Publications | Schreier Lab

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13
Apr 23

Investigating the effects of maltreatment and acute stress on the concordance of blood and DNA methylation methods of estimating immune cell proportions

Background Immune cell proportions can be used to detect pathophysiological states and are also critical covariates in genomic analyses. The complete blood count (CBC) is the most common method of immune cell proportion estimation, but immune cell proportions can also be estimated using whole-genome DNA methylation (DNAm). Although the concordance of CBC and DNAm estimations has been validated in various adult and clinical populations, less is known about the concordance of existing estimators among stress-exposed individuals. As early life adversity and acute psychosocial stress have both been associated with unique DNAm alterations, the concordance of CBC and DNAm immune cell proportion needs to be validated in various states of stress. Results We report the correlation and concordance between CBC and DNAm estimates of immune cell proportions using the Illumina EPIC DNAm array within two unique studies: Study 1, a high-risk pediatric cohort of children oversampled for exposure to maltreatment (N = 365, age 8 to 14 years), and Study 2, a sample of young adults who have participated in an acute laboratory stressor with four pre- and post-stress measurements (N = 28, number of observations = 100). Comparing CBC and DNAm proportions across both studies, estimates of neutrophils (r = 0.948, p < 0.001), lymphocytes (r = 0.916, p < 0.001), and eosinophils (r = 0.933, p < 0.001) were highly correlated, while monocyte estimates were moderately correlated (r = 0.766, p < 0.001) and basophil estimates were weakly correlated (r = 0.189, p < 0.001). In Study 1, we observed significant deviations in raw values between the two approaches for some immune cell subtypes; however, the observed differences were not significantly predicted by exposure to child maltreatment. In Study 2, while significant changes in immune cell proportions were observed in response to acute psychosocial stress for both CBC and DNAm estimates, the observed changes were similar for both approaches. Conclusions Although significant differences in immune cell proportion estimates between CBC and DNAm exist, as well as stress-induced changes in immune cell proportions, neither child maltreatment nor acute psychosocial stress alters the concordance of CBC and DNAm estimation methods. These results suggest that the agreement between CBC and DNAm estimators of immune cell proportions is robust to exposure to child maltreatment and acute psychosocial stress.

CITATION: Apsley, A.T., Etzel, L., Hastings, W.J. et al. Investigating the effects of maltreatment and acute stress on the concordance of blood and DNA methylation methods of estimating immune cell proportions. Clin Epigenet 15, 33 (2023). https://doi.org/10.1186/s13148-023-01437-5

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13
Apr 23

Mean affect and affect variability may interact to predict inflammation

Introduction Individuals with greater affect variability (i.e., moment-to-moment fluctuations possibly reflecting emotional dysregulation) are at risk for greater systemic inflammation, which is associated with cardiovascular disease. Some evidence suggests that affect variability is linked with poorer health indicators only among those with higher average levels of affect, particularly for positive affect (PA), and that associations may be non-linear. The present study sought to examine whether links between both PA and negative affect (NA) variability and inflammation are moderated by average level of affect. Methods Participants (N = 300, 50 % female, ages 21–70, 60 % non-Hispanic White, 19 % Hispanic, 15 % non-Hispanic Black) completed a lab assessment and provided a blood sample to measure systemic inflammation (i.e., TNF-α, IL-6, CRP). Affect was collected via a two-day ecological momentary assessment protocol where reports were collected about every 45-min during waking hours. Momentary affect ratings were averaged across both days (i.e., iM), separately for PA and NA, for each participant. Affect variability was calculated as the person-specific SD (i.e., iSD) of affect reports, separately for PA and NA. Linear and quadratic interactions were tested. Models included covariates for sex, race, and body mass index. Results There were significant interactions between NA iM and NA iSD predicting TNF-α (b = 6.54; p < 0.05) and between PA iM and PA iSD predicting IL-6 (b = 0.45; p < 0.05). Specifically, the association between these affect variability indicators and inflammatory markers were suggestive of a positive association among those with higher average affect but a negative association among those with lower average affect. There was no evidence of non-linear associations between affect and inflammation. Discussion Incorporating interactive effects between affect variability and average affect may be an important consideration in understanding affective-inflammatory associations.

CITATION: Dusti R. Jones, John M. Ruiz, Hannah M.C. Schreier, Matthew A. Allison, Burt N. Uchino, Michael A. Russell, Daniel J. Taylor, Timothy W. Smith, Joshua M. Smyth, Mean affect and affect variability may interact to predict inflammation, Brain, Behavior, and Immunity, Volume 109, 2023, Pages 168-174, ISSN 0889-1591, https://doi.org/10.1016/j.bbi.2023.01.008. (https://www.sciencedirect.com/science/article/pii/S0889159123000089)

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13
Jul 22

Obesity and accelerated epigenetic aging in a high-risk cohort of children

New insights into mechanisms linking obesity to poor health outcomes suggest a role for cellular aging pathways, casting obesity as a disease of accelerated biological aging. Although obesity has been linked to accelerated epigenetic aging in middle-aged adults, the impact during childhood remains unclear. We tested the association between body mass index (BMI) and accelerated epigenetic aging in a cohort of high-risk children. Participants were children (N = 273, aged 8 to 14 years, 82% investigated for maltreatment) recruited to the Child Health Study, an ongoing prospective study of youth investigated for maltreatment and a comparison youth. BMI was measured as a continuous variable. Accelerated epigenetic aging of blood leukocytes was defined as the age-adjusted residuals of several established epigenetic aging clocks (Horvath, Hannum, GrimAge, PhenoAge) along with a newer algorithm, the DunedinPoAm, developed to quantify the pace-of-aging. Hypotheses were tested with generalized linear models. Higher age-and sex- adjusted z-scored BMI was significantly correlated with household income, blood cell counts, and three of the accelerated epigenetic aging measures: GrimAge (r = 0.31, P < .0001), PhenoAge (r = 0.24, P < .0001), and DunedinPoAm (r = 0.38, P < .0001). In fully adjusted models, GrimAge (β = 0.07; P = .0009) and DunedinPoAm (β = 0.0017; P < .0001) remained significantly associated with higher age- and sex-adjusted z-scored BMI. Maltreatment-status was not associated with accelerated epigenetic aging. In a high-risk cohort of children, higher BMI predicted epigenetic aging as assessed by two epigenetic aging clocks. These results suggest the association between obesity and accelerated epigenetic aging begins in early life, with implications for future morbidity and mortality risk.

CITATION: Etzel, L., Hastings, W. J., Hall, M. A., Heim, C. M., Meaney, M., Noll, J. G., Rose, E. J., Schreier, H. M. C., Shenk, C., & Shalev, I., (in press). Obesity and accelerated epigenetic aging in a high-risk cohort of children.

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13
Jul 22

The Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y): Adaptation and Validation Across a Varied Sample of Children and Adolescents

Flexible self-regulation has been shown to be an adaptive ability. This study adapted and validated the adult Flexible Regulation of Emotional Expression (FREE) Scale for use with youth (FREE-Y) in community and maltreatment samples. The FREE-Y measures the ability to flexibly enhance and suppress emotion expression across an array of hypothetical social scenarios. Participants (N = 654, 8-19 years) were included from three studies. Confirmatory factor analysis (CFA) confirmed a theoretically appropriate higher order factor structure. Using multiple-group CFAs, measurement invariance was achieved across maltreatment status, age, and gender. Reliabilities were adequate and construct validity was demonstrated through associations with measures of emotion regulation, psychopathology, IQ, and executive functioning. Group comparisons indicated lower Suppression and Flexibility scores for maltreated versus comparison participants. Findings suggest that the FREE-Y is a valid measure of expressive regulation ability in youth that can be applied across a range of populations.

CITATION: Haag, A.-C., Cha, C. B., Noll, J. G., Gee, D. G., Shenk, C. E., Schreier, H. M. C., Heim, C., Shalev, I., Rose, E. J., Jorgensen, A., & Bonanno, G. A. (in press). Adaptation and validation of the Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y). Assessment.

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13
Jul 22

First-generation college students have greater systemic inflammation following the initial college transition

Background First-generation college students (“first-gens”) are often at a disadvantage socially and academically; whether they are at risk physiologically is unknown despite the well-established link between greater education and better long-term health. Purpose To examine whether first-gens have higher levels of cardiovascular disease (CVD) risk markers relative to continuing-generation college students (“continuing-gens”). Methods A panel of CVD risk markers was assessed among 87 emerging adults (41 first-gens) twice over their first year of college. Results Compared to continuing-gens, first-gens had greater systemic inflammation (composite of averaged z-scores for C-reactive protein and interleukin-6; B = 0.515, SE = 0.171, p = .003) during the fall but not spring semester (p > .05). Associations were independent of family home ownership and childhood adversity, even though first-gens were more likely to live in rental homes and reported riskier home environments. Lower childhood subjective social status (SSS) accounted for greater systemic inflammation among first-gens as evidenced by an indirect effect of college generation status on systemic inflammation through childhood SSS (a1b1 = 0.261, bootstrapped SE = 0.103, 95% boot CI [0.078, 0.482]). There were no differences in metabolic risk and latent virus regulation by college generation status in either semester (p > .10). Conclusions This is the first study to find that first-gens have higher levels of systemic inflammation than continuing-gens following the college transition and that childhood SSS may be one explanatory pathway. First-gens may benefit from university resources that address social class differences, which should be provided early on so that first-gens can reap the health-relevant benefits of higher education, at least in the short term.

CITATION: Jones E. J., & Schreier H. M. C. First-Generation College Students, Emotional Support, and Systemic Inflammation Following the College Transition. J Adolesc Health. 2023 Jan;72(1):36-43. doi: 10.1016/j.jadohealth.2022.08.012. Epub 2022 Oct 8. PMID: 36220685.

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13
Jul 22

Comparing qPCR and DNA-Methylation-based Measurements of Telomere Length in a High-Risk Pediatric Cohort

Various approaches exist to assess population differences in biological aging. Telomere length (TL) is one such measure, and is associated with disease, disability and early mortality. Yet, issues surrounding precision and reproducibility are a concern for TL measurement. An alternative method to estimate TL using DNA methylation (DNAmTL) was recently developed. Although DNAmTL has been characterized in adult and elderly cohorts, its utility in pediatric populations remains unknown. We examined the comparability of leukocyte TL measurements generated using qPCR (absolute TL; aTL) to those estimated using DNAmTL in a high-risk pediatric cohort (N = 269; age: 8-13 years, 83% investigated for maltreatment). aTL and DNAmTL measurements were correlated with one another (r = 0.20, p = 0.001), but exhibited poor measurement agreement and were significantly different in paired-sample t-tests (Cohen’s d = 0.77, p < 0.001). Shorter DNAmTL was associated with older age (r = -0.25, p < 0.001), male sex (β = -0.27, p = 0.029), and White race (β = -0.74, p = 0.008). By contrast, aTL was less strongly associated with age (r = -0.13, p = 0.040), was longer in males (β = 0.31, p = 0.012), and was not associated with race (p = 0.820). These findings highlight strengths and limitations of high-throughput measures of TL; although DNAmTL replicated hypothesized associations, aTL measurements were positively skewed and did not replicate associations with external validity measures. These results also extend previous research in adults and suggest that DNAmTL is a sensitive TL measure for use in pediatric populations.

CITATION: Hastings, W. J., Etzel, L., Heim, C. M., Noll, J. G., Rose, E. J., Schreier, H. M. C., Shenk, C. E., Tang, X.& Shalev, I. (in press). Comparing qPCR and DNA-Methylation-based Measurements of Telomere Length in a High-Risk Pediatric Cohort. Aging.

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13
Jul 22

Associations of childhood and adult adversity with daily experiences in adulthood

Data from 213 adults were analysed to test the stress accumulation and stress sensitization models as they relate to daily mood, health behaviours and social interactions. Adults reported on childhood adversity, past year adversity, and daily experiences on 14 evenings. Results largely supported the stress accumulation and not stress sensitization model such that childhood and past year adversity had independent but not synergistic effects on daily experiences. Both adversity measures were independently associated with greater daily negative affect and negative affect variability. Childhood adversity independently associated with greater mean variability in daily positive affect. Past year adversity was associated with more daily social activities, greater odds of reporting interpersonal tension at least once, and daily tension. Although childhood adversity was associated with greater odds of sharing about one’s day at least once, past year adversity was associated with more daily sharing and childhood adversity with less. Both measures were unrelated to daily health behaviours except childhood adversity was associated with lower odds of being a current drinker. The only support for the stress sensitization model was number of daily cigarettes among smokers. Our findings suggest childhood and recent adversity independently relate to adults’ daily experiences and should be considered jointly.

CITATION: Jones, E. J., Nayman, S., Smyth, J. M. & Schreier, H. M. C. (2021). Associations of childhood and adult adversity with daily experiences in adulthood. Stress & Health.

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13
Jul 22

Self-rated mental and physical health are prospectively associated with psychosocial and academic adjustment to college

To examine prospective associations between physical and mental self-rated health (SRH), college generation status and college adjustment among first-year college students. Participants and methods: Eighty-seven first-year college students (41 first-generation college students) reported their SRH when starting college, and then, reported on psychosocial and academic adjustment and health behaviors midway through each semester. Results: Better physical and mental SRH were associated with better psychosocial adjustment in both semesters and academic adjustment in the fall but were generally not predictive of health behaviors. Specifically, better physical SRH was associated with less loneliness (fall: B = -.192, p = .048; spring: B = -.233, p = .008) and fewer anxiety symptoms in both semesters (fall: B = -.236, p = .011; spring: B = -.210, p = .014) and fewer depressive symptoms (fall: B = -.134, p = .016) and more fall semester credits (B = .965, p = .002). Better mental SRH was associated with greater sense of belonging (fall: B = .317, p < .001; spring: B = .242, p = .009), less loneliness (fall: -.210, p = .008; spring: B = -.181, p = .012), and fewer anxiety symptoms (fall: -.193, p = .011; spring: -.195, p = .006) in both semesters and higher fall semester grade point average (B = .129, p = .032). Independent effects of physical and mental SRH are also discussed. Largely, college generation status did not matter for college adjustment within this sample. Conclusions: Physical and mental SRH when starting college may be important indicators of psychosocial adjustment over the first year and academic adjustment in the fall.

CITATION: Jones, E. J. & Schreier, H. M. C. (2021). Self-rated mental and physical health are prospectively associated with psychosocial and academic adjustment to college. Journal of American College Health.

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13
Jul 22

Assembling a cohort for in-depth, longitudinal assessments of the biological embedding of child maltreatment: Methods, complexities, and lessons learned

As championed by the work of Ed Zigler, investing in nurturing environments for all children is a chief tenet of primary prevention that will have far-reaching benefits to the health and welfare of all members of society. Children who endure child maltreatment (CM) are among society’s most vulnerable. Prospective longitudinal research aimed at a comprehensive understanding of the mechanisms linking CM to subsequent adverse health consequences is needed to improve outcomes and to strengthen causal inference. This paper outlines the methods of the Child Health Study (CHS), a large, state-wide longitudinal cohort of recently maltreated and nonmaltreated youth aged 8-13 who will be assessed every 2 years. The CHS is designed to include in-depth assessments of multiple environmental, behavioral, neural, physiological, and molecular mechanisms through which CM may impact a broad spectrum of youth development, including behavioral and physical health outcomes. In addition to describing the conceptual framework and methods underlying the CHS, we provide information on valuable “lessons learned” in the hopes of supporting future research efforts facing similar challenges. The ultimate goal of this research is demonstrating how policies regarding CM impact the well-being, resilience and recovery of survivors and that they are worthy of large public investment.

CITATION: Schreier, H. M. C., Heim, C. M., Rose, E. J., Shalev, I., Shenk, C. E., & Noll, J. G. (2021). Assembling a cohort for in-depth, longitudinal assessments of the biological embedding of child maltreatment: Methods, complexities, and lessons learned. Development & Psychopathology, 33(2), 394-408.

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13
Jul 22

Hypothalamic-pituitary-adrenal axis attenuation and obesity risk in sexually abused females

Background Childhood sexual abuse (CSA) confers elevated risks for obesity in females. Mechanisms that explain this link remain unclear. This study tracked serum basal cortisol levels with body mass index (BMI) from childhood into adulthood to test whether hypothalamic-pituitary-adrenal (HPA) axis attenuation accounts for elevated obesity risks for sexually abused females. Methods Data drew from six timepoints of a longitudinal study of the impact of CSA on development. Participants were females aged 6-16 years at time of study enrollment with substantiated CSA and demographically matched non-abused peers. Analyses included only participants who did not have obesity at study enrollment. Main outcomes were BMI growth trajectories across ages 6-27 (n = 150; 66 abused, 84 comparisons) and early adulthood obesity status (ages 20-27; n = 133; 62 abused, 71 comparison). HPA axis functioning indicators were intercept and linear slope parameters extracted from multilevel growth trajectories of serum basal cortisol levels across development. Racial-ethnic minority status, parity, steroid medication use, depression history and disordered eating history were covaried. Results While controlling for covariates, multilevel modeling indicated that high initial serum basal cortisol levels in childhood and attenuated cortisol growth rate over time (i.e., HPA axis attenuation) were associated with accelerated BMI accumulation (p < .01). Attenuated cortisol growth rate mediated the effect of CSA on accelerated BMI accumulation and on elevated adulthood obesity rates (p < .05). Conclusion This work establishes a mechanistic association between HPA axis attenuation and obesity, suggesting that trauma treatments for abuse survivors should include interventions that reduce health consequences associated with dysregulated stress physiology.

CITATION: Li, J. C., Hall, M. A., Shalev, I., Schreier, H. M. C., Zarzar, T. G., Marcovici, I., Putnam, F. W., & Noll, J. G. (2021). Hypothalamic-pituitary-adrenal axis attenuation and obesity risk in sexually abused females. Psychoneuroendocrinology, 129, 105254.

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13
Jul 22

The intergenerational interplay of adversity on salivary inflammation in young children and caregivers

Systemic inflammation links exposure to early childhood adversity to later disease. The associations among adversity and disease risk might in part operate through poor oral hygiene and subsequent periodontal inflammation, which can be measured in saliva. Few studies, however, have examined the association between adversity and salivary inflammation in young children. Further, there is a dearth of literature investigating adverse experiences and salivary inflammation in children and caregivers together, limiting our understanding of the intergenerational, dual effects of adversity on inflammation for both members of the caregiver-child dyad. This study tested child and caregiver adversity and their associations with an inflammatory composite (i.e., IL-6, IL-1β, IL-8, TNF-α) and CRP in 93 preschool-age children and their caregivers. Caregivers reported on their child’s experiences of adversity, as well as on their own adverse experiences, using a comprehensive questionnaire synthesized from previous checklists for complete coverage of possible adverse events. Results showed that caregivers’ salivary inflammatory markers (i.e., IL-6, IL-1β, IL-8, TNF-α, and CRP) were not significantly correlated with the same five inflammatory markers in children’s saliva. Among children, adversity was associated with significantly higher levels of the inflammatory composite, though not CRP. This association was amplified among children whose caregivers also experienced more adversity during adulthood. Among caregivers, childhood adversity and adulthood adversity were each independently associated with significantly higher levels of the inflammatory composite and CRP. The association between caregivers’ own childhood adversity and inflammation was amplified among caregivers whose children also experienced more adversity during their childhoods. These findings provide preliminary evidence for the possible dual role of young children’s and caregivers’ adverse experiences in contributing to salivary inflammation for both members of the dyad, suggesting possible implications for systemic inflammation and future disease.

CITATION: Huffhines, L., Jackson, Y., McGuire, A. B. & Schreier, H. M. C. (2021). The intergenerational interplay of adversity on salivary inflammation in young children and caregivers. Psychoneuroendocrinology, 128, 105222.

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13
Jul 22

Childhood physical neglect is associated with exaggerated systemic and intracellular inflammatory responses to repeated psychosocial stress in adulthood

Experiences of child maltreatment are associated with a host of adverse mental and physical health outcomes in adulthood. Altered reactivity to psychosocial stress exposure may partially explain known associations between early experiences of maltreatment and later life health. The present study focuses on examining whether experiences of child maltreatment are associated with physiological reactions to initial and repeated psychosocial stress in adulthood. To this end, 44 healthy adults (52% male, aged 18-65) completed the Childhood Trauma Questionnaire to provide information about exposure to child maltreatment and completed the Trier Social Stress Test (TSST) on 2 consecutive days. Peripheral blood was collected prior to as well as 30 and 120 min following the TSST on each day. Plasma Interleukin-6 (IL-6) and gene expression of IL-6, IL-1β, nuclear factor-kB (NF-kB), and inhibitor of kB (IkB) were measured from each blood sample. Total CTQ scores were unrelated to plasma IL-6 and gene expression (ps > .10) but a history of childhood physical neglect was associated with increased interleukin-1β (β =.35; p =.02; R² =.19) and nuclear factor-kB (β =.30; p =.046; R² =.13) expression following initial stress. Following repeated exposure to the TSST, childhood physical neglect was associated with increased plasma IL-6 reactivity (β =.34; p =.02; R² =.16) and increased expression of nuclear factor-kB (β =.31; p =.04; R² =.08). Finally, childhood physical neglect was associated with decreased habituation following repeated exposure to the TSST. Other CTQ subscales were not related to plasma IL-6 and gene expression when considered individually. Results from this study are suggestive of a unique effect of childhood physical neglect on the physiological stress response following initial and repeated exposure to a common psychosocial stressor. This provides important directions for future research because the effect of childhood physical neglect on long-term neglect are not well understood and in need of further investigation.

CITATION: Schreier, H. M. C., Kuras, Y. I., McInnis, C. M., Thoma, M. V., Gianferante, D., Hanlin, L., Chen, X., Wang, D., Goldblatt, D. & Rohleder, N. (2020). Childhood physical neglect is associated with exaggerated systemic and intracellular inflammatory responses to repeated psychosocial stress in adulthood. Frontiers Psychiatry, 11, 504.

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13
Jul 22

Neuroendocrine coordination and youth behavior problems: A review of studies assessing sympathetic nervous system and hypothalamic-pituitary-adrenal axis activity using salivary alpha amylase and salivary cortisol

Externalizing and internalizing behavior problems can have deleterious psychosocial consequences for youth. Both sympathetic nervous system (SNS) and hypothalamic-pituitary adrenal (HPA) axis activity and reactivity may contribute to behavior problems but have largely been studied separately, with inconsistent findings. Because the SNS and HPA axis interact to carry out physiological processes (e.g., responding to stressors), considering SNS and HPA axis activity jointly may elucidate disparate findings. This review discusses studies that simultaneously assessed SNS and HPA axis (re)activity and youth behavior problems using measures of salivary alpha amylase (sAA) and salivary cortisol. Multiple patterns of SNS and HPA axis coordination were associated with problem behaviors, especially when considering individual differences and youth’s psychosocial context. Importantly, many study findings may be artifacts of widespread methodological differences. The reviewed studies lay the foundation for future research on neuroendocrine coordination as a contributing factor to youth problem behaviors and some recommendations for future research are discussed.

CITATION: Jones, E. J., Rohleder, N., & Schreier, H. M. C. (2020). Neuroendocrine coordination and youth behavior problems: A review of studies assessing sympathetic nervous system and hypothalamic-pituitary-adrenal axis activity using salivary alpha amylase and salivary cortisol. Hormones & Behavior, 122.

Family Influences / Publications — No Comments
13
Jul 22

Associations between adverse childhood family environments and blood pressure vary by gender

Background It is unclear how adverse childhood family environments differentially impact adult health outcomes among men and women. This brief communication reports on the independent and joint effects of adverse childhood family environments and sex on indicators of health in adulthood. Methods and Results 213 18-55-year olds reported on their childhood family environment (Risky Families Questionnaire (RFQ); Family Environment Scale (FEStotal)) and their current perceived stress and depressive and anxious affect. Resting systolic (SBP) and diastolic blood pressure (DBP), and heart rate (HR) were taken during a laboratory visit, and total cortisol output was measured in saliva samples collected at home. Exposure to childhood adversity did not vary by sex. Women had lower SBP, DBP, and total cortisol output, but higher HR, than men (ps < .05). Sex moderated the association between childhood family environment and SBP (RFQ: B = -.316; SE = .120; p = .009; FEStotal: B = -.274; SE = .117; p = .021) and DBP (FEStotal: B = -.193; SE = .094; p = .041), such that exposure to greater childhood adversity was linked to lower BP in women only. Results were largely unchanged after adjusting for concurrent perceived stress and depressive and anxious affect. Separate effects of individual FES subscales are also discussed. Conclusions Contrary to expectations, exposure to adverse childhood family environments was associated with lower resting BP among women, perhaps indicative of basal cardiovascular hypoactivation, whereas early adversity was not linked to BP among men.

CITATION: Schreier, H. M. C., Jones, E. J., Nayman, S., & Smyth, J. M. (2019). Associations between adverse childhood family environments and blood pressure vary by gender. PlosONE, 14(12), e0225544.

Adolescents / Family Influences / Publications / Trauma — No Comments
09
Mar 20

Is sexual abuse a unique predictor of sexual risk behaviors, pregnancy, and motherhood in adolescence?

This study tested sexual abuse as a unique predictor of subsequent adolescent sexual behaviors, pregnancy, and motherhood when in company with other types of maltreatment (physical abuse, neglect) and alternative behavioral, family, and contextual risk factors in a prospective, longitudinal study of maltreated (n = 275) and comparison (n = 239) nulliparous females aged 14-19 years old assessed annually through 19 years old. Hierarchical regression was used to disentangle risk factors that account for the associations of maltreatment type on risky sexual behaviors at 19 years old, adolescent pregnancy, and adolescent motherhood. Findings indicate that sexual and physical abuse remain significant predictors of risky sexual behaviors, and that sexual abuse remains a significant predictor of adolescent motherhood when alternative explanatory variables are controlled.

CITATION: Noll, J. G., Guastaferro, K., Beal, S. J., Schreier, H. M. C., Barnes, J., Reader, J.M., & Font, S. A. (2019). Is sexual abuse a unique predictor of sexual risk behaviors, pregnancy, and motherhood in adolescence? Journal of Research on Adolescence, 29(4), 967-983.

Family Influences / Publications — No Comments
09
Mar 20

Prospective relations between prenatal maternal cortisol and child health

Objective The aim of the study was to investigate prospective, longitudinal associations between maternal prenatal cortisol response to an interpersonal stressor and child health for the subsequent 3 years. Methods One hundred twenty-three women expecting their first child provided salivary cortisol samples between 12 and 32 weeks of gestation (M (SD) = 22.4 (4.9) weeks) before and after a videotaped couple conflict discussion with their partner. Mothers reported on overall child health and several indicators of child illness (sick doctor visits, fevers, ear, and respiratory infections) when children were 6 months (n = 114), 1 (n = 116), and 3 (n = 105) years old. Associations between maternal prenatal cortisol reactivity and recovery and later child health at each of the three time points were analyzed using longitudinal regression models. Results Greater cortisol reactivity in response to the couple conflict discussion was associated with maternal self-report of better overall child health (p = .016, 95% CI = 0.06-1.30, Cohen’s f = 0.045) across the study period. Greater cortisol reactivity was also associated with lower incidence rate ratios for maternal reports of sick doctor visits (incidence rate ratio 95% CI = 0.25-0.83, p = .006), fevers (95% CI = 0.25-0.73, p = .002), ear infections (95% CI = 0.25-0.58, p < .001), and respiratory infections (95% CI = 0.08-1.11, p = .073). Cortisol recovery was unrelated to study outcomes (all p’s > 0.05). Maternal prenatal depressive symptoms moderated the association between cortisol reactivity and overall child health (p = .034, 95% CI = 0.07-1.87 for interaction term) but no other health outcomes (p’s > 0.05). Among women with lower depressive symptoms, cortisol reactivity was not associated with overall child health; among women with higher levels of depressive symptoms, greater cortisol reactivity was associated with better overall child health. Conclusions This study provides longitudinal evidence that greater maternal cortisol reactivity to a salient interpersonal stressor during pregnancy is associated with fewer child health problems and better maternal report of overall child health during infancy and into early childhood.

CITATION: Roettger, M. E., Schreier, H. M. C., Feinberg, M. E., & Jones, D. E. (2019). Prospective relations between prenatal maternal cortisol and child health. Psychosomatic Medicine, 81(6), 557-565.

Family Influences / Publications — No Comments
03
Oct 18

Aspects of the parent–child relationship and parent metabolic outcomes

Much is known about the effect of parent–child relationships on child health; less is known about how parent–child relationships influence parent health. To assess the association between aspects of the parent–child relationship and parent metabolic outcomes, and whether these associations are moderated by parent gender. Five metabolic outcomes (systolic and diastolic blood pressure, heart rate, total cholesterol and glycated hemoglobin) were assessed among 261 parents (45.83 ± 5.50 years) of an adolescent child (14.57 ± 1.072 years). Parents completed questionnaires assessing their child’s hassles and the quality of their days with their child. Parents’ perceptions of their child’s hassles were associated with parent heart rate (B = 2.954, SE = 1.267, p = 0.021) and cholesterol (B = 0.028, SE = 0.011, p = 0.010), such that greater perceived child hassles were associated with higher heart rate and cholesterol levels, on average. These associations were not moderated by parent gender (all ps [ 0.30). Parent report of their day with their child was not associ- ated with parent metabolic outcomes (all ps [ 0.20). Par- ent gender moderated the association between parent report of their day with their child and parent systolic blood pressure (B = 13.861, SE = 6.200, p = 0.026), such that less positive reports were associated with higher blood pressure readings among fathers, but not mothers. This study suggests that parent metabolic health may in part be influenced by aspects of the parent–child relationship.

CITATION: Jones, E.J., Chen, E., Levine, C.S., Lam, P.H., Liu, V.Y., & Schreier, H.M.C. (2019). Aspects of the parent-child relationship and parent metabolic outcomes. Journal of Behavioral Medicine, 42(2), 204-216.

Adolescents / Family Influences / Publications — No Comments
03
Oct 18

Chronic Family Stress and Adolescent Health: The Moderating Role of Emotion Regulation

Objective The aim of the study was to assess whether the association between chronic family stress and physiological measures is moderated by emotion regulation strategies in an adolescent sample. Methods Chronic family stress was assessed via a semi-structured interview and emotion regulation strategies (cognitive reappraisal and suppression) via questionnaire among 261 adolescents (14.57 (1.07) years). Several metabolic (waist-hip ratio, systolic and diastolic blood pressure) and inflammatory markers (basal and stimulated pro-inflammatory cytokine production in response to bacterial challenge) as well as glucocorticoid sensitivity were assessed. Results There were no main effects of chronic family stress, cognitive reappraisal, or suppression on physiological measures (all p’s > .10). Emotion regulation moderated the association between chronic family stress and physiological measures. As chronic family stress increased, adolescents higher in cognitive reappraisal had smaller waist-hip ratios (B = −.003, SE = .001, p = .015) and lower systolic blood pressure (B = −.303, SE = .143, p = .035), although no moderation was found with respect to inflammatory markers and glucocorticoid sensitivity (all p’s > .30). In addition, as chronic family stress increased, adolescents higher in suppression showed evidence of higher stimulated pro-inflammatory cytokine production (B = .046, SE = .020, p = .021) and lower glucocorticoid sensitivity (B = .051, SE = .021, p = .015), although basal inflammation and metabolic measures were not moderated by suppression (all p’s > .50). Conclusions This study suggests that the types of emotion regulation strategies used by adolescents may affect the extent to which chronic family stress affects important metabolic and immune processes.

CITATION: Jones, E. J., Lam, P.H., Hoffer, L.C., Chen, E., & Schreier, H.M.C. (2018). Chronic stress and adolescent health: the moderating role of emotion regulation. Psychosomatic Medicine, 80(8), 764-773.

Publications / Trauma — No Comments
27
Aug 18

Assessing risk of commercial sexual exploitation among children involved in the child welfare system

The objective of this study was to assess item characteristics indicative of the severity of risk for commercial sexual exploitation among a high-risk population of child welfare system involved youth to inform the construction of a screening tool. Existing studies have discerned factors that differentiate Commercial Sexual Exploitation of Children (CSEC) victims from sexual abuse victims, yet no research has been conducted to discriminate which items in a high risk population of youth are most predictive of CSEC. Using the National Survey of Child and Adolescent Well- Being (NSCAW) cohorts I and II, we examined responses from 1063 males and 1355 females ages 11 and older, over three interview periods.

A 2-parameter logistic Item Response Theory (2 PL IRT) model was employed in order to examine item performance as potential indicators for the severity of risk for CSEC. Differential Item Functioning (DIF) analysis was conducted in order to examine potential differences in item responses based on gender. Modeling strategies to assess item difficulty and discrimination were outlined and Item Characteristic Curves for the final retained items were presented. Evidence for uniform DIF were present within items that asked about runaway, any drug use, suicidality, and experiencing severe violence. Results from this study can inform the construction of a screening instrument to assess the severity of risk for experiencing CSEC.

CITATION: Panlilio, C., Miyamoto, S., Font, S., & Schreier, H.M.C. (2019). Assessing risk of commercial sexual exploitation among children involved in the child welfare system. Child Abuse & Neglect, 87, 88-99.

Adolescents / Inflammation / Publications — No Comments
27
Aug 16

Low-Grade Inflammation and Ambulatory Cortisol in Adolescents: Interaction Between Interviewer-Rated Versus Self-Rated Acute Stress and Chronic Stress

Objective: To determine whether the association between self-rated or interviewer-rated recent acute stress exposures and low-grade inflammation and daily cortisol production in adolescents is moderated by chronic stress ratings. Methods: Acute and chronic stress exposures were assessed in 261 adolescents aged 13 to 16 years using a semistructured life stress interview. The negative impact of acute stressors was independently rated by both adolescents (self-rated) and interviewers (interviewer-rated). Markers of inflammation (interleukin (IL)-6, IL-1ra, C-reactive protein) were measured from peripheral blood samples obtained via antecubital venipuncture. Participants collected 4 saliva samples at home on each of 6 consecutive days for the analysis of diurnal salivary cortisol profiles. Results: There were no main effects of acute stressors (self- and interviewer-rated) and chronic family or peer stress on adolescent inflammation markers and cortisol (p values > .10). However, the interaction between interviewer-rated acute stress and chronic family stress was significantly associated with adolescent inflammation markers (IL-6, IL-1ra). Specifically, as chronic family stress increased, the association between acute stressor impact (interviewer-rated) and inflammation markers became more positive (IL-6 (B = .054, SE = .023, p = .022); IL-1ra (B = .030, SE = .014, p = .034)). Interactions between self-rated acute stress and chronic family stress were not associated with any biological measures (p values > .10). Interactions between acute stressor impact (both self- and interviewer-rated) and chronic peer stress were also not significantly associated with any biological measures (p values > .05). Conclusions: Among adolescents, interviewer-based ratings of acute stressor impact may allow for better prediction of health-relevant inflammation markers than adolescents’ own ratings.

CITATION: Schreier, H. M. C. & Chen, E. (2016). Low-Grade Inflammation and Ambulatory Cortisol in Adolescents: Interaction Between Interviewer-Rated Versus Self-Rated Acute Stress and Chronic Stress. Psychosomatic Medicine.

Family Influences / Inflammation / Publications — No Comments
27
Aug 16

Social role conflict predicts stimulated cytokine production among men, not women

Objective: To assess whether perceived role conflict is associated with stimulated pro-inflammatory cytokine production and glucocorticoid sensitivity, and whether these associations are moderated by sex. Methods: 153 healthy adults (aged 45.8±5.5years, 78% female) listed their 3 main social roles and indicated the amount of role conflict they perceived between each pair of social roles. Subsequently, participants underwent blood draws and leukocyte response to microbial challenge and glucocorticoid sensitivity were assessed by incubating whole blood with lipopolysaccharide (LPS) in the presence or absence of hydrocortisone. Stimulated levels of Interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor alpha (TNFα) were measured. Results: Multiple regression analyses controlling for sociodemographics revealed significant sex×role conflict interactions for LPS-stimulated production of IL-1β, IL-6, and TNFα (all interaction ps<0.05), and a marginal interaction on LPS-stimulated IL-8 production (interaction p<0.10). Greater perceived role conflict was associated with greater pro-inflammatory cytokine production in response to microbial stimulation only among men, not women. There also were significant sex×role conflict interactions with respect to glucocorticoid sensitivity for IL-1β, IL-6, and TNFα production (all interaction ps<0.05) and a marginal interaction for IL-8 (interaction p<0.10). Greater perceived role conflict was unrelated to glucocorticoid sensitivity among women, but associated with less sensitivity to glucocorticoid signaling among men. Conclusions: Perceived social role conflict, indicating greater perceived demand across multiple social roles, may take a greater toll on the regulation of inflammatory processes among men compared to women.

CITATION: Schreier, H. M. C, Hoffer, L. C. & Chen, E. (2016). Social role conflict predicts stimulated cytokine production among men, not women. Brain, Behavior, & Immunity.

Chronic Illnesses / Publications / Trauma — No Comments
11
Apr 16

Child maltreatment and pediatric asthma: A review of the literature

Background: Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. Main: This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report an association between maltreatment experiences and asthma outcomes in childhood. However, this literature is in its early stages; there are only a handful studies, most of them rely on self-reports of both child maltreatment and asthma history, and none have investigated the physiological underpinnings of this association. Taken together, however, the studies are suggestive of child maltreatment playing a role in pediatric asthma incidence and expression that should be explored further. Conclusion: Existing data are sparse and do not allow for specific conclusions. However, the data are suggestive of child maltreatment influencing asthma risk and morbidity long before the adult years. Future research should focus on understanding how child maltreatment contributes to asthma disease risk and progression in this highly vulnerable population.

CITATION: Schreier, H. M. C., Chen, E. & Miller, G. E. (2016). Child maltreatment and pediatric asthma: a review of the literature. Asthma Research and Practice, 2(7).

Publications / Trauma — No Comments
22
Jan 16

Lifetime exposure to traumatic and other stressful life events and hair cortisol in a multi-racial sample of pregnant women

Background Hypothalamic–pituitary–adrenal (HPA) axis activity is known to be altered following events such as childhood abuse. However, despite potential adverse consequences for the offspring of women who have experienced abuse, very little is known about altered HPA axis activity during pregnancy. Methods During pregnancy, 180 women from diverse racial/ethnic backgrounds reported on their exposure
to emotional, physical and/or sexual abuse before the age of 11, and general post-traumatic stress symptoms (ie, not limited to childhood years or abuse experiences). Around delivery, they provided hair samples for the assessment of cortisol levels during pregnancy. Hair cortisol was assessed for each pregnancy trimester. The effect of childhood abuse on hair cortisol was assessed using mixed-effects analyses of covariance models allowing for within-subject correlated observations, and were first performed in the entire sample and subsequently stratified by race/ethnicity. Results Controlling for post-traumatic stress symptoms, hair cortisol levels varied by history of child abuse, F(2,166)=3.66, p=0.028. Childhood physical and/or sexual abuse was associated with greater hair cortisol levels, t(166)=2.65, p=0.009, compared with no history of abuse. Because childhood rates of abuse and hair cortisol levels varied by race/ethnicity, analyses were stratified by race/ethnicity. The associations between history of abuse and cortisol levels were only significant among black women, F(2,23)=5.37, p=0.012. Conclusions Childhood abuse, especially physical and/ or sexual abuse, is associated with differences in cortisol production during pregnancy, particularly among black women. Future research should investigate how these differences impact physical and mental health outcomes among offspring of affected women.

CITATION: Schreier, H. M. C., Bosquet Enlow, M., Ritz, T., Coull, B. A., Wright, R. O., & Wright, R. J. (2016). Lifetime exposure to traumatic and other stressful life events and hair cortisol in a multi-racial sample of pregnant women. Stress, 19(1), 45-52.

Adolescents / Chronic Illnesses / Publications — No Comments
15
Sep 15

Prospective associations between coping and health among youth with asthma and healthy youth

The present study evaluated whether primary and secondary coping would predict longitudinal asthma-related clinical outcomes, such as peak expiratory flow rate (PEFR) and self-reported school absenteeism, rescue inhaler use, and asthma-related physician contacts, in youth with asthma. The 62 youth (68% males) had an average age of 12.6 +/- 2.73 years and were primarily of European origin. Coping and asthma outcomes were obtained by youth self-report at baseline and over a 12-month follow-up period. Greater secondary coping at baseline was related to greater increases in PEFR and a greater likelihood of physician contact over the following year. Greater primary coping at baseline was related to greater likelihood of rescue inhaler use, school absenteeism, and physician contact over the following year. In contrast, asthma measures at baseline did not predict changes in coping over the following year. These patterns suggest that youth who engage in secondary coping accept and adapt to their asthma in ways that improve pulmonary function over time. Youth who engage in primary coping may be more likely to communicate asthma problems to others, and such communication perhaps leads to increases in behaviors meant to address these problems.

CITATION: Schreier, H. M. C. & Chen, E. (2008). Prospective associations between coping and health among youth with asthma and healthy youth. Journal for Consulting and Clinical Psychology, 76(5), 790-798.

Adolescents / Chronic Illnesses / Family Influences / Inflammation / Publications — No Comments
15
Sep 15

Chronic traffic-related air pollution and stress interact to predict biologic and clinical outcomes in asthma

Background: Previous research has documented effects of both physical and social environmental exposures on childhood asthma. However, few studies have considered how these two environments might interact to affect asthma. Objective: This study aimed to test interactions between chronic exposure to traffic-related air pollution and chronic family stress in predicting biologic and clinical outcomes in children with asthma. Method: Children with asthma (n = 73, 9-18 years of age) were interviewed about life stress, and asthma-relevant inflammatory markers [cytokine production, immunoglobulin E (IgE), eosinophil counts] were measured. Parents reported on children’s symptoms. Children completed daily diaries of symptoms and peak expiratory flow rate (PEFR) measures at baseline and 6 months later. Exposure to traffic-related air pollution was assessed using a land use regression model for nitrogen dioxide concentrations. Results: NO(2) by stress interactions were found for interleukin-5 (beta for interaction term = -0.31, p = 0.02), IgE (interaction beta = -0.29, p = 0.02), and eosinophil counts (interaction beta = -0.24, p = 0.04). These interactions showed that higher chronic stress was associated with heightened inflammatory profiles as pollution levels decreased. Longitudinally, NO(2) by stress interactions emerged for daily diary symptoms (interaction beta = -0.28, p = 0.02), parent-reported symptoms (interaction beta = -0.25, p = 0.07), and PEFR (interaction beta = 0.30, p = 0.03). These interactions indicated that higher chronic stress was associated with increases over time in symptoms and decreases over time in PEFR as pollution levels decreased. Conclusions: The physical and social environments interacted in predicting both biologic and clinical outcomes in children with asthma, suggesting that when pollution exposure is more modest, vulnerability to asthma exacerbations may be heightened in children with higher chronic stress.

CITATION: Chen, E., Schreier, H. M. C., Strunk, R. C., & Brauer, M. (2008). Chronic traffic-related air pollution and stress interact to predict biologic and clinical outcomes in asthma. Environmental Health Perspectives, 116(7), 970-975.

Adolescents / Chronic Illnesses / Publications / Socioeconomic Status — No Comments
15
Sep 15

Resilience in low socioeconomic status children with asthma: adaptations to stress

Background: Low socioeconomic status (SES) is a strong predictor of many health problems, including asthma impairment; however, little is understood about why some patients defy this trend by exhibiting good asthma control despite living in adverse environments. Objective: This study sought to test whether a psychological characteristic, the shift-and-persist strategy (dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future), protects low-SES children with asthma. Methods: One hundred twenty-one children aged 9 to 18 years with a physician’s diagnosis of asthma were recruited from medical practices and community advertisements (mean age, 12.6 years; 67% male; 61% white). Shift-and-persist scores and asthma inflammation (eosinophil counts and stimulated IL-4 cytokine production) were assessed at baseline, and asthma impairment (daily diary measures of rescue inhaler use and school absences) and daily peak flow were monitored at baseline and at a 6-month follow-up. Results: Children who came from low-SES backgrounds but who engaged in shift-and-persist strategies displayed less asthma inflammation at baseline (β = 0.19, P < .05), as well as less asthma impairment (reduced rescue inhaler use and fewer school absences; β = 0.32, P < .01) prospectively at the 6-month follow-up period. In contrast, shift-and-persist strategies were not beneficial among high-SES children with asthma. Conclusion: An approach that focuses on the psychological qualities that low-SES children develop to adapt to stressors might represent a practical and effective starting point for reducing health disparities. Moreover, the approaches that are effective in low-SES communities might be different from those that are optimal in a high-SES context.

CITATION: Chen, E., Strunk, R. C., Threthewey, A., Schreier, H. M. C., Maharaj, N., & Miller, G. E. (2011). Resilience in low socioeconomic status children with asthma: adaptations to stress. Journal of Asthma and Clinical Immunology, 128(5), 970-976.

Adolescents / Chronic Illnesses / Family Influences / Inflammation / Publications — No Comments
15
Sep 15

Longitudinal relationships between family routines and biological profiles among youth with asthma

Objective: To investigate whether longitudinal trajectories of inflammatory markers of asthma can be predicted by levels of family routines in youth with asthma. Design: Family routines were assessed through parent questionnaires and peripheral blood samples obtained from youth every 6 months throughout the 18-month study period. Longitudinal relationships were evaluated using hierarchical linear modeling. Main Outcome Measures: Mitogen-stimulated production of cytokines implicated in asthma, specifically IL-4, IL-5, and IL-13. Results: Youth with more family routines in their home environment showed decreases in IL-13 (but not IL-4 or IL-5) over the course of the study period. In turn, within-person analyses indicated that at times when stimulated production of IL-13 was high, asthma symptoms were also high, pointing to the clinical relevance of changes in IL-13 over time. A variety of child and parent psychosocial as well as child behavioral characteristics could not explain these effects. However, medication use eliminated the relationship between family routines and stimulated production of IL-13. Conclusion: Our study suggests that family routines predict asthma outcomes at the biological level, possibly through influencing medication use. Considering daily family behaviors when treating asthma may help improve both biological and clinical profiles in youth with asthma.

CITATION: Schreier, H. M. C. & Chen, E. (2010). Longitudinal relationships between family routines and biological profiles among youth with asthma. Health Psychology, 29(1), 82-90.

Adolescents / Chronic Illnesses / Publications / Socioeconomic Status — No Comments
15
Sep 15

Socioeconomic status in one’s childhood predicts offspring cardiovascular risk

Objective: To test whether effects of socioeconomic environments can persist across generations, we examined whether parents’ childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. Methods: BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). Results: If parents’ childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents’ childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. Conclusion: Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth.

CITATION: Schreier, H. M. C. & Chen, E. (2010). Socioeconomic status in one’s childhood predicts offspring cardiovascular risk. Brain, Behavior, & Immunity, 24, 1324-1331.

Adolescents / Chronic Illnesses / Publications — No Comments
15
Sep 15

Clinical potentials for measuring stress in youth with asthma

It is well established that the course of asthma can be affected by the psychological stress an individual experiences. This article reviews literature assessing the effects of psychological stress on asthma outcomes and discusses the benefits and disadvantages of different measures for assessing stress, including subjective questionnaires, event checklists, and interview-based approaches. We discuss the importance of taking into account the timing and chronicity of stress, as well as individuals’ subjective appraisals of stress. We suggest that, although questionnaire and checklist approaches are easier to administer, interview-based stress assessments are preferable, where feasible, because they generate richer and more in-depth information regarding the stressors that people experience. In addition, this kind of information seems to be more robustly linked to pediatric asthma outcomes of interest.

CITATION: Schreier, H. M. C., Miller, G. E., & Chen, E. (2011). Clinical potentials for measuring stress in youth with asthma. Immunology and Allergy Clinics of North America, 31(1), 41-54.

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