Sex Differences in the Contribution of Respiratory Sinus Arrhythmia and Trauma to Children’s Psychopathology

Respiratory sinus arrhythmia (RSA), a marker of parasympathetic activity, has been shown to moderate the relation between adversity and child behavioral outcomes; however, this work has been conducted in primarily Caucasian samples and limited in focus to family-level adversity. The current analysis extends the previous literature to examine the co-contribution of exposure to potentially traumatic events (PTEs), baseline RSA, and RSA withdrawal to internalizing and externalizing behavior in a sample of primarily African American youth (n = 92) recruited using neighborhood mapping techniques from communities high in epidemiological indicators of adversity. Exposure to PTEs was associated with lower baseline RSA. Complex interactions were observed between sex of the child, baseline RSA and RSA withdrawal, and PTE exposure predicting to internalizing behaviors. Among girls with high (4+) levels of PTEs, high baseline RSA and RSA withdrawal predicted higher internalizing; for RSA withdrawal only, the inverse was observed for girls with low PTE exposure, for whom high RSA withdrawal predicted lower internalizing. No associations were observed from RSA to externalizing, or among boys to internalizing. Findings are consistent with distinct patterns among primarily African American samples and suggest the need for sex-specific conceptualizations of the link between environmental adversity, physiological reactivity, and internalizing behaviors.     

学前儿童迷走神经活动与情绪反应、情绪调节及冲动性的关系

Porges的多迷走神经理论提出迷走神经活动(vagal activity)与儿童的情绪及社会行为密切联系,已有研究探讨了儿童迷走神经活动与儿童的情绪反应及调节的关系,但研究结论不够清晰,需要进一步研究澄清。本研究选取93名4-6岁学前儿童被试,运用生理测量手段与呼吸性窦性心律不齐(respiratory sinus arrhythmia,RSA)分析的方法,采用父母报告的学前儿童情绪反应强度、情绪调节能力、冲动性为结果变量,进一步探讨儿童迷走神经活动(以基线RSA、RSA撤出、RSA恢复为指标)与情绪反应、情绪调节及冲动性的关系。研究发现:(1)基线RSA与儿童情绪反应强度显著负相关,与儿童情绪调节能力显著正相关,基线RSA是儿童情绪反应强度显著负向预测因子,是儿童情绪调节能力的显著正向预测因子;(2)RSA撤出、RSA恢复性与儿童冲动性显著负相关,是儿童冲动性显著负向预测因子。研究结果支持了Porges的多迷走神经理论,表明迷走神经活动与儿童情绪反应、情绪调节及冲动性密切联系。     

Children’s Externalizing and Internalizing Symptoms over Time: The Role of Individual Differences in Patterns of RSA Responding

We examined associations between basal respiratory sinus arrhythmia (RSA) in conjunction with RSA regulation with the hypothesis that their interaction would explain unique variability in children’s prospective adjustment 2 years later. Participants were 176 children (98 girls; 78 boys) in middle childhood. RSA regulation was assessed through social and problem-solving challenges. Parents reported on children’s internalizing and externalizing symptoms. Interactions between RSA baseline and regulation to the social stressor predicted children’s later internalizing symptoms. Interactions between RSA baseline and responding to the problem-solving stressor predicted children’s externalizing symptoms. The highest levels of internalizing symptoms were predicted for children with both lower basal RSA and higher RSA suppression. The highest levels of externalizing symptoms were predicted for children who demonstrated lower basal RSA in conjunction with RSA augmentation. Findings highlight the importance of the contemporaneous consideration of basal RSA and RSA regulation in the prediction of developmental psychopathology symptomology.     

Physiological Emotion Regulation in Children with ADHD with and without Comorbid Internalizing Disorders: a Preliminary Study

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience deficits in emotion regulation that can be measured physiologically under environmental stress conditions by examining respiratory sinus arrhythmia (RSA), a marker of parasympathetic nervous system (PNS) withdrawal. The current pilot study examined the impact of comorbid internalizing disorders and comorbid Oppositional Defiant Disorder (ODD) on emotion regulation in children with ADHD by measuring RSA as an indicator of dysregulated emotional reactivity. Twenty-four 7–10 year old children with ADHD participated in the current study. Children completed a 5-min resting attending baseline while electrocardiogram data (ECG) were recorded to examine baseline RSA. Children then completed a stress inducing, blocked goal, Card Sorting Task to measure RSA reactivity to stress. Results revealed a significant effect of internalizing disorder status on RSA difference score, F (1, 18)?=?5.83, p?=?.03, η² = .25. Children in the comorbid internalizing disorder group had a significantly greater decrease in RSA from the baseline time period to the card sorting task. There was no significant effect of ODD diagnostic status on RSA difference score, p?>?.05. The results of this preliminary study suggest that among children with ADHD, the presence of a comorbid internalizing disorder predicts greater withdrawal of the PNS. These findings represent an important step in understanding autonomic functioning of children with ADHD and comorbid disorders.     

Are Elevations in ADHD Symptoms Associated with Physiological Reactivity and Emotion Dysregulation in Children?

The present study examined whether children with elevated attention-deficit/hyperactivity disorder (ADHD) symptoms display a unique pattern of emotion dysregulation as indexed by both parent report and physiological reactivity during experiences of failure. A sample of 61 children (9 to 13 years; M?=?11.62, SD?=?1.29; 48 % male) with and without clinical elevations in ADHD symptoms participated. Parent and teacher report of ADHD and oppositional defiant disorder (ODD) symptoms and parent report of internalizing problems were collected. Parents also provided ratings of children’s emotional negativity/lability and emotion regulation. Children’s physiological reactivity, based on changes in respiratory sinus arrhythmia (RSA) and skin conductance level (SCL), were assessed while they completed a manipulated social rejection task and impossible puzzle task. Regression analyses indicated that ADHD symptoms were associated with higher parent-rated emotional negativity/lability and with blunted RSA withdrawal in response to social rejection; these effects were not accounted for by co-occurring ODD symptoms or internalizing problems. ODD symptoms also were uniquely associated with parent ratings of poor emotion regulation. Internalizing problems were uniquely associated with emotional negativity/lability, poor emotion regulation, and increased SCL activity in response to social rejection. Results suggest that there may be a pattern of emotion dysregulation that is specific to ADHD symptomatology. The importance of contextual factors when examining physiological reactivity to stress in youth with ADHD is discussed.     

HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health

Individual differences in a child’s sensitivity to stress may influence whether youth exposed to trauma develop symptoms of psychopathology. We examined the interaction between HPA-axis reactivity to an acute stressor and exposure to different types of childhood trauma as predictors of mental health symptoms in a sample of youth. Youth (n?=?121, ages 9–16; 47% female) completed a standardized stress task, including 5 post-stress salivary cortisol samples. Parents also completed the Child Behavior Checklist as a measure of child internalizing and externalizing symptoms in the past month, and completed the Early Trauma Inventory (ETI) as a measure of their child’s trauma exposure. More emotional abuse and non-intentional trauma were associated with greater internalizing symptoms. Youth exposed to physical abuse who demonstrated slower HPA-axis reactivity had elevated internalizing and externalizing symptoms. Youth exposed to emotional abuse or non-intentional traumatic events who demonstrated faster HPA-axis reactivity had elevated internalizing and externalizing symptoms. Profiles of exaggerated or attenuated HPA-axis reactivity to acute stress may be risk factors for psychopathology in children facing different stressful social environments.     

Testing Models of Psychopathology in Preschool-aged Children Using a Structured Interview-based Assessment

A number of studies have found that broadband internalizing and externalizing factors provide a parsimonious framework for understanding the structure of psychopathology across childhood, adolescence, and adulthood. However, few of these studies have examined psychopathology in young children, and several recent studies have found support for alternative models, including a bi-factor model with common and specific factors. The present study used parents’ (typically mothers’) reports on a diagnostic interview in a community sample of 3-year old children (n?=?541; 53.9 % male) to compare the internalizing-externalizing latent factor model with a bi-factor model. The bi-factor model provided a better fit to the data. To test the concurrent validity of this solution, we examined associations between this model and paternal reports and laboratory observations of child temperament. The internalizing factor was associated with low levels of surgency and high levels of fear; the externalizing factor was associated with high levels of surgency and disinhibition and low levels of effortful control; and the common factor was associated with high levels of surgency and negative affect and low levels of effortful control. These results suggest that psychopathology in preschool-aged children may be explained by a single, common factor influencing nearly all disorders and unique internalizing and externalizing factors. These findings indicate that shared variance across internalizing and externalizing domains is substantial and are consistent with recent suggestions that emotion regulation difficulties may be a common vulnerability for a wide array of psychopathology.     

Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar psychosocial outcomes as CD. However, relatively little work has examined whether forms of psychopathology (e.g., externalizing and/or internalizing disorders) mediates the relationship between youth CD and adult psychosocial outcomes. The present study examined associations between youth CD and adult psychosocial outcomes and sought to identify forms of psychopathology that may potentially mediate this relationship. Participants completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Analyses found that most domains of adult psychosocial functioning were associated with youth CD. Adult antisocial behavior was the only form of psychopathology predicted by CD. Adult antisocial behavior appeared to mediate the relationship between CD and marital status, life satisfaction, and being in jail and partially mediated the relationship between CD and family support and global functioning. These data suggest that reducing the progression to adult antisocial behavior may improve multiple psychosocial outcomes among those with a history of CD.     

Cross-setting consistency in early adolescent psychopathology: deviant friendships and problem behavior sequelae

This study examines adult reports of externalizing and internalizing psychopathology at home and school in a sample of 224 high-risk adolescent boys and girls (average age 12 years). Four groups of young adolescents were defined, based on the consistency of the teacher and parent Child Behavior Checklist reports: normal, internalizing, externalizing only, and comorbid. Group comparisons revealed the comorbid and externalizing groups were more engaged in a deviant peer group and were observed in higher levels of deviancy training with their friends, compared to other young adolescent groups. In general, elevated levels of arrest, drug use, and sexual promiscuity were associated with cross-setting consistency in externalizing disorders. Comorbid youth, however, showed the highest levels of sexual promiscuity in middle adolescence, compared to all other groups. These findings are consistent with a developmental account of adolescent maladjustment and suggest that emotional disturbance in early adolescence might exacerbate youth vulnerability, especially to deviancy training within friendships.     

Dramatic-erratic personality disorder symptoms: I. Continuity from early adolescence into adulthood

This longitudinal study examined dramatic-erratic personality disorder symptoms (histrionic, borderline, and narcissistic symptoms) in a community sample of 407 adolescents to assess whether this diagnostic construct is meaningful in young people. Based on latent variable models and dimensional symptom scales, these so-called Cluster B symptoms were highly stable across an eight-year interval from early adolescence to early adulthood. Furthermore, when compared with internalizing and externalizing symptoms, dramatic-erratic symptoms were more stable over time than these well-established Axis I symptom clusters. Based on high correlations with co-occurring internalizing and externalizing symptoms, Cluster B symptoms clearly reflect emotional distress during adolescence. These analyses reinforce recent efforts to establish personality disorders as a clinically significant and valid diagnostic construct in young people.     

Parental Marital Conflict and Growth in Adolescents’ Externalizing Problems: the Role of Respiratory Sinus Arrhythmia

Previous studies have examined the moderating effect of respiratory sinus arrhythmia (RSA) on the association between marital conflict and externalizing problems, however the findings were inconsistent. One possible reason is that the covariation of internalizing problems in externalizing problems. Therefore, the present study aimed to examine this issue. Participants were 332 Chinese adolescents (54.5% boys) age from 13 to 15 years old. At T1, electrocardiogram monitoring was performed on adolescents during the resting state and stressor tasks (a speech task and a mental arithmetic task) to obtain RSA data. The Chinese version of the Achenbach Youth Self-Report-2001 (YSR-2001) and the Chinese version of the Children’s Perception of Interparental Conflict scale were used to assess adolescents’ externalizing and internalizing problems and their perception of marital conflict, respectively. Adolescents’ problem behaviors were assessed again in the second and third waves of data collection, with a 1-year lag among each wave. The results revealed that the 3- interactions of marital conflict × RSA reactivity in speech task × sex significantly predicted the trajectory of externalizing problems when controlling for internalizing problems from externalizing problems. Specifically, girls with greater RSA suppression to the speech task reported low and stable externalizing problems, however, boys with the same pattern were associated with slightly increased levels of externalizing problems. While, RSA augmentation to the speech task predicted the increase in externalizing problems among both girls and boys in high marital conflict families over time. However, this interaction effects were not significant when not partial out internalizing problems from externalizing problems. The findings highlight the importance of controlling for the covariation of internalizing problems when examining the interaction effects of person and environment on the development of adolescents’ externalizing problems.

     

Spontaneous emotion regulation to positive and negative stimuli

The ability to regulate one’s emotions is an integral part of human social behavior. One antecedent emotion regulation strategy, known as reappraisal, is characterized by cognitively evaluating an emotional stimulus to alter its emotional impact and one response-focused strategy, suppression, is aimed at reducing behavioral output. People are capable of using these specific emotion regulation strategies when instructed to do so; however, it is equally important to investigate natural and self-selected strategy use. This study was designed to determine to what extent people spontaneously regulate their emotions and the emotion regulation strategies they choose to achieve their regulatory goals. Participants were given no instructions to regulate their emotions before they were shown a negative and a positive film clip, but were instead asked afterwards about the specific strategies that they had used. Participants reported regulating their emotions more to the negative film than to the positive film. Reappraisal was more frequently selected as an emotion regulation strategy than suppression. As expected, participants with high baseline respiratory sinus arrhythmia (RSA) adopted reappraisal strategies more than those with low RSA but, surprisingly, RSA was not associated with facial expressivity. Suggestions for future research in this relatively young field of spontaneous emotion regulation are offered.     

An initial investigation of baseline respiratory sinus arrhythmia as a moderator of treatment outcome for young children born premature with externalizing behavior problems

The aim of the current study was to examine the moderating effect of baseline respiratory sinus arrhythmia (RSA) on Parent-Child Interaction Therapy (PCIT), a behavioral parent-training intervention, for young children born premature. In this pilot randomized controlled trial, 28 young children (mean age of 37.79 months), who were born <37 weeks gestation and presented with elevated externalizing behavior problems, were randomly assigned to an immediate treatment or waitlist control group. RSA, which provides an approximate marker of individual differences in cardiac vagal tone, was measured during a baseline period. Past research has generally shown that higher levels of baseline RSA correlate with various positive psychological states (e.g., empathy, sustained attention), whereas lower levels of baseline RSA correlate with less optimal psychological states (e.g., higher externalizing behavior problems). Results indicated that baseline RSA significantly interacted with treatment condition in predicting changes in child disruptive behavior. Specifically, low levels of baseline RSA were associated with greater improvements in child disruptive behavior following PCIT. While acknowledging the caveats of measuring and interpreting RSA and the need to include a sympathetic-linked cardiac measure in future research, these findings provide preliminary evidence that children with lower capacity for emotion regulation receive even greater treatment gains. Future research should also examine the moderating effect of RSA in larger samples and explore the potential mediating role of RSA on behavioral parenting interventions.     

Facets of Emotion Regulation and Emotional Disorder Symptom Dimensions: Differential Associations and Incremental Validity in a Large Clinical Sample

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. The best-fitting measurement model of emotion regulation included four dimensions: Problematic Responses, Poor Recognition/Clarity, Negative Thinking, and Emotional Inhibition/Suppression. Although many zero-order associations between the four latent emotion regulation dimensions and five latent symptom dimensions were significant, few associations remained significant in a structural regression model that included neuroticism. Specifically, Negative Thinking and Problematic Responses incrementally predicted depression symptoms, while Emotional Inhibition/Suppression predicted both social anxiety and depression symptoms. Associations between neuroticism and the emotional disorder dimensions were similar regardless of whether the emotion regulation dimensions were held constant. These results suggest that self-reported emotion regulation dimensions are associated with the severity and expression of a range of emotional disorder symptoms, but that some emotion regulation dimensions have limited incremental validity after accounting for general emotional reactivity. Studies of emotion regulation should assess neuroticism as a key covariate.     

Intergenerational Transmission of Emotion Dysregulation Through Parental Invalidation of Emotions: Implications for Adolescent Internalizing and Externalizing Behaviors

We examined parent emotion dysregulation as part of a model of family emotion-related processes and adolescent psychopathology. Participants were 80 parent–adolescent dyads (mean age = 13.6; 79 % African-American and 17 % Caucasian) with diverse family composition and socioeconomic status. Parent and adolescent dyads self-reported on their emotion regulation difficulties and adolescents reported on their perceptions of parent invalidation (i.e., punishment and neglect) of emotions and their own internalizing and externalizing behaviors. Results showed that parents who reported higher levels of emotion dysregulation tended to invalidate their adolescent’s emotional expressions more often, which in turn related to higher levels of adolescent emotion dysregulation. Additionally, adolescent-reported emotion dysregulation mediated the relation between parent invalidation of emotions and adolescent internalizing and externalizing behaviors. Potential applied implications are discussed.     

Pure Versus Co-occurring Externalizing and Internalizing Symptoms in Children: The Potential Role of Socio-Developmental Milestones

Co-occurring internalizing and externalizing disorders are moderately prevalent in children, adolescents, and adults (Anderson, Williams, McGee, & Silva, 1987; McConaughy & Skiba, 1994), but much remains to be understood regarding why some children show “pure” versus co-occurring internalizing and externalizing symptoms. One possible influence that has previously not been considered is the failure to attain socio-developmental milestones, which paradoxically may prevent the development of co-occurring symptoms for some children. The present study proposes a model in which failure to attain relevant socio-developmental milestones might explain why some children may not develop heterotypic co-occurring symptoms. Specifically, it is proposed that specific clusters of internalizing symptoms (i.e., high social anxiety, withdrawal, and inhibition) and externalizing symptoms (i.e., high impulsivity, hyperactivity, and emotional reactivity) may be associated with the failure to attain socio-developmental milestones (i.e., poor peer relations for anxious children, lack of self-reflection and evaluation for impulsive/reactive children) that, in turn, may prevent subgroups of children from developing co-occurring, heterotypic symptoms.     

Developmental Variation in the Associations of Attention Bias to Emotion with Internalizing and Externalizing Psychopathology

Research on Child and Adolescent Psychopathology - Attention biases to emotion are associated with symptoms of internalizing and externalizing psychopathology in children and adolescents. It is...     

Parental drinking problems and children's adjustment: vagal regulation and emotional reactivity as pathways and moderators of risk.

Children's emotional regulation (as indexed by vagal suppression) and children's emotional reactivity during an argument were examined as moderators and mediators of parental problem drinking and children's adjustment in a sample of 6- to 12-year-olds. Cardiac vagal tone was assessed during both a baseline condition and exposure to an audiotaped argument. Vagal suppression was calculated by subtracting vagal tone during the baseline from that recorded during the argument, with a higher number representing increased suppression of vagal tone during the argument. Emotional reactivity was based on both observations of overt behaviors of children and their reported feelings during the argument. A higher level of vagal suppression was a protective factor against children's externalizing, internalizing, and social problems associated with exposure to parental problem drinking. Emotional reactivity was a vulnerability factor, and children's increased anger and fear, and to a lesser degree sadness, each moderated and exacerbated the effects of parental problem drinking on child outcomes.     

Associations Between Fathers’ and Mothers’ Psychopathology Symptoms,Parental Emotion Socialization,and Preschoolers’ Social-Emotional Development

In this study we tested whether the relation between fathers’ and mothers’ psychopathology symptoms and child social-emotional development was mediated by parents’ use of emotion talk about negative emotions in a sample of 241 two-parent families. Parents’ internalizing and externalizing problems were measured with the Adult Self Report and parental emotion talk was observed while they discussed a picture book with their children (child age: 3 years). Children’s parent-reported internalizing and externalizing problems and observed prosocial behaviors were assessed at the age of 3 years and again 12 months later. We found that mothers’ use of emotion talk partially mediated the positive association between fathers’ internalizing problems and child internalizing problems. Fathers’ internalizing problems predicted more elaborative mother–child discussions about negative emotions, which in turn predicted more internalizing problems in children a year later. Mothers’ externalizing problems directly predicted more internalizing and externalizing problems in children. These findings emphasize the importance of examining the consequences of parental psychological difficulties for child development from a family-wide perspective.     

Marital Conflict and Risk for Child Maladjustment over Time: Skin Conductance Level Reactivity as a Vulnerability Factor

Skin conductance level reactivity (SCLR) was examined as a longitudinal mediator and moderator of relations between parental marital conflict and psychopathology among children and young adolescents. Participants were 157 boys and girls (M age at T1 = 9.31 years; SD = 1.97); there was a 2-year lag between T1 and T2 assessments. At T1, participants' SCLR was assessed in response to lab challenges. Parents completed measures of aggressive marital conflict and child adjustment at T1 and T2. Supportive of moderation effects, T1 marital conflict interacted with T1 SCLR and gender in the prediction of changes in maladjustment. The link between marital conflict and increased internalizing and externalizing symptoms was stronger for girls with higher SCLR than girls with lower SCLR. Marital conflict predicted increased externalizing behaviors for boys with lower SCLR but not higher SCLR, although levels of externalizing behaviors were similar among boys with lower and higher SCLR especially at higher levels of marital conflict. Findings build on the literature by illustrating the importance of examinations of both family risk and youth biological vulnerability for the prediction of psychopathology.