Background The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long-term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents. Method Participants included 537 children and adolescents (3 to 16 years; 272 females) with maltreatment (n = 245) or without maltreatment histories (n = 292). Maltreated subjects were recruited from child protection services (CPS; n = 95), youth psychiatric services (n = 56), and the community (n = 94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3 cm hair-segment. Results Analyses uniformly supported that maltreatment coincides with a gradual and dose-dependent reduction of HCC from 9-10 years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group-comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9 to 16-year-olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms. Conclusions From middle childhood onwards, maltreatment coincides with a relative reduction of cortisol secretion, which, in turn, may predispose to externalizing symptoms.

Practitioners and researchers alike face the challenge that different sources report inconsistent information regarding child maltreatment. The present study capitalizes on concordance and discordance between different sources and probes applicability of a multisource approach to data from three perspectives on maltreatment-Child Protection Services (CPS) records, caregivers, and children. The sample comprised 686 participants in early childhood (3- to 8-year-olds; n = 275) or late childhood/adolescence (9- to 16-year-olds; n = 411), 161 from two CPS sites and 525 from the community oversampled for psychosocial risk. We established three components within a factor-analytic approach: the shared variance between sources on presence of maltreatment (convergence), nonshared variance resulting from the child's own perspective, and the caregiver versus CPS perspective. The shared variance between sources was the strongest predictor of caregiver- and self-reported child symptoms. Child perspective and caregiver versus CPS perspective mainly added predictive strength of symptoms in late childhood/adolescence over and above convergence in the case of emotional maltreatment, lack of supervision, and physical abuse. By contrast, convergence almost fully accounted for child symptoms for failure to provide. Our results suggest consistent information from different sources reporting on maltreatment is, on average, the best indicator of child risk.

Parents perceive changes in their daily life and discrimination of their children due to their children's seizure and developmental disorders. An intellectual disability combined with seizure disorder caused the highest constraint. What is Known: • Seizure and/or developmental disorders of children may adversely influence quality of life for affected parents. • Caring for a child with special health care needs can take complete attention and own parental needs may therefore be difficult to meet. What is New: • Two out of three parents stated changes of their daily life such as quitting work, change of habitation, or breakup of partnership due to their child's diagnosis. • As judged by the parents, one in two children with developmental disorder of any kind is being discriminated against, even teachers and own family are held responsible.

Despite the well-established link between parental depressive symptoms and children's internalizing symptoms, studies that divide transmission into gender-specific components remain scarce. Therefore, the present study focused on gender-specific associations between internalizing symptoms of parents and children over the course of early school age, a key stage where gender-specific roles are increasingly adopted. Participants were 272 children (49.6% girls) oversampled for internalizing symptoms. Parents completed questionnaires twice during early school age (mean age time 1 = 7.4 years; SD = 0.24; mean age time 2 = 8.5 years; SD = 0.28). Mothers and fathers separately reported on their own depressive symptoms and their child's internalizing symptoms. Latent multiple group analyses indicated gender-independent stability as well as gender-specific relations between parental and child outcomes. Maternal depressive symptoms were concurrently associated with symptoms of girls and boys, while paternal symptoms were concurrently associated only with symptoms of boys, but not of girls. Moreover, the associations between children and the parent of the same gender became more relevant over time, suggesting a growing identification with the same-gender model, particularly for fathers and boys. In regard to prospective effects, girls' internalizing symptoms at age 7 predicted paternal depressive symptoms 1 year later. In a rigorous longitudinal design, this study underscores the importance of gender specificity in the associations of internalizing symptoms between children and their mothers and fathers after controlling for symptom stability over time. The study also raises the interesting possibility that girls' internalizing symptoms elicit similar symptoms in their fathers.

Recent proposals suggest early adversity sets in motion particularly chronic and neurobiologically distinct trajectories of internalizing symptoms. However, few prospective studies in high-risk samples delineate distinct trajectories of internalizing symptoms from preschool age onward. We examined trajectories in a high-risk cohort, oversampled for internalizing symptoms, several preschool risk/maintenance factors, and school-age outcomes. Parents of 325 children completed the Strengths and Difficulties Questionnaire on up to four waves of data collection from preschool (3-5 years) to school age (8-9 years) and Preschool Age Psychiatric Assessment interviews at both ages. Multi-informant data were collected on risk factors and symptoms. Growth mixture modelling identified four trajectory classes of internalizing symptoms with stable low, rising low-to-moderate, stable moderate, and stable high symptoms. Children in the stable high symptom trajectory manifested clinically relevant internalizing symptoms, mainly diagnosed with anxiety disorders/depression at preschool and school age. Trajectories differed regarding loss/separation experience, maltreatment, maternal psychopathology, temperament, and stress-hormone regulation with loss/separation, temperament, maternal psychopathology, and stress-hormone regulation (trend) significantly contributing to explained variance. At school age, trajectories continued to differ on symptoms, disorders, and impairment. Our study is among the first to show that severe early adversity may trigger a chronic and neurobiologically distinct internalizing trajectory from preschool age onward.