Dynamics of Affective Reactivity during Mother-Daughter Interactions: The Impact of Adolescent Non-Suicidal Self-Injury.

Non-suicidal self-injury (NSSI) is an alarming public health concern that is particularly widespread among adolescents. The current study examined affective responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed two interaction tasks: one positive and one negative. During these interactions, facial affect was assessed via electromyography (EMG). Results of Actor-Partner Interdependence Modeling (APIM) revealed several intra- and interpersonal disruptions in affect during both tasks among dyads in which the adolescent had an NSSI history. Findings suggest deficits in both self- and co-regulation of facial affect during mother-daughter interactions involving dyads in which the adolescents reports NSSI. Ultimately, if replicated and extended in longitudinal research, these disruptions may prove to be promising targets of intervention to reduce risk for future NSSI in adolescent girls.

Maternal criticism and children's neural responses to reward and loss.

Parental criticism is linked to a number of detrimental child outcomes. One mechanism by which parental criticism may increase risk for negative outcomes in children is through children's neural responses to valenced information in the environment. The goal of the current study, therefore, was to examine the relation between maternal criticism and children's neural responses to monetary gains and losses. To represent daily environmental experiences of reward and punishment, we focused on reactivity to monetary gains versus losses in a guessing task. Participants were 202 children and their mothers recruited from the community. The average age of the children was 9.71 years (SD = 1.38, range = 7-11), with 52.0% of them male and 72.8% Caucasian. Mothers completed the Five Minute Speech Sample to assess expressed emotion-criticism, and of these dyads 51 mothers were rated as highly critical. In addition, children completed a simple guessing game during which electroencephalography was recorded. Children of critical mothers displayed less neural reactivity to both monetary gain and loss than children without critical mothers. Our results were at least partially independent of children's and mothers' current levels of internalizing psychopathology. These findings suggest that children exposed to maternal criticism may exhibit disruptions in adaptive responses to environmental experiences regardless of valence. Targeted interventions aimed at reducing expressed emotion-criticism may lead to changes in a child's reward responsiveness and risk for psychopathology.

Children's history of suicidal ideation and synchrony of facial displays of affect during mother-child interactions.

BACKGROUND: Suicidal thoughts and behavior can begin early in childhood and are a leading cause of death in youth. Although specific mechanisms of risk remain largely unknown, theorists and researchers highlight the importance of the parent-child relationship. The current study focused on one aspect of this relationship: the dynamic exchange of facial affect during interactions. Specifically, we examined the relation between children's history of suicidal ideation (SI) and synchrony of facial expressions during positive and negative mother-child interactions. METHODS: Participants were 353 mother-child dyads. Of these, 44 dyads included a child with an SI history. Dyads engaged in positive and negative discussions during which their facial electromyography was recorded from mothers and children to index second-to-second changes in positive (zygomaticus) and negative (corrugator) facial affect. RESULTS: Child SI dyads were characterized specifically by reduced synchrony of positive facial affect during the positive discussion compared to dyads without child SI. CONCLUSIONS: These findings suggest child SI dyads exhibit reduced synchrony of normative positive expressions during mother-child interactions. If replicated and extended in longitudinal research, these results may help to explain one mechanism of risk among children with SI.

Attentional biases to emotional faces among women with a history of single episode versus recurrent major depression.

Major depressive disorder (MDD) is a highly prevalent psychiatric disorder, and recurrent depression is associated with severe and chronic impairment. Identifying markers of risk is imperative to improve our ability to predict which individuals are likely to experience a recurrence. According to cognitive theories, biases in attention for affectively-salient information may serve as one mechanism of risk. Existing research has combined participants with a single episode (sMDD) and those with recurrent MDD (rMDD); therefore, little is known about whether these biases track the severity of disease course. The current study examined attentional biases to facial displays of emotion among 115 women with a history of rMDD, sMDD, or no history of psychopathology using a passive viewing eye-tracking task. Women with rMDD exhibited significantly lower sustained attention to happy faces compared to both healthy controls and sMDD women. These results extend previous research on the presence of attentional avoidance of positive stimuli in individuals with a history of MDD and provide preliminary evidence that this bias is strongest among individuals with a history of rMDD.

Sustained Attention and Individual Differences in Adolescents' Mood and Physiological Reactivity to Stress.

Biased attention to sad faces is associated with depression in adults and is hypothesized to increase depression risk specifically in the presence, but not absence, of stress by modulating stress reactivity. However, few studies have tested this hypothesis, and no studies have examined the relation between attentional biases and stress reactivity during adolescence, despite evidence that this developmental window is marked by changes in depression risk, stress, and the function of attention. Seeking to address these limitations, the current study examined the impact of adolescents' sustained attention to facial displays of emotion on individual differences in both mood reactivity to real-world stress and physiological (i.e., respiratory sinus arrhythmia [RSA]) reactivity to a laboratory-based stressor. Consistent with vulnerability-stress models of attention, greater sustained attention to sad faces was associated with greater depressive reactions to real-world stress. In addition, there was preliminary evidence from exploratory analyses that the impact of sustained attention on mood and/or physiological reactivity may be moderated by adolescents' age and sex such that relations are stronger for older adolescents and girls. The results of this study contribute to the current body of research on the role of attention in stress reactivity and depression risk and highlight the importance of considering age differences when examining these relations.

Maternal major depression and synchrony of facial affect during mother-child interactions.

Maternal history of Major Depressive Disorder (MDD) dramatically increases children's risk for developing depression, highlighting the critical need for further research on the specific processes involved in the intergenerational transmission of depression. Although previous research suggests that maternal depression may adversely affect the quality of mother-child interactions, less is known about the role of maternal MDD in the moment-to-moment changes in affect that occur during these interactions. The goal of this project, therefore, was to examine synchrony of facial displays of affect during a positive (Vacation Planning) and a negative (Issues Discussion) mother-child interaction, and how this synchrony may be impacted by maternal history of MDD. In doing so, we examined both concurrent and lagged synchrony of facial affect. We recruited 341 mother-child dyads (child average age = 9.30 years; 50.1% girls; 71.6% Caucasian) with and without a maternal history of MDD. Facial electromyography (EMG), continuously recorded during those tasks, was used to index mother and child facial affect. We found that a maternal history of MDD was associated with reduced concurrent synchrony and lagged synchrony (mother facial affect predicting changes in child facial affect) of positive affect during Vacation Planning. Reduced concurrent mother-child synchrony of positive affect during the discussion was also associated with an increase in child self-reported sad affect from before to after the discussion. These findings provide promising initial evidence for how the dynamic exchange of positive affect during mother-child interactions may be disrupted in families with maternal MDD history. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Children's sustained attention to emotional facial expressions and their autonomic nervous system reactivity during parent-child interactions.

The way individuals process socio-affective information is thought to impact their responses to social interactions, but research testing the relation between these processes is scarce, particularly among children. This study examined if children's attention to socio-affective stimuli was associated with their autonomic nervous system (ANS) reactivity during parent-child interactions. Children's sustained attention to facial expressions of emotion (afraid, happy, sad) was indexed using the late positive potential (LPP) event-related potential (ERP) component during a computer-based task. To measure ANS reactivity, children's respiratory sinus arrhythmia (RSA) was assessed at baseline and during positive and negative parent-child discussions. Enhanced LPP amplitudes in response to all emotional facial expressions, reflecting greater sustained attention to socio-affective stimuli, were associated with increased RSA reactivity during parent-child discussions. These results show correspondence between two psychophysiological substrates of emotion processing in healthy children and highlight how these systems may be synergistic forces contributing to emotion reactivity.

Less frequent dosing of erythropoiesis stimulating agents in patients undergoing dialysis: a European multicentre cost study.

OBJECTIVE: To calculate the variable costs involved with the process of delivering erythropoiesis stimulating agents (ESA) in European dialysis practices. METHODS: A conceptual model was developed to classify the processes and sub-processes followed in the pharmacy (ordering from supplier, receiving/storing/delivering ESA to the dialysis unit), dialysis unit (dose determination, ordering, receipt, registration, storage, administration, registration) and waste disposal unit. Time and material costs were recorded. Labour costs were derived from actual local wages while material costs came from the facilities' accounting records. Activities associated with ESA administration were listed and each activity evaluated to determine if dosing frequency affected the amount of resources required. RESULTS: A total of 21 centres in 8 European countries supplied data for 142 patients (mean) per hospital (range 42-648). Patients received various ESA regimens (thrice-weekly, twice-weekly, once-weekly, once every 2 weeks and once-monthly). Administering ESA every 2 weeks, the mean costs per patient per year for each process and the estimates of the percentage reduction in costs obtainable, respectively, were: pharmacy labour (10.1 euro, 39%); dialysis unit labour (66.0 euro, 65%); dialysis unit materials (4.11 euro, 61%) and waste unit materials (0.43 euro, 49%). LIMITATION: Impact on financial costs was not measured. CONCLUSION: ESA administration has quantifiable labour and material costs which are affected by dosing frequency.