Individual differences in trajectories of emotion regulation processes: the effects of maternal depressive symptomatology and children's physiological regulation

Cognitive and affective links between childhood adversity and psychological adjustment in emerging adults with chronic medical conditions

OBJECTIVE

Childhood adversity has been linked to poor psychological adjustment and decreased emotion regulation (ER) abilities. The extended process model of ER outlines the pivotal role of cognitive appraisals in the generation and expression of emotion as well as the pursuit of ER. The aim of the current study is to examine whether illness-related cognitive appraisals (i.e., illness uncertainty and illness intrusiveness) and emotion dysregulation serially mediate the relationship between childhood adversity and psychological adjustment for emerging adults with chronic medical conditions (CMCs).

METHODS

Participants included 557 undergraduate college students (Mage= 19.53 years, SD = 1.34) enrolled in a Midwestern public university with self-reported CMCs. Participants completed measures of adverse childhood experiences (ACEs), illness uncertainty, illness intrusiveness, emotion dysregulation, anxious symptoms, and depressive symptoms. A path analysis was conducted examining ACEs → cognitive appraisals (i.e., illness uncertainty, illness intrusiveness) → emotion dysregulation → depressive and anxious symptoms.

RESULTS

The overall model was significant and predicted 63.5% of the variability in anxious symptoms and 60.2% of the variability in depressive symptoms. All anticipated direct and indirect paths were significant.

CONCLUSIONS

The current study indicates that greater childhood adversity is indeed associated with negative appraisals of one's CMC, such as greater perceived uncertainty and intrusiveness. Negative illness-related cognitive appraisals thus may limit one's ability to effectively employ adaptive strategies to regulate emotions, which could contribute to greater depressive and anxious symptoms.

Prenatal tobacco, tobacco-cannabis coexposure, and child emotion regulation: The role of child autonomic functioning and sensitive parenting

Prenatal tobacco exposure (PTE) and tobacco-cannabis coexposure (PTCE) co-occur with negative maternal emotional functioning (termed prenatal risks) and together increase risk for child regulatory problems at early school age (ESA). Little is known about developmental processes in early childhood that may mediate this association. We examined two hypothesized mediational processes linking prenatal risks to ESA emotion regulation (ER) and lability-negativity; parasympathetic functioning at toddler age and chronic risk reflected by continued postnatal maternal negative emotional functioning (i.e., depression, anger/hostility, and emotion dysregulation) and substance exposure. Congruent with differential susceptibility theory, we examined interactions between sensitive parenting and toddler parasympathetic functioning predicting ESA ER. Finally, we explored the role of child sex as a moderator. Mothers (N = 247; 53% male infants; 51% Black, 31% White, 19% Hispanic, and 8% other or mixed race) were recruited in the first trimester of pregnancy into one of three groups: PTE (n = 81), PTCE (n = 97), and no substance exposure (n = 69) matched on age and education. Substance exposure was assessed using multiple methods, maternal negative emotional functioning via self-reports, parenting with observations, and child ER using teacher, maternal, and lab assessor reports. Results supported a chronic risk pathway with less support for a parasympathetic pathway. Toddlers who demonstrated respiratory sinus arrhythmia withdrawal to frustration were susceptible to the positive context of sensitive parenting in predicting higher ER. Results emphasize the importance of chronicity of postnatal risks including substance exposure and evaluating the differential impact of positive environments for children with substance exposure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A longitudinal investigation of caregiving and adolescent post-traumatic stress symptoms during COVID-19: evidence for high resting RSA as a susceptibility factor

BACKGROUND

Post-traumatic stress symptoms (PTSS) were the most frequently reported mental health concern for youth during COVID-19, yet variations in youth's PTSS responses warrant empirical consideration. Features of the caregiving environment influence youth's responses to environmental stressors, and youth's parasympathetic nervous system regulation may qualify the magnitude and/or direction of these effects. This prospective investigation evaluated diathesis stress and differential susceptibility models of caregiving and parasympathetic influences on youth's PTSS responses to COVID-19.

METHOD

Participants were 225 caregiver-youth dyads (youth 49.8% female at birth; 88.4% non-white) followed from childhood through adolescence and COVID-19. Youth's resting respiratory sinus arrhythmia (RSA; Mage = 6.11, s.d. = 0.21), caregiving features (i.e. attachment security [youth Mage = 12.24, s.d. = 0.35] and caregiver internalizing psychopathology [caregiver Mage = 39.29, s.d. = 6.78]) were assessed pre-pandemic. Youth's PTSS was assessed one year prior to the US COVID-19 pandemic (Mage = 14.24, s.d. = 0.50) and during the spring of 2020 at the height of the pandemic (Mage = 15.23, s.d. = 0.57).

RESULTS

Youth's PTSS increased during COVID-19. Youth with relatively high resting RSA evidenced the lowest PTSS when their caregiving environment featured high attachment security or low caregiver internalizing problems, but the highest PTSS when their caregiving environment featured low attachment security or high caregiver internalizing problems. In contrast, PTSS levels of youth with relatively low or average resting RSA did not differ significantly depending on attachment security or caregiver internalizing.

CONCLUSIONS

Results are consistent with a differential susceptibility hypothesis, wherein relatively high resting RSA conferred heightened sensitivity to caregiving environments in a for-better-and-for-worse manner during COVID-19.

Early childhood trauma exposure and neurocognitive and emotional processes: Associations in young children in a partial hospital program

Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.

Development of symptoms of oppositional defiant disorder from preschool to adolescence: the role of bullying victimization and emotion regulation

BACKGROUND

Childhood oppositional defiant disorder (ODD) is associated with adverse outcomes which can continue to impair life well into adulthood. Identifying modifiable etiological factors of ODD is therefore essential. Although bullying victimization and poor emotion regulation are assumed to be risk factors for the development of ODD symptoms, little research has been conducted to test this possibility.

METHODS

A sample (n = 1,042) from two birth cohorts of children in the city of Trondheim, Norway, was assessed biennially from age 4 to 14 years. Parents and children (from age 8) were assessed with clinical interviews to determine symptoms of ODD, children reported on their victimization from bullying, and teachers reported on children's emotion regulation.

RESULTS

Oppositional defiant disorder symptoms increased from age 4 to 6, from age 8 to 10, and then started to wane as children entered adolescence. A Random Intercept Cross-Lagged Panel Model revealed that increased emotion regulation predicted a reduced number of ODD symptoms across development (β = -.15 to -.13, p < .001). This prediction was equally strong for the angry/irritable and argumentative/defiant dimensions of ODD. No longitudinal links were observed between bullying victimization and ODD symptoms.

CONCLUSIONS

Improving emotion regulation skills may protect against ODD symptoms throughout childhood and adolescence.

Being sensitive in their own way: parental ethnotheories of caregiver sensitivity and child emotion regulation across five countries

Caregiver sensitivity builds a basis for children's sense of security and effective emotion regulation during their development. Applying a cross-cultural lens, caregiver sensitivity can be divided into two subtypes, reactive and proactive, and its prevalence and meaning may differ across cultures. Guided by the theoretical frameworks of developmental niche and parental ethnotheories, the current study examines culture-specific meanings of caregiver sensitivity across five countries: India, Nepal, Korea, the United States of America (USA), and Germany. We examine the prevalence of maternal reactive and proactive sensitivity, children's emotional lability and regulation, and how mothers' sensitivity types are related to children's emotional characteristics. Participants included 472 mothers from the five countries with children aged between 6 and 7 years. Mothers reported their sensitivity preference in multiple vignettes and completed an emotion regulation checklist to report their children's emotional lability and regulation. A set of analyses of covariance (ANCOVAs) found cultural differences in mothers' preference for proactive and reactive sensitivity. Mothers in India and Nepal reported the highest preference for proactive sensitivity followed by Korea and the USA, while German mothers reported the lowest preference for proactive sensitivity. Consequent regression analyses revealed varying associations between proactive sensitivity and child emotional characteristics in all five countries either directly or as moderated by child sex. These results evidence that parental ethnotheories are part of the developmental niche embedded in a larger cultural context. Findings on the differential links between the types of sensitivity and child emotion regulation provide cultural models of parental emotion socialization and children's emotional functioning.

Vagal Flexibility Moderates the Links between Observed Sensitive Caregiving in Infancy and Externalizing Behavior Problems in Middle Childhood

This study explored how patterns of physiological stress reactivity underpin individual differences in sensitivity to early rearing experiences and childhood risk for psychopathology. To examine individual differences in parasympathetic functioning, past research has largely relied on static measures of stress reactivity (i.e., residual and change scores) in infancy which may not adequately capture the dynamic nature of regulation across contexts. Using data from a prospective longitudinal study of 206 children (56% African Americans) and their families, this study addressed these gaps by employing the latent basis growth curve model to characterize the dynamic, non-linear patterns of change in infants' respiratory sinus arrhythmia (i.e., vagal flexibility) across the Face-to-Face Still-Face Paradigm. Furthermore, it investigated whether and how infants' vagal flexibility moderates the links between sensitive parenting, observed during a free play task when children were 6 months of age, and parent-report of children's externalizing problems at 7 years of age. Results of the structural equation models revealed that infants' vagal flexibility moderates the predictive relations between sensitive parenting in infancy and children's later externalizing problems. Simple slope analyses revealed that low vagal flexibility, characterized by less suppression and flatter recovery patterns, exacerbated risk for externalizing psychopathology in the context of insensitive parenting. Children with low vagal flexibility also benefited most from sensitive parenting, as indicated by the lower number of externalizing problems. Findings are interpreted in the light of the biological sensitivity to context model and provide evidence for vagal flexibility as a biomarker of individual's sensitivity to early rearing contexts.

Maternal depression trajectories in childhood, subsequent maltreatment, and adolescent emotion regulation and self-esteem: the 2004 Pelotas birth cohort

This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents' self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent-Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents' emotion regulation are partly mediated by child maltreatment at age 11.

EgoActive: Integrated Wireless Wearable Sensors for Capturing Infant Egocentric Auditory-Visual Statistics and Autonomic Nervous System Function 'in the Wild'

There have been sustained efforts toward using naturalistic methods in developmental science to measure infant behaviors in the real world from an egocentric perspective because statistical regularities in the environment can shape and be shaped by the developing infant. However, there is no user-friendly and unobtrusive technology to densely and reliably sample life in the wild. To address this gap, we present the design, implementation and validation of the EgoActive platform, which addresses limitations of existing wearable technologies for developmental research. EgoActive records the active infants' egocentric perspective of the world via a miniature wireless head-mounted camera concurrently with their physiological responses to this input via a lightweight, wireless ECG/acceleration sensor. We also provide software tools to facilitate data analyses. Our validation studies showed that the cameras and body sensors performed well. Families also reported that the platform was comfortable, easy to use and operate, and did not interfere with daily activities. The synchronized multimodal data from the EgoActive platform can help tease apart complex processes that are important for child development to further our understanding of areas ranging from executive function to emotion processing and social learning.

Examining transactional associations between maternal internalizing symptoms, infant negative emotionality, and infant respiratory sinus arrhythmia

The current study examined transactional associations between maternal internalizing symptoms, infant negative emotionality, and infant resting respiratory sinus arrhythmia (RSA). We used data from the Longitudinal Attention and Temperament Study (N = 217) to examine the associations between maternal internalizing symptoms, infant negative emotionality, and infant resting RSA from 4-months to 18-months using a random-intercepts cross-lagged panel model. We found that mothers with higher average internalizing symptoms have infants with higher levels of resting RSA. However, there were no stable, between-individual differences in infant negative emotionality across time. Additionally, we found significant negative within-dyad cross-lagged associations from maternal internalizing symptoms to subsequent measures of infant negative emotionality, as well as a significant negative cross-lagged association from maternal internalizing symptoms to child resting RSA after 12-months of age. Lastly, we find evidence for infant-directed effects of negative emotionality and resting RSA to maternal internalizing symptoms. Results highlight the complex, bidirectional associations in maternal-infant dyads during the first two years of life, and the importance of considering the co-development of infant reactivity and regulatory processes in the context of maternal internalizing symptoms.

Investigating the developmental timing of self-regulation in early childhood

Self-regulation often refers to the executive influence of cognitive resources to alter prepotent responses. The ability to engage cognitive resources as a form of executive process emerges and improves in the preschool-age years while the dominance of prepotent responses, such as emotional reactions, begins to decline from toddlerhood onward. However, little direct empirical evidence addresses the timing of an age-related increase in executive processes and a decrease in age-related prepotent responses over the course of early childhood. To address this gap, we examined children's individual trajectories of change in prepotent responses and executive processes over time. At four age points (24 months, 36 months, 48 months, and 5 years), we observed children (46% female) during a procedure in which mothers were busy with work and told their children they had to wait to open a gift. Prepotent responses included children's interest in and desire for the gift and their anger about the wait. Executive processes included children's use of focused distraction, which is the strategy considered optimal for self-regulation in a waiting task. We examined individual differences in the timing of age-related changes in the proportion of time spent expressing a prepotent response and engaging executive processes using a series of nonlinear (generalized logistic) growth models. As hypothesized, the average proportion of time children expressed prepotent responses decreased with age, and the average proportion of time engaged in executive processes increased with age. Individual differences in the developmental timing of changes in prepotent responses and executive process were correlated r = .35 such that the timing of decrease in proportion of time expressing prepotent responses was coupled with the timing of increase in proportion of time engaging executive processes.

Stability of maternal postnatal bonding between 3 and 6 months: Associations with maternal mental health and infant temperament

Maternal bonding is key for infant development and well-being. Research to date focused on prenatal bonding experience, with fewer studies looking at the postnatal period. Moreover, evidence suggests significant associations among maternal bonding, maternal mental health, and infant temperament. The joint impact of maternal mental health and infant temperament on maternal postnatal bonding remains unclear, with limited research reporting longitudinal data. Hence, the present study aims (1) to explore the impact of maternal mental health and infant temperament on postnatal bonding at both 3 and 6 months of age, (2) to explore postnatal bonding stability from 3 to 6 months, and (3) to determine which factors are linked with 3-to-6-month changes in bonding. At the infants' 3 months (n = 261) and 6 months of age (n = 217), mothers provided measures of bonding, depressive and anxious symptoms, and infant temperament via validated questionnaires. At 3 months, higher levels of maternal bonding were predicted by lower levels of anxiety and depression in the mothers and by higher infants' regulation scores. At 6 months, lower levels of anxiety and depression predicted higher levels of bonding. Moreover, mothers showing decreases in bonding were characterized by 3-to-6-month increases in depression and anxiety, as well as increased reported difficulties in regulation dimensions of infant temperament. This study highlights the impact of both maternal mental health and infant temperament on maternal postnatal bonding in a longitudinal sample and could offer useful information for early childhood prevention and care.

Postnatal maternal distress, infant subcortical brain macrostructure and emotional regulation

BACKGROUND

Maternal distress is associated with an increased risk for adverse emotional development in infants, including difficulties with emotion regulation. Prenatal maternal distress has been associated with alterations in infant brain development. However, less is known about these associations with postnatal maternal distress, despite this being an important modifiable risk factor that can promote healthy brain development and emotional outcomes in infants.

METHODS & RESULTS

Infants underwent magnetic resonance imaging (MRI) and mothers completed standardized questionnaires concerning their levels of perceived distress 2-5 months postpartum. Infant emotion regulation was assessed at 8-11 months via maternal report. When examining the associations between maternal distress and infant macrostructure, maternal anxiety was associated with infant right pallidum volumes. Increased display of negative emotions at 8-11 months of age was associated with smaller hippocampal volumes and this association was stronger in girls than boys.

CONCLUSION

Findings suggest that postnatal maternal distress may be associated with early infant brain development and emphasize the importance of maternal mental health, supporting previous work. Furthermore, macrostructural properties of infant subcortical structures may be further investigated as potential biomarkers to identify infants at risk of adverse emotional outcomes.

Trajectories and Associations Between Maternal Depressive Symptoms, Household Chaos and Children's Adjustment through the COVID-19 Pandemic: A Four-Wave Longitudinal Study

The COVID-19 pandemic and associated public health measures have adversely affected the lives of people worldwide, raising concern over the pandemic's mental health consequences. Guided by a systemic model of family functioning during the COVID-19 pandemic (Prime et al., 2020), the current study aimed to examine how caregiver well-being (i.e., maternal depressive symptoms) and family organization (i.e., household chaos) are related to longitudinal trajectories of children's emotional and behavioral problems. Data were collected at four time points during and after home lockdown periods. Mothers of children (N = 230; 55% male) between the ages of two to five years were asked to complete questionnaires via an Israeli online research platform. Results indicated that emotional and behavioral problems, household chaos, and maternal depressive symptoms were the highest during the first lockdown assessment and dropped in the post-lockdown periods. Multilevel models further revealed that at the between-participants level, maternal depressive symptoms and household chaos positively predicted children's emotional and behavioral problems. At the within-participants level, household chaos fluctuations positively predicted fluctuations in child behavioral but not emotional problems. Our findings suggest that lockdowns have adverse effects on both maternal and child mental health. Screening for depressive symptoms among mothers of young children and maintaining household structure are important targets for future interventions to assist parents in navigating the multiple challenges brought upon by the COVID-19 pandemic.

Emotion regulation in blind and visually impaired children aged 3 to 12 years assessed by a parental questionnaire

Emotion regulation develops from the earliest years of a child's life and mostly through visual information. Considering the importance of emotion regulation in daily life situations, it is important to study the effect of visual experience on the development of this ability. This study is the first to examine the effect of visual experience and age in emotion regulation by comparing groups of children with different visual status and age. For this purpose, after testing the reliability and consistency of the French version of Emotion Regulation Checklist (ERC-vf) with 245 parents of blind, visually impaired and sighted children aged 3-5, 6-8 or 9-12 years, we conducted analyses on the effect of visual status and age on emotion regulation composite scores. The first result confirmed that the ERC-vf can be reliably used on populations of blind and visually impaired children. The second result revealed an effect of visual status on ER composite scores of emotion regulation: Blind children and visually impaired children each had significantly lower composite scores than sighted children. Moreover, the effect of age and the interaction between age and visual status were not significant on ER composite scores. The ER subscale results suggest, however, that age may have a variable effect for blind and visually impaired children as blind children's scores become lower and those of visually impaired children become equal to sighted children with age. The results of our study may help the children's entourage to better adapt their interactions in a context of visual impairment.

Pathways From Preschool Language Difficulties to School-Age Internalizing Problems

PURPOSE

Early language difficulties are associated with later internalizing problems across different ages and for different aspects of language. The mechanisms behind this association are, however, less understood. In the current study, we investigated longitudinal associations between language difficulties at 5 years and internalizing problems at 6 years. We also examined emotion regulation, empathy, assertiveness, and social engagement at 6 years as possible pathways for this association.

METHOD

A subsample from the Norwegian Mother, Father and Child Cohort Study (MoBa) was used (N = 928). Structural equation models were developed to test the longitudinal associations and indirect pathways between language and internalizing problems.

RESULTS

The results showed high stability for internalizing problems from 5 to 6 years (β = .59, p < .001). Furthermore, semantic language difficulties predicted change in internalizing problems (β = .12, p < .001). Finally, the path between semantic language and internalizing problems was partially mediated by social engagement and emotion regulation, with the indirect pathways accounting for 55% of the initial association. For girls, there was a significantly stronger correlation (p < .05) between semantic language difficulties and internalizing problems at baseline (r = .30, p < .001) than for boys (r = .16, p < .001). Otherwise, there were no sex differences.

CONCLUSIONS

Indirect pathways from language difficulties to internalizing problems were identified through social engagement and emotion regulation. The results may guide targets for intervention in groups of children with language difficulties at risk for developing internalizing problems.

Listening in: An Alternative Method for Measuring the Family Emotional Environment

The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.

When is Parental Suppression of Black Children's Negative Emotions Adaptive? The Role of Preparation for Racial Bias and Children's Resting Cardiac Vagal Tone

Research demonstrates that Black parents attempt to suppress children's expressions of negative emotions (e.g., anger, fear), in part, to protect them from experiencing racial bias from authority figures. The goal of this study was to examine whether the effectiveness of parental suppression strategies in reducing behavior problems depends on whether parents talk to children about the potential of experiencing racism (i.e., preparation for bias) and children's resting cardiac vagal tone as indexed by baseline respiratory sinus arrhythmia (RSA). Ninety-four parents (97% mothers) who identified their child as Black (56% girls) completed questionnaires about their punitive and minimizing responses to their child's negative emotions and their child's internalizing and externalizing problems at ages 5 and 6. Children's baseline RSA was assessed at age 5. Results indicated that parents' suppression of children's negative emotions predicted decreased externalizing behaviors (e.g., acting out) only when parents talked to their children about racism. When parents did not contextualize their restrictions on children's emotional expressions with discussions about race, children with higher baseline RSA demonstrated increased externalizing behaviors, whereas those with lower baseline RSA were unaffected. Parental suppression strategies led to increased internalizing symptoms (e.g., anxiety, withdrawal) among children with higher baseline RSA regardless of whether parents discussed racism. Black parents face a conundrum in which suppressing their children's negative emotions, in hopes of subverting racism, may reduce their children's externalizing problems under some circumstances, but may increase the risk of their children developing internalizing problems. Implications for systemic policy change to combat racism are discussed.

Neonatal brain and physiological reactivity in preschoolers: An initial investigation in an Asian sample

Parasympathetic nervous system (PNS) activity is important to physiological regulation. Limbic structures are important in determining what information the PNS receives, potentially influencing concurrent physiological responsivity and, ultimately, shaping PNS development. Yet, whether individual differences in these structures are linked to PNS activity in early childhood remains unclear. Here, in an exploratory capacity, we examined the association between neonatal limbic structures (i.e., the left and right amygdala and hippocampus) and preschoolers' resting-state respiratory sinus arrhythmia (RSA). RSA is a measure of heart-rate variability, a physiological marker that reflects fluctuation in the PNS and is often found predictive of emotion regulation and psychological wellbeing. Data were extracted from the "Growing Up in Singapore towards Healthy Outcomes" (GUSTO) cohort (n = 73, 39 girls). Neonatal limbic volume was collected within two weeks after birth while infants were asleep. Resting-state RSA was collected during a coloring session at 42 months of age. After controlling for potential confounders, a Bonferroni-corrected significant association between neonatal left hippocampal volume and resting-state RSA emerged wherein larger hippocampal volume was associated with higher resting-state RSA. No significant associations were present between resting-state RSA and right or left amygdala, or right hippocampal volume. These findings contribute to an increasing body of evidence aiming at enhancing our understanding of neurobiological underpinnings of parasympathetic activity and modulation. Results are also discussed with reference to ideas concerning biological sensitivity to context, as both left hippocampal volume and resting-state RSA were previously found to moderate associations between adversity and psychological function.

Sex moderated and RSA mediated effects of prenatal cocaine exposure on behavior problems at age 7

This study was designed to assess whether prenatal cocaine exposure (PCE) is associated with sex differences in behavior problems in middle childhood and whether there are sex differences in the way in which parasympathetic functioning mediates the relations between PCE and behavior problems within a diverse low-income sample. Participants included 164 high risk mother-child dyads including 89 PC exposed children and 75 control children participating in an ongoing longitudinal study. Respiratory sinus arrhythmia (RSA) was measured to assess parasympathetic functioning at 13 months of age and maternal reports of child behavior problems were collected at 7 years of age. Results revealed no significant association between PCE and behavior problems for the full sample. A 2 × 2 Anova revealed a significant interaction between PCE and child sex on internalizing, externalizing, and total behavior problems (F (3, 160) = 13.45, p < .001) with cocaine exposed females averaging the highest behavior problem scores. Results also revealed a statistically significant indirect effect linking cocaine exposure to lower externalizing problems via lower baseline RSA among males. Findings indicate that cocaine exposed females may be more vulnerable to developing behavior problems than cocaine exposed males and that high baseline RSA may present a sex specific risk factor for externalizing problems among exposed males.

Applying new RDoC dimensions to the development of emotion regulation: Examining the influence of maternal emotion regulation on within-individual change in child emotion regulation

While the Research Domain Criteria (RDoC) acknowledges that environmental and developmental influences represent important elements of the RDoC framework, there is little specificity regarding how and when to systematically examine the impact of these dimensions on domains of function. The primary aims of this paper are to demonstrate the ways in which the RDoC can be expanded to include an explicit emphasis on 1) examining within-individual change in developmental processes over time and 2) evaluating the extent to which selective and measurable environmental influences drive meaningful change during key developmental periods. We provide data from an ongoing randomized control trial as a proof of concept to highlight how repeated assessments within an experimental intervention design affords the unique opportunity to test the impact of environmental influences on within-individual change. Using preliminary data from 77 mother-child dyads repeatedly assessed across 12 months during the preschool period, we demonstrate the influence of changes in maternal emotion regulation (ER) on within-individual growth in child ER and link that growth to fewer teacher-reported externalizing problems. In line with this Special Issue, findings are discussed within the context of expanding and clarifying the existing RDoC framework to explicitly incorporate environmental and developmental dimensions.

Patterns of Infant Amygdala Connectivity Mediate the Impact of High Caregiver Affect on Reducing Infant Smiling: Discovery and Replication

BACKGROUND

Behavioral research indicates that caregiver mood disorders and emotional instability in the early months following childbirth are associated with lower positive emotionality and higher negative emotionality in infants, but the neural mechanisms remain understudied.

METHODS

Using resting-state functional connectivity as a measure of the functional architecture of the early infant brain, we aimed to determine the extent to which connectivity between the amygdala, a key region supporting emotional learning and perception, and large-scale neural networks mediated the association between caregiver affect and anxiety and early infant negative emotionality and positive emotionality. Two samples of infants (first sample: n = 58; second sample: n = 31) 3 months of age underwent magnetic resonance imaging during natural sleep.

RESULTS

During infancy, greater resting-state functional connectivity between the amygdala and the salience network and, to a lesser extent, lower amygdala and executive control network resting-state functional connectivity mediated the effect of greater caregiver postpartum depression and trait anxiety on reducing infant smiling (familywise error-corrected p < .05). Furthermore, results from the first sample were replicated in the second, independent sample, to a greater extent for caregiver depression than for caregiver anxiety.

CONCLUSIONS

We provide evidence of early objective neural markers that can help identify infants who are more likely to be at risk from, versus those who might be protected against, the deleterious effects of caregiver depression and anxiety and reduced positive emotionality.

Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults' depressive symptoms

The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory. Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.

Parenting Stress During the COVID-19 Outbreak: Socioeconomic and Environmental Risk Factors and Implications for Children Emotion Regulation

The COVID-19 outbreak imposed to Italian families many changes in their daily life increasing the risk of developing psychological problems. The present study explored risk factors associated with parenting stress and implications for children's emotion regulation in families with different socioeconomic risks. Parents of 2-14 years old children completed a survey reporting difficulties experienced due to the lockdown, level of household chaos, parenting stress, parent involvement in the child's daily life, and children emotion regulation competences. The general mean levels of parenting stress and children emotion regulation abilities were not at clinical level compared with Italian norms. Household chaos predicted higher levels of parenting stress, which, in turn, was associated with less effective emotion regulation in children through the mediating role of parental involvement. More stressed parents were less involved in their children's activities, decreasing children's effective emotion regulation. Only for SES no-risk families, the lockdown constraints increased parenting stress. For SES at-risk families, the impact of parenting stress and involvement on children regulation strategies was stronger, with a protective role played by parental involvement on children's negativity not evident for SES no-risk families. Dealing with the lockdown is a stressful experience for parents who have to balance personal life, work, and children upbringing, without other help. This situation potentially impairs their ability to be supportive caregivers and is consequently detrimental for children well-being. Policies should take into consideration the implications of the lockdown for families' mental health and tailor supportive interventions according to family's risk factors.

Transcranial Direct Current Stimulation (tDCS) Augments the Effects of Gamified, Mobile Attention Bias Modification

Anxiety-related attention bias (AB) is the preferential processing of threat observed in clinical and sub-clinical anxiety. Attention bias modification training (ABMT) is a computerized cognitive training technique designed to systematically direct attention away from threat and ameliorate AB, but mixed and null findings have highlighted gaps in our understanding of mechanisms underlying ABMT and how to design the most effective delivery systems. One neuromodulation technique, transcranial direct current stimulation (tDCS) across the pre-frontal cortex (PFC) may augment the effects of ABMT by strengthening top-down cognitive control processes, but the evidence base is limited and has not been generalized to current approaches in digital therapeutics, such as mobile applications. The present study was a single-blind randomized sham-controlled design. We tested whether tDCS across the PFC, vs. sham stimulation, effectively augments the beneficial effects of a gamified ABMT mobile app. Thirty-eight adults (Mage = 23.92, SD = 4.75; 18 females) evidencing low-to-moderate anxiety symptoms were randomly assigned to active or sham tDCS for 30-min while receiving ABMT via a mobile app. Participants reported on potential moderators of ABMT, including life stress and trait anxiety. ECG was recorded during a subsequent stressor to generate respiratory sinus arrhythmia (RSA) suppression as a metric of stress resilience. ABMT delivered via the app combined with tDCS (compared to sham) reduced AB and boosted stress resilience measured via RSA suppression, particularly for those reporting low life stress. Our results integrating tDCS with ABMT provide insight into the mechanisms of AB modulation and support ongoing evaluations of enhanced ABMT reliability and effectiveness via tDCS.

Maternal Depressive Symptoms Predict Girls' but Not Boys' Emotion Regulation: A Prospective Moment-to-Moment Observation Study

We aimed to further the understanding of maternal depressive symptoms on temporal dynamics of child emotion regulation by applying the process model of emotion regulation to preschoolers and incorporating insights from children's moment-to-moment emotional expressions. Following 108 mother-child dyads (57 girls; 72 mothers identified as White, 23 mothers as Black or African American, 10 mothers as multi-racial, 3 mothers did not report their race) from child age three (T1; M_{child age} = 3.23; SD = 0.19) to four years old (T2; M_age = 4.21; SD = 0.15), we asked whether T1 maternal depressive symptoms predicted T2 boys' and girls' faster transitions into and slower transitions out of negative emotion displays when children were frustrated. The results from multilevel Cox Regression models for latencies and durations of emotion displays showed that child gender moderated the associations between maternal depressive symptoms and latencies of child emotion displays for sadness but not anger. Higher levels of maternal depressive symptoms predicted faster transitions into sadness only for girls but not for boys. The findings suggested that girls of mother with elevated depressive symptoms showed impairment in antecedent-focused emotion regulation of sadness.

Biological signatures of emotion regulation flexibility in children: Parenting context and links with child adjustment

Emotion regulation (ER) is a key facet of positive adjustment throughout the lifespan. Recent theoretical and empirical innovations suggest that current methods for assessing ER are limited, because they measure discrete strategy use instead of ER flexibility and are insensitive to ecologically valid social contexts that influence ER. This is particularly important for studying the impact of parenting on ER development during childhood. The current study (N = 93; 47 females; M_age = 6.98, SD = 1.12) examined child ER flexibility during a directed reappraisal task (DRT) with two parenting contexts: passive parent presence or active scaffolding. Two biological signatures of ER flexibility were measured: respiratory sinus arrhythmia (RSA), an index of physiological flexibility; and the late positive potential (LPP), an index of neurocognitive flexibility. Emotion regulation behavior was observed during a frustrating wait, and parents reported on child ER and adjustment. Greater ER flexibility indexed via the LPP and RSA both predicted observed ER during the frustrating wait, but only RSA predicted parent-reported trait ER and fewer adjustment problems. Emotion regulation flexibility indexed by the LPP was bolstered by parent presence and scaffolding of child ER during the DRT, but RSA measures were not sensitive to parenting context. Taken together, the results provide converging evidence for the conceptualization of ER in terms of physiological and neurocognitive flexibility in childhood. Furthermore, among school-aged children, while physiological flexibility broadly predicted parent-reported child adjustment, neurocognitive flexibility may be context-sensitive and predictive of concurrent observed ER.

Interpretation biases and depressive symptoms among anxiety-disordered children: The role of individual differences in respiratory sinus arrhythmia

Individual differences in interpretation biases-the tendency to interpret ambiguous stimuli as threatening-partially explain the presence of comorbid depressive symptoms among anxious youth. Increasing efforts have examined physiological processes that influence the association between interpretation biases and depressive symptoms in this population, and potential gender differences in this relationship. This study examined the moderating role of respiratory sinus arrhythmia (RSA) suppression (i.e., decrease from baseline)-an index of parasympathetic nervous system reactivity-in the association between interpretation biases and depressive symptoms in clinically anxious youth. One-hundred-and-five clinically anxious children (Mage  = 10.09 years, SD = 1.22; 56.7% female; 61.9% racial/ethnic minority) completed measures of self-reported and behaviorally indexed interpretation biases, reported anxiety/depression symptom severity, and participated in a speech task. RSA suppression during the task moderated the association between interpretation biases and depressive symptom severity in the total sample. Separate exploratory moderation analyses were conducted among girls and boys. Among girls, RSA suppression moderated the association between behaviorally indexed interpretation biases and depressive symptoms, and marginally moderated (p = .067) the association between self-reported interpretation biases and depressive symptoms. Among boys, RSA suppression was not a significant moderator. These findings may help identify clinically anxious youth most at-risk for comorbid depressive symptoms.

Trajectories of internalizing symptoms in early childhood: Associations with maternal internalizing symptoms and child physiology

Research has shown that children's internalizing symptom development during early childhood are shaped by biopsychosocial processes including physiology and parental symptoms. However, associations between maternal internalizing symptoms, child physiology and trajectories of child internalizing symptoms are not well understood. We used growth curve models to examine how maternal internalizing symptoms, child physiology and the interaction between maternal internalizing symptoms and child physiology may be associated with trajectories of internalizing symptoms during early childhood. Mothers reported their children's internalizing symptoms when children were 3, 4, 5 and 6 years of age, and mothers self-reported their own internalizing symptoms when children were 3. Respiratory Sinus Arrhythmia (RSA) was collected when children were 3.5-years-old. Results showed that there is a non-linear, quadratic trajectory across all participants from age 3 to 6. Maternal internalizing symptoms were not associated with children's internalizing symptoms at age 6, but were associated with both linear and quadratic change. Lower resting RSA was associated with greater increases in children's internalizing symptoms over time. Interactions between maternal internalizing symptoms and RSA were not associated with children's internalizing symptom development. The findings demonstrate that maternal internalizing symptoms and child physiology are independently associated with internalizing symptom development during early childhood.

Developmental patterns of emotion regulation in toddlerhood: Examining predictors of change and long-term resilience

Emotion regulation is critical for optimal functioning across a wide range of domains and may be even more important for individuals in high-risk environments. While evidence suggests that childhood is generally a period of emotion regulation growth and development, research is needed to examine factors that may contribute to deviations from a typical trajectory. In a prospective study of 1,905 children, latent class growth analysis (LCGA) was used to identify trajectory groups of emotion regulation across toddlerhood (age 14-36 months), examine predictors of those trajectory groups from child temperament, parenting behaviors, and environmental risk, and explore predictions of resilience in 5th grade from the identified groups. LGCA supported a three-class model, with a Stable Incline group, a Decline group, and a Catch-Up group. Child negative emotionality, positive and negative parenting, and environmental risk predicted group membership. These trajectory groups in toddlerhood were predictive of child resilient functioning in the 5th grade. Our findings highlight the importance of utilizing developmental models of emotion regulation and provide implications for prevention and early intervention services to enhance emotion regulation development in early childhood.

Paternal antisociality and growth in child delinquent behaviors: Moderating effects of child sex and respiratory sinus arrhythmia

Children of fathers with antisocial personality disorder (ASPD) are at risk for developing delinquency, and both biological and environmental mechanisms contribute. In this study, we test parasympathetic nervous system (PNS) function as a vulnerability/sensitivity attribute in predicting intergenerational associations between fathers' antisociality and children's delinquency scores. We followed 207 children (ages 8-12 years at intake; 139 boys) across three annual assessments. Fathers' antisociality was measured via maternal reports on the Family Interview for Genetic Studies (FIGS). At Year 1, children's resting respiratory sinus arrhythmia (RSA) was measured. At Years 1, 2, and 3, child delinquent behaviors were assessed using the delinquency subscale of the Youth Self-Report. At age 8, boys' delinquency scores were associated weakly with paternal antisocial behaviors. However, boys' delinquency scores increased steeply thereafter specifically for those who had fathers with higher antisocial symptoms. In addition, associations between delinquency and paternal antisociality were largest for boys with higher resting RSA. For girls, growth in delinquency was unrelated to both father antisociality and resting RSA. These findings (a) suggest moderating effects of children's age, sex, and PNS function on associations between father antisocial behavior and offspring delinquency; and (b) provide insights into differential vulnerability among children of fathers with ASPD.

Infant biological sensitivity to father engagement in low-income Mexican American families

Despite a sizeable literature documenting meaningful contributions of father involvement to child health and development, researchers have paid little attention to biological characteristics that may render a child more or less sensitive to fathering behavior. The identification of child and paternal characteristics that promote child behavioral health is particularly critical in the context of sociocultural risk. We hypothesized that respiratory sinus arrhythmia (RSA) measured during infancy would moderate the impact of father engagement in caregiving activities on child behavioral health. In a sample of 181 Mexican American families, we evaluated the impact of infant RSA at 6 weeks, mother- and father-reported father engagement in caregiving activities at 15 and 21 weeks, and their interaction on toddler social or emotional behavior problems and competence at 2 years of age. Only infants with average or higher RSA exhibited more behavior problems in the context of low father engagement (p = .021). Neither RSA nor father engagement predicted behavioral competence. The results are consistent with a stress-diathesis process such that higher infant RSA increases vulnerability to suboptimal father involvement, but does not enhance the benefits of high father involvement.

Getting to the heart of childhood empathy: Relations with shyness and respiratory sinus arrhythmia

Although prior studies have found that shyness and empathy are inversely related and that well-regulated children tend to express empathic behaviors more often, little work has assessed combinations of these factors in predicting affective and cognitive empathy in early childhood. The authors examined relations among shyness, resting respiratory sinus arrhythmia (RSA), and observed affective and cognitive empathy in a sample of 130 typically developing children (M_age  = 63.5 months, SD = 12.2; 62 males). Shyness was assessed by observing children's behaviors during a self-presentation task, and this observed measure was then combined with a maternal report of children's temperamental shyness. Children's shyness predicted lower levels of both affective and cognitive responses to an experimenter feigning an injury. Resting RSA moderated the relation between children's shyness and observed empathy such that relatively higher shyness combined with lower RSA levels conferred the lowest levels of cognitive empathy. Children who were relatively low in shyness exhibited similar levels of cognitive empathy across different levels of RSA. However, this moderation was not found when predicting children's affective empathy. Our results suggest that not all shy children are alike in terms of their empathic behaviors: shy children who are physiologically dysregulated appear to have difficulties exploring and/or processing others' pain.

Socioemotional Mechanisms of Children's Differential Response to the Effects of Maternal Sensitivity on Child Adjustment

OBJECTIVE

Children differ in the extent to which they reap the benefits of maternal sensitive care or suffer the adverse consequences of insensitive care, and these differences can be accounted for by biological characteristics. However, how susceptible children adapt to maternal sensitivity in ways that either maximize positive development or lead to maladjustment has yet to be determined. Here, we propose a novel model of socioemotional mechanisms by which the joint influences of maternal sensitivity and child biological characteristics influence child adjustment.

DESIGN

We propose a theoretical model, in which children's vagal functioning and polymorphisms in serotonin transporter (5-HTTLPR) and dopamine receptor D4 (DRD4) genes confer susceptibility to the effects of maternal sensitivity on internalizing, externalizing, prosocial and moral behavior via changes in interpersonal strategies for emotion regulation, the threat response system, and empathy.

RESULTS

Theoretical and empirical support for the proposed mechanisms are provided.

CONCLUSIONS

The proposed mechanistic model of susceptibility to maternal sensitivity offers a novel framework of for whom and how children are affected by early maternal care, highlighting multiple reciprocal, interacting influences across genes, physiology, behavior, and the environment.

Emotion socialization in mothers with mood disorders: Affective modeling and recollected responses to childhood emotion

Growing evidence suggests that emotion socialization may be disrupted by maternal depression. However, little is known about emotion-related parenting by mothers with bipolar disorder or whether affective modeling in early childhood is linked to young adults' recollections of emotion socialization practices. The current study investigates emotion socialization by mothers with histories of major depression, bipolar disorder, or no mood disorder. Affective modeling was coded from parent-child interactions in early childhood and maternal responses to negative emotions were recollected by young adult offspring (n = 131, 59.5% female, M age = 22.16, SD = 2.58). Multilevel models revealed that maternal bipolar disorder was associated with more neglecting, punishing, and magnifying responses to children's emotions, whereas maternal major depression was associated with more magnifying responses; links between maternal diagnosis and magnifying responses were robust to covariates. Young adult recollections of maternal responses to emotion were predicted by affective modeling in early childhood, providing preliminary validity evidence for the Emotions as a Child Scale. Findings provide novel evidence that major depression and bipolar disorder are associated with altered emotion socialization and that maternal affective modeling in early childhood prospectively predicts young adults' recollections of emotion socialization in families with and without mood disorder.

Development and Pilot Testing a Self-Reported Pediatric PROMIS App for Young Children Aged 5-7 Years

PURPOSE

The aims of this study are threefold. Firstly, Using the state of science PROMIS (Patient-Reported Outcomes Measurement Information System) methods to develop a smartphone application to monitor the emotional distress for young children aged 5-7 years old; Secondly, to test the usability of this application; and thirdly, to determine the level of agreement between reports by parents and young children's self-report.

DESIGN AND METHODS

A multidisciplinary research team, made up of senior pediatric nurses and doctors, software engineers' team, and pediatric health researchers worked together to develop this application. Three phases of stakeholders and user studies were conducted. Phase 1 focused on prototype development; Phase 2 involved cognitive interview and usability testing; Phases 3 focused on the pilot testing of this application.

RESULTS

We included the original parent proxy reporting version of Patient Reported Outcome Measurement Information System-emotional distress in the application, as well as self-reporting animated version for young children. After many rounds of modification, all participants felt that this application was easy to use and the animated items were easy to understand for young children aged 5-7 years. Correlations between parents-children reports are significant and moderate, parents underestimated child depression, and overestimated child anger and anxiety compared to child self-report.

CONCLUSIONS

This smartphone application and its Web-based administration portal demonstrate good usability and are well accepted by young children aged 5-7 years, which can be used to promote young children's participation when reporting or assessing symptoms of young pediatric patients.

PRACTICE IMPLICATIONS

Parent reports cannot be substituted for child reports and evaluations of pediatric patients' perspectives regarding treatment outcomes should be included in pediatric clinic. This animated application can be used as a smart measurement to investigate the symptoms for young children aged 5-7 years, so as to amplify young children's voice in clinical care.

Parental and Family-Level Sociocontextual Correlates of Emergent Emotion Regulation: Implications for Early Social Competence

OBJECTIVES

Emotion regulation skills in early childhood are essential for healthy emotional and behavioral development, yet factors related to emergent emotion regulation during the early preschool period have not been extensively explored.

METHODS

In the present study (N = 90), we specifically examine parental and family-level sociocontextual correlates in relation to emotion regulation skills in three-year-olds, a crucial time when the onset of several cognitive and socioemotional abilities are intertwined. We also investigate the role of these developing emotion regulatory capacities with behavioral problems and social competence.

RESULTS

Children whose parents use more adaptive emotion regulation strategies (r = .33, p = .001) and who grow up in a higher income (r = .25, p = .02), less chaotic household (r = -.30, p = .004) have better emergent emotion regulation. Additionally, better child emotion regulation skills are associated with more positive outcomes such as fewer behavioral problems (r = -.46, p < .001) and more instrumental helping behaviors (r = .23, p = .04).

CONCLUSIONS

Findings indicate that identifying individual differences in emotion regulation earlier than most prior studies may be particularly important for fostering this crucial skill and overall psychological well-being in young children.

Family Functioning and Life Satisfaction: The Mediatory Role of Emotional Intelligence

BACKGROUND

The functioning of the family of origin seems to be one of the key variables that contribute to life satisfaction. Since relationships with one's parents are associated with well-being throughout life, the purpose of our study was to examine the association between family functioning and life satisfaction among Polish adults. Moreover, because some researchers postulate that family functioning affects quality of life directly as well as indirectly through some other variables, we focused on investigating how emotional intelligence might affect the link between family functioning and life satisfaction, as the character of this relationship has received surprisingly little attention.

PATIENTS METHODS AND DATA COLLECTION

The sample consisted of 204 participants (86% women). We measured family functioning, satisfaction with life, and emotional intelligence. The data were collected using online forums through convenience sampling on the basis of availability and the willingness of the participants to respond.

RESULTS

The results showed that both life satisfaction and emotional intelligence correlated positively and significantly with cohesion, flexibility, communication, and family satisfaction. Life satisfaction correlated negatively and significantly with enmeshed, disengaged, and chaotic functioning. In contrast, emotional intelligence correlated negatively and significantly only with chaotic and disengaged functioning. Moreover, emotional intelligence partially mediated the relationship between six dimensions of family functioning (cohesion, flexibility, communication, family satisfaction, disengagement, and chaos) and life satisfaction.

CONCLUSION

Our findings provide evidence of an indirect association between family functioning and life satisfaction through the mediating role of emotional intelligence. They indicate that individuals who evaluate their family functioning as cohesive, flexible, communicative, and fulfilled, are more likely to process their own emotions and enjoy higher life satisfaction. Conversely, assessment of family of origin as disengaged and chaotic may diminish the ability to manage one's own emotions, which, in turn, can lead to lower life satisfaction.

Emotion Dysregulation, ODD and Conduct Problems in a Sample of Five and Six-Year-Old Children

Previous studies examining the relationship between emotion dysregulation and externalizing behavior problems have, so far, focused on using general screening questionnaires capturing a wide range of externalizing behaviors and emotion dysregulation has mostly been assessed through direct observation using negative mood induction and behavioral tasks. The purpose of this study was to explore this relationship using a multi-informant rated clinical questionnaires. Parents and teachers of 609 5-6-year-old children (46% girls, 54% boys) completed the ERC, DBRS, and SDQ. ODD symptoms/conduct problems and lability/negativity were more severe among boys but girls had better emotion regulation. The results also showed a significant main effect for emotion dysregulation and ODD symptoms/conduct problems and that gender had no moderating effect on the relationship. These findings show a strong association between emotion dysregulation and concurrent ODD symptoms/conduct problems and suggest that emotional difficulties should be considered when exploring causes of behavior difficulties in daily life.

Improving mental health and physiological stress responses in mothers following traumatic childbirth and in their infants: study protocol for the Swiss TrAumatic biRth Trial (START)

INTRODUCTION

Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother-infant interactions, but also on long-term infant development. The partner's mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma.

METHODS AND ANALYSIS

This study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game 'Tetris' on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit.The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother-infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017-02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media.

TRIAL REGISTRATION NUMBER

NCT03576586.

Childhood anxiety sensitivity, fear downregulation, and anxious behaviors: Vagal suppression as a moderator of risk

Anxiety sensitivity-the fear that anxiety-related sensations will result in catastrophic physical, social, or psychological consequences-is a robust risk factor for clinical anxiety. However, less is known about how anxiety sensitivity may interact with physiological modulation of arousal to predict anxious children's fear responses. The present investigation examined vagal withdrawal as a moderator of the association between anxiety sensitivity and anxious children's ability to downregulate subjective feelings of fear in response to an anxiety-provoking speech task. Observer ratings of anxious behaviors and performance during the task were also examined. It was hypothesized that children's anxiety sensitivity levels would interact with respiratory sinus arrhythmia (RSA) suppression to explain unique variance in subjective fear downregulation, anxious behaviors, and task performance. Participants were 105 children with anxiety disorders (N = 105; M = 10.07 years, SD = 1.22; 57% female) who completed diagnostic interviews, questionnaires, a speech about their family, and an RSA assessment in baseline and speech conditions. Interactions between RSA suppression and anxiety sensitivity predicted unique variance in subjective fear downregulation. Specifically, the greatest difficulties downregulating subjective fear responses were exhibited by children with high anxiety sensitivity and low RSA suppression. Interactions between RSA suppression and anxiety sensitivity did not predict variance in observer ratings of anxious behaviors or task performance. However, higher baseline RSA and speech RSA were significantly associated with fewer anxious behaviors during the speech. Higher baseline RSA was also significantly associated with better speech performance. These findings highlight the importance of vagal withdrawal and its interaction with anxiety sensitivity in predicting downregulation of subjective fear among clinically anxious children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care: Parents' perspectives

A child's emotional and social development depends on the parents' provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short-term consultations at Child Health Centers. This study qualitatively explored parents' experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists' technique. Parents were also clustered into three so-called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight-promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.

Excitability and irritability in preschoolers predicts later psychopathology: The importance of positive and negative emotion dysregulation

Emotion dysregulation is a risk factor for the development of a variety of psychopathologic outcomes. In children, irritability, or dysregulated negative affect, has been the primary focus, as it predicts later negative outcomes even in very young children. However, dysregulation of positive emotion is increasingly recognized as a contributor to psychopathology. Here we used an exploratory factor analysis and defined four factors of emotion dysregulation: irritability, excitability, sadness, and anhedonia, in the preschool-age psychiatric assessment collected in a sample of 302 children ages 3-5 years enriched for early onset depression. The irritability and excitability factor scores defined in preschoolers predicted later diagnosis of mood and externalizing disorders when controlling for other factor scores, social adversity, maternal history of mood disorders, and externalizing diagnoses at baseline. The preschool excitability factor score predicted emotion lability in late childhood and early adolescence when controlling for other factor scores, social adversity, and maternal history. Both excitability and irritability factor scores in preschoolers predicted global functioning into the teen years and early adolescence, respectively. These findings underscore the importance of positive, as well as negative, affect dysregulation as early as the preschool years in predicting later psychopathology, which deserves both further study and clinical consideration.

Temperamental vulnerability to emotion dysregulation and risk for mental and physical health challenges

Emotion dysregulation characterizes many forms of psychopathology. Patterns of dysregulation occur as a function of a developmental process in which normative and adaptive emotion regulation skills fail to become part of the child's behavioral repertoire due to biological, psychological, and contextual processes and experiences. Here we highlight the processes involved in the dysregulation of temperamental anger and frustration that become core features of externalizing problems and place children at risk for more serious forms of psychopathology. We imbed these processes in a larger self-regulatory framework, and we discuss how they influence mental as well as physical health, using data from our 20-year longitudinal study following a large cohort of children into young adulthood. Recommendations are made for future research involving the integration of biological systems with mental and physical health outcomes.

Infant Vagal Tone and Maternal Depressive Symptoms: A Bottom-Up Perspective

Children vary in their susceptibility to environmental exposures such as maternal depression, but little is known about how children shape those same environments. When raising an infant with low arousal, mothers at risk of depression may experience decreased parenting self-efficacy and increased depressive symptoms. We evaluated a longitudinal mediated moderation model that hypothesized interactive effects of infant vagal tone (indexed by respiratory sinus arrhythmia [RSA]) and maternal postpartum depressive (PPD) symptoms on maternal depressive symptoms in early childhood via parenting self-efficacy. Among a sample of 322 very low-income Mexican American mother-infant dyads (46% male infants), infant RSA was assessed at 6 weeks of age; mothers (M_age = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 weeks to 6 months, parenting self-efficacy at 18 and 24 months, and depressive symptoms at 18 and 36 months. Higher PPD symptoms predicted higher maternal depressive symptoms at 36 months, especially among mothers whose infants had lower resting RSA. The interactive effect of PPD symptoms and infant RSA on 36-month depressive symptoms was partially mediated by lower parenting self-efficacy. Lower infant RSA may exacerbate the detrimental effects of PPD symptoms on subsequent maternal well-being via damage to mothers' beliefs in their ability to parent effectively.

Emotion dysregulation as a dynamic process

In this article we adopt the view that emotion dysregulation is characterized by emotion regulation dynamics that are defined as dysfunctional based on contextual criteria. We regard the construct of emotion regulation as valuable because it permits the integration of the classic view of emotions as interfering with human functioning and contemporary views of emotion as adaptive and beneficial. To define patterns that reflect emotion dysregulation, we explain our views of emotion as a dynamic process, and emotion regulation as the bidirectional interplay between emotions and actions/thoughts (extrinsic factors) and the contextual factors that constitute the criteria for that interplay reflecting dysregulation. This conceptualization of emotion regulation and dysregulation leads to methods for studying the intrinsic dynamics of emotion, extrinsic factors that change the intrinsic dynamics of emotion, and how emotion regulation changes over time at multiple time scales. We then apply this thinking to several emotion dysregulation patterns. Emotion regulation is a complex construct, embracing emotion as regulator and as regulated, as self- and other-regulated, and as incorporating both top-down and bottom-up regulatory processes. We highlight an emerging line of research on the development of emotion regulation in early childhood and indicate how this work can inform understanding of emotion dysregulation and the emergence of psychopathology.

Emotion dysregulation, temperamental vulnerability, and parental depression in adolescents: Correspondence between physiological and informant-report measures

Although numerous studies reveal altered respiratory sinus arrhythmia (RSA) among children, adolescents, and adults who exhibit emotion dysregulation, effects of temperamental vulnerability and parental mental health on RSA remain unclear. We evaluated the relationship among emotion regulation, RSA, and RSA reactivity in a pooled sample of 24 vulnerable and 31 resilient adolescents (mean age = 13.69 years; 60% girls), including associations with temperamental vulnerability and parental depressive symptoms. Participants watched a neutral film clip while their resting RSA was recorded, and then completed a reward and frustration task, using an affective Posner paradigm. Temperament and emotion regulation were assessed via self-report and parent report, and parents reported on their own depressive symptoms. Low resting RSA was associated with temperamental negative emotionality, whereas greater RSA reactivity to frustration was associated with maladaptive emotion regulation strategies. No significant relations were found between RSA and parental depressive symptoms. This study elucidates the role of RSA as a biomarker of individual differences in emotion dysregulation and temperamental vulnerability and stresses the importance of considering multiple units of analyses, as well as functional domains, when studying emotional responding and regulation in adolescents.