Temperamental and Theoretical Contributions to Clinical Psychology.

This review considers two themes. The first section describes the influence of two temperamental biases detectable in infants that render children vulnerable to maladaptive behavior if the rearing environment invites such responses. Infants who display high levels of limb activity and crying in response to unexpected events are likely to be shy and fearful as children and are at risk for an anxiety disorder. Infants who display little limb movement and crying are susceptible to assuming risks and vulnerable to asocial behavior if the rearing environment invites these actions. The second section criticizes three common research practices: failure to examine patterns of measures for predictors and outcomes, an indifference to the power of the setting on the evidence recorded, and the distortions that semantic terms in questionnaires impose on replies.

Effect of Maternal Distress on Perceptions of Infant Behavior May Differ in Chinese-American and European-American Mothers and Infants.

OBJECTIVE: This study examined the associations between maternal distress (symptoms of depression and anxiety) and observer and maternal ratings of infant temperament in Chinese-American (CA) and European-American (EA) 4-month-old infants (N = 114 dyads). METHODS: Maternal distress was obtained through self-reported symptoms of depression and anxiety. Mothers reported infant temperament (distress at limitations, soothability, and fear) through the short form of the Infant Behavior Questionnaire-Revised. To obtain observer-rated infant reactivity, infants were administered a battery of visual and auditory stimuli in the laboratory, in which infant behaviors (fret/cry, limb activity, and arching of the back) were coded. RESULTS: Maternal distress accounted more for the maternal perception of her infant among EA mothers than among CA mothers, but the relation was only observed for soothability. Higher maternal distress was associated with maternal report of lower soothability for EA mothers. Observer-rated infant reactivity, but not maternal distress, was positively associated with EA and CA maternal report of distress at limitations. Observer-rated infant negativity was associated with somewhat higher ratings of infant fear for EA mothers, although this association for EA mothers was not significantly different from CA mothers. CONCLUSIONS: Potential biases in maternal report of infant behavior due to effects from maternal distress may not be generalizable across cultures but may vary because of cultural norms for emotional experience and expectations for infant behavior. EA mothers' ratings of infant distress and soothability, but not fear, may be influenced by maternal distress.

Kinds of individuals defined by patterns of variables.

This paper argues that investigators should consider replacing the popular practice of comparing individuals varying in gender, social class, and/or ethnicity on one or more continuous measures with a search for kinds of individuals defined by patterns of properties that include not only their values on outcome measures but also their gender, social class, and ethnicity. Investigators who believe that a particular predictor contributes to an outcome independent of the gender, class, or ethnicity of the participants often implement statistical procedures that promise to remove the contributions of the above categories. These analyses lead to misleading conclusions when the controlled category is correlated with the dependent measures. The final sections summarize the properties of genders, classes, and ethnic groups that make distinctive contributions to many psychological outcomes. The paper ends by noting that a society's ethical beliefs constitute a defensible basis for ignoring the biological properties associated with these categories in order to allow members of these groups access to whatever educational or occupational goals they desire.

Three Unresolved Issues in Human Morality.

This article discusses three major, but related, controversies surrounding the idea of morality. Is the complete pattern of features defining human morality unique to this species? How context dependent are moral beliefs and the emotions that often follow a violation of a moral standard? What developmental sequence establishes a moral code? This essay suggests that human morality rests on a combination of cognitive and emotional processes that are missing from the repertoires of other species. Second, the moral evaluation of every behavior, whether by self or others, depends on the agent, the action, the target of the behavior, and the context. The ontogeny of morality, which begins with processes that apes possess but adds language, inference, shame, and guilt, implies that humans are capable of experiencing blends of thoughts and feelings for which no semantic term exists. As a result, conclusions about a person's moral emotions based only on questionnaires or interviews are limited to this evidence.

Perspectives on two temperamental biases.

This paper describes the contribution of two infant temperamental biases to variation in behaviour and biology over the first 18 years in a sample of middle-class Caucasian children. One bias, called high reactive, is defined by frequent display of limb activity and crying in four-month-old infants to unexpected or unfamiliar events. The other, called low reactive, is defined by the opposite pair of behaviours to the same incentives. High reactive infants are likely to display cautious, avoidant responses and signs of an excitable amygdala to unexpected experiences. Low reactives are characterized by a sociable, emotionally spontaneous profile to the same experiences and a minimally excitable amygdala. However, each bias is a better predictor of the future traits that are unlikely to develop than the ones that do. The final pattern of traits is a function of the person's temperaments, life history, and current circumstances.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.

A Neurobehavioral Mechanism Linking Behaviorally Inhibited Temperament and Later Adolescent Social Anxiety.

OBJECTIVE: Behavioral inhibition (BI) is a temperament identified in early childhood that is a risk factor for later social anxiety. However, mechanisms underlying the development of social anxiety remain unclear. To better understand the emergence of social anxiety, longitudinal studies investigating changes at behavioral neural levels are needed. METHOD: BI was assessed in the laboratory at 2 and 3 years of age (N = 268). Children returned at 12 years, and an electroencephalogram was recorded while children performed a flanker task under 2 conditions: once while believing they were being observed by peers and once while not being observed. This methodology isolated changes in error monitoring (error-related negativity) and behavior (post-error reaction time slowing) as a function of social context. At 12 years, current social anxiety symptoms and lifetime diagnoses of social anxiety were obtained. RESULTS: Childhood BI prospectively predicted social-specific error-related negativity increases and social anxiety symptoms in adolescence; these symptoms directly related to clinical diagnoses. Serial mediation analysis showed that social error-related negativity changes explained relations between BI and social anxiety symptoms (n = 107) and diagnosis (n = 92), but only insofar as social context also led to increased post-error reaction time slowing (a measure of error preoccupation); this model was not significantly related to generalized anxiety. CONCLUSION: Results extend prior work on socially induced changes in error monitoring and error preoccupation. These measures could index a neurobehavioral mechanism linking BI to adolescent social anxiety symptoms and diagnosis. This mechanism could relate more strongly to social than to generalized anxiety in the peri-adolescent period.

Posttraumatic Stress Disorder Diagnosis in Young Children With Burns.

The primary aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in young children hospitalized for burns. A secondary aim was to assess partial PTSD in this population. PTSD diagnosis and symptoms were evaluated utilizing both the diagnostic interview for children and adolescents (DICA-P) module and the PTSD semistructured interview and observational report (PTSDSSI). PTSD symptomatology was assessed from parent interviews at 1 month after discharge from a major pediatric burn center. Four of the 42 participants who completed the DICA-P met full criteria for a diagnosis of PTSD (10%).Of the 39 who also completed the PTSDSSI, 1 (3%) met full criteria for PTSD diagnosis on that measure. Twenty-seven percentage of subjects met partial criteria on the DICA-P vs 16% on the PTSDSSI, without impairment. Furthermore, 67% of subjects met DICA-P criteria for the re-experiencing cluster and 54% met the PTSDSSI re-experiencing criteria. Although only a small percentage met full PTSD diagnostic criteria by either measure, a high percentage of young children with burns manifested some posttraumatic symptoms 1 month after discharge. Because PTSDSSI diagnosis is strongly linked to the diagnostic and statistical manual-5 (DSM-5) criteria for "PTSD in children 6 years and younger," these results may offer clues to current diagnoses of PTSD in young children. Future research is needed to improve care by determining the risk factors and course of PTSD to further refine the diagnostic criteria for identifying children most in need of intervention, such as those hospitalized for burn injuries.

An Overly Permissive Extension.

In this article, I describe how the current practice of classifying as a stressor any event that is accompanied by a change in any of a number of biological or behavioral measures-even when it is not accompanied by a long-term compromise in an organism's health or capacity to cope with daily challenges-has limited the utility of this concept. This permissive posture, which began with Selye's writings more than 65 years ago, is sustained by the public's desire for a simple term that might explain the tension generated by the threat of terrorists, growing economic inequality, increased competiveness in the workplace or for admission to the best universities, rogue nuclear bombs, and media reports of threats to health in food and water. I believe that the concept stress should be limited to select events that pose a serious threat to an organism's well-being or discarded as too ambiguous to be theoretically useful.

Why Stress Remains an Ambiguous Concept: Reply to McEwen & McEwen (2016) and Cohen et al. (2016).

This reply to the commentaries by Cohen, Giannaros, and Manuck (2016, this issue) and McEwen and McEwen (2016, this issue) acknowledges investigators' reluctance to relinquish the term stress, despite the lack of agreement on its meaning and the evidence that is a sign of its presence. This brief reply urges scientists studying the exemplars of this ambiguous concept to search for robust relations that specify the type of event, the properties of the agent, the agent's circumstances, and the behavioral or biological consequences. The accumulation of these relations will reveal that the word stress adds little to our understanding.

The relation between reactivity at 4 months and Behavioral Inhibition in the second year: Replication Across Three Independent Samples.

This paper examines the predictive relations between two infant temperamental biases assessed at 4 months and inhibited behavior during the first two years of life in three independent samples from two research laboratories. Although each sample used slightly different criteria for classifying infants, the results across samples were consistent. Infants of both genders who displayed high levels of motor activity and distress to unfamiliar events were more inhibited at 14 months of age. By 24 months there were significant sex differences: boys identified as high reactive were more inhibited than high reactive girls.

Review: the future of the mind: the scientific quest to understand, enhance, and empower the mind.

In Jerome Kagan's review of The Future of the Mind by physicist and futurist Michio Kaku, Kagan leans on his own experience as co-director of the Harvard Mind/Brain/Behavior Interfaculty Initiative to explore a book that imagines a world where we will have the power to record, store, and transmit signals of brain activity, and where interchangeable thoughts and self-aware robots will be part of everyday life.

Three Lessons Learned.

In this article, I describe varied observations from the past 60 years that motivated three significant changes in the assumptions I held as a young psychologist interested in the development of children. Aspects of these early assumptions penetrate a great deal of current research. The new beliefs are (a) a greater willingness to base concepts on patterns of measurements rather than single independent or dependent variables, (b) learning to include the physical features of the observational setting, including the procedure that generated the evidence, as well as the participants' gender, social class, and cultural background, as part of the concept, and (c) remaining aware of the possibility that the relations among continuous variables can change as a function of brain maturation during the early stages of childhood.

Structural differences in adult orbital and ventromedial prefrontal cortex predicted by infant temperament at 4 months of age.

CONTEXT: The term temperament refers to a biologically based predilection for a distinctive pattern of emotions, cognitions, and behaviors first observed in infancy or early childhood. High-reactive infants are characterized at age 4 months by vigorous motor activity and crying in response to unfamiliar visual, auditory, and olfactory stimuli, whereas low-reactive infants show low motor activity and low vocal distress to the same stimuli. High-reactive infants are biased to become behaviorally inhibited in the second year of life, defined by timidity with unfamiliar people, objects, and situations. In contrast, low-reactive infants are biased to develop into uninhibited children who spontaneously approach novel situations. OBJECTIVE: To examine whether differences in the structure of the ventromedial or orbitofrontal cerebral cortex at age 18 years are associated with high or low reactivity at 4 months of age. DESIGN: Structural magnetic resonance imaging in a cohort of 18-year-olds enrolled in a longitudinal study. Temperament was determined at 4 months of age by direct observation in the laboratory. SETTING: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital. PARTICIPANTS: Seventy-six subjects who were high-reactive or low-reactive infants at 4 months of age. MAIN OUTCOME MEASURE: Cortical thickness. RESULTS: Adults with a low-reactive infant temperament, compared with those categorized as high reactive, showed greater thickness in the left orbitofrontal cortex. Subjects categorized as high reactive in infancy, compared with those previously categorized as low reactive, showed greater thickness in the right ventromedial prefrontal cortex. CONCLUSIONS: To our knowledge, this is the first demonstration that temperamental differences measured at 4 months of age have implications for the architecture of human cerebral cortex lasting into adulthood. Understanding the developmental mechanisms that shape these differences may offer new ways to understand mood and anxiety disorders as well as the formation of adult personality.

Preliminary evidence for the effects of morphine on posttraumatic stress disorder symptoms in one- to four-year-olds with burns.

This study tested the hypothesis that very young children who received more morphine for acute burns would have larger decreases in posttraumatic symptoms 3 to 6 months later. This has never before been studied in very young children, despite the high frequency of burns and trauma in this age group. Seventy 12- to 48-month-old nonvented children with acute burns admitted to a major pediatric burn center and their parents participated. Parents were interviewed at three time points: during their child's hospitalization, 1 month, and 3 to 6 months after discharge. Measures included the Child Stress Disorders Checklist - Burn Version (CSDC-B). Chart reviews were conducted to obtain children's morphine dosages during hospitalization. Mean equivalency dosages of morphine (mg/kg/d) were calculated to combine oral and intravenous administrations. Eleven participants had complete 3 to 6-month data on the CSDC. The correlation between average morphine dose and amount of decrease in posttraumatic stress disorder symptoms on the CSDC (r = -0.32) was similar to that found in studies with older children. The correlation between morphine dose and amount of decrease in symptoms on the arousal cluster of the CSDC was significant (r = -0.63, P < .05). Findings from the current study suggest that, for young children, management of pain with higher doses of morphine may be associated with a decreasing number of posttraumatic stress disorder symptoms, especially those of arousal, in the months after major trauma. This extends, with very young children, the previous findings with 6- to 16-year olds.

Two Is Better Than One.

Psychologists too often rely on only one source of evidence to affirm the validity of a construct. However, they usually do not know all the conditions that can produce the evidence they gather. Hence, the inference is often limited to the data gathered and does not generalize to other categories of information. Examples of this habit are presented along with the suggestion that all social scientists should affirm the utility of their concepts with more than one class of information.

In defense of qualitative changes in development.

The balance between the preservation of early cognitive functions and serious transformations on these functions shifts across time. Piaget's writings, which favored transformations, are being replaced by writings that emphasize continuities between select cognitive functions of infants and older children. The claim that young infants possess elements present in the older child's concepts of number, physical impossibility, and object permanence is vulnerable to criticism because the inferences are based primarily on the single measure of change in looking time. It is suggested that investigators use unique constructs to describe phenomena observed in young infants that appear, on the surface, to resemble the psychological competences observed during later developmental stages.

Using the proper vocabulary.

This paper makes three points. First, inferences from biological and psychological evidence pertaining to psychological constructs must use distinct vocabularies because they represent different phases of a cascade of processes. Second, there are necessarily indeterminate relations between phases of the cascade that begins with an incentive evoking a brain state which, in turn, may generate a psychological reaction and/or action. Finally, all biological and psychological phenomena occur in particular species and specific contexts; hence it is useful to append to every conclusion information on the agent and the setting in which the evidence was gathered.