Effects of stress on memory in children and adolescents: Testing causal connections

Parents' attachment orientation, interviewers' support, and children's memory for a mildly distressing event

Parents' attachment orientations predict children's memory about distressing life events, such that parents who are less secure in close relationships tend to have children who are less accurate in their memory reports. This study examined whether socially supportive interviewing would reduce differences in children's memory performance associated with parents' attachment. Children (3 to 5 years, N = 63) and their primary caretakers took part in the Preschool Attachment Classification System (PACS), a moderately distressing event for children of preschool age that is based on the Strange Situation Procedure. Children's memory for the event was then tested shortly thereafter by either a supportive or a non-supportive interviewer. In the non-supportive condition, children whose parents scored higher on attachment avoidance provided lower proportions of correct free recall. However, the association was not significant for children in the supportive condition. In addition, higher parental attachment anxiety predicted lower proportions of correct free recall for children of highly avoidant parents, but not for children of parents lower in attachment avoidance. For direct questions, age differences in proportion correct and proportion incorrect favoured older children. Findings provide insight into interviewing techniques at time of memory retrieval that benefit children of insecure parents.

Youths' processing of emotion information: Responses to chronic and video-based laboratory stress

Integrating multiple sources of information about others' emotional states is critical to making accurate emotional inferences. There is evidence that both acute and chronic stress influence how individuals perceive emotional information. However, there is little research examining how acute and chronic stress interact to impact these processes. The current study examined whether acute and chronic stress interact to influence how children make emotional inferences. Eighty-nine youths (aged 11-15 years) underwent a novel video-based social stressor. Children completed an emotion recognition task prior to and after the stressor in which they saw integrated displays of facial expressions and contexts depicting congruent or incongruent emotional information. Eye tracking assessed changes in attention to the stimuli. Children became more likely to use and attended more to facial information than contextual information when labeling emotions following exposure to acute stress. Moreover, the effect of acute stress on use of facial information to label emotions was stronger for children who experienced higher levels of chronic stress. These data suggest that acute stress shifts attention towards facial information while suppressing processing of other sources of emotional information, and that youths with a history of chronic stress are more susceptible to these effects.

Talking about emotions: Effects of emotion-focused interviewing on children's physiological regulation of stress and discussion of the subjective elements of a stressful experience

This is the first study to examine the effect of questioning children about emotions and cognitions versus facts on children's stress reactivity and regulation, as well as children's abilities to discuss their subjective experiences, in the context of adult-child discussions about a stressful event. A total of 80 8- to 12-year-old children participated in a stressful laboratory task (i.e., Trier Social Stress Test). Following the task, half of the children were engaged in an emotion-focused conversation with an adult interviewer about the event, and half were engaged in a fact-focused conversation. Electrodermal and cardiac preejection activity and respiratory sinus arrhythmia were derived at baseline, during the laboratory stressor, and during the conversation to index stress reactivity and regulation. Children's narratives were coded for indicators of emotion processing (i.e., positive and negative emotion words, cognitive words [e.g., think, know]). Children's English language abilities, self-reported stress, and several parent-report measures (demographics, child life stress, and children's emotion regulation strategies) were also obtained. Results indicate that the emotion-focused interview facilitated children's discussions of their subjective experiences without increasing their stress reactivity and that children showed enhanced physiological stress regulation during the emotion-focused interview. This research will be of interest to those in the fields of child narratives, stress, and social context as well as to parents and practitioners interested in improving children's understanding, reporting, and recovery after stressful experiences.

Individual Differences in Children's Suggestibility: An Updated Review

The present review is intended as an overview of our current understanding of how children's individual characteristics, in terms of demographic, cognitive, and psycho-social variables, may influence their susceptibility to suggestion. The goals are to revisit conceptual models of the mechanisms of suggestibility, to provide an updated practical guide for practitioners, and to make recommendations for future research. Results suggest that children with intellectual impairment and those with nascent language skills may be particularly vulnerable to suggestion. Further, memory for separate events, theory of mind, executive function, temperament, and social competence may not be related to suggestibility, whereas additional work is needed to clarify the potential contributions of knowledge, stress, mental health, parental elaborative style, and adverse experiences/maltreatment to children's suggestibility.

Implicit Encouragement: Enhancing Youth Productivity when Recounting a Stressful Experience

In recent years, increasing efforts have been focused on testing strategies of improving victimized children's narrative productivity, given that, for many youth, finding out what has happened to them is crucial to intervening and promoting their well-being. Implicit encouragement strategies, such as back channeling by conversational partners, have shown some preliminary promise, but their precise effects on productivity and accuracy have not been adequately examined. In this study, 98 youth, ages 8-14, completed a laboratory-based stressful activity, and a week later, a surprise memory test regarding what happened in the lab activity. Interviewers varied their use of implicit encouragement. Open-ended recall questions asked youth about both factual details and detail about their feelings and thoughts during the laboratory activity. Implicit encouragement increased the amount of both types of details and had no effect on errors. In fact, few youth provided any incorrect information in their recall reports. Neither age nor stress was related to youth's productivity or accuracy, directly or in conjunction with implicit encouragement. Results highlight the value of interviewers using encouraging behaviors when questioning children and adolescents to elicit a range of information about prior stressful experiences.

Overcoming Disclosure Reluctance in Youth Victims of Sex Trafficking: New Directions for Research, Policy, and Practice

An alarming number of youth worldwide are victims of commercial sexual exploitation, particularly sex trafficking. Normative developmental processes and motivations across the adolescent period-the age when youth are at greatest risk for trafficking-combined with their history, make them highly likely to be reluctant to disclose their exploitation to police, who often encounter victims because they are suspected of delinquency and crime and who interrogate the victims as suspects. Little scientific and policy attention has been devoted to understanding how to question these victims in a way that reduces their disclosure reluctance and increases their provision of legally relevant information. In the current review, we describe research concerning trafficking victims' histories and exploitative experiences, juvenile suspects' and victims' encounters with the legal system, and best-practice forensic interviewing approaches to elicit disclosures from child victims. We highlight the implications of these areas for understanding the dynamics between how police encounter and interact with adolescent trafficking victims and whether and how the victims disclose trafficking details during these interactions. We close with an agenda for research to test interviewing methods for suspected victims of sex trafficking and with policy and practice recommendations for interviewers.

Using implicit encouragement to increase narrative productivity in children: Preliminary evidence and legal implications

Statements made by children in a range of legal settings can irrevocably impact their family structure, relationships, and living environment. Because these statements can fundamentally alter children's futures, efforts have been made to identify methods to enhance children's reports by increasing comprehensiveness, completeness, and accuracy. Interviewer support has broadly been considered a method of interest, but variations in what constitutes "support" have highlighted the need for greater specificity in documenting how different facets of supportive behaviors relate to children's reporting tendencies. In this review, we describe work focused on the effects of interviewer support, on children's memory completeness and accuracy. We then describe to a subset of interviewer behaviors that encourage elaboration in dyadic interactions: back-channeling and vocatives. We present preliminary evidence suggesting that these utterances, referred to as implicit encouragement, can increase the amount of detail provided without compromising accuracy. Implications for custody evaluations are discussed.

Effects of Interviewer Support on Children's Memory and Suggestibility: Systematic Review and Meta-Analyses of Experimental Research

The accuracy of children's reports of abuse has been hotly debated in the press, academia, and the courtroom. Yet, children's accuracy depends, in part, on the context in which children are interviewed. Guidelines often recommend creating a supportive psychosocial context to promote open, honest responding; however, there is also concern that support promotes social desirability and acquiescence to suggestion, leading children to report more of what they perceive adults want to hear than the truth. The question remains as to whether there is a sufficient body of scientific research to determine whether interviewer supportiveness improves interview outcomes while minimizing children's stress or whether it increases suggestibility and impairs accuracy. Using a systematic search strategy and meta-analyses, this study identifies and reviews findings from experimental studies of the effects of interviewer supportiveness on the accuracy of children's reports. Although the number of studies in the evidence base is small ( n = 15), the studies are of relatively good quality. Results suggest noncontingent interviewer support bolsters children's accuracy. Children are more resistant and less acquiescent to suggestive questions when interviewers are supportive as compared to nonsupportive or neutral. Effects are in the moderate range. Interviewer support is also associated with fewer errors on nonsuggestive questions. Discussion focuses on implications for practice; directions for future research; identifying vulnerable subgroups; and underlying cognitive, social, and emotional mechanisms.

Stress physiology and memory for emotional information: Moderation by individual differences in pubertal hormones

In contrast to a large body of work concerning the effects of physiological stress reactivity on children's socioemotional functioning, far less attention has been devoted to understanding the effects of such reactivity on cognitive, including mnemonic, functioning. How well children learn and remember information under stress has implications for a range of educational, clinical, and legal outcomes. We evaluated 8-14 year olds' (N = 94, 50 female) memory for negative, neutral, and positive images. Youth had seen the images a week previously as a part of a laboratory stress task. At encoding and retrieval, and in between, youth provided saliva samples that were later assayed for cortisol, salivary α amylase (sAA), testosterone, and dehydroepiandrosterone (DHEA). Overall, higher cortisol reactivity to the lab task predicted enhanced memory for emotional but not neutral images. However, cortisol further interacted with pubertal hormones (testosterone and DHEA) to predict memory. Among girls with lower pubertal hormone levels, greater cortisol reactivity was associated with enhanced memory for negative information, whereas among boys with higher pubertal hormone levels, cortisol reactivity was associated with enhanced memory for positive information. sAA, was unrelated to memory. Overall, our findings reveal that individual differences in hormone levels associated with pubertal development have implications for our understanding of how stress-responsive biological systems directly and interactively influence cognitive outcomes. (PsycINFO Database Record

How children remember the Strange Situation: The role of attachment

This study tested predictions from Bowlby's attachment theory about children's memory and suggestibility. Young children (3-5years old, N=88; 76% Caucasians) and their parents took part in the Strange Situation Procedure, a moderately distressing event and "gold standard" for assessing children's attachment quality. The children were then interviewed about what occurred during the event. Children's age and attachment security scores positively predicted correct information in free recall and accuracy in answering specific questions. For children with higher (vs. lower) attachment security scores, greater distress observed during the Strange Situation Procedure predicted increased resistance to misleading suggestions. In addition, for children who displayed relatively low distress during the Strange Situation Procedure, significant age differences in memory and suggestibility emerged as expected. However, for children who displayed greater distress during the Strange Situation Procedure, younger and older children's memory performances were equivalent. Findings suggest that attachment theory provides an important framework for understanding facets of memory development with respect to attachment-related information and that distress may alter assumed age patterns in memory development.

Memory for objects and startle responsivity in the immediate aftermath of exposure to the Trier Social Stress Test

Previously, we observed enhanced long-term memory for objects used (central objects) by committee members in the Trier Social Stress Test (TSST) on the next day. In addition, startle responsivity was increased. However, response specificity to an odour involved in the stressful episode was lacking and recognition memory for the odour was poor. In the current experiments, immediate effects of the stressor on memory and startle responsivity were investigated. We hypothesised memory for central objects of the stressful episode and startle response specificity to an odour ambient during the TSST to be enhanced shortly after it, in contrast to the control condition (friendly TSST). Further, memory for this odour was also assumed to be increased in the stress group. We tested 70 male (35) and female participants using the TSST involving objects and an ambient odour. After stress induction, a startle paradigm including olfactory and visual stimuli was conducted. Indeed, memory for central objects was significantly enhanced in immediate aftermath of the stressor. Startle responsivity increased at a trend level, particularly with regard to the odour involved in the stressful episode. Moreover, the stress group descriptively tended towards a better recognition of the odour involved. The study shows that stress enhances memory for central aspects of a stressful situation before consolidation processes come into play. In addition, results preliminarily suggest that the impact of stress on startle responsivity increases in strength but decreases in specificity during the first 24h after stress exposure.

Stress, stress-induced cortisol responses, and eyewitness identification performance

In the eyewitness identification literature, stress and arousal at the time of encoding are considered to adversely influence identification performance. This assumption is in contrast with findings from the neurobiology field of learning and memory, showing that stress and stress hormones are critically involved in forming enduring memories. This discrepancy may be related to methodological differences between the two fields of research, such as the tendency for immediate testing or the use of very short (1-2 hours) retention intervals in eyewitness research, while neurobiology studies insert at least 24 hours. Other differences refer to the extent to which stress-responsive systems (i.e., the hypothalamic-pituitary-adrenal axis) are stimulated effectively under laboratory conditions. The aim of the current study was to conduct an experiment that accounts for the contemporary state of knowledge in both fields. In all, 123 participants witnessed a live staged theft while being exposed to a laboratory stressor that reliably elicits autonomic and glucocorticoid stress responses or while performing a control task. Salivary cortisol levels were measured to control for the effectiveness of the stress induction. One week later, participants attempted to identify the thief from target-present and target-absent line-ups. According to regression and receiver operating characteristic analyses, stress did not have robust detrimental effects on identification performance. Copyright © 2016 John Wiley & Sons, Ltd. © 2016 The Authors Behavioral Sciences & the Law Published by John Wiley & Sons Ltd.

When Parents Know Little about What Happened: Parent-guided Conversations, Stress, and Young Children's Eyewitness Memory

This study examined how 4- to 7-year-olds' memories for a stressor were influenced by conversations with a parent who had little knowledge of the target event, and the stress children experienced before, during, and after the event. Children (N = 43) watched a mildly stressful video before talking about it with a parent. Parents were asked to focus on either the children's feelings or the content of the video itself. A researcher interviewed the children about their memory following the conversation. Behavioral and physiological measures of children's stress were collected at multiple stages. Children recalled more inaccurate information with the parent than with the interviewer. Younger age and parent insecure attachment were associated with poorer memory. Manipulation of parents' emotion orientation did not predict memory, but individual differences in the talk did, although in different ways from what would be expected from research on conversations about shared events. Less stress (according to self-reported happiness and observed negative affect) before and after, but not during, the stressor was linked with better memory. Implications for children's memory in legal settings are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Stress and emotional valence effects on children's versus adolescents' true and false memory

Despite considerable interest in understanding how stress influences memory accuracy and errors, particularly in children, methodological limitations have made it difficult to examine the effects of stress independent of the effects of the emotional valence of to-be-remembered information in developmental populations. In this study, we manipulated stress levels in 7-8- and 12-14-year-olds and then exposed them to negative, neutral, and positive word lists. Shortly afterward, we tested their recognition memory for the words and false memory for non-presented but related words. Adolescents in the high-stress condition were more accurate than those in the low-stress condition, while children's accuracy did not differ across stress conditions. Also, among adolescents, accuracy and errors were higher for the negative than positive words, while in children, word valence was unrelated to accuracy. Finally, increases in children's and adolescents' cortisol responses, especially in the high-stress condition, were related to greater accuracy but not false memories and only for positive emotional words. Findings suggest that stress at encoding, as well as the emotional content of to-be-remembered information, may influence memory in different ways across development, highlighting the need for greater complexity in existing models of true and false memory formation.

Experimental manipulation of the Trier Social Stress Test-Modified (TSST-M) to vary arousal across development

Reliable laboratory protocols manipulating the intensity of biobehavioral arousal for children are uncommon, and those available have minimal converging evidence of their efficacy in manipulating arousal across multiple biological systems. This report presents two studies of the efficacy of the modified Trier Social Stress Test (TSST-M). In Study 1, sixty-three 7-15-year olds, and 19 young adults (18-25 yrs) completed the TSST-M. Comparable reactivity across age groups was observed for salivary cortisol, salivary alpha-amylase (sAA), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA), whereas self-reported stress was higher in adults compared to children. In Study 2, eighty-four 7-8-year olds and eighty-six 12-15-year olds were randomly assigned to a standard or low-stress TSST-M condition. Cortisol and self-reported stress responses were higher in the standard compared to the low-stress condition. In contrast, sAA and PEP were higher in the low-stress condition and RSA responses were comparable between the two TSST-M conditions. In addition, age group differences emerged in Study 2, though never in conjunction with the TSST-M manipulation. To test, refine, and advance theory about the implications of stress for child development, laboratory tasks that manipulate and enable assessment of biobehavioral arousal in children are needed.

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.

Stress, interviewer support, and children's eyewitness identification accuracy

Few studies have investigated how stress affects eyewitness identification capabilities across development, and no studies have investigated whether retrieval context in conjunction with stress affects accuracy. In this study, one hundred fifty-nine 7- to 8- and 12- to 14-year-olds completed a high- or low-stress laboratory protocol during which they interacted with a confederate. Two weeks later, they attempted to identify the confederate in a photographic lineup. The lineup administrator behaved in either a supportive or a nonsupportive manner. Participants who experienced the high-stress event and were questioned by a supportive interviewer were most accurate in rejecting target-absent lineups. Results have implications for debates about effects of stress on eyewitness recall, how best to elicit accurate identifications in children, and developmental changes in episodic mnemonic processes.

Stress at encoding, context at retrieval, and children's narrative content

Research concerning the relations between stress and children's memory has been primarily correlational and focused on memory volume and accuracy. In the current study, we experimentally manipulated 7- and 8-year-olds' and 12- to 14-year-olds' experienced stress during a to-be-remembered event to examine the effects of stress on the content of their memory. We further manipulated the degree of interviewer support at retrieval to determine whether it moderated the effects of stress at encoding on memory. Children's age, gender, stress at encoding, and interviewer support all influenced the type of information included in their narrative reports. Most notably, across ages, children who experienced a more stressful event but were questioned in a supportive manner provided the largest ratio of terms representing internal states such as those about cognitions and emotions. Results suggest that how children process past events may be influenced by both the nature of the event itself and the context within which it is recalled.