Asthma-Related Immune Responses in Youth With Asthma: Associations With Maternal Responsiveness and Expressions of Positive and Negative Affect in Daily Life

Relationship quality and physical health: Responsiveness as an active ingredient predicting health across the lifespan

A growing body of research has established responsiveness as a robust predictor of physical health. Here, we evaluate the extent to which this work establishes partner responsiveness as an active ingredient- a specific component within the broader construct of relationship quality that accounts for a demonstrated association between relationship quality and health. We review work demonstrating that responsiveness predicts a wide range of physical health outcomes, above and beyond other facets of relationship quality, and that it moderates the effects of other protective processes and risk factors. Finally, we discuss how new methodological and interdisciplinary approaches can provide generalizable, causal, and mechanistic evidence to further validate responsiveness as an active ingredient linking relationships and health.

Sleep Efficiency and Naturalistically-Observed Social Behavior Following Marital Separation: The Critical Role of Contact with an Ex-partner

Marital disruption is associated with increased risk for a range of poor health outcomes, including disturbed sleep. This report examines trajectories of actigraphy-assessed sleep efficiency following marital separation as well as the extent to which daily social behaviors and individual differences in attachment explain variability in these trajectories over time. One hundred twenty-two recently-separated adults (N = 122) were followed longitudinally for three assessment periods over five months. To objectively assess daily social behaviors and sleep efficiency, participants wore the Electronically Activated Recorder (EAR) during the day (for one weekend at each assessment period) and an actiwatch at night (for seven days at each assessment period). Greater time spent with an ex-partner, as assessed by the EAR, was associated with decreased sleep efficiency between participants (p = .003). Higher attachment anxiety was also associated with decreased sleep efficiency (p = .03), as was the EAR-observed measure of "television on." The latter effect operated both between (p = .004) and within participants (p = .005). Finally, study timepoint moderated the association between EAR-observed measure of "television on" and sleep efficiency (p = .007). The current findings deepen our understanding of sleep disturbances following marital separation and point to contact with an ex-partner and time spent with the television on as behavioral markers of risk.

The Link Between Positive and Negative Parenting Behaviors and Child Inflammation: A Systematic Review

Children's inflammation may be an important link between parenting behaviors and health outcomes. The aims of this systematic review were to: (1) describe associations between parenting behaviors and child inflammatory markers, and (2) evaluate the relevance of existing literature to the review question. Database searches identified 19 studies that included a measure of positive or negative parenting behaviors and a marker of child inflammation, 53% of which measured parental responsiveness/warmth. Greater parental responsiveness/warmth was associated with lower levels of child pro-inflammatory markers in 60% of studies. Across studies, the association between parenting and child inflammation varied as a function of parenting construct, inflammatory measure, and sample characteristics. Studies were highly relevant, with 42% rated 5 + out of 6 for study's ability to address links between parenting behavior and child inflammation. If future research uncovers causal effects of parenting behaviors on inflammation, parenting interventions could be employed as a preventative tool.

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.

Sensing everyday activity: Parent perceptions and feasibility

Mobile and wearable sensors provide a unique opportunity to capture the daily activities and interactions that shape developmental trajectories, with potential to revolutionize the study of development (de Barbaro, 2019). However, developmental research employing sensors is still in its infancy, and parents' comfort using these devices is uncertain. This exploratory report assesses parent willingness to participate in sensor studies via a nationally representative survey (N = 210) and live recruitment of a low-income, minority population for an ongoing study (N = 359). The survey allowed us to assess how protocol design influences acceptability, including various options for devices and datastream resolution, conditions of data sharing, and feedback. By contrast, our recruitment data provided insight into parents' true willingness to participate in a sensor study, with a protocol including 72 h of continuous audio, motion, and physiological data. Our results indicate that parents are relatively conservative when considering participation in sensing studies. However, nearly 41 % of surveyed parents reported that they would be at least somewhat willing to participate in studies with audio or video recordings, 26 % were willing or extremely willing, and 14 % reported being extremely willing. These results roughly paralleled our recruitment results, where 58 % of parents indicated interest, 29 % of parents scheduled to participate, and 10 % ultimately participated. Additionally, 70 % of caregivers stated their reason for not participating in the study was due to barriers unrelated to sensing while about 25 % noted barriers due to either privacy concerns or the physical sensors themselves. Parents' willingness to collect sensitive datastreams increased if data stayed within the household for individual use only, are shared anonymously with researchers, or if parents receive feedback from devices. Overall, our findings suggest that given the correct circumstances, mobile sensors are a feasible and promising tool for characterizing children's daily interactions and their role in development.

Best practices for Electronically Activated Recorder (EAR) research: A practical guide to coding and processing EAR data

Since its introduction in 2001, the Electronically Activated Recorder (EAR) method has become an established and broadly used tool for the naturalistic observation of daily social behavior in clinical, health, personality, and social science research. Previous treatments of the method have focused primarily on its measurement approach (relative to other ecological assessment methods), research design considerations (e.g., sampling schemes, privacy considerations), and the properties of its data (i.e., reliability, validity, and added measurement value). However, the evolved procedures and practices related to arguably one of the most critical parts of EAR research-the coding process that converts the sampled raw ambient sounds into quantitative behavioral data for statistical analysis-so far have largely been communicated informally between EAR researchers. This article documents "best practices" for processing EAR data, which have been tested and refined in our research over the years. Our aim is to provide practical information on important topics such as the development of a coding system, the training and supervision of EAR coders, EAR data preparation and database optimization, the troubleshooting of common coding challenges, and coding considerations specific to diverse populations.

Contact with an Ex-partner is Associated with Psychological Distress after Marital Separation

This study examined the association between naturalistically-observed in-person contact with one's ex-partner and separation-related psychological distress (SRPD). 122 recently-separated adults were assessed using the Electronically Activated Recorder (Mehl, 2017) on three occasions across five months. The association between in-person contact with one's ex-partner, as a between-person variable, and concurrent SRPD was not reliably different from zero, nor was the time-varying effect of in-person contact. However, more frequent in-person contact with one's ex-partner predicted higher SRPD two months later, above and beyond the variance accounted for by concurrent in-person contact, demographic, relationship, and attachment factors. Follow-up analyses yielded that this effect was only present for people without children; a one standard deviation increase in in-person contact offset and slowed the predicted decline in SRPD over two months by 112%. Our discussion emphasizes new ways to think about the role of in-person contact in shaping adults' psychological adjustment to separation over time.

Optimal sampling strategies for characterizing behavior and affect from ambulatory audio recordings

Advances in mobile and wearable technologies mean it is now feasible to record hours to days of participant behavior in its naturalistic context, a great boon for psychologists interested in family processes and development. While automated activity recognition algorithms exist for a limited set of behaviors, time-consuming human annotations are still required to robustly characterize the vast majority of behavioral and affective markers of interest. This report is the first to date which systematically tests the efficacy of different sampling strategies for characterizing behavior from audio recordings to provide practical guidelines for researchers. Using continuous audio recordings of the daily lives of 11 preschool-aged children, we compared sampling techniques to determine the most accurate and efficient approach. Results suggest that sampling both low and high frequency verbal and overt behaviors is best if samples are short in duration, systematically rather than randomly selected, and sampled to cover at least 12.5% of recordings. Implications for assessment of real-world behavior are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The impact of cumulative stress on asthma outcomes among urban adolescents

INTRODUCTION

Many families living in low-income, urban areas experience a number of stressors (e.g., poverty, neighborhood stress, family functioning) that place adolescents at risk for worse asthma outcomes. Adolescents may face additional challenges (e.g., peer pressure, school stress) that add to their overall stress and influence their disease care and health outcomes. The current study examined the impact of a cumulative risk model of stressors including poverty, neighborhood stress, school stress, peer pressure, and caregiver-adolescent conflict on asthma outcomes (e.g., emergency department [ED] visits, asthma control, quality of life [QOL]) among urban adolescents (13-17 years).

METHODS

Data were collected from 61 urban families of adolescents with asthma (54.1% female; 93.4% African American) in the United States. Caregivers and adolescents completed questionnaires assessing stressors and asthma outcomes separately during a research session.

RESULTS

Cumulative risk was significantly associated with worse adolescent QOL and asthma control, and more ED visits. The cumulative risk index was also a more robust predictor of QOL and asthma control than any one individual predictor. Poverty, neighborhood stress, and school stress emerged as individual predictors of ED visits. Further, adolescents with well-controlled asthma had significantly lower neighborhood and school-related stress scores.

CONCLUSIONS

Findings suggest that beyond the risk conferred by individual risk factors, an accumulation of stress can have an especially negative impact on asthma outcomes for urban adolescents. Future intervention work aimed at improving asthma outcomes should consider incorporating strategies for minimizing overlapping sources of stress in adolescents' daily lives.

Objectively Measured Social Integration Is Associated With an Immune Risk Phenotype Following Marital Separation

Background

Close relationships play an integral role in human development, and robust evidence links marital separation and divorce to poor health outcomes. Social integration may play a key role in this association. In many ways, the study of marital separation and divorce provides an ideal model system for a more complete understanding of the association between life stress and physical health.

Purpose

The current study investigated associations among objectively measured social integration, psychological distress, and biomarkers of immune health in recently separated adults (N = 49).

Methods

We collected four measures of immune functioning-interleukin-6, C-reactive protein, and antibody titers to latent cytomegalovirus and Epstein-Barr virus-that were combined to yield a viral-Immune Risk Profile. To assess how variability in social integration is associated with immunological correlates following the end of a marriage, we incorporated observational ecological momentary assessment data using a novel methodology (the Electronically Activated Recorder).

Results

We found that objectively measured social behaviors are associated with concurrent viral-Immune Risk Profile scores over and above the effects of psychological distress and that psychological distress may be linked to biomarkers of immune health through social integration.

Conclusions

This research expands current knowledge of biomarkers of immune health after divorce and separation and includes a new methodology for objective measures of social engagement.

Toward a Mechanistic Understanding of Links Between Close Relationships and Physical Health

Although researchers have made great strides in identifying links between close relationship processes and physical health, we know less about the psychological and behavioral mechanisms underlying these links. As we move toward considering relationships as a public health issue, understanding mechanistic pathways in relationships–health links is crucial for designing efficient and effective interventions. In this review, we outline criteria for establishing a construct as a relationships–health mechanism. We then discuss how best to test potential mechanisms of relationships–health links and identify some promising mechanism candidates on the basis of initial evidence (emotion, attachment, sleep, and substance abuse). We conclude by recommending key directions for future research.

The costs of high self-control in Black and Latino youth with asthma: Divergence of mental health and inflammatory profiles

Emerging evidence in psychology suggests a paradox whereby high levels of self-control when striving for academic success among minority youth can have physical health costs. This study tested the skin-deep resilience hypothesis in asthma- whether minority youth who are striving hard to succeed academically experience good psychological outcomes but poor asthma outcomes. Youth physician-diagnosed with asthma (N = 276, M age = 12.99; 155 = White, 121 = Black/Latino) completed interviews about school stress and a self-control questionnaire. Outcomes included mental health (anxiety/depression) and ex-vivo immunologic processes relevant to asthma (lymphocyte Th-1 and Th-2 cytokine production, and sensitivity to glucocorticoid inhibition). Physician contacts were tracked over a one-year follow-up. For minority youth experiencing high levels of school stress, greater self-control was associated with fewer mental health symptoms (beta = -0.20, p < .05), but worse asthma inflammatory profiles (larger Th-1 and Th-2 cytokine responses, lower sensitivity to glucocorticoid inhibition), and more frequent physician contacts during the one-year follow-up (beta's ranging from 0.22 to 0.43, p's < .05). These patterns were not evident in White youth. In minority youth struggling with school, high levels of self-control are detrimental to asthma inflammatory profiles and clinical outcomes. This suggests the need for health monitoring to be incorporated into academic programs to ensure that 'overcoming the odds' does not lead to heightened health risks in minority youth.

Self-Disclosure and Perceived Responsiveness Among Youth With Asthma: Links to Affect and Anti-Inflammatory Gene Expression

Self-disclosure and perceived responsiveness are important building blocks of social relationships that have long-lasting consequences for health and well-being. However, the conditions under which self-disclosure and responsiveness are likely to benefit health, and how early in life these benefits arise, remain unclear. Among 141 youth (aged 10-17) with asthma, we investigated how average daily levels of self-disclosure and responsiveness are linked to positive and negative affect and the expression of the glucocorticoid receptor gene NR3C1, a marker of improved regulation of stress physiology and immune functioning. Higher levels of self-disclosure were associated with higher NR3C1 expression and positive affect only when perceptions of responsiveness were high. Furthermore, perceived responsiveness was linked to NR3C1 expression for females but not males. These results suggest that the potential benefits of self-disclosure depend on the extent to which interaction partners are perceived as responsive and that these benefits emerge prior to adulthood.

Automated Detection of Infant Holding Using Wearable Sensing: Implications for Developmental Science And Intervention

Physical contact is critical for children's physical and emotional growth and well-being. Previous studies of physical contact are limited to relatively short periods of direct observation and self-report methods. These methods limit researchers' understanding of the natural variation in physical contact across families, and its specific impacts on child development. In this study we develop a mobile sensing platform that can provide objective, unobtrusive, and continuous measurements of physical contact in naturalistic home interactions. Using commercially available motion detectors, our model reaches an accuracy of 0.870 (std: 0.059) for a second-by-second binary classification of holding. In addition, we detail five assessment scenarios applicable to the development of activity recognition models for social science research, where required accuracy may vary as a function of the intended use. Finally, we propose a grand vision for leveraging mobile sensors to access high-density markers of multiple determinants of early parent-child interactions, with implications for basic science and intervention.

Smartphones and Close Relationships: The Case for an Evolutionary Mismatch

This article introduces and outlines the case for an evolutionary mismatch between smartphones and the social behaviors that help form and maintain close social relationships. As psychological adaptations that enhance human survival and inclusive fitness, self-disclosure and responsiveness evolved in the context of small kin networks to facilitate social bonds, promote trust, and enhance cooperation. These adaptations are central to the development of attachment bonds, and attachment theory is a middle-level evolutionary theory that provides a robust account of the ways human bonding provides for reproductive and inclusive fitness. Evolutionary mismatches operate when modern contexts cue ancestral adaptations in a manner that does not provide for their adaptive benefits. We argue that smartphones and their affordances, although highly beneficial in many circumstances, cue humans’ evolved needs for self-disclosure and responsiveness across broad virtual networks and, in turn, have the potential to undermine immediate interpersonal interactions. We review emerging evidence on the topic of technoference, which is defined as the ways in which smartphone use may interfere with or intrude into everyday social interactions. The article concludes with an empirical agenda for advancing the integrative study of smartphones, intimacy processes, and close relationships.

Automated sensing of daily activity: A new lens into development

Rapidly maturing technologies for sensing and activity recognition can provide unprecedented access to the complex structure daily activity and interaction, promising new insight into the mechanisms by which experience shapes developmental outcomes. Motion data, autonomic activity, and "snippets" of audio and video recordings can be conveniently logged by wearable sensors (Lazer et al., 2009). Machine learning algorithms can process these signals into meaningful markers, from child and parent behavior to outcomes such as depression or teenage drinking. Theoretically motivated aspects of daily activity can be combined and synchronized to examine reciprocal effects between children's behaviors and their environments or internal processes. Captured over longitudinal time, such data provide a new opportunity to study the processes by which individual differences emerge and stabilize. This paper introduces the reader to developments in sensing and activity recognition with implications for developmental phenomena across the lifespan, sketching a framework for leveraging mobile sensors for transactional analyses that bridge micro- and longitudinal- timescales of development. It finishes by detailing resources and best practices to facilitate the next generation of developmentalists to contribute to this emerging area.

Early maternal sensitivity, attachment security in young adulthood, and cardiometabolic risk at midlife

Children who experience high-quality early parenting tend to have better physical health, but limited research has tested whether this association extends into adulthood using prospective, observational assessments. Likewise, mechanisms that may explain such links have not yet been illuminated. In this study, we test whether the quality of early maternal sensitivity experienced during the first 3½ years of life predicts cardiometabolic risk at midlife (ages 37 and 39 years) via attachment representations measured in young adulthood (ages 19 and 26 years). We do so by comparing the predictive significance of two different forms of attachment representations coded from the Adult Attachment Interview (AAI): (a) secure base script knowledge and (b) coherence of mind. Using data from the Minnesota Longitudinal Study of Risk and Adaptation, we find that early maternal sensitivity is negatively associated with cardiometabolic risk at midlife. Secure base script knowledge (but not coherence of mind) partially mediated this link. These findings are consistent with the possibility that early parenting has lasting significance for physical health in part by promoting higher levels of secure base script knowledge.

Secure Base Representations in Children With Asthma: Links With Symptoms, Family Asthma Management, and Cytokine Regulation

Children's perceptions of caregivers as a secure base have been linked with socioemotional outcomes, but little is known about connections to physical health. We examined whether secure base representations are associated with children's symptoms, family management strategies, and inflammatory processes in children with asthma. Participants included 308 children (ages 8-17) and one parent. Children completed a blood draw to measure asthma-related immune functions and reported on perceptions of their mothers as a secure base and their asthma symptoms. Dyads completed interviews about asthma management. Analyses revealed that children's secure base perceptions were associated with better family asthma management and lower Type 2 T-helper cell cytokine production. These findings suggest that secure base representations may be protective for children with asthma.

Socioeconomic status, family negative emotional climate, and anti-inflammatory gene expression among youth with asthma

The glucocorticoid receptor gene NR3C1 is an important down-regulator of inflammation and is typically under-expressed in individuals with low socioeconomic status (SES). Negative emotionality has been suggested as a potential mediator of SES disparities in health outcomes. In this study, we expand this literature by naturalistically assessing negative emotionality in a key emotional environment: the family. In a sample of 104 youth with asthma (10-17 years) and their primary caregiver, we assessed SES via caregiver report, emotional expression by youth and parents in the home over four days using the electronically activated recorder (EAR), and NR3C1 expression via blood collected from youth. Although there was not a direct effect of SES on NR3C1 expression, bootstrapping mediation analyses showed a significant indirect path such that lower SES was associated with a more negative family emotional climate, which in turn predicted reduced NR3C1 expression. No mediation effects were found for family positive emotional climate. This research demonstrates the importance of examining the effects of SES on emotion expression in the family context and suggests a critical biopsychosocial pathway underlying SES-based health disparities that may extend beyond youth.

Youth secrets are associated with poorer sleep and asthma symptoms via negative affect

OBJECTIVE

Among older children and adolescents, keeping secrets from parents is consistently associated with lower levels of psychological well-being. Further, concealing one's thoughts and emotions has been associated with poor physical health outcomes in adults. However, it remains an open question whether secret-keeping is associated with poorer health and health-related behaviors (such as sleep) among youth and, if those hypothesized links exist, what the psychological mechanisms might be. We investigated the associations among youth secrecy towards parents, daily asthma symptoms and daily sleep behaviors in a sample of low-income youth with asthma aged 10-17 and tested negative affect as a possible mediator of these associations.

METHODS

One hundred and seventy two youths reported the extent to which they kept secrets towards parents over a period of four days. Asthma symptoms, nighttime awakenings, sleep onset latency, and subjective sleep quality were assessed with daily diaries completed by youths.

RESULTS

More frequent secret-keeping was associated with more severe asthma symptoms, lower ratings of sleep quality and greater number of nighttime awakenings. Secrecy was also associated with increased negative affect, which accounted for the associations between secrecy and number of awakenings and daytime asthma symptoms. These findings remained significant after controlling for youth age and other relevant demographic factors.

CONCLUSIONS

Our findings suggest that secrecy towards parents can have consequential health outcomes for youth with asthma and point to the importance of investigating affective processes as mediators of the influence of secret-keeping on youth health.

The Electronically Activated Recorder (EAR): A Method for the Naturalistic Observation of Daily Social Behavior

This article reviews the Electronically Activated Recorder or EAR as an ambulatory ecological momentary assessment tool for the real-world observation of daily behavior. Technically, the EAR is an audio recorder that intermittently records snippets of ambient sounds while participants go about their lives. Conceptually, it is a naturalistic observation method that yields an acoustic log of a person's day as it unfolds. The power of the EAR lies in unobtrusively collecting authentic real-life observational data. In preserving a high degree of naturalism at the level of the raw recordings, it resembles ethnographic methods; through its sampling and coding, it enables larger empirical studies. The article provides an overview of the EAR method, reviews its validity, utility, and limitations, and discusses it in the context of current developments in ambulatory assessment, specifically the emerging field of mobile sensing.

Youth reports of parents' romantic relationship quality: Links to physical health

OBJECTIVE

Prior work has shown that negative aspects (e.g., conflict) of marriage or marriage-like relationships are associated with poor health of offspring, but much less is known about the effects of positive aspects (e.g., affection) of parental romantic relationships. This study investigated links between conflict and affection within parents' romantic relationships and the health of youth with asthma.

METHOD

Eighty youths with asthma aged 10-17 answered daily questions over a 4-day period about conflict and affection within their parents' romantic relationship, as well as their own daily mood, asthma symptoms, and expiratory peak flow.

RESULTS

Multiple regression analyses revealed that romantic affection-but not conflict-was directly associated with higher expiratory peak flow. Further, there was a significant indirect effect of romantic affection via youth positive affect on lower asthma symptoms.

CONCLUSION

These results are the first to our knowledge to demonstrate that youth-reported positive characteristics of parents' romantic relationships are associated with better health among youth with asthma. (PsycINFO Database Record

Neighborhood Stress, Depressive Symptoms, and Asthma Morbidity in Youth

OBJECTIVE

Living in a dangerous and disadvantaged neighborhood is consistently linked with poor health outcomes; however, few studies have investigated psychosocial mechanisms of this relationship. We hypothesized that a specific facet of depression-anhedonia-would partially explain the relationship between stressful neighborhoods and poor health in youth with asthma.

METHOD

156 youths provided reports on their depressive symptoms, daily asthma symptoms, and peak expiratory flow rate (PEFR). Caregivers provided reports on neighborhood characteristics.

RESULTS

Youth residing in more at-risk neighborhoods experienced more symptoms of depression, greater asthma symptoms (both during the day and night), and marginally lower PEFR. Indirect effect analyses revealed that the relationship between neighborhood stress and youth asthma symptoms was partially explained by a key symptom of depression, anhedonia.

CONCLUSIONS

These findings suggest that the neighborhood-health link is partially explained by symptoms of depression tapping into difficulties experiencing pleasure and motivation.