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Maternal prenatal stress influences offspring neurodevelopment and birth outcomes including the ratio of males to females born; however, there is limited understanding of what types of stress matter, and for whom. Using a data-driven approach with 27 variables from questionnaires, ambulatory diaries, and physical assessments collected early in the singleton pregnancies of 187 women, 3 latent profiles of maternal prenatal stress emerged that were differentially associated with sex at birth, birth outcomes, and fetal neurodevelopment. Most women (66.8%) were in the healthy group (HG); 17.1% were in the psychologically stressed group (PSYG), evidencing clinically meaningful elevations in perceived stress, depression, and anxiety; and 16% were in the physically stressed group (PHSG) with relatively higher ambulatory blood pressure and increased caloric intake. The population normative male:female secondary sex ratio (105:100) was lower in the PSYG (2:3) and PHSG (4:9), and higher in the HG (23:18), consistent with research showing diminished male births in maternal stress contexts. PHSG versus HG infants were born 1.5 wk earlier (P < 0.05) with 22% compared to 5% born preterm. PHSG versus HG fetuses had decreased fetal heart rate–movement coupling (P < 0.05), which may indicate slower central nervous system development, and PSYG versus PHSG fetuses had more birth complications, consistent with previous findings among offspring of women with psychiatric illness. Social support most strongly differentiated the HG, PSYG, and PHSG groups, and higher social support was associated with increased odds of male versus female births. Stress phenotypes in pregnant women are associated with male vulnerability and poor fetal outcomes.

Attention‐deficit/hyperactivity disorder (ADHD) – and its underlying behavioral dimensions of inattention and hyperactivity–impulsivity – have been understudied in females. We first cover the conceptual issues of prevalence, diagnostic practices, diversity, comorbidity, and causal factors, plus forces limiting awareness of ADHD in females. After a narrative review of cross‐sectional and longitudinal findings, we conclude the following. (a) Girls meet diagnostic criteria for ADHD at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood. (b) Girls and women with ADHD show a predominance of inattention and associated internalizing problems; boys and men display greater levels of hyperactive–impulsive symptoms and associated externalizing problems. (c) Sex differences in ADHD symptoms and related outcomes depend heavily on the clinical versus nonreferred nature of the samples under investigation. (d) Females with ADHD experience, on average, serious impairments, with a particularly heightened risk for problems in close relationships and engagement in self‐harm. (e) Clinicians may overlook symptoms and impairments in females because of less overt (but still impairing) symptom manifestations in girls and women and their frequent adoption of compensatory strategies. Our review of predictors and mediators of adult outcomes highlights (a) the potential for heterotypically continuous pathways in females with childhood ADHD and (b) developmental progressions to self‐harm, intimate partner violence, unplanned pregnancy, and comorbid psychopathology. Focusing on ADHD in females is necessary to characterize causal and maintaining mechanisms with accuracy and to foster responsive interventions, as highlighted in our closing list of clinical implications and research priorities.

What incites infant locomotion? Recent research suggests that locomotor exploration is not primarily directed toward distant people, places, or things. However, this question has not been addressed experimentally. In the current study, we asked whether a room filled with toys designed to encourage locomotion (stroller, ball, etc.) elicits different quantities or patterns of exploration than a room with no toys. Caregivers were present but did not interact with infants. Although most walking bouts in the toy-filled room involved toys, to our surprise, 15-month-olds in both rooms produced the same quantity of locomotion. This finding suggests that mere space to move is sufficient to elicit locomotion. However, infants' patterns of locomotor exploration differed: Infants in the toy-filled room spent a smaller percent of the session within arms' reach of their caregiver and explored more locations in the room. Real-time analyses show that infants in the toy-filled room took an increasing number of steps per bout and covered more area as the session continued, whereas infants in the no-toy room took fewer and fewer steps per bout and traveled repeatedly over the same ground. Although not required to elicit locomotion, moving with toys encouraged infants to travel farther from their caregivers and to explore new areas.

Objective: Adapting mental health-care interventions to the race, ethnicity, or culture of the target group can enhance the acceptance and effectiveness of the treatment. Dialectical behavior therapy (DBT) is an evidence-based treatment that is principle-driven, rendering it well-suited for adaptations across cultural contexts. This article conducts a systematic review of the literature to determine the nature and extent of cultural adaptations of DBT to date. Method: We searched databases for original articles describing cultural adaptations of DBT, as applied to both (a) people of color within Western countries and (b) populations within non-Western countries. Consistent with the focus on descriptively characterizing extant DBT cultural adaptations, we included both published and nonpublished studies, as well as both observational and experimental studies. Results: Our search yielded 18 articles that met inclusion criteria. Of these articles, half described adaptations made with people and communities of color within the U.S. Most adaptations involved modifications to language, metaphors, methods, and context. Conclusions: Culturally adapted DBT has been implemented and accepted among several racial, ethnic, and cultural groups, although there is insufficient evidence to determine whether culturally adapted DBT is more efficacious than nonadapted DBT. We conclude with recommendations for best practices for DBT researchers and clinicians, and situate our findings among larger efforts to render existing evidence-based psychotherapies more optimal for people of color and people from non-Western countries.What is the public health significance of this article? Dialectical behavior therapy (DBT) may require cultural adaptation to be efficacious and accepted by all racial, ethnic, and cultural groups. The studies reviewed detail a number of cultural adaptations of DBT, most commonly in terms of language translation and addition of culturally congruent metaphors and sayings. The field must continue to both train culturally competent DBT clinicians and further adapt DBT to different cultural contexts.

Summary Although long-term outcomes of girls with attention-deficit hyperactivity disorder are understudied, high risk for adolescent and young-adult self-harm is salient. We present data on predictors and mediators of such risk, highlighting a recent dual-process model involving trait impulsivity plus family- and peer-related contributors. We conclude with recommendations for assessment and preventive intervention.

Background Research on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains. Methods We examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD). Results After adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status. Conclusions Given our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.

Behavioral flexibility—the ability to tailor motor actions to changing body-environment relations—is critical for functional movement. Navigating the everyday environment requires the ability to generate a wide repertoire of actions, select the appropriate action for the current situation, and implement it quickly and accurately. We used a new, adjustable barrier paradigm to assess flexibility of motor actions in 20 17-month-old (eight girls, 12 boys) and 14 13-month-old (seven girls, eight boys) walking infants and a comparative sample of 14 adults (eight women, six men). Most participants were White, non-Hispanic, and middle class. Participants navigated under barriers normalized to their standing height (overhead, eye, chest, hip, and knee heights). Decreases in barrier height required lower postures for passage. Every participant altered their initial walking posture according to barrier height for every trial, and all but two 13-month-olds found solutions for passage. Compared to infants, adults displayed a wider variety of strategies (squat-walking, half-kneeling, etc.), found more appropriate solutions based on barrier height (ducked at eye height and low crawled at knee height), and implemented their solutions more quickly (within 4 s) and accurately (without bumping their heads against the barrier). Infants frequently crawled even when the barrier height did not warrant a low posture, displayed multiple postural shifts prior to passage and thus took longer to go, and often bumped their heads. Infants’ improvements were related to age and walking experience. Thus, development of flexibility likely involves the contributions of multiple domains—motor, perception, and cognition—that facilitate strategy selection and implementation.