Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery

Understanding how parents influence their child’s medical procedures can inform future work to reduce pediatric procedural distress and improve recovery outcomes. Following a pediatric injury or illness diagnosis, the associated medical procedures can be potentially traumatic events that are often painful and distressing and can lead to the child experiencing long-term physical and psychological problems. Children under 6 years old are particularly at risk of illness or injury, yet their pain-related distress during medical procedures is often difficult to manage because of their young developmental level. Parents can also experience ongoing psychological distress following a child’s injury or illness diagnosis. The parent and parenting behavior is one of many risk factors for increased pediatric procedural distress. The impact of parents on pediatric procedural distress is an important yet not well-understood phenomenon. There is some evidence to indicate parents influence their child through their own psychological distress and through parenting behavior. This paper has three purposes: (1) review current empirical research on parent-related risk factors for distressing pediatric medical procedures, and longer-term recovery outcomes; (2) consider and develop existing theories to present a new model for understanding the parent–child distress relationship during medical procedures; and (3) review and make recommendations regarding current assessment tools and developing parenting behavior interventions for reducing pediatric procedural distress.     

Qualitative job insecurity and in-role performance: a bidirectional longitudinal relationship?

This study adds to the understanding of the relationship between qualitative job insecurity and employee in-role performance, by analysing the association longitudinally. While social exchange theory predicts that the relationship should be negative and bidirectional, the job preservation motivation model indicates a self-correcting mechanism, where job insecurity leads to increased performance, which, in turn, could decrease job insecurity. We developed competing hypotheses and examined them using structural equation modelling in a heterogeneous sample of 337 employees. For employees with a higher professional level, results pointed towards a reciprocal causal relationship between qualitative job insecurity and in-role performance, indicating a loss cycle. For employees with a lower professional level, results showed a small positive direct causal relationship between qualitative job insecurity and in-role performance, while the negative direct path from in-role performance to qualitative job insecurity did not reach statistical significance. This is the first study to test the diverging theoretical predictions of social exchange theory and the job preservation motivation model, with regard to the relationship between qualitative job insecurity and in-role performance. Being longitudinal, our study only allows us to hint at possible causal relationships between the involved variables, the chronological order being necessary, but not sufficient to prove causality.     

When expressing forgiveness backfires in the workplace: victim power moderates the effect of expressing forgiveness on transgressor compliance

Expressing (vs. withholding) forgiveness is often promoted as a beneficial response for victims. In the present research, we argue that withholding (vs. expressing) forgiveness can also be beneficial to victims by stimulating subsequent transgressor compliance – a response that is valuable in restoring the victim’s needs for control. Based on deterrence theory, we argue that a victim’s withheld (vs. expressed) forgiveness promotes transgressor compliance when the victim has low power, relative to the transgressor. This is because withheld (vs. expressed) forgiveness from a low-power victim elicits transgressor fear. On the other hand, because people are fearful of high-power actors, high-power victims can expect high levels of compliance from a transgressor, regardless of whether they express forgiveness or not. A critical incidents survey (Study 1) and an autobiographic recall study (Study 2) among employees, as well as a laboratory experiment among business students (Study 3), support these predictions. These studies are among the first to reveal that withholding forgiveness can be beneficial for low-power victims in a hierarchical context – ironically, a context in which offering forgiveness is often expected.     

Eating behaviors and emotional distress are predicted by treatment and adverse outcome in patients with type 2 diabetes

Depression and anxiety are hightly prevalent among patients with Type 2 Diabetes (T2D), however not commonly related to outcomes, treatment and comorbidities. Eating behaviors could also have an implication. To evaluate the relation between mood and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D we conducted this exploratory cross sectional study in a population from Mexico. Hospital Anxiety and Depression Scale and the Three Factor Eating Questionnaire Revised 21 (TFEQ-R21) were correlated with age, gender, blood pressure, treatment and comorbidities (nephropathy, neuropathy, retinopathy and cardiopathy). Multi-linear regression models and 2^k factorial analyses were conducted. Sixty-one patients (31 male) 55 years old (SD 13) with at least 5 years of T2D were included. Anxiety correlated with depression (r = 0.25, p < 0.05). Gender (women) (std B 0.026, p < 0.001), insulin therapy (std B 0.3, p = 0.11), systolic blood pressure (std B 0.263, p = 0.02) and cardiovascular disease (std B 0.232, p = 0.035) predicted depression. Insulin therapy had a positive effect in cognitive restraint. (std B 0.32, p = 0.001). Age (std B 0.37, p = 0.003) and systolic blood pressure (std B 0.237, p = 0.048) predicted positively emotional eating (not previously published). 2^k factorial analyses proved additive interaction between complications and insulin therapy with depression. This study supports the relation between mood disorders and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D and the additive interaction between factors and mood disorders.     

Maternal distress in the context of their child’s type 1 diabetes: exploring the role of adaptive maternal emotion regulation on child outcomes

Parents of children with Type 1 diabetes (T1D) experience high levels of distress, which may negatively impact child functioning. However, little is known about mechanisms that may buffer the adverse impact of parental distress. The current study explored the possible buffering role of maternal adaptive cognitive emotion regulation (CER) for the relationship between maternal distress and child psychological functioning. Forty-three children with T1D (8–15 years) completed measures assessing trait anxiety and depressive symptoms. Their mothers reported on general distress, illness-related parenting stress, and adaptive CER. Maternal illness-related parenting stress (but not general distress) was significantly associated with child psychological functioning. No buffering role for maternal adaptive CER was observed. As the current study is rather preliminary, future research using other methods to examine maternal adaptive CER, and examining other parental variables that may buffer against the negative impact of parental distress is warranted.     

Effects of feedback reliability on feedback-related brain activity: A feedback valuation account

Adaptive decision making relies on learning from feedback. Because feedback sometimes can be misleading, optimal learning requires that knowledge about the feedback’s reliability be utilized to adjust feedback processing. Although previous research has shown that feedback reliability indeed influences feedback processing, the underlying mechanisms through which this is accomplished remain unclear. Here we propose that feedback processing is adjusted by the adaptive, top-down valuation of feedback. We assume that unreliable feedback is devalued relative to reliable feedback, thus reducing the reward prediction errors that underlie feedback-related brain activity and learning. A crucial prediction of this account is that the effects of feedback reliability are susceptible to contrast effects. That is, the effects of feedback reliability should be enhanced when both reliable and unreliable feedback are experienced within the same context, as compared to when only one level of feedback reliability is experienced. To evaluate this prediction, we measured the event-related potentials elicited by feedback in two experiments in which feedback reliability was varied either within or between blocks. We found that the fronto-central valence effect, a correlate of reward prediction errors during reinforcement learning, was reduced for unreliable feedback. But this result was obtained only when feedback reliability was varied within blocks, thus indicating a contrast effect. This suggests that the adaptive valuation of feedback is one mechanism underlying the effects of feedback reliability on feedback processing.     

Cognitive-behavioral and electrophysiological evidence of the affective consequences of ignoring stimulus representations in working memory

Ignoring visual stimuli in the external environment leads to decreased liking of those items, a phenomenon attributed to the affective consequences of attentional inhibition. Here we investigated the generality of this “distractor devaluation” phenomenon by asking whether ignoring stimuli represented internally within visual working memory has the same affective consequences. In two experiments we presented participants with two or three visual stimuli and then, after the stimuli were no longer visible, provided an attentional cue indicating which item in memory was the target they would have to later recall, and which were task-irrelevant distractors. Participants subsequently judged how much they liked these stimuli. Previously-ignored distractors were consistently rated less favorably than targets, replicating prior findings of distractor devaluation. To gain converging evidence, in Experiment 2, we also examined the electrophysiological processes associated with devaluation by measuring individual differences in attention (N2pc) and working memory (CDA) event-related potentials following the attention cue. Larger amplitude of an N2pc-like component was associated with greater devaluation, suggesting that individuals displaying more effective selection of memory targets—an act aided by distractor inhibition—displayed greater levels of distractor devaluation. Individuals showing a larger post-cue CDA amplitude (but not pre-cue CDA amplitude) also showed greater distractor devaluation, supporting prior evidence that visual working-memory resources have a functional role in effecting devaluation. Together, these findings demonstrate that ignoring working-memory representations has affective consequences, and adds to the growing evidence that the contribution of selective-attention mechanisms to a wide range of human thoughts and behaviors leads to devaluation.     

Neurocognitive mechanisms behind emotional attention: Inverse effects of anodal tDCS over the left and right DLPFC on gaze disengagement from emotional faces

Background

Attention to relevant emotional information in the environment is an important process related to vulnerability and resilience for mood and anxiety disorders. In the present study, the effects of left and right dorsolateral prefrontal cortex (i.e., DLPFC) stimulation on attentional mechanisms of emotional processing were tested and contrasted.

Methods

A sample of 54 healthy participants received 20 min of active and sham anodal transcranial direct current stimulation (i.e., tDCS) either of the left (n = 27) or of the right DLPFC (n = 27) on two separate days. The anode electrode was placed over the left or the right DLPFC, the cathode over the corresponding contra lateral supraorbital area. After each neurostimulation session, participants completed an eye-tracking task assessing direct processes of attentional engagement towards and attentional disengagement away from emotional faces (happy, disgusted, and sad expressions).

Results

Compared to sham, active tDCS over the left DLPFC led to faster gaze disengagement, whereas active tDCS over the right DLPFC led to slower gaze disengagement from emotional faces. Between-group comparisons showed that such inverse change patterns were significantly different and generalized for all types of emotion.

Conclusions

Our findings support a lateralized role of left and right DLPFC activity in enhancing/worsening the top-down regulation of emotional attention processing. These results support the rationale of new therapies for affective disorders aimed to increase the activation of the left over the right DLPFC in combination with attentional control training, and identify specific target attention mechanisms to be trained.

     

A database of orthography-semantics consistency (OSC) estimates for 15,017 English words

Orthography–semantics consistency (OSC) is a measure that quantifies the degree of semantic relatedness between a word and its orthographic relatives. OSC is computed as the frequency-weighted average semantic similarity between the meaning of a given word and the meanings of all the words containing that very same orthographic string, as captured by distributional semantic models. We present a resource including optimized estimates of OSC for 15,017 English words. In a series of analyses, we provide a progressive optimization of the OSC variable. We show that computing OSC from word-embeddings models (in place of traditional count models), limiting preprocessing of the corpus used for inducing semantic vectors (in particular, avoiding part-of-speech tagging and lemmatization), and relying on a wider pool of orthographic relatives provide better performance for the measure in a lexical-processing task. We further show that OSC is an important and significant predictor of reaction times in visual word recognition and word naming, one that correlates only weakly with other psycholinguistic variables (e.g., family size, word frequency), indicating that it captures a novel source of variance in lexical access. Finally, some theoretical and methodological implications are discussed of adopting OSC as one of the predictors of reaction times in studies of visual word recognition.