Pre-COVID respiratory sinus arrhythmia moderates associations between COVID-19 stress and child externalizing behaviors: Testing neurobiological stress theories.

Exposure to stress related to the COVID-19 pandemic contributes to psychopathology risk, yet not all children are negatively impacted. The current study examined a parasympathetic biomarker of stress sensitivity, respiratory sinus arrhythmia (RSA), as a moderator of the effects of exposure to pandemic stress on child internalizing and externalizing behaviors in a sample of children experiencing economic marginalization. Three to five years pre-pandemic, when children were preschool-aged, RSA during baseline and a challenging parent-child interaction were collected. Mid-pandemic, between November 2020 and March 2021, children's exposure to pandemic stress and internalizing and externalizing behaviors were collected. Results demonstrated that children who, pre-pandemic, demonstrated blunted parasympathetic reactivity (i.e., no change in RSA relative to baseline) during the dyadic challenge exhibited elevated risk for externalizing behaviors mid-pandemic. Further, this risk was greatest for children exposed to high and moderate levels of pandemic stress. Consistent with diathesis stress and polyvagal frameworks, these conditional effects suggest that blunted parasympathetic reactivity in response to stress in early childhood may escalate the development of externalizing behaviors following stress exposure at school age.

Disrupting the Family Stress-Proximal Process: A Scoping Review of Interventions for Children with Incarcerated Parents.

The United States' overreliance on incarceration has resulted in the imprisonment of millions of individuals - the majority of whom are parents of minor children. While mass incarceration has failed to effectively reduce crime or increase safety, it has dramatically harmed children and families in the United States. In turn, a wealth of research confirms the negative social, emotional, and psychological impacts of parental incarceration on children and the disproportionate impact on Black and Hispanic families and families living in poverty. As activists work towards dismantling this discriminatory and overly punitive system, it is also necessary to support children and adolescents currently impacted by parental incarceration. Using the Family Stress-Proximal Process (FSPP) model (Arditti, 2016) as a frame, the current paper critically reviews the literature on interventions to support children with incarcerated parents (CIP). The use of the FSPP frame highlights that while most intervention research has focused on promoting parenting skills of incarcerated parents and improving visit experiences, there is a dearth of research on interventions that 1) support at-home caregivers, 2) provide developmentally-targeted and -appropriate services and 3) acknowledge and counteract systems of inequality like structural racism and poverty that cause and exacerbate incarceration-related stress. These findings support a research agenda that prioritizes interventions framed around the intersectional identities of CIP and the intersecting systems that impact their lives.

The Protective Effects of Parent-Child Emotion Dialogues for Preschoolers Exposed to Intimate Partner Violence.

Exposure to intimate partner violence (IPV) during early childhood is associated with self-regulation difficulties. Caregivers can facilitate children's self-regulation through emotion-focused conversations about past experiences, buffering downstream effects. However, caregivers experiencing violence may avoid distressing emotions activated by such conversations. This paper explores two different models of relational stress responses, one involving indirect effects (i.e. spillover effects) and the other moderation (i.e. buffering effects). Mothers (n = 117), oversampled for violence exposure, self-reported on IPV and participated in an emotional reminiscing task with children (aged 3-5 years); narratives were coded for maternal sensitive guidance. Maternal sensitive guidance was related to children's self-regulation. Sensitive guidance did not have indirect effects in the association between IPV exposure and children's self-regulation, but did buffer the association between physical IPV and self-regulation; this pattern did not hold for psychological IPV. Results suggest sensitive guidance during reminiscing may promote self-regulation in contexts of high IPV.

Linking preschoolers' parasympathetic activity to maternal early adversity and child behavior: An intergenerational perspective.

Increasing evidence suggests intergenerational effects of maternal early adversity on offspring self-regulation. Prior work has demonstrated associations between maternal adverse childhood experiences (ACEs) and infant respiratory sinus arrhythmia (RSA), a parasympathetic biomarker associated with emotional and behavioral self-regulation. The present study examined these associations and additional potential pathways including children's violence exposure and maternal psychopathology among 123 biological mother-child dyads. Families were low-income and oversampled for violence exposure; children were 3-5 years old. RSA was examined during dyadic interaction using latent growth curve modeling (LGCM). On average, females exhibited greater RSA reactivity. Greater RSA withdrawal across the interaction was associated with greater child negative affect during the interaction, linking RSA reactivity to concurrent child behavior. Consistent with previous findings among infants, high maternal ACEs were associated with lower child RSA at task initiation but not with RSA reactivity across the interaction. Findings suggest that the association between high maternal ACEs and a lower set point for offspring RSA persists into the early childhood period, beyond the influence of maternal psychopathology and children's own violence exposure. These data provide further evidence for the biological embedding of maternal early adversity across generations as well as for the relevance of RSA to child behavioral regulation.

Parental insightfulness and parenting behavior: a two-dimensional analysis of parent contributions to child cognitive outcomes.

Utilizing a two-dimensional model of parenting emphasizing both (1) proximity seeking and (2) exploration, consistent with a conceptual framework rooted in attachment theory, the relations between parental insightfulness, observed parenting, and child cognitive outcomes were investigated in a low-income sample of 64 of caregivers and their young 3-5-year-old children. Specifically, observed parental sensitivity (proximity seeking) and intrusiveness (exploration) and parental insightfulness assessed dimensionally to capture Positive Insight and Focus on Child were examined in relation to child cognitive outcomes. Parental intrusiveness was negatively correlated with cognitive performance; however, parental sensitivity was not associated with child cognitive outcomes. Parents' capacity to remain child-focused during the Insightfulness Assessment was negatively correlated with observed intrusiveness and was associated with child cognitive performance. These results suggest unique contributions of dimensions of parental insightfulness and parenting behaviors to child cognitive outcomes - specifically, parents' capacity to remain focused on children's experience during the Insightfulness Assessment and nonintrusive parenting behavior, which may reflect strategies to support children's exploration.

Respiratory Sinus Arrhythmia in Cognitive Behavioral Therapy for Posttraumatic Stress Symptoms in Children: Preliminary Treatment and Gender Effects.

Cognitive behavioral therapy (CBT) is an efficacious treatment for posttraumatic stress disorder (PTSD) symptoms, but the effect of CBT on physiological indicators is largely unknown. Respiratory sinus arrhythmia (RSA) is an established parasympathetic marker of self-regulatory capacity and stress responsivity. The present study tested if and how resting RSA and RSA reactivity changed following treatment among a sample of children (n = 48) who experienced at least one traumatic event and presented with PTSD symptoms. RSA reactivity was measured in response to personalized trauma-related scripts. Results indicated that changes in RSA after treatment were dependent on pretreatment resting levels of RSA, with individuals with high and low pretreatment resting RSA levels appearing to converge over time in both resting RSA and RSA reactivity by the 3-month follow up. Specific to RSA reactivity, a sex difference was evident, as following treatment, females showed less RSA withdrawal whereas males showed more RSA withdrawal. PTSD symptoms were significantly reduced after CBT but symptom change was not associated with pretreatment resting RSA levels. Overall, these results suggest that there may be multiple physiological patterns within children with PTSD and the direction of the physiological changes after CBT may depend on initial differences in resting RSA levels.

"Am I Doing the Right Thing?": Pathways to Parenting a Gender Variant Child.

Gender variant (GV) children have a subjective sense of gender identity and/or preferences regarding clothing, activities, and/or playmates that are different from what is culturally normative for their biological sex. Despite increases in rates of GV children and their families presenting at clinics, there is little research on how raising a GV child affects the family as a whole or how families make decisions regarding their care. This study took an ecological-transactional framework to explore the question, "what is the experience of parents who raise a GV or transgender child?" Eight mothers and three fathers of GV male and female children (ages 5-13) referred through a GV support group participated in interviews. Transcripts were analyzed using an adaptation of grounded theory analysis. These parents attempted to pave the way to a nonstigmatized childhood for their GV child, typically through two pathways: rescuing the child from fear of stigma and hurt or accepting GV and advocating for a more tolerant world. Many participants used both pathways to different degrees or shifted paths over time, and the paths selected were related to parents' own understanding of GV and their experiences and backgrounds as well as characteristics of the children they were parenting and the communities they inhabited. Limitations, clinical implications, and future directions are discussed.

Caregiver insightfulness and young children's violence exposure: testing a relational model of risk and resilience.

This study employed a relational post-traumatic stress frame to explore the co-contribution of young children's exposure to violence and caregiver insightfulness on child behavioral outcomes in a high-risk, non-referred sample of caregivers and preschoolers (n = 64; mean age 3.83 years, SD = .77). Caregiver insightfulness did not have a main effect on child outcomes but did moderate the relation between violence exposure and child behavior across all observed outcomes. Violence-exposed children with non-insightful caregivers demonstrated higher caregiver-rated internalizing and externalizing behaviors and observer-rated negative affect than all other groups. Among children not exposed to violence, insightfulness was not related to children's behavior problems or negative affect, suggesting violence-specific processes. Though cross-sectional, results suggest that the effects of violence and caregiver insightfulness on child outcomes are contingent on one another and that caregiver insightfulness may play a protective role in contexts of violence.

Widening the circle of security: a quasi-experimental evaluation of attachment-based professional development for family child care providers.

This pilot program evaluation was undertaken to examine the effectiveness of an attachment-based, group professional-development experience, Circle of Security-Parenting, on family childcare (FCC) providers' psychological resources and self-efficacy in managing children's challenging behaviors and supporting children's socioemotional development. Licensed FCC providers with children actively in their care (n = 34) self-selected into the program, offered in English and Spanish through a regional support network for FCC providers; a comparison group of providers was recruited from the state database of licensed providers (n = 17). A significant Time × Group interaction was observed for self-efficacy in managing challenging behaviors, F(1, 46) = 30.59, p = .000, partial η(2) = .40, with participating providers' mean self-efficacy scores increasing, p = .000, d = .78, while comparison providers' decreased, p = .003, d = 1.40. Mean depressive symptoms decreased over time for both groups whereas job stress-related resources were stable over time in both groups. Patterns of association were found between providers' self-report of difficulties considering children's mental states and depressive symptoms, job stress resources, and self-efficacy. Limitations and implications for future research are reviewed, including the impact of conducting this work within an organized support network for FCC providers.

Preschool children's observed disruptive behavior: variations across sex, interactional context, and disruptive psychopathology.

Sex differences in disruptive behavior and sensitivity to social context are documented, but the intersection between them is rarely examined empirically. This report focuses on sex differences in observed disruptive behavior across interactional contexts and diagnostic status. Preschoolers (n = 327) were classified as nondisruptive (51%), clinically at risk (26%), and disruptive (23%) using parent and teacher reports on developmentally validated measures of disruptive behavior and impairment. Observed disruptive behavior was measured with the Disruptive Behavior Diagnostic Observation Schedule, a developmentally sensitive observational paradigm characterizing variation in preschoolers' disruptive behavior across two interactional contexts (parent and examiner). Repeated measures analyses of variance revealed a three-way interaction of child sex by diagnostic status by interactional context (F = 9.81, p < .001). Disruptive boys were the only subgroup whose behavior was not sensitive to interactional context: They displayed comparable levels of disruptive behavior with parents and examiners. In contrast, disruptive girls demonstrated the strongest context effect of any group. Specifically, with the examiner, disruptive girls' behavior was comparable to nondisruptive boys (though still more elevated than nondisruptive girls). However, in interactions with their mothers, disruptive girls displayed the highest rates of disruptive behavior of any subgroup in any context, although the difference between disruptive boys and disruptive girls in this context was not statistically significant. Findings suggest the importance of sex-specific conceptualizations of disruptive behavior in young children that take patterns across social contexts into account.

Harnessing Virtual Mom Power: Process and Outcomes of a Pilot Telehealth Adaptation of a Multifamily, Attachment-Based Intervention.

Objective: The COVID-19 pandemic and mitigation strategies amplified racial and income-based health disparities, profoundly shifted family life, and altered delivery systems for support services. We report pilot data from a telehealth adaptation of Mom Power, an evidence-based, attachment-informed multifamily preventive intervention (clinicaltrials.gov: de-identified). Method: Virtual Mom Power (VMP), adapted for economically marginalized, predominantly Black mothers and their young children (n = 9) was implemented in New Orleans, an early COVID-19 hotspot with an entrenched history of structural racism and trauma. We outline our approach to adaptation of curriculum and service delivery, using a trauma-informed lens. Results: Maternal reports of maternal and child functioning from pre to post were consistent with improvements in maternal depressive and posttraumatic stress symptoms and child competence, comparable to outcomes from in-person trials. Feasibility and acceptability data were strong. Discussion: Preliminary results and reflections on process suggest that telehealth service delivery of a multifamily preventive intervention, with attention to decreasing barriers to online access and consideration of culture and context, facilitated engagement while maintaining fidelity and effects on intervention targets. Future research using larger samples, randomized controlled design, and multi-method assessment should continue to guide dissemination of reflective, group-based telehealth parenting programs.

Health, Neighborhoods, and School Readiness from the Parent Perspective: A Qualitative Study of Contextual and Socio-Emotional Factors.

The objective of this qualitative study was to address existing gaps in the literature by gathering parent perspectives on both health and school readiness in regard to neighborhood context, specifically parents' perceived level of neighborhood safety and support, on physical health and the behavioral and cognitive domains of school readiness. Focus groups were conducted with a total of 28 parents or caregivers whose children attended Early Head Start/Head Start Centers or who received Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services in New Orleans, Louisiana during fall 2015. Parents discussed concepts of school readiness, neighborhood, the intersection between the two, and parental stress; however, few expressed a clear connection between their concerns about safety, their own stress, and their child's readiness for school. Disparities in both health and school readiness exist between both racial and socioeconomic groups in the United States, and this study offers a unique and enhanced understanding of the impact of non-academic factors on the well-being and development of young children.

Family social support buffers the intergenerational association of maternal adverse childhood experiences and preschoolers' externalizing behavior.

Despite previous work demonstrating that an accumulation of maternal adverse childhood experiences (ACEs) is associated with negative health outcomes across generations, few studies have investigated protective factors beyond the parent-child dyad in the intergenerational transmission of adversity. The current study extends previous findings by examining maternal family social support as a culturally relevant buffer in the association between mothers' ACEs and her children's behavior problems in early childhood. Participants included 121 African American mothers and their preschool-aged children experiencing high sociodemographic risk. Mothers completed questionnaires on ACEs, perceived family social support, children's violence exposure and behavior problems as well as relevant demographics. Maternal family social support moderated the relation between maternal ACEs and children's externalizing behaviors (b = -.14, p < .01), such that children of mothers who reported high ACEs and also moderate to high family social support did not show elevated externalizing behaviors; this pattern was not observed for internalizing behaviors (b = -.06, p = .06). Additionally, the intergenerational buffering effects of family social support were observed above and beyond mothers' psychopathology and children's exposure to violence. These results have implications for culturally relevant prevention and intervention efforts supporting African American mothers with young children that reflect resiliency in the face of disparities across generations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Parental Emotion Regulation and Mentalization in Families of Children With ADHD.

Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.

Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates.

Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being.

Caregiver Self-Reports and Reporting of Their Preschoolers' Trauma Exposure: Discordance Across Assessment Methods.

Nearly half of preschool-aged children from low-income families in the United States have been exposed to potentially traumatic events (PTEs), yet few are identified or receive trauma-focused mental health care. Given the critical need to accurately and efficiently identify PTE-exposed individuals, the current study examined discordant caregiver self-reporting of PTE exposure and caregiver reporting of child PTE exposure across two assessment methods: checklist and interview. Research has demonstrated significant cross-method discrepancies among adults reporting stressful life experiences, but examinations of caregiver reporting for their young children have not been conducted. Further, given their possible impact on reporting patterns, caregiver and child characteristics were examined in relation to discordant caregiver reporting by trauma type. Participants were 64 low-income, racially and ethnically diverse caregivers and their preschool-aged children from a Northeastern US city. Caregivers reported self and child PTE exposure via checklist and semi-structured interview. Cross-method discordance for caregiver and child exposure by trauma type ranged from 10.9% to 46.9% (Cohen's kappa =.06-.70). Caregiver race and education were associated with discordant reporting, as were caregiver and child psychopathology. Lower levels of caregiver psychopathology were associated with discordant caregiver reporting of their own exposure, whereas higher levels were associated with discordant caregiver reporting of child exposure. Discordant caregiver reporting of PTE exposure varies by assessment format and trauma type and is differentially related to caregiver demographics and caregiver and child psychopathology. Associations between assessment methods, individual characteristics, and reporting should be considered when assessing PTE exposure to support service engagement and targeted treatment.

Emotion Regulation and Parent Distress: Getting at the Heart of Sensitive Parenting among Parents of Preschool Children Experiencing High Sociodemographic Risk.

OBJECTIVES: Sensitive parenting requires modulation of emotions in order to effectively organize and orient behavioral responses. There is considerable evidence that psychological distress can impair sensitive parenting practices, and also that psychological distress is associated with deficits in emotion regulation capacities. The negative effect that psychological distress has on parents' emotion regulation capacities may be a mechanistic pathway through which psychological distress impacts parenting, as dysregulated emotions may be more proximal to parenting behaviors than distress itself; however, this specific link between psychological distress, emotion regulation, and parenting is not often examined in parenting models. METHODS: The current study tested these relations in a high sociodemographic risk community-sample, oversampled for violence exposure, of caregivers of preschoolers. Caregivers self-reported on their psychological distress and emotion regulation difficulties. Parent sensitivity was assessed via observations of parent-child interactions. RESULTS: Results indicated that difficulties in emotion regulation were a mediator for the relation between parents' psychological distress and sensitive parenting behaviors. Difficulties in emotion regulation predicted decreased sensitivity above and beyond the effect of psychological distress. CONCLUSIONS: These findings emphasize the importance of regulation of emotional reactions in order to orient and engage in sensitive parenting behaviors. Additionally, they suggest clinically that supporting parents' emotion regulation capacities specifically may promote more sensitive parenting in contexts of parental psychological distress.

The transgenerational transmission of maternal adverse childhood experiences (ACEs): Insights from placental aging and infant autonomic nervous system reactivity.

OBJECTIVE: To test alterations in placental cellular aging as one pathway by which maternal early adversity influences physiologic development in her offspring. METHODS: Maternal report of her adverse childhood experiences (ACE) was obtained prenatally along with measures of prenatal stress and demographic information. Placentas (N = 67) were collected at birth and telomere length (TL) was measured in four separate fetally-derived placental tissues: amnion, chorion, villus, and umbilical cord. At four months of age, infants completed the still-face paradigm (SFP) during which respiratory sinus arrhythmia (RSA) data were collected; RSA reactivity and RSA recovery was available from 44 and 41 infants respectively. Multi-level mixed effects models examined the impact of maternal ACE score on placental TL. Generalized linear models tested the relation between composite placental TL and infant RSA, as well as the moderation of maternal ACE score and infant RSA by composite placental TL. RESULTS: Higher maternal ACE score significantly predicted shorter placental TL across tissues (ß = -0.015; P = 0.036) and infant RSA across the SFP. No direct relation was found between placental TL and RSA, however composite placental TL moderated the relation between ACE score and both infant RSA reactivity (ß = 0.025; P = 0.005) and RSA recovery (ß = -0.028; P = 0.032). In infants with shorter composite placental TL, higher ACE score predicted greater RSA suppression during the still-face epoch relative to play period 1 and greater RSA augmentation during play period 2 relative to the still-face epoch. CONCLUSIONS: These data are the first, to our knowledge, to report that changes in placental TL influence the transgenerational impact of maternal early life adversity on the development of her offspring's autonomic nervous system.

Polymorphic variation in the SLC5A7 gene influences infant autonomic reactivity and self-regulation: A neurobiological model for ANS stress responsivity and infant temperament.

OBJECTIVE: To examine the impact of polymorphic variation in the solute carrier family 5 member 7 (SLC5A7) gene on autonomic nervous system (ANS) reactivity indexed by respiratory sinus arrhythmia (RSA) and heart rate (HR) in infants during a dyadic stressor, as well as maternal report of infant self-regulation. Given evidence of race differences in older individuals, race was specifically examined. METHODS: RSA and HR were collected from 111 infants during the still-face paradigm (SFP). Mothers completed the Infant Behavior Questionnaire-Revised short-form. Multi-level mixed effects models examined the impact of SLC5A7 genotype on RSA and HR across the SFP. Linear models tested the influence of genotype on the relation between RSA, HR, and maternal report of infant self-regulation. RESULTS: SLC5A7 genotype significantly predicted RSA stress responsivity (ß = -0.023; p = 0.028) and HR stress responsivity (ß = 0.004; p = 0.002). T-allele carriers exhibited RSA suppression and HR acceleration in response to stress while G/G homozygotes did not suppress RSA and exhibited less HR acceleration. All infants exhibited modest RSA augmentation and HR deceleration during recovery. Race-stratified analyses revealed that White T-allele carriers drove the overall results for both RSA (ß = -0.044; p = 0.007) and HR (ß = 0.006; p = 0.008) with no relation between SLC5A7 genotype and RSA or HR in Black infants. Maternal report of infant orienting/regulation was predicted by the interaction of SLC5A7 genotype and both RSA recovery (ß = 0.359; p = 0.001) and HR recovery (ß = -1.659; p = 0.020). RSA augmentation and HR deceleration during recovery were associated with higher maternal reports of self-regulation among T-allele carriers, a finding again primarily driven by White infants. CONCLUSIONS: Early in development, genetic contributions to ANS are evident and predict maternal report of infant self-regulation within White infants, consistent with prior literature. The lack of associations in Black infants suggest that race differences in physiological reactivity and self-regulation are emerging during the first year of life potentially providing early evidence of disparities in health risk trajectories.

Young Children's Physiological Reactivity during Memory Recall: Associations with Posttraumatic Stress and Parent Physiological Synchrony.

Autonomic reactivity is implicated in stress response and social engagement - both key components of posttraumatic stress disorder (PTSD) - but few studies have examined autonomic reactivity in pediatric samples, and no known studies have examined physiological synchrony among children with PTSD and caregivers. In a sample of 247 young children (94 girls, 153 boys), most (85%) of whom had exposure to trauma and 40% who met criteria for PTSD, we examined children's patterns of respiratory sinus arrhythmia (RSA) at baseline and in response to a memory recall task, as well as correspondence between parents' and children's RSA. Children with PTSD demonstrated significantly higher reactivity than other groups during their recollection of a traumatic memory, but not during other memory tasks. Regarding synchrony, caregivers' and children's RSA were more significantly and positively correlated during the trauma recall task among children who had had exposure to a potentially traumatic event but did not meet PTSD criteria, suggesting physiological synchrony may be protective in contexts of trauma. Overall, findings demonstrate physiological reactivity differences among young children with PTSD. While more work is needed to understand the meaning of parent-child physiological synchrony, these data suggest that children's psychopathology is associated with physiological synchrony processes among young children with exposure to trauma.