multiple adverse experiences and child cognitive development

289 Pages·2015·3.23 MB·English

by  Stephanie Witt

MULTIPLE ADVERSE EXPERIENCES AND CHILD COGNITIVE
DEVELOPMENT

by
Stephanie Guinosso

A dissertation submitted to Johns Hopkins University in conformity with the
requirements for the degree of Doctor of Philosophy

Baltimore, Maryland
September, 2015

© 2015 Stephanie Guinosso
All Rights Reserved
ABSTRACT
Background
Children exposed to multiple adversities in their social environment are more
likely to have poorer cognitive outcomes. This dissertation examined the relations
between multiple adverse experiences in childhood and cognitive development with a
particular emphasis on the type of adversity, timing of exposure, and underlying
mechanisms.

Methods
For Aim 1, a guiding conceptual framework describing the relationship between
multiple adverse experiences and child cognitive development was developed through a
systematic review of the literature. For Aim 2, the relations between multiple adverse
experiences and measures of child verbal ability, attention and working memory,
including the effects of different domains (or types) of adverse experiences as well as the
timing of exposure, were examined using a longitudinal cohort of 2976 children followed
from birth to nine years. Using this same cohort, Aim 3 examined whether characteristics
of the home environment mediated the effect of different domains of adverse experiences
on these cognitive outcomes and whether gender moderated this process.

Results
The conceptual framework proposed from the literature review in Aim 1
presented three domains of adverse experiences, including lack of safety, family
instability and economic hardship which were all hypothesized to influence children’s
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general cognitive ability and executive function by impairing the safety, stability,
nurturance and stimulation a child receives in the home environment. In Aim 2, exposure
to adversity in infancy and at age three directly predicted cognitive outcomes at ages five
and nine, even after controlling for concurrent adverse exposures. Furthermore,
economic hardship had the most salient effects. Results from Aim 3 showed that the
availability of reading materials and to a lesser extent maternal warmth at age three
partially mediated the effect between economic hardship at infancy and cognitive
outcomes at ages five and nine. The availability of reading materials also partially
mediated the effect between lack of safety and family instability on verbal ability, for
boys only.

Conclusions
Efforts to promote safe, stable, nurturing and stimulating home environments
through early interventions are promising strategies to improve outcomes for youth.
Additionally, policies that alleviate poverty and boost maternal education may positively
impact future generations.
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COMMITTEE OF FINAL THESIS READERS

Committee Members

Dr. David Bishai, Professor
Department of Population, Family & Reproductive Health (Primary)
Health, Behavior and Society (Joint)
International Health (Joint)
Johns Hopkins Bloomberg School of Public Health

Dr. Nicholas Ialongo, Professor
Department of Mental Health
Johns Hopkins Bloomberg School of Public Health

Dr. Sara Johnson, Associate Professor and Thesis Advisor
Department of Pediatrics (Primary)
Johns Hopkins School of Medicine
Department of Population, Family & Reproductive Health (Joint)
Johns Hopkins Bloomberg School of Public Health

Dr. Anne Riley, Professor and Thesis Advisor
Department of Population, Family & Reproductive Health (Primary)
Health Policy and Management (Joint)
Mental Health (Joint)
Johns Hopkins Bloomberg School of Public Health

Non-Voting Members

Dr. Sharon Ghazarian, Adjunct Faculty
School of Nursing
Johns Hopkins University

Alternate Members

Dr. Christina Bethell, Professor
Department of Population, Family and Reproductive Health
Johns Hopkins Bloomberg School of Public Health

Dr. Elizabeth Letourneau, Associate Professor
Department of Mental Health
Johns Hopkins Bloomberg School of Public Health

Dr. Erica Sibinga, Associate Professor
Department of Pediatrics
Johns Hopkins School of Medicine
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ACKNOWLEDGEMENTS

“You are at my side, dear friends, and God is everywhere. Yet ultimately we are alone,
making our way home by the candle of the heart. The light is steady and sure but extends
only far enough to see the next step. Many times the light seems to go out. But another
light, one held by a stranger or friend, a book or a song, a blackbird or a wild flower,
comes close enough so that we can see our path by its light. And in time we realize that
the light we have borrowed was always our own.”
~Joan Borysenko

This favorite quote by Joan Borysenko so perfectly captures the challenging
process of completing a dissertation. With gratitude, I wish to acknowledge the many
people willing to share with me their light so that I could walk this path.
To my committee members, Dr. Anne Riley, Dr. Sara Johnson, Dr. Sharon
Ghazarian, Dr. David Bishai, and Dr. Nicholas Ialongo, thank you for your thoughtful
review and feedback on this dissertation. To Dr. Erica Sibinga, Dr. Elizabeth
LeTourneau, and Dr. Christina Bethell, thank you for your willingness to serve as
alternates on my committee. To my advisors, Dr. Riley and Dr. Johnson, your
commitment, patience, encouragement, mentorship, and dedication to my success over
the last five years has been phenomenal. Thank you for challenging me to do my best
work. You are brilliant, and I am so grateful to have learned from you both –
professionally and personally. Dr. Ghazarian, your willingness to dedicate time and
energy to assist me remotely with my analyses was such a gift! You were an absolute
pleasure to work with on these analyses, and I can’t imagine having had to navigate the
nuances of Mplus without you! Thank you.
I wish to offer a special thanks to the generous Jack Kent Cooke Foundation for
granting me a scholarship in the final year of my program. This scholarship was truly a
blessing that enabled me work less and focus more on completing my dissertation. A
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whole-hearted thank you for all that you do to support students on their path to an
education.
To my doctoral cohort, and especially Ali Crandall, Laura Hinson, Loral Patchen,
Ashli Owen, and Samira Soleimanpour, thank you for lending a listening ear, words of
encouragement, and laughs along the way. I’ve learned there are things that only fellow
doctoral students can understand. We are bonded for life!
To my friends and community who held a space for me to leave my home in
California while I ventured to Baltimore, and who continued to hold space for me while I
buried myself in my home office to finish writing my dissertation, thank you for the
continued encouragement. I am so grateful to have your support.
To my family, I know you often wonder what I am still doing in school, but the
fact that you believe that I am somehow saving the world makes me smile. Thank you
for always celebrating my successes and showing me how to stay positive.
To the young men I work with in juvenile hall, you are my inspiration, and you
remind me why I do this work. I only hope that one day my work will benefit your lives
so that you can reach your highest potential.
Finally, to my husband of four years, Pete Guinosso, you are without a doubt, the
best thing in my world. Thank you for enduring a year and half of a long distance
relationship, feeding me, doing the laundry, holding my hand, and keeping me focused on
the important things in life. I love you. Oh, and to the animals, Zoey and Kali, thank you
for tolerating my endless relationship with my computer when you would have rather
been cuddling and playing fetch.
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TABLE OF CONTENTS

Abstract ii
Committee of Final Thesis Readers iv
Acknowledgements v
Table of Contents vii
List of Tables ix
List of Figures xi
Chapter 1: An Introduction to Multiple Adverse Experiences and Child Cognitive 1
Development
Dissertation Overview 2
Dissertation Organization 3
Specific Aims and Hypotheses 3
Background and Significance 6
Theoretical and Conceptual Frameworks 16
Conclusion 21
Chapter 2: Methods and Research design 31
Aim 1 Methods 32
Aims 2 and 3 – Fragile Families and Child Wellbeing Study 35
Aims 2 and 3 – Description of Study Measures 38
Aims 2 and 3 – Analytic Sample 48
Aims 2 and 3 – Missing Data Analysis 50
Aim 2 – Analyses 56
Aim 3 – Analyses 69
Strengths and Limitations of Quantitative Methods 72
Chapter 3: Multiple Adversities and Child Cognitive Development: A Conceptual 91
Framework
Introduction 92
Methods 94
Results 96
Discussion 106
Chapter 4: Timing of Multiple Adverse Experiences and Child Cognitive 143
Development
Introduction 144
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Methods 151
Results 164
Discussion 173
Chapter 5: Mediators of Early Adversity Domains on Child Cognitive 203
development
Introduction 204
Methods 213
Results 228
Discussion 232
Chapter 6: Conclusions and Implications for Research, Policy and Practice 251
Dissertation Aims 252
Conclusions from Dissertation Aims 252
Implications 259
Concluding Comments 265
Curriculum Vitae 271
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LIST OF TABLES

Table 2.1. Scoring Criteria for Literature Review 74
Table 2.2. Number of Studies for Each Cognitive Outcome by Study Design 75
Table 2.3. Summary of Measures 76
Table 2.4. Adversity Measures Collected at each Wave 79
Table 2.5. Original and Final Analytic Sample (Covariates and Cognitive 80
Outcomes)
Table 2.6. Original and Final Analytic Sample (Adverse Experiences) 81
Table 2.7. Original and Final Analytic Sample (Mediating Variables) 82
Table 2.8. Sample Attrition 83
Table 2.9. Correlations among Individuals Adversities 84
Table 2.10. List of Adversities in each Domain 86
Table 3.1. Number of Studies for Each Cognitive Outcome by Study Design 96
Table 3.2. Number of Studies for Each Cognitive Outcome by Methodology 98
Table A3.1. Studies of Multiple Adversities and General Cognitive Ability 118
Table A3.2. Studies of Multiple Adversities and Executive Function 131
Table 4.1. Description of Key Variables 183
Table 4.2. Correlations among all Variables 184
Table 4.3. Total, Direct and Specific Indirect Effects of Cumulative Adversity 185
Indices on Cognitive Outcomes
Table 4.4. Total, Direct and Specific Indirect Effects of Domains on Cognitive 186
Outcomes
Table A4.1. Bivariate Relations Between Individual Adversities and Cognitive 187
Outcomes
Table A4.2. Adjusted Relations Between Individual Adversities and Cognitive 189
Outcomes
Table A4.3. Bivariate Relations Between Cumulative Adversities, Domains, and 191
Cognitive Outcomes
Table A4.4. Adjusted Relations Between Cumulative Adversities, Domains, and 192
Cognitive Outcomes
Table A4.5. Adjusted Longitudinal Relations Between Cumulative Indices and 193
Cognitive Outcomes
Tables A4.6. Adjusted Longitudinal Relations Between Adversity Domains and 194
Cognitive Outcomes
Table 5.1. Description of Key Variables 240
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Table 5.2. Correlations Among All Variables 241
Table 5.3. Specific Indirect Effects of Adversity Domains in Infancy on Cognitive 242
Outcomes through Age Three Reading and Maternal Warmth

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