Maternal suicide risk predicts preschooler emotional and behavioral problems.

Maternal history of suicidal thoughts and behaviors (STBs) has been identified as a robust risk factor for offspring emotional and behavioral problems, including risk for offspring STBs. The impact of maternal history of STBs has been well-documented in adolescent and young adult samples, with emerging research highlighting the need to examine early clinical correlates of risk in young children, prior to the emergence of STBs. In an extension of prior work, the current study examined associations between maternal history of STBs and previously identified emotional and behavioral correlates of STBs (negative affect, internalizing problems, attention problems, aggressive behavior) in young children. These associations were examined in a mother-preschooler sample (n = 158, mean preschooler age=41.52 months) with approximately half of mothers endorsing a history of STBs and 20 % of the sample scoring at the threshold that indicates suicide risk. In multivariate models, maternal history of STBs was significantly associated with preschooler aggressive behavior, assessed via mother- (ß=0.19) and teacher-report (ß=0.21), as well as mother-reported negative affect (ß=0.22). Results document a link between maternal history of STBs and increased risk for heightened negative affect and aggressive behavior at home and school during the sensitive preschool period. Findings are discussed within the context of enhancing models of intergenerational transmission suicide risk.

Maternal invalidation and child RSA reactivity to frustration interact to predict teacher-reported aggression among at-risk preschoolers.

BACKGROUND: Aggression is a transdiagnostic indicator of risk and represents one of the most common reasons children are referred for mental health treatment. Theory and research highlight the impact of maternal invalidation on child aggression and suggest that its influence may vary based on differences in child physiological reactivity. Moreover, the interaction between these risk factors may be particularly pronounced among children of mothers with emotion regulation (ER) difficulties. The current study examined the independent and interactive effects of maternal invalidation and child physiological reactivity to frustration on teacher-reported aggression in an at-risk sample of preschool children. METHOD: Participants included 77 mothers (Mage = 33.17 years, s.d. = 4.83; 35% racial/ethnic minority) and their children (Mage = 42.48 months; s.d. = 3.78; 56% female; 47% racial/ethnic minority). Groups of mothers with and without clinician-rated ER difficulties reported on maternal invalidation, and child respiratory sinus arrhythmia (RSA) was assessed continuously during a frustration task as an indicator of physiological reactivity. Teachers or daycare providers reported on child aggression. RESULTS: Results demonstrated positive associations between maternal ER difficulties and both maternal invalidation and child RSA reactivity to frustration. As expected, the interaction between maternal invalidation and child RSA reactivity was significant, such that higher maternal invalidation and greater child RSA reactivity to frustration predicted more aggression in a daycare or preschool setting. Importantly, this effect was demonstrated while controlling for demographic covariates and baseline RSA. CONCLUSIONS: Findings are in line with diathesis-stress and biosocial models of risk and point to multiple targets for prevention and early intervention.

The role of youths' cardiac autonomic balance and parental responses to youth emotion in vulnerability to borderline personality disorder development.

Developmental models of borderline personality disorder (BPD) emphasize the effects of youths' biological vulnerabilities and their experiences of parental responses to emotion, as well as the interaction between these two elements. The current study evaluated the independent and interactive effects of two indices of autonomic nervous system response and parental responses to youth negative emotions on severity and exacerbation of youths' BPD features during the transition to adolescence. The sample consisted of 162 psychiatric youth (10-14 years; 47.2% female) and their parents. At baseline, youth and their parents completed a lab-based conflict discussion during which parasympathetic and sympathetic nervous system response were measured and indices of sympathetic-parasympathetic balance and coactivation/coinhibition were calculated. Youth also reported on supportive and non-supportive parental responses. At baseline and after 9 months, youth self-reported on their BPD features. Results demonstrated that shifting toward sympathetic dominance independently predicted exacerbation of BPD across 9 months. Additionally, fewer experiences of supportive parental responses and more non-supportive parental responses were associated with greater severity of BPD features in youth. This study highlights the role of autonomic response to parent-child conflict as well as the significance of parental responses to youth emotion for the development of BPD during this developmental window.

Internalizing and Externalizing Problems Among At-Risk Preschoolers: The Mediating Role of Maternal Invalidation.

Children of parents with emotion regulation (ER) difficulties may be at heightened risk for internalizing and externalizing problems, and maternal invalidation may explain this association. The current study used a cross-informant design to test the indirect effect of clinician-rated maternal ER difficulties on teacher-reported internalizing and externalizing problems through maternal invalidation. This risk pathway was tested in two groups of preschoolers: children of mothers with ER difficulties and children of mothers without ER difficulties (healthy controls; HC). Participants were 85 mothers (Mage =33.30 years; 36% racial/ethnic minoritized status) and their children (Mage =4234 months; 47% racial/ethnic minoritized status). Maternal ER difficulties had a significant indirect effect on child internalizing problems and externalizing problems, specifically aggressive behavior, through maternal invalidation. Specifically, mothers with ER difficulties reported more maternal invalidation, and their children exhibited more internalizing problems and aggressive behavior in a preschool/daycare setting, pointing to multiple avenues for prevention and intervention.

Momentary borderline personality disorder symptoms in youth as a function of parental invalidation and youth-perceived support.

BACKGROUND: Parental invalidation is central to etiological models of borderline personality disorder (BPD). Previous studies relied on retrospective accounts or laboratory observations to examine these associations. There is a dearth of research assessing these constructs in daily life, and limited studies have tested the effect of parental invalidation on BPD symptoms during early adolescence, when BPD onsets. The current study took a dynamic approach to assess parents' validating and invalidating behavior and its effect on youths' BPD symptom expression in daily life, while accounting for parent-perceived helpfulness of these behaviors and youth-perceived support. METHODS: A psychiatric sample of 162 early adolescents (age range = 10-14 years; 47% female) and their parent completed a four-day ecological momentary assessment study. Parents reported on the use of validating and invalidating (e.g. punishing and ignoring) behaviors during parent-child conflict, as well as perceived helpfulness of these behaviors. Youth reported on their BPD symptoms and perceived parental support. Multilevel models were used to test the between- and within-person effects of parents' validating and invalidating behaviors, parent-perceived helpfulness and youth-perceived support, and their interaction on youth's momentary expression of BPD symptoms. RESULTS: At the between-person level, invalidating behaviors, specifically punishing behaviors, were related to greater BPD symptoms in daily life, while ignoring behaviors were associated with fewer BPD symptoms. Youth-perceived support predicted fewer BPD symptoms. CONCLUSIONS: Results underscore the importance of parental invalidation for the expression of BPD symptoms in daily life and also highlight the importance of youth's subjective experience of parental support. Findings are discussed in terms of etiological and intervention models that emphasize a dyadic framework.

Age related sex differences in maladaptive regulatory responses to sadness: A study of youths at high and low familial risk for depression.

Offspring of parents with depression histories are at increased risk of developing depression and also report maladaptive ways of self-regulating sadness. Maladaptive regulation of sadness tends to be more prevalent among females than males and has been proposed as one explanation of sex differences in depression rates that emerge around mid-adolescence. However, there is scant information about the age at which the sex differences in maladaptive regulatory responses become evident and whether such age-related sex differences vary depending on depression risk. The present study examined two samples aged 8-18 years: 86 offspring of emotionally healthy parents and 98 offspring of parents with depression histories. Subjects were clinically assessed and provided self-reports of maladaptive responses to sadness. In the combined samples, sex differences in maladaptive responses were significant at age 12.5 years and older ages (i.e., chronologically earlier than the documented emergence of sex differences in depression). While in the high-risk group, sex differences in maladaptive regulatory responses were significant at 12.11 years of age and older, in the low-risk group there was no age at which sex differences were significant. Our findings support the possible mechanistic role of maladaptive emotion regulation in the emergence of sex disparities in depression rates and have implications for prevention.

Autonomic Nervous System Inflexibility During Parent-child Interactions is Related to Callous-unemotional Traits in Youth Aged 10-14 Years Old.

Youth with callous-unemotional (CU) traits are at high risk for aggression and antisocial behavior. Extant literature suggests that CU traits are related to abnormal autonomic responses to negatively-valenced emotional stimuli, although few studies have tested autonomic responding specifically during social interactions. To address this knowledge gap, the current study tested whether CU traits were related to autonomic activity, assessed via respiratory sinus arrhythmia (RSA), during several parent-child interaction tasks designed to provoke negative emotion. The sample was 162 clinically referred youth (M age = 12.03, SD = .92; 47% female). Using piecewise latent growth models, we estimated individual differences in RSA during three semi-structured social interaction tasks (reading aloud to a parent and research assistant; a recovery period from the reading task; and a parent-child conflict discussion) and tested whether CU traits were related to patterns of RSA responding across tasks. Overall, youth showed expected RSA decreases during the reading period, increases in RSA during recovery, and further decreases during the conflict discussion. However, youth with clinically-elevated CU traits had a different pattern of RSA change across tasks, such that CU traits were related to significantly less RSA change during reading and recovery. Findings suggest that less RSA engagement during social interactions and less RSA recovery may be a biomarker of CU traits. Future research is needed to examine whether this inflexibility contributes to the development of CU traits beginning early in childhood.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

An interaction between early threat exposure and the oxytocin receptor in females: Disorder-specific versus general risk for psychopathology and social-emotional mediators.

Early threat exposure is a transdiagnostic risk factor for psychopathology, and evidence suggests that genetic variation in the oxytocin receptor (OXTR) moderates this association. However, it is unclear if this gene-by-environment (G×E) interaction is tied to unique risk for disorder-specific outcomes or instead increases shared risk for general psychopathology. Moreover, little is known about how this G×E interaction increases risk. The current study utilized a prospective, longitudinal sample of females (n = 2,020) to examine: (a) whether the interaction between early threat exposure and OXTR variation (rs53576, rs2254298) confers risk for disorder-specific outcomes (depression, anxiety, borderline and antisocial personality disorders) and/or general psychopathology in early adulthood; and (b) whether social-emotional deficits (emotion dysregulation, callousness, attachment quality) during adolescence constitute mediating mechanisms. Consistent with hypotheses, the interactive effects of early threat exposure and OXTR variation (rs53576) predicted general psychopathology, with threat-exposed women carrying at least one copy of the rs53576 A-allele at greatest risk. This interaction was mediated via emotional dysregulation in adolescence, with threat-exposed A-allele carriers demonstrating greater emotion dysregulation, and greater emotion dysregulation predicting general psychopathology in early adulthood. Findings suggest that this G×E places women at risk for a broad range of psychopathology via effects on emotion dysregulation.

Natural emotion vocabularies as windows on distress and well-being.

To date we know little about natural emotion word repertoires, and whether or how they are associated with emotional functioning. Principles from linguistics suggest that the richness or diversity of individuals' actively used emotion vocabularies may correspond with their typical emotion experiences. The current investigation measures active emotion vocabularies in participant-generated natural speech and examined their relationships to individual differences in mood, personality, and physical and emotional well-being. Study 1 analyzes stream-of-consciousness essays by 1,567 college students. Study 2 analyzes public blogs written by over 35,000 individuals. The studies yield consistent findings that emotion vocabulary richness corresponds broadly with experience. Larger negative emotion vocabularies correlate with more psychological distress and poorer physical health. Larger positive emotion vocabularies correlate with higher well-being and better physical health. Findings support theories linking language use and development with lived experience and may have future clinical implications pending further research.

Mental health during the COVID-19 pandemic: Effects of stay-at-home policies, social distancing behavior, and social resources.

Social distancing is the most visible public health response to the COVID-19 pandemic, but its implications for mental health are unknown. In a nationwide online sample of 435 U.S. adults, conducted in March 2020 as the pandemic accelerated and states implemented stay-at-home orders, we examined whether stay-at-home orders and individuals' personal distancing behavior were associated with symptoms of depression, generalized anxiety disorder (GAD), intrusive thoughts, insomnia, and acute stress. Stay-at-home order status and personal distancing were independently associated with higher symptoms, beyond protective effects of available social resources (social support and social network size). A subsample of 118 participants who had completed symptom measures earlier in the outbreak (February 2020) showed increases in depression and GAD between February and March, and personal distancing behavior was associated with these increases. Findings suggest that there are negative mental health correlates of social distancing, which should be addressed in research, policy, and clinical approaches to the COVID-19 pandemic.

RSA reactivity to parent-child conflict as a predictor of dysregulated emotion and behavior in daily life.

BACKGROUND: Individual variability in tonic (resting) and phasic (reactivity) respiratory sinus arrhythmia (RSA) may underlie risk for dysregulated emotion and behavior, two transdiagnostic indicators that permeate most psychological disorders in youth. The interaction between tonic and phasic RSA may specify unique physiological profiles during the transition to adolescence. The current study utilized clinically referred youth (Mage = 12.03; s.d. = 0.92) to examine baseline RSA, RSA reactivity, and their interaction as predictors of dysregulated emotion and behavior in daily life. METHOD: Participants were 162 youth (47% female; 60% minority) in psychiatric treatment for any mood or behavior problem. RSA was assessed during three, 2-minute baselines and an 8-minute parent-child conflict discussion task. Dysregulated emotion and behavior were assessed during a 4-day ecological momentary assessment protocol that included 10 time-based prompts over a long weekend. RESULTS: Greater RSA withdrawal to the conflict was associated with dysregulated basic emotion (sadness, anger, nervousness, stress) in daily life. Two distinct interactions also emerged, such that baseline RSA was related to dysregulated complex emotion (shame, guilt, loneliness, emptiness) and dysregulated behavior as a function of RSA reactivity to conflict. Lower baseline RSA and greater RSA withdrawal were associated with dysregulated complex emotion, while higher baseline RSA and greater RSA withdrawal were associated with dysregulated behavior. CONCLUSIONS: Findings point to physiological profiles that increase the risk of dysregulated emotion and behavior during the transition to adolescence. Excessive RSA withdrawal uniquely, and in combination with baseline RSA, increased risk for dysregulation in daily life, underscoring the role of autonomic stress responding as a risk factor for psychopathology.

Sympathetic arousal during the processing of dysphoric affect by youths at high and low familial risk for depression.

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never-depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre-ejection period (PEP); mood repair outcome was indexed by self-rated affect. High-risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low-risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high-risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low-risk but not in the high-risk group. The findings suggest that: (a) depression-prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status.

Affective Dynamics Across Internalizing and Externalizing Dimensions of Psychopathology.

Little is known about pathogenic affective processes that cut across diverse mental disorders. The current study examines how dynamic features of positive and negative affect differ or converge across internalizing and externalizing disorders in a diagnostically diverse urban sample using bivariate dynamic structural equation modeling. One-hundred fifty-six young women completed semi-structured clinical interviews and a 21-day ecological momentary assessment protocol with seven assessments of affective states per day. Internalizing and externalizing dimensions of psychopathology were modeled using confirmatory factor analysis of mental disorders. After controlling for externalizing disorders, internalizing disorders were associated with higher negative affective mean intensity, higher negative affective variability (i.e., unique innovation variance), and lower positive affective variability. Conversely, externalizing disorders were associated with less persistent positive affect (i.e., lower inertia) and more variable positive emotionality. Results suggest internalizing and externalizing disorders have distinct affective dynamic signatures, which have implications for development of tailored interventions.

The Structure of Psychopathology in a Sample of Clinically Referred, Emotionally Dysregulated Early Adolescents.

This investigation answers and amplifies calls to model the transdiagnostic structure of psychopathology in clinical samples of early adolescents and using stringent psychometric criteria. In 162 clinically referred, clinically evaluated 11-13-year-olds, we compared a correlated two-factor model, containing latent internalizing and externalizing factors, to a bifactor model, which added a transdiagnostic general factor. We also evaluated the bifactor model psychometrically, including criterion validity with broad indicators of psychosocial functioning. In doing so, we compared alternative approaches to defining and interpreting criterion validity: a recently proposed incremental definition based on amounts of variance in criterion factors explained, and the more typical definition based on the presence of conceptually meaningful relationships. While traditional fit statistics favored the bifactor model as expected, psychometric analyses added important nuance. Despite moderate reliability, the general factor was not fully transdiagnostic (i.e., was not informed by several externalizing scores), and was partially redundant with internalizing scores. Approaches to criterion validity yielded opposing results. Compared to the correlated two-factor model, the bifactor model redistributed, without incrementally increasing, the total variance explained in criterion indicators of psychosocial functioning. Yet, the bifactor model did improve the precision of clinically important relationships to psychosocial functioning, raising questions about meaningful tests of bifactor psychopathology models.

Adolescent suicide risk and experiences of dissociation in daily life.

Dissociation is associated with risk for suicide in adults, but this link is not well studied in adolescents, in spite of their marked suicide risk. This study assessed adolescents' dissociative experiences in daily life and evaluated the association between dissociative experiences and suicide risk, including the independence of this relationship from related affective and clinical states and demographic characteristics. Clinically referred early adolescents (N = 162; aged 11-13) were assessed via multi-informant clinical interview, questionnaires, and 4-day ecological momentary assessment protocol. Adolescents were classified as being at elevated suicide risk using multi-informant, multi-method reports of suicide risk behavior and/or at elevated proximal risk using the 4-day EMA only. Suicide risk was associated with daily dissociative experiences, and this relationship was independent of daily negative and positive affect and co-occurring borderline personality symptoms. Gender differences emerged, such that the relationship between daily dissociative experiences and suicide risk was only significant in adolescent girls. Overall, findings suggest dissociation may be independently relevant to adolescent suicide risk, above and beyond effects of psychopathology and affective disturbance, and especially in girls. Daily dissociative experiences may help understand and detect suicide risk among early adolescents and warrant further research.

Socially oriented thinking and the biological stress response: Thinking of friends and family predicts trajectories of salivary cortisol decline.

The cortisol stress response has been related to perceived social support, but previous studies rely on self-reported social support variables. The cortisol recovery phase in particular has been theorized to serve a social coping function, but individual differences in recovery slope have not yet been examined in relation to social coping-relevant indices. This study addressed these gaps by examining the relationship of cortisol trajectories after a socioevaluative task to individual differences in covertly assessed cognitions related to close social relationships. We examined trajectories of cortisol change related to socially oriented thinking, the semi-implicit activation of cognitive representations of friends or family. Young adults (N = 64) gave salivary cortisol samples before and for 45 min after a speech task. Participants' thoughts were sampled repeatedly; the frequency of words related to friends or family was assessed to index socially oriented thinking. A free curve slope intercept latent growth curve model showed excellent fit with the cortisol data. Socially oriented thinking was unrelated to overall magnitude of cortisol response to the task (latent intercept) but predicted the latent cortisol trajectory, independently of cortisol intercept and baseline cortisol levels. Socially oriented thinkers showed more gradual cortisol declines, whereas nonsocially oriented thinkers showed a steeper downslope driven primarily by cortisol changes 45 min after the task. Individual differences in socially oriented thinking may manifest in different rates of biological changes following a performance task.

Too Much Too Soon?: Borderline Personality Disorder Symptoms and Romantic Relationships in Adolescent Girls.

Despite the centrality of adult romantic relationships to the conceptualization of borderline personality disorder (BPD), little is known about the earlier development of this interdependency during adolescence. Thus, we examined the co-development of romantic relationships and BPD symptoms from ages 15 to 19 in a large urban sample of girls (N = 2310) in the Pittsburgh Girls Study. We had two major aims. First, we sought to examine associations between BPD symptoms and romantic relationship involvement (number of partners, importance of relationship) and relational insecurity (concerns about infidelity and tactics to maintain relationship) during adolescence. Second, we investigated mutual influences and temporal precedence of BPD symptoms and four specific romantic relationship characteristics (perceived support and antagonism, verbal and physical aggression) during adolescence using latent growth curve models (LGCMs). Results indicated that BPD symptoms were associated with increased involvement in romantic relationships and heightened relational insecurity across adolescence. Furthermore, higher BPD symptoms at age 15 predicted increases in antagonism, verbal aggression, and physical aggression across ages 15 to 19. Conversely, perceptions of higher levels of relationship support at age 15 predicted steeper increases in BPD symptoms across ages 15 to 19, suggesting a potential negative influence of early involvement in close romantic relationships. These findings demonstrate the reciprocal nature of romantic relationship functioning and BPD symptoms during adolescence and suggest novel prevention targets for youth at risk for BPD.

Adversity and Depression: The Moderating Role of Stress Reactivity among High and Low Risk Youth.

Adverse life events have been causally linked to depression among youth at high risk for depression. But given that not all high-risk youth develop depression following adversity, individual differences in various processes, including physiological reactivity to stress, are likely to be at play. This longitudinal prospective study tested the hypothesis that, among high-risk youth exposed to adversities, extent of physiological reactivity to laboratory stress (indexed as respiratory sinus arrhythmia; RSA) would predict subsequent depressive symptoms. Subjects were youth at high (n = 80) and low (n = 74) familial risk for depression. At Time 1 (T1), RSA was assessed during a cognitive stress task. At Time 2 (T2) about 2 years later, parents reported on adversities experienced by their offspring during the interim. At T1 and T2, youth received a diagnostic evaluation, which included assessment of their depressive symptoms. The three-way interaction of group-X-adversities-X-RSA predicted T2 depressive symptoms (controlling for T1 depressive symptoms). This interaction was mostly driven by the moderating effect of RSA among high-risk youth, such that adversities predicted higher depressive symptoms for those who displayed greater RSA reactivity to stress. Among low-risk youth, an inverse marginal moderating effect of RSA was found, such that adversities tended to predict depressive symptoms for those who displayed blunted RSA reactivity to stress. Thus, high physiological stress reactivity appears to be an additional risk factor for depressive symptoms only among youth at elevated risk for such outcomes, and should be taken into consideration in efforts to prevent depression in these populations.

Less is more? Effects of exhaustive vs. minimal emotion labelling on emotion regulation strategy planning.

Previous research suggests that labelling emotions, or describing affective states using emotion words, facilitates emotion regulation. But how much labelling promotes emotion regulation? And which emotion regulation strategies does emotion labelling promote? Drawing on cognitive theories of emotion, we predicted that labelling emotions using fewer words would be less confusing and would facilitate forms of emotion regulation requiring more cognitively demanding processing of context. Participants (N = 82) mentally immersed themselves in an emotional vignette, were randomly assigned to an exhaustive or minimal emotion labelling manipulation, and then completed an emotion regulation strategy planning task. Minimal (vs. exhaustive) emotion labelling promoted higher subjective emotional clarity. Furthermore, in terms of specific emotion regulation strategies, minimal emotion labelling prompted more plans for problem solving and marginally more plans for reappraisal, but did not affect plans for behavioural activation or social support seeking. We discuss implications for the cognitive mechanisms supporting the generation of emotion regulation strategies.