Socioeconomic disadvantage has been repeatedly found to increase risk for internalizing and externalizing problems in children. Socioeconomic disadvantage is theorized to exert these effects in part through its effects on parent and child stress physiology. Yet, these mechanistic pathways are not well understood. In this study, we examined the associations among socioeconomic factors, parental hair cortisol concentration (HCC) and emotional distress, and children's HCC and internalizing and externalizing symptoms. Participants were 106 typically developing 5- to 13-year-olds (57 % male; 74 % White, non-Hispanic/Latine) from a range of socioeconomic backgrounds. Hair samples 3 centimeters in length were collected from parents and children and assayed for cortisol. Parent self-reports of anxiety and depression symptoms and perceived stress were used to compute a parental emotional distress composite via factor analysis. Parents also reported on their children's internalizing and externalizing symptoms. Results indicated that lower family income-to-needs ratio was significantly associated with increased parental HCC and emotional distress. Controlling for parental emotional distress, higher parental HCC was significantly associated with greater externalizing behavior in children. Lower family income-to-needs ratio was indirectly associated with higher child HCC via higher parental HCC. These findings point to elevated parental HCC as potentially part of the mechanisms explaining socioeconomic disparities in children's mental health. Results align with calls for interventions that ensure economic resources and address caregiver well-being to support families and children.

Socioeconomic disadvantage has been robustly linked with lower academic achievement in children. These associations may be partially attributable to the effects of socioeconomic disadvantage on error monitoring neural activity in children. The error positivity (Pe) is an event-related potential component that reflects higher-order neural processing involved in recognizing and evaluating errors. In this study, we examined the associations among socioeconomic factors (family income-to-needs ratio, parental educational attainment), Pe amplitude, and parent-reported performance monitoring in typically developing children. Participants were 5- to 13-year-olds (N = 108; 57% male; 13% Hispanic/Latine; 75% White, non-Hispanic/Latine) from a range of socioeconomic backgrounds. Electroencephalography (EEG) data were collected while children completed a speeded arrow flanker task. Parents completed the Task-Monitor scale of the Behavior Rating Inventory of Executive Function, Second Edition. Results indicated that lower parental education was significantly associated with reduced Pe amplitudes in children, independent of age and flanker task error rate. Reduced Pe amplitudes were significantly associated with higher levels of performance monitoring difficulties in children. Family income-to-needs ratio was not associated with Pe amplitude in children. These findings suggest that lower socioeconomic resources are associated with altered neural processing following errors in children. These differences at the neural level could underlie behavioral differences children exhibit in everyday settings, such as home and school.

Veterans and Veteran family members experiencing mental health problems face significant barriers when accessing military culturally competent providers trained in evidence-based treatments (EBTs). Telehealth is a low-cost solution that may increase access. Ongoing evaluation is needed to demonstrate the feasibility and acceptability of this emerging practice among military members and their families. Accordingly, authors piloted a telehealth clinic in 2018-19 (before the COVID-19 pandemic). Clinicians in a U.S.-based non-Veterans Affairs outpatient clinic offered military culture informed EBTs (cognitive processing therapy, acceptance and commitment therapy, and the unified protocol for transdiagnostic treatment of emotional disorders) via telehealth to Veterans and Veteran family members. Self-report measures were used to assess psychological symptoms before and after treatment and one month post-treatment. Seventy-one percent of participants (Veteran or family member) completed treatment. Participants reported significant reductions in posttraumatic stress disorder symptoms, depressive symptoms, and psychological distress, and significantly increased physical and psychological quality of life following treatment. Treatment gains were maintained or improved after one month. Participants also reported high satisfaction with treatment and strong alliances with providers. Findings show promise for use of telehealth as a solution for connecting Veterans and Veteran family members to timely, high-quality, specialized care.

Variability in associations between socioeconomic status and cortical gray matter may be due in part to the common, functional brain-derived neurotrophic factor (BDNF) Val66Met polymorphism, which alters BDNF signaling. In this study, we examined whether BDNF Val66Met genotype moderated the associations between socioeconomic factors (family income, parental education) and cortical surface area (SA) and thickness (CT) in two large independent samples of typically-developing children and adolescents. Participants were 3- to 21-year-olds (N = 383; 47% female) from the Pediatric Imaging, Neurocognition, and Genetics (PING) study and 11- to 14-year-olds (N = 2566; 46% female) in the Adolescent Brain Cognitive Development (ABCD) study. High-resolution, T1-weighted magnetic resonance imaging data were acquired in both studies. Analyses were conducted on global and regional SA and CT. In the PING sample, BDNF Val66Met genotype significantly moderated the association between family income and total SA and SA in the left fusiform gyrus. In the ABCD sample, there were no significant interactions for global or regional SA or CT. Collectively, these results suggest that BDNF Val66Met genotype may not explain variability in associations between socioeconomic factors and SA or CT in children and adolescents.

Socioeconomic disadvantage during childhood predicts an increased risk for mental health problems across the life span. Socioeconomic disadvantage shapes multiple aspects of children’s proximal environments and increases exposure to chronic stressors. Drawing from multiple literatures, we propose that childhood socioeconomic disadvantage may lead to adaptive changes in the regulation of stress response systems including the hypothalamic-pituitary-adrenal (HPA) axis. These changes, in turn, affect the development of prefrontal cortical (PFC) circuitry responsible for top-down control over cognitive and emotional processes. Translational findings indicate that chronic stress reduces dendritic complexity and spine density in the medial PFC and anterior cingulate cortex, in part through altered HPA axis regulation. Socioeconomic disadvantage has frequently been associated with reduced gray matter in the dorsolateral and ventrolateral PFC and anterior cingulate cortex and lower fractional anisotropy in the superior longitudinal fasciculus, cingulum bundle, and uncinate fasciculus during middle childhood and adolescence. Evidence of socioeconomic disparities in hair cortisol concentrations in children has accumulated, although null findings have been reported. Coupled with links between cortisol levels and reduced gray matter in the PFC and anterior cingulate cortex, these results support mechanistic roles for the HPA axis and these PFC circuits. Future longitudinal studies should simultaneously consider multiple dimensions of proximal factors, including cognitive stimulation, while focusing on epigenetic processes and genetic moderators to elucidate how socioeconomic context may influence the HPA axis and PFC circuitry involved in cognitive and emotional control. These findings, which point to modifiable factors, can be harnessed to inform policy and more effective prevention strategies.

BACKGROUND:Depression has frequently been associated with smaller hippocampal volume. The hippocampus varies in function along its anterior-posterior axis, with the anterior hippocampus more strongly associated with stress and emotion processing. The goals of this study were to examine the associations among parental history of anxiety/depression, polygenic risk scores for depression (PGS-DEP), and anterior and posterior hippocampal volumes in children and adolescents. To examine specificity to PGS-DEP, we examined associations of educational attainment polygenic scores (PGS-EA) with anterior and posterior hippocampal volume. METHODS:Participants were 350 3- to 21-year-olds (46 % female). PGS-DEP and PGS-EA were computed based on recent, large-scale genome-wide association studies. High-resolution, T1-weighted magnetic resonance imaging (MRI) data were acquired, and a semi-automated approach was used to segment the hippocampus into anterior and posterior subregions. RESULTS:Children and adolescents with higher polygenic risk for depression were more likely to have a parent with a history of anxiety/depression. Higher polygenic risk for depression was significantly associated with smaller anterior but not posterior hippocampal volume. PGS-EA was not associated with anterior or posterior hippocampal volumes. LIMITATIONS:Participants in these analyses were all of European ancestry. CONCLUSIONS:Polygenic risk for depression may lead to smaller anterior but not posterior hippocampal volume in children and adolescents, and there may be specificity of these effects to PGS-DEP rather than PGS-EA. These findings may inform the earlier identification of those in need of support and the design of more effective, personalized treatment strategies. DECLARATIONS OF INTEREST:none. DECLARATIONS OF INTEREST:None.

LAY SUMMARY Behavioural health peer support connects individuals to needed professional services (e.g., counselling) and provides benefits in groups of people that might face more challenges, like military Veterans. Different training exists for peer supporters, but not a lot of information is available to demonstrate whether these trainings, or checking in with trained peers, is helpful. This study took a peer support training program used in fire service and updated it to fit the needs of Veterans and Veteran family members (V/VFM) in Texas, United States. Texas has a lot of Veterans and lacks enough mental health providers (e.g., psychologists). In this study, V/VFM were trained in peer support skills and had six months of peer check-in calls after the training. The trainees completed a test before training asking about their engagement and confidence with helping others, as well as a test after training asking these questions again and assessing satisfaction with training. Results show training was appropriate and acceptable. V/VFM appreciated the check ins and showed increases in confidence in their ability to help others. They tried to help more peers and were more successful when they did reach out. This study describes one way peer support can improve mental health access.

Abstract Introduction Disrupted sleep has been consistently linked with lower academic achievement and worse mental health in children. Less is understood about sleep as a potential factor underlying socioeconomic differences in brain morphometry in children. The goals of this study were to investigate the associations among socioeconomic factors, sleep duration, and brain morphometry in children, and to examine the roles of the sleep environment and family routines in these associations. Methods Participants were 5‐ to 9‐year‐old children from socioeconomically diverse families (N = 94; 61% female). Parents reported on children's weekday and weekend sleep durations, sleep environment, and family routines. High‐resolution, T1‐weighted structural magnetic resonance imaging (MRI) data were acquired. Analyses focused on cortical thickness, cortical surface area, and amygdala and hippocampal volume. Results Results indicated that lower family income‐to‐needs ratio and parental education were significantly associated with shorter weekday sleep duration in children. Shorter weekday sleep duration was significantly associated with reduced thickness in the left middle temporal, right postcentral, and right superior frontal cortices and smaller basolateral but not centromedial amygdala volume. Family routines significantly mediated the associations of family income‐to‐needs ratio and parental education with weekday sleep duration in children. Conclusion These results contribute to our understanding of sleep factors as proximal mechanisms through which socioeconomic context may alter neural development during childhood.

Background Genome-wide polygenic scores for educational attainment (PGS-EA) and socioeconomic factors, which are correlated with each other, have been consistently associated with academic achievement and general cognitive ability in children and adolescents. Yet, the independent associations of PGS-EA and socioeconomic factors with specific underlying factors at the neural and neurocognitive levels are not well understood. The goal of this study was to examine the unique contributions of PGS-EA and parental education to cortical thickness (CT), cortical surface area (SA), and neurocognitive skills in children and adolescents. Methods Participants were typically developing children and adolescents (3-21 years of age; 53% male; N = 391). High-resolution, T1-weighted magnetic resonance imaging data were acquired. PGS-EA were computed based on the most recent genome-wide association study of educational attainment. Sustained attention, inhibitory control, working memory, vocabulary, and episodic memory were measured. Results PGS-EA and parental education were independently and significantly associated with SA, vocabulary, and attention outcomes but were not associated with CT. Vertex-wise analyses indicated that higher PGS-EA was significantly associated with greater SA in the left medial orbitofrontal gyrus and inferior frontal gyrus after accounting for parental education. Higher parental education was significantly associated with greater SA in the left parahippocampal gyrus after accounting for PGS-EA. Conclusions These findings suggest that education-linked genetics may influence SA, particularly in certain frontal regions, leading to variability in academic achievement. Results suggested genetic confounding in associations between parental education and SA in children and adolescents, with these associations remaining significant after controlling for PGS-EA.

Background Head injuries are common injury in the fire service; however, very little data exist on the risks this may pose to the development of post-traumatic stress disorder (PTSD) and depression in this high-risk population. Aims Our study aimed to compare levels of PTSD and depression symptoms in firefighters with a line-of-duty head injury, non-line-of-duty head injury and no head injury. Methods In this cross-sectional study, we assessed current PTSD and depression symptoms as well as retrospective head injuries. Results Seventy-six per cent of the total sample reported at least one head injury in their lifetime. Depression symptoms were significantly more severe among firefighters with a line-of-duty head injury compared to those with no head injury, but not compared to those who sustained a non-line-of-duty head injury. Depression symptoms did not differ between firefighters with a non-line-of-duty head injury and those with no head injury. PTSD symptoms were significantly more severe among firefighters with a line-of-duty head injury compared to both firefighters with no head injury and those with a non-line-of-duty head injury. Conclusions We found that firefighters who reported at least one line-of-duty head injury had significantly higher levels of PTSD and depression symptoms than firefighters who reported no head injuries. Our findings also suggest head injuries sustained outside of fire service could have less of an impact on the firefighter's PTSD symptom severity than head injuries that occur as a direct result of their job.

Background: Mild traumatic brain injury (mTBI) is a nationwide problem; yet, no firefighter mTBI data are available. Methods: In this cross-sectional study, we assessed retrospective head injuries using WHO guidelines. We captured mTBI frequency and examined firefighters' symptoms (e.g., using Ohio State University Traumatic Brain Injury Identification method, Brief Traumatic Brain Injury Screen, Warrior Administered Retrospective Causality Assessment Tool). Findings: Of 1,112 firefighters contacted, 60 responses were included. Most participants were White (80%), male (90%), former athletes (75%). 62% met mTBI symptom criteria. 75% reported at least one lifetime head injury. Number of head injuries and depression symptoms were associated (r = .36, p < .05). Conclusion/application to practice: Overall, it appears most firefighters have sustained at least one lifetime mTBI. Those with multiple head injuries may be at increased risk of depression. Occupational health professionals should be aware of firefighters' mTBI risk. Further research is warranted given findings.