Our Research

A young baby prepared for medical scan in hospitalResearch at the Family Studies Lab is addressing several inter-related questions about how experiences of trauma and maltreatment may be transmitted intergenerationally.

One question involves how our experiences of adversity get embedded in our neurobiology. Our current work from an ongoing multi-site NICHD-funded study is examining, in the first 15 months of life, several pathways through which the effects of the mother's own childhood maltreatment may be transmitted to the infant. These pathways include effects on maternal stress regulation and limbic brain volumes, mother-infant interaction, infant stress regulation, and infant limbic brain volumes and connectivity. In addition, in work under R21 HD100902 with Dr. Kerry Ressler, we are evaluating whether maternal childhood maltreatment is linked to acceleration of epigenetic aging in both mother and infant.

Related publications:

  1. Khoury, J. E., Bosquet Enlow, M., Plamondon, A., & Lyons-Ruth, K. The association between adversity and hair cortisol levels in humans: A Meta-analysis. Psychoneuroendocrin. 2019;103:104-117. PMID: 0682626
  2. Khoury JE, Ahtam B, Sisitsky M, Ou Y, Gagoski B, Enlow MB, Teicher MH, Grant PE, & Lyons-Ruth K. Maternal childhood maltreatment is associated with lower infant grey matter volume and amygdala volume during the first two years of life. Biol Psychiatry: Glob Open Sci 2022. 2(4), 440-449 https://doi.org/10.1016/j.bpsgos.2021.09.005
  3. Lyons-Ruth K, Ahtam B, Khoury JE, Li FH, Sisitsky M, Ou Y, Bosquet Enlow M, Grant PE. Maternal childhood abuse versus neglect associated with differential patterns of infant brain development. Res Child Adolesc Psychopathol. 2023, in press.
  4. Khoury, J. E., Beeney, J., Bosquet Enlow, M., Shiff, I. & Lyons-Ruth, K. Maternal experiences of childhood maltreatment moderate patterns of mother-infant cortisol regulation under stress. Developmental Psychobiology 2021; 1-13. https://doi.org/10.1002/dev.22109

A second question is whether early adverse experiences have long-term effects on later social adaptation. Given the importance of the early identification of risk factors for psychopathology, the Family Studies Lab began one of the pioneering prospective longitudinal studies of infants from adverse environments characterized by poverty and high rates of maltreatment. Findings from the first five years of this study were among the first to identify long-term risks for childhood psychopathology associated with risk factors evident in infancy. The first key finding established in our lab was that infant disorganized attachment behaviors identified in the first two years of life were predictors of later aggressive behavior problems by school entry. This long-term risk has now been confirmed by three subsequent meta-analyses. Maternal depressive symptoms were also shown to be important longitudinal predictors of later school-age behavior problems, and that early finding has also been confirmed by numerous subsequent studies. Finally, this early work provided evidence that interventions focused on the mother-infant relationship had a measurable impact on infant outcomes into the school years.

Related publications:

  1. Lyons-Ruth, K., Zoll, D., Connell, D., Grunebaum, H. Family deviance and family disruption in childhood: Associations with maternal behavior and infant maltreatment during the first two years of life. Dev Psychopathol 1989; 1: 219-236. doi: 10.1017/S0954579400000420
  2. Lyons-Ruth, K., Connell, D.,Grunebaum, H., Botein,D. Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment. Child Dev 1990; 61:85-98. PMID: 2307048
  3. Alpern, L., Lyons-Ruth, K. Preschool children at social risk: Chronicity and timing of maternal depressive symptoms and child behavior problems at school and at home. Dev Psychopathol 1993; 5: 369-385.
    doi: 10.1017/S0954579400004478
  4. Lyons-Ruth, K., Easterbrooks, M., Cibelli, C. Infant attachment strategies and mental lag in infancy: Prediction of externalizing problems at age seven. Dev Psychol 1997; 33: 681-692. PMID: 9232383

A third question is how early and later childhood experiences combine to affect adult mental health outcomes and amygdala volumes. Given our interest in long-term outcomes of early experience, the Family Studies Lab has conducted NIMH-funded follow-up studies of our initial cohort of high-risk infants and their families up to age 30. In a series of reports, we have evaluated the relative contributions of economic adversity, traumatic events, and early versus later caregiving quality to the prediction of psychopathology in young adulthood. Our findings have revealed that maternal withdrawal from the infant's attachment bids during the first two years of life makes a unique contribution to the prediction of both suicidality and antisocial behavior at age 20, while controlling for the effects of childhood abuse, the short serotonin allele, and quality of caregiving at later ages. Depression and dissociation in young adulthood are predicted by other aspects of maternal disturbance in infancy, again with a variety of other potential predictors controlled. Finally, in follow-up MRI studies at age 30 in collaboration with M. Teicher, we found that early disturbed mother-infant interactions predicted volume of the left amygdala and hippocampus, even after controlling for childhood maltreatment and quality of later interaction. Taken together, these findings raise the possibility of an early sensitive period for the development of effective emotion regulation capacities.

Related publications:

  1. Lyons-Ruth, K., Bureau, J.-F., Holmes, B., Easterbrooks, M., Brooks, N. H. Borderline symptoms and suicidality/self-injury in late adolescence: Prospectively observed relationship correlates in infancy and childhood. Psychiatry Research 2013; 206: 273-281. PMID: 23123044
  2. Shi, Z., Bureau, JF., Easterbrooks, M.A., Zhao, X., Lyons-Ruth, K. Childhood maltreatment and prospectively observed quality of early care as predictors of antisocial personality disorder. Infant Mental Health Journal 2012; 33: 1-14. PMID: 22754051
  3. Lyons-Ruth, K., Pechtel, P., Yoon, S.A., Anderson C.M., Teicher, M.H. Disorganized attachment in infancy predicts greater amygdala volume in adulthood. Beh Brain Research 2016; 308: 83-93. PMID: 27060720
  4. Khoury, J., Pechtel, P., Andersen C.M., Teicher, M.H., Lyons-Ruth, K. Relations Among maternal withdrawal in infancy, borderline features, suicidality/self-Injury, and adult hippocampal volume: A 30-year longitudinal study. Beh Brain Research 2016.

Can we improve our observational assessments of high-risk forms of parent-child interaction? Over the course of our longitudinal study, we became aware of gaps in direct observational assessments for child risk behaviors. Thus, one focus of the work in our lab has been to develop validated assessments that capture more disturbed forms of interaction in infancy, middle childhood, and adolescence. Toward this end, we have developed and validated a fine-grained assessment for maternal disrupted communication with her infant (AMBIANCE coding system). This assessment is now used internationally. The AMBIANCE coding system has shown concurrent validity in relation to infant disorganized attachment behavior and infant cortisol dysregulation, and predictive validity in relation to later suicidality, substance abuse, and antisocial behavior, even after controlling for the effects of childhood maltreatment.

The Rating of Infant Stranger Engagement (RISE) assesses the indiscriminate social behaviors constituting the criteria for disinhibited social engagement disorder. This scale has been validated among socially at-risk infants reared at home in relation to maternal risk and later behavior problems. Dr. I. Soares lab extended the use of the RISE scale to Portuguese children reared in institutions and validated it in relation to caregiver report. The Goal-Corrected Partnership in Adolescence Coding System (GPACS), developed under NIMH #R01062030, assesses forms of disturbed adolescent-parent interaction during a conflict discussion. The GPACS has demonstrated good validity in relation both to earlier attachment measures and to concurrent measures of impulsive, self-damaging psychopathology. Dr. R. Kobak's lab also found that the GPACS at age 13 significantly predicted increases in adolescent risky behavior by age 15. Finally, the Middle Childhood Attachment Strategies Coding System (MCAS) was validated in relation to theoretically relevant constructs, and this measure is now being coded in a large Norwegian cohort, Dr. L Wichstrom, PI. We offer reliability training to other labs on all assessments, and all are now being used in labs other than our own.

Related publications:

  1. Lyons-Ruth, K., Bronfman, E., Parsons, E. Maternal frightened, frightening, and atypical behavior and disorganized infant attachment strategies. In J. Vondra and D. Barnett (Eds.) Atypical attachment in infancy and early childhood among children at developmental risk. Monogr Soc Res Child 1999; 64: 67-96. PMID: 10597543
  2. Tereno, S., Madigan, S., Lyons-Ruth, K., Plamondon, A., Atkinson, L., Guedeney, N., Greacen, T., Dugravier, R., Saias, T., Guedeney, A. Assessing a change mechanism in a randomized home-visiting trial: Reducing disrupted maternal communication decreases infant disorganization. Dev.Psychopathol 2017; 29: 637–649. PMID: 28401851
  3. Lyons-Ruth, K., Bureau J., Riley, C., Atlas-Corbett, A. F. Socially indiscriminate attachment behavior in the Strange Situation: Convergent and discriminant validity in relation to caregiving risk, later behavior problems, and attachment insecurity. Dev Psychopathol 2009; 21(2): 355-372. PMID: 19338688
  4. Oliveira, P., Soares, I., Martins, C., Silva, J., Marques, S., Baptista, J., Lyons-Ruth, K. Indiscriminate behavior observed in the Strange Situation among institutionalized toddlers: Relations to caregiver report and to early family risk. Infant Mental Health Journal 2012; 33: 187-196. PMID: 25552781
  5. Obsuth, I., Brumariu, L., Lyons-Ruth, K. Disorganized behavior in adolescent-parent interactions: Relations to attachment state of mind, partner abuse, and psychopathology. Child Dev, 2014; 85: 370-387. PMID: 23621826
  6. Brumariu, L., Giuseppone, K., Kerns, K., Van de Walle, M., Bureau, J-F., Bosmans, G., Lyons-Ruth, K. Middle childhood attachment strategies: Validation of an observational measure. Att & Hum Dev 2018; 1-23. PMID: 29402188

Can we improve our understanding of the developmental precursors of Borderline Personality Disorder? Given our lab's interest in early caregiver regulation of infant stress, identifying predictors and correlates of the impulsive self-damaging features of BPD was one of the goals of our work under NIMH #R01062030. Only one previous study had assessed developmental pathways from infancy to BPD features in young adulthood, and no previous work had assessed the attachment interactions associated with BPD in young adulthood. In addition, no previous studies had reported on the interactions between mothers with BPD and their infants. Thus, work from our lab has been groundbreaking in characterizing the maternal disorientation and young adult role-confusion associated with mothers and/or young adults diagnosed with BPD.

Related publications:
1. Hobson, R.P., Patrick, M., Hobson, J.A., Crandell, L., Bronfman E., Lyons-Ruth, K. How mothers with borderline personality disorder relate to their one-year-old infants. Br J Psychiatry 2009; 195: 325-330. PMID: 19794201
2. Lyons-Ruth, K., Riley, C., Patrick, M.P.H., Hobson, R.P. Disinhibited attachment behavior among infants of mothers with borderline personality disorder, depression, and no diagnosis. Personality Disorders: Theory, Research, and Treatment, 2019; 10: 163-172. PMID: 30628799
3. Lyons-Ruth, K. Choi-Kain, L., Pechtel, P., Bertha, E., Gunderson, J. Perceived parental protection and cortisol responses among young females with borderline personality disorder and controls. Psychiatry Research 2011 189: 426-432. PMID: 21872341
4. Khoury, J., Zona, K., Bertha, E., Choi-Kain, L., Henighausen, K., Lyons-Ruth, K. Disorganized attachment interactions among young adults with borderline personality disorder, other diagnoses, and no diagnosis. Journal of Personality Disorders 2019; 33: 1 – 21. PMID 30785838.

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