Search Results (226)

Hurricanes and flooding events substantially elevate indoor fungal spore levels, which have been associated with increased risks of developing childhood asthma and other adverse respiratory outcomes. Although environmental fungal compositions following major hurricanes have been well characterized, the fungal communities within the nasal cavity (i.e., the nasal mycobiome) of exposed individuals remain unexplored. We collected nasal swab samples from infants following Hurricane Maria in San Juan, Puerto Rico, during two periods (March to August 2018 and February to September 2019). We processed a total of 58 samples (26 from the first year and 32 from the second year post-Hurricane Maria) and performed internally transcribed spacer (ITS) rRNA gene sequencing to characterize and compare the infant nasal mycobiome between the two groups. Although alpha-diversity did not differ significantly, beta-diversity analyses revealed significantly different fungal compositions between the two groups (p <0.01). Infants exposed during the first year post-Hurricane Maria had significantly higher abundances of Alternaria, Eutypella, Schizophyllum, and Auricularia, compared to infants from the second year. Alternaria was also more prevalent in the first-year than in the second-year infants (42% vs. 9%, p = 0.01). Our study provides evidence linking early-life hurricane exposures to elevated risks of developing childhood asthma. Full article

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

X-linked adrenoleukodystrophy (ALD) is an inherited metabolic disorder that can cause adrenal insufficiency and cerebral ALD (cALD) in childhood. Early detection prevents adverse health outcomes and can be achieved by newborn screening (NBS) followed by monitoring disease progression. However, monitoring is associated with high costs. This study evaluates the cost–effectiveness of NBS for ALD in The Netherlands compared to no screening using a health economic model. A decision tree combined with a Markov model was developed to estimate societal costs, including screening costs, healthcare costs, and productivity losses of parents, and health outcomes over an 18-year time horizon. Model parameters were derived from the literature and expert opinion. A probabilistic sensitivity analysis (PSA) was performed to assess uncertainty. The screening costs of detecting one ALD case by NBS was EUR 40,630. Until the age of 18 years, the total societal cost per ALD case was EUR 120,779 for screening and EUR 62,914 for no screening. Screening gained an average of 1.7 QALYs compared with no screening. This resulted in an incremental cost–effectiveness ratio (ICER) of EUR 34,084 per QALY gained for screening compared to no screening. Although the results are sensitive to uncertainty surrounding costs and effectiveness due to limited data, NBS for ALD is likely to be cost–effective using a willingness-to-pay (WTP) threshold of EUR 50,000– EUR 80,000 per QALY gained. Full article

Adverse childhood experiences (ACEs) in early childhood may increase the risk of emotional behavioral problems (EBPs); however, few studies have explored the longitudinal effect of ACEs in early childhood on later EBPs and their underlying mechanisms. This study examined the serial mediating role of psychological resilience (PR) and problematic media use (PMU) in the relationship between ACEs in early childhood and EBPs. Participants included 534 three-year-old children (mean age of 33.29 years, SD = 3.97) and their parents from Wuhu, China. The parents completed online questionnaires measuring children’s ACEs, PR, and demographic information in September 2022 (Time 1), children’s PMU in September 2023 (Time 2), and EBPs in September 2024 (Time 3). Macro Process 6 was used to test the serial mediating effects of PR and PMU. A total of 5000 bootstrap samples were used to estimate the 95% confidence intervals. The results revealed that ACEs in early childhood did not directly predict EPBs. PR (b = 0.132 (95% CI [0.051, 0.221])) mediated the relationship between ACEs and children’s EBPs. PR and PMU also played a serial mediating role in the association of ACEs and children’s EBPs (b = 0.026, 95% CI [0.008, 0.054]). Our findings highlight the importance of improving PR and addressing PMU when designing interventions targeting Chinese preschoolers exposed to ACEs. Full article

Background/Objectives: Childhood overweight/obesity status is a critical risk factor for adverse cardiometabolic outcomes. We aimed to evaluate the sex-specific associations between a maintained childhood overweight status and late-adolescent cardiometabolic risk factors using data from a Korean longitudinal study. Methods: We used data from the Korean Children-Adolescents Study, a prospective cohort of children enrolled at age 7 and followed annually from 2005 to 2020. Among participants who were followed at least once, a total of 899 children (438 boys, 461 girls) with consistent body mass index (BMI) status at ages 7–9 and 10–12 were included in the analysis. Participants were categorized into two groups on the basis of BMI: normal weight maintenance and overweight maintenance. Multivariable linear regression was used to examine the associations between BMI patterns and cardiometabolic risk factors, with adjustments for covariates. Results: Among the 899 children (mean age: 7.1 ± 0.4 years, 48.7% boys), 12.8% of boys and 5.9% of girls were classified into the overweight maintenance group. Boys in the overweight maintenance group had significantly greater BMIs, waist circumferences (WC), body fat percentages, trunk fat mass, and aspartate aminotransferase and alanine aminotransferase levels at ages 15 and 18. Girls in the same group had elevated BMI, WC, body fat percentage, trunk fat mass, and blood pressure and experienced earlier pubertal onset. Conclusions: Maintaining an overweight status during childhood is associated with adverse cardiometabolic profiles in adolescence, with sex-specific differences. These findings highlight the importance of early, sex-specific interventions to prevent long-term health risks associated with childhood obesity. Full article

Youth exposed to early-life adversity (ELA) are at greater risk for poorer physical and mental health outcomes in adolescence and adulthood. Although the biological mechanisms underlying these associations remain elusive, DNA methylation (DNAm) has emerged as a potential pathway. DNAm-based measures of epigenetic age have been associated with ELA, indicating accelerated aging. According to the stress sensitization hypothesis, prenatal adversity may further heighten sensitivity to subsequent stressors in childhood and adolescence. This study examined the associations between ELA and six epigenetic aging measures, considering both the timing of adversity and the participant’s sex. Data were drawn from the Quebec Longitudinal Study of Child Development, with two cumulative indices of ELA derived from prospectively collected data: the Perinatal Adversity and the Child and Adolescent Adversity indices. Higher Perinatal Adversity scores were associated with accelerated DunedinPACE scores. No significant associations were found between ELA and the other epigenetic clocks, nor did we find support for the stress sensitization hypothesis—though a sex-specific trend emerged among girls. The findings suggest that DunedinPACE may be more sensitive to variations in ELA than other clocks. Future research should systematically investigate sex-dimorphic associations between ELA and epigenetic aging, with particular attention to the impact of perinatal adversity. Full article

Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global samples, particularly using large-scale, multi-country panel data. Objectives: To examine whether the long-term association between childhood abuse and changes in depressive symptoms during adulthood differ between men and women, after adjusting for demographic and socioeconomic factors. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel study covering 22 diverse countries. The sample included adult participants with complete data on childhood abuse (yes/no); depression at baseline and follow-up; sex/gender; and relevant covariates (age; education; marital status; immigration status; smoking status; and employment). Depression was measured using a two-item scale. Multi-group structural equation models were used to test the effect of ACE on changes in depression over time where groups were defined based on sex/gender. Results: Overall, childhood abuse was associated with a statistically significant increase in depression scores between Wave 1 and Wave 2. This association was significant among women but not among men. Conclusions: Our findings suggest that the mental health consequences of childhood abuse extend into adulthood and disproportionately affect women. These sex/gender differences may reflect variations in stress processing; coping; and social roles. Interventions addressing early adversity may need to be tailored to recognize and respond to such sex/gender-specific vulnerabilities. Full article

Background: Exposure to early life stress significantly increases the risk of psychopathology later in life. However, the impact of early life stress on the gut microbiome and its potential role in mental health outcomes remains insufficiently understood. This narrative review examines the current knowledge on how early life stress and its associated consequences may affect the gut microbiome, with a particular focus on conditions such as anxiety, depression, and post-traumatic stress disorder. Method: A comprehensive literature search was conducted in the PubMed and Web of Science databases between January and February 2025, covering studies published between 2015 and 2025. Results: Early life stress can profoundly impact cognitive function and neurodevelopment, with maternal early-life nutrition playing a significant role in modulating the effects of prenatal and postnatal stress. Early life stress influences the gut microbiome, disrupting its composition and function by altering the synthesis of microbial metabolites, neurotransmitters, and the activation of key metabolic pathways. However, the precise role of the gut microbiome in modulating stress responses during childhood and adolescence has not yet been fully elucidated. Conclusions: Several studies have demonstrated an association between early life stress and the gut microbiome. However, causality has not yet been established due to the numerous intrinsic and extrinsic factors influencing the microbiome-gut–brain axis. In the coming years, research on key microbial regulators, such as short-chain fatty acids, amino acids, and psychobiotics, may represent a promising approach for addressing central nervous system alterations linked to early life stress. Thus, further studies will be necessary to evaluate their potential as therapeutic agents. Full article

Background/Objectives: Suicide is a major public health concern with severe consequences for individuals, families, and communities. Each year, approximately 800,000 individuals die by suicide, equating to one suicide-related death every 40 s. This study aims to determine the prevalence of suicidal ideation and psychoactive substance use among middle and high school students in Morocco and to examine the relationship between suicidal ideation, substance use, depression, and early trauma. Methods: From January to June 2023, a cross-sectional study was conducted in the Marrakech region of central Morocco among middle and high school students selected using stratified cluster random sampling. Data were collected through anonymous self-administered questionnaires. The Suicidal Ideation Attributes Scale (SIDAS) was used to assess the frequency of suicidal ideation among participants. The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria were applied for substance use and depression assessment, while early trauma was evaluated using the Adverse Childhood Experiences (ACE) questionnaire. Results: A total of 791 students participated in the study. The prevalence of suicidal ideation was 16.66%, while 25% of students reported current psychoactive substance use. Significant positive correlations were found between suicidal ideation and early trauma (r = 0.12; p < 0.004), depression (r = 0.52; p < 0.001), and substance use (r = 0.12; p < 0.001). Conclusions: The findings highlight the importance of considering multiple risk factors in suicide assessment and prevention. The interplay between these factors often exhibits bidirectional and significant associations. Implementing early screening, management, and treatment strategies for individuals exhibiting suicidal ideation and mental health disorders is crucial to reducing the burden of suicide. Full article

One form of corporal punishment commonly used in the United States is spanking. Spanking is a well-known risk factor for adverse child development, although its influence on children’s approaches to learning (ATL) has been largely overlooked. Existing research is particularly limited in inadequately considering multiple confounds and selection biases in children’s exposure to spanking. This study examined the links between spanking and children’s ATL, using a matched-group design to strengthen causal estimates among children aged 5 to 7.5 (N = ~12,800) from the Early Childhood Longitudinal Study, Kindergarten Class of 2010–2011. Entropy-balanced matching mitigated selection and confounding biases, controlling for a wide array of covariates. The sensitivity of spanking’s effects on ATL was also tested by limiting the sample to low-frequency spanking (once in the past week) to address concerns that primarily higher-frequency spanking predicts ATL. Findings indicated that spanking at age 5.5 was associated with less positive ATL at ages 6.5 and 7.5. These results remained significant when limited to low-frequency spanking. This study’s findings suggest that spanking may hinder children’s development of positive approaches to learning, which holds significant implications for lifelong well-being. This study contributes to the growing literature on the potential negative effects of physical punishment on child development across multiple domains. Full article

Objective: The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological variables on both the presence and severity of PTSD symptomatology in this high-risk occupational cohort. Methods: A cross-sectional investigation was performed to assess psychological conditions among 760 metropolitan male firefighters, employing conditional process analysis with multiple mediation modeling (PROCESS macro Model 6). The investigative protocol employed validated psychometric instruments including the PTSD Checklist (PCL-5); the Childhood Trauma Questionnaire (CTQ-33); the Dissociative Experiences Scale (DES); the Suicidal Behaviors Questionnaire (SBQ-4); and the Patient Health Questionnaire (PHQ-9). Bootstrap resampling (n = 5000) generated bias-corrected 95% confidence intervals, enabling interrogation of complex trauma response mechanisms. Results: Conditional process analysis demonstrated that childhood trauma functions as a significant mediator (indirect effect = 0.142, 95% CI [0.086, 0.198]), with emotional abuse pathways revealing significant mediational effects (β = 0.285, p < 0.001). Stratifying participants using a PCL-5 ≥ 33 threshold (non-PTSD: n = 543, 71.5%, median PCL-5: 22; PTSD: n = 217, 28.5%, median PCL-5: 39), the investigation elucidated serial mediation mechanisms, particularly through childhood trauma to dissociative experiences (serial indirect effect = 0.168, 95% CI [0.092, 0.244]), collectively explaining nearly half of PTSD variance through complex psychological interaction pathways. Conclusions: Conditional process analysis revealed childhood trauma as a pivotal mediator, with emotional abuse pathways demonstrating significant mediational effects, while dissociative experiences emerged as a significant secondary mechanism, collectively explaining a substantial portion of PTSD variance through interactions between occupational trauma exposure and intrinsic psychological vulnerabilities. Full article

A Neonatal Intensive Care Unit (NICU) stay complicates the transition to parenthood for new mothers. Women respond differently to perinatal stressors, which can impact their mental health and relationship with their new baby. Mothers’ own histories of adverse and benevolent childhood experiences can also shape their early parenting experiences. This study investigated the relationship between mothers’ adverse and benevolent childhood experiences and the observed and reported quality of interactions with their infant at 1 year following a NICU stay. Somewhat unexpectedly, we found that more maternal childhood adversity predicted less intrusive behavior and more responsiveness during a free play interaction at 12 months, while more benevolent childhood experiences predicted higher levels of observed intrusive mothering. Childhood experiences were not related to maternal perceptions of parent–child interaction quality. The length of the NICU stay was positively associated with maternal responsiveness. Findings highlight that childhood risk and protective factors may interact uniquely with a stay in the NICU, with greater adversity and a longer stay predicting more maternal responsiveness and sensitivity. Our study offers evidence that mothers can overcome their own early life challenges, and that overcoming childhood adversity may build resilience that uniquely prepares mothers for the challenge of a NICU stay. Full article

Previous research consistently identified depression and anxiety as leading contributors to the global disease burden. Recognizing risk and protective factors that lead to or guard against negative mental health outcomes therefore remains a research priority. The present study examined mediation models for the often-cited association between childhood verbal victimization and adult depression and anxiety symptomatology. Specifically, we investigated whether memories of childhood teasing related to adult adverse mental health outcomes indirectly via the mediated effects of self-esteem and social anxiety. Three hundred sixty-four (64.8% female) adult participants took part in a retrospective study by completing the Teasing Questionnaire—Revised; epidemiological scales of depression, anxiety, stress, social phobia, and social interaction anxiety; and a self-esteem measure. Memories of childhood teasing were indeed positively related to depression, anxiety, stress, social interaction anxiety, and social phobia scores and negatively related to current self-esteem, i.e., the individual’s subjective evaluation of their worth. Self-esteem and recalling being teased for one’s social skills were consistent predictors across all adult outcomes (depression, anxiety, stress, social anxiety, and social phobia). Lastly, self-esteem was found to be a partial mediator of the relationship between the memories of childhood teasing and depression and anxiety in adulthood, while social interaction anxiety partially mediated the relationship between teasing and anxiety, but not depression. These findings highlight the long-term psychological impact of childhood teasing and underscore the critical role of self-esteem and social anxiety as pathways through which early verbal victimization contributes to adult mental health outcomes, emphasizing the need for targeted interventions to foster resilience and mitigate lasting effects. Full article

Background/Objective: To address the growing demand for mental health services, Nova Scotia Health introduced the Rapid Access Stabilization Program (RASP) through its Mental Health and Addictions Program (MHAP) in April 2023. RASP is designed to help reduce long wait times, frequent emergency department visits, and admissions to provide early intervention for individuals experiencing mental health problems. The RASP focuses on rapid access and early mental health intervention, aiming to prevent the worsening of patients’ symptoms, improve access to psychiatric care, and reduce service pressures on programs like the Community Mental Health Program (CMHP), which provide more extended, ongoing mental health support. This study compared participants’ sociodemographic and clinical profiles in the RASP and the CMHP. Methods: Data were collected from 1392 participants accessing mental health support either through the RASP or CMHP. A comparative analysis of sociodemographic factors (e.g., age, education, and income) and clinical characteristics (e.g., depression, anxiety, resilience, and substance use) was conducted. Chi-square tests and independent sample t-tests were used to evaluate the mean differences between the groups. Results: Significant sociodemographic and clinical differences emerged between the RASP and CMHP participants. The RASP group was older (M = 40.10 vs. 34.52 years) and more socioeconomically stable, with higher rates of employment (55.3% vs. 47.9%) and homeownership (36.5% vs. 17.7%). In contrast, the CMHP group had higher unemployment (25.7% vs. 16.5%) and lower income levels, with 47.5% earning <CAD 29,590 compared to 30.3% in the RASP group. Clinical profiles differed markedly: depression was more prevalent in the RASP (48.2% vs. 19.3%), whereas the CMHP had higher rates of psychosis (10.6% vs. 2.5%) and substance use disorder (7.8% vs. 1.9%). The RASP participants exhibited higher anxiety (GAD-7: M = 14.17 vs. 11.81) and depression symptoms (PHQ-9: M = 16.62 vs. 14.20) but lower resilience (BRS: M = 2.47 vs. 2.77). The CMHP participants had more adverse childhood experiences (ACE: M = 3.92 vs. 3.16) and lower suicidal intent (81.4% vs. 99.4% had no intention to act). Conclusions: The findings highlighted the unique profiles between the RASP and CMHP participants, suggesting the need for program-specific interventions. While the CMHP participants may benefit from integrated social support and trauma-informed care, the RASP participants may require cognitive behavioral therapy and resilience-building interventions. Tailoring mental health services to meet these unique needs could enhance program effectiveness and patient outcomes across both groups. Full article

Background: Adverse childhood experiences (ACEs) have been identified as a major risk factor for physical and mental ill health in adulthood. So far, no studies have investigated whether ACEs during sensitive periods in infant development are associated with a higher likelihood of chronic pain (CP) in adulthood. Methods: Patients of the University Hospital of Innsbruck (Austria) completed questionnaires retrospectively assessing their ACEs as well as their current levels of CP, psychological distress, and trauma-related symptoms in this cross-sectional study. Dose-dependent associations of ACEs with CP were investigated through binary logistic regressions. To detect vulnerable developmental periods, a machine learning grid search was applied. Results: A total of n = 2577 patients were included in the analyses, with 31.5% reporting CP. Polytraumatization (i.e., four or more types of ACEs) was associated with a threefold increase for CP (OR: 3.01; 95% CI: 2.16–4.19; p < 0.001). The machine learning approach revealed maltreatment between 10 and 12 years to be the most predictive of CP (Ada Boost Classifier). Discussion: CP is a highly prevalent symptom among hospital patients and is clearly associated with ACEs. This is the first study to present evidence for a timing-dependent association of ACEs with CP. Early identification and appropriate psychosocial support for patients with ACEs is a crucial task for healthcare professionals. Full article