printed by The Interaction Between Parental Depression and Parental Hostility on Preschoolers’ Cortisol Awakening Response Katherine A. Leppert, Feven Fisseha, Victoria C. Smith, Suzanne A. Rose, & Lea R. Dougherty University of Maryland-College Park Funded by: Funded by: BSOS Dean's Research Initiative & University of Maryland Research and Scholarship Award  Interaction between parental lifetime depression and parental hostility on child CAR  For offspring of parents with lifetime depression, parental hostility was associated with increased child CAR, as seen in Table 1 and Figure 1 (β = 3.79, SE = 1.88, p = 0.044).  In contrast, for offspring of parents with no lifetime depression, parental hostility was not significantly associated with child CAR (β = -2.58, SE = 2.34, p = 0.269).  Post-hoc tests demonstrated that this effect was driven by differences in waking cortisol only (β = -0.15, SE = 0.04, p < 0.001).  For offspring of parents with lifetime depression, parental hostility was associated with lower waking cortisol (β = -0.07, SE = 0.03, p = 0.021).  In contrast, for offspring of parents with no lifetime depression, parental hostility was associated with increased waking cortisol (β = 0.06, SE = 0.03, p = 0.029).  Interaction between exposure to parental depression and parental hostility on child CAR  As seen in Table 2 and Figure 2, these effects were specific to offspring who were exposed to parental depression and experienced high levels of parental hostility during early childhood.  For offspring exposed to parental depression during the first few years of life, parental hostility was associated with an elevated CAR (β = 4.92, SE = 2.03, p = 0.015). In contrast, parental hostility was not significantly associated with the CAR for children of parents with no lifetime depression (β = -2.68, SE = 2.56, p = 0.295), or for children of parents with depression before the child’s life (β = -0.41, SE = 3.57, p = 0.908).  Similarly, these effects were driven by differences in waking cortisol levels.  146 children between 3 and 5 years-old and their biological parents were recruited from the Washington DC area.  Mean age = 4.14 years (SD = 0.81)  48.6% male  Ethnically diverse sample: 49.3% Caucasian, 34.0% African American, 1.4% Asian, 15.3% Mixed/Other; 17.6% Hispanic  Mostly middle class, two-parent families Adam, E. K., Vrshek-Schallhorn, S., Kendall, A. D., Mineka, S., Zinbarg, R. E., & Craske, M. G. (2014). Prospective associations between the cortisol awakening response and first onsets of anxiety disorders over a six-year follow-up–2013 Curt Richter Award Winner. 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The cortisol awakening response is blunted in psychotherapy inpatients suffering from depression. Psychoneuroendocrinlogy, 31(7), Liang, K. Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13–22. Vreeburg, S. A., Hartman, C. A., Hoogendijk, W. J., van Dyck, R., Zitman, F. G., Ormel, J., & Penninx, B. W. (2010). Parental history of depression or anxiety and the cortisol awakening response. The British Journal of Psychiatry, 197(3), Saridjan, N. S., Velders, F. P., Jaddoe, V. W., Hofman, A., Verhulst, F. C., & Tiemeier, H. (2014). The longitudinal association of the diurnal cortisol rhythm with internalizing and externalizing problems in pre-schoolers. The Generation R Study. Psychoneuroendocrinology, 50,  We found that the combination of parental depression and high parental hostility is associated with lower waking cortisol and increased CAR in preschoolers.  Moreover, these effects were specific to the young offspring who were exposed to parental depression during the first few years of life.  These findings provide support for previous research implicating negative parenting and parental psychopathology in the dysregulation of HPA axis functioning.  Results demonstrate that these established risk factors for depression are also associated with increased CAR as early as the preschool years, supporting the CAR as a potential early emerging vulnerability marker for depression.  Our findings hold significance for understanding the developmental pathways and mechanisms of risk and has the potential to inform prevention and intervention efforts for very young children.  Future longitudinal research is needed to examine how cumulative exposure to parental depression may affect the CAR across development and neuroendocrine pathways involved in the development of psychopathology.  Evidence suggests that the early rearing environment plays a role in children’s cortisol response to stress.  We previously reported that the young offspring of depressed mothers who experienced high levels of parental hostility demonstrated increased cortisol reactivity and greater observed oppositional behavior (Dougherty et al., 2013). Moreover, these findings were specific to the offspring exposed to maternal depression during the first few years of life.  Given these findings, we aimed to examine whether the combination of parental depression and parental hostility was associated with other indices of offspring’s cortisol function.  The cortisol awakening response (CAR) is the natural rise in cortisol levels after waking, is moderately heritable, and has been proposed as an early-emerging biomarker for depression.  Abnormalities in the CAR have been observed in depressed patients, recovered depressed patients, and the high-risk offspring of depressed parents (Huber et al., 2006; Bhagwagar, Hafizi, & Cowen, 2003; Vreeburg et al., 2010).  CAR has been found to predict internalizing symptoms and disorders in youth (Adam et al., 2014; Saridjan et al., 2014).  However, little is known about the early environmental influences on the CAR in the high- risk offspring of depressed parents. This data could provide insight into the etiology of abnormalities of the CAR in high-risk offspring and the pathways from early risk to later psychopathology in the offspring of depressed parents. Introduction  We aimed to:  1. Test the joint, interactive effect of parental depression and parental hostility on preschoolers’ CAR.  2. Examine whether the interactive effect is specific to offspring who were exposed to parental depression during the first few years of life.  We hypothesized that the combination of parental hostility and parental depression would affect offspring's CAR, and that these effects would be largest for children exposed to parental depression in the first few years of life  Parental Psychopathology  Structured Clinical Interview for DSM-IV, Non-Patient Version (SCID-NP; First et al. 1996)  89 (61.8%) children had parents with a history of lifetime depression (Kappa = 1.0)  71 (49.3%) mothers, 35 (25.9%) fathers with lifetime depression  56 parents had depression during the child’s lifetime.  Observations of Parental Hostility  Parent-child interaction task used a modified version of the Teaching Task Battery (Egeland et al.,1995)  Parental Hostility (α =.76; ICC =.89)  Home Salivary Cortisol Collection  Salivary cortisol samples were collected at child initial awakening, 30 and 45 minutes after waking, and bedtime across two days  The CAR was calculated as the area under the curve with respect to the increase (AUC i ; total change in cortisol across the 3 morning samples) Current Study Table 1. Associations between parental hostility, parental lifetime depression, and preschoolers’ CAR Note. *p <.05. AUC i = Area under the curve with respect to increase; parental depression 0 = Neither parent with a lifetime history of depression, 1 = At least one parent with a lifetime history of depression; (n = 129). Child CAR (AUC i ) Variable Wald X 2 Pseudo- R 2 BSEp Sampling compliance % Time of waking %-.001< Parent education % Parental hostility % Parental depression before child’s life Parental depression during the child’s life <0.01% 11.63% Parental depression before child’s life X Parental hostility % Parental depression during child’s life X Parental hostility % * Child CAR (AUC i ) Variable Wald X 2 Pseudo- R 2 BSEp Sampling compliance % Time of waking %-0.001< Parent education % Parental hostility % Parental lifetime depression % Parental depression X Parental hostility % * Figure 1. Children’s total change in morning cortisol (AUCi) as a function of parental depression and parental hostility. Table 2. Associations between parental hostility, exposure to parental depression, and preschoolers’ CAR Note. *p <.05. AUC i = Area under the curve with respect to increase; parental depression 0 = Neither parent with a lifetime history of depression, 1 = At least one parent with a lifetime history of depression; (n = 129). Results Measures Participants Figure 2. Children’s total change in morning cortisol (AUCi) as a function of parental depression exposure and parental hostility. References Discussion Data Analysis  Generalized estimating equations (GEE) were conducted to examine the interactive effect of depression and hostility on children’s CAR while accounting for the within-person correlation of cortisol over sampling times (Liang & Zeger, 1986).  Sampling compliance was assessed using MEMSCap Trackers or parent-report and was controlled for in all analyses.