The Role of Neurobiological Bases of Dyadic Emotion Regulation in the Development of Psychopathology: Cross-Brain Associations Between Parents and Children

Characteristics of child development in the context of serious illness: a scoping review

BACKGROUND

Despite evidence on the benefits for including children in their own (palliative) care, studies show that children are not sufficiently involved nor are their preferences sufficiently elicited in a developmentally appropriate manner. The aim of this scoping review is to provide an overview of characteristics of child development in the context of serious illness.

METHODS

A scoping review was performed using methods from Arksey and O'Malley and the Joanna Briggs Institute. A structured literature search was conducted in four databases: Medline, Embase, Psychinfo and CINAHL. Articles were included until October 2022. Thematic analysis was performed to present domains and key factors influencing child development.

RESULTS

We selected 24 out of 11,246 articles. We found different characteristics describing the ongoing development of seriously ill children in early to middle childhood, early adolescence, and middle to late adolescence. Key themes were: psychological/emotional aspects, general cognitive aspects, social aspects, coping strategy, conceptualization of illness, conceptualization of death, and communication about their illness. Several accelerators of ongoing development were found (e.g. cortical maturation, prior medical experience, social experience with adults) and several decelerators (e.g. stress, hospital admission, avoidance of illness-related communication in the family).

CONCLUSION

Our review highlights essential aspects to consider when discussing illness and healthcare preferences with children at various developmental stages. However, our findings also underscore a significant gap in understanding the factors that impact the development of children with a serious illness. It is recommended to monitor development throughout the illness trajectory to gather more evidence and utilize this information to support the child's engagement in their own healthcare in a developmentally appropriate way.

Interactions among dyadic coping, self-efficacy, and negative emotions in Chinese parents of children with leukemia

BACKGROUND AND AIM

The prevalence of childhood leukemia in China has been on the rise, imposing significant psychological burden on parents. Currently, few studies have explored the dyadic coping status of parents of children with leukemia and its influencing factors. This study aimed to investigate the associations among dyadic coping, self-efficacy, anxiety and depression in parents of children with leukemia.

METHODS

A cross-sectional design was performed to conveniently sample 342 parents from the pediatric hematology ward of Peking University People's Hospital. The general demographic information, dyadic coping inventory, general self-efficacy scale, and hospital anxiety and depression scale were collected and analyzed using SPSS.22.0 software.

RESULTS

The average age of the parents was (37.29 ± 5.73) years, while the total score of dyadic coping was 122.95 ± 16.68, the self-efficacy score was 25.03 ± 3.93, anxiety score was 15.58 ± 3.59, and depression score was 16.27 ± 3.86. Dyadic coping was significantly positively correlated with self-efficacy (r = 0.386, P < 0.01), and negatively correlated with parental anxiety and depression scores (r=-0.372; r=-0.264; P < 0.01). Multiple linear regression revealed that self-efficacy(β = 0.262), anxiety(β=-0.242), income per month (RMB,β = 0.182), knowledge of the child's illness(β = 0.138), number of relapses(β=-0.135), current treatment programs(β=-0.149), education level(β = 0.101) and the duration of diagnosis(β = 0.092) were significant factors influencing the parents' dyadic coping level (R2 = 0.378, P < 0.01).

CONCLUSION

The dyadic coping level of parents of children with leukemia is generally moderate, is positively correlation with self-efficacy and negatively correlated with anxiety. Therefore, interventions targeting dyadic interactions between parents should be established to improve parental communication, foster coping mechanisms under stress, and alleviate the negative emotional responses.

Multimodal analysis of mother-child interaction using hyperscanning and diffusion maps

The current work aims to reveal mother-child synchronization patterns using several interaction modalities and combining them using the diffusion maps method. Twenty-two Hebrew-speaking toddlers (ages = 33 ± 5.38 months, 17 males) and their mothers (ages = 35 ± 5.79 years) participated in two interaction conditions while data was collected from several modalities, i.e. EEG, joint attention (measured through video coding of looking behavior), and motion analysis. Dimension reduction and data fusion of these modalities were performed using diffusion maps to enable a comprehensive assessment of mother-child synchronization dynamics. This multimodal approach allows better characterization of mother-child interaction and examining the associations between interaction patterns and maternal parenting style and their importance to the child's long-term language abilities.

The ecology of poverty and children's brain development: A systematic review and quantitative meta-analysis of brain imaging studies

A growing number of studies have demonstrated associations between poverty and brain structure and function. However, the strength of this association and the effects of poverty level (e.g., family or neighborhood poverty), age and sex on the association are strikingly inconsistent across studies. We aimed to synthesize findings on gray matter volume and task-based brain activation associated with poverty in youth samples and disentangle the effects of poverty level, age, and sex. In general, poverty was associated with alterations in volume and activation in the frontal, temporal, and subcortical regions. Among 14,188 participants and 14,057 participants, poverty was associated with smaller gray matter volumes in the amygdala and hippocampus, respectively. Moderator testing revealed that family poverty had a stronger association than neighborhood poverty and that poverty was related to slower development of amygdala volume. Among 2696 participants, convergent functional alterations associated with poverty were observed in the left middle temporal gyrus (MTG) and left middle frontal gyrus across all task domains, with the percentage of girls positively associated with increased activation in the precuneus. Subgroup analyses revealed that greater poverty was associated with deactivation in the left MTG for top-down control and hyperactivity in the right superior temporal gyrus, left superior frontal gyrus, left insula, cerebellum/left fusiform gyrus, and left amygdala/hippocampus for bottom-up processing. These findings provide insights into the neuroscience of poverty, suggesting implications for targeted interventions to support the cognitive and mental health of children living in poverty.

Parent emotional support alters the association between parent-child interbrain synchrony and interaction quality

Using functional near-infrared spectroscopy (fNIRS) hyperscanning methodology, this study investigated whether parent emotional support moderated the relation between parent-child interbrain synchrony and interaction quality (via behavioral observation and child-report), controlling for individual emotional distress. Eighty-eight parent-child dyads (96.6% Han ethnicity), including a school-age child between the ages of 6 and 11 (Mage = 8.07 years, SD = 1.16 years; 58.0% boys) and their parent (Mage = 39.03 years, SD = 3.54 years; 69.3% mothers), participated in a cooperative task during which brain activity was assessed. Cluster-based permutations indicated parent-child interbrain synchrony in the left and right temporoparietal junction (TPJ). Interbrain synchrony in the left TPJ positively related to parent-child interaction quality in the context of high parent emotional support, whereas the association was weaker and negative when parents demonstrated low emotional support. Findings suggest the emotional context of an interaction is critical when assessing interbrain synchrony.

Interplay between Children's Electronic Media Use and Prosocial Behavior: The Chain Mediating Role of Parent-Child Closeness and Emotion Regulation

In the contemporary digital milieu, children's pervasive engagement with electronic media is ubiquitous in their daily lives, presenting complex implications for their socialization. Prosocial behavior, a cornerstone of social interaction and child development, is intricately intertwined with these digital experiences. This relation gains further depth, considering the significant roles of parent-child relationships and emotion regulation in shaping children's social trajectories. This study surveyed 701 families to examine the association between children's electronic media use and prosocial behavior, specifically exploring the mediating roles of parent-child closeness and emotion regulation. Structural equation modeling was employed for the analysis. Children's electronic media use negatively correlated with prosocial behavior, parent-child closeness, and emotion regulation. In contrast, a positive association emerged between parent-child closeness, emotion regulation, and prosocial behavior. Emotion regulation also correlated positively with prosocial behavior. Statistical analyses revealed that parent-child closeness and emotion regulation function as both individual and sequential mediators in the relation between electronic media use and prosocial behavior. The study's analyses reveal that fostering children's prosocial behavior in the digital era requires strong family ties, effective emotional management, and balanced digital exposure, which are pivotal for their comprehensive development.

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

PURPOSE OF REVIEW

Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health.

RECENT FINDINGS

(1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse.

SUMMARY

During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.

Integrating Biobehavioral and Environmental Components of Developmental Psychopathology via Interpersonal Dynamics: An RDoC-Advancing Model

Although the Research Diagnostic Criteria (RDoC) framework proposes biological and environmental mechanisms intersect in the etiology of psychopathology, there is no guidance on how to define or measure experiences in the environment within the RDoC matrix. Interpersonal dynamics during caregiver-child interactions involve temporal coordination of interacting partners' biobehavioral functioning; repeated experiences of signaling to caregivers and responding to caregivers' signals shape children's subsequent socioemotional and brain development. We begin with a review of the extant literature on caregiver-child dynamics, which reveals that RDoC's units of analysis (brain circuits, physiology, behavior, and self-report) are inextricably linked with moment-to-moment changes in the caregiving environment. We then offer a proof-of-concept for integrating biobehavioral RDoC units and environmental components via caregiver-child dynamics. Our approach uses dynamic structural equation models to estimate within-dyad dynamics involving arousal, social, cognitive, and negative or positive affective processes based on second-by-second changes in parasympathetic activity (RSA) during a conflict discussion and a positive event-planning task. Our results illustrate variation in parent-child RSA synchrony, suggesting differences depending on the driver (i.e., child- or parent-led) and on the unique and intersecting domains involved (e.g., positive or negative affect valence systems). We conclude with recommendations for conducting robust, methodologically rigorous studies of interpersonal dynamics that advance the RDoC framework and provide a summary of the clinical implications of this research. Examining caregiver-child dynamics during and across multiple dyadic interaction paradigms that differentially elicit key domains of functioning can deepen understanding of how caregiver- and child-led interpersonal dynamics contribute to child psychopathology risk.

Parenting links to parent-child interbrain synchrony: a real-time fNIRS hyperscanning study

Parent-child interaction is crucial for children's cognitive and affective development. While bio-synchrony models propose that parenting influences interbrain synchrony during interpersonal interaction, the brain-to-brain mechanisms underlying real-time parent-child interactions remain largely understudied. Using functional near-infrared spectroscopy, we investigated interbrain synchrony in 88 parent-child dyads (Mage children = 8.07, 42.0% girls) during a collaborative task (the Etch-a-Sketch, a joint drawing task). Our findings revealed increased interbrain synchrony in the dorsolateral prefrontal cortex and temporo-parietal areas during interactive, collaborative sessions compared to non-interactive, resting sessions. Linear regression analysis demonstrated that interbrain synchrony in the left temporoparietal junction was associated with enhanced dyadic collaboration, shared positive affect, parental autonomy support, and parental emotional warmth. These associations remained significant after controlling for demographic variables including child age, child gender, and parent gender. Additionally, differences between fathers and mothers were observed. These results highlight the significant association between brain-to-brain synchrony in parent-child dyads, the quality of the parent-child relationship, and supportive parenting behaviors. Interbrain synchrony may serve as a neurobiological marker of real-time parent-child interaction, potentially underscoring the pivotal role of supportive parenting in shaping these interbrain synchrony mechanisms.

An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context

Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.

The association between parent-child quality time and children's flourishing level

PURPOSE

Few studies have examined the association between parental quality time and flourishing measures in young children. This study explored the association between parental quality time and children's flourishing in a national sample of USA children 1-5 years of age.

DESIGN AND METHODS

A cross sectional study using data from the 2019-2020 National Survey of Children's Health (N = 17,855). Flourishing was measured with a composite score (values 0-4) derived from 4 questions on attachment with parent, resilience, learning, and contentment with life. Having all 4 items was optimal. Parent-child quality time per week was measured with 3 items: singing or storytelling, reading to child, and family meal with child; using a 4-point scale: 0 days, 1-3 days, 4-6 days, and every day/week. Multivariable logistic regression models were conducted to assess the odds of lower flourishing in SAS 9.4.

RESULTS

After controlling for confounding, only the lack of singing and storytelling were negatively associated with greater odds of lower levels of flourishing (0-2 items OR = 5.06, 95% CI 2.11-12.14; 3 items OR = 2.92, 95% CI 1.73-4.93).

CONCLUSIONS

Insufficient parent-child quality time is associated with lower flourishing levels. Fostering parental opportunities to engage in weekly quality time with their children should be a priority of child health programs seeking to improve child flourishing.

PRACTICE IMPLICATIONS

Nurses should provide guidance to parents on ways to nurture quality family time and promote children's psychosocial, environmental, and physical well-being. Nurses can advocate for programmatic and policy changes to ensure familial work/life balance and licensing/accreditation of all child centers.

Hyperscanning Studies on Interbrain Synchrony and Child Development: A Narrative Review

Social interactions between parents and children are closely linked with children's development, and interbrain synchrony has been shown to be a neural marker of social interaction. However, to truly capture the essence of social interactions through interbrain synchrony, it is necessary to simultaneously discuss the parental and child brains and adequately record neurological signals during parent-child interactions in interactive tasks. In the current review, we have reviewed three main contents. First, we discuss the correlation between parent-child interbrain synchrony and the development of cognitive (e.g., emotion regulation, attention, and learning) and behavioral abilities (e.g., cooperation, problem-solving) in children. Second, we examine the different neural mechanisms of interbrain synchrony in mother-child and father-child interactions, aiming to highlight the separate roles of mother and father in child development. Last, we have integrated four methods to enhance interbrain synchrony, including communication patterns, nonverbal behavior, music, and multichannel stimulation. A significant correlation exists between parent-child interbrain synchrony and the development of children's cognitive and behavioral abilities. This summary may be useful for expanding researchers' and practitioners' understanding of the ways in which parenting and the parent-child relationship shape children' cognitive and behavioral abilities.

Family Cohesion Moderates the Relation between Parent-Child Neural Connectivity Pattern Similarity and Youth's Emotional Adjustment

Despite a recent surge in research examining parent-child neural similarity using fMRI, there remains a need for further investigation into how such similarity may play a role in children's emotional adjustment. Moreover, no prior studies explored the potential contextual factors that may moderate the link between parent-child neural similarity and children's developmental outcomes. In this study, 32 parent-youth dyads (parents: M age = 43.53 years, 72% female; children: M age = 11.69 years, 41% female) watched an emotion-evoking animated film while being scanned using fMRI. We first quantified how similarly emotion network interacts with other brain regions in responding to the emotion-evoking film between parents and their children. We then examined how such parent-child neural similarity is associated with children's emotional adjustment, with attention to the moderating role of family cohesion. Results revealed that higher parent-child similarity in functional connectivity pattern during movie viewing was associated with better emotional adjustment, including less negative affect, lower anxiety, and greater ego resilience in youth. Moreover, such associations were significant only among families with higher cohesion, but not among families with lower cohesion. The findings advance our understanding of the neural mechanisms underlying how children thrive by being in sync and attuned with their parents, and provide novel empirical evidence that the effects of parent-child concordance at the neural level on children's development are contextually dependent.SIGNIFICANCE STATEMENT What neural processes underlie the attunement between children and their parents that helps children thrive? Using a naturalistic movie-watching fMRI paradigm, we find that greater parent-child similarity in how emotion network interacts with other brain regions during movie viewing is associated with youth's better emotional adjustment including less negative affect, lower anxiety, and greater ego resilience. Interestingly, these associations are only significant among families with higher cohesion, but not among those with lower cohesion. Our findings provide novel evidence that parent-child shared neural processes to emotional situations can confer benefits to children, and underscore the importance of considering specific family contexts in which parent-child neural similarity may be beneficial or detrimental to children's development, highlighting a crucial direction for future research.

Parents regulate arousal while sharing experiences with their child: a study of pupil diameter change responses

Introduction

Parents provide their children with their first exposures to reciprocal shared experiences, and parental modeling of socio-emotional behaviors and regulatory responses largely influences their child's behavioral and neurological development. Some parental reactions are conscious, while others are non-volitional. This project aimed to explore parent-child pupil dilation change responses during shared interactions, specifically, whether parents' neuro-regulatory responses when sharing experiences with their child are different than responses of children interacting with their parents or children and adult peers sharing with each other.

Methods

To test this, four distinct interacting groups were recruited: (1) Parents sharing with their child; (2) Children sharing with their parent; (3) Children sharing with peers; and (4) Adults sharing with peers. All dyads engaged in a computerized shared imagery task, which facilitates communication and mental imagery during a shared experience. During the task, pupil diameter change was recorded as a measure of regulatory response.

Results

Findings highlight that parents sharing with their child have lower pupil diameter change than children sharing with their parents (p < 0.01), children sharing with peers (p < 0.01), and adults sharing with peers (p < 0.05), While no differences were seen between children sharing with parents, children sharing with peers or adults sharing with peers.

Discussion

Findings deepen the understanding of the neuroscience of parenting, by suggesting that parents, even of older children and adolescents, tend to regulate their arousal when interacting with their child, a response that proves to be unique compared to other dyad types for sharing experiences. Considering this dynamic, findings may direct future parent-led intervention methods to improve the child's socio-emotional development.

Long-term postoperative quality of life in childhood survivors with cerebellar mutism syndrome

Background

To investigate the long-term quality of life (QoL) of children with cerebellar mutism syndrome (CMS) and explore the risk factors for a low QoL.

Procedure

This cross-sectional study investigated children who underwent posterior fossa surgery using an online Pediatric Quality of Life Inventory questionnaire. CMS and non-CMS patients were included to identify QoL predictors.

Results

Sixty-nine patients were included (male, 62.3%), 22 of whom had CMS. The mean follow-up time was 45.2 months. Children with CMS had a significantly lower mean QoL score (65.3 vs. 83.7, p < 0.001) and subdomain mean scores (physical; 57.8 vs. 85.3, p < 0.001; social: 69.5 vs. 85.1, p = 0.001; academic: p = 0.001) than those without CMS, except for the emotional domain (78.0 vs. 83.7, p = 0.062). Multivariable analysis revealed that CMS (coefficient = -14.748.61, p = 0.043), chemotherapy (coefficient = -7.629.82, p = 0.013), ventriculoperitoneal (VP) shunt placement (coefficient = -10.14, p = 0.024), and older age at surgery (coefficient = -1.1830, p = 0.007) were independent predictors of low total QoL scores. Physical scores were independently associated with CMS (coefficient = -27.4815.31, p = 0.005), VP shunt placement (coefficient = -12.86, p = 0.025), and radiotherapy (coefficient = -13.62, p = 0.007). Emotional score was negatively associated with age at surgery (coefficient = -1.92, p = 0.0337) and chemotherapy (coefficient = -9.11, p = 0.003). Social scores were negatively associated with male sex (coefficient = -13.68, p = 0.001) and VP shunt placement (coefficient = -1.36, p = 0.005), whereas academic scores were negatively correlated with chemotherapy (coefficient = -17.45, p < 0.001) and age at surgery (coefficient = -1.92, p = 0.002). Extent of resection (coefficient = 13.16, p = 0.021) was a good predictor of higher academic scores.

Conclusion

CMS results in long-term neurological and neuropsychological deficits, negatively affecting QoL, and warranting early rehabilitation.

Unmet Social Needs and Patterns of Hair Cortisol Concentration in Mother-Child Dyads

Background

Mothers and their children demonstrate dyadic synchrony of hypothalamic-pituitary-adrenal (HPA) axis function, likely influenced by shared genetic or environmental factors. Although evidence has shown that chronic stress exposure has physiologic consequences for individuals-including on the HPA axis-minimal research has explored how unmet social needs such as food and housing instability may be associated with chronic stress and HPA axis synchrony in mother-child dyads.

Methods

We conducted a secondary analysis of data from 364 mother-child dyads with low-income recruited during a randomized trial conducted in an urban pediatric clinic. We used latent profile analysis (LPA) to identify subgroups based on naturally occurring patterns of within-dyad hair cortisol concentration (HCC). A logistic regression model predicted dyadic HCC profile membership as a function of summative count of survey-reported unmet social needs, controlling for demographic and health covariates.

Results

LPA of HCC data from dyads revealed a 2-profile model as the best fit. Comparisons of log HCC for mothers and children in each profile group resulted in significantly "higher dyadic HCC" versus "lower dyadic HCC" profiles (median log HCC for mothers: 4.64 vs 1.58; children: 5.92 vs 2.79, respectively; P < .001). In the fully adjusted model, each one-unit increase in number of unmet social needs predicted significantly higher odds of membership in the higher dyadic HCC profile when compared to the lower dyadic HCC profile (odds ratio  =  1.13; 95% confidence interval [1.04-1.23]; P  =  .01).

Conclusion

Mother-child dyads experience synchronous patterns of physiologic stress, and an increasing number of unmet social needs is associated with a profile of higher dyadic HCC. Interventions aimed at decreasing family-level unmet social needs or maternal stress are, therefore, likely to affect pediatric stress and related health inequities; efforts to address pediatric stress similarly may affect maternal stress and related health inequities. Future research should explore the measures and methods needed to understand the impact of unmet social needs and stress on family dyads.