David S. Bennett

Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12–24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.

Shame is consistently associated with poor adjustment (e.g., depressive symptoms) among community samples but, surprisingly, has rarely been directly examined among people living with HIV/AIDS (PLWH). This limited research on shame is likely due, in part, to shame's having been subsumed within measures of internalized stigma, an imprecise construct with varied definitions in the HIV literature. The current review summarizes research directly examining the correlates of shame among PLWH. Findings indicate that shame is associated with greater depressive symptoms, less healthcare utilization, and poorer physical health among PLWH. Directions for future research examining shame among PLWH are highlighted, including the need for more prospective research examining shame as a predictor of future adjustment.

Objective To examine whether prenatal cocaine exposure (PCE) predicts externalizing problems in late childhood. Methods Externalizing problems were assessed using caregiver, teacher, and child ratings and a laboratory task when children (N = 179; 74 cocaine exposed) were aged 8–10 years. PCE, environmental risk, sex, neonatal health, other prenatal exposures, and foster care history were examined as predictors of externalizing problems. Results Multiple regression analyses indicated that PCE, environmental risk, and male sex explained significant variance in externalizing problems in late childhood. Models varied by source of information. PCE predicted externalizing problems for child laboratory behavior and interacted with sex because males with PCE reported more externalizing problems. PCE did not predict caregiver or teacher ratings of externalizing problems. Conclusions The effect of PCE on externalizing problems may persist into late childhood. The findings highlight the potential importance of including child-based measures of externalizing problems in studies of prenatal exposure.

Children prenatally exposed to tobacco exhibit higher rates of learning and emotional-behavioral problems related to worse working memory performance. Brain function, however, among tobacco exposed children while performing a working memory task has not previously been examined. This study compared the brain function of tobacco-exposed (n = 7) and unexposed (n = 11) 12-year-olds during a number N-back working memory task using an event-related functional magnetic resonance imaging (fMRI) design. Prenatal alcohol exposure, neonatal medical problems, environmental risk, and sex were statistically controlled. Tobacco-exposed children showed greater activation in inferior parietal regions, whereas unexposed children showed greater activation in inferior frontal regions. These differences were observed in the context of correct responses, suggesting that exposed and unexposed children use different brain regions and approaches to succeed in working memory tasks. Implications for future research and intervention are discussed.

Neglected children may be at increased risk for depressive symptoms. This study examines shame-proneness as an outcome of child neglect and as a potential explanatory variable in the relation between neglect and depressive symptoms. Participants were 111 children (52 with a Child Protective Services [CPS] allegation of neglect) seen at age 7. Neglected children reported more shame-proneness and more depressive symptoms than comparison children. Guilt-proneness, in contrast, was unrelated to neglect and depressive symptoms, indicating specificity for shame-proneness. The potential role of shame as a process variable that can help explain how some neglected children exhibit depressive symptoms is discussed.

Child neglect has been hypothesized to be a risk factor for both obesity and underweight in early childhood, although little research has examined the relation between neglect and body mass index (BMI). The current study examined the relation between neglect and BMI among 185 children (91 with a Child Protective Services [CPS] history of neglect) who were initially seen at ages 4—6 years and who were followed through ages 7—9 years. Neglected and comparison children were found to have similar BMIs, although both groups had BMIs that were significantly greater than Centers for Disease Control and Prevention (CDC) norms for age, gender, and ethnicity. Neglect chronicity did predict lower BMIs but only at ages 8 and 9 years. The current findings suggest that greater examination of moderators is needed to identify the specific contexts in which neglect is related to children’s weight.