Adolescents' perceptions of maternal response to negative affect predict emotional reactivity during mother-daughter interaction: A multi-modal assessment.

Parental socialization of emotion consists of parental behaviors that scaffold child emotional reactivity and regulation. The current study examined whether adolescents' perceptions of their mothers' supportive versus non-supportive responses to negative emotions could predict adolescent emotional reactivity. Thirty adolescent girls (Mage  = 14.41 [1.55]) reported on how their mothers typically respond to their negative emotions and then completed a laboratory-based mother-adolescent interaction task. A multi-modal assessment of adolescent emotional reactivity during the interaction included adolescents' skin conductance levels (SCLs) and state anxiety, and mother-daughter interactions were behaviorally coded to assess how often dyads engaged in both negative and positive escalation (i.e., a pattern of negative or positive behavior of one partner being reciprocated by the other). Adolescents who reported that their mothers used more non-supportive responses to their negative emotion tended to exhibit higher SCL and engage in more negative escalation with their mothers during the interaction task. Furthermore, adolescents' SCL was positively correlated with both their state anxiety levels and negative escalation during the task. Together, these findings suggest that adolescents who perceive their mothers as less supportive of negative emotions are more likely to exhibit greater negative emotionality during parent-adolescent interaction, which may relate to risk for emotional disorders.

Using mobile eye-tracking technology to examine adolescent daughters' attention to maternal affect during a conflict discussion.

Attention to socio-emotional stimuli (i.e., affect-biased attention) is an integral component of emotion regulation and human communication. Given the strong link between maternal affect and adolescent behavior, maternal affect may be a critical influence on adolescent affect-biased attention during mother-child interaction. However, prior methodological constraints have precluded fine-grained examinations of factors such as maternal affect on adolescent attention during real-world social interaction. Therefore, this pilot study capitalized on previously validated technological advances by using mobile eye-tracking and facial affect coding software to quantify the influence of maternal affect on adolescents' attention to the mother during a conflict discussion. Results from 7,500 to 9,000 time points sampled for each mother-daughter dyad (n = 28) indicated that both negative and positive maternal affect, relative to neutral, elicited more adolescent attentional avoidance of the mother (ORs = 2.68-9.20), suggesting that typically developing adolescents may seek to avoid focusing on maternal affect of either valence during a conflict discussion. By examining the moment-to-moment association between in vivo displays of maternal affect and subsequent adolescent attention toward the mother's face, these results provide preliminary evidence that maternal affect moderates adolescent attention. Our findings are consistent with cross-species approach-avoidance models suggesting that offspring respond to affectively charged conversations with greater behavioral avoidance or deference.

Validating a mobile eye tracking measure of integrated attention bias and interpretation bias in youth.

INTRODUCTION: This study sought to validate a real-world speech task designed to assess attention and interpretation bias in an integrated and ecologically valid manner. METHODS: Thirty adolescent girls gave a speech in front of an emotionally ambiguous judge and a positive judge while wearing mobile eye tracking glasses to assess how long they looked at each judge (i.e., attention bias). They also reported their interpretations of the ambiguous judge and distress associated with the task (i.e., interpretation bias). RESULTS: These task-based measures correlated with self-report of interpretation bias and mother-report of attentional control, demonstrating convergent validity. They did not correlate with frustration or high intensity pleasure, indicating discriminant validity. Task-based measures of interpretation bias also showed predictive and incremental validity in relation to child distress during the speech. DISCUSSION: This proof-of-concept study demonstrates the initial validity of a novel task designed to assess attention and interpretation bias as they manifest in real-world social interactions.

Properties of the Continuous Assessment of Interpersonal Dynamics Across Sex, Level of Familiarity, and Interpersonal Conflict.

The Continuous Assessment of Interpersonal Dynamics (CAID) is a method in which trained observers continuously code the dominance and warmth of individuals who interact with one another in dyads. This method has significant promise for assessing dynamic interpersonal processes. The purpose of this study was to examine the impact of individual sex, dyadic familiarity, and situational conflict on patterns of interpersonal warmth, dominance, and complementarity as assessed via CAID. We used six samples with 603 dyads, including two samples of unacquainted mixed-sex undergraduates interacting in a collaborative task, two samples of couples interacting in both collaborative and conflict tasks, and two samples of mothers and children interacting in both collaborative and conflict tasks. Complementarity effects were robust across all samples, and individuals tended to be relatively warm and dominant. Results from multilevel models indicated that women were slightly warmer than men, whereas there were no sex differences in dominance. Unfamiliar dyads and dyads interacting in more collaborative tasks were relatively warmer, more submissive, and more complementary on warmth but less complementary on dominance. These findings speak to the utility of the CAID method for assessing interpersonal dynamics and provide norms for researchers who use the method for different types of samples and applications.

Physiological feelings.

The role of peripheral physiology in the experience of emotion has been debated since the 19th century following the seminal proposal by William James that somatic responses to stimuli determine subjective emotion. Subsequent views have integrated the forebrain's ability to initiate, represent and simulate such physiological events. Modern affective neuroscience envisions an interacting network of "bottom-up" and "top-down" signaling in which the peripheral (PNS) and central nervous systems both receive and generate the experience of emotion. "Feelings" serves as a term for the perception of these physical changes whether emanating from actual somatic events or from the brain's representation of such. "Interoception" has come to represent the brain's receipt and representation of these actual and "virtual" somatic changes that may or may not enter conscious awareness but, nonetheless, influence feelings. Such information can originate from diverse sources including endocrine, immune and gastrointestinal systems as well as the PNS. We here examine physiological feelings from diverse perspectives including current and historical theories, evolution, neuroanatomy and physiology, development, regulatory processes, pathology and linguistics.

Looking for the negative: Depressive symptoms in adolescent girls are associated with sustained attention to a potentially critical judge during in vivo social evaluation.

Attention biases toward negative stimuli are implicated in the development and maintenance of depression. However, research is needed to understand how depression affects attention biases as they unfold in a dynamic social environment, particularly during adolescence when depression rates significantly increase due to enhanced reactivity to social stress. To examine attention biases in a live, socially evaluative environment, 26 adolescent girls from the community gave a speech in front of a potentially critical judge and a positive judge while wearing mobile eye tracking glasses. Girls' depressive symptoms were measured using the Moods and Feelings Questionnaire. Across the sample, girls looked at the positive judge more frequently and for longer periods of time compared with the potentially critical judge. In contrast, higher depressive symptoms were associated with looking at the potentially critical judge for longer periods of time. When directly comparing attention to the potentially critical judge relative to the positive judge, dysphoric girls looked at the potentially critical judge more frequently and for longer periods of time compared with the positive judge. Findings suggest that adolescent depressive symptoms are related to sustained attention toward potentially critical evaluation at the exclusion of positive evaluation. This novel approach allowed for an in vivo examination of attention biases as they unfold during social evaluation, which begins to illuminate the interpersonal significance of attention biases. If replicated and extended longitudinally, this research could be used to identify adolescents at high risk for future depression and potentially be leveraged clinically in attention bias modification treatment.

Adolescent Gaze-Directed Attention During Parent-Child conflict: The Effects of Depressive Symptoms and Parent-Child Relationship Quality.

Although dysfunctions in attention have been implicated in the development and maintenance of depression in adults, findings from studies of depressed adolescents have been inconsistent. While some research has shown that youth with depressive symptoms exhibit increased attention to negative stimuli, other findings demonstrated attentional avoidance. Additionally, given the increase in parent-child conflict during adolescence, parent-child relationship quality may be an important moderating factor in the association between depressive symptoms and attention. To examine how depressive symptoms and parent-child relationship quality during adolescence influence attention, 25 mother-daughter pairs (girls ages 11-16) completed a conflict discussion task while wearing mobile eye-tracking glasses. Results suggest that girls with low positive parent-child relationship quality and greater depressive symptoms may have difficulty disengaging from their mother during negative interactions, which may exacerbate depressive symptoms. Therefore, the parent-child relationship should be further considered in treatments that target maladaptive attention patterns in youth with depressive symptoms.

History of childhood emotional abuse predicts lower resting-state high-frequency heart rate variability in depressed women.

Childhood emotional abuse impairs emotion regulation and increases risk for major depressive disorder in adulthood. Mounting evidence suggests that decreased resting-state high-frequency heart rate variability, an index of parasympathetic function, represents a transdiagnostic biomarker of emotion dysregulation. We propose that adults with histories of major depressive disorder and childhood emotional abuse represent a subpopulation at particularly high risk to exhibit deficits in parasympathetic control. The current report compared resting-state high-frequency heart rate variability across three groups: (1) depressed women who endorsed childhood emotional abuse (N = 11); (2) depressed women without childhood emotional abuse (N = 19), and (3) never-depressed women without childhood emotional abuse (N = 22). Participants completed childhood trauma self-reports and assessment of resting-state high-frequency heart rate variability. ANCOVAs comparing the three groups after controlling for health-related, psychiatric, and respiratory factors were significant. Depressed women with childhood emotional abuse exhibited lower high-frequency heart rate variability than both groups without childhood emotional abuse (d's ranging from 0.81-0.92). Surprisingly, psychiatric factors were non-significant predictors, indicating that childhood emotional abuse may have a unique impact on autonomic functioning. Future research on larger samples is needed to disentangle the relative and synergistic burdens of depression and childhood trauma on physiologic indicators of emotion dysregulation.

Moderators and mediators of a maternal depression treatment study: Impact of maternal trauma and parenting on child outcomes.

OBJECTIVE: Treatment of maternal depression with psychotherapy has been shown to confer indirect benefits to school-age offspring with psychiatric disorders. The current study sought to understand mechanisms by which improvement in depressed mothers, with and without histories of trauma and treated with psychotherapy, produce changes in children who struggle with psychiatric illnesses themselves. We hypothesized that maternal history of childhood trauma would moderate the relationship between maternal and child outcomes and that increased positive and decreased negative parenting behaviors would mediate the relationship between maternal and child outcomes. We also examined whether maternal history of trauma would moderate the mediational effects of parenting behaviors. METHODS: Participants were dyads (n = 62) of mothers with major depressive disorder and their children, ages 7-18, with at least one internalizing disorder. Mothers were treated with nine sessions of psychotherapy and children were treated openly in the community. Dyads were evaluated every three months over one year. RESULTS: Maternal improvement in depressive symptoms was associated, in a lagged fashion, with child improvement in functioning six months later. There was a significant interaction of time and change in maternal symptoms [F(1, 45) = 5.84, p = 0.02], where change in maternal depressive symptoms from baseline to six months was robustly associated with change in child functioning from baseline to 12 months (ß = 0.49, p = 0.0002). Maternal history of childhood sexual abuse moderated the association between change in maternal and child depressive symptoms [F(1,87) = 5.8, p = 0.02], and maternal history of physical neglect moderated the relationship between improvement in maternal depression and improvement in child functioning [F(1,36) = 4.34, p = 0.04], where significant associations between maternal and child outcomes were only found in mothers without histories of sexual abuse or physical neglect. Increase in positive parenting strategies (acceptance) by mothers mediated 6-month lagged associations between maternal and child outcomes, but reduction in negative parenting strategies (psychological control) did not. Maternal history of childhood emotional neglect moderated the mediational model, such that improved positive parenting did not explain lagged improvement in child depression among the subset of mothers with childhood histories of emotional neglect. CONCLUSIONS: In dyads comprised of depressed mothers and school-age children with internalizing disorders, children improved when mothers improved, but not among those whose mothers who had histories of sexual abuse or physical neglect. Increased use of positive parenting strategies among mothers accounted for lagged relationships between improvement in maternal depressive symptoms and improvement in child functioning. This pattern was not, however, observed among mothers with childhood histories of emotional neglect. Interventions that directly enhance positive parenting and more rapidly change these behaviors may hasten improvement in offspring. Offspring of depressed mothers with histories of early trauma are at high risk for poor outcomes, even when their mothers receive depression treatment.

Therapist Use of Specific and Nonspecific Strategies Across Two Affect-Focused Psychotherapies for Depression: Role of Adherence Monitoring.

Psychotherapists routinely use both specific and non-specific strategies to deliver empirically supported treatments (ESTs). Psychotherapy adherence monitoring has traditionally focused on assessing therapist use of EST-specific strategies (to distinguish between ESTs), paying less attention to non-specific techniques common to multiple psychotherapies. This study used the Collaborative Study Psychotherapy Rating Scale (CSPRS) to evaluate therapist use of both specific and non-specific techniques in two affect-focused ESTs for depression. Blinded raters evaluated 180 recorded sessions of interpersonal psychotherapy (IPT) and brief supportive psychotherapy (BSP). Because IPT and BSP both emphasize attention to affective states and developing a warm therapy relationship, we expected overlap across scales measuring therapist warmth, empathy, and focus on feelings. In contrast, we expected differences in scales measuring therapist directiveness, as well as IPT- and BST-specific interventions. Results showed raters displayed good inter-rater reliability on primary subscales and could discriminate between two treatments with considerable overlap. Both IPT and BSP therapists used similarly high levels of non-specific, facilitative interventions. Expectedly, IPT therapists were more directive and used more IPT-specific strategies, while BSP therapists utilized more non-directive, supportive strategies. Unexpectedly, BSP therapists showed greater focus on feelings than IPT therapists. Exploratory analyses suggested that greater focus on feelings in early sessions was associated with greater depressive symptom reduction in the first eight weeks of treatment for both ESTs. Additional treatment adherence research is needed to investigate both shared and distinctive features of ESTs, as well as the effect of the relative use of specific versus non-specific interventions on psychotherapy outcomes.

Prospective assessment of social network quality among depressed mothers treated with brief psychotherapy: The Social Network Quality (SNQ) scales.

OBJECTIVE: Social relationships play important roles in emotional health, and are common targets of psychotherapeutic interventions. To better evaluate social relationship structure and function in the context of psychotherapy trials, this study introduces and psychometrically evaluates the Social Network Quality (SNQ) scales, which supplement the Social Network Index (SNI). The original SNI evaluates social network structure (i.e., extent of participation in diverse social roles and number of social relationships). The SNQ adds two social network quality scales evaluating levels of: (a) positivity/support, and (b) negativity/stress, within and across specific social roles. METHOD: Participants included 168 depressed mothers of psychiatrically-ill children participating in a psychotherapy treatment trial utilizing interpersonal therapy (IPT) and brief supportive therapy (BSP). The SNI, SNQ, and measures of social functioning and psychopathology were collected at baseline and at 3-month intervals over a one-year period. RESULTS: SNQ scores showed meaningful concurrent relationships with measures of social support and interpersonal distress, as well as incremental utility in explaining variance in relationship and mood outcomes above and beyond the SNI. SNQ scores also detected global and relationship-specific changes in social relationship quality following psychotherapy treatment. CONCLUSION: This report demonstrates that SNQ scales reliably assess psychotherapy-induced changes in relationship quality.

Depression impacts the physiological responsiveness of mother-daughter dyads during social interaction.

BACKGROUND: Maternal depression is associated with increased risk of psychiatric illness in offspring. While risk may relate to depressed mothers' difficulties regulating emotions in the context of interacting with offspring, physiological indicators of emotion regulation have rarely been examined during mother-child interactions-and never among mother-adolescent dyads in which both mother and adolescent have histories of major depressive disorder (MDD). METHODS: We examined changes in high-frequency heart rate variability (HF-HRV), an indicator of parasympathetic (vagal) function that has been related to depression, stress, social engagement, and emotion regulation, in 46 mother-daughter dyads (23 in which both mother and daughter had an MDD history and 23 never-depressed controls). Hierarchical linear models evaluated changes in HF-HRV while mother-daughter dyads engaged in discussions about shared pleasant events and relationship conflicts. RESULTS: While control dyads displayed positive slopes (increases) in HF-HRV during both discussions, MDD dyads displayed minimal change in HF-HRV across discussions. Among controls, HF-HRV slopes were positively correlated between mothers and daughters during the pleasant events' discussion. In contrast, HF-HRV slopes were negatively correlated between MDD mothers and daughters during both discussions. CONCLUSIONS: Vagal responses observed in control mother-daughter dyads suggest a pattern of physiological synchrony and reciprocal positive social engagement, which may play a role in adolescent development of secure social attachments and healthy emotion regulation. In contrast, MDD mothers and daughters displayed diminished and discordant patterns of vagal responsiveness. More research is needed to understand the development and consequences of these patterns of parasympathetic responses among depressed mother-daughter dyads.

Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children.

OBJECTIVE: Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families. METHOD: Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year. RESULTS: Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. CONCLUSION: IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed Mothers of Psychiatrically Ill Children; http://clinicaltrials.gov/; NCT00919594.

Maternal response to child affect: Role of maternal depression and relationship quality.

BACKGROUND: Maternal depression is associated with negative outcomes for offspring, including increased incidence of child psychopathology. Quality of mother-child relationships can be compromised among affectively ill dyads, such as those characterized by maternal depression and child psychopathology, and negatively impact outcomes bidirectionally. Little is known about the neural mechanisms that may modulate depressed mothers' responses to their psychiatrically ill children during middle childhood and adolescence, partially because of a need for ecologically valid personally relevant fMRI tasks that might most effectively elicit these neural mechanisms. METHODS: The current project evaluated maternal response to child positive and negative affective video clips in 19 depressed mothers with psychiatrically ill offspring using a novel fMRI task. RESULTS: The task elicited activation in the ventral striatum when mothers viewed positive clips and insula when mothers viewed negative clips of their own (versus unfamiliar) children. Both types of clips elicited activation in regions associated with affect regulation and self-related and social processing. Greater lifetime number of depressive episodes, comorbid anxiety, and poor mother-child relationship quality all emerged as predictors of maternal response to child affect. LIMITATIONS: Findings may be specific to dyads with psychiatrically ill children. CONCLUSIONS: Altered neural response to child affect may be an important characteristic of chronic maternal depression and may impact mother-child relationships negatively. Existing interventions for depression may be improved by helping mothers respond to their children's affect more adaptively.

Speech volume indexes sex differences in the social-emotional effects of alcohol.

Men and women differ dramatically in their rates of alcohol use disorder (AUD), and researchers have long been interested in identifying mechanisms underlying male vulnerability to problem drinking. Surveys suggest that social processes underlie sex differences in drinking patterns, with men reporting greater social enhancement from alcohol than women, and all-male social drinking contexts being associated with particularly high rates of hazardous drinking. But experimental evidence for sex differences in social-emotional response to alcohol has heretofore been lacking. Research using larger sample sizes, a social context, and more sensitive measures of alcohol's rewarding effects may be necessary to better understand sex differences in the etiology of AUD. This study explored the acute effects of alcohol during social exchange on speech volume--an objective measure of social-emotional experience that was reliably captured at the group level. Social drinkers (360 male; 360 female) consumed alcohol (.82 g/kg males; .74 g/kg females), placebo, or a no-alcohol control beverage in groups of 3 over 36-min. Within each of the 3 beverage conditions, equal numbers of groups consisted of all males, all females, 2 females and 1 male, and 1 female and 2 males. Speech volume was monitored continuously throughout the drink period, and group volume emerged as a robust correlate of self-report and facial indexes of social reward. Notably, alcohol-related increases in group volume were observed selectively in all-male groups but not in groups containing any females. Results point to social enhancement as a promising direction for research exploring factors underlying sex differences in problem drinking.