A qualitative, multi-perspective study on causal beliefs about adolescent depression.

OBJECTIVES: The current study aimed to examine: (1.1) causal beliefs about adolescent depression in a sample of adolescents with a clinical depression and their mothers and fathers; (1.2) within-family overlap of causal beliefs; (2.1) mothers' and fathers' reflected causal beliefs about their child's perspective; (2.2) the accuracy of mothers' and fathers' reflected causal beliefs as related to their child's causal beliefs. DESIGN: Qualitative study using a within-family approach. METHODS: Adolescents with a current clinical depression (MDD/dysthymia; N = 34) and their parents (N = 34 mothers, N = 26 fathers) were independently interviewed about their causal beliefs about the adolescents' depression. Parents were additionally interviewed about their perception of their child's causal beliefs (i.e., reflected causal beliefs). RESULTS: The causal beliefs most frequently mentioned by adolescents, mothers and fathers are: characteristics of the child, social factors, school and various stressful experiences. Parent-child overlap was relatively low, specifically for the themes of bewilderment, cumulative effect and stressful life events, whereas overlap was relatively high for themes of social factors, school and stressful experiences outside of the family. Parents were relatively accurate in their reflected causal beliefs, but tended to underestimate their child's insights into possible causes of their depression. Accuracy of parents' reflected causal beliefs was particularly low for the theme cumulative effect and high for social factors. CONCLUSIONS: The various causal beliefs of adolescents and their parents could be used in therapeutic setting. Future research could examine whether (guided) conversations may promote alignment within families and treatment efficacy.

A closer look into the affect dynamics of adolescents with depression and the interactions with their parents: An ecological momentary assessment study.

Adolescents with depression tend to perceive behavior of parents as less positive than adolescents without depression, but conclusions are based on retrospective reports assessed once or over long time intervals, with the risk of memory biases affecting the recall. The current study used ecological momentary assessments to examine the link between adolescent affect and the amount of warmth and criticism expressed by both mothers and fathers in families with adolescents with depression versus adolescents without psychopathology in daily life. It also explored the possible bias by assessing parenting on the momentary, daily (EMA), and retrospective level. The sample consisted of 34 adolescents with depression and 58 parents and 80 healthy controls and 151 parents (adolescents: Mage = 15.8, SD = 1.41; 67.5% girls, parents: Mage = 49.3, SD = 5.73; 54.1% mothers). Participants completed retrospective questionnaires and four surveys a day for 14 consecutive days. Preregistered multilevel models showed that momentary parenting reports of adolescents with depression and healthy controls did not differ. The associations between perceived parenting of both mothers and fathers and adolescent affect did also not differ between the two groups. These results illustrate that adolescents generally benefit from supportive parenting, but substantial differences between individuals were found. In contrast to the momentary data, both adolescents with depression and their parents did report more negative parenting on retrospective questionnaires than healthy controls and their parents indicating that adolescents with depression may have a negativity bias in their retrospective recall. These findings are highly relevant for clinical practice and underscore the need for careful assessments on different time scales and including all family members.

Tracking real-time proximity in daily life: A new tool to examine social interactions.

Social interactions, spending time together, and relationships are important for individuals' well-being, with people feeling happier when they spend more time with others. So far, most information about the frequency and duration of spending time together is based on self-report questionnaires. Although recent technological innovations have stimulated the development of objective approaches for measuring physical proximity in humans in everyday life, these methods still have substantial limitations. Here we present a novel method, using Bluetooth low-energy beacons and a smartphone application, to measure the frequency and duration of dyads being in close proximity in daily life. This method can also be used to link the frequency and duration of proximity to the quality of interactions, by using proximity-triggered questionnaires. We examined the use of this novel method by exploring proximity patterns of family interactions among 233 participants (77 Dutch families, with 77 adolescents [Mage = 15.9] and 145 parents [Mage = 48.9]) for 14 consecutive days. Overall, proximity-based analyses indicated that adolescents were more often and longer in proximity to mothers than to fathers, with large differences between families in frequency and duration. Proximity-triggered evaluations of the interactions and parenting behavior were generally positive for both fathers and mothers. This innovative method is a promising tool that can be broadly used in other social contexts to yield new and more detailed insights into social proximity in daily life.

Neural and affective responses to prolonged eye contact with parents in depressed and nondepressed adolescents.

Eye contact improves mood, facilitates connectedness, and is assumed to strengthen the parent-child bond. Adolescent depression is linked to difficulties in social interactions, the parent-child bond included. Our goal was to elucidate adolescents' affective and neural responses to prolonged eye contact with one's parent in nondepressed adolescents (HC) and how these responses are affected in depressed adolescents. While in the scanner, 59 nondepressed and 19 depressed adolescents were asked to make eye contact with their parent, an unfamiliar peer, an unfamiliar adult, and themselves by using videos of prolonged direct and averted gaze, as an approximation of eye contact. After each trial, adolescents reported on their mood and feelings of connectedness, and eye movements and BOLD-responses were assessed. In HCs, eye contact boosted mood and feelings of connectedness and increased activity in inferior frontal gyrus (IFG), temporal pole, and superior frontal gyrus. Unlike HCs, eye contact did not boost the mood of depressed adolescents. While HCs reported increased mood and feelings of connectedness to the sight of their parent versus others, depressed adolescents did not. Depressed adolescents exhibited blunted overall IFG activity. These findings show that adolescents are particularly sensitive to eye contact and respond strongly to the sight of their parents. This sensitivity seems to be blunted in depressed adolescents. For clinical purposes, it is important to gain a better understanding of how the responsivity to eye contact in general and with their parents in particular, can be restored in adolescents with depression.

A Network Study of Family Affect Systems in Daily Life.

Adolescence is a time period characterized by extremes in affect and increasing prevalence of mental health problems. Prior studies have illustrated how affect states of adolescents are related to interactions with parents. However, it remains unclear how affect states among family triads, that is adolescents and their parents, are related in daily life. This study investigated affect state dynamics (happy, sad, relaxed, and irritated) of 60 family triads, including 60 adolescents (Mage = 15.92, 63.3% females), fathers and mothers (Mage = 49.16). The families participated in the RE-PAIR study, where they reported their affect states in four ecological momentary assessments per day for 14 days. First, we used multilevel vector-autoregressive network models to estimate affect dynamics across all families, and for each family individually. Resulting models elucidated how family affect states were related at the same moment, and over time. We identified relations from parents to adolescents and vice versa, while considering family variation in these relations. Second, we evaluated the statistical performance of the network model via a simulation study, varying the percentage missing data, the number of families, and the number of time points. We conclude with substantive and statistical recommendations for future research on family affect dynamics.

Sticky criticism? Affective and neural responses to parental criticism and praise in adolescents with depression.

BACKGROUND: Parent-adolescent interactions, particularly parental criticism and praise, have previously been identified as factors relevant to self-concept development and, when negative, to adolescent depression. Yet, whether adolescents with depression show aberrant emotional and neural reactivity to parental criticism and praise is understudied. METHODS: Adolescents with depression (n = 20) and healthy controls (n = 59) received feedback supposedly provided by their mother or father in the form of negative ('untrustworthy'), neutral ('chaotic'), and positive ('respectful') personality evaluations while in an MRI-scanner. After each feedback word, adolescents reported their mood. Beforehand, adolescents had rated whether these personality evaluations matched their self-views. RESULTS: In both groups, mood decreased after criticism and increased after praise. Adolescents with depression reported blunted mood responses after praise, whereas there were no mood differences after criticism. Neuroimaging analyses revealed that adolescents with depression (v. healthy controls) exhibited increased activity in response to criticism in the subgenual anterior cingulate cortex, temporal pole, hippocampus, and parahippocampal gyrus. Praise consistent with adolescents' self-views improved mood independent of depression status, while criticism matching self-views resulted in smaller mood increases in adolescents with depression (v. healthy controls). Exploratory analyses indicated that adolescents with depression recalled criticism (v. praise) more. CONCLUSIONS: Adolescents with depression might be especially attentive to parental criticism, as indexed by increased sgACC and hippocampus activity, and memorize this criticism more. Together with lower positive impact of praise, these findings suggest that cognitive biases in adolescent depression may affect how parental feedback is processed, and may be fed into their self-views.

Looking into troubled waters: Childhood emotional maltreatment modulates neural responses to prolonged gazing into one's own, but not others', eyes.

One of the most prevalent nonverbal, social phenomena known to automatically elicit self- and other-referential processes is eye contact. By its negative effects on the perception of social safety and views about the self and others, childhood emotional maltreatment (CEM) may fundamentally affect these processes. To investigate whether the socioaffective consequences of CEM may become visible in response to (prolonged) eye gaze, 79 adult participants (mean [M]age = 49.87, standard deviation [SD]age = 4.62) viewed videos with direct and averted gaze of an unfamiliar other and themselves while we recorded self-reported mood, eye movements using eye-tracking, and markers of neural activity using fMRI. Participants who reported higher levels of CEM exhibited increased activity in ventromedial prefrontal cortex to one's own, but not to others', direct gaze. Furthermore, in contrast to those who reported fewer of such experiences, they did not report a better mood in response to a direct gaze of self and others, despite equivalent amounts of time spent looking into their own and other peoples' eyes. The fact that CEM is associated with enhanced neural activation in a brain area that is crucially involved in self-referential processing (i.e., vmPFC) in response to one's own direct gaze is in line with the chronic negative impact of CEM on a person's self-views. Interventions that directly focus on targeting maladaptive self-views elicited during eye gaze to self may be clinically useful.

Adolescents' and parents' affect in relation to discrepant perceptions of parental warmth in daily life.

The current study aimed to evaluate how adolescents' and parents' perceptions of daily parenting-and their discrepancies-relate to daily parent and adolescent affect. Daily parental warmth and affect were assessed using electronic diaries in 150 American adolescent-parent dyads (61.3% females, Mage = 14.6, 83.3% White; 95.3% mothers, Mage = 43.4; 89.3% White) and in 80 Dutch adolescents with 79 mothers and 72 fathers (63.8% females, Mage = 15.9, 91.3% White; Mage = 49.0, 97.4% White). Results of preregistered models indicated that individuals' affect may be more important for perceptions of parenting than discrepancies between parent-adolescent reports of parenting for affect, stressing the need to be aware of this influence of affect on parenting reports in clinical and research settings.

Aberrant neural network activation during reliving of autobiographical memories in adolescent depression.

BACKGROUND: Adolescents with depression exhibit negative biases in autobiographical memory with detrimental consequences for their self-concept and well-being. Investigating how adolescents relive positive autobiographical memories and activate the underlying neural networks could reveal mechanisms that drive such biases. This study investigated neural networks when reliving positive and neutral memories, and how neural activity is modulated by valence and vividness in adolescents with and without depression. METHODS: Adolescents (N = 69; n = 17 with depression) retrieved positive and neutral autobiographical memories. On a separate day, they relived these memories during fMRI scanning, and reported on pleasantness and vividness after reliving each memory. We used a multivariate, data-driven approach - event-related independent component analysis (eICA) - to characterize neural networks supporting autobiographical recollection. RESULTS: Adolescents with depression reported their positive memories as significantly less pleasant compared to healthy controls, while subjective vividness was unaffected. Using eICA, we identified a broad autobiographical memory network, and subnetworks related to reliving positive vs neutral memories. These subnetworks comprised a 'self-referential processing network' including medial prefrontal cortex, posterior cingulate cortex/precuneus, and temporoparietal junction, anti-correlating with parts of the central executive network and salience network. Adolescents with depression exhibited aberrant activation in this self-referential network, but only when reliving relatively 'low' pleasant memories. CONCLUSIONS: Our findings provide first insights into how the quality of reliving autobiographical memories in adolescents with depression may relate to aberrant self-referential neural network activation, and underscore the potential of targeting memory reliving in therapeutic interventions to foster self-esteem and diminish depressive symptoms.

Neural and Affective Responses to Prolonged Eye Contact with One's Own Adolescent Child and Unfamiliar Others.

Eye contact is crucial for the formation and maintenance of social relationships, and plays a key role in facilitating a strong parent-child bond. However, the precise neural and affective mechanisms through which eye contact impacts on parent-child relationships remain elusive. We introduce a task to assess parents' neural and affective responses to prolonged direct and averted gaze coming from their own child, and an unfamiliar child and adult. While in the scanner, 79 parents (n = 44 mothers and n = 35 fathers) were presented with prolonged (16-38 s) videos of their own child, an unfamiliar child, an unfamiliar adult, and themselves (i.e., targets), facing the camera with a direct or an averted gaze. We measured BOLD-responses, tracked parents' eye movements during the videos, and asked them to report on their mood and feelings of connectedness with the targets after each video. Parents reported improved mood and increased feelings of connectedness after prolonged exposure to direct versus averted gaze and these effects were amplified for unfamiliar targets compared to their own child, due to high affect and connectedness ratings after videos of their own child. Neuroimaging results showed that the sight of one's own child was associated with increased activity in middle occipital gyrus, fusiform gyrus and inferior frontal gyrus relative to seeing an unfamiliar child or adult. While we found no robust evidence of specific neural correlates of eye contact (i.e., contrast direct > averted gaze), an exploratory parametric analysis showed that dorsomedial prefrontal cortex (dmPFC) activity increased linearly with duration of eye contact (collapsed across all "other" targets). Eye contact-related dmPFC activity correlated positively with increases in feelings of connectedness, suggesting that this region may drive feelings of connectedness during prolonged eye contact with others. These results underline the importance of prolonged eye contact for affiliative processes and provide first insights into its neural correlates. This may pave the way for new research in individuals or pairs in whom affiliative processes are disrupted.

Eyes on you: Ensuring empathic accuracy or signalling empathy?

The eye region is thought to play an important role in the ability to accurately infer others' feelings, or empathic accuracy (EA), which is an important skill for social interaction. However, most past studies used static pictures, including only visual information, and knowledge about the contribution of the eye region to EA when visual information is presented together with verbal content is lacking. We therefore examined whether eye gazing contributes to EA during videos of emotional autobiographical stories including both visual and verbal content. One hundred seven perceivers watched videos of targets talking about positive and negative life events and continuously rated the targets' feelings during the videos. Simultaneously, perceivers' eyes were tracked. After each video, perceivers reported on their feelings and the extent to which they empathized with and took the perspective of the targets. In contrast to studies using static pictures, we found that gazing to the eyes of targets during the videos did not significantly contribute to EA. At the same time, results on the association between the amount of gaze towards the eye region of targets and perceivers' state and trait empathy ratings suggest that eye gazing might signal empathy and social engagement to others.

Adolescents' affective and neural responses to parental praise and criticism.

Social feedback from parents has a profound impact on the development of a child's self-concept. Yet, little is known about adolescents' affective and neural responses to parental social feedback, such as criticism or praise. Adolescents (n = 63) received standardized social feedback supposedly provided by their mother or father in the form of appraisals about their personality (e.g., 'respectful', 'lazy') during fMRI scanning. After each feedback word, adolescents reported their mood. Additionally, adolescents had rated whether feedback words matched their self-views on an earlier occasion. In line with preregistered hypotheses, negative parental feedback worsened adolescents' mood, which was exacerbated when feedback did not match adolescents' self-views. Negative feedback was associated with increased activity in the neural 'saliency network', including anterior insula, anterior cingulate cortex and dorsomedial prefrontal cortex. Positive feedback improved mood and increased activity in brain regions supporting social cognition, including temporoparietal junction, posterior superior temporal sulcus, and precuneus. A more positive general self-view and perceived parental warmth were associated with elevated mood, independent of feedback valence, but did not impact neural responses. Taken together, these results enhance our understanding of adolescents' neural circuitry involved in the processing of parental praise and criticism, and the impact of parental feedback on well-being.

Perceptions of Parenting in Daily Life: Adolescent-Parent Differences and Associations with Adolescent Affect.

Adolescents can perceive parenting quite differently than parents themselves and these discrepancies may relate to adolescent well-being. The current study aimed to explore how adolescents and parents perceive daily parental warmth and criticism and whether these perceptions and discrepancies relate to adolescents' daily positive and negative affect. The sample consisted of 80 adolescents (Mage = 15.9; 63.8% girls) and 151 parents (Mage = 49.4; 52.3% women) who completed four ecological momentary assessments per day for 14 consecutive days. In addition to adolescents' perception, not parents' perception by itself, but the extent to which this perception differed or overlapped with adolescents' perception was related to adolescent affect. These findings highlight the importance of including combined adolescents' and parents' perspectives when studying dynamic parenting processes.

Neural signatures of parental empathic responses to imagined suffering of their adolescent child.

Empathy is deemed indispensable for sensitive caregiving. Neuroimaging studies have identified canonical empathy networks consisting of regions supporting cognitive and affective aspects of empathy. However, not much is known about how these regions support empathy towards one's own offspring and how this neural activity relates to parental caregiving. We introduce a novel task to assess affective and neural responses to the suffering of one's own adolescent child. While in the scanner, 60 parents (n = 35 mothers, n = 25 fathers) were confronted with unpleasant situations involving their own child, an unfamiliar child, and themselves. Parents were asked to vividly imagine these situations and indicate their levels of distress. Parents reported higher levels of distress when imagining suffering for their own child relative to an unfamiliar child or themselves. Neuroimaging results showed increased activation within the cognitive empathy network (i.e., temporoparietal junction, dorsomedial- and ventromedial prefrontal cortex) when contrasting suffering of one's own child versus an unfamiliar child or the self. The task also engaged regions of the affective empathy network (i.e., anterior insula and anterior mid-cingulate cortex), which was however not modulated by whether suffering was for the self, one's own child, or an unfamiliar child. Parental care did not co-vary with activity in the empathy networks, but parents who were perceived as less caring exhibited increased activity in anterior prefrontal regions when imagining their own child suffering. These results provide new insights into neural processes supporting parental empathy, highlighting the importance of regions in the cognitive empathy network when confronted with the suffering of their own adolescent child, and suggest that additional (i.e., emotion regulation) networks may be relevant for parental caring behavior in daily life.

Vicarious praise and pain: parental neural responses to social feedback about their adolescent child.

Social feedback, such as praise or critique, profoundly impacts our mood and social interactions. It is unknown, however, how parents experience praise and critique about their child and whether their mood and neural responses to such 'vicarious' social feedback are modulated by parents' perceptions of their child. Parents (n = 60) received positive, intermediate and negative feedback words (i.e. personality characteristics) about their adolescent child during a magnetic resonance imaging scan. After each word, parents indicated their mood. After positive feedback their mood improved and activity in ventromedial prefrontal cortex and posterior cingulate cortex/precuneus increased. Negative feedback worsened parents' mood, especially when perceived as inapplicable to their child, and increased activity in anterior cingulate cortex, anterior insula, dorsomedial prefrontal cortex and precuneus. Parents who generally viewed their child more positively showed amplified mood responses to both positive and negative feedback and increased activity in dorsal striatum, inferior frontal gyrus and insula in response to negative feedback. These findings suggest that vicarious feedback has similar effects and engages similar brain regions as observed during feedback about the self and illustrates this is dependent on parents' beliefs of their child's qualities and flaws. Potential implications for parent-child dynamics and children's own self-views are discussed.

Tracking Infant Development With a Smartphone: A Practical Guide to the Experience Sampling Method.

The COVID-19 pandemic has forced developmental researchers to rethink their traditional research practices. The growing need to study infant development at a distance has shifted our research paradigm to online and digital monitoring of infants and families, using electronic devices, such as smartphones. In this practical guide, we introduce the Experience Sampling Method (ESM) - a research method to collect data, in the moment, on multiple occasions over time - for examining infant development at a distance. ESM is highly suited for assessing dynamic processes of infant development and family dynamics, such as parent-infant interactions and parenting practices. It can also be used to track highly fluctuating family dynamics (e.g., infant and parental mood or behavior) and routines (e.g., activity levels and feeding practices). The aim of the current paper was to provide an overview by explaining what ESM is and for what types of research ESM is best suited. Next, we provide a brief step-by-step guide on how to start and run an ESM study, including preregistration, development of a questionnaire, using wearables and other hardware, planning and design considerations, and examples of possible analysis techniques. Finally, we discuss common pitfalls of ESM research and how to avoid them.

The Link between Parental Support and Adolescent Negative Mood in Daily Life: between-Person Heterogeneity in within-Person Processes.

Lack of parental support is related to more adolescent negative mood. However, little is known about how fluctuations of parental support relate to fluctuations of negative mood within adolescents in daily life. The current study aimed to elucidate these processes at a day to day micro-level and examined to which extent adolescents would differ in the association between perceived parental support and adolescent negative mood. The sample consisted of 242 Dutch adolescents (Mage = 13.82, 63.2% female) who completed ecological momentary assessments of 3 weeks 3 months apart. Results from the multilevel regression analyses showed that, on average, adolescents experienced higher levels of negative mood on days when they perceived their parents to be less supportive. Substantial individual differences were found in this association, however, these were partially explained by the level of depressive symptoms and perceived parental intrusiveness. These findings suggest that advice on parental support should be tailored to the unique characteristics of the adolescent.

Does the COVID-19 pandemic impact parents' and adolescents' well-being? An EMA-study on daily affect and parenting.

Due to the COVID- 19 outbreak in the Netherlands (March 2020) and the associated social distancing measures, families were enforced to stay at home as much as possible. Adolescents and their families may be particularly affected by this enforced proximity, as adolescents strive to become more independent. Yet, whether these measures impact emotional well-being in families with adolescents has not been examined. In this ecological momentary assessment study, we investigated if the COVID-19 pandemic affected positive and negative affect of parents and adolescents and parenting behaviors (warmth and criticism). Additionally, we examined possible explanations for the hypothesized changes in affect and parenting. To do so, we compared daily reports on affect and parenting that were gathered during two periods of 14 consecutive days, once before the COVID-19 pandemic (2018-2019) and once during the COVID-19 pandemic. Multilevel analyses showed that only parents' negative affect increased as compared to the period before the pandemic, whereas this was not the case for adolescents' negative affect, positive affect and parenting behaviors (from both the adolescent and parent perspective). In general, intolerance of uncertainty was linked to adolescents' and parents' negative affect and adolescents' positive affect. However, Intolerance of uncertainty, nor any pandemic related characteristics (i.e. living surface, income, relatives with COVID-19, hours of working at home, helping children with school and contact with COVID-19 patients at work) were linked to the increase of parents' negative affect during COVID-19. It can be concluded that on average, our sample (consisting of relatively healthy parents and adolescents) seems to deal fairly well with the circumstances. The substantial heterogeneity in the data however, also suggest that whether or not parents and adolescents experience (emotional) problems can vary from household to household. Implications for researchers, mental health care professionals and policy makers are discussed.