Prenatal Effects on CMH

Question 1

When do behavioural problems commonly start?

Answer 1

Before age 5 and persist into adult life into the form of criminality, personality and other psychiatric disorders with increased risk of maltreatment of the next generation

Question 2

What does evidence from studies of children and adolescents suggest?

Answer 2

That different biological and psychological mechanisms underpin subtypes of aggressive and disruptive behaviour problems. This implies the existence of distinctive pathways from infancy, which have yet to be clarified

Question 3

What was the design of the Wirral child health and development study (WCHDS)?

Answer 3

Prospective longitudinal study - starting at 20 weeks of pregnancy with follow up to 9 year olds

Question 4

What was done in the two state epidemiological sampling strategy?

Answer 4

Consecutive extensive whole sample of first time mothers aged 18 and above, English speaking and their partners. Smaller intensive subsample stratified by relationship functioning assessed by screening at 20 weeks gestation and provides sample with higher environmental and genetic risks for conduct disorders

Question 5

What were the multiple phases of assessment between birth and 9 years?

Answer 5

Birth, 4, 12, 20 weeks, 6 months, 32 weeks, 14 months, 2.5 year, 3.5, 4.5-5, 7 and 9 years

Question 6

What was done in the child lab assessments?

Answer 6

Mother-child interaction: cognitive, behavioural, social and emotional development, physiological reactivity, temperament and psychopathology, parenting quality and repeated DNA sampling

Question 7

What were the parental measures of the WCHDS?

Answer 7

Mental health, personality, life events, relationship quality, demographics, drug/alcohol/smoking

Question 8

In studies of animal models, how did an experimenter induce stress?

Answer 8

Restraint, electric foot shock, disruption of social relationships, predator exposure and unexpected loud noises

Question 9

What was used in the biological intervention of the animal model?

Answer 9

Gluco-cortiod administration

Question 10

In the study of human participants, what were the questionnaire measures in the self report about naturally occurring stress?

Answer 10

State/Trait anxiety, depression, life events, family and marital discord and pregnancy related anxiety

Question 11

What were the biological measures in the human participant study?

Answer 11

Markers of HPA axis function - cortisol

Question 12

What was the summary of effects of antenatal stress and offspring development in animal models?

Answer 12

Poor motor development, increased emotionally, reduced exploratory behaviour, increased stress response and shorter attention span.

Question 13

What was the summary of effects of antenatal stress and offspring development in human participants?

Answer 13

Delayed motor development, behavioural/emotional problems, delayed language development, delayed cognitive development, poor attention regulation and psychopathology

Question 14

What is the HPA axis?

Answer 14

A major part of the neuroendocrine system that controls reactions to stress and regulates many body processes

Question 15

What does the human placenta express the gene for?

Answer 15

The major stress hormone (CRH) profoundly altering the fight of flight system in mother and foetus

Question 16

Although endocrine changes are important for fetal maturation, what occurs if the levels are altered?

Answer 16

They program the fetal nervous system with long term consequences

Question 17

What occurs when a fetal exposure to levels of stress hormones is elevated?

Answer 17

Delays fetal nervous system maturation, restricts the neuromuscular development and alters the stress response of the neonate, impairs mental development and increases fearful behaviour in the infant and may result in diminished grey matter volume

Question 18

Human studies find that indices of prenatal stress such as maternal depression in pregnancy also predict what?

Answer 18

Altered HPA reactivity, altered cardiovascular regulate, negative emotionality and conduct disorders and emotional problems in children

Question 19

What was the hypothesis in relation to whether infant stress reactivity can be modified by maternal stroking?

Answer 19

The effects of prenatal stress (depression) on infant
temperament and physiological response to social stress will
be modified by mothers’ reports of how often they stroked
their babies over the first 2 months of life.

Question 20

What was the outcomes of maternal stroking>

Answer 20

Increasing maternal prenatal depression was associated with decreasing physiological adaptability under social stress only in the presence of low maternal stroking and associated with reports of increasing negative emotionality only in the presence of low maternal stroking.

Question 21

What did children exposed to anxiety in utero have?

Answer 21

Higher levels of emotional and behavioural problems at age 2.5

Question 22

What did maternal postnatal stroking significantly alter?

Answer 22

The associations between prenatal maternal anxiety and child internalising problems, depressed/anxious symptoms and attention hyperactivity at age 2.5

Question 23

Does maternal prenatal cortisol predict infant negative temperament in a sex-dependent matter?

Answer 23

Disturbances in maternal mood during pregnancy result in higher levels of circulating cortisol in humans - which crosses the placental barrier and alters fetal development.

Question 24

What was maternal salivary cortisol in late pregnancy associated with?

Answer 24

Maternal reports of more negative infant reactivity at 2 months

Question 25

What was amniotic fluid cortisol not associated with?

Answer 25

Maternal reports of temperament at 3 months

Question 26

What may prenatal cortisol may be a predictor of?

Answer 26

Of early infant behaviour but not childhood behaviour

Question 27

Why are there sex differences in humans when it comes to prenatal risks?

Answer 27

Females may become more reactive to challenge and anxious and males become less reactive and more aggressive. Internalising symptoms in females and externalising behaviours in males

Question 28

What are the 9 manoeuvres of irritability?

Answer 28

Uncover/place in supine, response decrement to tactile stimulation of the foot, undressing, passive tone in the legs/arms, pull to sit, place in prone, defensive movements, tonic neck reflex and moro reflex

Question 29

What is irritability?

Answer 29

A count of the number of times the infant changes from a calm state to fussing or crying for three or more seconds in response to a series of 9 standardised mildly aversive manoeuvres