Longitudinal growth patterns of internalizing and externalizing behavior problems were examined in a community sample of 441 children across the ages of 2 to 5 using hierarchical linear modeling. Contextual risk was measured using five indicators (socioeconomic status, marital status, number of siblings, parent stress, parent psychopathology), and three levels of child resilience (biological, behavioral, and relational) were also assessed. Results indicate that a general pattern of decline in both types of behavior problems was observed for the entire sample across time, although considerable individual variability in this pattern was observed. Children's externalizing and internalizing behavior at age 5 was predicted by the level of risk at age 2. All three child resilience factors were also predictive of externalizing and internalizing behaviors at age 5. In the prediction of the slope of problem behavior over time, risk status interacted with both temperamental fearlessness and a mutually responsive orientation with the mother to predict the decline in externalizing and internalizing problem behavior. Results underscore the complex interactions of risk and multiple levels of resilience that are implicated in the maintenance of problem behavior over time. They highlight the importance of considering whether expected resilience factors operate similarly across different levels of risk.

In this study we investigated the development of the hypothalamic–pituitary–adrenal (HPA) axis in 21 group-living rhesus monkeys infants that were physically abused by their mothers in the first few months of life and in 21 nonabused controls. Cortisol and adrenocorticotropin hormone (ACTH) responses to a corticotropin-releasing hormone (CRH) challenge were assessed at 6-month intervals during the subjects' first 3 years of life. Abused infants exhibited greater cortisol responses to CRH than controls across the 3 years. Abused infants also exhibited blunted ACTH secretion in response to CRH, especially at 6 months of age. Although there were no significant sex differences in abuse experienced early in life, females showed a greater cortisol response to CRH than males at all ages. There were no significant sex differences in the ACTH response to CRH, or significant interactions between sex and abuse in the ACTH or cortisol response. Our findings suggest that early parental maltreatment results in greater adrenocortical, and possibly also pituitary, responsiveness to challenges later in life. These long-term alterations in neuroendocrine function may be one the mechanisms through which infant abuse results in later psychopathologies. Our study also suggests that there are developmental sex differences in adrenal function that occur irrespective of early stressful experience. The results of this study can enhance our understanding of the long-term effects of child maltreatment as well as our knowledge of the development of the HPA axis in human and nonhuman primates.

Few studies have examined the associations between environmental conditions and developing infant emotionality or the differential susceptibility to those conditions. The present longitudinal study aims to make a contribution to close that gap. We analyzed whether positive emotionality, negative emotionality/irritability, and withdrawal/fear at the end of the first year of life are predictable from preceding caregiver's depression/anxiety, social support, and sensitivity in the interaction with the infant while controlling for antecedent states of emotionality. Furthermore, the question of whether associations between maternal characteristics and subsequent fear are stronger in the subgroup of infants high in irritability as opposed to those who are low in irritability was investigated. Subjects were 101 healthy firstborn infants and their primary caregivers. Assessments were conducted at infant ages of 4, 8, and 12 months. Depression, anxiety, and the social support of the caregiver were assessed by questionnaire. Sensitivity in the caregiver–infant interaction was assessed by behavior observations within the scope of home visits. Temperament characteristics were observed in standardized laboratory episodes. Whereas negative emotionality and withdrawal/fear were significantly predictable from the maternal characteristics, no predictability could be shown for developing positive emotionality. There were indications of a stronger association between the maternal characteristics and developing withdrawal/fear in irritable infants.The research for this article was supported by a grant from the Deutsche Forschungsgemeinschaft (DFG) to U. Pauli–Pott and D. Beckmann (Grant PA 543/2-1, 2-2, 2-3). The sample was recruited from the maternity wards of two hospitals in Giessen. The authors thank PD Dr. C. Schubring, Head of the Department of Obstetrics and Gynecology at the Evangelical Hospital, and Dr. A. Esch, Dr. K. D. Fleck, and Dr. H. J. Meier of St. Josef's Hospital, as well as the neonatal nurses in both hospitals for the friendly cooperation with which they supported the present study. Finally, special thanks are given to the families who participated in the study.

This study examined growth patterns in adaptation of immigrant youth from a risk and resilience perspective. Students from first- and second-generation immigrant families living in Greece and their nonimmigrant classmates (N = 1,057) were assessed over the first 3 years of secondary school (ages 13–15). Three-level hierarchical linear models were used to disentangle individual and classroom-level effects on initial level and change in academic achievement, conduct, peer popularity, and psychological well-being. At the individual level, adaptation was more related to self-efficacy and parental school involvement (resources) than immigrant status and social adversity (risks). Only for academic achievement did risks explain variance when resources were controlled. Parental school involvement moderated the effect of immigrant status for initial level and growth in achievement. For all students, achievement and conduct worsened over time. At the classroom level, socioeconomic and ethnic composition of the classroom moderated the effects of self-efficacy and immigrant status on academic achievement and peer popularity, respectively. Second-generation immigrants were more popular than first-generation immigrants, but showed a larger decrease over time in school achievement. Results support a developmental, differentiated, and contextualized approach to the study of immigrant youth adaptation.

The objective of this study was to explore the relationship among extremely low birthweight (ELBW), psychopathology, and impairments in adaptive functioning in a regional cohort of 7–8-year-old children with a birthweight of 501–1,000 g compared to a sample of full-term controls. One-hundred twenty-nine of 143 (90%) ELBW survivors and 145 controls, born between 1977 and 1981, agreed to participate in the study. The children were assessed at a mean, unadjusted age of 7.8 years. Results showed that parents of ELBW children were more likely than parents of controls to report specifically problems of attention-deficit hyperactivity disorder (ADHD). There were few differences between the groups in terms of impairments in adaptive functioning. Further analyses showed that the relationship between ELBW and ADHD could not be explained by confounding psychosocial risk factors, nor were ELBW children from disadvantaged environments more likely to have ADHD problems than ELBW children from nondisadvantaged environments. The relationships between ELBW and ADHD problems appeared to be associated with the lower IQ of the ELBW subjects.

Low socioeconomic status (SES) background has been identified as a risk for several mental disorders. However evidence regarding SES and the developmental course of personality disorder (PD) has not been addressed. Nor is it clear whether an SES relationship to PD symptom course may be attributable to known associated risks. Further, specificity of such relationships to a particular PD diagnostic pattern independent of comorbidity with other PD or with depression has not been investigated. Data are from a general population studied longitudinally between ages 10 and 36 in four assessment waves. Effects of SES-associated risks on the level of symptoms of schizotypal and borderline disorders are estimated and compared to effects on depressive symptoms. Low family SES had robust modest independent effects on both PDs over the entire age span despite substantial cumulative effects of trauma history, stressful recent life events, IQ, poor parenting, and comorbid symptoms. SES effects on depressive symptoms were generally absent, but a small “protective” effect of low SES appeared when comorbidity with PD symptoms was taken into account. Cumulatively, these risks account for developmental failures of substantial magnitude and consequence, marking the importance of understanding the remaining mechanisms of SES effects and programmatic implications for minimizing associated risk.

There is debate about the relative importance of timing of stressful events prenatally and over the life course and risk for subsequent depressive/anxious illness. The aim of this study was to examine the relative roles of prenatal stress and postnatal stress trajectories in predicting depression and anxiety in early adulthood in males and females. Exposure to life stress events was examined in the Western Australian Pregnancy Cohort (Raine) Study during pregnancy and ages 1, 2, 3, 5, 8, 10, 14, and 17 years. At age 20, offspring completed the Depression Anxiety Stress Scale. Prenatal stress and trajectories of stress events from age 1 to 17 were analyzed in linear regression analyses. Five postnatal stress trajectories were identified. In females, medium to high chronic stress exposure or exposure during puberty/adolescence predicted depression and anxiety symptoms while low or reduced stress exposure over the life course did not, after adjustment for relevant confounders. High stress early in pregnancy contributed to male depression/anxiety symptoms independent of postnatal stress trajectory. In females, postnatal stress trajectory was more important than prenatal stress in predicting depression/anxiety symptoms. Interventions focused on reducing and managing stress events around conception/pregnancy and exposure to chronic stress are likely to have beneficial outcomes on rates of depression and anxiety in adults.

The purpose of this study was to examine the relationship between fathers' alcoholism and the quality of parent–infant interactions during free play. A related goal was to study the potential mediating or moderating role of comorbid parental psychopathology, such as depression and antisocial behavior, difficult infant temperament, and parental aggression. The sample consisted of 204 families with 12-month-old infants (104 alcoholic and 100 control families), recruited from New York State birth records. Results indicated that fathers' alcoholism was associated with a number of other risk factors (depression, antisocial behavior, and family aggression). Fathers' alcoholism was also associated with more negative father–infant interactions as indicated by lower paternal sensitivity, positive affect, verbalizations, higher negative affect, and lower infant responsiveness among alcoholic fathers. As expected, fathers' depression mediated the relationship between fathers' alcoholism and sensitivity, while maternal depression mediated the association between maternal alcohol problems and maternal sensitivity. Parents' psychopathology did not moderate the association between alcoholism and parent-infant interactions. The results from the present study suggest that the origins of risk for later maladjustment among children of alcoholic fathers are apparent as early as infancy and highlight the role of comorbid parental risk factors.

The current study examined the interactive effects of infant activity level and fear on growth trajectories of behavior problems in early childhood (age 4 to 8 years) using maternal ratings. The sample was drawn from the National Longitudinal Survey of Youth (NLSY) and included children who were between 1 and 11 months in 1986. Findings suggested that boys characterized by high activity level and low levels of fear in infancy escalated in both externalizing and internalizing symptoms. Also, boys characterized by high fear and low activity level increased in internalizing symptoms and these effects seemed to be specific to depression rather than anxiety. Temperament did not predict escalation in externalizing symptomatology for girls, but low levels of fear predicted increases in internalizing symptoms. There was also evidence for a decline in depression specific symptoms for girls characterized by high fear and low activity in infancy. These findings suggest the importance of examining interactive models of temperament risk and considering gender specific pathways to behavior problems.

Maltreatment can impact the earliest stages of development during which time patterns of emotion regulation and attachment begin to be established (Carlson, Cicchetti, Barnett, & Braunwald, 1989b; Cicchetti, Ganiban, & Barnett, 1991). These disruptive patterns are problematic for early moral development and are likely to play a role in the development of conduct disorders (Aber & Cicchetti, 1984). Thus, maltreated children are clearly in a high-risk situation. To examine emotion regulation, internal representations of relationships, and early moral development, the use of a play narrative story stem technique (Bretherton, Ridgeway, & Cassidy, 1990; Buchsbaum & Emde, 1990) with maltreated children and a nonmaltreated disadvantaged comparison group of children is described. Representative case examples from each group are used to illustrate the effectiveness of this technique for eliciting themes about family relationships, conflicts, and their resolution or lack thereof as well as defenses and coping styles. The potential usefulness of this paradigm for clinical assessment and intervention are discussed.

Three hundred sixty-three school-aged children from maritally violent and nonviolent families were interviewed about their friendship networks, frequency of social contact, the interpersonal quality of their friendships, and hostile attributional biases. Mothers answered items from the Child Behavior Checklist about peer conflict. Children did not differ on the number of friends they claimed or their frequency of contact with peers. However, children exposed to marital violence reported feeling more lonely and having more conflict with a close friend. Their mothers also reported them as having more problems with peers. In addition, children with punitive mothers had more conflict with a best friend. Residing in a shelter added further to children's feelings of loneliness, with one third having no best friend. Children's attributional biases were unrelated to the quality of their peer relations or any other index of peer functioning. Results are discussed in terms of an attachment framework. Findings confirm that it is important to examine the quality of relationships to determine how children at risk fare in their social lives.

Glucocorticoids (GCs), produced by the stress-responsive hypothalamic–pituitary–adrenal axis, are well recognized for their regulatory role in peripheral metabolism. GCs are also known to regulate various brain functions, with well-described effects on human cognition. Increased GC exposure in humans—including exposure to the endogenous GC, cortisol—at levels associated with stress, decreases memory and learning function. These results extend evidence from in vitro studies of synaptic and cell function and evidence from animals indicating the GCs can regulate substrates of memory function. While considerable evidence details these effects in adult humans and animals, relatively less is know about the effect of GCs on cognitive function in children and older adults. Investigators have suggested that children, particularly preschool-aged children, may be vulnerable to adverse consequences of increased GC secretion resulting from stress and neuropsychiatric diseases such as depression. Adverse GC effects on memory substrates and memory function in the adult have also fostered concern that age-related changes, including changes in GC receptors and changes in circulating cortisol levels, could lead to age-related increases in the adverse effect of GCs on brain function. Investigators have reported an association between age-related increases in cortisol levels and age-related memory decline, but this association may or may not be due to a direct effect of cortisol on memory substrates. A number of possible treatment approaches to prevent or remediate adverse GC-induced effects are under development. In general, the use of safe and effective agents for blocking adverse GC effects on brain functions including memory may offer benefits to individuals suffering acute and chronic stressors and could prevent brain changes relevant to stress, aging, and stress-related neuropsychiatric diseases.

Interactive coordination was observed in laboratory play interactions of pairs of 29 clinically depressed and 14 nondepressed mothers and their 13–29-month-old children (M = 18.9 months). Nondepressed mothers and their children displayed more interactive coordination than depressed-mother dyads (p < .001). Depressed mothers were less likely to repair interrupted interactions, and their toddlers were less likely to maintain interactions than nondepressed controls. Toddlers matched their nondepressed but not their depressed mothers' negative behavior rates. Results suggested that early interventions focus on training mothers to attend to, maintain, and repair mother–child interactions to more closely approximate normal levels of interactive coordination.

This paper examines the relationship between childhood exposure to cumulative risk and three indicators of psychosocial adjustment in adulthood (educational attainment, mental health, and criminal behavior) and tests three different models (linear, quadratic, and interaction). Data were collected over several time points from individuals who were part of a prospective cohort design study that matched children with documented cases of abuse and/or neglect with children without such histories and followed them into adulthood. Hierarchical multiple regressions compared linear and quadratic models and then examined potential moderating effects of child abuse/neglect and gender. Exposure to a greater number of childhood risk factors was significantly related to fewer years of education, more anxiety and depression symptomatology, and more criminal arrests in adulthood. The relationship between cumulative risk and years of education demonstrated a curvilinear pattern, whereas the relationship between cumulative risk and both mental health and criminal arrests was linear. Child abuse/neglect did not moderate these relationships, although there were direct effects for both child abuse/neglect and gender on criminal arrests, with more arrests for abused/neglected individuals than controls and more for males than females. Gender interacted with cumulative risk to impact educational attainment and criminal behavior, suggesting that interventions may be more effective if tailored differently for males and females. Interventions may need to be multifaceted and designed to address these different domains of functioning.

This study distinguished between factors that were protective for children at high risk and those that were resources for children regardless of risk level and determined the generality of these factors across three different risk definitions: school-age children of mothers with (a) unipolar depression (n = 22), (b) bipolar disorder (n = 18), and (c) medical illness (n = 18), each compared to a low-risk control group (n = 38). Results were verified at a 1-year follow-up. Positive self-concept, academic success, social competence, and positive perceptions of the mothers were resource factors associated with lower diagnostic ratings for children in all risk groups. Maternal social competence and having a healthy father in the home were resource factors for maternal unipolar risk but, unexpectedly, were vulnerability factors for maternal bipolar risk. Children's friendships were protective for children of medically ill mothers; however, frequent contact with an adult friend was a risk factor for unipolar offspring. The latter finding suggests that such contact might be a consequence of poor parent-child relationships. Findings are discussed in terms of possible interventions for children at risk, and suggestions for additional research are offered.

Borderline personality disorder (BPD) represents a severe distortion in the development of attachment, self, and emotion regulation. Study of children at high risk of developing BPD may inform precursors to BPD. In a low socioeconomic status sample of 30 children aged 4–7 whose mothers have BPD and 30 normative comparisons, representations of the caregiver–child relationship and of the self, and emotion regulation were assessed with a story-stem completion measure. In contrast to comparisons and controlling for major depressive disorder, children whose mothers have BPD told stories with the following: (a) more parent–child role reversal, more fear of abandonment, and more negative mother–child and father–child relationship expectations; (b) more incongruent and shameful representations of the self; and (c) poorer emotion regulation indicated by more confusion of boundaries between fantasy and reality and between self and fantasy, more fantasy proneness, less narrative coherence, and marginally more intrusion of traumatic themes. In the sample as a whole, (a) a maladaptive caregiver–child relationship composite was associated with maternal identity disturbance and self-harm; (b) a maladaptive self-composite was associated with maternal self-harm; and (c) a maladaptive emotion regulation composite was associated with maternal identity disturbance, negative relationships, and self-harm. Results are discussed in terms of putative precursors to BPD and preventive interventions.

This study examined associations between temperament at age 3 and depressotypic cognitive styles at age 7 in a community sample of children. Sixty-four preschool aged children were assessed for positive emotionality (PE) and negative emotionality (NE) using a standardized battery of laboratory tasks and naturalistic home observations. At follow-up 4 years later, the children completed laboratory tasks designed to tap helplessness in social and problem-solving situations, positive and negative information-processing biases, and self-reports of attributional style. Lower PE at age 3 predicted greater helplessness in the interpersonal task and decreased positive schematic processing. There was little evidence for a relationship between NE and depressotypic cognitive styles. Our findings are consistent with the hypothesis that some portion of cognitive vulnerability to depression may stem from early-emerging differences in the expression of positive emotions.This work is based upon a dissertation submitted to the Graduate School of SUNY at Stony Brook by the first author. Portions of this work were supported by NIMH Research Grants RO1 MH45757 and RO1 MH069942. The authors acknowledge the consultation and support of Hill Goldsmith and Everett Waters, and the assistance of Cindy Huang, Grace Lee, Magda Kulesza, Suzanne Rose, and Jayanta Hegde for their help in data collection. Thanks also to the families who participated in this study.

The current study examined biomarkers of stress in war-exposed young children and addressed maternal and child factors that may correlate with children's stress response. Participants were 232 Israeli children aged 1.5–5 years, including 148 children exposed to continuous war. Similarly, 56 were diagnosed with posttraumatic stress disorder (PTSD) and 92 were defined as exposed-no-PTSD. Child cortisol (CT) and salivary alpha amylase (sAA), biomarkers of the hypothalamic–pituitary–adrenal and sympathetic–adrenal–medullary arms of the stress response, were measured at baseline, following challenge, and at recovery. Maternal CT and sAA, PTSD symptoms, and reciprocal parenting, and child negative emotionality and regulatory strategies were assessed. Differences between war-exposed children and controls emerged, but these were related to child PTSD status. Children with PTSD exhibited consistently low CT and sAA, exposed-no-PTSD displayed consistently high CT and sAA, and controls showed increase in CT following challenge and decrease at recovery and low sAA. Exposed children showed higher negative emotionality; however, whereas exposed-no-PTSD children employed comfort-seeking strategies, children with PTSD used withdrawal. Predictors of child CT included maternal CT, PTSD symptoms, low reciprocity, and negative emotionality. Findings suggest that high physiological arousal combined with approach strategies may be associated with greater resilience in the context of early trauma.

Consistent with developmental cascade notions, the present study investigated (a) associations between trajectories of interparental conflict and early externalizing problems during childhood and (b) early trajectories of externalizing problems as a pathway by which interparental conflict impacts children's social competence in preadolescence. Participants were 235 children and their parents and teachers. Children were assessed annually for 3 years, beginning when they were in kindergarten. Parents provided reports of interparental conflict and child externalizing problems. Children's social competence (prosocial behavior, social problems) was assessed approximately 5 years later via parent and teacher reports. Results from parallel process models indicated that changes in interparental conflict were positively associated with changes in externalizing problems during childhood. Further, demonstrating pathways consistent with notions of developmental cascades, early trajectories of externalizing problems accounted for the longitudinal link between early trajectories of interparental conflict and children's social problems in preadolescence.

Progress in the field of developmental psychopathology is appraised in general and with regard to the particular lens of our understanding of the development of disorder. In general, the outpouring of research on various features of disorder and underlying processes could not have even been imagined 25 years ago. The progress is dazzling. At the same time, work on the development of disorders, beginning with antecedent patterns of adaptation, pales in comparison with work on the correlates of disorder. However, progress has been made. It is well established that the brain develops in the context of experience and that organism and environment continually interact over time. Something is now known about pathways leading to certain disorders and what initiates and impels individuals along them. If developmental psychopathology is to completely fulfill its promise of offering new ways of conceptualizing disorder and new guidance for prevention and intervention, much more work on developmental processes and a new way of exploring the development of disorder will be needed. Such a path is suggested.