Early life adversity and adolescent sleep problems during the COVID-19 pandemic.

The COVID-19 pandemic resulted in a reorganization of adolescents' routines, especially their sleep schedules. Utilising 175 caregiver-adolescent dyads, the current study examined associations of biological (e.g., prenatal substance use), environmental (e.g., poverty), and relational (e.g., child maltreatment) subtypes of early life adversity (ELA) with various components of adolescents' sleep across the first year of the COVID-19 pandemic. Relational ELA explained unique variance in adolescents' sleep disturbances, but not other sleep components, following short- and longer-term exposure to the COVID-19 pandemic. However, the direction of this association switched such that relational ELA predicted decreased sleep disturbances during the initial phase of the U.S. COVID-19 pandemic in spring 2020 beyond pre-pandemic levels, but, over time, contributed to increased sleep disturbances beyond early-pandemic levels as the pandemic extended into the winter of 2020.

Predictors of treatment completion in group psychotherapy for male veterans with posttraumatic stress disorder.

Group therapy is a frequently used therapy format for posttraumatic stress disorder (PTSD). However, factors contributing to treatment completion remain understudied. The current study examined predictors of treatment completion, defined as having completed 10 out of 14 sessions within 16 weeks, in veterans with PTSD who engaged in a hybrid efficacy-effectiveness randomized controlled trial of group psychotherapy for PTSD. Veterans (N = 198) were randomly assigned to 14 sessions of either group cognitive behavioral treatment (GBCT; n = 98) or group present-centered treatment (GPCT; n = 100). Four primary domains of predictors were examined, encompassing sociodemographic factors, the severity of PTSD and comorbid conditions, modifiable predictors, and treatment condition. Multilevel binomial logistic regression models following the Fournier analysis approach were used to examine significant predictors within domains, which were then included in a final model. Overall, 70.7% of participants completed treatment (GCBT = 61.6%, GPCT = 79.8%). Participants in the GPCT condition were 2.389 times, 95% CI [1.394, 4.092], more likely to complete treatment than those in the GCBT condition. Older age, a higher income and level of educational attainment, more lifetime and current mental health diagnoses, and higher use of positive reappraisal ER skills predicted treatment completion. Higher levels of depressive symptoms, cumulative trauma burden, and use of positive refocusing ER skills predicted treatment noncompletion. These findings are discussed in the context of current clinical and research practices for examining treatment noncompletion, with attention to the inclusion of translational predictors.

Elements of Control Differentiate Associations Between Childhood Emotional Abuse and Anxiety Symptoms.

Among adolescents experiencing childhood maltreatment, there exists wide variability regarding the development and maintenance of anxious symptoms. Existing research has identified the protective role of effortful control against childhood anxiety (Raines et al. in Child Psychiatry and Human Development, 2021). The current study aimed to uncover how distinct elements of effortful control differentially diminish or intensify anxiety symptoms arising from a perceived lack of control following childhood emotional abuse (CEA). 467 college student participants provided reports of their experience with childhood emotional abuse, locus of control, anxiety symptoms, and effortful control via in-person surveys. We explored three categories of effortful control: inhibitory control (the capacity to suppress inappropriate behavior), attentional control (the capacity to focus or shift attention), and activational control (the capacity to perform an action despite a strong tendency to avoid). Consistent with our hypotheses, results revealed that CEA predicted increased anxiety symptoms. External LOC significantly mediated the relationship between CEA and anxiety. When effortful control was broken down into its component elements, higher inhibitory control acted as a protective factor for locus of control driven anxiety, whereas higher levels of activational control acted as a risk factor. Attentional control was not a significant moderator. These findings stress the importance of identifying risk and protective factors that contribute to resilience, and may aid in the development of interventions targeted to specific aspects of effortful control.

The development of empathy in child maltreatment contexts.

BACKGROUND: Despite robust associations between child maltreatment experiences and emotional development, a paucity of research examines the influence of child maltreatment on empathy development, and still fewer studies differentiate these effects across maltreatment subtypes. OBJECTIVE: The present study examined the development of children's empathy from ages six to eight, as predicted by maltreatment, and as moderated by children's attachment representations. PARTICIPANTS AND SETTING: Participants were a community sample of 250 children followed longitudinally and assessed in a laboratory setting with their primary caregivers. METHOD: Child maltreatment experiences from birth to age six were assessed by semi-structured interviews with caregivers, which were rated according to widely-used child maltreatment coding protocols, and by caregiver and child self-report measures. Child empathy was assessed at ages six and eight by caregiver-report. Attachment representations were observed in children using the MacArthur Story Stem Battery. RESULTS: Child emotional abuse (ß = -0.150, p = .012) and child neglect (ß = -0.137, p = .016) predicted decreased empathy at age eight, whereas child physical abuse (ß = 0.132, p = .027) and child exposure to domestic violence (ß = 0.164, p = .004) predicted increased empathy at age eight. Further, children's negative representations of mother figures moderated the positive association between child physical abuse and empathy (ß = -0.177, p = .005), such that the association became weaker as negative representations increased. CONCLUSIONS: These results highlight the nuanced ways in which child maltreatment experiences of different subtypes contribute to the development of empathy in school-aged children.

Exploratory factor analysis and validity of the virtual reality symptom questionnaire and computer use survey.

The widespread use of virtual reality head-mounted-displays (HMDs) calls for a re-examination of the impact of prolonged exposure to fixed visual displays at close ocular proximity. The purpose of this study is to validate the Virtual Reality Symptoms Questionnaire (VRSQ), created to understand symptoms of prolonged HMDs use, and Computer Use Survey (CUS), created to assess general physical and visual discomfort symptoms. Participants (N = 100) recorded their general discomfort symptoms using the CUS, performed an interactive task using a HMD for thirty minutes, and then answered the CUS again along with the VRSQ. VRSQ, analysed using an exploratory factor analysis, indicated a clear two-factor solution, and demonstrated very good internal consistency (α = 0.873). The CUS, also analysed using an exploratory factor analysis, indicated a four-factor solution, and demonstrated good internal consistency (α = 0.838). Practitioner Summary: A quantitative-experimental study was conducted to explore the factor structure and validate both the Virtual Reality Symptoms Questionnaire (VRSQ), and the Computer Use Survey (CUS). Findings indicate the VRSQ and CUS are precise and accurate survey instruments for evaluating discomfort after VR-HMD use and the latter for computer use. Abbreviations: VRSQ: virtual reality symptom questionnaire; CUS: computer use survey; OLED: organic light-emitting diode; MSQ: pensacola motion symptom questionnaire; SSQ: simulator sickness questionnaire; 3 D: three-dimensional computer generated space; VR: virtual reality; VR-HMD: virtual reality head-mounted-display; HMDs: head-mounted-displays; EFA: exploratory factor analysis.

Childhood emotional abuse characteristics moderate associations with adult psychopathology and caregiving.

As the consequences of childhood maltreatment for adult adjustment become increasingly established in the literature, investigations of individual differences in these effects must evolve to examine more nuanced components of the maltreatment experience. This is particularly true for studies of childhood emotional abuse (CEA), which represents an umbrella label for numerous qualitatively different experiences. The present study examined the distinct contributions and potential interactive effects of CEA frequency and intensity on adult psychopathology, caregiving behaviors, and caregivers' representations of the caregiver-child relationship in a diverse sample of 62 female caregivers of 4-year-old children, all of whom had experienced CEA. Frequency and intensity emerged as orthogonal characteristics of CEA with differential effects on adult adaptation. Higher CEA frequency predicted increased adult psychopathology, whereas higher CEA intensity predicted increased boundary dissolution in caregivers' representations. Further, an interaction between frequency and intensity predicted negativity in caregivers' representations, such that higher frequency of high intensity, but not low intensity, CEA predicted decreased negativity. Neither frequency nor intensity of CEA predicted observed caregiving behaviors. These results provide evidence that characteristics of CEA signal important differences in its experience, with differential implications for later adjustment. The specific differences in caregiving representations associated with high vs. low intensity CEA suggest that diverging mechanisms by which these experiences eventuate in adult outcomes should also be investigated. Above all, this study suggests that the measurement of CEA, and childhood maltreatment broadly, will benefit from enhanced attention to specific characteristics of individuals' experiences.

Distinct emotion regulation skills explain psychopathology and problems in social relationships following childhood emotional abuse and neglect.

Efforts to differentiate between the developmental sequelae of childhood emotional abuse and childhood emotional neglect are critical to both research and practice efforts. As an oft-identified mechanism of the effects of child maltreatment on later adjustment, emotion dysregulation represents a key potential pathway. The present study explored a higher order factor model of specific emotion regulation skills, and the extent to which these skill sets would indicate distinct developmental pathways from unique emotional maltreatment experiences to multidomain adjustment. A sample of 500 ethnoracially diverse college students reported on their experiences. A two-factor model of emotion regulation skills based on subscales of the Difficulties in Emotion Regulation Scale was revealed. Significant indirect effects of childhood emotional abuse on psychopathology and problems in social relationships were found through response-focused difficulties in emotion regulation, whereas a significant indirect effect of childhood emotional neglect on problems in social relationships was found through antecedent-focused difficulties in emotion regulation. These results are consistent with theoretical models and empirical evidence suggesting differential effects of childhood emotional abuse and emotional neglect, and provide an important indication for developing targeted interventions focusing on specific higher order emotion dysregulation skill clusters.

The differential influences of parenting and child narrative coherence on the development of emotion recognition.

The ability to recognize and label emotions serves as a building block by which children make sense of the world and learn how to interact with social partners. However, the timing and salience of influences on emotion recognition development are not fully understood. Path analyses evaluated the contributions of parenting and child narrative coherence to the development of emotion recognition across ages 4 through 8 in a diverse (50% female; 46% Hispanic, 18.4% Black, 11.2% White, .4% Asian, 24.0% multiracial) longitudinally followed sample of 250 caregiver-child dyads. Parenting behaviors during interactions (i.e., support, instructional quality, intrusiveness, and hostility) and children's narrative coherence during the MacArthur Story Stem Battery were observed at ages 4 and 6. Emotion recognition increased from age 4 to 8. Parents' supportive presence at age 4 and instructional quality at age 6 predicted increased emotion recognition at 8, beyond initial levels of emotion recognition and child cognitive ability. There were no significant effects of negative parenting (i.e., intrusiveness or hostility) at 4 or 6 on emotion recognition. Child narrative coherence at ages 4 and 6 predicted increased emotion recognition at 8. Emotion recognition at age 4 predicted increased parent instructional quality and decreased intrusiveness at 6. These findings clarify whether and when familial and child factors influence emotion recognition development. Influences on emotion recognition development emerged as differentially salient across time periods, such that there is a need to develop and implement targeted interventions to promote positive parenting skills and children's narrative coherence at specific ages. (PsycINFO Database Record

The Role of Parental Distress in Moderating the Influence of Child Neglect on Maladjustment.

Despite pervasive evidence of the harmful impact of neglect on children's adjustment, individual differences in adaptation persist. This study examines parental distress as a contextual factor that may moderate the relation between neglect and child adjustment, while considering the specificity of the relation between neglect and internalizing versus externalizing problems. In a sample of 66 children (33 with a documented child protective services history of neglect prior to age six), neglect predicted internalizing, and to a lesser extent externalizing, problems as rated by teachers at age seven. Parental distress moderated the relation between neglect and internalizing, but not externalizing, problems. Specifically, higher levels of neglect predicted more internalizing problems only among children of distressed parents. These findings indicate that parent-level variables are important to consider in evaluating the consequences of neglect, and point to the importance of considering contextual factors when identifying those children most at risk following neglect.

Preschoolers' emotion knowledge and the differential effects of harsh punishment.

This study examined the influence of caregiver-reported harsh physical and verbal punishment on children's behavioral and self-system adjustment. Children's emotion knowledge was evaluated as a heretofore unrecognized moderator of these relations. We assessed 250 preschool-aged children (50% female; Mage = 49.06 months) from diverse backgrounds (50% Hispanic, 18% African American, 10.4% Caucasian, 21.6% multiracial/other) using various instruments through teacher, caregiver, self, and observer report in the domains of harsh punishment, conduct problems, self-concept, and emotion knowledge. Emotion knowledge moderated the relation between harsh punishment and child adjustment. Harsh physical punishment was associated with conduct problems for children with higher emotion knowledge, especially for boys. Harsh verbal punishment was associated with self-concept deficits among children with higher emotion knowledge, especially for girls. These relations were also specifically applicable to non-Hispanic children. These results highlight the importance of investigating hypothesis-driven interactive effects and the specificity of experience to understand the psychosocial sequelae of parenting practices broadly, and to clarify the mixed evidence in the punishment literature specifically. Clinical implications point to the salience of emotion processes in parent-child disciplinary interventions for understanding the prevalence and pattern of child behavioral adjustment and self-concept, as well as more broadly to the role of individual differences in children's responses to adversity and subsequent therapeutic needs.

Externalizing problems in late childhood as a function of prenatal cocaine exposure and environmental risk.

OBJECTIVE: To examine whether prenatal cocaine exposure (PCE) predicts externalizing problems in late childhood. METHODS: Externalizing problems were assessed using caregiver, teacher, and child ratings and a laboratory task when children (N = 179; 74 cocaine exposed) were aged 8-10 years. PCE, environmental risk, sex, neonatal health, other prenatal exposures, and foster care history were examined as predictors of externalizing problems. RESULTS: Multiple regression analyses indicated that PCE, environmental risk, and male sex explained significant variance in externalizing problems in late childhood. Models varied by source of information. PCE predicted externalizing problems for child laboratory behavior and interacted with sex because males with PCE reported more externalizing problems. PCE did not predict caregiver or teacher ratings of externalizing problems. CONCLUSIONS: The effect of PCE on externalizing problems may persist into late childhood. The findings highlight the potential importance of including child-based measures of externalizing problems in studies of prenatal exposure.

Classes and consequences of multiple maltreatment: a person-centered analysis.

While the overwhelming majority of research on the consequences of childhood maltreatment reports differential outcomes of specific maltreatment subtypes (e.g., physical abuse vs. emotional abuse) as though they are independent, maltreatment experiences often occur in combination. The present study evaluated multiple maltreatment experiences in a sample of 2,637 undergraduate students who reported on childhood maltreatment and current adjustment. The authors used latent class analysis to examine predominant patterns of multiple maltreatment experiences and investigated indices of psychosocial adjustment associated with those patterns. Results suggested that specific constellations of multiple maltreatment have qualitatively different associations with adjustment. Emotional abuse, alone or in combination with other maltreatment types, was especially salient for psychopathology (e.g., anxiety, depression), while a combination of physical and emotional abuse was most strongly associated with conduct-related problems (e.g., substance use, risky sexual behavior). These findings have both practical and empirical significance for understanding and classifying experiences of maltreatment.