From risk to resilience: understanding and altering profiles of multisystem stress physiology to protect children vulnerable to internalizing disorders

PROJECT SUMMARY/ABSTRACT
Internalizing disorders are among the most prevalent forms of psychopathology in early childhood with
negative consequences that persist across the life course. Although parental depression heightens risk for
children's internalizing problems, a significant proportion of at-risk offspring do not develop psychopathology.
The factors that render children at risk or confer resilience in the context of parental depression remain poorly
understood and in particular, scarce research has explored physiological moderators of the relations between
parental depression and children's internalizing. Variations in children's integrated, multisystem stress
physiology and parent-child physiological synchrony may distinguish children who are resilient from those who
are adversely affected by parental depression. Moreover, stress-sensitive physiological pathways are a
promising, but understudied target of treatments that can help elucidate the etiology of children's internalizing
disorders and contribute to more effective interventions. This K23 Award builds upon the candidate's prior
training and experience to fill critical gaps in the areas of developmental psychopathology and psychobiology,
resilience, and intervention research. First, the candidate will examine the longitudinal, transactional relations
between parental depressive symptoms and children's internalizing symptoms using in-depth data collected
from two unique, extant longitudinal community samples of children that vary in age and exposure to risk.
Second, the candidate will test children's multisystem stress reactivity as a moderator of these relations in the
same two cohorts. Finally, the candidate will examine the feasibility of the Attachment and Biobehavioral
Catch-up (ABC) intervention in a pilot sample of parent-child dyads with elevated depressive and internalizing
symptoms, respectively, and assess the preliminary effects of ABC on children's multisystem physiology and
parent-child physiological synchrony. Using the NIMH experimental therapeutics approach to intervention
development, the candidate will test whether the ABC intervention improves regulation of these physiological
factors as potential mechanisms by which to ultimately reduce children's internalizing symptoms. The ABC
program is an empirically-supported biobehavioral intervention that is well-suited to attenuate patterns of
physiological dysregulation that may underlie relations between parental depression and children's
internalizing symptoms, but to date, it has only been delivered to children in foster care and the child welfare
system. This novel pilot study will be the first to test the intervention among parents and children with elevated
mental health symptoms and will explore its effects on a broader range of physiological outcomes. This
research will advance understanding of the dynamic relations among parent depression, child and parent-child
stress physiology, and child internalizing early in life, and will contribute to the development of innovative
prevention and treatment programs. Through the proposed training and research, the candidate will contribute
to cutting-edge research that promotes positive mental health outcomes among at-risk children and families.