Doctor of Medicine, Harvard University (2018)
Master of Arts, University College London (2012)
Bachelor of Arts, Stanford University, HUMBI-BA (2008)
Master of Science, University Of London (2011)
Diversity and Identity
Immigrants and Immigration
Parents and Family Issues
Poverty and Inequality
Current Research and Scholarly Interests
Developing a novel measure of immigration-related stress and trauma among children and parents; assessing associations with child developmental and mental health outcomes in order to inform advocacy and clinical interventions.
Graduate and Fellowship Programs
Developmental-Behavioral Pediatrics (Fellowship Program)
- Negative caregiving and stress reactivity moderate the relation between early life stress and externalizing in adolescence DEVELOPMENTAL PSYCHOBIOLOGY 2022; 64 (7)
Socioeconomic and psychological correlates of postpartum depression at 6 months in Dhaka, Bangladesh
INTERNATIONAL JOURNAL OF PSYCHOLOGY
2021; 56 (5): 729-738
To current study aimed to estimate the point prevalence and identify correlates of postpartum depression (PPD) in a sample of mothers in Dhaka. A total of 235 participants from low- and middle-SES neighbourhoods in Dhaka completed the Edinburgh Postnatal Depression Scale (EPDS) and other assessments of socioeconomic and psychological factors at 24 weeks postpartum. Regression models were fit to explore potential correlates of PPD. The estimated prevalence of high PPD risk in the current sample is 24.3%. In multivariable linear regression models, recent life events, perceived stress and household resources (e.g., access to cooking gas, telephone, furniture, electricity, television, etc.) were significantly associated with PPD. The association of social support with PPD when controlling for other variables was sensitive to the choice of social support measure, highlighting an important methodological issue. The point prevalence of PPD among poor, urban mothers in Bangladesh ranges from 12.3 to 28.5%, with psychological risk factors and household resources as strong correlates.
View details for DOI 10.1002/ijop.12735
View details for Web of Science ID 000599908700001
View details for PubMedID 33331021
View details for PubMedCentralID PMC8451745
Cumulative psychosocial risk and early child development: validation and use of the Childhood Psychosocial Adversity Scale in global health research
2019; 86 (6): 766-775
Evidence suggests that cumulative early psychosocial adversity can influence early child development (ECD). The Childhood Psychosocial Adversity Scale (CPAS) is a novel measure of cumulative risk designed for use in global ECD research. We describe its development and assess validity from its first application in Bangladesh, where it predicts cognitive development scores among young children.Items were generated from literature review and qualitatively assessed for local relevance. Two-hundred and eighty-five mother-child dyads from an urban slum of Dhaka completed the CPAS at child ages 18, 24, 48, and/or 60 months. The CPAS was assessed for internal consistency, retest reliability, and convergent, incremental, and predictive validity.The CPAS includes subscales assessing child maltreatment, caregiver mental health, family conflict, domestic violence, and household/community psychosocial risks. In Bangladesh, subscales had good internal consistency (Cronbach's α > 0.70). Full-scale score had good 2-week test-retest reliability (intra-class correlation coefficient = 0.89; F(38,38) = 8.45, p < 0.001). Using multivariate regression, 48-month CPAS score significantly predicted 60-month intelligence quotient, accounting for more variance than socioeconomic status or malnutrition.The CPAS is a novel tool assessing cumulative childhood psychosocial risk. Evidence supports validity of its use in ECD research in Bangladesh, and ongoing work is applying it in additional countries.
View details for DOI 10.1038/s41390-019-0431-7
View details for Web of Science ID 000500568000017
View details for PubMedID 31103019
View details for PubMedCentralID PMC6859196
- Early career investigator highlight PEDIATRIC RESEARCH 2019; 86 (6): 682
Effects of poverty on interacting biological systems underlying child development
LANCET CHILD & ADOLESCENT HEALTH
2017; 1 (3): 225-239
The developmental sequelae of childhood poverty are well documented. However, it is not poverty per se, but a multitude of risk factors associated with poverty that have a deleterious effect on children's development. Key risks factors that are likely to contribute to the adverse developmental effects of poverty include, for instance, food insecurity, infectious disease, and psychological stress related to the child's rearing environment. In this Review, we highlight synergistic biological pathways through which co-occurring risks related to poverty interact to shape children's neurocognitive development. We focus on pathways related to neural growth, energy metabolism, inflammation, and neuroendocrine responses to stress as key biological axes through which poverty becomes biologically embedded and might have long-term effects on children's neurocognitive development. We also discuss how biomarkers targeting these axes can be used to advance research on the biological processes through which poverty affects children's cognitive outcomes. Although the discussion has global relevance, we focus on low-resource settings where rates of poverty are highest and access to treatment might be limited.
View details for DOI 10.1016/S2352-4642(17)30024-X
View details for Web of Science ID 000453159100021
View details for PubMedID 30169171
Biological embedding of childhood adversity: from physiological mechanisms to clinical implications
2017; 15: 135
Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses. Additional work has shed light on the potential molecular mechanisms by which early adversity becomes "biologically embedded" in altered physiology across body systems. This review surveys evidence on such mechanisms and calls on researchers, clinicians, policymakers, and other practitioners to act upon evidence.Childhood psychosocial adversity has wide-ranging effects on neural, endocrine, immune, and metabolic physiology. Molecular mechanisms broadly implicate disruption of central neural networks, neuroendocrine stress dysregulation, and chronic inflammation, among other changes. Physiological disruption predisposes individuals to common diseases across the life course.Reviewed evidence has important implications for clinical practice, biomedical research, and work across other sectors relevant to public health and child wellbeing. Warranted changes include increased clinical screening for exposures among children and adults, scale-up of effective interventions, policy advocacy, and ongoing research to develop new evidence-based response strategies.
View details for DOI 10.1186/s12916-017-0895-4
View details for Web of Science ID 000405897800001
View details for PubMedID 28724431
View details for PubMedCentralID PMC5518144
The science of early adversity: is there a role for large institutions in the care of vulnerable children?
Lancet (London, England)
2015; 386 (9991): 388-98
It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed in orphanages or other institutions. Informed by such findings, global conventions, including the 1989 UN Convention on the Rights of the Child, assert a child's right to care within a family-like environment that offers individualised support. Nevertheless, an estimated 8 million children are presently growing up in congregate care institutions. Common reasons for institutionalisation include orphaning, abandonment due to poverty, abuse in families of origin, disability, and mental illness. Although the practice remains widespread, a robust body of scientific work suggests that institutionalisation in early childhood can incur developmental damage across diverse domains. Specific deficits have been documented in areas including physical growth, cognitive function, neurodevelopment, and social-psychological health. Effects seem most pronounced when children have least access to individualised caregiving, and when deprivation coincides with early developmental sensitive periods. Offering hope, early interventions that place institutionalised children into families have afforded substantial recovery. The strength of scientific evidence imparts urgency to efforts to achieve deinstitutionalisation in global child protection sectors, and to intervene early for individual children experiencing deprivation.
View details for DOI 10.1016/S0140-6736(14)61131-4
View details for PubMedID 25638660
Asylum Seekers, Violence and Health: A Systematic Review of Research in High-Income Host Countries
AMERICAN JOURNAL OF PUBLIC HEALTH
2013; 103 (3): E30-E42
We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate.
View details for DOI 10.2105/AJPH.2012.301136
View details for Web of Science ID 000330762600008
View details for PubMedID 23327250
View details for PubMedCentralID PMC3673512