Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans.

U.S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity in 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment. PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV (CAPS-IV) at baseline and 12 months (n =101). Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (ß = -.59; p < .001; ΔR(2) = .34; f(2) = .67; large effect) and predicted 12-month PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (ß = -.24; p = .008; ΔR(2) = .03; f(2) = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans.

Perceived Executive Functioning in Parents at Risk for Child Physical Abuse.

Research suggests that deficits in executive functioning are associated with negative parenting behaviors. However, limited research has examined the link between executive functioning and risk for child physical abuse (CPA) perpetration. Early studies examining executive functioning in parents at risk for perpetrating CPA relied on performance-based measures, which are designed to occur under carefully controlled conditions and may not capture difficulties experienced under less optimal conditions (e.g., during chaotic caregiving situations). Moreover, prior studies examining executive functioning in parents at risk for perpetrating CPA have relied on small samples comprised of only mothers. To advance our understanding of the linkage between executive functioning and CPA risk, the present study examined perceived deficits in executive functioning in a sample of general population mothers and fathers (N = 98) using a standardized self-report measure of executive functioning, namely, the adult version of the Behavior Rating Inventory of Executive Function (BRIEF-A). Parents were classified as low CPA risk or high CPA risk using the Child Abuse Potential Inventory. Compared with low-risk parents, high-risk parents had higher rates of clinical elevations on several BRIEF-A subscales, namely, Working Memory Problems, Emotional Control Difficulties, and Difficulties Shifting Thoughts, Feelings, and Behaviors. These findings highlight the potential importance of assessing and strengthening executive functioning in interventions designed to reduce risk of parent-to-child aggression.

A Pilot Study of a 4-Week eHealth-Based Protocol of the Attention Training Technique Component of Metacognitive Therapy Among Patients With Anxiety Disorders.

The attention training technique (ATT) component of metacognitive therapy seeks to reduce anxiety and strengthen executive attention. ATT has the potential to expand mental health service delivery, with researchers labeling ATT as a possible form of eHealth. However, the only known published study to examine ATT in that delivery capacity was not supportive of its use. The current pilot study examined a new 4-week eHealth-based protocol of ATT among a small mixed sample of patients with anxiety disorders (N = 16). Patients attended a single in-person session to practice ATT and then practiced ATT remotely by accessing a standardized recording of ATT through the Internet for 4 weeks. There was no attrition and over 80% of patients achieved the practice benchmark. Improvements were noted across clinician-rated, patient-rated, and performance-based outcomes. Results support further examination of ATT as a possible eHealth treatment for anxiety disorders. Recommendations for future research are discussed.

Do emotion regulation difficulties explain the association between executive functions and child physical abuse risk?

This study examined the associations between executive functioning problems, emotion regulation difficulties, and risk for perpetrating child physical abuse (CPA). It was hypothesized that: (a) poor executive functions (i.e., working memory problems and inhibition/switching problems) would be associated with higher levels of emotion regulation difficulties and CPA risk; (b) emotion regulation difficulties would be positively associated with CPA risk; and (c) emotion regulation difficulties would partially explain the association between executive functions (i.e., working memory problems and inhibition/switching problems) and CPA risk. To examine these predictions, a sample of 133 general population parents (31% fathers) completed self-report measures of CPA risk, emotion regulation difficulties, working memory problems, and a performance-based measure of inhibition/switching skills. Results revealed that executive functioning problems were linked with emotion regulation difficulties, which in turn were associated with CPA risk. Moreover, emotion regulation difficulties explained the relationship between executive functions (working memory, inhibition/switching) and CPA risk. The final model accounted for 41% of the variance in CPA risk. Although additional research is needed, the present findings suggest that enhancing parents' executive functioning and teaching them effective emotion regulation skills may be important targets for CPA prevention efforts.

Heart Rate and Heart Rate Variability in Parents at Risk for Child Physical Abuse.

The present study examined heart rate and heart rate variability (i.e., respiratory sinus arrhythmia [RSA]) in a sample of 48 general population parents (41.7% fathers), who were either at high risk (n = 24) or low risk (n = 24) for child physical abuse. During baseline assessments of heart rate and RSA, parents sat quietly for 3 min. Afterward, parents were presented with a series of anagrams (either easy or difficult) and were instructed to solve as many anagrams as possible in 3 min. As expected, high-risk (compared with low-risk) parents evinced significantly higher resting heart rate and significantly lower resting RSA. During the anagram task, high-risk parents did not evince significant changes in heart rate or RSA relative to baseline levels. In contrast, low-risk parents evinced significant increases in heart rate and significant decreases in RSA during the anagram task. Contrary to expectations, the anagram task difficulty did not moderate the study findings. Collectively, this pattern of results is consistent with the notion that high-risk parents have chronically higher levels of physiological arousal relative to low-risk parents and exhibit less physiological flexibility in response to environmental demands. High-risk parents may benefit from interventions that include components that reduce physiological arousal and increase the capacity to regulate arousal effectively.

Borderline personality features and emotion regulation deficits are associated with child physical abuse potential.

The present study extends prior research examining the association between borderline personality disorder (BPD) features and child physical abuse (CPA) risk. We hypothesized that: (1) high CPA risk parents (compared to low CPA risk parents) would more often report clinically elevated levels of BPD features; (2) high CPA risk parents with elevated BPD features would represent a particularly high-risk subgroup; and (3) the association between elevated BPD features and CPA risk would be partially explained by emotion regulation difficulties. General population parents (N=106; 41.5% fathers) completed self-report measures of BPD features, CPA risk, and emotion regulation difficulties. Results support the prediction that BPD features are more prevalent among high (compared to low) CPA risk parents. Among the parents classified as high CPA risk (n=45), one out of three (33.3%) had elevated BPD features. In contrast, none of the 61 low CPA risk parents reported elevated BPD symptoms. Moreover, 100% of the parents with elevated BPD features (n=15) were classified as high-risk for CPA. As expected, high CPA risk parents with elevated BPD features (compared to high CPA risk parents with low BPD features) obtained significantly higher scores on several Child Abuse Potential Inventory scales, including the overall abuse scale (d=1.03). As predicted, emotion regulation difficulties partially explained the association between BPD features and CPA risk. Findings from the present study suggest that a subset of high CPA risk parents in the general population possess clinically significant levels of BPD symptoms and these parents represent an especially high-risk subgroup. Interventions designed to address BPD symptoms, including emotion regulation difficulties, appear to be warranted in these cases.

Baseline Functioning and Stress Reactivity in Maltreating Parents and At-Risk Adults: Review and Meta-Analyses of Autonomic Nervous System Studies.

We reviewed and meta-analyzed 10 studies ( N = 492) that examined the association between (risk for) child maltreatment perpetration and basal autonomic activity, and 10 studies ( N = 471) that examined the association between (risk for) child maltreatment and autonomic stress reactivity. We hypothesized that maltreating parents/at-risk adults would show higher basal levels of heart rate (HR) and skin conductance (SC) and lower levels of HR variability (HRV) and would show greater HR and SC stress reactivity, but blunted HRV reactivity. A narrative review showed that evidence from significance testing within and across studies was mixed. The first set of meta-analyses revealed that (risk for) child maltreatment was associated with higher HR baseline activity ( g = 0.24), a possible indication of allostatic load. The second set of meta-analyses yielded no differences in autonomic stress reactivity between maltreating/at-risk participants and nonmaltreating/low-risk comparison groups. Cumulative meta-analyses showed that positive effects for sympathetic stress reactivity as a risk factor for child maltreatment were found in a few early studies, whereas each subsequently aggregated study reduced the combined effect size to a null effect, an indication of the winner's curse. Most studies were underpowered. Future directions for research are suggested.

Pain tolerance, pain sensitivity, and accessibility of aggression-related schemata in parents at-risk for child physical abuse.

This study examined whether parents with varying degrees of child physical abuse (CPA) risk differed in pain tolerance, pain sensitivity, and accessibility of aggression-related schemata. Participants included 91 (51 low CPA risk and 40 high CPA risk) general population parents. Participants were randomly assigned to complete either an easy or a difficult anagram task. Pain tolerance and pain sensitivity were assessed using a cold pressor task. Accessibility of aggression-related schemata was assessed at the outset of the data collection session and at the end of the session using a word completion task. Parents' self-reported negative affect was assessed three times over the course of the study: baseline, after the anagram task, and after the cold pressor task. As expected, high-risk (compared to low-risk) parents reported higher levels of negative affect at each time point. Moreover, after completing the difficult anagram task, high-risk (compared to low-risk) parents exhibited higher pain sensitivity during the cold pressor task. Following completion of the cold pressor task, high-risk (compared to low-risk) parents exhibited greater accessibility of aggression-related schemata. Collectively, these findings indicate that under certain conditions, high-risk parents experience a confluence of aggression-related risk factors (i.e., negative affect, pain sensitivity, and aggression-related information processes) that may predispose them to aggressive behavior.

Child physical abuse risk moderates spontaneously inferred traits from ambiguous child behaviors.

The present study examined whether parents at high-risk for child physical abuse (CPA) differed from low-risk parents in their tendency to infer positive traits and negative traits from children's behaviors. The final sample consisted of 58 (25 low CPA risk and 33 high CPA risk) parents. Parents completed a false-recognition task, which involved viewing behavior descriptions paired with child photographs. Half of the behavior descriptions vaguely/strongly implied a trait and half of the implied traits were positive/negative. The contributions of automatic processes and controlled processes to task performance were examined using process dissociation procedures. Low CPA risk parents were significantly less likely to indicate negative traits were present in behavioral descriptions of children when negative traits were vaguely (compared to strongly) implied. In contrast, high CPA risk parents were equally likely to indicate negative traits were present regardless of whether the traits were vaguely or strongly implied. For low (but not high) CPA risk parents, automatic processes contributed significantly less to task performance when negative traits were vaguely implied compared to when the same traits were strongly implied. Given that parenting involves negotiating a seemingly endless series of ambiguous behaviors as children grow and develop, the capacity to refrain from automatically attributing negative traits to children when they exhibit vaguely negative behaviors may serve an important function in reducing risk of aggressive parenting behavior.

Assessing psychological inflexibility: the psychometric properties of the Avoidance and Fusion Questionnaire for Youth in two adult samples.

The current study examined whether the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; L. A. Greco, W. Lambert, & R. A. Baer, 2008), a self-report measure of psychological inflexibility for children and adolescents, might be useful for measuring psychological inflexibility for adults. The psychometric properties of the AFQ-Y were examined using data from a college student sample (N = 387) and a clinical sample of patients with anxiety disorders (N = 115). The AFQ-Y, but not the Acceptance and Action Questionnaire-II (AAQ-II; F. W. Bond et al., in press), demonstrated a reading level at or below the recommended 5th or 6th grade reading level. The AFQ-Y also demonstrated adequate reliability (internal consistency), factorial validity, convergent and discriminant validity, and concurrent validity predicting psychological symptoms. Moreover, the AFQ-Y showed incremental validity over the AAQ-II in predicting several psychological symptom domains. Implications for the assessment of psychological inflexibility are discussed.

Event-related potentials: search for positive and negative child-related schemata in individuals at low and high risk for child physical abuse.

OBJECTIVE: The present investigation used event-related potentials (ERPs, N400 and N300) to determine the extent to which individuals at low and high risk for child physical abuse (CPA) have pre-existing positive and negative child-related schemata that can be automatically activated by ambiguous child stimuli. METHODS: ERP data were obtained from individuals at low (n=13) and high risk (n=12) for CPA and used in a procedure check, from which a sub-group of low-risk (n=7) and high-risk (n=7) individuals were selected for inclusion in the main study. ERP data were collected during the presentation of a priming paradigm consisting of non-child pictures (primes) and congruent and incongruent word descriptors (targets). ERP data also were collected during a second priming paradigm consisting of ambiguous child pictures (primes) and positive and negative word descriptors (targets). Data from this second paradigm were used to test the hypothesis that low-risk and high-risk individuals' putative pre-existing child-related schemata (i.e., positive schemata in low-risk individuals and negative schemata in high-risk individuals) provide a context that influences whether targets (positive or negative word descriptors) are congruent or incongruent with ambiguous child picture primes. RESULTS: Analyses revealed the expected larger N400 waves in response to non-child picture, incongruent word pairs. There were no N400 differences between risk groups nor were there any risk group interactions, indicating that all participants responded in a similar manner to the non-child picture, congruent/incongruent word presentations. However, when ambiguous child picture primes were used with positive and negative word descriptors, low-risk individuals showed greater N400 and N300 responses to negative, relative to positive, word descriptors; whereas high-risk individuals showed no ERP differences with respect to positive and negative word descriptors. CONCLUSIONS: ERP evidence supports the view that low-risk individuals have greater accessibility to pre-existing positive (relative to negative) child-related schemata, which may reduce the likelihood of negative child-related evaluations. In contrast, high-risk individuals have pre-existing positive and negative child-related schemata that are equally accessible. Hence, high-risk, relative to low-risk, individuals appear to have greater accessibility to negative child-related schemata that may increase the likelihood of negative child-related evaluations and attributions that have been linked to CPA risk.