient safety. Conclusions Clinical simulation can be effectively used to orient CBTs and identify critical safety issues in a newly constructed healthcare facility.

Despite evidence that prolonged periods of sitting may influence biological mediators of cancer development, few studies have considered these relationships in a cancer-specific context.This cross-sectional study included 755 postmenopausal women enrolled in an ancillary study of the Women's Health Initiative. Plasma levels of Insulin-like growth factor-I (IGF-I), IGF-binding protein-3, leptin, insulin, C-peptide, C-reactive protein (CRP), and Interleukin (IL)-6 were measured. The time spent sitting per day was categorized as quartiles (Qs). The relationships between sedentary time and biomarkers were modified by race, physical activity, and exogenous estrogen use.IGF-I levels among African American (AA) women were higher than those of white women across the Qs of sedentary time. Likewise, IL-6 levels in AA women were higher than those in white women at Q3 and Q4 of sedentary time. IGFBP-3 levels were higher and insulin levels were lower across the Qs of sedentary time among women meeting guidelines for physical activity than women who were not. Additionally, CRP levels were higher among estrogen users than nonusers at Q1, Q2, and Q4 of sedentary time.These results suggest that relationship between time spent sitting and cancer-related biomarkers may not be simply linear, but differ in the context of effect modifiers.

Purpose: The role of exogenous estrogen use in explaining racial/ethnic differences in insulin-like growth factor-I (IGF-I) levels in relation to cancer risk is not clear. We investigated whether the relationship between race and circulating bioactive IGF-I proteins is mediated by exogenous estrogen and the extent to which exogenous estrogen explained the race–IGF-I relationship in postmenopausal women. Methods: This cross-sectional study included 636 white and 133 black postmenopausal women enrolled in an ancillary study of the Women's Health Initiative Observational Study between February 1995 and July 1998. The race–IGF-I relationship was analyzed using ordinal regression, and quartiles of molar ratios of IGF-I/IGF binding protein-3 were used as a proxy of bioactive IGF-I outcomes. To assess exogenous estrogen as a mediator of the race–IGF-I relationship, we used the Baron-Kenny method and an estimation of the proportional change in the odds ratios for race on IGF-I levels plus a bootstrapping test for the significance of the mediation effect. Results: Compared with white women, black women were more likely to have high IGF-I levels and less likely to use exogenous estrogen. After accounting for race, estrogen nonusers had higher IGF-I levels than estrogen users did. When women were stratified by oral contraceptive (OC) ever use, among OC ever users, exogenous estrogen showed a strong mediation effect (67%; P=0.018) in the race–IGF-I relationship. Moreover, when women were classified by a history of hypertension, the IGF-I levels of women with a history of hypertension were higher than those of women with no history of hypertension. Of the women with a history of hypertension, exogenous estrogen explained differences in IGF-I levels between white and black women to a modest degree (23%; P=0.029). Conclusions: Exogenous estrogen use has a potentially important role in racial/ethnic disparities in cancer risk among postmenopausal women. This abstract is also presented as Poster A38. Citation Format: Su Yon Jung, Jennifer Hays-Grudo, Electra Paskett, Stephen D. Hursting, Jenifer Fenton, Michael Pollak, Mara Vitolins, Shine Chang. Exogenous estrogen as a mediator of racial differences in insulin-like growth factor-I levels among postmenopausal women. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr PR04.

Purpose: Despite convincing evidence that prolonged periods of sitting may influence critical biological mediators of cancer development, few studies assessed the relationship between time spent sitting and cancer-related biomarkers. Methods: This cross-sectional study included 825 postmenopausal women who were enrolled in an ancillary study of the Women's Health Initiative Observational Study between February 1995 and July 1998. Plasma levels of biomarkers were measured at the third annual visit. The time spent sitting per day was categorized as quartiles (Qs) and analysis of covariance was used to assess the relationships between sedentary time and cancer biomarkers. Results: No clear linear patterns were observed between the time spent sitting and levels of biomarkers; however, these relationships were modified by race, physical activity level, and exogenous estrogen use. Insulin-like growth factor-I (IGF-I) levels among black women were higher than those of white women across the Qs of time spent sitting. Likewise, IL-6 levels in black women were higher than those in white women at Q3 and Q4 of sedentary time. IGF binding protein-3 levels were higher and insulin levels were lower among women meeting guidelines for physical activity than women who were not across the Qs of sedentary time. Additionally, C-reactive protein levels were higher among estrogen users than nonusers at Q1, Q2, and Q4 of sedentary time. Conclusions: Few meaningful associations were observed between the time spent sitting and the cancer-related biomarkers. More research is needed to characterize the relationship between time spent sitting and cancer-related biomarkers in the context of pertinent effect modifiers. Citation Format: Su Yon Jung, Raheem J. Paxton, Jennifer Hays-Grudo, Electra Paskett, Stephen D. Hursting, Jenifer Fenton, Michael Pollak, Mara Vitolins, Shine Chang. Associations between time spent sitting and cancer-related biomarkers: An exploration of effect modifiers. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr A35.

Background. Postmenopausal estrogen (E) therapy, especially in combination with progestin (P) doubles the relative risk of venous thrombosis (VTE). Risk with hormones is higher with increasing age, obesity and with factor V Leiden. We studied coagulation markers as susceptibility factors for postmenopausal hormone-related VTE. Methods. The Women’s Health Initiative program included two placebo-controlled double-blind randomized trials of two E regimens, E (conjugated equine estrogens) or E+P (E + medroxyprogesterone acetate), in 16,608 postmenopausal women aged 50–79. We performed a nested case control study that measured baseline levels of coagulation markers in 215 women who developed VTE during follow up and 867 age-matched controls. The joint effects of treatment assignment to either E regimen vs placebo and prespecified abnormal levels of each coagulation factor on relative risk of VTE were estimated by logistic regression adjusting for age, race, body-mass index and type of E regimen. Results. Low levels of protein C and free protein S ( Conclusions. We report new findings of elevated F1-2 and PAP as VTE risk factors in women in this prospective study nested in trials of E or E+P versus placebo. Protein C or S values below the 5th percentile were also clinically relevant even though they do not represent inherited deficiency. Lower protein C and free protein S, and higher D-dimer, F1-2 and PAP all identified women at increased risk of VTE with hormones. If our findings are confirmed in management studies, measurement of these factors might assist women with decision-making on safety of E or E+P.