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Brown MA, Gao MM, Isenhour J, Shakiba N, Crowell SE, Raby KL, Conradt E. Understanding emotion dysregulation from infancy to toddlerhood with a multilevel perspective: The buffering effect of maternal sensitivity. Dev Psychopathol 2024:1-14. [PMID: 38682545 DOI: 10.1017/s0954579424000774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Challenges with childhood emotion regulation may have origins in infancy and forecast later social and cognitive developmental delays, academic difficulties, and psychopathology. This study tested whether markers of emotion dysregulation in infancy predict emotion dysregulation in toddlerhood, and whether those associations depended on maternal sensitivity. When children (N = 111) were 7 months, baseline respiratory sinus arrhythmia (RSA), RSA withdrawal, and distress were collected during the Still Face Paradigm (SFP). Mothers' reports of infant regulation and orientation and maternal sensitivity were also collected at that time. Mothers' reports of toddlers' dysregulation were collected at 18 months. A set of hierarchical regressions indicated that low baseline RSA and less change in RSA from baseline to stressor predicted greater dysregulation at 18 months, but only for infants who experienced low maternal sensitivity. Baseline RSA and RSA withdrawal were not significantly associated with later dysregulation for infants with highly sensitive mothers. Infants who exhibited low distress during the SFP and who had lower regulatory and orienting abilities at 7 months had higher dysregulation at 18 months regardless of maternal sensitivity. Altogether, these results suggest that risk for dysregulation in toddlerhood has biobehavioral origins in infancy but may be buffered by sensitive caregiving.
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Affiliation(s)
| | - Mengyu Miranda Gao
- Department of Psychology, Beijing Normal University School of Psychology, Beijing, China
| | - Jennifer Isenhour
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Nila Shakiba
- Department of Psychology, Boston University, Boston, MA, USA
| | | | - K Lee Raby
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Kiel N, Samdan G, Wienke AS, Reinelt T, Pauen S, Mathes B, Herzmann C. From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months. Infant Ment Health J 2024; 45:135-152. [PMID: 38175546 DOI: 10.1002/imhj.22098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.
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Affiliation(s)
- Natalie Kiel
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Gizem Samdan
- Human and Health Sciences, University of Bremen, Bremen, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Annika S Wienke
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Tilman Reinelt
- Department of Neonatology, University of Zurich, University Hospital Zurich, Zurich, Switzerland
- Leibniz Institute for Research and Information in Education, Frankfurt am Main, Germany
- Center for Individual Development and Adaptive Education of Children at Risk, Frankfurt am Main, Germany
| | - Sabina Pauen
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Birgit Mathes
- Human and Health Sciences, University of Bremen, Bremen, Germany
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3
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Markowitz ES, Maier MC, Ludwig RJ, Austin J, Maybach AM, Jaffe ME, Welch MG. Qualitative insights from a randomized clinical trial of a mother-child emotional preparation program for preschool-aged children. BMC Psychol 2023; 11:257. [PMID: 37653536 PMCID: PMC10472558 DOI: 10.1186/s40359-023-01288-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Early life stress and adversity conveys risk for emotional, behavioral, and developmental disorders. To address this risk in the preschool population, Mother-Child Emotional Preparation (MCEP) was tested as an in-school dyadic intervention for facilitating mother-child emotional connection through mother-child calming cycles. In a computer-generated block randomized controlled trial enrolling preschool-aged children and their mothers, in partnership with an early childhood learning center, we at Columbia University Irving Medical Center tested effects of MCEP across multiple domains. Within this RCT we designed a qualitative sub-study to understand how MCEP aligns with calming cycle theory and its impact on mothers and the mother-child relationship. METHODS A qualitative researcher observed 14 group MCEP sessions consisting of nurture specialists facilitating reciprocal calming interactions through shared emotional expression between mothers and their preschool-aged children. We conducted two waves of participant interviews in English or Spanish, per participant preference. Participants (n = 8) were majority Hispanic at or below the federal poverty level. Group session observations were coded and analyzed for frequency, co-occurrence, variance by session, and alignment with calming cycle theory, incorporating demographic variables and attendance. Interview transcripts were translated from Spanish to English if needed, then coded and analyzed using thematic analysis. RESULTS Qualitative analysis revealed mothers' experiences of MCEP. Data demonstrated that calming position and emotional expression were mutually supportive, and that barriers to connection were calming cycle entry-points, not barriers. At the group level, supported by nurture specialists, fellow participants helped each other progress through calming cycles. Moreover, MCEP adapted to meet individual dyad needs, and mothers described its far-reaching impact. CONCLUSIONS Qualitative methods show that MCEP helps mother-child dyads emotionally connect through the calming cycle and fills a gap in early childhood education services. This study generated insights for quantitative studies and suggested implications for MCEP dissemination. TRIAL REGISTRATION ClinicalTrials.gov, NCT03908268 , Registered April 9, 2019-Retrospectively registered.
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Affiliation(s)
- Elizabeth S Markowitz
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
| | - Malia C Maier
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Robert J Ludwig
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Judy Austin
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Anna M Maybach
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Marc E Jaffe
- Children's Learning Centers of Fairfield County, Stamford, CT, USA
| | - Martha G Welch
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
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Séassau A, Munos P, Gire C, Tosello B, Carchon I. Neonatal Care Unit Interventions on Preterm Development. CHILDREN (BASEL, SWITZERLAND) 2023; 10:999. [PMID: 37371231 DOI: 10.3390/children10060999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent and detect complications in order to support the development of preterm infants. This article aims to distinguish sensory intervention programs according to the gradient of the type of solicitations, uni- or multi-modal, and according to the function of the person who performs these interventions. Uni-sensorial interventions are essentially based on proprioceptive, gustatory, or odorant solicitations. They allow, in particular, a reduction of apneas that support the vegetative states of the preterm infant. On the other hand, the benefits of multi-sensory interventions seem to have a longer-term impact. Most of them allow the support of the transition from passive to active feeding, an increase in weight, and the improvement of sleep-wake cycles. These solicitations are often practiced by caregivers, but the intervention of parents appears optimal since they are the main co-regulators of their preterm child's needs. Thus, it is necessary to co-construct and train the parents in this neonatal care.
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Affiliation(s)
- Alexia Séassau
- Centre Hospitalier du Pays d'Aix, 13100 Aix-en-Provence, France
| | | | - Catherine Gire
- Department of Neonatology, Hôpital Nord de Marseille, 13015 Marseille, France
| | - Barthélémy Tosello
- Department of Neonatology, Hôpital Nord de Marseille, 13015 Marseille, France
| | - Isabelle Carchon
- CHART Human and Artificial Cognition Laboratory at Ephe, École Pratique des Hautes Études-PSL Paris-Sciences-Lettres, 93322 Aubervilliers, France
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Aftyka A, Rybojad B, Mędrzycka-Dąbrowska W. Neonatal Pictures in a NICU as a Mode of Nursing Intervention to Enhance Parent-Infant Bonding: Parents' Experience during the COVID Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3576. [PMID: 36834269 PMCID: PMC9958686 DOI: 10.3390/ijerph20043576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Neonatal departments around the world have changed their policies to prevent the spread of infection during the COVID-19 pandemic. The birth of an extremely premature baby can disrupt physical contact between the mother/parent and the baby. This situation affects the bonding process between mother and child. The aim of the study was to investigate the opinions of parents who receive photographs or videos of their children electronically on the usefulness of this intervention, as well as the emotional reaction of parents to the photos or videos received, and potential ways to improve the intervention. METHODS The study used a qualitative approach and relied on phenomenology, which is a research method used to study experience as experienced from the subjective point of view. Pilot interviews were conducted in January and February 2021, and the final study ran from March to June 2021. RESULTS The uploaded photographs and videos provided a useful communication tool. The parents' emotions at the proposal to send photographs of the child and while viewing the first photographs were strong and marked by considerable ambivalence. CONCLUSIONS This study showed how important it is to ensure communication between the parent and the medical staff. Despite the positive reception, in the future obtaining consent from the legal guardian for taking pictures should be considered, whether this form will be accepted, and to ensure the presence of medical staff while the parent is watching the photographs/videos, as this method of communication will not fully ensure direct skin-to-skin contact to build bonds between the parent and the infant. Neonatal intensive care units need to find strategies to mitigate the impact of separation on parental experiences and bonds should a similar situation arise in the future.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Medical University of Lublin, 20-081 Lublin, Poland
| | - Beata Rybojad
- Clinic of Anaesthesiology and Paediatric Intensive Care, Medical University of Lublin, Gebali Str. 6, 20-093 Lublin, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University in Gdansk, 80-211 Gdansk, Poland
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Kobus S, Diezel M, Dewan MV, Huening B, Dathe AK, Marschik PB, Felderhoff-Mueser U, Bruns N. Music Therapy in Preterm Infants Reduces Maternal Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:731. [PMID: 36613052 PMCID: PMC9819311 DOI: 10.3390/ijerph20010731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Preterm delivery is a stressful event for mothers, posing them at risk for post-traumatic stress reactions. This study examined the degree of depressive symptoms and post-traumatic stress in mothers of preterm infants born before 32 gestational weeks depending on whether the infant received music therapy in the neonatal intensive care unit (NICU) or not. We included 33 mothers of preterm infants enrolled in a previously described prospective randomized controlled trial, of whom 18 received music therapy (mean mothers' age 34.1 ± 4.6 years) and 15 did not (mean mothers' age 29.6 ± 4.2). The degree of depressive symptoms, anxiety and acute stress reactions of these mothers were measured by using the German version of the Center for Epidemiologic Studies Depression Scale (CES-D) and Impact of Events Scale-Revised (IES-R) one week after birth (T1) and at infants' hospital discharge (T2). 605 music therapy sessions with a mean duration of 24.2 ± 8.6 min (range 10 to 50 min) were conducted two times a week from the second week of life (T1) until discharge (T2) to the infants from the intervention group. The infants from the control group received standard medical care without music therapy. The mean total CES-D score decreased from T1 (mean 34.7, 95% Confidence Interval (CI) 31.1-38.1) until T2 in all mothers (mean 16.3, 95% CI 12.6-20.1). Mothers whose infants received music therapy showed stronger declines of depressive and stress symptoms (with music therapy: CES-D mean difference of total score 25.7, 95% CI 20.0-31.3, IES-R mean difference of total score 1.7, 95% CI 0.9-2.5, IES-R mean difference of subcategory hyperarousal 10.2, 95% CI 6.2-14.3; without music therapy: CES-D mean difference of total score 9.5, 95% CI 3.8-15.3, IES-R mean difference of total score 0.1, 95% CI -1.0-1.2, IES-R mean difference of subcategory hyperarousal 1.6, 95% CI -4.7-7.9). Effect sizes were strong for CES-D, IES-R, and the hyperarousal subcategory, moderate for intrusion, and low for avoidance. These findings show that mothers of preterm infants are highly susceptible to supportive non-medical interventions such as music therapy to reduce psychological symptoms and distress during their infants' NICU stay.
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Affiliation(s)
- Susann Kobus
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
- Center of Artistic Therapy, University Medicine Essen, 45147 Essen, Germany
| | - Marlis Diezel
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
| | - Monia Vanessa Dewan
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
| | - Britta Huening
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
| | - Anne-Kathrin Dathe
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
- Department of Health and Nursing, Occupational Therapy, Ernst-Abbe-University of Applied Sciences Jena, 07745 Jena, Germany
| | - Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz ScienceCampus Primate Cognition, 37075 Göttingen, Germany
- iDN—Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 11330 Stockholm, Sweden
| | - Ursula Felderhoff-Mueser
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
| | - Nora Bruns
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of Medicine, University Duisburg-Essen, 45147 Essen, Germany
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Carter CS. Sex, love and oxytocin: Two metaphors and a molecule. Neurosci Biobehav Rev 2022; 143:104948. [PMID: 36347382 PMCID: PMC9759207 DOI: 10.1016/j.neubiorev.2022.104948] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
Dozens of studies, most conducted in the last four decades, have implicated oxytocin, as well as vasopressin and their receptors, in processes that mediate selective sociality and the consequences of early experience. Oxytocin is critical for the capacity to experience emotional safety and healthy sexuality. Oxytocin also plays a central role in almost every aspect of physical and mental health, including the coordination of sociality and loving relationships with physiological reactions to challenges across the lifespan. Species, including prairie voles, that share with humans the capacity for selective social bonds have been a particularly rich source of insights into the behavioral importance of peptides. The purpose of this historical review is to describe the discovery of a central role for oxytocin in behavioral interactions associated with love, and in the capacity to use sociality to anticipate and cope with challenges across the lifespan - a process that here is called "sociostasis."
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Affiliation(s)
- C Sue Carter
- Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA; Kinsey Institute, Indiana University, Bloomington, IN 47405, USA.
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8
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Welch MG, Grieve PG, Stark RI, Isler JR, Ludwig RJ, Hane AA, Gong A, Darilek U, Austin J, Myers MM. Family Nurture Intervention increases term age forebrain EEG activity: a multicenter replication trial. Clin Neurophysiol 2022; 138:52-60. [DOI: 10.1016/j.clinph.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/26/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
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Carter CS. Oxytocin and love: Myths, metaphors and mysteries. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 9:100107. [PMID: 35755926 PMCID: PMC9216351 DOI: 10.1016/j.cpnec.2021.100107] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
Oxytocin is a peptide molecule with a multitude of physiological and behavioral functions. Based on its association with reproduction - including social bonding, sexual behavior, birth and maternal behavior - oxytocin also has been called “the love hormone.” This essay specifically examines association and parallels between oxytocin and love. However, many myths and gaps in knowledge remain concerning both. A few of these are described here and we hypothesize that the potential benefits of both love and oxytocin may be better understood in light of interactions with more ancient systems, including specifically vasopressin and the immune system. Oxytocin is anti-inflammatory and is associated with recently evolved, social solutions to a variety of challenges necessary for mammalian survival and reproduction. The shared functions of oxytocin and love have profound implications for health and longevity, including the prevention and treatment of excess inflammation and related disorders, especially those occurring in early life and during periods of chronic threat or disease. Oxytocin is a peptide molecule with functions that support a sense of safety, sociality, as well as survival and reproduction. Oxytocin is associated with social and neuroimmune solutions to chronic stress. The related, but more primitive, peptide vasopressin supports more individualistic survival strategies. Controversies and myths surround the properties of oxytocin and love.
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10
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Kolacz J, daSilva EB, Lewis GF, Bertenthal BI, Porges SW. Associations between acoustic features of maternal speech and infants' emotion regulation following a social stressor. INFANCY 2021; 27:135-158. [PMID: 34618391 DOI: 10.1111/infa.12440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 09/02/2021] [Accepted: 09/20/2021] [Indexed: 01/17/2023]
Abstract
Caregiver voices may provide cues to mobilize or calm infants. This study examined whether maternal prosody predicted changes in infants' biobehavioral state after the still face, a stressor in which the mother withdraws and reinstates social engagement. Ninety-four dyads participated in the study (infant age 4-8 months). Infants' heart rate and respiratory sinus arrhythmia (measuring cardiac vagal tone) were derived from an electrocardiogram (ECG). Infants' behavioral distress was measured by negative vocalizations, facial expressions, and gaze aversion. Mothers' vocalizations were measured via a composite of spectral analysis and spectro-temporal modulation using a two-dimensional fast Fourier transformation of the audio spectrogram. High values on the maternal prosody composite were associated with decreases in infants' heart rate (β = -.26, 95% CI: [-0.46, -0.05]) and behavioral distress (β = -.23, 95% CI: [-0.42, -0.03]), and increases in cardiac vagal tone in infants whose vagal tone was low during the stressor (1 SD below mean β = .39, 95% CI: [0.06, 0.73]). High infant heart rate predicted increases in the maternal prosody composite (β = .18, 95% CI: [0.03, 0.33]). These results suggest specific vocal acoustic features of speech that are relevant for regulating infants' biobehavioral state and demonstrate mother-infant bi-directional dynamics.
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Affiliation(s)
- Jacek Kolacz
- Traumatic Stress Research Consortium, Kinsey Institute, Indiana University, Bloomington, Indiana, USA
| | | | - Gregory F Lewis
- Traumatic Stress Research Consortium, Kinsey Institute, Indiana University, Bloomington, Indiana, USA.,Intelligent Systems Engineering, Indiana University, Bloomington, Indiana, USA
| | - Bennett I Bertenthal
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Stephen W Porges
- Traumatic Stress Research Consortium, Kinsey Institute, Indiana University, Bloomington, Indiana, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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11
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O'Banion DD, Hane AA, Litsas D, Austin J, Welch MG. The Welch Emotional Connection Screen: Adapting observational methods to pediatric primary care via resident training. Infant Behav Dev 2021; 65:101629. [PMID: 34425493 DOI: 10.1016/j.infbeh.2021.101629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
The Welch Emotional Connection Screen (WECS) is a novel instrument that is a brief, practicable, evidenced-based observational screening tool for assessing relationship health between parent and child. The WECS requires observing 2-3 min of face-to-face interactions between parent and child, without toys, prompts, paradigms or technology. Here, we describe a translational project from the coding lab to the primary care provider via a residency training program conducted with 50 residents during a 30-day developmental and behavioral pediatrics medical resident education rotation. The aims of this study were to evaluate the efficacy of WECS pediatric resident training: 1) to improve residents' accuracy in recognizing the dyadic behaviors of emotional connection (EC) via WECS training; and 2) to improve residents' attitudes, self-efficacy, and perceived professional norms (ASPPN) pertaining to Early Relational Health in Pediatrics. Results indicate that using a rapid prototyping approach to training, residents improved in their identification of dyads showing low to midrange levels of emotional connection. As well, resident attitudes about the importance of relationship health in pediatrics and their self-efficacy in identifying emotional connection improved significantly after this brief resident training.
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Affiliation(s)
- D David O'Banion
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Amie A Hane
- Department of Psychology, Williams College, Williams, MA, USA; Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Diana Litsas
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Judith Austin
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Martha G Welch
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA; Department of Anatomy and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
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12
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Grumi S, Cappagli G, Aprile G, Mascherpa E, Gori M, Provenzi L, Signorini S. Togetherness, beyond the eyes: A systematic review on the interaction between visually impaired children and their parents. Infant Behav Dev 2021; 64:101590. [PMID: 34062369 DOI: 10.1016/j.infbeh.2021.101590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Parent-child interaction is essential to promote adaptive emotional, cognitive, and social development. The majority of previous research on parent-child interaction is largely dependent on face-to-face exchanges that require the interactive partners to visually recognize reciprocal communicative bids. Therefore, previous findings in the field can only partially apply to the early interactive patterns occurring between visually impaired infants and their parents. The present study was aimed to systematically review the available evidence on parent-child interaction in the context of developmental visual impairment. METHODS Fourteen papers were finally selected after literature search on PubMed and Scopus. Data synthesis was focused on three core topics: visually impaired children's contribution to the interaction, parental caregiving behaviors with visually impaired children, and the association between parents' behaviors and the developmental outcomes of children with visual impairment. RESULTS Visually impaired children may exhibit reduced reactivity to maternal stimuli and less-than-optimal levels of interactive initiations in social exchanges. Parents of children with visual impairment may use more descriptive communicative acts and greater directiveness compared to mothers of sighted counterparts. Specific caregiving behaviors (e.g., responsiveness and goal setting) of parents of children with visual impairment may significantly support language and socio-emotional development as well as sensorimotor integration. DISCUSSION Children with visual impairment may be less responsive and they may produce less clear communicative bids while interacting with their parents. Their parents may face specific challenges while engaging with them and they may become increasingly directive and intrusive. Nonetheless, even in the presence of visual impairment, the quality of parental caregiving behaviors appears to play a potential preventive role in the face of children's socio-emotional and cognitive outcomes. These results suggest that early interventions focused on parent-child interactions are especially needed in this population.
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Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giulia Cappagli
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy; Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Giorgia Aprile
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
| | - Eleonora Mascherpa
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
| | - Monica Gori
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
| | - Sabrina Signorini
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
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13
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Norholt H. Delivering Clinically on Our Knowledge of Oxytocin and Sensory Stimulation: The Potential of Infant Carrying in Primary Prevention. Front Psychol 2021; 11:590051. [PMID: 33995157 PMCID: PMC8116555 DOI: 10.3389/fpsyg.2020.590051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/16/2020] [Indexed: 11/18/2022] Open
Abstract
Oxytocin (OT) is one of the most intensively researched neuropeptides during the three past decades. In benign social contexts, OT exerts a range of desirable socioemotional, stress-reducing, and immunoregulatory effects in mammals and humans and influences mammalian parenting. Consequentially, research in potential pharmacological applications of OT toward human social deficits/disorders and physical illness has increased substantially. Regrettably, the results from the administration of exogenous OT are still relatively inconclusive. Research in rodent maternal developmental programming has demonstrated the susceptibility of offspring endogenous OT systems to maternal somatosensory stimulation, with consequences for behavioral, epigenetic, cognitive, and neurological outcomes. A translation of this animal research into practically feasible human parenting recommendations has yet to happen, despite the significant prevention potential implied by the maternal developmental programming research. Extended physical contact with full-term healthy infants in the months following birth (infant carrying) might constitute the human equivalent of those specific rodent maternal behaviors, found to positively influence emerging OT systems. Findings from both OT and maternal programming research parallel those found for infants exposed to such extended parental physical contact, whether through skin-to-skin contact or infant carrying. Clinical support of parents to engage in extended physical contact represents a feasible intervention to create optimum conditions for the development of infant OT systems, with potential beneficial long-term health effects.
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Affiliation(s)
- Henrik Norholt
- SomAffect - The Somatosensory & Affective Neuroscience Group, Liverpool, United Kingdom
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14
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Grumi S, Saracino A, Volling BL, Provenzi L. A systematic review of human paternal oxytocin: Insights into the methodology and what we know so far. Dev Psychobiol 2021; 63:1330-1344. [PMID: 33694219 DOI: 10.1002/dev.22116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/04/2021] [Accepted: 02/20/2020] [Indexed: 02/03/2023]
Abstract
With the consolidation of fathers' engagement in caregiving, understanding the neuroendocrine and hormonal mechanisms underlying fatherhood becomes a relevant topic. Oxytocin (OT) has been linked with maternal bonding and caregiving, but less is known about the role of OT in human fatherhood and paternal caregiving. A systematic review of methods and findings of previous OT research in human fathers was carried. The literature search on PubMed and Scopus yielded 133 records. Twenty-four studies were included and analyzed. Significant variability emerged in OT methodology, including laboratory tasks, assessment methods, and outcome measures. Fathers' OT levels appear to increase after childbirth. OT was significantly correlated with less hostility and with the quality of paternal physical stimulation in play interactions, but not with paternal sensitivity. Fathers' and children's OT levels were significantly correlated in a limited subset of studies, intriguingly suggesting that cross-generational OT regulation may occur during the early years of life. This study highlights relevant issues and limitations of peripheral OT assessment in human subjects, especially in fathers. Although the study of paternal neuroendocrinology appears promising, coping with these issues requires dedicated efforts and methodological suggestions are provided to guide future advances in this field.
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Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Annalisa Saracino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Brenda L Volling
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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15
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Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, Youngstrom EA, Stefana A. The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Front Psychol 2021; 12:630594. [PMID: 33716895 PMCID: PMC7943863 DOI: 10.3389/fpsyg.2021.630594] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Biban
- Department of Neonatal and Pediatric Critical Care, Verona University Hospital, Verona, Italy
| | - Jessica Janos
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Joshua Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angelina Tsai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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16
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Ludwig RJ, Welch MG. How babies learn: The autonomic socioemotional reflex. Early Hum Dev 2020; 151:105183. [PMID: 32971304 DOI: 10.1016/j.earlhumdev.2020.105183] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Human and animal research has long documented the negative effects of early traumatic events on long-term development and socioemotional behavior. Yet, how and where the body stores these memories remains unclear. Current theories propose that the brain stores such memory in the subcortical limbic system. However, a clear theory of change with testable hypothesis has yet to emerge. AIMS In this paper, we review the classical Pavlovian conditioning learning tradition, along with its functional variant. Then, we review calming cycle theory, which builds upon the idea that mother/infant learning is distinct from other types of learning, requiring a new set of assumptions in light of functional Pavlovian conditioning. CONCLUSION Calming cycle theory states that learning of behaviors associated with subcortical autonomic physiology is separate and distinct from learning of behaviors associated with cortical physiology. Mother/infant autonomic learning starts in the uterine environment via functional Pavlovian co-conditioning that is stored as conditional reflexes within the dyad's autonomic nervous systems. These reflexes are preserved transnatally as autonomic socioemotional reflexes (ASRs), which can be used to monitor mother-infant relational health. The functional Pavlovian co-conditioning mechanism can be exploited to change the physiological/behavioral reflex response. The theory provides a well established learning mechanism, a theory of change and a method of change, along with a set of hypotheses with which to test the theory. We present evidence from a randomized controlled trial with prematurely born infants and their mothers that supports calming cycle theory.
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Affiliation(s)
- Robert J Ludwig
- Department of Pediatrics, Columbia University Medical Center, 630 W. 168th St, New York, NY 10032, United States of America
| | - Martha G Welch
- Department of Pediatrics, Columbia University Medical Center, 630 W. 168th St, New York, NY 10032, United States of America; Department of Psychiatry, Columbia University Medical Center, 630 W. 168th St, New York, NY 10032, United States of America; Department of Pathology & Cell Biology, Columbia University Medical Center, 630 W. 168th St, New York, NY 10032, United States of America.
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17
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Family nurture intervention in the NICU increases autonomic regulation in mothers and children at 4-5 years of age: Follow-up results from a randomized controlled trial. PLoS One 2020; 15:e0236930. [PMID: 32750063 PMCID: PMC7402490 DOI: 10.1371/journal.pone.0236930] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background Maturation of multiple neurobehavioral systems, including autonomic regulation, is altered by preterm birth. The purpose of this study was to determine the long-term effects of Family Nurture Intervention (FNI) in the NICU on autonomic regulation of preterm infants and their mothers. Method A subset of infants and mothers (48% of infants, 51% of mothers) randomly assigned to either standard are (SC), or SC plus the FNI in the NICU in a prior RCT (ClincalTrials.gov; NCT01439269) returned for follow-up assessments when the children were 4 to 5 years corrected age (CA). ECGs were collected for 10 minutes in mothers and their children while children were in their mothers’ laps. Heart rate, standard deviation for heart rate, respiratory sinus arrhythmia (RSA)–an index of parasympathetic regulation, and a measure of vagal efficiency were quantified. Results Both children and mothers in the FNI group had significantly greater levels of RSA compared to the SC group (child: mean difference = 0.60, 95% CI 0.17 to 1.03, p = 0.008; mother: mean difference = 0.64, 95% CI 0.07 to 1.21, p = 0.031). In addition, RSA increased more rapidly in FNI children between infancy and the 4 to 5-year follow-up time point (SC = +3.11±0.16 loge msec2, +3.67±0.19 loge msec2 for FNI, p<0.05). These results show that the rate of increase in RSA from infancy to childhood is more rapid in FNI subjects. Conclusion Although these preliminary follow-up results are based on approximately half of subjects originally enrolled in the RCT, they suggest that FNI-NICU led to healthier autonomic regulation in both mother and child, when measured during a brief face-to-face socioemotional interaction. A Pavlovian autonomic co-conditioning mechanism may underly these findings that can be exploited therapeutically.
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18
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Early Life Maternal Separation and Maternal Behaviour Modulate Acoustic Characteristics of Rat Pup Ultrasonic Vocalizations. Sci Rep 2019; 9:19012. [PMID: 31831757 PMCID: PMC6908621 DOI: 10.1038/s41598-019-54800-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/15/2019] [Indexed: 02/06/2023] Open
Abstract
Early separation of preterm infants from their mothers has adverse, long-term neurodevelopmental consequences. We investigated the effects of daily maternal separation (MS) of rat pups from postnatal days 2-10 (PND2-10) on neurobehavioural responses to brief isolation at PND12 compared with pups receiving controlled handling without MS. Ultrasonic vocalizations (USV) were measured at PND12 during two, 3-minute isolations occurring immediately before and after a 3-minute maternal reunion. There were no significant differences in acoustic characteristics between MS and control animals in the first isolation. However, in the second isolation, MS pups produced a greater proportion of high (~60 kHz) vs low (~40 kHz) frequency calls. During this isolation, control pups made longer and louder low frequency calls compared to the first isolation, whereas MS pups did the opposite. Maternal behaviour of control and MS mothers modulated pup acoustic characteristics in opposite directions; higher maternal care was associated with more low frequency calls in control pups but more high frequency calls in MS pups. We hypothesize that MS results in USV emission patterns reflective of a greater stress response to isolation. This translational model can be used to identify mechanisms and interventions that may be exploited to overcome the negative, long-term effects of MS.
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19
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Stefana A, Lavelli M, Rossi G, Beebe B. Interactive sequences between fathers and preterm infants in the neonatal intensive care unit. Early Hum Dev 2019; 140:104888. [PMID: 31670161 DOI: 10.1016/j.earlhumdev.2019.104888] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/15/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
AIMS The first purpose of the study was to examine fathers' spontaneous communicative behavior with their preterm infants in the neonatal intensive care unit, and how father's and infant's behaviors affected each other. The second purpose was to examine any possible association between the fathers' and/or infants' characteristics and the quality of fathers' behaviors with their infants. STUDY DESIGN/SUBJECTS/OUTCOME MEASURES Father-preterm infant dyads (n=20) were assessed at 34-36 weeks postmenstrual age, during a spontaneous face-to-face communication with the infant placed in a heated cot in the NICU, and coded according to the Parent-Preterm Infant Coding System. RESULTS The presence of the father's Affiliative Behavior increased the occurrences of infant Gazing at the parent's face. In turn, infant gazing increased the occurrence of paternal Affiliative Behavior. The likelihood of infant's Gazing at the father's face was also significantly elicited by infrequent occurrences of paternal Affectionate Talk, co-occurring with Gazing at infant with Positive Facial Affect (but no Touch). With regard to the predictors of quality in father-infant interactions, we found a significant positive correlation between fathers' level of depressive symptomatology and fathers' Affiliative Behavior. CONCLUSION Our results show the of bidirectional sequential patterns of communication between fathers and preterm infants at 35 weeks postmenstrual age, and provide important information about the quality and modalities of paternal communication and their influence on infant behavioral states. From a clinical perspective, these results suggest that father-specific interventions designed to improve and sustain fathers' positive engagement with infants in the NICU should be pursued.
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Affiliation(s)
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Germano Rossi
- Department of Psychology, University of Milan Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy
| | - Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, 40 Haven Avenue Unit 78 New York, NY 10032, USA
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20
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Fagan MA, Frosch CA, Middlemiss W, LaCoursiere JN, Owen MT, Hane AA, Welch MG. The practical utility of the Welch Emotional Connection Screen for rating parent-infant relational health. INFANCY 2019; 24:881-892. [PMID: 32677361 DOI: 10.1111/infa.12311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 11/27/2022]
Abstract
Emotional Connection (EC) measured by the Welch Emotional Connection Screen (WECS) was related to the Parent-Infant Interaction Rating System (PIIRS), a 5-point adaptation of the rating system developed for the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (e.g., NICHD Early Child Care Research Network, 1999, Developmental Psychology, 35, 1399). Parent-infant dyads (n = 49 mothers; 43 fathers) were videotaped during face-to-face interaction at infant age 6 months; interactions were coded with both the WECS and PIIRS. At age 3, mothers completed the Child Behavior Checklist. WECS ratings of EC were associated with PIIRS rating items for both mother-infant and father-infant dyads. Mother-infant EC related positively to maternal sensitivity and positive regard for child, child positive mood and sustained attention, and dyadic mutuality, and negatively with maternal intrusiveness. Father-infant EC related positively to fathers' positive regard for child, child positive mood and sustained attention, and dyadic mutuality. Mother-infant EC predicted child behavior problems at age 3 better than mother-infant PIIRS ratings of dyadic mutuality. With fathers, neither EC nor dyadic mutuality ratings predicted mother-reported child behavior problems. Findings highlight the practical utility of the WECS for identifying potentially at-risk dyads and supporting early relational health.
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Affiliation(s)
- Marcus A Fagan
- Department of Educational Psychology, University of North Texas, Denton, Texas
| | - Cynthia A Frosch
- Department of Educational Psychology, University of North Texas, Denton, Texas
| | - Wendy Middlemiss
- Department of Educational Psychology, University of North Texas, Denton, Texas
| | | | - Margaret T Owen
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas
| | - Amie A Hane
- Department of Pediatrics, Columbia University Medical Center, New York, New York.,Department of Psychology, Williams College, Williamstown, Massachusetts
| | - Martha G Welch
- Department of Pediatrics, Columbia University Medical Center, New York, New York.,Department of Psychiatry, Columbia University Medical Center, New York, New York.,Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
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21
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Leng H, Zhang X, Wang Q, Luan X, Sun X, Guo F, Gao S, Liu X, Xu L. Regulation of stress-induced gastric ulcers via central oxytocin and a potential mechanism through the VTA-NAc dopamine pathway. Neurogastroenterol Motil 2019; 31:e13655. [PMID: 31172654 DOI: 10.1111/nmo.13655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/29/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Oxytocin (OT) plays an important role in regulating gastric function. How OT regulates stress-induced gastric ulcers is not understood. We investigated OT's protective role in stress-induced gastric ulcers, with a focus on OT's interaction with the ventral tegmental area (VTA) to nucleus accumbens (NAc) dopamine pathway. METHODS Drugs administration into the rats brain nuclei by brain stereotaxic apparatus, to examine related changes in gastric ulcer index, pH of gastric content, and mucus secretion, and to determine complex interactions between OT and DA systems in the regulation of stress and gastric functions. KEY RESULTS Neurons in the VTA were co-immunoreactive for the OT receptor (OTR) and DA. In a rat model of stress-induced ulcer, water-immersion restricted stress, direct administration of OT into the VTA significantly reduced gastric ulcer index and increased the pH of gastric content and mucus secretion. OT's effects were eliminated by pretreatment with the OTR antagonist atosiban in the VTA and weakened with pretreatment of the DA D2 receptor (DA D2R) antagonist raclopride in the NAc. In OTR gene knockout (Oxtr-/- ) mice, OT's protective effect was lost. OT administered to the VTA of dorsal motor nucleus of the vagus (DMV)-lesioned rats had minimal protective effects on gastric mucosa. CONCLUSIONS AND INFERENCES This study provides important data necessary for a deeper understanding of the complex interactions between OT and DA systems in the regulation of stress and gastric functions. It provides relevant mechanistic clues into OT's role as a protective factor against stress-induced changes to gastric function.
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Affiliation(s)
- Hui Leng
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Xiaoqian Zhang
- Doctoral School of Biomedical Sciences, Leuven, Belgium.,Family Medicine Department, Qingdao United Family Hospital, Qingdao, China
| | - Qian Wang
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Xiao Luan
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Xiangrong Sun
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Feifei Guo
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Shengli Gao
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Xuehuan Liu
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
| | - Luo Xu
- Department of Pathophysiology, Medical College of Qingdao University, Qingdao, China
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22
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Bergman NJ, Ludwig RJ, Westrup B, Welch MG. Nurturescience versus neuroscience: A case for rethinking perinatal mother–infant behaviors and relationship. Birth Defects Res 2019; 111:1110-1127. [DOI: 10.1002/bdr2.1529] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Nils J. Bergman
- Department of Women's and Children's HealthKarolinska Institute Stockholm Sweden
| | - Robert J. Ludwig
- Department of PediatricsColumbia University Irving Medical Center New York New York
| | - Björn Westrup
- Department of Women's and Children's HealthKarolinska Institute Stockholm Sweden
| | - Martha G. Welch
- Department of PediatricsColumbia University Irving Medical Center New York New York
- Department of Pathology and Cell BiologyColumbia University Irving Medical Center New York New York
- Department of PsychiatryColumbia University Irving Medical Center New York New York
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23
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Franck LS, O'Brien K. The evolution of family-centered care: From supporting parent-delivered interventions to a model of family integrated care. Birth Defects Res 2019; 111:1044-1059. [PMID: 31115181 DOI: 10.1002/bdr2.1521] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
There is increasing recognition that parents play a critical role in promoting the health outcomes of low birthweight and preterm infants. Despite a large body of literature on interventions and models to support family engagement in infant care, parent involvement in the delivery of care for such infants is still restricted in many neonatal intensive care units (NICUs). In this article, we propose a taxonomy for classifying parent-focused NICU interventions and parent-partnered care models to aid researchers, clinical teams, and health systems to evaluate existing and future approaches to care. The proposed framework has three levels: interventions to support parents, parent-delivered interventions, and multidimensional models of NICU care that explicitly incorporate parents and partners in the care of their preterm or low birthweight infant. We briefly review the available evidence for interventions at each level and highlight the strong level of research evidence to support the parent-delivered intervention of skin-to-skin contact (also known as the Kangaroo Care position) and for the Kangaroo mother care and family integrated care models of NICU care. We suggest directions for future research and model implementation to improve and scale-up parent partnership in the care of NICU infants.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California, San Francisco, California
| | - Karel O'Brien
- Department of Paediatrics, Sinai Health System, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
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24
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Ludwig RJ, Welch MG. Darwin's Other Dilemmas and the Theoretical Roots of Emotional Connection. Front Psychol 2019; 10:683. [PMID: 31031667 PMCID: PMC6473325 DOI: 10.3389/fpsyg.2019.00683] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/11/2019] [Indexed: 12/20/2022] Open
Abstract
Modern scientific theories of emotional behavior, almost without exception, trace their origin to Charles Darwin, and his publications On the Origin of Species (1859) and The Expression of the Emotions in Man and Animals (1872). The most famous dilemma Darwin acknowledged as a challenge to his theory of evolution through natural selection was the incomplete Sub-Cambrian fossil record. However, Darwin struggled with two other rarely referenced theoretical and scientific dilemmas that confounded his theories about emotional behavior. These included (1) the origin of social instincts (e.g., altruism, empathy, reciprocity and cooperation) and the reasons for their conservation in evolution and (2) the peripheral control of heart rate vis-à-vis emotional behavior outside of consciousness. Darwin acknowledged that social instincts are critical to the survival of some species, but had difficulty aligning them with his theory of natural selection in humans. Darwin eventually proposed that heart rate and emotions are controlled via one's intellect and cortical mechanisms, and that instinctive behavior is genetically programmed and inherited. Despite ongoing efforts, these two theoretical dilemmas are debated to this day. Simple testable hypotheses have yet to emerge for the biological mechanisms underlying instinctive behavior or the way heart rate is controlled in infants. In this paper, we review attempts to resolve these issues over the past 160 years. We posit that research and theories that supported Darwin's individualistic brain-centric and genetic model have become an "orthodox" Western view of emotional behavior, one that produced the prevailing behavioral construct of attachment as developed by John Bowlby. We trace research and theories that challenged this orthodoxy at various times, and show how these challenges were repeatedly overlooked, rejected, or misinterpreted. We review two new testable theories, emotional connection theory and calming cycle theory, which we argue resolve the two dilemmas We show emerging scientific evidence from physiology and a wide variety of other fields, as well from clinical trials among prematurely born infants, that supports the two theories. Clinical implications of the new theories and possible new ways to assess risk and intervene in emotional, behavioral and developmental disorders are discussed.
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Affiliation(s)
- Robert J. Ludwig
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Martha G. Welch
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- Department of Anatomy and Cell Biology, Columbia University Irving Medical Center, New York, NY, United States
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25
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Kolacz J, Kovacic KK, Porges SW. Traumatic stress and the autonomic brain-gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology. Dev Psychobiol 2019; 61:796-809. [PMID: 30953358 DOI: 10.1002/dev.21852] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 12/14/2022]
Abstract
A range of psychiatric disorders such as anxiety, depression, and post-traumatic stress disorder frequently co-occur with functional gastrointestinal (GI) disorders. Risk of these pathologies is particularly high in those with a history of trauma, abuse, and chronic stress. These scientific findings and rising awareness within the healthcare profession give rise to a need for an integrative framework to understand the developmental mechanisms that give rise to these observations. In this paper, we introduce a plausible explanatory framework, based on the Polyvagal Theory (Porges, Psychophysiology, 32, 301-318, 1995; Porges, International Journal of Psychophysiology, 42, 123-146, 2001; Porges, Biological Psychology, 74, 116-143, 2007), which describes how evolution impacted the structure and function of the autonomic nervous system (ANS). The Polyvagal Theory provides organizing principles for understanding the development of adaptive diversity in homeostatic, threat-response, and psychosocial functions that contribute to pathology. Using these principles, we outline possible mechanisms that promote and maintain socioemotional and GI dysfunction and review their implications for therapeutic targets.
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Affiliation(s)
- Jacek Kolacz
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, Indiana
| | - Katja K Kovacic
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Stephen W Porges
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, Indiana.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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26
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Hane AA, LaCoursiere JN, Mitsuyama M, Wieman S, Ludwig RJ, Kwon KY, V. Browne J, Austin J, M. Myers M, Welch MG. The Welch Emotional Connection Screen: validation of a brief mother-infant relational health screen. Acta Paediatr 2019; 108:615-625. [PMID: 29959878 DOI: 10.1111/apa.14483] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/08/2018] [Accepted: 06/27/2018] [Indexed: 12/11/2022]
Abstract
AIM The Welch Emotional Connection Screen (WECS), assesses mother-infant Emotional Connection in clinical settings. It includes: Attraction, Vocal Communication, Facial Communication, Sensitivity/Reciprocity and clinical decision of Emotional Connection (yes/no). We tested concurrent and construct validity of the WECS and associations with behavioural and physiological measures in preterm infants. METHODS Videos from 76 mothers-infants (gestational age 36 weeks) during an in-NICU caregiving paradigm were coded for maternal caregiving behaviour. Videos of mothers-infants were also obtained at 4 months during 10 minutes of face-to-face play (coded with WECS and for maternal positivity and infant social engagement) and the still-face paradigm (coded for infant behavioural approach towards mother; infant electrocardiogram acquired in vivo). RESULTS WECS maternal scores were positively associated with maternal sensitivity and quality of vocal contact at 36 weeks (caregiving) and maternal positivity at 4 months (face-to-face). WECS infant scores positively correlated with infant social engagement and maternal positivity during face-to-face interactions at 4 months. Infants from emotionally not connected dyads (vs. emotionally connected dyads) displayed autonomic dysregulation and less approach-seeking behaviour towards mother during interactive/play sessions of the still-face paradigm. CONCLUSION This preliminary evidence supports the WECS as a valid screen for rating mother-preterm infant emotional connection associated with healthier infant biobehavioural stress responding.
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Affiliation(s)
- Amie A. Hane
- Department of Psychology; Williams College; Williamstown MA USA
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
| | - Jasmine N. LaCoursiere
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
| | - Mai Mitsuyama
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
| | - Sarah Wieman
- Department of Psychology; Williams College; Williamstown MA USA
| | - Robert J. Ludwig
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
| | - Katie Y. Kwon
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
| | - Joy V. Browne
- Department of Pediatrics and Psychiatry; University of Colorado School of Medicine; Aurora CO USA
- Fielding Graduate University; Santa Barbara CA USA
| | - Judy Austin
- Heilbrunn Department of Population and Family Health; Mailman School of Public Health; Columbia University Medical Center; New York NY USA
| | - Michael M. Myers
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
- Developmental Neuroscience; Department of Psychiatry; Columbia University Medical Center; New York NY USA
| | - Martha G. Welch
- Nurture Science Program; Department of Pediatrics; Columbia University Medical Center; New York NY USA
- Developmental Neuroscience; Department of Psychiatry; Columbia University Medical Center; New York NY USA
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27
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Porges SW, Davila MI, Lewis GF, Kolacz J, Okonmah‐Obazee S, Hane AA, Kwon KY, Ludwig RJ, Myers MM, Welch MG. Autonomic regulation of preterm infants is enhanced by Family Nurture Intervention. Dev Psychobiol 2019; 61:942-952. [DOI: 10.1002/dev.21841] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/10/2018] [Accepted: 12/23/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Stephen W. Porges
- Traumatic Stress Research Consortium Kinsey Institute, Indiana University Bloomington Indiana
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Maria I. Davila
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Gregory F. Lewis
- Traumatic Stress Research Consortium Kinsey Institute, Indiana University Bloomington Indiana
- Intelligent Systems Engineering Indiana University Bloomington Indiana
| | - Jacek Kolacz
- Traumatic Stress Research Consortium Kinsey Institute, Indiana University Bloomington Indiana
| | | | - Amie Ashley Hane
- Department of Psychology Williams College Williamstown Massachusetts
| | - Katie Y. Kwon
- Department of Pediatrics Columbia University Medical Center New York New York
| | - Robert J. Ludwig
- Department of Pediatrics Columbia University Medical Center New York New York
| | - Michael M. Myers
- Department of Pediatrics Columbia University Medical Center New York New York
- Department of Psychiatry Columbia University Medical Center New York New York
| | - Martha G. Welch
- Department of Pediatrics Columbia University Medical Center New York New York
- Department of Psychiatry Columbia University Medical Center New York New York
- Department of Anatomy and Cell Biology Columbia University Medical Center New York New York
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28
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Abstract
Selective relationships and attachments are central to human health and well-being, both in current societies and during the course of evolution. The presence or absence of social bonds has consequences across the lifespan. The neurobiology of attachment is grounded in neuroendocrine substrates that are shared with reproduction and survival. Experimental studies of species, such as sheep or prairie voles, capable of showing selective social behaviors toward offspring or partners, have provided empirical evidence for the role of oxytocin and vasopressin in the formation of selective attachments. Developmental exposure to social experiences and to peptides, including oxytocin and vasopressin, also can "retune" the nervous system, altering thresholds for sociality, emotion regulation, and aggression. Without oxytocin and without the ability to form attachments the human brain as we know it could not exist. Knowledge of the neurobiology of attachment, and especially the role of oxytocin, also has implications for understanding both healthy behavior and treating mental disorders.
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Affiliation(s)
- C Sue Carter
- Director, Kinsey Institute, Rudy Professor of Biology, Indiana University, Bloomington
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