Faculty Bibliography

Parenting behaviors play a critical role in children's socioemotional development and risk for psychopathology. Prior research has relied on both variable- and person-centered approaches to examine links between parenting and children's internalizing and externalizing behaviors, yet few studies have integrated these approaches within a single investigation. In the current study, we combined both approaches by first utilizing latent profile analyses to identify profiles of parenting practices across multiple dimensions. We then utilized path analyses to examine whether parenting profiles (person-centered) and individual parenting dimensions (variable-centered) were associated with children's internalizing and externalizing behaviors. The sample included children participating in the ECHO Cohort (N = 2,752; 49% female; Mage = 9.90 years, range = 5-18). Three parenting profiles were identified: Higher Positive Parenting-Better Supervision, Lower Positive Parenting-Medium Supervision, and Medium Positive Parenting-Poorer Supervision. The three profiles differed in children's internalizing and externalizing behaviors, with symptom levels increasing from Higher Positive - Better Supervision to Lower Positive - Medium Supervision, and highest in Medium Positive - Poorer Supervision. At the dimension level, positive parenting was negatively related to both internalizing and externalizing behaviors, whereas inconsistent discipline was positively related to both outcomes. Poor supervision was positively related to externalizing behaviors but was not associated with internalizing behaviors. Together, these findings advance theoretical models of the caregiving environment and its associations with child psychopathology risk, suggesting that interventions should target both specific dimensions and broader profiles of parenting practices.

BACKGROUND/UNASSIGNED:Pregnancy requires finely tuned immune changes that support implantation, placental development, maternal-fetal tolerance, and preparation for labor, yet the normative trajectories of circulating inflammatory proteins across gestation remain poorly defined. This cross-sectional study investigates how circulating inflammatory proteins vary with gestational age in pregnancy and examines the impacts of fundamental biological characteristics, such as gravidity and fetal sex. METHODS/UNASSIGNED:Data were drawn from 1154 pregnant individuals from six study sites of the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Cohort. We used Olink high-throughput proteomic profiling to map cross-sectional associations between protein expression levels and gestational age at blood draw using linear, spline-based, and generalized additive modeling approaches. RESULTS/UNASSIGNED:Generalized additive models provided the best fit, revealing that immune changes across pregnancy were predominantly nonlinear. Sixty-one proteins showed significant associations with gestational age, with many exhibiting shared inflection points that aligned with major physiological transitions. A small subset of proteins also showed evidence of modification by fetal and maternal characteristics. CD244 displayed different gestational patterns by fetal sex, while CST5 and SIRT2 showed varied gestational associations by maternal gravidity. CONCLUSION/UNASSIGNED:The findings highlight pregnancy as a sequence of coordinated immune transitions rather than a simple linear shift and provide one of the most detailed characterizations to date of circulating inflammatory protein dynamics across human gestation. Establishing these normative trajectories offers a crucial reference for detecting early deviations that may signal risk for pregnancy complications and for identifying biomarkers in maternal and fetal health research.

Intrinsic timescale is a commonly used measure of spontaneous neural dynamics that quantifies the temporal window of processing of neuronal populations. Intrinsic timescale displays a hierarchical cortical organization across multiple species and imaging modalities, with shorter timescales in sensorimotor cortex compared to association cortex. However, less is known about how intrinsic timescale evolves during human brain development and whether its cortical maturation patterns generalize to independent developmental samples. Here we estimate the intrinsic timescale in two independent cross-sectional datasets of youth (HCPD: n = 565; HBN: n = 729; age range 8-22 years) and investigate its neurodevelopmental patterns. We find that developmental patterns in the intrinsic timescale follow a hierarchical pattern that recapitulates an axis spanning sensorimotor to association cortices (S-A axis). Our analysis of an independent healthy young adult dataset (HCPYA: n = 973, age range 22-37 years) underscores the specificity of these developmental findings, suggesting that the intrinsic timescale develops along the S-A axis in youth and stabilizes in adulthood. Together, these results reveal convergence between major axes of cortical organization and development, highlighting intrinsic timescale as a principled marker of hierarchical brain maturation in youth.

IMPORTANCE/UNASSIGNED:Autism affects 1 in every 31 children in the US, with significant racial and ethnic disparities in prevalence, age at diagnosis, and access to services. Maternal health conditions during pregnancy have been linked with autism in offspring. However, the extent to which these associations vary by maternal race and ethnicity remains understudied. OBJECTIVE/UNASSIGNED:To evaluate whether associations between maternal conditions during pregnancy and the risk of autism in offspring differ by maternal race and ethnicity. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This retrospective cohort study included children born at Kaiser Permanente Northern California from 2010 to 2017, followed up until February 29, 2020, autism diagnosis, disenrollment, or death. Data were analyzed from September 2024 to July 2026. EXPOSURES/UNASSIGNED:Maternal International Classification of Diseases, Ninth Revision and Tenth Revision diagnoses of any of 25 conditions previously identified as associated with autism during the perinatal period. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Cox proportional hazards models examined associations between maternal diagnoses and autism with racial and ethnic differences evaluated via stratified and interaction models. Covariates included maternal age at delivery, insurance type, child sex, birth year, and maternal health care utilization. RESULTS/UNASSIGNED:Of 224 353 children, 5448 (2.4%) were diagnosed with autism, with prevalence varying by maternal race and ethnicity (493 Black [3.2%], 1693 Asian and Pacific Islander [2.9%], 1309 Hispanic [2.5%], 1838 White [2.0%], and 115 other or unknown race and ethnicity [2.4%] children; percentages indicate prevalence within each race and ethnicity group). Associations between maternal health conditions during pregnancy and offspring autism were largely consistent across racial and ethnic groups. Differences in risk estimates by maternal race and ethnicity were observed for 4 of the 25 conditions, including overweight and obesity, depressive episode, asthma, and other maternal disease complicating pregnancy. All those conditions exhibited stronger associations with autism in White mothers, compared with Black, Hispanic, and Asian and Pacific Islander mothers. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this cohort study of 224 353 children-mother pairs, maternal health conditions during pregnancy showed consistent observational associations with autism across racial and ethnic groups, but some exhibited heterogeneous association estimates. These differences may reflect disparities in health care access, diagnostic practices, or unmeasured environmental and genetic factors. Further research is needed to clarify underlying mechanisms and implications for maternal and child health.

BACKGROUND/UNASSIGNED:Latinx adolescents are the largest minoritized ethnic group in the United States. They are at elevated risk for suicidal and non-suicidal behaviors and symptoms of borderline personality disorder (BPD). Dialectical behavior therapy for adolescents (DBT-A) is an evidence-based treatment that targets these behaviors, yet limited evidence exists on the effectiveness of adapting DBT-A to Latinx adolescents with Spanish-speaking families. OBJECTIVE/UNASSIGNED:This study compared an established English-language DBT-A program to a Spanish DBT Program for Adolescents (DBT-SPA), a translated and adapted Spanish version designed for Latinx adolescents and their Spanish-speaking families. METHOD/UNASSIGNED:A retrospective chart review was completed on 201 adolescents (ages 11-18) who began the first cycle of an outpatient DBT-A program. The sample included 148 teens who participated in DBT-A and 53 adolescents from Spanish-speaking households who participated in DBT-SPA. Before beginning treatment, adolescents completed baseline assessments on borderline personality disorder (BPD) symptoms (BPD subscale of the Structured Clinical Interview for DSM-IV; Life Problems Inventory), lifetime history of suicidal and non-suicidal self-injurious behaviors (Lifetime Suicide Attempt Self-Injury Interview), depression (Beck Depression Inventory), and higher-level care utilization. RESULTS/UNASSIGNED:The results showed no significant differences in baseline psychopathology symptoms between the two programs. Participants, regardless of program language, exhibited relatively high rates of clinically significant improvements, with at least 60% achieving abstinence for all outcomes at all time points. The findings indicated that both the English and Spanish programs were comparably effective at reducing suicide attempts, non-suicidal self-injury, BPD symptoms, depression, and service utilization in statistically significant and clinically meaningful ways, with high participant satisfaction. CONCLUSIONS/UNASSIGNED:This study contributes to the growing body of research on DBT-A, particularly regarding Spanish-speaking adaptations. To the authors' knowledge, this is the first study to demonstrate the effectiveness of a community-based, translated, and culturally adapted DBT-A program in the United States.

IMPORTANCE/UNASSIGNED:Attention-deficit/hyperactivity disorder (ADHD) affects tens to hundreds of millions of adults worldwide, and preliminary evidence suggests it may be associated with increased risk of mild cognitive impairment (MCI) and dementia. However, concerns regarding diagnostic ascertainment and residual confounding remain. OBJECTIVE/UNASSIGNED:To investigate the association of ADHD with incident cognitive impairment, defined as MCI or dementia, using electronic health record (EHR) diagnoses and genetic liability measured using genome-wide ADHD polygenic risk score (ADHD PRS) in the same individuals. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This cohort study used data from the US All of Us Research Program (enrollment May 6, 2018, to October 1, 2023; EHR data from January 4, 1985, to October 1, 2023; mean [SD] follow-up 10.26 [6.75] years). A total of 187 341 participants aged 50 years and older with available EHR and genomic data were included. Data were analyzed from October 2025 to July 2026. EXPOSURES/UNASSIGNED:ADHD diagnosis and ADHD PRS. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Incident MCI or dementia. RESULTS/UNASSIGNED:Among 187 341 participants (mean [SD] age, 56.41 [7.88] years; 107 266 [57%] female), 3026 (1.6%) had ADHD. Among participants with ADHD, 203 (6.7%) developed cognitive impairment, compared with 6259 (3.4%) among those without ADHD. In adjusted Cox models, ADHD was associated with a more than 4-fold higher hazard of cognitive impairment (hazard ratio [HR], 4.60; 95% CI, 3.99-5.29; P < .001). Adjustments for comorbidities, educational attainment, and health care utilization attenuated but did not eliminate the association. Similarly, ADHD PRS was associated with incident cognitive impairment (highest vs lowest quintile: HR, 1.35; 95% CI, 1.25-1.46; P < .001). Among participants who developed cognitive impairment, comorbid ADHD diagnosis was associated with a nearly 2-fold higher odds of suboptimal mental health (odds ratio [OR], 1.69; 95% CI, 1.18-2.39; P = .01), quality of life (OR, 1.66; 95% CI, 1.14-2.39; P = .02), social satisfaction (OR, 2.39; 95% CI, 1.69-3.37; P < .001), and 20% higher health care utilization (incidence rate ratio, 1.20; 95% CI, 1.09-1.34; P = .003), suggesting greater care burden beyond the elevated incidence risk. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this cohort study, convergent clinical and genetic evidence revealed ADHD was associated with a markedly increased risk of late-life cognitive impairment. Among those who develop cognitive impairment, an ADHD diagnosis was associated with worse health outcomes and greater health care utilization, supporting the need for targeted monitoring and integrated care in this population.

INTRODUCTION/BACKGROUND:Cognitive-behavioural therapy (CBT) is a widely used intervention for depression and anxiety. However, its effectiveness is typically evaluated using subjective self-report symptom scales, which are susceptible to bias. It is hypothesised that improvements in clinical symptoms following CBT may be accompanied by improvements in physiological regulation, particularly heart rate variability (HRV), which has been proposed as a marker of emotion regulation. We conducted a systematic review with meta-analysis to examine the effects of CBT on HRV in adults with depression and/or anxiety disorders. METHODS:Following a pre-registered protocol (PROSPERO: CRD420251040957), we searched Embase, PsycINFO, PubMed, and Web of Science for randomised controlled trials (RCTs) and non-randomised interventional studies involving adults with depression and/or anxiety in CBT, and reporting HRV before and after the intervention. Random-effects meta-analyses in R estimated pooled effect sizes (Hedges' g). RESULTS:After screening 9713 records, we identified 12 studies; 5 RCTs were included in the meta-analysis, and the remaining 7 in the narrative review because they did not provide calculable effect sizes. Meta-analysis results found that adults randomised to CBT had significantly greater pre-to-post intervention increases in HF-HRV, LF-HRV, and SDNN-HRV. No significant changes were observed for the LF/HF ratio, RMSSD-HRV, and the HRV Triangular Index. CONCLUSION/CONCLUSIONS:Our meta-analysis provides emerging evidence that CBT might significantly increase selected HRV indices, suggesting that physiological changes may accompany improvements in psychological symptoms. However, further high-quality research is needed to determine the clinical utility of HRV as a predictor of treatment response and a biomarker for treatment effectiveness.

We aimed to assess the moderating role of context processing (i.e., context-encoding and -memory) in the association between maternal posttraumatic stress symptoms (PTSS) and the changes in maternal sensitivity in reaction to a separation from their toddler. Thirty-one mothers and their toddlers participated in the study in Switzerland. Mothers reported their current PTSS and performed a context processing task where they had to recognize contexts that they had previously seen paired with emotional faces. Maternal sensitivity was assessed during free play with their child and following a 3-min separation and was coded using the CARE-Index. A ratio score was calculated to assess the change in maternal sensitivity. Although the recognition of contexts previously associated with angry faces did not significantly moderate the relationship between maternal PTSS and the changes in maternal sensitivity, the recognition of contexts previously associated with neutral faces did. More PTSS led to a greater improvement of maternal sensitivity for mothers who had a better recognition of such contexts. This may be due to the ambiguity of neutral faces, which individuals with PTSS tend to focus on more closely, potentially due to their hypervigilance. Enhancing context processing may therefore help mothers use vigilance to improve sensitive caregiving.

Over the past decade, mental health problems have disproportionately increased among U.S. ethnoracially minoritized college students, though explanations for this disparity remain understudied. In the present study, we examined the direct and indirect associations between online racial/ethnic discrimination, suicidal ideation (SI), and alcohol misuse. We also investigated whether internalized racism helps explain the association between online racial/ethnic discrimination (i.e., individual or vicarious exposures) and SI and alcohol misuse. Lastly, we examined the moderating role of ethnic identity dimensions (i.e., exploration and commitment) in this indirect association. Participants included 494 ethnoracially minoritized college students ages 18-30 years (M = 19.62, SD = 2.08; 79% female; 60% Latine; 83% U.S.-born) from the U.S. who completed an online survey. Findings revealed that online racial/ethnic discrimination (i.e., individual and vicarious exposures) was directly associated with increased SI and alcohol misuse. The indirect association of online racial/ethnic discrimination (i.e., individual and vicarious) on SI via internalized racism was statistically significant. These indirect associations, however, were not observed with alcohol misuse. Ethnic identity commitment moderated the indirect association of vicarious, though not individual, online racial/ethnic discrimination on SI via internalized racism. These findings underscore the impact of online racial/ethnic discrimination on ethnoracially minoritized college students' mental health, identify internalized racism as a potential pathway through which this type of discrimination may confer risk for SI, as well as ethnic identity commitment as a potential protective factor that may buffer these harmful effects.

OBJECTIVE:The present study examined the role of racism-based traumatic stress (RBTS) symptoms (i.e., traumatic stress reactions in direct response to experiences of racial discrimination) and suicide-related risk in a national sample of U.S. Black and Latine adolescents. METHOD/METHODS:= 1.64). Logistic regression analyses were used to test the association between RBTS symptoms and past-year suicidal ideation, plans, and attempts, accounting for conventional and racism-based potentially traumatic exposures (PTEs) and posttraumatic stress disorder symptoms. RESULTS:= .73. CONCLUSION/CONCLUSIONS:RBTS symptoms may be relevant in identifying suicide-related risk, particularly suicide attempts, among Black and Latine adolescents. While these findings provide insights into the relationship between RBTS and suicide-related risk, the cross-sectional design limits causal inference, and the use of a convenience sample may limit generalizability to the broader Black and Latine populations. Tailored interventions that address the nuanced effects of racial trauma on suicide risk are needed among youth of color. (PsycInfo Database Record (c) 2026 APA, all rights reserved).