Parental drinking problems and children's adjustment: vagal regulation and emotional reactivity as pathways and moderators of risk

[Current applications of hypnosis in the field of cardiac electrophysiology]

With a growing acceptance of clinical hypnosis in medicine, new fields of application are being explored. Data from recent studies support the use of hypnosis for pain management during procedures, such as ablation of arrhythmias and implantation of subcutaneous implantable cardioverter defibrillators, management of preoperative anxiety and reduction of postoperative atrial fibrillation. The aim of this review article is to summarize the findings of investigations showing the application of hypnosis in the field of cardiac electrophysiology, to review the rationale for the efficacy of hypnosis in management of cardiac arrhythmias and to highlight possible future directions in clinical applications and scientific perspectives.

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.

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.

Improvement in women's cardiovascular functioning during cognitive-behavioral therapy for alcohol use disorder

The cardiovascular system is disrupted by chronic excessive alcohol use and often impaired in individuals with an alcohol use disorder (AUD). Less is known about cardiovascular recovery when an individual receives treatment for AUD. This observational study aimed to extend the growing body of evidence for cardiovascular biomarkers and intervention targets in the treatment of AUD. We examined cardiovascular function in 92 women before and after 12 weeks of cognitive-behavioral therapy (CBT) for AUD. Participants were recruited exclusively from a randomized clinical trial comparing group versus individual CBT treatment strategies (parent study); no control group of untreated, but treatment-seeking women was available. Demographic and drinking data were obtained from the parent study. Cardiovascular data were collected as part of this separate study, prior to and following the clinical trial. Mixed-model analyses revealed multiple within-person cardiovascular changes indicative of improving health from pre- to posttreatment, including reduced heart rate and vessel stiffness as well as increased heart rate variability and baroreflex sensitivity. These significant improvements remained when extent of drinking during treatment was included in the models, suggesting that active ingredients of AUD treatment may serve to benefit physical health over and above drinking reductions. Future studies should assess the time course of cardiovascular recovery during addiction treatment and the mechanisms by which evidence-based AUD treatments may benefit physical as well as mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Infant Parasympathetic and Sympathetic Activity during Baseline, Stress and Recovery: Interactions with Prenatal Adversity Predict Physical Aggression in Toddlerhood

Exposure to prenatal adversity is associated with aggression later in life. Individual differences in autonomic nervous system (ANS) functioning, specifically nonreciprocal activation of the parasympathetic (PNS) and sympathetic (SNS) nervous systems, increase susceptibility to aggression, especially in the context of adversity. Previous work examining interactions between early adversity and ANS functioning in infancy is scarce and has not examined interaction between PNS and SNS. This study examined whether the PNS and SNS moderate the relation between cumulative prenatal risk and early physical aggression in 124 children (57% male). Cumulative risk (e.g., maternal psychiatric disorder, substance (ab)use, and social adversity) was assessed during pregnancy. Parasympathetic respiratory sinus arrhythmia (RSA) and sympathetic pre-ejection period (PEP) at baseline, in response to and during recovery from emotional challenge were measured at 6 months. Physical aggression and non-physical aggression/oppositional behavior were measured at 30 months. The results showed that cumulative prenatal risk predicted elevated physical aggression and non-physical aggression/oppositional behavior in toddlerhood; however, the effects on physical aggression were moderated by PNS and SNS functioning. Specifically, the effects of cumulative risk on physical aggression were particularly evident in children characterized by low baseline PNS activity and/or by nonreciprocal activity of the PNS and SNS, characterized by decreased activity (i.e., coinhibition) or increased activity (i.e., coactivation) of both systems at baseline and/or in response to emotional challenge. These findings extend our understanding of the interaction between perinatal risk and infant ANS functioning on developmental outcome.

Specificity of Reward Sensitivity and Parasympathetic-Based Regulation among Children with Attention-Deficit/Hyperactivity and Disruptive Behavior Disorders

Attention-deficit/hyperactivity disorder (ADHD) is associated with disruptionsin reward sensitivity and regulatory processes. However, it is unclear whether thesedisruptions are better explained by comorbid disruptive behavior disorder (DBD)symptomology. This study sought to examine this question using multiple levels ofanalysis (i.e., behavior, autonomic reactivity). One hundred seventeen children (aged 6 to 12 years; 72.6% male; 69 with ADHD) completed theBalloon-Analogue Risk Task (BART) to assess external reward sensitivity behaviorally.Sympathetic-based internal reward sensitivity and parasympathetic-based regulationwere indexed via cardiac pre-ejection period (PEP) and respiratory sinus arrhythmia(RSA), respectively. Children with ADHD exhibited reduced internal reward sensitivity (i.e.,lengthened PEP; F(1,112)=4.01, p=0.047) compared to healthy controls and werecharacterized by greater parasympathetic-based dysregulation (i.e., reduced RSAaugmentation F(1,112)=10.12, p=0.002). However, follow-up analyses indicated theADHD effect was better accounted for by comorbid DBD diagnoses; that is, childrenwith ADHD and comorbid ODD were characterized by reduced internal rewardsensitivity (i.e., lengthened PEP; t=2.47, p=0.046) and by parasympathetic-baseddysregulation (i.e., reduced RSA augmentation; t=3.51, p=0.002) in response to rewardwhen compared to typically developing youth. Furthermore, children with ADHD and comorbid CD exhibited greater behaviorally-based external reward sensitivity (i.e.,more total pops; F(3,110)= 5.96, p=0.001) compared to children with ADHD only (t=3.87, p=0.001) and children with ADHD and ODD (t=3.56, p=0.003). Results suggest that disruptions in sensitivity to reward may be betteraccounted for, in part, by comorbid DBD.Key Words: attention-deficit/hyperactivity disorder, autonomic nervous system,disruptive behavior disorders, reward sensitivityPowered.

Dysregulated Fear, Social Inhibition, and Respiratory Sinus Arrhythmia: A Replication and Extension

Behavioral inhibition indicates increased risk for development of social anxiety. Recent work has identified a pattern of dysregulated fear (DF), characterized by high fear in low-threat situations, that provides a more precise marker of developmental risk through early childhood. This study tested a new longitudinal sample of children (n = 124) from ages 24 to 48 months. Replicating prior findings, at 24 months, we identified a pattern of fearful behavior across contexts marked by higher fear to putatively low-threat situations. DF was associated with higher parental report of social inhibition at 24, 36, and 48 months. Extending prior findings, we observed differences in cardiac physiology during fear-eliciting situations, suggesting that the neurobiological underpinnings of DF relate to difficulty with regulation.

The Translational Value of Psychophysiology Methods and Mechanisms: Multilevel, Dynamic, Personalized

OBJECTIVE

It has been nearly 15 years since Kazdin and Nock published methodological and research recommendations for understanding mechanisms of change in child and adolescent therapy. Their arguments and enthusiasm for research on mechanisms of behavior change (MOBCs) resonated across disciplines and disorders, as it shined a light on the crucial importance of understanding how and for whom treatments instigate behavior change and how therapeutic mechanisms might be extended to "situations and settings of everyday life." Initial efforts focused on how psychotherapy works and linear models, yet the use of theory to guide the study of mechanisms, and laboratory experiments to manipulate them, is broadly applicable.

METHOD

This article considers dynamic physiological processes that support behavior change. Specifically, it examines the utility of psychophysiological methods to measure and promote behavior change. Moreover, it embeds the baroreflex mechanism, a well-defined heart-brain feedback loop, within the theories and strategies of MOBC research.

RESULTS AND CONCLUSION

Individuals' subjective and expressive experience of change does not always align with their physiological reactivity. Thus, behavior change may be best understood when concurrently assessed across multiple biobehavioral levels. Further, behavior is initiated in the moment, often before conscious deliberation, suggesting that multilevel behavior change research may benefit from real-time methodological designs. Last, substance use trajectories vary widely, suggesting that different MOBCs are more or less active in individuals depending on their personal constituency and the functional need that their substance use serves; thus, methods that are amenable to personalized modeling approaches are important.

Defining the phenotype of young adults with family histories of alcohol and other substance use disorders: Studies from the family health patterns project

Individuals with a family history of alcohol and other drug use disorders (FH+) are at increased risk for developing substance use disorders themselves relative to those with no such histories (FH-). Here we sought to identify key characteristics associated with FH+ status and alcohol and other drug use disorder status in a large cohort of FH+ and FH- young adults. We conducted principal component analyses on demographic, temperament, and cognitive measures differentiating 506 FH+ and 528 FH- young adults. Three principal components were identified, and these component scores were then used to predict the odds of being FH+ and the odds of having an alcohol or other drug use disorder. Component 1 consisted of measures indexing internalizing traits, with higher component scores indicating greater depressive, anxious, and emotional instability tendencies. Component 2 consisted of measures of externalizing traits as well as exposure to early life adversity (ELA), with higher scores indicating less impulse control, more antisocial behavior, and greater ELA exposure. Component 3 consisted of estimated intelligence, delay discounting, and demographic characteristics, with higher scores indicating lower estimated intelligence, greater discounting of delayed rewards, less education, and lower childhood socioeconomic status. For each 1-point increase in the Component 1, 2, and 3 scores, the odds of being classified FH+ increased by 2%, 8%, and 4%, respectively. Similar findings were observed when individuals with alcohol or other drug use disorders were removed from the analyses. Finally, greater Component 2 scores were also associated with increased odds of having an alcohol or other drug use disorder. Collectively, these findings provide a more comprehensive understanding of the FH+ phenotype in young adults and help form a basis for further studies on biological mechanisms underlying risk for substance use disorders. The present findings also provide further support for a prominent role of ELA in promoting risk for problem alcohol and other drug use.

Young adults' internet addiction: Prediction by the interaction of parental marital conflict and respiratory sinus arrhythmia

The aim of the current study was to address the potential moderating roles of respiratory sinus arrhythmia (RSA; baseline and suppression) and participant sex in the relation between parents' marital conflict and young adults' internet addiction. Participants included 105 (65 men) Chinese young adults who reported on their internet addiction and their parents' marital conflict. Marital conflict interacted with RSA suppression to predict internet addiction. Specifically, high RSA suppression was associated with low internet addiction, regardless of parental marital conflict; however, for participants with low RSA suppression, a positive relation between marital conflict and internet addiction was found. Internet addiction also was predicted by a significant three-way interaction among baseline RSA, marital conflict, and participant sex. Specifically, for men, marital conflict positively predicted internet addiction under conditions of low (but not high) baseline RSA. For women, marital conflict positively predicted internet addiction under conditions of high (but not low) baseline RSA. Findings highlight the importance of simultaneous consideration of physiological factors, in conjunction with family factors, in the prediction of young adults' internet addiction.

Interaction between prenatal risk and infant parasympathetic and sympathetic stress reactivity predicts early aggression

Nonreciprocal action of the parasympathetic (PNS) and sympathetic (SNS) nervous systems, increases susceptibility to emotional and behavioral problems in children exposed to adversity. Little is known about the PNS and SNS in interaction with early adversity during infancy. Yet this is when the physiological systems involved in emotion regulation are emerging and presumably most responsive to environmental influences. We examined whether parasympathetic respiratory sinus arrhythmia (RSA) and sympathetic pre-ejection period (PEP) response and recovery at six months, moderate the association between cumulative prenatal risk and physical aggression at 20 months (N=113). Prenatal risk predicted physical aggression, but only in infants exhibiting coactivation of PNS and SNS (i.e., increase in RSA and decrease in PEP) in response to stress. These findings indicate that coactivation of the PNS and SNS in combination with prenatal risk is a biological marker for the development of aggression.

Reduced vagal tone in women with the FMR1 premutation is associated with FMR1 mRNA but not depression or anxiety

Background

Autonomic dysfunction is implicated in a range of psychological conditions, including depression and anxiety. The fragile X mental retardation-1 (FMR1) premutation is a common genetic mutation that affects ~1:150 women and is associated with psychological vulnerability. This study examined cardiac indicators of autonomic function among women with the FMR1 premutation and control women as potential biomarkers for psychological risk that may be linked to FMR1.

Methods

Baseline inter-beat interval and respiratory sinus arrhythmia (a measure of parasympathetic vagal tone) were measured in 35 women with the FMR1 premutation and 28 controls. The women completed anxiety and depression questionnaires. FMR1 genetic indices (i.e., CGG repeat, quantitative FMRP, FMR1 mRNA, activation ratio) were obtained for the premutation group.

Results

Respiratory sinus arrhythmia was reduced in the FMR1 premutation group relative to controls. While depression symptoms were associated with reduced respiratory sinus arrhythmia among control women, these variables were unrelated in the FMR1 premutation. Elevated FMR1 mRNA was associated with higher respiratory sinus arrhythmia.

Conclusions

Women with the FMR1 premutation demonstrated autonomic dysregulation characterized by reduced vagal tone. Unlike patterns observed in the general population and in study controls, vagal activity and depression symptoms were decoupled in women with the FMR1 premutation, suggesting independence between autonomic regulation and psychopathological symptoms that is atypical and potentially specific to the FMR1 premutation. The association between vagal tone and mRNA suggests that molecular variation associated with FMR1 plays a role in autonomic regulation.

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood

Effective regulation of emotion is one of the most important skills that develops in childhood. Research interest in this area is expanding, but empirical work has been limited by predominantly correlational investigations of children's skills. Relatedly, a key conceptual challenge for emotion scientists is to distinguish between emotion responding and emotion regulatory processes. This paper presents a novel method to address these conceptual and methodological issues in child samples. An experimental paradigm that assesses the effectiveness with which children regulate emotion is described. Children are randomly assigned to use specific emotion regulation strategies, negative emotions are elicited with film clips, and changes in subsequent psychophysiology index the extent to which emotion regulation is effective. Children are instructed to simply watch the emotion-eliciting film (control), distract themselves from negative emotions (cognitive distraction), or reframe the situation in a way that downplays the importance of the emotional event (cognitive reappraisal). Cardiac physiology, continuously acquired before and during the emotional task, serves as an objective measure of children's unfolding emotional responding while viewing evocative films. Key comparisons in patterns of obtained physiological reactivity are between the control and emotion regulation strategy conditions. Representative results from this approach are described, and discussion focuses on the contribution of this methodological approach to developmental science.

Preschoolers' psychophysiological responses to mood induction tasks moderate the intergenerational transmission of internalizing problems

To identify factors that can both exacerbate risk for, and protect against, internalizing problems during early childhood, the present study examined whether children's respiratory sinus arrhythmia (RSA) suppression in response to emotionally-laden film clips would moderate the association between maternal and child anxious/depressive symptoms in a cross-sectional sample of 108 mothers (M age=30.68years, SD=6.06) and their preschool-age children (M age=3.50years, SD=0.52, 61.30% male). Results indicated that RSA suppression in response to the fear clip moderated the positive association between maternal and child anxious/depressive symptoms, such that higher suppression served a protective-stabilizing function while lower suppression exacerbated children's risk for internalizing symptoms in the context of higher maternal symptoms. Moderation findings involving RSA suppression in response to a happiness-inducing clip were consistent with biological sensitivity to context; the association between maternal and child symptoms was strongest for children higher in suppression.

5-HTTLPR Expression Outside the Skin: An Experimental Test of the Emotional Reactivity Hypothesis in Children

Background

There is increasing evidence that variation in the promoter region of the serotonin transporter gene SLC6A4 (i.e., the 5-HTTLPR polymorphism) moderates the impact of environmental stressors on child psychopathology. Emotional reactivity −the intensity of an individual’s response to other’s emotions− has been put forward as a possible mechanism underlying these gene-by-environment interactions (i.e., G×E). Compared to children homozygous for the L-allele (LL-genotypes), children carrying an S-allele (SS/SL-genotypes), specifically when they have been frequently exposed to negative emotions in the family environment, might be more emotionally reactive and therefore more susceptible to affective environmental stressors. However, the association between 5-HTTLPR and emotional reactivity in children has not yet been empirically tested. Therefore, the goal of this study was to test this association in a large-scale experiment.

Methods

Children (N = 521, 52.5% boys, Mage = 9.72 years) were genotyped and randomly assigned to happy, angry or neutral dynamic facial expressions and vocalizations. Motor and affective emotional reactivity were assessed through children’s self-reported negative and positive affect (n = 460) and facial electromyography activity (i.e., fEMG: the zygomaticus or “smile” muscle and the corrugator or “frown” muscle, n = 403). Parents reported on their negative and positive parenting behaviors.

Results

Children mimicked and experienced the emotion they were exposed to. However, neither motor reactivity nor affective reactivity to these emotions depended on children’s 5-HTTLPR genotype: SS/SL-genotypes did not manifest any stronger response to emotional stimuli than LL-genotypes. This finding remained the same when taking the broader family environment into account, controlling for kinship, age, gender and genetic ancestry, and when including a tri-allelic factor.

Conclusions

We found no evidence for an association between the 5-HTTLPR polymorphism and children’s emotional reactivity. This finding is important, in discounting one potential underlying endophenotype of G×E between the 5-HTTLPR and affective environmental stressors.

The effects of distraction and reappraisal on children's parasympathetic regulation of sadness and fear

Children commonly experience negative emotions like sadness and fear, and much recent empirical attention has been devoted to understanding the factors supporting and predicting effective emotion regulation. Respiratory sinus arrhythmia (RSA), a cardiac index of parasympathetic function, has emerged as a key physiological correlate of children's self-regulation. But little is known about how children's use of specific cognitive emotion regulation strategies corresponds to concurrent parasympathetic regulation (i.e., RSA reactivity while watching an emotion-eliciting video). The current study describes an experimental paradigm in which 101 5- and 6-year-olds were randomly assigned to one of three different emotion regulation conditions: Control, Distraction, or Reappraisal. All children watched a sad film and a scary film (order counterbalanced), and children in the Distraction and Reappraisal conditions received instructions to deploy the target strategy to manage sadness/fear while they watched. Consistent with predictions, children assigned to use either emotion regulation strategy showed greater RSA augmentation from baseline than children in the Control condition (all children showed an overall increase in RSA levels from baseline), suggesting enhanced parasympathetic calming when children used distraction or reappraisal to regulate sadness and fear. But this pattern was found only among children who viewed the sad film before the scary film. Among children who viewed the scary film first, reappraisal promoted marginally better parasympathetic regulation of fear (no condition differences emerged for parasympathetic regulation of sadness when the sad film was viewed second). Results are discussed in terms of their implications for our understanding of children's emotion regulation and affective physiology.

Longitudinal associations between temperament and socioemotional outcomes in young children: the moderating role of RSA and gender

Temperament is an important predictor of socioemotional adjustment, such as externalizing and internalizing symptoms. However, there is not a one-to-one correspondence between temperamental predispositions and these outcomes, implying that other factors also contribute to the development of internalizing and externalizing problems. Self-regulation is believed to interact with temperament, and has been studied as a predictor for later socioemotional outcomes. Respiratory sinus arrhythmia (RSA) is a psychophysiological measure of self-regulation that has been studied as a moderator of risk. The primary aim of the present study was to test if RSA baseline and RSA reactivity would moderate the link between temperament and socioemotional outcomes. Mothers reported the temperament of their infants (20 months; N = 154), RSA was collected at 24- and 42-months, and mothers reported externalizing and internalizing behaviors at kindergarten entry. RSA baseline and RSA reactivity moderated the relation between exuberant temperament and externalizing behaviors. However, these results were only significant for girls, such that high RSA baseline and greater RSA suppression predicted more externalizing behaviors when exuberance was high. Fearful temperament predicted later internalizing behaviors, but no moderation was present. These results are discussed in light of recent evidence regarding gender differences in the role of RSA as a protective factor for risk.

The contributions of early adverse experiences and trajectories of respiratory sinus arrhythmia on the development of neurobehavioral disinhibition among children with prenatal substance exposure

Neurobehavioral disinhibition (ND) is a complex condition reflecting a wide range of problems involving difficulties with emotion regulation and behavior control. Respiratory sinus arrhythmia (RSA) is a physiological correlate of emotion regulation that has been studied in a variety of at-risk populations; however, there are no studies of RSA in children with ND. Data were drawn from a prospective longitudinal study of prenatal substance exposure that included 1,073 participants. Baseline RSA and RSA reactivity to an attention-demanding task were assessed at 3, 4, 5, and 6 years. ND was assessed at ages 8/9, 11, and 13/14 years via behavioral dysregulation and executive dysfunction composite measures. Greater exposure to early adversity was related to less RSA reactivity at 3 years, increases in RSA reactivity from ages 3 to 6 years, and increased behavioral dysregulation from ages 8/9 to 13/14. RSA reactivity was examined as a moderator of the association between early adversity and changes in ND. A significant Early Adversity × RSA Reactivity quadratic interaction revealed that children with decelerations in RSA reactivity exhibited increases in behavioral dysregulation, regardless of their exposure to early adversity. However, greater exposure to early adversity was related to greater increases in behavioral dysregulation, but only if children exhibited accelerations in RSA reactivity from ages 3 to 6 years. The results contribute to our understanding of how interactions across multiple levels of analysis contribute to the development of ND.

Behavior problems among cocaine exposed children: role of physiological regulation and parenting

This study examined interrelations between prenatal cocaine exposure, child autonomic regulation, parenting behavior and child sex on parent-reported behavior problems at 36 months of age. We hypothesized that respiratory sinus arrhythmia (RSA) at 13 months of age would mediate the relation between cocaine exposure and behavior problems. We also hypothesized that child sex, maternal negative affect, and maternal sensitivity observed at 13 months of age would moderate the relation between RSA and behavior problems. Results revealed that cocaine exposure predicted low baseline RSA and low RSA withdrawal during a negative affect task. Low baseline RSA, in turn, predicted fewer behavior problems offering support for an indirect association between cocaine exposure and behavior problems. The association between baseline RSA and behavior problems was further moderated by maternal negative affect such that high baseline RSA was more strongly related to behavior problems under conditions of high compared to low maternal negative affect. Results also revealed a near significant trend for baseline RSA to be more strongly related to behavior problems among boys than girls. These findings highlight several possible pathways toward behavior problems among cocaine exposed children.

Family conflict, autonomic nervous system functioning, and child adaptation: state of the science and future directions

The family is one of the primary contexts of child development. Marital and parent-child conflict (family conflict) are common and predict a wide range of negative behavioral and emotional outcomes in children. Thus, an important task for developmental researchers is to identify the processes through which family conflict contributes to children's psychological maladjustment, as well as vulnerability and protective factors in the context of family conflict. In the current paper, we aim to advance a conceptual model that focuses on indices of children's autonomic nervous system (ANS) functioning that increase vulnerability or provide protection against psychological maladjustment in the context of family conflict. In doing so, we provide a selective review that reflects the state of the science linking family conflict, children's ANS activity, and child psychological adjustment, and offer directions and guidance for future research. Our hope is to accelerate research at the intersection of family conflict and ANS functioning to advance understanding of risk and resilience among children.

Cardiac vagal control and children's adaptive functioning: a meta-analysis

Polyvagal theory has influenced research on the role of cardiac vagal control, indexed by respiratory sinus arrhythmia withdrawal (RSA-W) during challenging states, in children's self-regulation. However, it remains unclear how well RSA-W predicts adaptive functioning (AF) outcomes and whether certain caveats of measuring RSA (e.g., respiration) significantly impact these associations. A meta-analysis of 44 studies (n=4996 children) revealed small effect sizes such that greater levels of RSA-W were related to fewer externalizing, internalizing, and cognitive/academic problems. In contrast, RSA-W was differentially related to children's social problems according to sample type (community vs. clinical/at-risk). The relations between RSA-W and children's AF outcomes were stronger among studies that co-varied baseline RSA and in Caucasian children (no effect was found for respiration). Children from clinical/at-risk samples displayed lower levels of baseline RSA and RSA-W compared to children from community samples. Theoretical/practical implications for the study of cardiac vagal control are discussed.

Effects of family cohesion and heart rate reactivity on aggressive/rule-breaking behavior and prosocial behavior in adolescence: The Tracking Adolescents' Individual Lives Survey study

The biological sensitivity to context hypothesis posits that high physiological reactivity (i.e., increases in arousal from baseline) constitutes heightened sensitivity to environmental influences, for better or worse. To test this hypothesis, we examined the interactive effects of family cohesion and heart rate reactivity to a public speaking task on aggressive/rule-breaking and prosocial behavior in a large sample of adolescents (N = 679; M age = 16.14). Multivariate analyses revealed small- to medium-sized main effects of lower family cohesion and lower heart rate reactivity on higher levels of aggressive/rule-breaking and lower levels of prosocial behavior. Although there was some evidence of three-way interactions among family cohesion, heart rate reactivity, and sex in predicting these outcome variables, these interactions were not in the direction predicted by the biological sensitivity to context hypothesis. Instead, heightened reactivity appeared to operate as a protective factor against family adversity, rather than as a susceptibility factor. The results of the present study raise the possibility that stress reactivity may no longer operate as a mechanism of differential susceptibility in adolescence.

Differential susceptibility and the early development of aggression: interactive effects of respiratory sinus arrhythmia and environmental quality

The purpose of the current study was to predict the development of aggressive behavior from young children's respiratory sinus arrhythmia (RSA) and environmental quality. In a longitudinal sample of 213 children, baseline RSA, RSA suppression in response to a film of crying babies, and a composite measure of environmental quality (incorporating socioeconomic status and marital adjustment) were measured, and parent-reported aggression was assessed from 18 to 54 months of age. Predictions based on biological sensitivity-to-context/differential susceptibility and diathesis-stress models, as well as potential moderation by child sex, were examined. The interaction of baseline RSA with environmental quality predicted the development (slope) and 54-month intercept of mothers' reports of aggression. For girls only, the interaction between baseline RSA and environmental quality predicted the 18-month intercept of fathers' reports. In general, significant negative relations between RSA and aggression were found primarily at high levels of environmental quality. In addition, we found a significant Sex × RSA interaction predicting the slope and 54-month intercept of fathers' reports of aggression, such that RSA was negatively related to aggression for boys but not for girls. Contrary to predictions, no significant main effects or interactions were found for RSA suppression. The results provide mixed but not full support for differential susceptibility theory and provide little support for the diathesis-stress model.

Marital conflict, respiratory sinus arrhythmia, and allostatic load: interrelations and associations with the development of children's externalizing behavior

Allostatic load theory hypothesizes that stress and the body's responses to stressors contribute to longer term physiological changes in multiple systems over time (allostasis), and that shifts in how these systems function have implications for adjustment and health. We investigated these hypotheses with longitudinal data from two independent samples (n = 413; 219 girls, 194 boys) with repeated measures at ages 8, 9, 10, and 11. Initial parental marital conflict and its change over time indexed children's exposure to an important familial stressor, which was examined in interaction with children's respiratory sinus arrhythmia (RSA) reactivity to laboratory tasks (stress response) to predict children's basal levels of RSA over time. We also investigated children's sex as an additional possible moderator. Our second research question focused on examining whether initial levels and changes in resting RSA over time predicted children's externalizing behavior. Boys with a strong RSA suppression response to a frustrating laboratory task who experienced higher initial marital conflict or increasing marital conflict over time showed decreases in their resting RSA over time. In addition, boys' initial resting RSA (but not changes in resting RSA over time) was negatively related to change over time in externalizing symptoms. Findings for girls were more mixed. Results are discussed in the context of developmental psychobiology, allostatic load, and implications for the development of psychopathology.

Dynamic measures of RSA predict distress and regulation in toddlers

In this study, we examined a new method for quantifying individual variability using dynamic measures of respiratory sinus arrhythmia (RSA). This method incorporated temporal variation into the measurement of RSA and provided information beyond that offered by more traditional quantifications such as difference scores. Dynamic and static measures of change in RSA were tested in relation to displays of emotion and affective behaviors during a fear-eliciting episode in a sample of 88 typically developing and high-fear toddlers during a laboratory visit at age 24 months. Dynamic measures of RSA contributed information that was unique from traditionally employed, static change scores in predicting high-fear toddlers' displays of shyness during a fear-eliciting episode. In contrast, RSA change scores offered information related to boldness in nonhigh-fear children. In addition, several associations included estimates of nonlinear change in RSA. Implications for the study of individual differences in RSA and relations with emotion and emotion regulation are discussed.

Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research

It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.

Emotion-related self-regulation and its relation to children's maladjustment

The development of children's emotion-related self-regulation appears to be related to, and likely involved in, many aspects of children's development. In this review, the distinction between effortful self-regulatory processes and those that are somewhat less voluntary is discussed, and literature on the former capacities is reviewed. Emotion-related self-regulation develops rapidly in the early years of life and improves more slowly into adulthood. Individual differences in children's self-regulation are fairly stable after the first year or two of life. Such individual differences are inversely related to at least some types of externalizing problems. Findings for internalizing problems are less consistent and robust, although emotion-related self-regulation appears to be inversely related to internalizing problems after the early years. Self-regulatory capacities have been related to both genetic and environmental factors and their interaction. Some interventions designed to foster self-regulation and, hence, reduce maladjustment, have proved to be at least partially effective.

How the study of regulation can inform the study of coping

It is advantageous to study regulation and coping and their development at multiple levels of expression and origin simultaneously. We discuss several topics of current interest in the emotion-related regulation literature that are relevant to coping, including conceptual issues related to definitions and types of coping, types of physiological responses deemed to tap emotion regulation that could be pursued in work on coping, and findings on the socialization of self-regulation that have implications for understanding the development of coping.

Harsh parenting and child externalizing behavior: skin conductance level reactivity as a moderator

Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting and child externalizing behavior. Participants were 251 boys and girls (8-9 years). Mothers and fathers provided reports of harsh parenting and their children's externalizing behavior; children also provided reports of harsh parenting. SCLR was assessed in response to a socioemotional stress task and a problem-solving challenge task. Regression analyses revealed that the association between harsh parenting and externalizing behavior was stronger among children with lower SCLR, as compared to children with higher SCLR. SCLR may be a more robust moderator among boys compared to girls. Results are discussed with regard to theories on antisocial behavior and multiple-domain models of child development.

Salivary alpha-amylase as a longitudinal predictor of children's externalizing symptoms: respiratory sinus arrhythmia as a moderator of effects

Salivary alpha-amylase (sAA) was examined as a predictor of children's externalizing symptoms cross-sectionally when children were in the 3rd grade (T1; N=64) and again in the 5th grade (T2; N=54) and longitudinally over two years. Parasympathetic nervous system (PNS) activity, indexed by respiratory sinus arrhythmia (RSA), was examined as a moderator of the sAA and child externalizing link. Participants were healthy, typically developing children, 34% of whom were African American and the rest European American. At each time point, saliva samples were collected during afternoon laboratory visits and assayed for sAA. Children's RSA was measured during baseline conditions and in response to an inter-adult argument and a star-tracing task. Cross-sectional associations between sAA and externalizing symptoms at T1 and T2 were moderated by PNS functioning. Longitudinally, sAA was directly associated with changes in externalizing symptoms in a non-linear fashion. Specifically, lower externalizing symptoms were predicted for children with moderate levels of sAA, but higher externalizing was predicted for children with higher or lower levels of sAA. Findings highlight the importance of the contemporaneous assessment of SNS and PNS functioning in the prediction of child psychopathology, and the need to examine curvilinear relations between ANS functioning and behavior.

Marital conflict and children's externalizing behavior: interactions between parasympathetic and sympathetic nervous system activity

Toward greater specificity in the prediction of externalizing problems in the context of interparental conflict, interactions between children's parasympathetic and sympathetic nervous system (PNS and SNS) activity were examined as moderators. PNS activity was indexed by respiratory sinus arrhythmia (RSA) and RSA reactivity (RSA-R) to lab challenges. SNS activity was indexed by skin conductance level (SCL) and SCL reactivity (SCL-R) to lab challenges. Moderation hypotheses were examined in 3 multi-informant studies with children ranging in age between 7 and 9 in Studies 1 and 2 and between 6 and 12 in Study 3. Findings are robust across studies and provide the first reported evidence of interactions between PNS and SNS activity as moderators of the association between children's exposure to marital conflict and externalizing behaviors. More specifically, opposing action of the PNS and SNS (i.e., coactivation and coinhibition) operated as a vulnerability factor for externalizing behavior in the context of marital conflict. Conversely, coordinated action of the PNS and SNS (i.e., reciprocal PNS or SNS activation) operated as a protective factor. Results are supportive of the authors' proposed biopsychosocial framework in which individual differences in the coordination of the activity of the PNS and SNS can function as vulnerability or protective factors in the context of family risk. Findings extend current theory indicating the importance of multisystem investigations for clarifying inconsistencies and discrepancies in the literature linking environmental stress, physiological responses, and child adjustment.

Children and violence: the role of children's regulation in the marital aggression-child adjustment link

Exposure to marital psychological and physical abuse has been established as a risk factor for children's socio-emotional, behavioral, and cognitive problems. Understanding the processes by which children develop symptoms of psychopathology and deficits in cognitive functioning in the context of marital aggression is imperative for developing efficient and effective treatment programs for children and families, and has far-reaching mental health implications. The present paper outlines our research program, Child Regulation and Exposure to Marital Aggression, which focuses on children's emotional and physiological reactivity and regulation as pathways in the marital aggression-child development link. Findings from our research program, which highlight the importance of children's regulatory processes for understanding children's adjustment in contexts of intimate partner violence, are presented, and future directions in this line of inquiry are outlined.

Physiological regulation of stress in referred adolescents: the role of the parent-adolescent relationship

BACKGROUND

Psychopathology in youth appears to be linked to deficits in regulating affective responses to stressful situations. In children, high-quality parental support facilitates affect regulation. However, in adolescence, the role of parent-child interaction in the regulation of affect is unclear. This study examined physiological reactivity to and recovery from stress in adolescents at risk for psychopathology, and their associations with internalising and externalising problems and parent-adolescent interactions.

METHODS

A total of 99 adolescents (M = 13.57 years, SD = 1.83) with a history of mental health problems underwent the Alarm Stress Task and were reunited with their primary caregiver after the stressor, while the physiological responses of the parasympathetic (respiratory sinus arrhythmia) and sympathetic (pre-ejection period) systems were measured. The quality of parent-adolescent interaction was determined from observations of secure-base seeking and providing during the task. Affect regulation was measured as physiological reactivity and recovery after the stressor.

RESULTS

Adolescents with high levels of externalising problems and low levels of secure-base support showed weaker parasympathetic reactivity and recovery. Higher level of adolescent secure-base seeking was associated with stronger sympathetic reactivity and recovery.

CONCLUSIONS

Secure-base interactions between parents and adolescents facilitate physiological regulation of stress, especially for adolescents with externalising symptomatology.

Respiratory sinus arrhythmia and tympanic membrane compliance predict spontaneous eye gaze behaviors in young children: a pilot study

The Polyvagal theory proposes the Social Engagement System as a theoretical model linking social behavior with the neural regulation of the heart (via the vagus) and the striated muscles of the face and head (via special visceral efferent pathways). The current pilot study tested the feasibility of this model with typically developing 3-5-year-old children by evaluating the relation between spontaneous social engagement behavior measured by eye gaze behaviors and the visceromotor (e.g., respiratory sinus arrhythmia) and somatomotor (e.g., right tympanic membrane compliance) components of the Social Engagement System. Regression analyses supported the hypothesis that the visceromotor and somatomotor components of the Social Engagement System significantly predict social behavior (indexed by spontaneous eye gazes). Future studies assessing indices of visceral regulation and middle ear muscle function may provide insights into neural mechanisms mediating features of developmental disorders, such as autism, that have deficits in spontaneous eye gaze, auditory processing, and social behavior.