Browsing by Subject "psychopathology"

Research on extreme deviations in early life caregiving has provided valuable insight into the effects of early adversity on brain development and risk for psychopathology. However, much remains unknown about the impact of normative range variation in parenting on these same processes. The primary aim of this dissertation is to begin to address this gap in the literature.

I first examined associations between variability in family functioning and threat-related amygdala reactivity. Analyses revealed that greater familial affective responsiveness was associated with increased amygdala reactivity to explicit, interpersonal threat. Moreover, this association was moderated by the experience of recent stressful life events such that higher affective responsiveness was associated with higher amygdala reactivity in adolescents reporting low but not high stress. I hypothesized that these paradoxical associations may suggest a mechanism through which parental overprotection manifests as psychosocial dysfunction. Centering this hypothesis as the focus of my next study, I examined more detailed aspects of both early caregiving experiences and corticolimbic circuitry. Analyses revealed that participants who reported higher maternal control exhibited increased amygdala reactivity to explicit, interpersonal threat and decreased structural integrity of the uncinate fasciculus. While not a direct replication, these findings supported my hypotheses regarding parental overprotection and expanded Study 1 findings into structural connectivity between the amygdala and regulatory regions of the prefrontal cortex.

I next conducted a scoping review of the extant literature centered on the question, “Is variability in normative range parenting associated with variability in brain structure and function?” This review yielded 23 records for qualitative review and revealed not only how few studies have explored associations between brain development and normative range parenting, but also how little methodological consistency exists across published studies. In light of these limitations, I proposed recommendations for future research on normative range parenting and brain development and highlighted a path forward. Lastly, I applied these recommendations to my own empirical analyses. In the same sample of young adults used in Study 2, I examined associations among parental care and control, neural structural phenotypes, and mood and anxiety symptoms. Analyses revealed no significant associations among parenting and structural indices of interest, suggesting that neural structure is robust to more subtle variability in parenting even while neural function is not.

This dissertation provides critical first steps in empirically investigating how normative parenting shapes brain development with the data currently available. Further, it highlights the work of others similarly investigating this question and establishes an agenda for advancing future research on this topic.

Up to two million women worldwide have obstetric fistula, a maternal morbidity prevalent in developing countries that causes uncontrollable leaking of urine and/or feces and a persistent bad odor. There is both theoretical and empirical evidence for psychopathology in patients presenting for fistula surgery, albeit with methodological limitations. The current studies sought to improve on past limitations of study design. Study A compared psychological symptoms and social support between fistula patients and a comparison group recruited from gynecology outpatient clinics. Measures included previously validated psychometric questionnaires, administered orally by data collectors. Results showed that compared to gynecology outpatients, fistula patients had significantly higher levels of depression, traumatic stress, somatic symptoms and avoidant coping, and had lower social support. Study B investigated changes in psychological symptoms, stigma and social support between the time of admission for fistula repair and 3 months after discharge from the hospital. At follow-up, fistula patients reported significant improvements in all study outcome variables. Exploratory analysis revealed that the extent of leaking was associated with depression and PTSD. These results indicate the potential benefit of mental health interventions for this population. Additionally, future research may clarify the relationship between residual leaking after fistula surgery, and its effect on post-surgery mental health outcomes.

As knowledge of the neurobiological basis of psychopathology has advanced, public perceptions have shifted towards conceptualizing mental disorders as disorders of biology. However, little is known about how people respond to biological information about their own disorders. Such information is auto-biological—describing our own biological systems as a component of our identity. Chapter 1 presents a theory-based approach to conceptualizing how auto-biological information can influence people’s beliefs about their disorders, and proposes an attributional framework for presenting auto-biological information in a way that encourages agency, rather than destiny. Chapter 2 tests that framework by measuring the impact of auto-biological beliefs about vulnerability for affective disorders on attentional bias in a sample of healthy undergraduates. Chapter 3 moves towards clinical application and examines auto-biological beliefs about the efficacy of cognitive strategies for influencing brain activity in a sample of individuals previously treated for depression. Chapter 4 discusses the evidence from these studies supporting the relevance of auto-biological beliefs for mental health, and presents challenges for future research.