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Association between maltreatment, hair cortisol concentration, positive parent–child interaction, and psychosocial outcomes in Chinese preschool children

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Abstract

Children now are facing an increasing risk of early life stress (ELS), which leads to detrimental psychosocial outcomes. Behavior studies suggested that positive parental interactions might moderate the negative impact of ELS, but the related biological alteration remains unclear. This study aims to investigate whether positive parent–child interactions moderate the association between maltreatment (as a severe form of ELS) and hair cortisol concentration (HCC), as well as between HCC and psychosocial outcomes in young children. Participants were 6-year-old Chinese children (N = 257, Mage = 6.2, 121 were male) selected by stratified cluster random sampling from a Shanghai population representative cohort. Proximal 3 cm hair strands were analyzed using liquid chromatography coupled with tandem mass spectrometry for HCC. Children’s psychosocial outcome was evaluated using the parental report Strengths and Difficulties Questionnaire (SDQ). Parents also reported the frequency of positive parent–child interactions using the Chinese Parent–Child Interaction Scale (CPCIS) as well as the history of maltreatment. Multi-level logistic regression models adjusting for individual, kindergarten, and district confounders were used to evaluate the associations between maltreatment, HCC, and psychosocial outcomes. Interactions terms tested whether more frequent positive parent–child interactions moderates the association between maltreatment and HCC, as well as between HCC and psychosocial outcomes. Maltreated children exhibited higher levels of HCC (B = 1.20, 95% CI: 0.38,2.02; p = 0.004), and children with higher HCC exhibited poorer psychosocial outcomes (B = 0.34, 95% CI: 0.18,0.51; p < 0.001). Positive parent–child interactions did not have a moderating effect on the association between maltreatment and HCC, but they demonstrated a moderating effect on the association between increased HCC and psychosocial outcomes (interaction term: B = −0.42, 95% CI: −0.75,−0.10; p = 0.01). These findings provide evidence that positive parental interaction may serve as a moderator between chronic cortisol exposure and psychosocial problems. It highlights the importance of frequent parent–child interactions, especially among children under a high risk of ELS.

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Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to shared ownership of Shanghai Municipal Education Commission but are available from the corresponding author on reasonable request.

Abbreviations

HCC:

Hair cortisol concentration

ELS:

Early life stress

SDQ:

Strengths and Difficulties Questionnaire

CPCIS:

Chinese Parent–Child Interaction Scale

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Acknowledgements

Study statistical expert: Dr. Hao Pan.

Funding

Supported by National Natural Science Foundation of China (82103866), Shanghai Municipal Health Commission (20214Y0112), Shanghai Municipal Education Commission (2022you1-2, D1502), The Innovative Research Team of High-level Local Universities in Shanghai (SHSMU-ZDCX20211900).

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Authors and Affiliations

  1. Department of International Clinic, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Wenjie Shan & Li Zhao

  2. Child Health Advocacy Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Wenjie Shan, Yunting Zhang & Jin Zhao

  3. Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jin Zhao & Fan Jiang

  4. Center for Global Health Equity, NYU Shanghai, Shanghai, China

    Brian J. Hall

  5. School of Global Public Health, New York University, New York, NY, USA

    Brian J. Hall

  6. Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Joseph D. Tucker

  7. Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

    Joseph D. Tucker

  8. Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China

    Fan Jiang

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  1. Wenjie Shan
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Contributions

WS, YZ and FJ took the initiative in conception and design, and WS analyzed the data and complete the draft of the manuscript. WS, YZ, JZ collected the data and provide critical suggestions on data analysis. FJ, LZ, BJH, and JDT made substantial contributions to the interpretation of data and manuscript revision. All authors reviewed the manuscript.

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Correspondence to Fan Jiang.

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The study received approval from the institutional review board of the Shanghai Children’s Medical Center, Shanghai Jiao Tong University (SCMCIRB-K2016022-01). Parents of the involved children signed the informed consent before participating in the study.

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Shan, W., Zhang, Y., Zhao, J. et al. Association between maltreatment, hair cortisol concentration, positive parent–child interaction, and psychosocial outcomes in Chinese preschool children. Eur Child Adolesc Psychiatry (2024). https://doi.org/10.1007/s00787-023-02355-w

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