# Early life adversities and the emergence of risk and resilience: a longitudinal study of child development

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $661,094

## Abstract

Abstract
Exposure to maternal depression in early life increases the risk of socioemotional and cognitive (SEC)
problems in childhood and over the lifecourse. This has led to the promotion of depression treatment as a
critical early childhood intervention. However, there is insufficient evidence on whether depression treatments
alone reduce offspring risk in low resource settings where other social and economic adversities are highly
prevalent. The proposed study in rural Pakistan will, first, examine the impact of a cluster randomized
intervention, extended to include both maternal depression and child development components, on child SEC
outcomes at ages 5-8. Second, we will closely examine the psychosocial and biological processes through
which maternal depression and other adversities lead to emerging SEC difficulties by continuing to follow the
mothers and children, currently in our study from birth to age three, through early primary school years.
Preliminary findings from our current study, consisting of a cluster-RCT examining the impact of a perinatal
maternal depression intervention on child development within a population representative birth cohort design,
have yielded several insights: (1) the “Thinking Healthy Program - Peer delivered” (THPP) shortened the initial
maternal depression episode but its longer term impact is unclear; (2) although the THPP did not have an
observable impact on SEC outcomes through age 2, it did favorably impact markers of hypothalamic–pituitary–
adrenal (HPA)-axis function in children at 12 months of age; and (3) exposure to adversities (acute poverty,
intimate partner violence (IPV), and low maternal social support) appear to be more impactful on child
outcomes than maternal depression during the earliest developmental period, and child sex may influence the
prevalence of certain adversity exposures after birth as well as their impact on child outcomes. The children of
this cohort are about to embark on their first major life transition requiring significant adaptation – that into
formal schooling. Following the children through this transition allows us to test key hypotheses linking the rich
data already collected on multiple adversities beginning in pregnancy, potential psychosocial and biological
mechanisms, and outcomes at this important stage of life course. This study will continue to follow our unique
cohort until the children turn 8. The specific aims of the proposed study are to: (1) evaluate the impact of the
ongoing and extended intervention (now called “THP Preschool” (THP-PS) on child socioemotional and
cognitive (SEC) outcomes at ages 5 through 8, and determine the extent to which the impact is mediated by
maternal depression trajectories; (2) examine how the type and timing of adversity exposures, including
maternal depression, impacts HPA-axis dysregulation in children, and whether HPA-axis indicators mediate
the effect of adversity exposures on child SEC indicators. As part of this aim ...

## Key facts

- **NIH application ID:** 9889487
- **Project number:** 2R01HD075875-07A1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Joanna Maselko
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $661,094
- **Award type:** 2
- **Project period:** 2014-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9889487

## Citation

> US National Institutes of Health, RePORTER application 9889487, Early life adversities and the emergence of risk and resilience: a longitudinal study of child development (2R01HD075875-07A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9889487. Licensed CC0.

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