Parent Stress and Trauma, Autonomic Responses, and Negative Child Behaviors.

Cumulative stress and trauma in parents may alter autonomic function. Both may negatively impact child behaviors, however these links have not been well established. We tested hypotheses that parent stress and trauma are associated with and interact with altered autonomic function during the toy wait task, an acute parent-child interaction challenge, to predict greater negative child behaviors. Sixty-eight parents and their 2-5 year old children were enrolled. More parent major and traumatic life events, and more parent recent life events coupled with increased heart rate and decreased heart rate variability (HRV), each related to more child disruptive/aggressive behavior. More major life and traumatic life events coupled with greater HRV predicted more child attention seeking behavior. Our novel approach to assessing parental life stress offers a unique perspective. Interventions mitigating parent stress and regulating physiological coping during parent-child interactions may both promote better parent health and improve child behavioral outcomes.

Sexual Identity and its Association with Trajectories of Depressive Symptoms and Emotion Regulation Difficulties from Early to Middle Adolescence.

Few studies have examined how changes in sexual identity impact trajectories of depressive symptoms and emotion regulation difficulties. The current study addresses this gap in the literature by examining these associations over a three-year period in a community sample of adolescents (N = 177; Mage = 12.56; SD = 0.60; nmale = 95). Multilevel modeling revealed that youth who consistently held sexual minority identities from early to middle adolescence-but not youth with inconsistent sexual identity-demonstrated increases in depressive symptoms and emotion regulation difficulties relative to their heterosexual peers. Findings suggest that treatments that bolster emotion regulation abilities and address depressive symptoms may be of particular benefit to youth with consistent sexual minority identities from early to middle adolescence.

High-Frequency Heart Rate Variability and Emotion-Driven Impulse Control Difficulties During Adolescence: Examining Experienced and Expressed Negative Emotion as Moderators.

Emotion-driven impulse control difficulties are associated with negative psychological outcomes. Extant research suggests that high frequency heart rate variability (HF-HRV) may be indicative of emotion-driven impulse control difficulties and potentially moderated by negative emotion. In the current study, 248 eleven- to 14-year-olds and their parent engaged in a negatively emotionally arousing conflict task at Time 1. Adolescents' HF-HRV and negative emotional expression and experience were assessed before, during, and/or after the task. Adolescents reported on their levels of emotion-driven impulse control difficulties at Time 1 and one year later. Results revealed that higher levels of HF-HRV reactivity (i.e., higher HF-HRV augmentation) predicted higher levels of emotion-driven impulse control difficulties one year later among adolescents who experienced higher negative emotion. These findings suggest that negative emotional context should be considered when examining HF-HRV reactivity as a risk factor for emotion-driven impulse control difficulties and associated outcomes.

Does Alcohol Initiation in Early-To-Middle Adolescence Predict Changes in Reward Motivation? Evidence of Sex Differences.

BACKGROUND: Reward motivation has been cross-sectionally correlated with adolescent alcohol use, but the temporal nature of this relationship remains unclear. This project sought to determine whether adolescent alcohol initiation longitudinally predicted changes in reward motivation and behavioral inhibition from early to middle adolescence, and explored the role of adolescent sex in this prediction. METHODS: A total of 180 11- to 14-year-olds were recruited and then followed for 3 years to age 14 to 17. Participants self-reported their alcohol use at all time points. We selected participants who were alcohol-naïve at Baseline (early adolescence) and then grouped them based on whether or not they reported alcohol initiation by Year 3 (Y3: middle adolescence). Adolescents completed self-report and experimental (delay discounting) measures of reward motivation and self-report measures of behavioral inhibition at Baseline and Y3. RESULTS: Adolescents' alcohol initiation significantly predicted higher Y3 self-reported reward motivation on one measure. Additionally, a significant sex × alcohol initiation interaction was found predicting Y3 task-based reward motivation (delay discounting), with boys' alcohol initiation predicting increased bias toward immediate reward at Y3. There was also a sex × alcohol initiation interaction predicting behavioral inhibition, with girls' alcohol initiation predicting higher behavioral inhibition at Y3. CONCLUSIONS: Results suggest that alcohol initiation among adolescents might precede changes in reward motivation, and the effects of alcohol on reward and behavioral inhibition may differ by adolescent sex.

Getting to the heart of food craving with resting heart rate variability in adolescents.

BACKGROUND: There is an epidemic of obesity in children and adolescents. Research into the self-regulatory factors that drive eating behavior is of critical importance. Food craving contributes to overeating and difficulty with weight loss and is strongly correlated with self-regulation. High-frequency heart rate variability (HF HRV) reflects parasympathetic activity and is positively associated with self-regulation. Few studies of HF HRV and food craving have been conducted in adolescents. The current study examined the association between HF HRV and food craving in a large-scale sample of healthy adolescents. METHOD: Electrocardiogram (ECG) was recorded in 134 healthy adolescents aged 10-17 during a 7-min resting state. Participants also completed the Food Craving Questionnaire-Trait (FCQ-T). The relative power of HF HRV was calculated. Association between HF HRV and food craving was examined in the context of sex and age. Next, the relative significance of all food craving subscales was considered in relation to HF HRV. RESULTS: HF HRV was inversely correlated with food craving, taking into account sex and age. Considering all the subscales of FCQ-T in relation to HF HRV, the "lack of control over eating" subscale accounted for the most significant variance. CONCLUSION: This was the first study to evaluate resting HRV and eating behaviors in a large-scale adolescent sample. HF HRV was negatively associated with food craving, with lower HF HRV correlating with higher food craving, especially in the context of diminished control over eating. HF HRV could be a potential biomarker for food craving and food-related self-regulation capacity, and therefore may aid weight management interventions.

Maternal Neurobiological Processing of Negative Adolescent Stimuli: Relations With Positive Parenting and Relationship Quality.

We examined associations between maternal affective neurobiology and positive parenting in a study of 20 mothers of adolescents. Mothers underwent functional magnetic resonance imaging during an emotion image task, rated parent-adolescent relationship quality, and completed an adolescent interaction task in which positive parenting behaviors were observed. Maternal structure was associated with lower responsivity in emotional processing regions in the general negative image contrast and was related to greater dorsolateral prefrontal cortex activation to negative adolescent images. Parent-adolescent relationship quality was associated with lower precuneus activation to negative adolescent images. Findings are among the first to connect functional brain processing with observed parenting behaviors for parents of adolescent children, and underscore the relative importance of affective processing in parenting older children.

Difficulties in Emotion Regulation Predict Depressive Symptom Trajectory from Early to Middle Adolescence.

Major depressive disorder begins to increase in early adolescence and is associated with significant impairment (e.g., suicidality). Difficulties in emotion regulation (ER) have been associated with depressive symptoms; however, little research has examined this relation over time beginning in early adolescence. Starting when they were 11-14 years old, 246 adolescents (nboys = 126; nwhite = 158) completed self-report questionnaires on their ER at Time 1 and depressive symptoms every year for 2 years. Results revealed that overall difficulties in ER (and limited access to ER strategies) at Time 1 predicted depressive symptoms both cross-sectionally and longitudinally. Gender moderated this relation cross-sectionally, such that higher overall ER difficulties at Time 1 was more strongly associated with higher depressive symptoms for girls than for boys. These findings suggest that depression prevention efforts should promote adaptive ER in early adolescence, particularly for girls, in order to prevent the increases in depressive symptoms seen into middle adolescence.

Preventing Childhood Obesity Through a Mindfulness-Based Parent Stress Intervention: A Randomized Pilot Study.

OBJECTIVE: To assess the feasibility of engaging stressed, low-income parents with obesity in a novel mindfulness-based parent stress intervention aimed at decreasing the risk of early childhood obesity. STUDY DESIGN: An 8-week mindfulness-based parent stress group intervention (parenting mindfully for health) plus nutrition and physical activity counseling (PMH+N) was developed for parents with obesity aimed at preventing obesity in their at-risk 2- to 5-year-old children. PMH+N was compared with a control group intervention (C+N), and improvement in parenting was assessed before and after the intervention using the laboratory-based toy wait task (TWT). In addition, nutrition, physical activity, and stress were assessed using a multimethod approach. RESULTS: After establishing feasibility in 20 parent-child dyads (phase 1), 42 dyads were randomized to PMH+N vs C+N (phase 2). Compared with the C+N group, the PMH+N group demonstrated significantly better group attendance (P < .015), greater improvement in parental involvement (P < .05), and decreased parental emotional eating rating (P < .011). Furthermore, C+N, but not PMH+N, was associated with significant increases in child body mass index percentile during treatment (P < .03) when accounting for the TWT before and after changes in parenting scores. CONCLUSIONS: These findings suggest that a mindfulness-based parent stress intervention to decrease childhood obesity risk is feasible, requires further testing of therapeutic mechanisms in larger samples, and may be a potential way to attenuate the risk of childhood obesity. TRIAL REGISTRATION: ClinicalTrials.govNCT01974102.

Developmental change in emotion expression in frustrating situations: The roles of context and gender.

Emotion expression is a central aspect of social-emotional functioning. Theorists assert that emotion expression undergoes significant changes in the preschool period. There is, however, limited observational evidence of those changes, which may vary by interpersonal context and gender. The present longitudinal study examined developmental changes in emotion expressions from ages 3 to 5 years in 120 children from rural economically strained families. Children's facial, vocal, and postural sadness, anger, and happiness expressions were observed in frustrating tasks in 3 social contexts (a perfect circles task with an experimenter, a toy wait task with mother, a locked box task when alone). Findings indicted that sadness expressions decreased with age in all 3 contexts. Anger expressions increased with age in the frustrating task with the experimenter and when alone but not with the mother. From age 4 to 5 years, happiness expressions decreased in the task with experimenter but increased when alone and increased marginally with mother. In terms of gender, girls expressed greater happiness (and lower sadness) than boys but only in the task with the experimenter. Findings suggest that sadness expressions decrease over the preschool years. Developmental changes in happiness and anger expressions (and gender differences) likely depend on context.

Prenatal cocaine exposure differentially affects stress responses in girls and boys: associations with future substance use.

Prenatal cocaine exposure may affect developing stress response systems in youth, potentially creating risk for substance use in adolescence. Further, pathways from prenatal risk to future substance use may differ for girls versus boys. The present longitudinal study examined multiple biobehavioral measures, including heart rate, blood pressure, emotion, and salivary cortisol and salivary alpha amylase (sAA), in response to a stressor in 193 low-income 14- to 17-year-olds, half of whom were prenatally cocaine exposed (PCE). Youth's lifetime substance use was assessed with self-report, interview, and urine toxicology/breathalyzer at Time 1 and at Time 2 (6-12 months later). PCE × Gender interactions were found predicting anxiety, anger, and sadness responses to the stressor, with PCE girls showing heightened responses as compared to PCE boys on these indicators. Stress Response × Gender interactions were found predicting Time 2 substance use in youth (controlling for Time 1 use) for sAA and sadness; for girls, heightened sadness responses predicted substance use, but for boys, dampened sAA responses predicted substance use. Findings suggest distinct biobehavioral stress response risk profiles for boys and girls, with heightened arousal for girls and blunted arousal for boys associated with prenatal risk and future substance use outcomes.

A person-centered approach to adolescent emotion regulation: Associations with psychopathology and parenting.

Adolescence is a unique period of heightened emotional arousal and still-developing regulatory abilities. Adolescent emotion regulation patterns may be critically involved in adolescents' psychosocial development, but patterns of emotion regulation in youths are not well understood. The current study used latent profile analysis (LPA) to elucidate patterns of emotion expression, experience, and emotion-related physiological arousal in adolescents. A sample of 198 adolescents and their primary caregivers participated in an emotionally arousing parent-adolescent conflict interaction. Adolescents' observed emotion expressions, emotion experiences, and heart rate (HR) and caregiver parenting behaviors were assessed during and/or after the interaction. Parents reported on adolescents' internalizing and externalizing symptoms, and youths reported on depressive symptoms. The LPA revealed four emotion regulation profiles: a moderate HR and high expression profile, a suppression profile (with low negative emotion expression and high emotion experience), a low reactive profile, and a high reactive profile. The moderate HR and high expression profile was associated with lower conduct disorder symptoms, the suppression profile was related to lower anxiety symptoms, and the high reactive profile was associated with higher adolescent depressive symptoms. The high reactive profile and moderate HR and high expression profile were associated with more negative/critical parenting behaviors. Findings suggest that profiles of adolescent emotion regulation can be empirically identified and may be significant risk factors for psychopathology.

The Relationship Between Autonomy and Relatedness and Adolescents' Adrenocortical and Cardiovascular Stress Response.

Developing autonomy and maintaining relatedness within the parent-adolescent relationship marks a realignment process that shifts adolescents' decision making and regulation from parents to youth. This process may be stressful for some adolescents, particularly those who perceive their daily lives as stressful. This study examined the associations of autonomy, relatedness and perceived stress with adolescents' cortisol and blood pressure response to conflict in a mother-adolescent interaction task among 100 adolescents (M age = 15.09; 68 % girls, 78 % Caucasian). Few direct associations were found, but results indicated that perceived stress moderated the effect of autonomy and relatedness such that youth who reported more perceived stress and whose mothers' restricted their autonomy and undermined their relatedness evidenced increased cortisol and systolic blood pressure when compared to youth lower in perceived stress. The results highlight the importance of examining individual differences in the association between normative developmental transitions and adolescents' neurobiological response to stress.

Neural correlates of stress and favorite-food cue exposure in adolescents: a functional magnetic resonance imaging study.

Adolescence is a critical period of neurodevelopment for stress and appetitive processing, as well as a time of increased vulnerability to stress and engagement in risky behaviors. This study was conducted to examine brain activation patterns during stress and favorite-food-cue experiences relative to a neutral-relaxing condition in adolescents. Functional magnetic resonance imaging was employed using individualized script-driven guided imagery to compare brain responses with such experiences in 43 adolescents. Main effects of condition and gender were found, without a significant gender-by-condition interaction. Stress imagery, relative to neutral, was associated with activation in the caudate, thalamus, left hippocampus/parahippocampal gyrus, midbrain, left superior/middle temporal gyrus, and right posterior cerebellum. Appetitive imagery of favorite food was associated with caudate, thalamus, and midbrain activation compared with the neutral-relaxing condition. To understand neural correlates of anxiety and craving, subjective (self-reported) measures of stress-induced anxiety and favorite-food-cue-induced craving were correlated with brain activity during stress and appetitive food-cue conditions, respectively. High self-reported stress-induced anxiety was associated with hypoactivity in the striatum, thalamus, hippocampus, and midbrain. Self-reported favorite-food-cue-induced craving was associated with blunted activity in cortical-striatal regions, including the right dorsal and ventral striatum, medial prefrontal cortex, motor cortex, and left anterior cingulate cortex. These findings in adolescents indicate the activation of predominantly subcortical-striatal regions in the processing of stressful and appetitive experiences and link hypoactive striatal circuits to self-reported stress-induced anxiety and cue-induced favorite-food craving.

Sex differences in emotion- and reward-related neural responses predicting increases in substance use in adolescence.

Adolescent substance use is a significant public health problem and there is a need for effective substance use preventions. To develop effective preventions, it is important to identify neurobiological risk factors that predict increases in substance use in adolescence and to understand potential sex differences in risk mechanisms. The present study used functional magnetic resonance imaging and hierarchical linear modeling to examine negative emotion- and reward-related neural responses in early adolescence predicting growth in substance use to middle adolescence in 81 youth, by sex. Adolescent neural responses to negative emotional stimuli and monetary reward receipt were assessed at age 12-14. Adolescents reported on substance use at age 12-14 and at 6 month, and 1, 2, and 3 year follow-ups. Adolescent neural responses did not predict initiation of substance use (yes/no), but, among users, neural responses predicted growth in substance use frequency. For girls, heightened right amygdala responses to negative emotional stimuli in early adolescence predicted growth in substance use frequency through middle adolescence. For boys, blunted left nucleus accumbens and bilateral ventromedial prefrontal cortex responses to monetary reward predicted growth in substance use frequency. Findings suggest different emotion and reward-related predictors of the development of substance use for adolescent girls versus boys.

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: a randomized effectiveness trial.

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10-15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness.

The stress response and adolescents' adjustment: the impact of child maltreatment.

Experience with and management of stress has implications for adolescents' behavioral and socioemotional development. This study examined the relationship between adolescents' physiological response to an acute laboratory stressor (i.e., Trier Social Stress Test; TSST) and anger regulation and interpersonal competence in a sample of 175 low-income urban adolescents (51.8% girls). Findings suggested that heightened reactivity as indicated by cortisol, heart rate, and blood pressure was associated with increased interpersonal competence and anger regulation. However, these findings were context dependent such that, for youth high in self-reported child maltreatment, heightened reactivity was associated with decreased interpersonal competence and anger regulation. Results highlight the importance of considering how context may condition the effect of stress reactivity on functioning during adolescence.

Task-based functional connectivity patterns: Links to adolescent emotion regulation and psychopathology.

Adolescence is a developmental period characterized by heightened emotional reactivity, neurobiological changes, and increased rates of anxiety and depression. Emotion regulation (ER) difficulties-or the inability to effectively regulate one's emotions-have been theoretically and empirically conceptualized as a transdiagnostic factor implicated in virtually all forms of psychopathology among youth. The current fMRI study investigates how young adolescents' ER abilities longitudinally mediate the relationship between their task-based (n=67) limbic-prefrontal functional connectivity values and subsequent levels of internalizing and externalizing symptoms. Findings revealed that adolescents with stronger limbic-prefrontal connectivity when viewing negative emotional images reported more ER difficulties one year later which, in turn, predicted higher levels of adolescent-reported internalizing and externalizing symptoms (with the exception of ADHD) two years later. This is the only study to date that provides compelling-albeit preliminary-evidence that ER problems longitudinally mediate the association between task-based functional connectivity patterns and future psychological symptoms among adolescents. Of note, participants were only scanned at baseline, limiting our ability to assess change in adolescents' task-based functional connectivity patterns as a function of developing ER abilities or burgeoning psychological symptomology. In sum, rather than conferring risk for any particular disorder, our results suggest that functional connectivity and subsequent ER abilities may serve a transdiagnostic risk factor for psychopathology. These findings may inform future emotion-focused prevention and intervention efforts aimed at youth susceptible to future internalizing and externalizing problems.

Effects of Parenting Environment on Child and Adolescent Social-Emotional Brain Function.

The caregiving environment that children and adolescents experience is critically important for their social-emotional development. Parenting may affect child social-emotional outcomes through its effects in shaping the child's developing brain. Research has begun to investigate effects of parenting on child and adolescent brain function in humans using functional magnetic resonance imaging (fMRI). Here we review these initial studies. These studies find associations between parenting behavior and child and adolescent functional activation in neural networks involved in emotional arousal, emotion regulation (ER), reward processing, cognitive control, and social-emotional information processing. Findings from these studies suggest that higher negative parenting and lower positive parenting are generally associated with heightened activation in emotional arousal networks in response to negative emotional stimuli in youth. Further, findings indicate that lower positive parenting is associated with higher response in reward processing networks to monetary reward in youth. Finally, findings show that lower positive parenting predicts lower activation in cognitive control networks during cognitive control tasks and less adaptive neural responses to parent-specific stimuli. Several studies found these associations to be moderated by child sex or psychopathology risk status and we discuss these moderating factors and discuss implications of findings for children's social-emotional development.

Affect-Related Brain Activity and Adolescent Substance Use: A Systematic Review.

Purpose of review: This review aims to summarize the research on brain activity during affective processing (i.e., reward, negative emotional stimuli, loss) and adolescent substance use (SU). Recent findings: Most research revealed links between altered neural activity in midcingulo-insular, frontoparietal and other network regions and adolescent SU. Increased recruitment of midcingulo-insular regions-particularly the striatum-to positive affective stimuli (e.g., monetary reward) was most often associated with initiation and low-level use of substances, whereas decreased recruitment of these regions was most often associated with SUD and higher risk SU. In regards to negative affective stimuli, most research demonstrated increased recruitment of midcingulo-insular network regions. There is also evidence that these associations may be sex-specific. Summary: Future research should employ longitudinal designs that assess affect-related brain activity prior to and following SU initiation and escalation. Moreover, examining sex as as moderating variable may help clarify if affective neural risk factors are sex-specific.