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Becker L, Kaltenegger HC, Nowak D, Rohleder N, Weigl M. Differences in stress system (re-)activity between single and dual- or multitasking in healthy adults: A systematic review and meta-analysis. Health Psychol Rev 2022; 17:78-103. [PMID: 35477383 DOI: 10.1080/17437199.2022.2071323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractIn the age of digitization, multitasking requirements are ubiquitous, especially in the workplace. Multitasking (MT) describes the activity of performing multiple (at least two) tasks at the same time. Dual tasking (DT) refers to the sequential switching between two tasks. The aim of our systematic review and meta-analysis was first to investigate whether physiological stress systems become activated in response to or during MT/DT and, secondly, whether this (re-)activity is higher compared to single tasking. We focused on the Sympathetic Nervous System (SNS), the Parasympathetic Nervous System (PNS), the hypothalamic-pituitary adrenal (HPA) axis, and the immune system. The systematic review has been pre-registered with PROSPERO (CRD42020181415). A total of twenty-five articles were identified as eligible, in which n = 26 studies were reported, with N = 1,142 participants. Our main findings are that SNS activity is significantly higher and PNS activity is significantly lower during MT/DT than during single tasking. Only two studies were found, in which HPA axis (re-)activity was surveyed. No eligible study was identified in which immune system (re-)activity was investigated. This is the first systematic synthesis of the literature base showing that stress system activity is increased during MT/DT in comparison to single-tasking.
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Affiliation(s)
- Linda Becker
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Helena C Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Germany
| | - Nicolas Rohleder
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Germany.,Institute for Patient Safety, University Hospital, Bonn, Germany
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Rodrigues J, Studer E, Streuber S, Meyer N, Sandi C. Locomotion in virtual environments predicts cardiovascular responsiveness to subsequent stressful challenges. Nat Commun 2020; 11:5904. [PMID: 33214564 PMCID: PMC7677550 DOI: 10.1038/s41467-020-19736-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Individuals differ in their physiological responsiveness to stressful challenges, and stress potentiates the development of many diseases. Heart rate variability (HRV), a measure of cardiac vagal break, is emerging as a strong index of physiological stress vulnerability. Thus, it is important to develop tools that identify predictive markers of individual differences in HRV responsiveness without exposing subjects to high stress. Here, using machine learning approaches, we show the strong predictive power of high-dimensional locomotor responses during novelty exploration to predict HRV responsiveness during stress exposure. Locomotor responses are collected in two ecologically valid virtual reality scenarios inspired by the animal literature and stress is elicited and measured in a third threatening virtual scenario. Our model's predictions generalize to other stressful challenges and outperforms other stress prediction instruments, such as anxiety questionnaires. Our study paves the way for the development of behavioral digital phenotyping tools for early detection of stress-vulnerable individuals.
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Affiliation(s)
- João Rodrigues
- Laboratory of Behavioral Genetics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, 1015, Switzerland.
| | - Erik Studer
- Laboratory of Behavioral Genetics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, 1015, Switzerland
| | - Stephan Streuber
- Laboratory of Behavioral Genetics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, 1015, Switzerland
| | - Nathalie Meyer
- Laboratory of Behavioral Genetics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, 1015, Switzerland
| | - Carmen Sandi
- Laboratory of Behavioral Genetics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, 1015, Switzerland.
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Discrimination of multiple stress levels in virtual reality environments using heart rate variability. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2017:3989-3992. [PMID: 29060771 DOI: 10.1109/embc.2017.8037730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
People are suffering from various stress during daily living. Stress can cause a variety of symptoms, and in severe cases, it can lead to a dangerous disease. For this reason, it is essential to develop a simple method to evaluate stress level precisely. Popularly, heart rate variability (HRV) is used because it can reflect autonomic nervous system (ANS) activity. On the other hand, virtual reality (VR), which can provide environments similar to reality, is widely used in laboratory-based experiments. In this paper, we analyzed the HRV of healthy people by using the photoplethysmogram (PPG) while providing diverse stress situations. To detect and classify the exact stress levels, extracted HRV features and linear discriminant analysis (LDA) were utilized. As a result, high multi-class classification accuracy was obtained: Baseline (74%), mild stress (81%), and severe stress (82%).
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Cho D, Ham J, Oh J, Park J, Kim S, Lee NK, Lee B. Detection of Stress Levels from Biosignals Measured in Virtual Reality Environments Using a Kernel-Based Extreme Learning Machine. SENSORS 2017; 17:s17102435. [PMID: 29064457 PMCID: PMC5677291 DOI: 10.3390/s17102435] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/20/2017] [Accepted: 10/20/2017] [Indexed: 02/07/2023]
Abstract
Virtual reality (VR) is a computer technique that creates an artificial environment composed of realistic images, sounds, and other sensations. Many researchers have used VR devices to generate various stimuli, and have utilized them to perform experiments or to provide treatment. In this study, the participants performed mental tasks using a VR device while physiological signals were measured: a photoplethysmogram (PPG), electrodermal activity (EDA), and skin temperature (SKT). In general, stress is an important factor that can influence the autonomic nervous system (ANS). Heart-rate variability (HRV) is known to be related to ANS activity, so we used an HRV derived from the PPG peak interval. In addition, the peak characteristics of the skin conductance (SC) from EDA and SKT variation can also reflect ANS activity; we utilized them as well. Then, we applied a kernel-based extreme-learning machine (K-ELM) to correctly classify the stress levels induced by the VR task to reflect five different levels of stress situations: baseline, mild stress, moderate stress, severe stress, and recovery. Twelve healthy subjects voluntarily participated in the study. Three physiological signals were measured in stress environment generated by VR device. As a result, the average classification accuracy was over 95% using K-ELM and the integrated feature (IT = HRV + SC + SKT). In addition, the proposed algorithm can embed a microcontroller chip since K-ELM algorithm have very short computation time. Therefore, a compact wearable device classifying stress levels using physiological signals can be developed.
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Affiliation(s)
- Dongrae Cho
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology, Gwangju 61005, Korea.
| | - Jinsil Ham
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology, Gwangju 61005, Korea.
| | - Jooyoung Oh
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology, Gwangju 61005, Korea.
| | - Jeanho Park
- Research Institute of Industrial Technology Convergence, Korea Institute of Industrial Technology, Ansan 15588, Korea.
| | - Sayup Kim
- Research Institute of Industrial Technology Convergence, Korea Institute of Industrial Technology, Ansan 15588, Korea.
| | - Nak-Kyu Lee
- Research Institute of Industrial Technology Convergence, Korea Institute of Industrial Technology, Ansan 15588, Korea.
| | - Boreom Lee
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology, Gwangju 61005, Korea.
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Trier Social Stress Test in vivo and in virtual reality: Dissociation of response domains. Int J Psychophysiol 2016; 110:47-55. [PMID: 27742258 DOI: 10.1016/j.ijpsycho.2016.10.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/04/2016] [Accepted: 10/10/2016] [Indexed: 11/19/2022]
Abstract
The Trier Social Stress Test (TSST) is considered a reliable paradigm for inducing psychosocial stress. Virtual reality (VR) has successfully been applied to ensure a greater degree of efficiency and standardization in the TSST. Studies using the TSST in VR (VR-TSST) have reported significant stress reactions, with subjective and peripheral physiological reactions comparable to those in response to the in vivo TSST and with lower cortisol reactions. The current study examined whether an additional virtual competitive factor triggers larger stress responses than a standard VR-TSST. Forty-five male participants were randomly assigned to either in vivo TSST, VR-TSST (VR) or VR-TSST with a virtual competitor (VR+). A significant increase of self-reported stress, electrodermal activity, and heart rate indicated a pronounced stress reaction with no differences between groups. For salivary cortisol, however, responder rates differed significantly between groups, with in vivo participants showing overall higher response rates (86%) than participants of both VR groups (VR: 33%, VR+: 47%). In contrast, participants of both VR groups judged the task significantly more challenging than did in vivo TSST participants. In sum, our results indicate successful stress induction in all experimental conditions, and a marked dissociation of salivary cortisol levels on the one hand, and the physiological and psychological stress reactions on the other hand. The competitive scenario did not significantly enhance stress reactions. VR technology may serve as a standardized tool for inducing social stress in experimental settings, but further research is needed to clarify why the stress reaction as assessed by cortisol differs from peripheral and subjective stress reactions in VR.
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Hawn SE, Paul L, Thomas S, Miller S, Amstadter AB. Stress reactivity to an electronic version of the Trier Social Stress Test: a pilot study. Front Psychol 2015; 6:724. [PMID: 26074862 PMCID: PMC4447999 DOI: 10.3389/fpsyg.2015.00724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 05/15/2015] [Indexed: 11/13/2022] Open
Abstract
Social stressors that rely on the inclusion of confederates (i.e., Trier Social Stress Test, TSST) are often used in clinical laboratory research paradigms to elicit a measurable stress response in participants. Although effective, the TSST is labor intensive and may introduce error variance as a function of confederate race, gender, and/or response characteristics. The present study aimed to develop and validate an electronic version of the TSST (e-TSST). The primary aim was to compare the e-TSST to an e-neutral control condition; the exploratory aim was to compare the magnitude of stress response elicited by the e-TSST to that elicited by the traditional TSST. Forty-three healthy adults were randomized to the e-TSST or e-neutral condition. Subjective (participant-rated distress) and objective [cortisol, heart rate (HR), and blood pressure] indices of stress were collected prior to, and multiple times following, the stressor. Using archival data collected from 19 healthy participants exposed to the traditional TSST in a prior study, stress reactivity was compared between the electronic and traditional versions of the TSST. The e-TSST elicited significant increases in all measures of stress reactivity compared to the e-neutral condition, with the exception of HR. Results showed that the magnitude of subjective distress, BP, and HR responses elicited by the e-TSST did not differ significantly from that elicited by the traditional TSST. The traditional TSST elicited significantly higher cortisol than the e-TSST. Although these findings provide initial support for the development of electronic versions of the TSST, further refinement of the e-TSST is warranted prior to broad adoption of this technology. A refined, reliable e-TSST could allow for increased utilization of the TSST by enhancing convenience, reducing labor costs, and limiting potential error variance introduced by human confederates.
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Affiliation(s)
- Sage E. Hawn
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Lisa Paul
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Suzanne Thomas
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Stephanie Miller
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B. Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Diemer J, Mühlberger A, Pauli P, Zwanzger P. Virtual reality exposure in anxiety disorders: impact on psychophysiological reactivity. World J Biol Psychiatry 2014; 15:427-42. [PMID: 24666248 DOI: 10.3109/15622975.2014.892632] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Anxiety disorders are among the most frequently encountered psychiatric disorders. Recommended treatments include cognitive behavioural therapy (CBT) and/or medication. In recent years, beneficial effects of virtual reality (VR) exposure therapy have been shown, making this technique a promising addition to CBT. However, the ability of VR to mimic threatening stimuli in a way comparable to in vivo cues has been discussed. In particular, it has been questioned whether VR is capable of provoking psychophysiological symptoms of anxiety. Since psychophysiological arousal is considered a prerequisite for effective exposure treatment, this systematic review aims to evaluate the evidence for the potential of VR exposure to evoke and modulate psychophysiological fear reactions. METHODS PubMed and PsycINFO/Academic Search Premier databases were searched. Thirty-eight studies investigating challenge or habituation effects were included. RESULTS VR exposure does provoke psychophysiological arousal, especially in terms of electrodermal activity. Results on psychophysiological habituation in VR are inconclusive. Study design and methodological rigour vary widely. CONCLUSIONS Despite several limitations, this review provides evidence that VR exposure elicits psychophysiological fear reactions in patients and healthy subjects, rendering VR a promising treatment for anxiety disorders, and a potent research tool for future investigations of psychophysiological processes and their significance during exposure treatment.
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Affiliation(s)
- Julia Diemer
- Department of Psychiatry, Depression and Anxiety Research Unit, University Hospital Muenster , Muenster , Germany
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Foster TC, Defazio RA, Bizon JL. Characterizing cognitive aging of spatial and contextual memory in animal models. Front Aging Neurosci 2012; 4:12. [PMID: 22988436 PMCID: PMC3439636 DOI: 10.3389/fnagi.2012.00012] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 05/15/2012] [Indexed: 11/30/2022] Open
Abstract
Episodic memory, especially memory for contextual or spatial information, is particularly vulnerable to age-related decline in humans and animal models of aging. The continuing improvement of virtual environment technology for testing humans signifies that widely used procedures employed in the animal literature for examining spatial memory could be developed for examining age-related cognitive decline in humans. The current review examines cross species considerations for implementing these tasks and translating findings across different levels of analysis. The specificity of brain systems as well as gaps in linking human and animal laboratory models is discussed.
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Affiliation(s)
- Thomas C Foster
- Department of Neuroscience, Evelyn F. and William L. McKnight Brain Institute, University of Florida Gainesville, FL, USA
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Lee SH, Shin DW, Stein MA. Increased cortisol after stress is associated with variability in response time in ADHD children. Yonsei Med J 2010; 51:206-11. [PMID: 20191011 PMCID: PMC2824865 DOI: 10.3349/ymj.2010.51.2.206] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 04/05/2009] [Accepted: 05/15/2009] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Children with attention-deficit/hyperactivity disorder (ADHD) often perform poorly during cognitive tests. We sought to evaluate cortisol as potential moderator of performance in mentally challenging tasks in children with ADHD. MATERIALS AND METHODS Ninety clinic-referred children with ADHD were studied. Cortisol contents in saliva were measured before and after administration of a continuous performance test (CPT). RESULTS Pre and post CPT cortisol levels were similar in 68 children. Children whose cortisol level increased after testing ( n = 22 ) displayed a significantly longer response time and increased response time variability scores as compared to children who did not display increase of cortisol after the CPT test. Even after controlling for the effects of response time and anxiety, the changes in cortisol levels were associated with effect on response time variability. CONCLUSION The patients who showed an increased cortisol level after stress displayed a higher variability in response time than the patients who showed no change or a decreased cortisol level. The result of the current study suggests that stress-induced high norepinephrine (NE) release may accompany poorer attention performance in patients with ADHD.
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Affiliation(s)
- Seung Hye Lee
- Department of Psychiatry, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kelly O, Matheson K, Martinez A, Merali Z, Anisman H. Psychosocial Stress Evoked by a Virtual Audience: Relation to Neuroendocrine Activity. ACTA ACUST UNITED AC 2007; 10:655-62. [DOI: 10.1089/cpb.2007.9973] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Owen Kelly
- Carleton University, Institute of Neuroscience, Ontario, Canada
- University of Ottawa, Institute of Mental Health Research, Ontario, Canada
| | | | | | - Zul Merali
- University of Ottawa, Institute of Mental Health Research, Ontario, Canada
| | - Hymie Anisman
- Carleton University, Institute of Neuroscience, Ontario, Canada
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McCormick CM, Lewis E, Somley B, Kahan TA. Individual differences in cortisol levels and performance on a test of executive function in men and women. Physiol Behav 2007; 91:87-94. [PMID: 17337021 DOI: 10.1016/j.physbeh.2007.01.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Revised: 01/11/2007] [Accepted: 01/31/2007] [Indexed: 11/16/2022]
Abstract
Despite evidence for a high concentration of corticosteroid receptors in prefrontal cortex, little research has examined the relationship between cortisol and prefrontal cortical function other than working memory. We investigated the association between salivary cortisol levels and performance on the Wisconsin Card Sorting Test (WCST) of executive function and on a test of mental rotation (to test specificity of the relationship between cortisol and cognitive performance) in men and women (n=116, ages 17-22). Higher cortisol levels at the beginning of the test session were associated with more errors in women on the WCST and fewer errors in men. However, men's cortisol levels were lower than women's at this point in time. Cortisol levels were not associated with mental rotation scores. Our results suggest that individual differences in cortisol levels among participants upon arrival to a test situation influence performance on a task involving the prefrontal cortex.
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Affiliation(s)
- C M McCormick
- Neuroscience Program, Bates College, Lewiston, ME 04240, USA.
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Waynforth D. The influence of parent–infant cosleeping, nursing, and childcare on cortisol and SIgA immunity in a sample of british children. Dev Psychobiol 2007; 49:640-8. [PMID: 17680611 DOI: 10.1002/dev.20248] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Substantial variation in childcare arrangements exists both within and between populations. Research has suggested negative stress-related outcomes for children who regularly attend daycare facilities. In the present study, 122 cortisol and 94 secretory immunoglobulin A (SIgA) samples from 32 British children aged between 3 and 8 were analyzed using multilevel modeling to assess effects of daycare attendance and other childcare-related variables on children's stress and SIgA immune function. Parents' reports of children's aggression and family discord within 2 hr of saliva collection were associated with elevated cortisol levels in children. With these acute stressors statistically controlled, retrospective data on parent-child cosleeping showed that children who had coslept in their parent(s) room had lower cortisol levels, as did children who had attended less daycare in the first 4 years of life. The parenting-related variables did not predict SIgA immunity. The results are discussed in the context of theories of parenting strategies.
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Affiliation(s)
- David Waynforth
- School of Medicine, Health Policy & Practice, University of East Anglia Norwich, Norfolk NR4 7TJ, UK.
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