UMD Theses and Dissertations
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Item THE INTERGENERATIONAL TRANSMISSION AND IMPACTS OF ADVERSE CHILDHOOD EXPERIENCES(2024) McConnell, Krystle; Shenassa, Edmond; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Evidence that adverse childhood experiences (ACEs) are associated with a wide range of adverse health and behavioral outcomes, including poor behavioral outcomes, and increased substance use, has been expanded to demonstrate that ACEs may be a determinant in adverse health and behavioral outcomes across generations as well. To disentangle the intergenerational impacts of ACEs on select health and behavioral outcomes and inform future intergenerational research and practice, three separate studies were conducted as part of this investigation. The first is a systematic review assessing whether ACEs predict earlier age of initiation differently depending on substance, conducted to inform timing of ACE screening and substance use intervention within generations. Given evidence to suggest that maternal ACEs predict related behavioral outcomes, the association between ACEs and earlier age of substance use may extend across generations as well. Informed by the first study, the second study in this investigation assesses the association between maternal ACEs and offspring age of alcohol initiation. Because offspring concordant for higher intergenerational ACE exposure may be most susceptible to the intergenerational impacts of adversity, this study also assesses whether the association between maternal ACEs and offspring age of alcohol initiation is different depending on offspring ACE exposure. The third study of this investigation assesses the association between maternal ACEs and internalizing and externalizing behavior. Importantly, the well-established intergenerational continuity of adversity was considered conceptually and methodologically for the latter two studies. If there is a direct association of maternal ACEs on offspring outcomes independent of offspring ACEs, then ACE screening and intervention efforts should be expanded to include and consider maternal ACEs in addition to offspring ACEs. Therefore, the controlled direct effect of maternal ACEs, not through offspring ACEs, was estimated. Findings from the first study suggest that while ACEs are associated with earlier age of alcohol, nicotine, marijuana, and opioid initiation, often in a dose-dependent manner, ACEs may predict earlier initiation of alcohol and nicotine relative to other substances assessed. Three or more ACEs were associated with initiation of alcohol across multiple studies, with effect sizes (OR) ranging from 1.9 (95% CI: 1.7, 2.1) to 6.2 (95% CI: 4.6, 8.3). Among the youngest samples included in this review (aged 9-10), ACEs were positively associated with use of alcohol at the time of interview OR=1.3 (95% CI: 1.1, 1.5). Studies that assessed the association between ACEs and nicotine used thresholds between 15-17 to define early initiation and reported a range of effect sizes (OR) from 1.6 (95% CI: 1.2, 2.2) after exposure to more than one ACE to 5.2 (95% CI: 2.9, 9.3) after exposure to more than two ACEs. Exposure to two or more ACEs was associated with initiating vaping before age 11 (OR=3.4 (95% CI: 2.2, 5.4). While not rising to statistical significance (p<0.05), findings from the second study suggest there is a small inverse relationship between maternal ACEs and offspring age of alcohol initiation among the full sample. However, among offspring exposed to >2 ACEs themselves, 2 maternal ACEs are associated with =-1.4 (95% CI: -2.7, -0.1) and >2 maternal ACEs are associated with =-2.1 (95% CI: -3.8, -0.5) earlier age of alcohol initiation. These findings suggest that offspring exposed to high levels of intergenerational ACE exposure are at greatest risk for early alcohol initiation. Findings from the third study suggest that maternal ACEs are associated with offspring internalizing and externalizing behavior in a dose-dependent manner, independent of offspring ACE exposure. Specifically, 1, 2, and >2 maternal ACEs were independently associated with a 1.8 (95% CI: 0.9, 2.8), 2.1 (95% CI: 0.7, 3.4), and 2.7 (95% CI: 1.0, 4.4) increase in internalizing score and a 1.8 (95% CI: 0.8, 2.7), 3.1 (95% CI: 1.7, 4.4), and 3.3 (95% CI: 1.4, 5.1) increase in externalizing score, respectively. Taken together, findings from this investigation suggest that universal ACE screening in pediatric settings, particularly prior to onset of puberty, may identify youth for service provision prior to substance initiation and that maternal ACEs should be screened for and considered in addition to offspring ACE exposure to inform interventions related to adolescent substance use and internalizing and externalizing behavior. To that end, the prenatal period may be an opportune time for maternal ACE screening. Conclusions from these investigations may apply to the impact of maternal ACEs on other relevant offspring outcomes across the life course. Future directions for research, including assessment of relevant biological and psychosocial mechanisms, and potential moderators of identified associations are discussed.Item The Role of Temperament and Emotion Understanding in the Development of Child Internalizing Disorders(2014) Gifford, Kathleen Marie; Teglasi, Hedy; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Internalizing disorders are among the most frequently diagnosed psychological problems in childhood (Crawford, Schrock, & Woodruff-Borden, 2011). Evidence suggests that children who have the tendency to avoid, and less developed effortful control, are more likely to develop symptoms of internalizing (White, McDermott, Degnan, Henderson, & Fox, 2011). Similarly, preschoolers who are rated as being more withdrawn during social interactions often display more social anxiety than less avoidant peers (Ale, Chorney, Brice, & Morris, 2010). Furthermore, more difficulty with emotion understanding, and social avoidance, has been shown to directly relate to internalizing problems such as depression, fear/anxiety, somatic complaints, worry and rumination (Rieffe & De Rooij, 2012). Although researchers have identified some early vulnerability factors that lead to the development of internalizing problems, research on anxiety/internalizing in the preschool age population is scarce (Wichstrom, Belsky, & Berg-Nielsen, 2013). The current study sought to fill this gap in the existing literature. The study sample consisted of 139 parent, teacher, and preschooler participants from a university setting (38 to 82 months old; with a mean age of 57 months). Temperament was examined through parent ratings on the Structured Temperament Interview (STI) (Teglasi, 2009) and the Children's Behavior Questionnaire (CBQ), Short Form (Putnam & Rothbart, 2006). Emotion understanding was examined by preschoolers' performance on the Emotion Comprehension Test (ECT) (unpublished). Internalizing behaviors were measured through teacher ratings on the Social Competence and Behavior Evaluation (SCBE) (LaFreniere & Dumas, 1996). Correlations between the STI factors and CBQ scales illustrated underlying aspects of emotionality and reactivity that influence children's approach/avoidance tendencies, and the link between temperament and overall adjustment. Children who were rated high on preferring familiar/routine activities were also rated as having more internalizing problems, and worse performance on a measure of emotion understanding; whereas, children who were rated high on sociability were rated as having fewer internalizing problems. Regression analyses demonstrated that effortful control moderated the relationship between sociability and internalizing behaviors such that children with high sociability and high effortful control displayed the best behavioral adjustment; and children with low sociability and high effortful control displayed the most internalizing behaviors.Item Profiles of Social Anxiety Symptoms and Impulsivity in College Students(2014) Lipton, Melanie; De Los Reyes, Andres; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Prior work points to a subtype of Social Anxiety (SA) characterized by disinhibition or high externalizing behaviors (e.g., substance use and Attention Deficit Hyperactivity Disorder (ADHD) symptoms). This study extended prior work by replicating subtypes of SA and impulsivity and examining differences among these subtypes in their expression of externalizing behavior. Three hundred seventy-five undergraduates completed an online study including measures of SA, substance use, ADHD symptoms and impulsivity. Latent class analyses revealed three classes of individuals who were: (a) low SA and low impulsivity, (b) high SA and low impulsivity, and (c) high SA and high impulsivity. Individuals high in both SA and impulsivity exhibited greater likelihoods of exhibiting externalizing behavior concerns, relative to the two other classes, with the largest differences on ADHD symptoms. These findings indicate that identifying differences among SA subtypes in externalizing behavior concerns depends on the externalizing domain.Item Pathways between exposure to violence, maternal depression, family structury [i.e. structure] and child outcomes through parenting: A multi-group analysis(2007-07-27) Westbrook, T'Pring R.; Jones-Harden, Brenda`; Human Development; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Arguably one of the greatest influences on a child's development is the parenting he or she experiences. With that perspective, family stress theory posits that children in low-income families are affected by poverty-related stressors through their effect on their parents. The present study used family stress theory as a framework to study the impact of proximal (i.e., family structure, maternal depression) and distal (i.e., community violence) risk factors, or stressors, on parenting characteristics which were in turn hypothesized to impact child social-emotional functioning. Data from the FACES 2000 study of children enrolled in Head Start and their families were used to conduct the analyses. The sample consisted of 1417 African American, Latino, and White mothers of preschool children. The present study hypothesized that exposure to violence, family structure, maternal depression, and parenting styles measured at time 1 would affect child social-emotional functioning at time 2. Moreover, it was hypothesized that a SEM model wherein violence exposure, family structure, and maternal depression's influenced parenting characteristics, which then impacted the child outcome, would fit the data. Finally, it was hypothesized that these findings would be consistent across African American, Latino, and White subgroups. The data revealed that the study variables were significant predictors of the child outcome. Although few of the key variables significantly contributed to the regression models or had significant pathways in the SEM models, the cumulative effect of the variables resulted in significant models that accounted for 21-37% of the outcome. The multi-group analysis revealed that despite differences in the amount of variance explained, the causal pathways were consistent for the groups analyzed. Findings support theories such as the family stress model that suggest that poverty related stressors negatively impact children's development by first negatively impacting parenting behaviors. This pattern of influence was consistent across race/ethnicities. It may not be practical to expect practitioners to address the myriad of potential risks factors encountered by low-income families, but parents can be equipped with mental health services, parent education, and other such assistance to help them maintain positive parenting practices in the face of life's challenges.Item Internalizing, and Externalizing Behaviors in Preschoolers: Physiological Mechanisms, Parental Ratings, and Lunchtime Observations(2005-05-03) koledin, myriah; Fox, Nathan; Human Development; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Physiological reactivity and regulation, via measures of vagal tone (a physiological measure), and heart period (HP), and their relation to social behavior as witnessed during lunchtime were examined in preschoolers. Participants included 100 children, 3-6 years of age from a day care center. Vagal tone and heart period were collected during a 25-minute protocol including four conditions. Parent ratings of their child's behavior were collected using the Child Behavior Checklist. Results indicated that for a group of withdrawn children (classified from lunchtime observations), significant correlations were found for HP recovery from a challenge task with total problems, and stability of HP was correlated with internalizing, externalizing and total problems. The stability measure for vagal tone in the HWD group was significantly correlated with externalizing and total problems. It is concluded that children high in withdrawn behavior exhibit a different physiology than those exhibiting low withdrawn behaviors as witnessed during lunchtime observations.