Five Minute Speech Sample in developmental research: A review

Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities

Research into clinical applications of speech-based emotion recognition (SER) technologies has been steadily increasing over the past few years. One such potential application is the automatic recognition of expressed emotion (EE) components within family environments. The identification of EE is highly important as they have been linked with a range of adverse life events. Manual coding of these events requires time-consuming specialist training, amplifying the need for automated approaches. Herein we describe an automated machine learning approach for determining the degree of warmth, a key component of EE, from acoustic and text natural language features. Our dataset of 52 recorded interviews is taken from recordings, collected over 20 years ago, from a nationally representative birth cohort of British twin children, and was manually coded for EE by two researchers (inter-rater reliability 0.84-0.90). We demonstrate that the degree of warmth can be predicted with an F1-score of 64.7% despite working with audio recordings of highly variable quality. Our highly promising results suggest that machine learning may be able to assist in the coding of EE in the near future.

Parental Expressed Emotion and Behavioural Outcomes in Autistic Children and Adolescents: A Systematic Review

Growing interest in the links between parent-child relationships and child behavioural presentations in families of autistic children has led to an increased use of the Five Minute Speech Sample (FMSS) measure of parental expressed emotion (EE) in autism research. This review focuses on studies exploring the relationships between parental EE and behavioural outcomes in autistic children. Electronic searches of six databases and grey literature wielded eight studies that met eligibility criteria. Study designs were a mixture of cross-sectional and longitudinal and quality of studies was variable. Parental criticism was largely positively related to, and showed some predictive value for, child behaviour problems. Warmth was mostly negatively related to, and showed some predictive value for, child behaviour problems. Preliminary evidence from one study showed paternal warmth to be significantly related to child behaviours, whilst child behaviours were also significantly related to paternal warmth, suggesting a bidirectional relationship. Analysis of additional EE components produced variable results, however parental stress and depressive symptoms were consistently related to child behaviour, and preliminary evidence suggests a possible role of maternal education level and family cohesion. Outcomes were variable across FMSS coding systems and greater consistency in their application is needed in future research. The current findings suggest that parental EE has an important relationship with child behaviour and future intervention efforts may benefit from aiming to reduced EE in order to improve child outcomes.

Coherence of Parental Representations Following Therapy for Autistic Children

Autistic children experience high rates of mental health challenges, and links have been found between child mental health and the parent-child relationship. As parents of autistic children are often actively involved in their child's treatment, it is important to consider aspects of the parent-child relationship within this context. The present study investigated changes in a component of the parent-child relationship, the coherence of parental representations, following participation in a 10-week cognitive behavioural therapy intervention designed to address autistic children's mental health challenges. Relationships were examined between coherence and child characteristics (i.e., autism symptoms, mental health), and associations with child treatment outcomes (i.e., mental health). Participants included 81 children (89% boys) aged 8 to 13 years and their parents (85% mothers) aged 35 to 54 years. Baseline levels of coherence were related to children's mental health symptoms but not autism symptoms. Although there were no significant changes in overall coherence across therapy, subscale-level improvements (i.e., concern, acceptance) emerged. Changes in coherence across therapy were linked with children's post-intervention behavioural symptoms and were approaching significance for internalizing problems, but were not associated with externalizing problems. It is critical to investigate factors that shape the coherence of parents' representations of their children, as this may provide insight into potential targets for intervention. Ascertaining whether participation in therapy improves parental coherence, and consequently child treatment outcomes, can advocate for parent-involved therapy, which will ultimately benefit the well-being of autistic children.

Relationship focused mother-infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning

We report on two preliminary evaluations of a group intervention, targeting vulnerable infants and their mothers within the first 6-months postpartum. The Mother-Baby Nurture® program aims to strengthen the developing infant-mother attachment relationship by increasing maternal mentalizing. These studies were undertaken with pre-post evaluations with the mothers of infants under 10-months of age. The mother-infant dyads participated in ten 2-h group sessions. Study one (N = 69 dyads) included self-reported maternal depression, anxiety, and parenting confidence. In study two (N = 27 dyads), parenting stress and reflective functioning were measured by self-report, and reflective functioning coded on the 5 min speech sample (completed by N = 22). Results from study one confirmed a decrease in depression (p < .001, d = .79) and anxiety (p < .001, d = .72) symptoms, and an increase in mothers' scores for parenting confidence (p < .001, d = -.98). Results from Study Two demonstrated a significant decrease in parenting stress (p < .001, d = .94) and significant improvement in measures of self-report reflective functioning (p = .007, .024; d = .56, .61). These findings are preliminary yet promising indications that this program could be effective in alleviating parenting stress, depression, and anxiety, and improving mother's reflective functioning and parenting confidence. Further research is needed, with a control group and long-term follow-up assessments.

Development of the motivational interviewing for loved ones skills assessment (MILO-SA)

AIM

Expressed emotion of family members is a key target for intervention for bettering psychosocial outcomes for transitional-age youth experiencing mental health crises. Motivational Interviewing for Loved Ones (MILO) seeks to reduce expressed emotion by teaching parents motivational interviewing skills such as taking a non-judgmental stance, exploring their loved one's thoughts and feelings, expressing optimism and confidence, and avoiding taking an expert role. This report details the creation of the Motivational Interviewing for Loved Ones- Skills Assessment (MILO-SA), its psychometric properties, and convergent validity with other measures of motivational interviewing adeptness.

METHODS

Our sample (n = 54) consisted of baseline assessments from parents participating in a pilot study of MILO. Parents were assessed for baseline knowledge of motivational interviewing as well as MILO skills with the MILO-SA and a traditional assessment clinician application of motivational interviewing skills.

RESULTS

We found that the MILO-SA displayed high interrater reliability (k = 0.81), and convergent validity with motivational interviewing knowledge (r = 0.32) as well as traditional assessments of clinician adeptness applying motivational interviewing skills (r = 0.67).

CONCLUSIONS

Our findings suggest that the MILO-SA has strong psychometric properties and is a useful tool for assessing parent acquisition of motivational interviewing skills. Specifically, the MILO-SA can be used in future studies focused on teaching non-clinicians motivational interviewing skills.

Using the Three-Minute Speech Sample to Examine the Parent-Adolescent Relationship in Autistic Youth: A Qualitative Analysis

PURPOSE

This qualitative study examines autistic adolescents' perception of the quality of their relationship with their parent using the Three Minute Speech Sample.

METHODS

Twenty autistic youth (13-17 years; 83% male) spoke, uninterrupted, for three minutes about their thoughts and feelings regarding their mothers. Audio-recorded speech samples were transcribed and coded for emergent themes.

RESULTS

Adolescents highlighted emotional support and acceptance in the context of their relationship, support mothers provide for mental health, love and caring, efforts to build the relationship through shared activities, and areas of adolescent-parent conflict.

CONCLUSION

The TMSS is a low cost, low burden method by which autistic adolescents can comfortably and effectively self-report the quality of their relationship with their parent/caregiver.

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.

Negative internal working models as mechanisms that link mothers' and fathers' personality with their parenting: A short-term longitudinal study

OBJECTIVE

Research on associations between parents' personality and parenting has a long history, but mechanisms that explain them remain unsettled. We examined parents' explicit and implicit negative internal working models (IWMs) of the child, assessed at toddler age, as linking parental personality and parenting.

METHOD

Mothers and fathers from 200 community families provided personality self-reports (Neuroticism, Agreeableness, Empathy, and Anger/Hostility) when their children were infants. When children were toddlers, the explicit negative IWMs included self-reported low-mentalizing reflective functioning and resentment regarding the child. The implicit negative IWMs were coded as negative relational schemas from parental interviews. Parental positive affect, responsiveness, and power-assertive control were observed in lengthy interactions. Measures were parallel for mother- and father-child dyads.

RESULTS

Mothers' implicit IWMs linked the association between low Empathy and more power-assertive control. Fathers' explicit IWMs linked the associations between high Neuroticism and low Agreeableness and lower responsiveness. Additionally, fathers' Agreeableness and Empathy directly predicted their parenting. Two paths (Agreeableness → implicit IWMs, and explicit IWMs → responsiveness) significantly differed between mothers and fathers.

CONCLUSIONS

IWMs may link parental personality with parenting. The findings integrate and inform several bodies of literature in personality, social cognition, and developmental psychology.

Expectant mothers' not fathers' mind-mindedness predicts infant, mother, and father conversational turns at 7 months

Parental mind-mindedness (MM), defined as the propensity to view one's child as an agent with thoughts, feelings, and desires, is associated with positive child outcomes (McMahon &amp; Bernier, 2017) and can be assessed in expectant parents by using five-minute speech samples (Magaña et al., 1986). Individual differences in MM appear stable across the transition to parenthood (Foley et al., in press), offering an exciting intervention opportunity, as expectant mothers' thoughts and feelings about their unborn infants are associated with the quality of mother-infant interactions. To assess prenatal MM as a predictor of parent-infant conversation at 7 months, we followed 93 low-risk British heterosexual couples across the transition to parenthood. Mothers' and fathers' MM was measured both in the third trimester of pregnancy and at 4 months. Wearable LENA devices were used to gather detailed measures of mother-, father-, and infant-initiated conversations at 7 months. Prenatal MM in both parents was associated with more frequent infant-initiated conversations at 7 months, while prenatal maternal (not paternal) MM was also associated with more mother- and father-initiated conversations. While longitudinal research with more diverse samples is needed, these findings highlight the importance of parental mentalizing in the prenatal period for early family interactions.

Mothers' and fathers' attachment styles and power-assertive control: Indirect associations through parental representations

Research on adults' self-reported attachment styles, investigated mostly in social and personality psychology, has rarely been bridged with research on parenting, studied mostly in developmental psychology. We proposed that parents' attachment insecurity (avoidance and anxiety) has an indirect association with their power-assertive control, mediated through their negative representations, or internal working models (IWM) of the child. In 200 community families from a Midwestern state (mothers, fathers, and children), we collected multimethod, parallel data for mother-child and father-child relationships. When children were infants, parents completed self-reports of their own attachment styles. When children were toddlers, we assessed parents' IWMs of the child in an interview and observed parental power-assertive control in structured, naturalistic discipline contexts in the laboratory. Mothers' avoidance showed a unique association with their IWM of their child. Consequently, there was an indirect association from the mother's avoidance to negative IWM to power-assertive control. Mothers' anxiety was associated directly with more power-assertive control. Fathers' avoidance and anxiety were also associated with their IWMs, but there were no unique associations, and the impact on parenting was limited. Forging a rapprochement between social and personality research on adults' attachment and developmental research on parenting, this work elucidates a potential mechanism of the intergenerational transmission of adaptive and maladaptive parenting in families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding Strengths in Adolescent-Parent Relationships: A Qualitative Analysis of Adolescent Speech Samples

Although adolescents' perspective on the parent-adolescent relationship uniquely predicts their mental health and wellbeing, there is limited research using qualitative methodologies to explore rich descriptions of adolescents' expectations, attitudes, and beliefs towards parents. The current study qualitatively analyzed adolescent narratives regarding their relationships with their parents. Seventy-two adolescents (68% female; M age = 16.56) provided three-minute speech samples that were examined using thematic analysis to understand key themes in adolescent-parent relationships from adolescents' perspectives. Overall, adolescents valued positive relationships with parents (involving emotional support and companionship), respected their authority, and looked to parents to role-model-valued traits. Mentions of negative interactions were mostly absent or justified as normal. Thus, normative adolescent-parent relationships are largely positive and valued by adolescents.

A comparison of expressed emotion between mothers and their adolescent daughters with and without a history of nonsuicidal self-injury

BACKGROUND

Expressed Emotion refers to the extent to which close relatives express critical/hostile and/or emotionally overinvolved attitudes and feelings when speaking about a family member. High Expressed Emotion is a valuable predictor of clinical outcomes and is related to the presence of various mental disorders, including nonsuicidal self-injury (NSSI). Interpersonal factors have been shown to be relevant in initiating and in maintaining with NSSI, as interpersonal difficulties are often reported as triggers for emotional dysregulation. The parental role in the etiology and treatment of NSSI needs to be further investigated. This study assesses Expressed Emotion in adolescents who engage in NSSI and their mothers.

METHOD

We examined Expressed Emotion levels of mother-daughter dyads among adolescents who engage in NSSI, clinical controls (CCs), and nonclinical controls (NCs). The sample consisted of 70 female adolescents aged 12-20 years (M = 15.28 years, SD = 1.81; NSSI: n = 21, CC: n = 17, NC: n = 32) and 24 mothers aged 38-56 years (M = 46.47 years, SD = 4.61) using The Five-Minute Speech Sample (FMSS).

RESULTS

Adolescents who engage in NSSI exhibited significantly more covert criticism and critical tone toward their mothers than CCs (d = 0.65, d = 1.10) and NCs (d = 1.30, d = 1.10).

CONCLUSION

The findings highlight the importance of family-based interventions for the treatment of NSSI in order to enhance a positive relationship quality between parents and adolescents.

"It brought my family more together": Mixed-methods study of low-income U.S. mothers during the pandemic

Objective

We sought to understand challenges and positive experiences of low-income families during the pandemic.

Background

Strength-based perspectives of economically disadvantaged mothers are missing from literature on the impact of the COVID-19 pandemic. Although it is imperative to recognize disparities that were highlighted by the pandemic, strengths-based approaches and a resilience framework can help professionals build upon and learn from ways families manage during those times.

Method

We used a mixed-method approach to gain understanding of the unique experiences of 15 low-income mothers at the height of the pandemic. We administered a brief COVID-19 stress screener, the Five-Minute Speech Sample measure, and an open-ended question about potential positive experiences during the pandemic.

Results

We learned that strength and resilience supersede the liabilities brought on by COVID-19 that are so often focused on. We found highly divergent experiences across mothers in terms of stress; even mothers with high levels of stress readily identified positive aspects of life during the pandemic. Mothers' responses were indicative of greater feelings of warmth and tenderness than negativity about their children.

Conclusion and Implications

We discuss findings in terms of strengths-based practices and policies for mothers receiving public assistance and provide suggestions for continued research on resilience of mothers during the pandemic.

Narrative coherence across the transition to parenthood: Primiparous parents' representations of their child in relation to parental sensitivity

Narrative coherence reflects parents' ability to provide a believable, clear, relevant, and internally consistent story about their child. Parents demonstrating more narrative coherence have been theorized to show higher parental sensitivity, but this has not been examined in a normative sample, nor across the transition to parenthood, and only once in fathers. The aim of this study was to examine stability and change in narrative coherence across the transition to parenthood in mothers and fathers, as well as the relation between pre- and postnatal narrative coherence and postnatal parental sensitivity. The sample consisted of 105 primiparous expecting parents. Narrative coherence was measured at 36-weeks pregnancy and when the child was 4 months old, using the Five Minute Speech Sample procedure. Parental sensitivity was observed in three episodes. Results demonstrated that narrative coherence was moderately stable (correlations) across the transition to parenthood in fathers only. Both mothers' and fathers' narrative coherence improved over time. Furthermore, mothers and fathers were overall equally coherent, and maternal and paternal narrative coherence were positively interrelated during pregnancy only. Lastly, our findings showed weak evidence for the theorized link between narrative coherence and parental sensitivity: only postnatal narrative coherence predicted paternal sensitivity, only during free play. Our findings give new insight in the development of narrative coherence across the transition to parenthood, and how it relates to actual parenting. More research is needed to confirm our findings and further explore this topic.

Intergenerational Transmission of Posttraumatic Stress Disorder in Australian Vietnam Veterans' Daughters and Sons: The Effect of Family Emotional Climate While Growing Up

Posttraumatic stress disorder (PTSD) in military veterans increases the risk of PTSD in their offspring, a concept known as "intergenerational transmission;" however, the mechanism by which this transmission may occur is, as yet, undetermined. The present study included a nonclinical sample of 197 Australian Army veterans of the Vietnam War who were interviewed 17 years before in-person interviews of their adult daughters (n = 163) and sons (n = 120) were conducted. Veterans' PTSD symptoms were assessed using the Mississippi Scale for Combat-Related PTSD. Approximately 17 years later, offspring PTSD symptoms were assessed using the Clinician-Administered PTSD Scale for DSM-IV. In addition, offspring described the family emotional climate during their youth; responses were coded using the Family Affective Attitude Rating Scale (FAARS) to produce scale scores of veterans' negative, positive, and family relationship styles. A path analysis was conducted via structural equation modeling to test for significant path coefficients between veteran PTSD, family emotional climate, and offspring PTSD symptoms. For daughters, significant path coefficients were observed between veteran PTSD scores and FAARS scores, path coefficient = -.268; FAARS scores and offspring CAPS severity scores, path coefficient = -.223; and veteran PTSD scores and daughters' CAPS severity scores, path coefficient = .186. No satisfactory model could be found for sons. The results suggest that a positive emotional climate while growing up may be a significant protective factor against the development of PTSD in veterans' daughters, but other factors remain significant in veteran-to-offspring intergenerational transmission.

Parental Expressed Emotion, Parenting Stress, and Behavioral Problems of Young Children with 22q11.2 Deletion Syndrome and Idiopathic Autism Spectrum Disorder

This study examined the associations of parents' expressed emotion (EE) and parenting stress, with behavioral problems of children with 22q11.2 deletion syndrome, idiopathic autism (iASD) and typically developing (TD) children. Parents of children aged 3-8 years completed the five-minute-speech-sample (FMSS), parental stress index and children behavioral checklist. Parents' FMSS-EE-criticism was higher among parents of children with 22q11DS and iASD compared to parents of TD children. FMSS-EE scores predicted children's behavioral problems, above and beyond parenting stress. The associations between FMSS-EE, parenting stress and children's behavioral problems were consistent across 22q11DS, iASD and TD children. These findings highlight the need for targeting parents' EE and parenting stress as integral elements in the screening and prevention of behavioral problems of young children with 22q11DS and iASD.

Prevention of child mental health problems through parenting interventions in Southeastern Europe (RISE): study protocol for a multi-site randomised controlled trial

BACKGROUND

Childhood adversities, such as poor parental practices, exposure to violence, and risk behaviours strongly impact children's future mental and behavioural problems. Adversities affect families living in disadvantaged environments and low- and middle-income countries (LMICs) to a greater extent than in high-income countries. Parenting programmes are an effective way to alleviate them, although their outreach and scalability is still limited in LMICs.

METHODS/DESIGN

A multi-site randomised controlled trial will be conducted in North Macedonia, Republic of Moldova and Romania to test the efficacy and cost-effectiveness of an optimised version of the promising Parenting for Lifelong Health Programme for Young Children (PLH-YC, 5 sessions), against a standard lecture on parenting issues (control group, 1 session). At least 864 participants who report having children between 2 and 9 years old who display elevated levels of behavioural difficulties will be randomised on a 1:1 basis to the intervention and control groups. The primary outcome will consist of parent report of child oppositional aggressive behaviour. Post-test (four months) and follow-up (12 months) assessments will provide information on short- and longer-term effects of PLH-YC compared to the parenting lecture in the control group.

DISCUSSION

This randomised trial will test the efficacy of PLH-YC in alleviating child behavioural problems and assess the cost-effectiveness, transportability across three different cultural contexts, and potential for scalability of the programme.

TRIAL REGISTRATION

ClinicalTrials.gov ., Registration number: NCT04721730 ( https://clinicaltrials.gov/ct2/show/NCT04721730 ). Registered 13.01.2021.

Relative predictive utility of the original and Autism-Specific Five-Minute Speech Samples for child behaviour problems in autistic preschoolers: A preliminary study

LAY ABSTRACT

Parental Expressed Emotion refers to the intensity and nature of emotion shown when a parent talks about their child, and has been linked to child behaviour outcomes. Parental Expressed Emotion has typically been measured using the Five-Minute Speech Sample; however, the Autism-Specific Five-Minute Speech Sample was developed to better capture Expressed Emotion for parents of children on the autism spectrum. In each case, parents are asked to talk for 5 min about their child and how they get along with their child. Parents' statements are then coded for features such as number of positive and critical comments, or statements reflecting strong emotional involvement. While both the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample have been used with parents of autistic school-aged children, their relative usefulness for measuring Expressed Emotion in parents of preschool-aged children - including their links to child behaviour problems in this group - is unclear. We collected speech samples from 51 parents of newly diagnosed autistic preschoolers to investigate similarities and differences in results from the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample coding schemes. This included exploring the extent to which the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample, separately, or together, predicted current and future child behaviour problems. While the two measures were related, we found only the Autism-Specific Five-Minute Speech Sample - but not the Five-Minute Speech Sample - was related to child behavioural challenges. This adds support to the suggestion that the Autism-Specific Five-Minute Speech Sample may be a more useful measure of parental Expressed Emotion in this group, and provides a first step towards understanding how autistic children might be better supported by targeting parental Expressed Emotion.

Mothers' Narratives on their Immigration Experiences: Associations with Maternal Relatedness and Adolescent Adjustment

We examined the hypothesis that lower maternal relatedness mediates the associations of immigrant mothers' acculturative stress and lack of benefit finding in immigration with poorer adjustment of their adolescents in terms of more externalizing problems and lower school achievements and self-worth. Participants were 93 adolescents (47.31% girls, M_age  = 16.04) and their mothers (M_age  = 45.83) from middle-class families. Mothers immigrated to Israel from the Former Soviet Union or Western countries (M_{years-in-Israel}  = 19.75). We used a multimethod multi-informant approach that included a novel narrative procedure for assessing acculturative stress and benefit finding. Structural Equation Modeling supported the hypothesis, suggesting that research on and practice with adolescents in immigrant families should consider the meaning parents derive from their immigration experiences.

Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors

This study examined the family emotional climate as assessed by Five Minute Speech Samples and the relation with parenting stress and parenting behaviors among parents of children (6-17 years, 64.7% boys) with autism spectrum disorder, cerebral palsy, Down syndrome, and without any known disability (n = 447). The large majority of parents (79%) showed low levels of Expressed Emotion, an indicator of a positive family climate. In all groups, more Emotional Over-involvement, more Criticism and fewer expressions of Warmth were associated with higher levels of parenting stress. Across groups, Emotional Over-involvement was related to more autonomy-supportive parenting, Criticism to more psychologically controlling and overreactive parenting, and Warmth was associated with more responsive and less psychologically controlling and overreactive parenting.

Negative parental emotional environment increases the association between childhood behavioral problems and impaired recognition of negative facial expressions

Impaired facial emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. Childhood behavioral difficulties and parental emotional environment have been independently associated with impaired emotion recognition; however, no study has examined the contribution of these factors in conjunction. We measured recognition of negative (sad, fear, anger), neutral, and happy facial expressions in 135 children aged 5-7 years referred by their teachers for behavioral problems. Parental emotional environment was assessed for parental expressed emotion (EE) - characterized by negative comments, reduced positive comments, low warmth, and negativity towards their child - using the 5-minute speech sample. Child behavioral problems were measured using the teacher-informant Strengths and Difficulties Questionnaire (SDQ). Child behavioral problems and parental EE were independently associated with impaired recognition of negative facial expressions specifically. An interactive effect revealed that the combination of both factors was associated with the greatest risk for impaired recognition of negative faces, and in particular sad facial expressions. No relationships emerged for the identification of happy facial expressions. This study furthers our understanding of multidimensional processes associated with the development of facial emotion recognition and supports the importance of early interventions that target this domain.

Effects of an adolescent depression prevention program on maternal criticisms and positive remarks

This study examined effects of an adolescent depression prevention program on maternal criticisms and positive remarks, whether the extent of adolescents' depression accounted for effects, and whether effects of the program on maternal criticisms and positive remarks differed by adolescents' gender. Participants were 298 adolescent (M_age = 14.79, SD = 1.36; 59% female) offspring of mothers with histories of depression; youth were randomized to either a cognitive-behavioral prevention (CBP) program or usual care (UC). At baseline and 9-month postintervention evaluations, mothers were administered the Five-Minute Speech Sample to measure number of criticisms and positive remarks made during an open-ended description of their child and their relationship. Adolescents' depression from pre- through postintervention was assessed with interviews. A hierarchical generalized linear model showed a significant condition-by-gender interaction, indicating that, controlling for baseline criticism, at postintervention mothers of girls in CBP made significantly more criticisms than did mothers of girls in UC, whereas mothers of boys in CBP made fewer criticisms than did mothers of boys in UC. The extent of adolescents' depression from pre- through postintervention partially mediated the relation between intervention condition and mothers' criticisms, for boys but not for girls. Second, controlling for preintervention positive remarks, at postintervention, mothers of youth in CBP made significantly more positive remarks about their child than did mothers of youth in UC, regardless of gender; this relation was not mediated by adolescent depression from pre- through postintervention. We suggest possible explanations for the observed effects of CBP on mothers' criticisms and positive remarks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Family emotional climate in childhood and risk of PTSD in adult children of Australian Vietnam veterans

The mechanisms of intergenerational transmission of posttraumatic stress disorder (PTSD) from parent to child are not yet known. We hypothesised that the mechanisms involved in trauma transmission may be dependent upon sex specific caregiver-child dyads and these dyads may have a differential impact on post-traumatic stress disorder (PTSD). A non-clinical sample of adult offspring (N = 306) of Australian Vietnam veterans was interviewed in-person to assess the relationship between family emotional climate and caregiver attachment with the offspring's adult experience of post-traumatic stress disorder (PTSD). Attachment to the veteran father was not associated with sons' PTSD, but was for daughters. Attachment to mother was associated with PTSD and depression for both sons and daughters, with positive and warm attachment related to reduced PTSD diagnosis and its symptom clusters. A less positive family emotional environment was related to increased PTSD symptoms in daughters, while for sons a negative relationship style with their mother was related to increased frequency and severity of numbing/avoidance behaviours and hyperarousal symptoms. The findings suggest that sex-related differences in caregiver-child dyads do have a differential impact on PTSD symptom domains and may be one environmental mechanism by which trauma is transmitted across generations.

A Meta-analytic Review of the Five Minute Speech Sample as a Measure of Family Emotional Climate for Youth: Relations with Internalizing and Externalizing Symptomatology

The Five Minute Speech Sample's (FMSS) measure of parental expressed emotion (EE), defined as criticism (CRIT) and emotional overinvolvement (EOI), has been increasingly used to measure family emotional climate in relation to youth psychopathological development. As CRIT and EOI were defined based on adults, a meta-analysis and systematic review was conducted to analyze the presence and strength of an effect among maternal CRIT and EOI with youth internalizing and externalizing problems. A random effects model was used to analyze the 42 studies on families of youth (aged 1.5 to 19). There was a small, significant relation among maternal CRIT with youth internalizing and externalizing problems and among EOI with youth internalizing problems. EOI was not significantly related to externalizing problems. The current study suggests that the FMSS measure of CRIT is a more robust correlate of youth internalizing and externalizing symptoms than EOI, but EOI does relate to internalizing behaviors. Few moderators emerged, highlighting a continued need to identify factors accounting for heterogeneity. The current results suggest that the FMSS measure of CRIT may be a valuable measure of the family emotional climate in families of youth, but care should be taken when including analyses on EOI.

Vasopressin and parental expressed emotion in the transition to fatherhood

In the last decades, parenting researchers increasingly focused on the role of fathers in child development. However, it is still largely unknown which factors contribute to fathers' beliefs about their child, which may be crucial in the transition to fatherhood. In the current randomized within-subject experiment, the effect of nasal administration of vasopressin (AVP) on both Five Minute Speech Sample-based (FMSS) expressed emotion and emotional content or prosody was explored in 25 prospectivefathers. Moreover, we explored how the transition to fatherhood affected these FMSS-based parameters, using prenatal and early postnatal measurements. Analyses revealed that FMSS-based expressed emotion and emotional content were correlated, but not affected by prenatal AVP administration. However,child's birth was associated with an increase in positivity and a decrease in emotional prosody, suggesting that the child's birth is more influential with regard to paternal thoughts and feelings than prenatal AVP administration.

Family Emotional Climate and Children with Autism Spectrum Disorder

Little research has examined family emotional climate in the context of having a child with autism spectrum disorder (ASD). The goal of the current study was to determine how the emotional quality of family subsystems (parent-child and parent couple relationships, for both mothers and fathers) combine to create various classes of family emotional climate and to identify predictors of class membership in 148 families of children with ASD. The emotional quality of family subsystems was assessed using Five Minute Speech Samples from mothers and fathers. In total, 148 families of children with ASD (86% male) aged 6-13 years were included in analyses. About one-third of parents did not have a college degree and more than two-thirds were of non-Hispanic White origin. Latent class analysis revealed that 43% of the sample was characterized by high levels of warmth and low levels of criticism in both the parent-child and parent couple relationships; 12% of the sample was characterized by low warmth and high criticism in both sets of relationships; and the rest of the sample was divided among three additional classes of emotional climate characterized by different configurations of warmth and criticism across both sets of relationships. Parent level of broader autism phenotype and child emotional and behavioral problems were associated with emotional climate class membership. Implications for interventions are discussed.

Family Emotional Climate and Children with Autism Spectrum Disorder

Little research has examined family emotional climate in the context of having a child with autism spectrum disorder (ASD). The goal of the current study was to determine how the emotional quality of family subsystems (parent-child and parent couple relationships, for both mothers and fathers) combine to create various classes of family emotional climate and to identify predictors of class membership in 148 families of children with ASD. The emotional quality of family subsystems was assessed using Five Minute Speech Samples from mothers and fathers. In total, 148 families of children with ASD (86% male) aged 6-13 years were included in analyses. About one-third of parents did not have a college degree and more than two-thirds were of non-Hispanic White origin. Latent class analysis revealed that 43% of the sample was characterized by high levels of warmth and low levels of criticism in both the parent-child and parent couple relationships; 12% of the sample was characterized by low warmth and high criticism in both sets of relationships; and the rest of the sample was divided among three additional classes of emotional climate characterized by different configurations of warmth and criticism across both sets of relationships. Parent level of broader autism phenotype and child emotional and behavioral problems were associated with emotional climate class membership. Implications for interventions are discussed.

Parental criticism and behavior problems in children with autism spectrum disorder

Associations between parent critical attitudes (a component of the Expressed Emotion construct) and behavior problems have been relatively well established in adolescents and young adults with autism spectrum disorder, but use of systems adapted for children with autism spectrum disorder and additional investigations with younger samples are needed. This study examined parental criticism, derived from a population-specific coding system, as related to behavior problems in children with autism spectrum disorder between the ages of 4 and 11 years, and considered parental warmth and children's psychophysiological reactivity as statistical moderators of these associations. In all, 40 children with autism spectrum disorder and their primary caregivers attended a visit involving collection of child electrodermal activity, parent-child interaction, a parent interview from which critical attitudes and warmth were coded, and parent report of child behavior problems. Criticism was directly related to higher child externalizing but not internalizing problems. Parental criticism interacted with warmth in the prediction of internalizing problems such that criticism was only associated with more problems in the context of moderate but not high warmth. Criticism was positively associated with externalizing problems under conditions of moderate and high, but not low, child electrodermal activity reactivity. Implications for conceptualizations of parental criticism in autism spectrum disorder, for understanding comorbid behavior problems in this population, and for intervention are discussed.

Relationship between posttraumatic stress symptoms, caregiving response, and parent mental health in youth exposed to single incident trauma

BACKGROUND

Family factors may alter the risk of developing posttraumatic stress disorder (PTSD) or depression in young people after a traumatic event, but it is not clear which modifiable family variables can be addressed in psychological therapies. This study examined the relationships between family factors (Expressed Emotion [EE] and family accommodation) and psychopathology (posttraumatic stress symptoms; PTSS) in young people following a single incident trauma. Potential mediators of these relationships were also investigated.

METHOD

Sixty-six parent-child dyads (aged 8-17 years) were assessed within one month of attending an Emergency Department. Self-reported PTSS and perceived EE were assessed in young people. Parents' own PTSS, mood symptoms, EE, and accommodating behaviours were also assessed.

RESULTS

Cross-sectional analyses revealed that young person-perceived EE, parent-reported emotional over involvement (EOI) and accommodation behaviours significantly predicted higher PTSS in young people. The stress experienced as a consequence of EE mediated the relationship between young person-perceived EOI and PTSS in young people. Parental PTSS and anxiety were positively correlated with EOI and accommodation. Parental PTSS was not significantly associated with symptoms in young people.

CONCLUSIONS

The results support the hypothesis that EE and accommodation are positively associated with PTSS in young people in the month following a potentially traumatic event. Understanding the child in the context of their family environment and relationships offers an important framework for making sense of and facilitating adaptive adjustment following a traumatic event.

Video feedback intervention to enhance parental reflective functioning in primary caregivers of inpatient psychiatric children: protocol for a randomized feasibility trial

Background

Children requiring hospitalization for psychiatric care have serious disorders, high use of psychotropic medication, and frequent readmissions. The development and implementation of therapies focused on incorporating primary caregivers or attachment figures is necessary for working with children with severe psychiatric disorders. Mentalization or parental reflective functioning (PRF) is the ability of parents to understand their children’s behaviors as an expression of internal emotional states and act accordingly to help them regulate their emotions; in this way mentalizing is a key component of sensitive parenting. Video-assisted therapies have proven to be effective in promoting change in parent–child relationships. The majority of studies have been carried out with mothers of pre-school children and in an outpatient setting. Video intervention therapy (VIT) is a flexible manualized therapy, which allows the intervention to be individualized to the context where it is applied, according to the needs and resources of the people who participate in it. The objective of the study is to evaluate the feasibility and acceptability of applying VIT to improve the PRF of the parents as primary carers of children hospitalized in a psychiatric service.

Methods

This is a pilot randomized, single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 2:1 allocation (with more people allocated to the intervention arm). The intervention consists of four modules; every module has both one video-recorded play session and one VIT session per week. People assigned to the control group will receive treatment as usual plus weekly play sessions. Feasibility and acceptability of the study will be quantitatively and qualitatively assessed. Evaluation of the caregivers will include assessments of PRF, wellbeing and personality structure; assessments of children will include parent-ratings and clinician-ratings of symptomatology and general functioning. After every video feedback (VF) session, PRF, the caregiver’s wellbeing and children’s general functioning will be reassessed.

Discussion

This study will contribute to the currently scarce evidence on how to provide family attachment-based interventions in a child inpatient psychiatric unit. It will also inform the design and implementation of a future randomized clinical trial.

Trial registration

ClinicalTrials.gov, NCT03374904. Registered on 14 December 2017 (retrospectively registered).

Electronic supplementary material

The online version of this article (10.1186/s13063-019-3310-y) contains supplementary material, which is available to authorized users.

Early relational experience: A foundation for the unfolding dynamics of parent-child socialization

Psychologists have long tried to understand why trajectories of socialization in individual parent-child dyads can be distinct, leading to adaptive or maladaptive developmental outcomes. In this article, we elucidate origins of those differences by examining the subtle yet enduring implications of early parent-child relationships in longitudinal studies of low- and high-risk families, using correlational and experimental designs, and multiple measures. Those relationships are key for socialization because they can alter cascades from children's biologically based difficult temperament to parents' negative control to negative children's outcomes, as demonstrated by social-learning theories. We suggest that those cascades unfold only in parent-child dyads whose early relationships lack positive mutuality and security. Such relationships set the tone for adversarial cascades. In contrast, early mutually positive, secure relationships initiate cooperative, effective socialization and defuse risks of negative cascades. Parents' and children's internal representations of each other may explain how such divergent sequelae unfold.

Growing up with a father with PTSD: The family emotional climate of the children of Australian Vietnam veterans

A non-clinical sample of male Australian Vietnam veterans, their wives, and adult offspring were interviewed in-person in a national epidemiological study to assess the relationship between the mental ill-health of veterans and the emotional climate of the family while the children were growing up. Veterans were assessed 17 years before their children using standardised psychiatric diagnostic interviews. Family emotional climate was assessed using offspring ratings of parental attachment, and codings of positive and negative family relationship styles based on five minute speech samples provided by the offspring. Sons and daughters had different views of their mothers and fathers, and were less positive towards their fathers particularly if he had posttraumatic stress disorder (PTSD). Veteran PTSD and depression significantly negatively impacted the family emotional climate, while mothers' mental health was not related. Veteran PTSD symptoms were lowest in secure attachment to the veteran and highest in inconsistent attachment for both sons and daughters, but were not related to attachment to the mother. Veteran PTSD was related to daughters' but not sons' perceptions of family emotional climate. The impact of veterans' PTSD on their families' emotional climate is more marked for daughters than sons.

Maternal depressive symptoms, self-focus, and caregiving behavior

BACKGROUND

Parent-child interactions set the stage for child mental health and development. Given that maternal depressive symptoms are associated with poorer observed caregiving behaviors, examining potential cognitive mediators is important for identifying mechanisms underlying the intergenerational transmission of risk and possible targets for intervention.

METHODS

We assessed depressive symptoms and levels of self-focus and psychological distancing from infant-centered verbal narratives obtained from 54 mothers, and examined caregiving behaviors in a structured interaction with their six-month-old infants.

RESULTS

Higher depressive symptoms were associated with pronoun use in narratives (i.e., greater "I" and reduced "we" use), reflecting increased self-focus and psychological distancing. Further, increased self-focus was associated with lower levels of caregiver warmth, and mediated the association between depressive symptoms and caregiving warmth.

LIMITATIONS

This observational study does not allow for causal interpretations.

CONCLUSION

These findings suggest that the cognitive styles associated with depression interfere with the caregiving relationship, affecting behavior in parent-child interactions that may increase the risk for the intergenerational transmission of depression.

Predictive factors for outcome in adolescents with anorexia nervosa: To what extent does parental Expressed Emotion play a role?

In studies on family therapy in Anorexia Nervosa, family relationships, as assessed by Expressed Emotion, have been associated with outcome. Our aim was to explore the contribution of Expressed Emotion as a predictor of 18-month outcome, above and beyond the usual predictive factors. Sixty adolescent girls suffering from Anorexia Nervosa and their parents were assessed at baseline and 18 months later. Levels of Expressed Emotion were evaluated in both parents with the Five-Minute Speech Sample. After controlling for treatment group and initial clinical status, high maternal Emotional Over-Involvement at baseline was significantly associated with better clinical state. More precisely, high maternal Emotional Over-Involvement was associated with higher nutritional status, lower eating disorder severity and fewer re-hospitalizations 18 months later. No associations were found with paternal levels of Expressed Emotion. Therefore, our study confirmed the importance of taking into account both maternal and paternal Expressed Emotion. Our results also underlined that high maternal Emotional Over-Involvement plays a positive role in the outcome of Anorexia Nervosa and needs to be explored further.

Mother-Adolescent Dialogues and Adolescents' Behavior Problems in a Multicultural Sample: The Mediating Role of Representations

This study examined whether the link between higher maternal sensitive guidance of emotional dialogues and fewer adolescent behavior problems is mediated by adolescents' more coherent representations of their mothers. The study also explored the consistency of this model across families from varied cultural backgrounds. Participants were 143 Jewish-Israeli mother-adolescent dyads from three cultural groups: immigrants from the Former Soviet Union, immigrants from Western countries, and native-born Israelis. Maternal sensitive guidance was observed during mother-adolescent dialogues about emotional experiences. Adolescents' representations were assessed via their narratives regarding their mother and their relationship. Examiners reported adolescents' behavior problems. Results indicated that across cultural groups adolescents' more coherent representations partially mediated the association between higher maternal sensitive guidance and fewer adolescent behavior problems.

Associations among mothers' representations of their relationship with their toddlers, maternal parenting stress, and toddlers' internalizing and externalizing behaviors

This study examined the array of associations among the emotional valence and the coherence of mothers' representations of their relationship with their toddlers, mothers' reported parenting stress, and toddlers' internalizing and externalizing behaviors. To evaluate maternal representations, 55 mothers were interviewed using the Five Minute Speech Sample procedure (FMSS; Magaña et al., 1986), which was coded for criticism and positive comments (Magaňa-Amato, 1993), as well as coherence (Sher-Censor & Yates, 2015). Mothers also completed the Parenting Stress Index - Short Form (PSI; Abidin, 1997) to evaluate their parenting stress and the Child Behavior Checklist (CBCL/1.5-5; Achenbach & Rescorla, 2000) to assess their toddlers' internalizing and externalizing behaviors. Results indicated that parenting stress was associated with maternal criticism and fewer positive comments in the FMSS, but not with the coherence of mothers' FMSS. Parenting stress, criticism, and lower coherence in the FMSS were associated with maternal reports of externalizing behaviors. Only parenting stress and lower coherence in the FMSS were related to mothers' reports of internalizing behaviors of the child. Thus, the emotional valence and the coherence of mothers' representations of their relationship with their child and parenting stress may each constitute a distinct aspect of parenting and contribute to the understanding of individual differences in toddlers' internalizing and externalizing behaviors. Implications for research and practice with families of toddlers are discussed.

Maternal Mind-Mindedness Provides a Buffer for Pre-Adolescents at Risk for Disruptive Behavior

Maternal mind-mindedness, defined as the propensity to view one's child as an agent with independent thoughts and feelings, mitigates the impact of low maternal education on conduct problems in young children (Meins et al. 2013), but has been little studied beyond the preschool years. Addressing this gap, we applied a multi-measure and multi-informant approach to assess family adversity and disruptive behavior at age 12 for a socially diverse sample of 116 children for whom ratings of disruptive behavior at age 6 were available. Each mother was asked to describe her child and transcripts of these five-minute speech samples were coded for (i) mind-mindedness (defined by the proportion of child attributes that were mental rather than physical or behavioral) and (ii) positivity (defined by the proportion of child attributes that were positive rather than neutral or negative). Our regression results showed that, independent of associations with prior adjustment, family adversity, child gender and low maternal monitoring, mothers' mind-mindedness (but not positivity) predicted unique variance in disruptive behavior at age 12. In addition, a trend interaction term provided partial support for the hypothesis that pre-adolescents exposed to family adversity may benefit in particular from maternal mind-mindedness. We discuss the possible mechanisms underpinning these findings and their implications for clinical interventions to reduce disruptive behavior in adolescence.