Stress and Development in Infants (PDF)

Tuesday, February 6, 2024 Stress and Development Stress in infants — 0-12 months In humans: - during sleep, cortisol is very low (almost nothing) - As we get closer to waking up, cortisol rises and peaks at waking up - Cortisol decreases Except in infants CORTISOL RESPONSE IN INFANTS - Newborns exhi...

Tuesday, February 6, 2024 Stress and Development Stress in infants — 0-12 months In humans: - during sleep, cortisol is very low (almost nothing) - As we get closer to waking up, cortisol rises and peaks at waking up - Cortisol decreases Except in infants CORTISOL RESPONSE IN INFANTS - Newborns exhibit two peaks in daily cortisol production not correlated with time of day Upon awakening and another peak during the day (after nap) - By 3 months, salivary cortisol levels are signi cantly higher within 30 minutes of waking compared to 30 minutes before bedtime - Cortisol levels drop during pre-school nap/rest time and rebound upon waking - Duration of nap time is negatively correlated with age but positively correlated with the - strength of the decrease in cortisol from morning to afternoon The older we get, the less the 2nd peak is high until it vanishes (~ 12mo) Cortisol (extra) is needed for normal development Infants do not show the cortisol response to stress Studies — Less cortisol during stress Lowered cortisol levels in laboratory settings as compared to home Lowered cortisol levels in novel situations ✓ Probably because everywhere is novel during this period, if cortisol were to increase every time, it would be high all the time Lowest levels in infants with greater positive affect and actively engaged in the situation ✓ Effect opposite to what we see in adults/adolescents ✓ This effect is no longer seen in children as they get older Starting from a lowered baseline might serve as a protective factor for the developing child fi 1 Tuesday, February 6, 2024 Stressors in Infancy Stressors come from the environment they grow up in PARENTAL STRESSORS Neglect, Abuse, Parental Mental Health, Insecure Attachment Study — Parental Stressors roughly 905,000 U.S. children were abused or neglected in 2006 In 2005, the CDC and Prevention estimated that approximately one in every 7 children has been maltreated In 2006, 11% of the victims reported to State Child Welfare agencies were under the age of 12 months Maltreatment rates are highest during infancy and adolescence ✓ Some people may not have the right abilities to take care of a baby, leading to stress increase and taking it out on them Maltreatment is also linked with poverty and its associated burdens: single parenthood, social isolation, unemployment, poor education, etc. ✓ The less resources = the less apt one is to take care of a baby Consequences of Parental Stressors 1. Proximal - Failure to Thrive (FTT): growth process is disrupted by psychological mechanisms with the parent-child relationship playing a central role Not meeting the developmental milestone, i.e. weight and height Effect of parental stressors - Height and weight are below the fth percentile for age and gender - De ciencies in terms of social responsiveness 2. Distal - Maltreatment can impair brain development and regulatory functioning - Later in childhood it can lead to disruptive behaviours and school performance problems Emotion regulation impairments - In adolescence and adulthood, it can cause depression and increase the likelihood to become substance abusers ENVIRONMENTAL STRESSORS Institutions/Orphanages Adoption study Attachment ✓ Adopted children were less secure in their attachment relationships than the comparison children ✓ Effect remains for years fi fi 2 Tuesday, February 6, 2024 Cognition ✓ Between-group differences observed in infancy were still evident at age four Emotional Understanding ✓ Adopted children were less able to understand emotions than family-reared children Physical Development and Shyness ✓ Physical development of the adoptive children showed improvement at age four ✓ Between-group differences disappeared in shyness after adoption TRAUMATIC EVENTS/EXPERIENCES Loss of a caregiver, Child Holocaust survivors Holocaust Study Participants: 133 childhood survivors of the Holocaust, who were subject to Nazi persecution during infancy Methods: assessed cortisol reactivity, depression, illness in late adulthood (~60-80 yo at assessment) Results: ✓ Survivors who had lost both parents during the war were signi cantly more depressed than those who lost only one parent or no parental loss ✓ Those with PTSD-functional impairment suffered signi cantly more from physical illness and depression ✓ elevated cortisol response to stress in the youngest male age group and in males suffering from PTSD-related functional impairments even when controlling for differences in loss of parents, depression and physical health Toddlers and Stress — 12 months to 5 years STRESSORS Relatively the same stressors, in addition to peers: - Peer neglect - Deprived environments (ex. orphanages, low SES) - Poor maternal attachment - Experiencing a traumatic event - Psychological abuse/maltreatment Study — Attachment & Cortisol (strange situation experiment) Secure ✓ Infants with secure attachment do not demonstrate signi cant HPA activation in response to the Strange Situation ✓ When parents are consistent, child can entrust their care to the caregiver fi fi fi 3 Tuesday, February 6, 2024 Insecure-Avoidant ✓ Parents avoid the needs of the children ✓ Same results as resistant (below) Insecure-Resistant ✓ Infants with insecure avoidant and insecure resistant attachments tend to show greater HPA activation in response to the SS than infants with secure attachments ✓ Parents reject the child and their needs ✓ Child believes do no one cares; cannot trust ✓ Related to hostility Disorganized ✓ Infants with insecure disorganized attachments show the greatest levels of HPA activation in response to the SS ✓ Sometimes parents are there, sometimes are not = unstable ✓ Related to anxiety Signs of Stress SLEEP DISRUPTION Two issues: 1. Those who have dif cult falling asleep (change from the norm) 2. Those who wake frequently and cry for the attention of a parent - Prevalence: 22% of 9 month olds 15-20% of 1-2 year olds 16% of 3 year olds - Dif culty concentrating Sudden changes in mood Repeating phrases/actions Temper tantrums Avoids physical contact/withdraw Cortisol Response to Peer Neglect - Children in full-time daycare showed signi cant increases in cortisol as the day progressed - Correlated with teacher/parent reports of social rejection - Suggests that peer interaction and emotional/language immaturity may lead to stress in preschool aged children fi fi fi 4 Tuesday, February 6, 2024 CORTISOL AND AGE PEER RELATIONSHIPS IN PRE-SCHOOL AND CORTISOL LEVELS Cortisol response is less in popular kids Neglected kids show lower cortisol response because they tend to not seek out social interactions Rejected kids have higher cortisol responses because they seek out interactions Study — Traumatic Events and Experiences ✓ Toddlers exposed to a traumatic life event and who experienced a dramatic change in demeanour post-shock, exhibited greater symptom severity on measures of social and emotional functioning ✓ Children lack the language skills required to report certain cognitive factors of PTSD but show a huge emphasis on behavioural manifestations as a reaction to trauma ✓ If a preschool aged child is exhibiting many behavioural outbursts, this may be the early signs of stress School-aged Stress — 5 years to 12 years SCHOOL PHOBIA - 1% of school-aged population have school phobia - Often misdiagnosed as separation anxiety - Characterized by physical symptoms such as agitation and physical resistance to the school situation (such as school refusal) 5 Tuesday, February 6, 2024 SIGNS OF STRESS - Regressing to Infantile Behaviour (bed wetting, thumb sucking) Social Withdrawal Loss of motivation Inability to concentrate in school Behaviour changes Poor Appetite and sleeplessness Unexplained Irritability Headaches and stomachaches Trouble getting along with peers Study — Subjects: 34 kindergarten to third grade students and their parents Methods: Questionnaires rating stress in given situations Results: ✓ Signi cant differences in child’s perceived stress and parents perception of the child’s stress. ✓ Children reported their overall stress level as higher than parents did ✓ They either do not recognize the signs or are resistant to the idea of their child having problems (taps into their own stress) Stress management for Kids - fi 6 Changing environment Being patient with them Reassurance Helping them understand bullying Helping them handle jealousy Allow children to run around and be energetic Prepare them for change and future situations Storytelling