Beyond family‐level adversities: Exploring the developmental timing of neighborhood disadvantage effects on the brain

A growing literature suggests that adversity is associated with later altered brain function, particularly within the corticolimbic system that supports emotion processing and salience detection (e.g., amygdala, prefrontal cortex [PFC]). Although neighborhood socioeconomic disadvantage has been shown to predict maladaptive behavioral outcomes, particularly for boys, most of the research linking adversity to corticolimbic function has focused on family‐level adversities. Moreover, although animal models and studies of normative brain development suggest that there may be sensitive periods during which adversity exerts stronger effects on corticolimbic development, little prospective evidence exists in humans. Using two low‐income samples of boys (n = 167; n = 77), Census‐derived neighborhood disadvantage during early childhood, but not adolescence, was uniquely associated with greater amygdala, but not PFC, reactivity to ambiguous neutral faces in adolescence and young adulthood. These associations remained after accounting for several family‐level adversities (e.g., low family income, harsh parenting), highlighting the independent and developmentally specific neural effects of the neighborhood context. Furthermore, in both samples, indicators measuring income and poverty status of neighbors were predictive of amygdala function, suggesting that neighborhood economic resources may be critical to brain development.     

Using functional near‐infrared spectroscopy to assess social information processing in poor urban Bangladeshi infants and toddlers

Children living in low‐resource settings are at risk for failing to reach their developmental potential. While the behavioral outcomes of growing up in such settings are well‐known, the neural mechanisms underpinning poor outcomes have not been well elucidated, particularly in the context of low‐ and middle‐income countries. In this study, we measure brain metabolic responses to social and nonsocial stimuli in a cohort of 6‐ and 36‐month‐old Bangladeshi children. Study participants in both cohorts lived in an urban slum and were exposed to a broad range of adversity early in life including extreme poverty, malnutrition, recurrent infections, and low maternal education. We observed brain regions that responded selectively to social stimuli in both ages indicating that these specialized brain responses are online from an early age. We additionally show that the magnitude of the socially selective response is related to maternal education, maternal stress, and the caregiving environment. Ultimately our results suggest that a variety of psychosocial hazards have a measurable relationship with the developing social brain.     

Strengthening Connections: Functional Connectivity and Brain Plasticity

The ascendancy of functional neuroimaging has facilitated the addition of network-based approaches to the neuropsychologist’s toolbox for evaluating the sequelae of brain insult. In particular, intrinsic functional connectivity (iFC) mapping of resting state fMRI (R-fMRI) data constitutes an ideal approach to measuring macro-scale networks in the human brain. Beyond the value of iFC mapping for charting how the functional topography of the brain is altered by insult and injury, iFC analyses can provide insights into experience-dependent plasticity at the macro level of large-scale functional networks. Such insights are foundational to the design of training and remediation interventions that will best facilitate recovery of function. In this review, we consider what is currently known about the origin and function of iFC in the brain, and how this knowledge is informative in neuropsychological settings. We then summarize studies that have examined experience-driven plasticity of iFC in healthy control participants, and frame these findings in terms of a schema that may aid in the interpretation of results and the generation of hypotheses for rehabilitative studies. Finally, we outline some caveats to the R-fMRI approach, as well as some current developments that are likely to bolster the utility of the iFC paradigm for neuropsychology.     

Cerebral blood flow in 5‐ to 8‐month‐olds: Regional tissue maturity is associated with infant affect

Infancy is marked by rapid neural and emotional development. The relation between brain function and emotion in infancy, however, is not well understood. Methods for measuring brain function predominantly rely on the BOLD signal; however, interpretation of the BOLD signal in infancy is challenging because the neuronal‐hemodynamic relation is immature. Regional cerebral blood flow (rCBF) provides a context for the infant BOLD signal and can yield insight into the developmental maturity of brain regions that may support affective behaviors. This study aims to elucidate the relations among rCBF, age, and emotion in infancy. One hundred and seven mothers reported their infants' (infant age M ± SD = 6.14 ± 0.51 months) temperament. A subsample of infants completed MRI scans, 38 of whom produced usable perfusion MRI during natural sleep to quantify rCBF. Mother‐infant dyads completed the repeated Still‐Face Paradigm, from which infant affect reactivity and recovery to stress were quantified. We tested associations of infant age at scan, temperament factor scores, and observed affect reactivity and recovery with voxel‐wise rCBF. Infant age was positively associated with CBF in nearly all voxels, with peaks located in sensory cortices and the ventral prefrontal cortex, supporting the formulation that rCBF is an indicator of tissue maturity. Temperamental Negative Affect and recovery of positive affect following a stressor were positively associated with rCBF in several cortical and subcortical limbic regions, including the orbitofrontal cortex and inferior frontal gyrus. This finding yields insight into the nature of affective neurodevelopment during infancy. Specifically, infants with relatively increased prefrontal cortex maturity may evidence a disposition toward greater negative affect and negative reactivity in their daily lives yet show better recovery of positive affect following a social stressor.     

Amygdala–orbitofrontal connectivity predicts alcohol use two years later: a longitudinal neuroimaging study on alcohol use in adolescence

This study tested the relation between cortical–subcortical functional connectivity and alcohol consumption in adolescents using an accelerated longitudinal design, as well as normative developmental patterns for these measures. Participants between ages 8 and 27 completed resting‐state neuroimaging scans at two time points separated by two years (N = 274 at T1, N = 231 at T2). In addition, participants between ages 12 and 27 reported on recent and lifetime alcohol use (N = 193 at T1, N = 244 at T2). Resting‐state connectivity analyses focused on amygdala–orbitofrontal connectivity given prior research linking reduced coupling between these regions to alcohol use. Mixed model analyses revealed that age had a cubic relationship with alcohol use, with little to no use in childhood, steep increases in adolescence and leveling off in adulthood. No age effects were found for amygdala–OFC connectivity. Prediction analyses showed that left amygdala–orbitofrontal connectivity at the first time point predicted recent and lifetime alcohol use two years later. There was no evidence for the reversed relation, suggesting that brain connectivity measures precede explorative risk‐taking behavior in adolescence, possibly because decreased subcortical–frontal connectivity biases towards more explorative or risky behavior.     

Development of infant sustained attention and its relation to EEG oscillations: an EEG and cortical source analysis study

The current study examined the relation between infant sustained attention and infant EEG oscillations. Fifty‐nine infants were tested at 6 (N = 15), 8 (N = 17), 10 (N = 14), and 12 (N = 13) months. Three attention phases, stimulus orienting, sustained attention, and attention termination, were defined based on infants' heart rate changes. Frequency analysis using simultaneously recorded EEG focused on infant theta (2–6 Hz), alpha (6–9 Hz), and beta (9–14 Hz) rhythms. Cortical source analysis of EEG oscillations was conducted with realistic infant MRI models. Theta synchronization was found over fontal pole, temporal, and parietal electrodes during infant sustained attention for 10 and 12 months. Alpha desynchronization was found over frontal, central and parietal electrodes during sustained attention. This alpha effect started to emerge at 10 months and became well established by 12 months. No difference was found for the beta rhythm between different attention phases. The theta synchronization effect was localized to the orbital frontal, temporal pole, and ventral temporal areas. The alpha desynchronization effect was localized to the brain regions composing the default mode network including the posterior cingulate cortex and precuneus, medial prefrontal cortex, and inferior parietal gyrus. The alpha desynchronization effect was also localized to the pre‐ and post‐central gyri. The present study demonstrates a connection between infant sustained attention and EEG oscillatory activities.     

Benchmarking Treatment Effectiveness of Community‐Delivered Trauma‐Focused Cognitive Behavioral Therapy

It is critical for urban youth with post‐traumatic stress disorder (PTSD) living in poverty to have access to evidence‐based interventions for their traumatic stress. However, there is limited research on the effectiveness of these interventions when provided in urban, community settings. The objectives of the current study are to (a) evaluate the effectiveness of trauma‐focused cognitive behavioral therapy delivered from 2013 to 2016 in 15 behavioral health agencies on youth (N = 114) PTSD as well as  general mental health symptoms and  functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. Effectiveness data are from the Philadelphia County Community Behavioral Health System, a system that has invested significantly in the training and ongoing support of clinicians providing high‐quality trauma services to youth since 2012. From baseline to last assessment, youth PTSD symptom severity (d = 0.34), PTSD functional impairment (d = 0.38), and overall mental health problem severity (d = 0.29) improved. The effect sizes of  improvements were smaller than effect sizes observed in efficacy and effectiveness studies. This study is the first benchmarking study of TF‐CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF‐CBT to urban community settings that serve youth in poverty.     

Habituation and novelty detection fNIRS brain responses in 5‐ and 8‐month‐old infants: The Gambia and UK

The first 1,000 days of life are a critical window of vulnerability to exposure to socioeconomic and health challenges (i.e. poverty/undernutrition). The Brain Imaging for Global Health (BRIGHT) project has been established to deliver longitudinal measures of brain development from 0 to 24 months in UK and Gambian infants and to assess the impact of early adversity. Here results from the Habituation‐Novelty Detection (HaND) functional near‐infrared spectroscopy (fNIRS) task at 5 and 8 months are presented (N = 62 UK; N = 115 Gambia). In the UK cohort distinct patterns of habituation and recovery of response to novelty are seen, becoming more robust from 5 to 8 months of age. In The Gambia, an attenuated habituation response is evident: a larger number of trials are required before the response sufficiently suppresses relative to the response during the first presented trials. Furthermore, recovery of response to novelty is not evident at 5 or 8 months of age. As this longitudinal study continues in The Gambia, the parallel collection of socioeconomic, caregiving, health and nutrition data will allow us to stratify how individual trajectories of habituation and recovery of response to novelty associate with different risk factors and adaptive mechanisms in greater depth. Given the increasing interest in the use of neuroimaging methods within global neurocognitive developmental studies, this study provides a novel cross‐culturally appropriate paradigm for the study of brain responses associated with attention and learning mechanisms across early development.     

Concurrent and lasting effects of emotion regulation on amygdala response in adolescence and young adulthood

This study used functional MRI (fMRI) to examine a novel aspect of emotion regulation in adolescent development: whether age predicts differences in both the concurrent and lasting effects of emotion regulation on amygdala response. In the first, active regulation, phase of the testing session, fMRI data were collected while 56 healthy individuals (age range: 10.50–22.92 years) reappraised aversive stimuli so as to diminish negative responses to them. After a short delay, the second, re‐presentation, phase involved passively viewing the aversive images from the reappraisal task. During active regulation, older individuals showed greater drops in negative affect and inverse rostrolateral prefrontal‐amygdala connectivity. During re‐presentation, older individuals continued to show lasting reductions in the amygdala response to aversive stimuli they had previously reappraised, an effect mediated by rostrolateral PFC. These data suggest that one source of heightened emotionality in adolescence is a diminished ability to cognitively down‐regulate aversive reactions.     

Parents Plus Systemic,Solution‐Focused Parent Training Programs: Description,Review of the Evidence Base,and Meta‐Analysis

Parents Plus (PP) programs are systemic, solution‐focused, group‐based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child‐focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta‐analysis of 10 controlled studies for child behavior problems compares favorably with those of meta‐analyses of other well‐established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front‐line mental health and educational professionals.     

The long‐term effects of institutional rearing,foster care intervention and disruptions in care on brain electrical activity in adolescence

Exposure to early psychosocial deprivation as a result of institutional care disrupts typical brain development. The Bucharest Early Intervention Project (BEIP) is the first longitudinal study to investigate the neurodevelopment of institutionalized infants randomized to a foster care (FCG) intervention versus care as usual (CAUG). Here, we present findings from a follow‐up assessment of brain electrical activity as indexed by resting EEG at age 16 years. In addition, we examined the effects of disruption of foster care placement (e.g. the number of moves among foster care placements) on brain electrical activity. Resting‐state EEG was collected from 48 CAUG, 46 FCG and 48 never institutionalized (NIG) control participants. Absolute (µV²) and relative (proportion) power were computed from eyes closed, resting EEG data for theta, alpha and beta frequency bands. The CAUG displayed higher relative theta and lower relative alpha power compared to the FCG at 16 years of age. The FCG showed brain activity comparable to the NIG. The results further showed that disruptions following the original foster care placement had an adverse effect on brain electrical activity. Within the foster care group, there were no effects of age of placement on EEG power. Placement of children who have experienced early institutional rearing into stable foster care settings ensure long‐term improvement in brain functioning.     

Self-referential processing of negative stimuli within the ventral anterior cingulate gyrus and right amygdala

Neural activity associated with self-referential processing of emotional stimuli was investigated using whole brain functional magnetic resonance imaging (fMRI). Fifteen healthy subjects underwent fMRI scanning while making judgments about positive and negative trait words in four conditions (self-reference, other-reference, semantic processing, and letter processing). Significant activity was observed in the right ventral anterior cingulate gyrus and the right amygdala in the negative-word/self-reference condition, and in the left amygdala in the positive-word/self-reference condition. Compared with the semantic-processing condition, the self-reference conditions showed significantly more activity in the medial prefrontal and temporal gyri, posterior cingulate gyrus, and precuneus. These results suggest that the medial prefrontal gyrus, posterior cingulate gyrus, and precuneus are associated with a self-referential processing, and the ventral anterior cingulate gyrus is involved in self-referential processing of negative emotional stimuli. The results also suggest that the amygdala is associated with self-referential processing of both positive and negative emotional stimuli.     

Adolescents' Reward‐related Neural Activation: Links to Thoughts of Nonsuicidal Self‐Injury

Adolescence is a critical developmental period marked by an increase in risk behaviors, including nonsuicidal self‐injury (NSSI). Heightened reward‐related brain activation and relatively limited recruitment of prefrontal regions contribute to the initiation of risky behaviors in adolescence. However, neural reward processing has not been examined among adolescents who are at risk for future engagement for NSSI specifically, but who have yet to actually engage in this behavior. In the current fMRI study (N = 71), we hypothesized that altered reward processing would be associated with adolescents' thoughts of NSSI. Results showed that NSSI youth exhibited heightened activation in the bilateral putamen in response to a monetary reward. This pattern of findings suggests that heightened neural sensitivity to reward is associated with thoughts of NSSI in early adolescence. Implications for prevention are discussed.     

Nonsuicidal Self‐Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders

Nonsuicidal self‐injury (NSSI) prior to age 18 was evaluated as a risk factor for adulthood suicide attempt (SA). Archival data from 222 mood‐disordered participants were analyzed using multivariate Cox proportional hazards analysis. Participants with a youth SA were excluded. The hazards of SA among adult participants with a history of youth NSSI were twice than those of mood‐disordered participants without youth NSSI (hazard ratio = 2.00, 95% confidence interval = 1.16–3.44, p = .01). Moreover, participants who had both youth and adult NSSI attempted suicide significantly earlier than participants who began NSSI as an adult. Youth NSSI is associated with persistent, elevated SA risk in adulthood.     

Brain structure mediates the association between socioeconomic status and attention‐deficit/hyperactivity disorder

Low socioeconomic status (SES) is associated with greater risk for symptoms of attention‐deficit/hyperactivity disorder (ADHD). One mechanism through which SES may confer risk for ADHD is by influencing brain structure. Alterations to cortical thickness, surface area and subcortical volume have been associated with low SES and with the presence of ADHD across multiple studies. The current study examined whether cortical thickness, surface area or subcortical volume mediate the associations between SES and ADHD in youth 3–21 years old (N = 874) from the Pediatric Imaging, Neurocognition and Genetics Study. Freesurfer was used to estimate cortical thickness, surface area and subcortical volume from structural magnetic resonance imaging. Parents reported on demographics, family SES, ADHD diagnoses and the presence of child attention problems. Statistical mediation was assessed using a bootstrap resampling procedure. Controlling for parental ADHD, child age, gender, birth weight and scanner, children in low SES families were more likely to be in the ADHD group. Consistent with previous reports in this sample, low SES was associated with reduced surface area across the frontal lobe and reduced subcortical volume in the amygdala, cerebellum, hippocampus and basal ganglia. Of these regions, a significant indirect effect of SES on ADHD status through subcortical volume was observed for the left cerebellum (95% confidence interval: 0.004, 0.022), the right cerebellum (95% confidence interval: 0.006, 0.025), and the right caudate (95% confidence interval: 0.002, 0.022). Environmentally mediated changes in the cerebellum and the caudate may be neurodevelopmental mechanisms explaining elevated risk of ADHD in children in low SES families.     

Here's looking at you,kid: attention to infant emotional faces in mothers and non‐mothers

Infant facial cues play a critical role in eliciting care and nurturance from an adult caregiver. Using an attentional capture paradigm we investigated attentional processing of adult and infant emotional facial expressions in a sample of mothers (n = 29) and non‐mothers (n = 37) to determine whether infant faces were associated with greater task interference. Responses to infant target stimuli were slower than adult target stimuli in both groups. This effect was modulated by parental status, such that mothers compared to non‐mothers showed longer response times to infant compared to adult faces. Both groups also responded more slowly to emotional faces, an effect that was more marked for infant emotional faces. Finally, it was found that greater levels of mothers' self‐reported parental distress was associated with less task interference when processing infant faces. These findings indicate that for adult women, infant faces in general and emotional infant faces in particular, preferentially engage attention compared to adult faces. However, for mothers, infant faces appear to be more salient in general. Therefore, infant faces may constitute a special class of social stimuli. We suggest that alterations in attentional processing in motherhood may constitute an adaptive behavioural change associated with becoming a parent.     

Physical home environment is associated with prefrontal cortical thickness in adolescents

Biologically embedded experiences alter developmental trajectories in ways that can influence health, learning, and/or behavior. These systematic differences in experiences may contribute to different biological outcomes as individuals grow and develop, including at the neural level. Previous studies of biologically embedded experiences on neurodevelopment have focused on large‐scale institutional or economic factors (e.g. socioeconomic status [SES]) and psychosocial factors (e.g. caregiving behavior). Less attention has focused on how the quality of the immediate home settings, such as the physical home environment (PHYS), influences neurodevelopment. Moreover, no study has investigated these effects in adolescents, who undergo significant physical maturation and neurodevelopment that may influence how they respond to their physical environments. The goal of the current study was to examine whether PHYS quality is biologically embedded in the developing adolescent brain as evidenced by cognitive achievement and cortical development in 56 (48% female) healthy adolescents (14–18 years (M = 16.83 years, SD = 1.17). Using in‐home assessments of the physical home environment, anatomical brain scans, and indices of academic achievement, we found that adolescents who have more physical problems in the home (e.g. structural hazards, crowding, excessive noise, poorly lit) have thinner prefrontal cortices, which was associated with lower levels of reading achievement, independent of SES and psychosocial factors. By conducting home visits to assess physical characteristics of adolescents’ home, we highlight a typically overlooked aspect of the home environment that has relevance for adolescents’ cognitive and brain development.     

PRENATAL AND POSTNATAL MATERNAL REPRESENTATIONS IN NONRISK AND AT‐RISK PARENTING: EXPLORING THE INFLUENCES ON MOTHER–INFANT FEEDING INTERACTIONS

The aim of this study was to investigate the mother–infant relationship in depressive, psychosocial, and cumulative‐risk parenting by assessing prenatal and postnatal maternal representations and mother–infant interactions during feeding at 4 months of age. The sample consisted of 167 mother–infant pairs: 41 nonrisk women, 40 depressive‐risk women, 40 psychosocial‐risk women, and 46 cumulative‐risk women. During pregnancy, the women were interviewed about psychosocial‐risk variables. Maternal representations and depressive symptoms were evaluated during pregnancy and again when the infants were 3 and 4 months old, respectively. All mother–infant pairs were observed in 20‐min video recordings during breast‐feeding. Maternal Integrated/balanced representations were more frequent in the nonrisk group whereas the maternal Nonintegrated/ambivalent category was more represented in the cumulative‐risk group during pregnancy and after the infant's birth. At 4 months, the cumulative‐risk group of mothers and infants showed a lack of reciprocity, conflictual communicative exchanges, and higher food refusal behavior. Moreover, at 4 months, differences between the quality of mother–infant feeding interactions and the quality of prenatal and postnatal maternal representations emerged, showing less adequate maternal scaffolding in the Nonintegrated/ambivalent and Restricted/disengaged women. This study has rich implications for intervention to support the affective and communicative caregiving system and to prevent infant feeding problems and mother–infant relational disturbances in childhood.     

Revisiting an era in Germany from the perspective of adolescents in mother‐headed single‐parent families

Much of the documented work on families headed by single mothers is based on empirical evidence from North America and a few Anglo‐Saxon countries. Many researchers consider single‐mother families to be at a disadvantage because of nonsupportive family policies. This paper uses data from a social context that differed hugely in this respect—the German Democratic Republic (GDR). The GDR provided extensive state support to single‐mother families and, thus, was vastly different from other countries. Based on a literature review and using Hill's family stress theory, this paper is based on the hypothesis that adolescents living in mother‐headed single‐parent families and those living with their biological parents would have near‐similar social outcomes (display of psychosomatic symptoms, perception of stress, display of delinquent behaviour, life satisfaction, academic self‐efficacy, and academic grades) and family‐related outcomes (relationship with parents and perception of family environment). Further, it was hypothesized that adolescents from stepfather families would display more negative social and family‐related outcomes when compared with respondents from the other two family types. The sample comprised 1302 adolescents (M  =  13.82 years, SD  =  1.88) who were recruited from the city of Leipzig in the year immediately following German unification, 1991. Respondents reported on measures of psychosomatic symptoms, stress, delinquency, life satisfaction, academic achievement, and family‐related variables. ANCOVAs, with a control for income adjusted for household size, indicated adolescents from single‐mother families to have very similar experiences to respondents living with their biological parents on all measures except for their assessment of family environment. Adolescents living in stepfather families reported the least favourable experiences. Results are indicative of a social context in Germany that, despite unification and the early hardships for single‐mother families, still provided these families with more opportunities than constraints.