Biomedical subjects

Marjorie H Klein

Publications and source records attributed to Marjorie H Klein.

7 recordsLinked to original sources

PubMed2006

Environmental influences on family similarity in afternoon cortisol levels: twin and parent-offspring designs.

Modest genetic effects on morning, but not late-day, cortisol levels have been established. Environmental demands may influence basal cortisol levels later in the day. Thus, we anticipated that individuals in the same family would have similar afternoon cortisol levels to the extent that they share aspects of their environment. We examined afternoon basal cortisol levels measured across 3 consecutive days in mothers and fathers and in multiple offspring in two separate large and longitudinal studies. Study I involved 321 families with singletons while study II involved 233 families with twins. Modest family similarity was apparent for afternoon basal cortisol levels in both studies. Spouses' cortisol levels were also correlated. Data from study II demonstrated that family resemblance in afternoon cortisol was accounted for by underlying shared environmental factors, but not underlying genetic factors. Shared environment accounted for 62% of the variation in twin afternoon basal cortisol levels and 14% of the variation in parent afternoon basal cortisol levels. We used pooled data from the two studies to examine whether parental depression, socioeconomic status (SES), and offspring sex and age impacted cortisol levels. Female offspring had higher cortisol levels than males, and cortisol decreased with age until about 9 years of age, after which cortisol increased with age. Family similarity persisted after accounting for parental depression, SES, time of day, and offspring sex and age, which suggests that the shared family environment influences parent and offspring stress hormone levels throughout the childhood years.

Adult↗

PubMed2006

Exploring risk factors for the emergence of children's mental health problems.

CONTEXT: Exploratory studies that generate testable models of how risk factors for childhood mental health problems work together over time are critical for developing effective prevention and treatment strategies. OBJECTIVE: To build models addressing the following 2 questions: (1) How early can we identify children at risk for mental health problems in third grade? (2) How do the risk factors work together over time? DESIGN AND PARTICIPANTS: We assessed a Wisconsin community sample 8 times, beginning during pregnancy. Three hundred seventy-nine families completed multi-informant reports (mothers, teachers, and children) of children's mental health symptoms in third grade. MAIN OUTCOME MEASURES: Symptom severity and directionality (externalizing vs internalizing). RESULTS: The hypothesis was generated that family socioeconomic status (SES) defined different pathways to symptom severity. In low/middle SES families, children were at risk if their mothers were distressed during the infancy period, which was then associated with more generalized maternal and child distress and dysregulation during the preschool period. In high SES families, the picture was more complex, beginning with parental histories of depression and family psychopathology, which then led to greater family stress in the infancy period and maternal and child distress and dysregulation during the preschool period. For all children, social and academic impairment during the school transition was an important mediator. Two pathways to later symptom directionality consisted of one beginning with child sex and the other with child temperament. CONCLUSIONS: Most risk factors predicted symptom severity and not directionality. The risk factors for internalizing and externalizing problems may be much the same, and the same preventive interventions might be effective for both classes of problems. Furthermore, at-risk children from high SES families might be identifiable as early as infancy, whereas those from lower SES families may be identifiable only as preschoolers.

Adult↗

PubMed2006

DSM-IV threshold versus subthreshold bulimia nervosa.

OBJECTIVE: The purpose of the present work is to determine whether bulimia nervosa (BN) and eating disorder not otherwise specified, BN type (EDNOS-BN) were qualitatively distinct in terms of eating and general psychopathology. METHOD: This study presents a comparison of 138 women with BN and 57 with EDNOS-BN from a multisite study on eating-related and general psychopathology measures. RESULTS: Although women with BN reported higher lifetime history rates of anorexia nervosa, greater binge eating and vomiting frequency, and more eating concerns, no significant differences were observed between groups on measures of perfectionism, impulsivity, obsessive-compulsiveness, anxiety, depressive symptomatology, or alcohol/substance problems. Based on the partial eta2 values, the distinction between BN and EDNOS-BN accounted for <5% of the criterion variance in general psychopathology measures. Post hoc analyses comparing EDNOS-BN with objective bulimic episodes (OBEs; n=34) versus no OBEs (n=23) found greater EDEQ-4 Restraint subscale scores for EDNOS-BN without OBEs. However, there was no significant difference on the EDEQ-4 Eating Concern subscale between the two EDNOS-BN subgroups. CONCLUSION: The findings highlight the clinical significance of BN partial syndrome and prompt reevaluation of existing BN diagnostic boundaries. Post hoc analyses also underscore the need for greater differentiation within EDNOS.

Adult↗

PubMed2006

Self-system therapy as an intervention for self-regulatory dysfunction in depression: a randomized comparison with cognitive therapy.

Self-system therapy (SST) is a new therapy based on regulatory focus theory (E. T. Higgins, 1997) for depressed individuals unable to pursue promotion goals effectively. The authors conducted a randomized trial comparing SST with cognitive therapy (CT) in a sample of 45 patients with a range of depressive symptoms to test 2 hypotheses: that SST would be more efficacious for depressed individuals characterized by inadequate socialization toward pursuing promotion goals and that SST would lead to greater reduction in dysphoric responses to priming of promotion goals. There was no overall difference in efficacy between treatments, but patients whose socialization history lacked an emphasis on promotion goals showed significantly greater improvement with SST. In addition, SST patients showed a greater reduction in dysphoric responses to promotion goal priming than did CT patients. The results illustrate the value of a theory-based translational approach to treatment design and selection.

Adult↗

PubMed2003

Exposure to maternal depression and marital conflict: gender differences in children's later mental health symptoms.

OBJECTIVE: To investigate effects of the timing of initial exposure to maternal depression and marital conflict on kindergarten children's mental health symptoms. METHOD: For 406 families (of 570 originally recruited), mothers reported on major depression and marital conflict on multiple occasions in the child's infancy and toddler/preschool periods. Mothers and teachers completed the MacArthur Health and Behavior Questionnaire when children were in kindergarten. RESULTS: Children evidenced co-occurring internalizing and externalizing symptoms, although the mix was more toward internalizing for girls and externalizing for boys. Symptoms were more severe among children exposed to either adversity, and these effects were additive. Boys exposed to maternal depression in infancy had a preponderance of internalizing behaviors, but if subsequently exposed to marital conflict, the mix toward externalizing behaviors increased to match levels of clinic-referred children. For girls, the preponderance of internalizing symptoms increased to match levels of clinic-referred children when initial exposure to marital conflict occurred in the toddler/preschool period. CONCLUSIONS: It is important to consider both adversities across developmental periods, to distinguish the symptom severity from directionality, and to consider child gender. Prevention and intervention efforts that consider these findings are warranted.

Child↗

PubMed2003

Validation of the Wisconsin Personality Disorders Inventory-IV with the SCID-II.

The Wisconsin Personality Disorders Inventory (WISPI-IV; Klein & Benjamin, 1996) is the latest version of a self-report measure of DSM-IV personality disorders (PDs) derived from an interpersonal perspective. When categorical diagnoses derived from the WISPI-IV were compared with independent SCID-II diagnoses, the majority of the kappas were poor (>.40). However, all but one of the effect sizes for the differences in WISPI-IV means between groups with and without SCID-II diagnoses were large (>.80). When SCID-II and WISPI-IV dimensional scores were considered, the average r between profiles was .61 (median = .58) and correlations between corresponding PD scales (mean diagonal r = .48; mean off-diagonal r = .18) indicated good convergent and discriminant validity for five of the WISPI-IV scales. These results add to the cumulating evidence suggesting greater reliability and validity of dimensional over categorical scores for PDs. Researchers and clinicians interested in having an efficient method of assessing PDs may consider using a dimensional approach such as the WISPI-IV as an alternative to diagnostic interview.

Adult↗

PubMed2002

Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior.

BACKGROUND: Preclinical studies demonstrate that the neonatal environment can permanently alter an individual's responses to stress. To demonstrate a similar phenomenon in humans, we prospectively examined the relationships of maternal stress beginning in infancy and concurrent stress on preschoolers' hypothalamic-pituitary-adrenal activity and later mental health symptoms. METHODS: Salivary cortisol levels were assessed in 282 4.5-year-old children and 154 of their siblings. Maternal reports of stress were obtained when the children were ages 1, 4, and 12 months, and again at 4.5 years. Children's mental health symptoms were assessed in first grade. RESULTS: A cross-sectional analysis revealed that preschoolers exposed to high levels of concurrent maternal stress had elevated cortisol levels; however, a longitudinal analysis revealed that concurrently stressed children with elevated cortisol also had a history of high maternal stress exposure in infancy. Importantly, children exposed only to high levels of concurrent or early stress had cortisol levels that did not significantly differ from those never exposed to stress. Further analysis of the components of stress indicated that maternal depression beginning in infancy was the most potent predictor of children's cortisol. We also found that preschoolers with high cortisol levels exhibited greater mental health symptoms in first grade. CONCLUSIONS: These results link the findings of preclinical studies to humans by showing that exposure to early maternal stress may sensitize children's pituitary-adrenal responses to subsequent stress exposure.

Adult↗