Background Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool‐aged children. Methods Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2–5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent‐report structured diagnostic interview developed for preschool‐age children. Sixty‐six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS‐related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age, race, SES, maternal substance use, and normative prenatal stress. Results Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p = .030), anxiety disorders (HR = 5.1, p < .0001), and attention‐deficit/disruptive behavioral disorders (HR = 3.4, p = .02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p = .004), attention‐deficit/hyperactivity disorder (ADHD; HR = 5.5, p = .01), oppositional‐defiant disorder (ODD; HR = 3.8, p = .05), and separation‐anxiety disorder (SAD; HR = 3.5, p = .001). Males had distinctively elevated risks for attention‐deficit/disruptive behavioral disorders (HR = 7.8, p = .02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p < .0001), phobia (HR = 2.8, p = .02) and depressive disorders (HR = 30.0, p = .03), including SAD, GAD, and dysthymia. Conclusions The findings demonstrate that in utero exposure to a major weather‐related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.

Objective To assess the role of the heart rate variability (HRV) in the relationship between prenatal anxiety exposure and subsequent child anxiety levels. Methods A longitudinal study of mother–child dyads (subsample of 89) measured maternal anxiety during the second trimester of pregnancy (self-reported via STAI-S) and subsequent child anxiety (maternal-reported via BASC-3) and baseline autonomic physiological measures (high and low frequency band of HRV power spectrum) at 5-years-old. Mediation analysis was conducted to test whether child high and/or low frequency HRV mediates the relationship between prenatal anxiety and child anxiety. Results Prenatal anxiety predicted child anxiety (β = 0.137, p = 0.004) and high frequency HRV (β = −0.009, p &lt; 0.001), but not low frequency HRV (β = −0.002, p = 0.231). Mediation analysis using bootstrapping procedure revealed that high frequency HRV (β = 0.044, 95% CI [0.007, 0.085]), but not low frequency HRV (β = 0.0117, 95% CI [−0.007, 0.047]), mediated the relationship between prenatal anxiety and child anxiety. After controlling for high frequency HRV, prenatal anxiety was no longer associated with child anxiety (β = 0.0753, p = 0.148). Conclusion Results indicate that in-utero exposure to maternal anxiety influences the child’s high frequency but not low frequency HRV. Importantly, changes in only high frequency HRV from prenatal anxiety is driving the relationship between prenatal anxiety and child anxiety levels, indicating that maternal anxiety during pregnancy affects the development of the autonomic nervous system with long term effects on child emotional regulation. The results suggest that the high frequency portion of the HRV power spectrum should be assessed in a multidimensional model of fetal programming and subsequent mental health risk of the child.

Objective The current study examines the associations between low resting heart rate (HR), low electrodermal activity (EDA), and externalizing behavior (EB) in children 1–5 years old through the following measures: baseline 1 (B1) HR, startle period HR, and recovery-stage HR HR, EDA amplitude and skin conductance responses (SCR). We also investigate whether in-utero stress (exposure to Hurricane Sandy) moderates these relationships. Method A subsample of 206 children was drawn from a NIMH longitudinal study, the Stress in Pregnancy Study, that follows offspring from in-utero to 6 years of age. HR and EDA data was collected during a startle-probe paradigm. Mean age of the participants was 3.89 years. Approximately 52% were female and 50.5% were Hispanic. Participants’ EB was assessed by the Behavioral Assessment Screening for Children Version-2 parent rating scales. Externalizing symptoms were trichotomized (high, medium, and low). Results One-way ANOVA showed that three EB groups differed in baseline-HR (p = 0.034), startle-HR (p = 0.006), and recovery-stage HR (p = 0.008) in 4-year olds. EDA was not significantly different between EB groups. Furthermore, Hurricane Sandy exposure significantly and marginally significantly moderates the relationship between EB and amplitude (b = 3.0344, p = 0.044) and EB and SCR (b = 1.5629, p = 0.056), respectively. Hurricane Sandy exposure did not moderate the relationship between EB and HR. Conclusion Externalizing problem symptom groups significantly differ in HR, but not EDA. Hurricane Sandy exposure moderates the relationship between EB and EDA, but not EB and HR. Results suggest that HR and EDA are differentially susceptible to environmental influence. Results can guide biologically informed treatments/screeners for EB in children.