The influence of pretreatment respiratory sinus arrhythmia dimensions on trauma-focused cognitive behavioral therapy outcomes: Findings from a randomized controlled feasibility trial.

Child maltreatment is associated with respiratory sinus arrhythmia (RSA) dysregulation, a physiological indicator of emotion regulation that predicts elevated posttraumatic stress disorder (PTSD) symptoms and may be a mechanism of action for exposure-based therapies, such as trauma-focused cognitive behavioral therapy (TF-CBT). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT for improving emotion regulation following maltreatment. The current study reports findings from a randomized controlled feasibility trial (N = 33; Mage = 11.79 years, SD = 3.08; 63.6% White; 66.7% female) that measured youths' resting RSA, RSA reactivity, and RSA recovery in response to a pretreatment laboratory challenge. We tested whether (a) lower pretreatment resting RSA was associated with blunted RSA during the challenge; (b) either of the pretreatment RSA dimensions predicted more severe pretreatment PTSD symptoms; and (c) either of the pretreatment RSA dimensions predicted less severe posttreatment PTSD symptoms and, as an exploratory aim, whether this was moderated by treatment group (i.e., TF-CBT vs. TF-CBT + AAT). Results from multiple linear regression indicated that, after controlling for pretreatment symptom severity, there was a large effect size for higher resting RSA predicting less severe caregiver-reported posttreatment PTSD symptoms, ß = -.52, p = .058, and higher RSA during recovery predicting less severe child-reported posttreatment PTSD symptoms, ß = -.70, p = .056, although these findings were not significant. These preliminary results offer important insights for future studies to investigate how the ability to regulate RSA informs which children need additional support to benefit from psychotherapeutic treatment.

Parental working memory buffers associations between COVID-19 hardships and child mental health.

The coronavirus (COVID-19) pandemic has impaired young children's mental health, underscoring the need for research on protective factors. Using a cross-sectional design, we examined whether parental working memory (WM) buffered relations between COVID-19 hardships (home-life, economic, and quarantine) and child internalizing and externalizing symptoms. Female parents (N = 339; 83.19% White/Caucasian, 8.85% Black/African American, 3.54% Asian, 1.47% Native American, and 2.36% mixed race; 7.67% Hispanic/Latinx ethnicity) of children 2-5-years-old reported COVID-19 hardships and child internalizing and externalizing symptoms and completed a backward digit span task to measure WM. All types of COVID-19 hardships were positively related to child internalizing and externalizing symptoms. Higher parental WM weakened positive relations between all types of hardships and child internalizing symptoms, and between home-life and economic hardships and externalizing symptoms. Results suggest that parental WM, a malleable target for intervention, may buffer associations between the detrimental effects of COVID-19 and young children's mental health.

Child Behavior Problems and Maltreatment Exposure.

OBJECTIVES: Establish the longitudinal cross-lagged associations between maltreatment exposure and child behavior problems to promote screening and the type and timing of interventions needed. METHODS: The Longitudinal Studies of Child Abuse and Neglect, a multiwave prospective cohort study of maltreatment exposure, enrolled children and caregivers (N = 1354) at approximately age 4 and followed them throughout childhood and adolescence. Families completed 7 waves of data collection with each wave occurring 2 years apart. Maltreatment was confirmed using official case records obtained from Child Protective Services. Six-month frequencies of behavior problems were assessed via caregiver-report. Two random-intercept, cross-lagged panel models tested the directional relations between maltreatment exposure and externalizing and internalizing behaviors. RESULTS: Maltreatment exposure predicted increases in externalizing behaviors at ages 8 (b = 1.06; 95% confidence interval [CI] 0.14-1.98), 12 (b = 1.09; 95% CI 0.08-2.09), and 16 (b = 1.67; 95% CI 0.30-3.05) as well as internalizing behaviors at ages 6 (b = 0.66; 95% CI 0.03-1.29), 12 (b = 1.25; 95% CI 0.33-2.17), and 14 (b = 1.92; 95% CI 0.76-2.91). Increases in externalizing behaviors predicted maltreatment exposure at age 12 (odds ratio 1.02; 95% CI 1.00-1.05). CONCLUSIONS: Maltreatment exposure is robustly associated with subsequent child behavior problems, strengthening inferences about the directionality of these relations. Early screening of externalizing behaviors in pediatric settings can identify children likely to benefit from intervention to reduce such behaviors as well as prevent maltreatment exposure at entry to adolescence.

Parental Regulation of Parent and Child Screen-Based Device Use.

Media use and screen time show both positive and negative effects on child development. Parents' behaviors, perceptions, and regulation of parent and child screen-based device (SBD) use may be critical understudied factors in explaining these mixed effects. We developed the Parent Screen-Based Device Use Survey (PSUS) to assess parental use of multiple SBDs (e.g., computers, phones, TVs) and tested its factor structure across two United States samples of mothers of children aged 2 to 6 years old (total N = 402). Subscales captured parental SBD use related to Discipline, Limit-Setting, Involvement, Child Care, Family Norms, Self-Regulation, Dysregulation, and Parenting Support, and showed good factor loadings and internal reliability. Validity was tested in relation to parent distress, parent executive function problems, and child behavior problems. Parental limit-setting and involvement were either unrelated to or related to fewer parent and child problems, whereas parental use of SBDs for self-regulation, child care, discipline, support, and family activities, as well as parents' more dysregulated use, were related to more parent and child problems. The PSUS holds promise in addressing the parental mechanisms that underlie media effects on child development.

Caregiver emotion regulation predicts trajectories of psychopathology during pediatric cancer treatment.

Elevated child and caregiver psychopathology are observed in families of children with cancer, with a subset developing clinically significant symptoms. This study examines whether caregivers' resting respiratory sinus arrhythmia (RSA) and observed emotion regulation (ER) are protective against caregiver and child psychopathology during the first year of pediatric cancer treatment. Primary caregivers of children recently diagnosed with cancer (N = 159; child Mage = 5.6 years; children 48% male, 52% female) completed 12 monthly questionnaires. At Month 3, primary caregivers were interviewed about their experiences of emotions, and their resting RSA was measured. Data were analyzed using multilevel models. Observed ER was associated with lower caregiver anxiety, depression, and posttraumatic stress symptoms (PTSS) 1 year postdiagnosis but was not associated with children's symptoms. Resting RSA had a significant positive association with child depression/anxiety at the start of treatment and Month 12 child PTSS. Findings suggest that caregivers would benefit from interventions to manage their negative emotions at the start of cancer treatment. Additionally, caregivers who are more physiologically regulated may be more attuned to their children's negative emotions. Our findings highlight the importance of taking a multimethod approach to understanding how ER impacts functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).