Physiological regulation of stress in referred adolescents: the role of the parent-adolescent relationship

Testing different sources of environmental unpredictability on adolescent functioning: ancestral cue versus statistical learning and the role of temperament

BACKGROUND

The dimensional model of environmental adversity highlighted the effects of an unpredictable environment in promoting risky development. Toward gaining greater specificity in understanding, this multimethod, longitudinal study investigated the role of two sources of environmental unpredictability-ancestral cues versus statistical learning, and their interaction with dove temperament conceptualized within the evolutionary model of temperament, in shaping adolescent functioning.

METHODS

Participants were 192 families with an adolescent (M_age  = 12.4) followed for two annual waves. We measured unpredictability within the ancestral-cue approach as incidents of disruptive family events, and statistical-learning unpredictability as the random variability in observed moment-to-moment maternal hostility during parent-child interaction. We focused on dove temperament, which characterizes strategies of cautious and inhibited behavior in novel contexts and persistence and intrinsic engagement in benign contexts.

RESULTS

Findings indicated unique effects of ancestral-cue versus statistical-learning unpredictability-in interaction with dove temperament-in association with adolescent functioning. Ancestral-cue unpredictability interacted with dove temperament in association with vagal stress reactivity, and the interactive effects of statistical-learning unpredictability were only associated with set-shifting. Furthermore, the family instability-x-dove temperament interaction was linked to adolescent adjustment via vagal reactivity. Adolescents with lower dove temperament showed dampened vagal reactivity within the more unpredictable environments, which was in turn associated with a greater decrease in social withdrawal over time.

CONCLUSIONS

The findings highlighted the specificity in different sources of environmental unpredictability in shaping adolescent development.

A systematic review and meta-analysis of the association between parenting and child autonomic nervous system activity

Parental socialization may influence the development of children's autonomic nervous system (ANS), a key stress-response system. However, to date no quantitative synthesis of the literature linking parenting and child ANS physiology has been conducted. To address this gap, we conducted a pre-registered meta-analysis. A systematic review of the literature identified 103 studies (n = 13,044 participants) with available effect sizes describing the association between parenting and either parasympathetic nervous system (PNS) or sympathetic nervous system (SNS) activity in children. The overall analysis revealed non-significant associations between parenting and child ANS physiology on average. However, moderation analyses revealed a positive association between more positive parenting and higher resting PNS activity that was stronger when a study was experimental rather than correlational, and when the sample included children with a clinical condition. In conclusion, well-controlled experimental studies show that positive parenting is associated with the development of higher resting PNS activity, an effect that may be stronger among children who are at elevated developmental risk.

Psychotherapy and youth suicide prevention: An interpretative phenomenological analysis of specialist clinicians' experiences

The study explored psychologists' experiences in delivering short-term psychotherapy for suicidal adolescents and sought to clarify how these experiences fit with empirically supported interventions and the interpersonal psychological theory of suicide. Semistructured interviews were conducted with 12 psychologists' who provided short-term psychotherapy in a suicide prevention programme for youth (12- to 25-year-olds). Interview transcripts were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: (i) understand the experience and context of the suicidality and the importance of a formulation-based approach to engagement and individualized treatment planning; (ii) involve broad support systems, and in particular families, to help the young person reduce feelings of burdensomeness and increase safety, connectedness and belonging; and (iii) improve affect regulation and reflective functioning, important not only for the young person but also for the support system to maximize the positive impact of supports via emotional coregulation and effective problem-solving. Interventions and approaches as well as the potential underlying processes of change being targeted are discussed in light of these findings. As an example, the development of a suicide safety plan was an intervention that traversed these themes. When used as a process tool, it helped foster a collaborative, formulation, dimensional and biopsychosocial approach to treat psychopathology and suicidality and extended beyond the therapist-client dyad. Moreover, treatment needs to be extended beyond the therapist-client dyad to allow therapists to facilitate a systemic treatment response, as this was seen as a major component of interventions for suicidal youth.

Food Insecurity and Adolescent Psychosocial Adjustment: Indirect Pathways through Caregiver Adjustment and Caregiver-Adolescent Relationship Quality

Household food insecurity is associated with youth behavioral problems, yet few studies have examined potential mechanisms that underline this association, particularly among adolescents. The Family Stress Model (FSM) states that food insecurity potentially impacts adolescent psychosocial adjustment indirectly through its effects on parental psychological functioning and parenting. The current study examined data from the Children, Welfare, and Families study (N = 687, 53% female, M_age of child at baseline = 11.74 years, SD = 1.39) to determine whether household food insecurity at the beginning of adolescence predicts later behavioral outcomes and whether that association is mediated through caregiver depression and caregiver–adolescent relationship quality. Caregivers completed measures of past-year household food insecurity, current self-reported depressive symptoms and adolescent behavior problems, while adolescents completed a measure of current caregiver–adolescent relationship quality. A serial multiple mediator model, controlling for baseline values of mediators, outcomes, and relevant demographic covariates, indicated a significant total indirect effect, whereas the total direct effect was not significant. Significant indirect effects through both caregiver depression and caregiver–adolescent relationship quality were also found. These results are the first to explicitly examine the FSM with respect to household food insecurity and to demonstrate the indirect effects of food insecurity on adolescent adjustment. The findings indicate the need to improve food security and address subsequent intra- and inter-personal difficulties among low-income families that contribute to behavioral problems among adolescents facing household food insecurity.

Sympathetic arousal during the processing of dysphoric affect by youths at high and low familial risk for depression

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never-depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre-ejection period (PEP); mood repair outcome was indexed by self-rated affect. High-risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low-risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high-risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low-risk but not in the high-risk group. The findings suggest that: (a) depression-prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status.

Internalizing Problems and Attentional Control

Abstract. Individuals with internalizing problems differ in levels of attentional control (AC), and this heterogeneity could be associated with differences in autonomic arousal. The present study investigated whether AC moderated the effect of internalizing problems on self-reported experience and autonomic nervous system (ANS) responses after the induction of negative affect. Children aged 9–13 years were recruited into a patient group (29) and a healthy control group (25). AC was measured by the Early Adolescent Temperament Questionnaire. Heart rate, heart rate variability (HRV) and pre-ejection period (PEP) were recorded during baseline, a sad film clip and recovery, and analyzed using a marginal linear model. Children reported their experienced emotion, valence, and arousal in response to the film. A significant interaction effect showed increased HRV and longer PEP from baseline to recovery for patients with higher AC. Patients with lower AC showed increased HRV followed by a return to baseline values after the film clip and no significant changes in PEP. Healthy controls showed no significant changes in HRV or PEP independent of level of AC. There were no differences between groups in self-reported experience. The results indicate that AC moderated the effect of internalizing problems on ANS regulation. Increased HRV and longer PEP from baseline to recovery were uniquely associated with higher AC and internalizing problems. This physiological response might indicate a cognitive avoidance strategy. AC could be an important factor explaining heterogeneity in ANS activity among individuals with internalizing problems. Clinical implications of the present findings are discussed.

A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome

OBJECTIVE

Steroid-sensitive nephrotic syndrome (SSNS) in children is often complicated by one or more relapses, as manifested by the appearance of proteinuria. Besides health-related triggers, psychological stress might be related to relapse. This longitudinal study examined the link between perceived stress, emotional valence (feeling happy vs. unhappy) and daily reported proteinuria, and investigated the temporal relation between stressful events and proteinuria.

METHOD

Sixteen children (4-13 years) diagnosed with SSNS were included. Patients kept an online diary for an average of 124 days, wherein they reported proteinuria (n = 1985 urine samples), perceived stress, emotional valence, medication use and health complaints. Stressful days were determined at the start of the study. Using multilevel analysis, the following associations were tested: (1) the relation between perceived stress, emotional valence and proteinuria, and (2) the temporal relation between stressful days and proteinuria.

RESULTS

Appearance of proteinuria was reported in 410/1985 urine samples. Perceived stress and not emotional valence significantly predicted proteinuria (95% CI [0.11, 0.27]), even five days later. There was a significant temporal association between stressful days and proteinuria (95% CI [0.22, 1.14]). The effect sizes of these associations were small, f = 0.04 and f = 0.12, respectively.

CONCLUSIONS

Our findings suggest that psychological stress may trigger proteinuria in children with SSNS. Future research in larger samples is needed to support our findings.

Recollections of positive early caregiving relate to sympathetic nervous system activation and chronic inflammation in subsequent generations

To understand links between early experience and biomarkers of peripheral physiology in adulthood, this study examined associations between quality of early caregiving and markers of sympathetic activation and chronic inflammation in a sample of 52 low-income mothers and their preschool-aged children. Mothers reported on levels of positive caregiving experienced during childhood using the Structural Analysis of Social Behavior-Intrex. Mother and child sympathetic activation was indexed via pre-ejection period (PEP) at rest, during a dyadic social engagement task, and for children, while interacting with an unfamiliar adult. C-reactive protein (CRP) was collected using whole blood spots to assess levels of low-grade chronic inflammation. Results showed that mothers who reported experiencing more warm guidance and support for autonomy in early childhood displayed lower resting sympathetic nervous system activation (i.e., longer PEP) and lower chronic inflammation (i.e., CRP levels). Further, lower maternal chronic inflammation levels were associated with lower sympathetic activation (i.e., longer PEP) in their children at rest, and during social interactions with mother and a female stranger.

School-Aged Children With Higher Reflective Functioning Exhibit Lower Cardiovascular Reactivity

Despite extensive theorizing regarding the regulatory role of reflective functioning (RF), few studies have explored the links between RF and physiological indices of emotion regulation, and none have examined these associations in children. Further, while scholars contend that RF promotes resilience via enhanced ability to process emotional experiences, including those occurring in attachment relationships, this argument has seldom been tested empirically in children. In the current study, we explore the association between RF and physiological measures of emotion reactivity and regulation, as well as the interaction of RF and attachment insecurity. We test these associations by examining children's (N = 76; 8–12 years old) cardiovascular responses [respiratory sinus arrhythmia (RSA)] to a standardized paradigm designed to evoke reactions regarding the experience and expression of attachment-related needs. Children also completed a semi-structured attachment interview, which was later coded for children's attachment insecurity (operationalized as attachment dismissal and preoccupation) and RF. Our findings were largely consistent with theory and our hypotheses, suggesting that higher RF is associated with lesser cardiovascular reactivity (higher levels of RSA) during the stressor task and better recovery following the task. These links were especially strong for children with greater attachment preoccupation but did not vary as a function of children's levels of attachment dismissal. These findings contribute to developmental theory in suggesting that RF is closely linked to physiological emotion regulation in children.

Chronic Stress in Children and Adolescents: A Review of Biomarkers for Use in Pediatric Research

PROBLEM

Incorporating biomarkers of chronic stress into pediatric research studies may help to explicate the links between exposure to adversity and lifelong health, but there are currently very few parameters to guide nurse researchers in choosing appropriate biomarkers of chronic stress for use in research with children and adolescents.

METHODS

Biomarkers of chronic stress are described, including primary mediators (glucocorticoids, catecholamines, and cytokines) and secondary outcomes (neurologic, immune, metabolic, cardiovascular, respiratory, and anthropometric) of the chronic stress response.

RESULTS

Evidence of the use of each biomarker in pediatric research studies is reviewed. Recommendations for pediatric researchers, including selection of appropriate biomarkers, measurement considerations, potential moderators, and future directions for research, are presented.

DISCUSSION

A wide range of biomarkers is available for use in research studies with children. While primary mediators of chronic stress have been frequently measured in studies of children, measurement of secondary outcomes, particularly immune and metabolic biomarkers, has been limited. With thoughtful and theoretically based approaches to selection and measurement, these biomarkers present an important opportunity to further explore the physiologic pathways linking exposure to chronic stress with later health and disease.

CONCLUSION

The incorporation of chronic stress biomarkers into pediatric research studies may provide valuable insight into the mechanisms through which stressful environments "get under the skin" and ultimately inform efforts to promote health and reduce inequities among children exposed to adversity.

Quantifying respiratory sinus arrhythmia: Effects of misspecifying breathing frequencies across development

Low resting respiratory sinus arrhythmia (RSA), and to a lesser extent excessive RSA reactivity to emotion evocation, are observed in many psychiatric disorders characterized by emotion dysregulation, including syndromes spanning the internalizing and externalizing spectra, and other conditions such as nonsuicidal self-injury. Nevertheless, some inconsistencies exist. For example, null outcomes in studies of RSA–emotion dysregulation relations are sometimes observed among younger participants. Such findings may derive from use of age inappropriate frequency bands in calculating RSA. We combine data from five published samples (N = 559) spanning ages 4 to 17 years, and reanalyze RSA data using age-appropriate respiratory frequencies. Misspecifying respiratory frequencies results in overestimates of resting RSA and underestimates of RSA reactivity, particularly among young children. Underestimates of developmental shifts in RSA and RSA reactivity from preschool to adolescence were also observed. Although correlational analyses revealed weak negative associations between resting RSA and aggression, those with clinical levels of externalizing exhibited lower resting RSA than their peers. No associations between RSA reactivity and externalizing were observed. Results confirm that age-corrected frequency bands should be used when estimating RSA, and that literature-wide overestimates of resting RSA, underestimates of RSA reactivity, and underestimates of developmental shifts in RSA and RSA reactivity may exist.

Mothers' implicit appraisals of their adolescents as unlovable: Explanatory factor linking family conflict and harsh parenting

This study examined the consequences of negative change in mothers' implicit appraisals of their adolescents after engaging in a family disagreement. Participants included 194 mothers and their early adolescents (Mage = 12.4 at Wave 1; 50% female) followed over 1 year. Mothers' implicit appraisals of her child as "unlovable" were assessed using the Go/No-Go Association Task-Child (Sturge-Apple, Rogge, Skibo, et al., 2015), an associative word-sorting task, before and after engaging in a family conflict task. Mothers' implicit appraisals, on average, did not become more negative following conflicts with their teen. However, substantial variability was evident, suggesting that important individual differences exist in mothers' cognitive reactivity to conflict. Greater susceptibility to implicit change predicted more harsh and insensitive parenting in response to their adolescents' bids for support 1 year later. This effect held over and above mothers' emotional reactivity to the conflict, their explicit negative attitudes about their adolescent, and maternal harshness at Time 1. Harsh and insensitive parenting, in turn, mediated the link between maternal implicit reactivity and subsequent increases in adolescent internalizing and externalizing problems. The results suggest that individual differences in maternal susceptibility to changes in implicit appraisals following conflictual interactions serve as a unique determinant of parenting in adolescence. (PsycINFO Database Record

Resting respiratory sinus arrhythmia is related to longer hospitalization in mood-disordered repetitive suicide attempters

OBJECTIVES

Our aims were (1) to measure respiratory sinus arrhythmia (RSA), a high-frequency spectrum component of heart rate variability (HRV) in mood-disordered suicide attempters and (2) to investigate the relationship of RSA to symptoms and length of hospitalization.

METHODS

Forty-nine female repetitive-suicide attempters with depressive disorder or bipolar disorder were recruited in a general hospital setting. Manic or psychotic patients were excluded. Resting RSA values were calculated from electrocardiogram data, and severity of clinical presentation shortly after admission and length of hospital stay were assessed.

RESULTS

RSA was positively associated with a higher Beck Scale for Suicidal Ideation score (r = 0.33 P = 0.019). Stepwise multiple regression analysis showed a significant correlation between RSA and hospitalization length after adjusting other variables (beta coefficient = 3.00; P = 0.030). Patients with a higher resting RSA had more prolonged hospitalizations (hospitalization beyond 30 days) after controlling for other variables (odds ratio = 5.08, P = 0.017).

CONCLUSIONS

Interaction between the environment and the autonomic nervous system is complex. Further and more comprehensive research is needed.

Characteristics of Youth Presenting to a Canadian Youth Concurrent Disorders Program: Clinical Complexity, Trauma, Adaptive Functioning and Treatment Priorities

OBJECTIVE

This study describes clinical characteristics of youth presenting for service at a Canadian youth concurrent mental health and substance use disorders (SUD) program.

METHOD

Participants were 100 adolescents and emerging adults (aged 14-25) who attended a Canadian concurrent mental health and substance use disorders outpatient program. SUDs were assigned using the Structured Clinical Interview for DSM-IV. Self-reported mental health symptoms, trauma exposure and adaptive functioning were also assessed.

RESULTS

Eighty-three percent of participants scored over the clinical cut-off on at least one mental health scale and 33% reported at least one suicide attempt. Sixty-six percent met criteria for a current SUD; 96% met lifetime criteria. Exposure to adverse events was nearly universal (94%). Almost half of female (46%) and almost a third of male (31%) participants endorsed symptoms consistent with posttraumatic stress disorder (PTSD). Youth reported impairment and need for support in multiple domains of functioning, including school, peer, family and mental health. Substance use was least likely to be identified as a treatment priority.

CONCLUSIONS

High rates of adverse events and PTSD highlight the need for trauma-informed care when providing services to this vulnerable population. Functional impairment in domains related to developmental transitions and tasks underscores the need for a developmental lens and integrated treatment that goes beyond mental health and SUD symptoms and addresses developmentally relevant domains during this transitional age.

The Relationship Between Autonomy and Relatedness and Adolescents' Adrenocortical and Cardiovascular Stress Response

Developing autonomy and maintaining relatedness within the parent-adolescent relationship marks a realignment process that shifts adolescents' decision making and regulation from parents to youth. This process may be stressful for some adolescents, particularly those who perceive their daily lives as stressful. This study examined the associations of autonomy, relatedness and perceived stress with adolescents' cortisol and blood pressure response to conflict in a mother-adolescent interaction task among 100 adolescents (M age = 15.09; 68 % girls, 78 % Caucasian). Few direct associations were found, but results indicated that perceived stress moderated the effect of autonomy and relatedness such that youth who reported more perceived stress and whose mothers' restricted their autonomy and undermined their relatedness evidenced increased cortisol and systolic blood pressure when compared to youth lower in perceived stress. The results highlight the importance of examining individual differences in the association between normative developmental transitions and adolescents' neurobiological response to stress.

Heart rate variability during adolescent and adult social interactions: a meta-analysis

Social interaction skill is important for psychological wellbeing, stress regulation, protection from disability and overall life satisfaction. Increase in activity of the vagus nerve, measured by heart rate variability (HRV), is associated with social interaction skill and decreased stress. In this meta-analysis we collated statistics from thirteen studies consisting of 787 participants who were participating in social interactions while HRV was simultaneously collected. Results revealed that while dyadic social interactions do not increase HRV generally from a baseline state, negative dyadic social interactions decrease HRV in a manner similar to the Trier Social Stress Task. Further, participants with psychopathology do not show cardiac autonomic flexibility during social interactions as indicated by reductions under stress and increases with subsequently positive social interactions. The role of age, gender and HRV index were also examined as potential moderators of HRV. Implications for health and wellbeing resulting from exposure to negative social interactions are discussed.

Family conflict, autonomic nervous system functioning, and child adaptation: state of the science and future directions

The family is one of the primary contexts of child development. Marital and parent-child conflict (family conflict) are common and predict a wide range of negative behavioral and emotional outcomes in children. Thus, an important task for developmental researchers is to identify the processes through which family conflict contributes to children's psychological maladjustment, as well as vulnerability and protective factors in the context of family conflict. In the current paper, we aim to advance a conceptual model that focuses on indices of children's autonomic nervous system (ANS) functioning that increase vulnerability or provide protection against psychological maladjustment in the context of family conflict. In doing so, we provide a selective review that reflects the state of the science linking family conflict, children's ANS activity, and child psychological adjustment, and offer directions and guidance for future research. Our hope is to accelerate research at the intersection of family conflict and ANS functioning to advance understanding of risk and resilience among children.

The relationship of religious and general coping to psychological adjustment and distress in urban adolescents

The present study explored the relationships among stress, general and religious coping, and mental health in a sample of urban adolescents. The participants included 587 9th- through 12th-grade students attending two Catholic high schools in the New York City area. They completed a set of self-report measures assessing perceived stress, religious coping, general coping, clinical symptomology, positive and negative affect, and life satisfaction. Correlation and regression analyses were used to describe relationships among variables. Perceived stress, negative religious coping, and avoidant coping were significantly associated with indicators of psychological distress. Conversely, positive religious coping and active/engagement coping were significantly associated with indicators of psychological adjustment. Negative religious coping also was found to moderate the relationship between perceived stress and positive affect. Finally, partial correlational analyses revealed significant relationships between religious coping and mental health indicators, even after controlling for the contributions of general coping. Implications of the findings for research and clinical practice with adolescent populations are considered.

The long reach of childhood. Childhood experiences influence close relationships and loneliness across life

This paper intends to gain insight into the role of childhood relationships and experiences within the parental home for the formation and meaning of later family relationships and loneliness. Particularly, childhood attachment to mother and father and stressful childhood experiences were studied in their association with satisfaction in the romantic relationship, the quality of adult family ties and the perceived quality of the social network, i.e. loneliness in adulthood. Based on data from the Netherlands Kinship Panel Study (N=3980) structural equation models were estimated to predict adult relationships and loneliness with childhood experiences. Positive attachment experiences with parents, such as reliability, closeness and supportiveness during childhood were associated with greater satisfaction in the romantic relationship, stronger family ties and less loneliness, whereas stressful childhood experiences, such as conflicts and violence negatively predicted the quality of adult relationships. Life span theoretical perspectives, such as attachment theory are discussed as useful unifying framework to study social relationships, their interconnectedness and association with outcome during all phases of life.

Cardiac vagal control and children's adaptive functioning: a meta-analysis

Polyvagal theory has influenced research on the role of cardiac vagal control, indexed by respiratory sinus arrhythmia withdrawal (RSA-W) during challenging states, in children's self-regulation. However, it remains unclear how well RSA-W predicts adaptive functioning (AF) outcomes and whether certain caveats of measuring RSA (e.g., respiration) significantly impact these associations. A meta-analysis of 44 studies (n=4996 children) revealed small effect sizes such that greater levels of RSA-W were related to fewer externalizing, internalizing, and cognitive/academic problems. In contrast, RSA-W was differentially related to children's social problems according to sample type (community vs. clinical/at-risk). The relations between RSA-W and children's AF outcomes were stronger among studies that co-varied baseline RSA and in Caucasian children (no effect was found for respiration). Children from clinical/at-risk samples displayed lower levels of baseline RSA and RSA-W compared to children from community samples. Theoretical/practical implications for the study of cardiac vagal control are discussed.

Effects of family cohesion and heart rate reactivity on aggressive/rule-breaking behavior and prosocial behavior in adolescence: The Tracking Adolescents' Individual Lives Survey study

The biological sensitivity to context hypothesis posits that high physiological reactivity (i.e., increases in arousal from baseline) constitutes heightened sensitivity to environmental influences, for better or worse. To test this hypothesis, we examined the interactive effects of family cohesion and heart rate reactivity to a public speaking task on aggressive/rule-breaking and prosocial behavior in a large sample of adolescents (N = 679; M age = 16.14). Multivariate analyses revealed small- to medium-sized main effects of lower family cohesion and lower heart rate reactivity on higher levels of aggressive/rule-breaking and lower levels of prosocial behavior. Although there was some evidence of three-way interactions among family cohesion, heart rate reactivity, and sex in predicting these outcome variables, these interactions were not in the direction predicted by the biological sensitivity to context hypothesis. Instead, heightened reactivity appeared to operate as a protective factor against family adversity, rather than as a susceptibility factor. The results of the present study raise the possibility that stress reactivity may no longer operate as a mechanism of differential susceptibility in adolescence.

Marital conflict, respiratory sinus arrhythmia, and allostatic load: interrelations and associations with the development of children's externalizing behavior

Allostatic load theory hypothesizes that stress and the body's responses to stressors contribute to longer term physiological changes in multiple systems over time (allostasis), and that shifts in how these systems function have implications for adjustment and health. We investigated these hypotheses with longitudinal data from two independent samples (n = 413; 219 girls, 194 boys) with repeated measures at ages 8, 9, 10, and 11. Initial parental marital conflict and its change over time indexed children's exposure to an important familial stressor, which was examined in interaction with children's respiratory sinus arrhythmia (RSA) reactivity to laboratory tasks (stress response) to predict children's basal levels of RSA over time. We also investigated children's sex as an additional possible moderator. Our second research question focused on examining whether initial levels and changes in resting RSA over time predicted children's externalizing behavior. Boys with a strong RSA suppression response to a frustrating laboratory task who experienced higher initial marital conflict or increasing marital conflict over time showed decreases in their resting RSA over time. In addition, boys' initial resting RSA (but not changes in resting RSA over time) was negatively related to change over time in externalizing symptoms. Findings for girls were more mixed. Results are discussed in the context of developmental psychobiology, allostatic load, and implications for the development of psychopathology.

Effects of video-feedback interaction training for professional caregivers of children and adults with visual and intellectual disabilities

BACKGROUND

Individuals in group homes may experience poor quality of social interaction with their professional caregivers, limiting their quality of life. The video-based Contact programme may help caregivers to improve their interaction with clients.

METHOD

Seventy-two caregivers of 12 individuals with visual and intellectual disabilities received a training programme and four individual video-feedback sessions. Quality of interaction was independently measured in an AB-design across subjects with two baseline and three intervention observations, using a time sampling coding system for interactive behaviour as well as a rating for affective mutuality.

RESULTS

From baseline to intervention, significant increases were found for the frequency with which caregivers confirmed the signals of clients, for the proportion of initiatives taken by clients that were responded to by the caregivers, and the affective mutuality as a quality of the interaction. No significant increase in client responsiveness was observed. Caregivers evaluated the intervention as useful and feasible.

CONCLUSIONS

The start of the Contact programme coincided with improved quality of interaction between professional caregivers and clients with visual and intellectual disabilities in group homes. Further research is necessary regarding the generalisability, long-term effects and effects on quality of life.

Emotion-related self-regulation and its relation to children's maladjustment

The development of children's emotion-related self-regulation appears to be related to, and likely involved in, many aspects of children's development. In this review, the distinction between effortful self-regulatory processes and those that are somewhat less voluntary is discussed, and literature on the former capacities is reviewed. Emotion-related self-regulation develops rapidly in the early years of life and improves more slowly into adulthood. Individual differences in children's self-regulation are fairly stable after the first year or two of life. Such individual differences are inversely related to at least some types of externalizing problems. Findings for internalizing problems are less consistent and robust, although emotion-related self-regulation appears to be inversely related to internalizing problems after the early years. Self-regulatory capacities have been related to both genetic and environmental factors and their interaction. Some interventions designed to foster self-regulation and, hence, reduce maladjustment, have proved to be at least partially effective.