Simon Fraser University, Burnaby; BC Children's Hospital Research Institute, Vancouver, BC, Canada.
University of California San Francisco, San Francisco, CA, USA.
Res Child Adolesc Psychopathol. 2021 May;49(5):629-642. doi: 10.1007/s10802-020-00762-0. Epub 2021 Jan 14.
The development of child mental health problems has been associated with experiences of adversity and dysregulation of stress response systems; however, past research has largely focused on externalizing or internalizing problems (rather than their co-occurrence) and single physiological systems in high-risk adolescent samples. The present study examined whether cumulative family adversity, functioning in the hypothalamic-pituitary-adrenal axis (i.e., cortisol) and the parasympathetic nervous system (i.e., respiratory sinus arrhythmia [RSA]), and their interactions, predicted trajectories of co-occurring externalizing and internalizing problems among young children. Participants included 338 socioeconomically and racially diverse children (M age = 5.32 years, SD = .32; male = 51.8%) from a community sample. Family adversity (assessed with six measures) and child daily cortisol output and resting RSA were assessed in kindergarten. Parents, teachers, and children reported on children's externalizing and internalizing psychopathology up to three times from kindergarten to grade 1. Latent class growth analyses identified stable trajectories of externalizing and internalizing psychopathology. Trajectories were combined to create groups: co-occurring externalizing and internalizing (13.1%), externalizing-only (14.0%), internalizing-only (11.3%), and low problems (61.3%). Family adversity and resting RSA significantly positively predicted co-occurring group membership. Tests for interactions showed adversity did not significantly interact with physiological indicators to predict group membership. However, the two physiological systems interacted, such that higher and lower daily cortisol predicted internalizing group membership for children with lower and higher resting RSA, respectively. Findings support the importance of considering family context and multiple physiological systems to inform understanding of the development of mental health problems, and their co-occurrence, in early childhood.
儿童心理健康问题的发展与逆境经历和应激反应系统失调有关；然而，过去的研究主要集中在高风险青少年样本中的外化或内化问题（而不是两者同时存在）和单一生理系统上。本研究考察了累积家庭逆境、下丘脑-垂体-肾上腺轴（即皮质醇）和副交感神经系统（即呼吸窦性心律失常 [RSA]）的功能以及它们的相互作用是否可以预测幼儿同时存在的外化和内化问题的轨迹。参与者包括来自社区样本的 338 名社会经济和种族多样化的儿童（M 年龄= 5.32 岁，SD=.32；男性= 51.8%）。家庭逆境（用六个指标评估）和儿童每日皮质醇输出和静息 RSA 在幼儿园进行评估。父母、教师和儿童在幼儿园到一年级期间最多报告了三次儿童的外化和内化精神病理学。潜在类别增长分析确定了外化和内化精神病理学的稳定轨迹。轨迹被组合成几个组：同时存在的外化和内化（13.1%）、仅外化（14.0%）、仅内化（11.3%）和低问题（61.3%）。家庭逆境和静息 RSA 显著正向预测同时存在的群体归属。交互作用的检验表明，逆境与生理指标没有显著相互作用来预测群体归属。然而，这两个生理系统相互作用，即较高和较低的每日皮质醇分别预测静息 RSA 较低和较高的儿童的内化群体归属。研究结果支持考虑家庭环境和多个生理系统的重要性，以深入了解儿童早期心理健康问题及其同时存在的问题的发展。
