The effectiveness of maternal regulatory attempts in the development of infant emotion regulation.

Caregivers are instrumental in the development of infant emotion regulation; however, few studies have focused on delineating the real-time effectiveness of strategies that caregivers use to reduce infant distress. It is also unclear whether certain caregiver traits facilitate engagement in more successful regulation strategies. This study addressed these gaps by: (1) examining the differential effectiveness of maternal regulatory attempts (MRAs; behavioral strategies initiated by mothers to assist infants with regulating emotional states) in reducing 12- to 24-month-old infants' frustration during a toy removal task; and (2) assessing whether maternal mind-mindedness (mothers' attunement to their infant's mental state) predicted mothers' selection of MRAs. Multilevel modeling revealed that distraction and control were the most effective MRAs in reducing infant negative affect across 5-s intervals (N = 82 dyads; M infant age = 18 months; 45 females). Greater use of non-attuned mind-related speech predicted less engagement in effective MRAs, supporting a link between caregivers' socio-cognitive skills and provision of in-the-moment regulation support. These findings highlight the value of considering caregiver regulatory behaviors as a target for elucidating how maternal socialization of emotion regulation occurs in real-time. They also underscore mothers' important role as socializing agents in the development of this foundational developmental ability.

A systematic review of sleep problems in children and adolescents with obsessive compulsive disorder.

There is growing interest in the relationship between obsessive-compulsive disorder (OCD) and sleep problems in youth, including the development of a theoretical model proposing how these disorders maintain each other. The model suggests that OCD symptoms are proposed to interfere with sleep duration (e.g., via increased arousal and delayed bedtime), which compounds OCD symptom severity during the daytime and into the evening, feeding back into the model. Whether the recent influx of research on sleep problems in youth with OCD supports this model is unknown. The primary aim of this systematic review was to characterize sleep problems in youth with OCD and evaluate whether current research supports previous theoretical inferences. Findings across 20 studies revealed a high prevalence of sleep problems among youth with OCD and support a bidirectional relationship. Studies largely did not assess hypothesized relationships proposed by the model; support for the model is therefore preliminary. A secondary aim was to assess the impacts of comorbidity and developmental stage. Findings suggest that in childhood, comorbid anxiety disorders may initially predate sleep problems, but they become mutually maintained over time; the role of comorbid depression appears to increase with age. Limitations, future directions, and clinical implications are discussed.

Parent-Infant Interaction Tasks Adapted for Remote Testing: Strengths, Challenges, and Recommendations.

The closure of in-person laboratories and decreased safety of face-to-face interactions resulting from the COVID-19 pandemic jeopardized the ability of many developmental researchers to continue data collection during this time. Disruptions in data collection are particularly damaging to longitudinal studies, in which the testing of different age groups occurs on a continuous basis, and data loss at one time point can have cascading effects across subsequent time points and threaten the viability of the study. In an effort to continue collecting data for a longitudinal study on emotion development started in-person pre-pandemic, we adapted two parent-infant interaction tasks (free-play task and toy removal task) for a remote testing framework. Our procedure for pivoting these tasks to a supervised, remote online testing framework is outlined and the associated strengths and challenges of testing in this format (e.g., feasibility and implementation, testing environment and task setup validity, and accessibility, recruitment, and diversity) are critically evaluated. Considerations for applying this framework to other behavioral tasks are discussed and recommendations are provided.

Are our samples representative? Understanding whether temperament influences infant dropout rates at 3 and 7 months.

In this study, we examined whether infant temperament predicted study dropout at 3.5 and 7 months and whether dropout was stable across time. Dropout was measured across four experimental tasks (free-play, ERP, still-face, and eye tracking). Temperament was not related to dropout at either timepoint. Dropout was not stable across time, nor was it stable across tasks. These findings suggest that individual differences in temperament are not systematically related to study completion across experimental tasks with varied requirements. These findings additionally suggest that dropout is not consistent across tasks, which may support the utility of multi-study data collection methods.

What drives the attentional bias for fearful faces? An eye-tracking investigation of 7-month-old infants' visual scanning patterns.

Seven-month-old infants display a robust attentional bias for fearful faces; however, the mechanisms driving this bias remain unclear. The objective of the current study was to replicate the attentional bias for fearful faces and to investigate how infants' online scanning patterns relate to this preference. Infants' visual scanning patterns toward fearful and happy faces were captured using eye tracking in a paired-preference task, specifically exploring if the fear preference is driven by increased attention to particular facial features. Infants allocated increased attention toward the fearful face compared to the happy face overall, thus successfully replicating the attentional bias, and greater attention toward the fearful eyes was associated with a greater magnitude of the fear preference. The current findings suggest that the fearful eyes are a salient facial feature in capturing infants' attention toward the fearful face and that increased scanning of the fearful eyes may be one mechanism driving the overall fear preference. In addition, scanning patterns, and attention to critical features specifically, are highlighted as a strategy for examining the mechanisms underlying the development of emotion recognition abilities in infancy.

Dynamic Advances in Emotion Processing: Differential Attention towards the Critical Features of Dynamic Emotional Expressions in 7-Month-Old Infants.

Infants' visual processing of emotion undergoes significant development across the first year of life, yet our knowledge regarding the mechanisms underlying these advances is limited. Additionally, infant emotion processing is commonly examined using static faces, which do not accurately depict real-world emotional displays. The goal of this study was to characterize 7-month-olds' visual scanning strategies when passively viewing dynamic emotional expressions to examine whether infants modify their scanning patterns depending on the emotion. Eye-tracking measures revealed differential attention towards the critical features (eyes, mouth) of expressions. The eyes captured the greatest attention for angry and neutral faces, and the mouth captured the greatest attention for happy faces. A time-course analysis further elucidated at what point during the trial differential scanning patterns emerged. The current results suggest that 7-month-olds are sensitive to the critical features of emotional expressions and scan them differently depending on the emotion. The scanning patterns presented in this study may serve as a link to understanding how infants begin to differentiate between expressions in the context of emotion recognition.

Children's recognition of emotion expressed by own-race versus other-race faces.

Adults are less accurate at recognizing emotions expressed by individuals from a different cultural background. However, the research with children is less clear; whereas some studies suggest better emotion recognition for own-race and own-culture faces, others have found no such relationship. The current study examined the influence of race on emotion recognition in children and adults who share a cultural background (i.e., Canadian). Based on previous studies, we hypothesized that participants would demonstrate better emotion recognition for own-race faces. We also hypothesized that emotion recognition would improve across the lifespan (from childhood to adulthood) and as a function of emotion, such that recognition would be better for happy faces than for the other emotions. Children (n = 69; ages 6-10 years; 41 female) and adults (n = 82; mean age = 19.94 years; 72 female) of Western European or South Asian descent were asked to complete a five-alternative forced-choice emotion recognition task (anger, fear, happiness, sadness, and neutral) in which expressions were displayed by White and South Asian faces. As predicted, adults performed better than older children, who performed better than younger children, and participants performed best on happy faces. South Asian participants, but not White participants, performed better when judging own-race faces compared with other-race faces. This finding only partially supports an own-race bias in emotion recognition and may reflect the tendency in the literature to conflate culture and race. More studies are needed to understand cross-race emotion recognition when individuals share the same culture.

An investigation of the effect of race-based social categorization on adults' recognition of emotion.

Emotion recognition is important for social interaction and communication, yet previous research has identified a cross-cultural emotion recognition deficit: Recognition is less accurate for emotions expressed by individuals from a cultural group different than one's own. The current study examined whether social categorization based on race, in the absence of cultural differences, influences emotion recognition in a diverse context. South Asian and White Canadians in the Greater Toronto Area completed an emotion recognition task that required them to identify the seven basic emotional expressions when posed by members of the same two groups, allowing us to tease apart the contributions of culture and social group membership. Contrary to our hypothesis, there was no mutual in-group advantage in emotion recognition: Participants were not more accurate at recognizing emotions posed by their respective racial in-groups. Both groups were more accurate at recognizing expressions when posed by South Asian faces, and White participants were more accurate overall compared to South Asian participants. These results suggest that in a diverse environment, categorization based on race alone does not lead to the creation of social out-groups in a way that negatively impacts emotion recognition.

Effectiveness of a modified dialectical behaviour therapy for adolescents within a stepped-care model.

OBJECTIVE: Early intervention with evidence-based treatment is important to halt the progression from early manifestations of personality disorder traits to adult personality disorders. The purpose of this study is to evaluate dialectical behaviour therapy (DBT) modified for an adolescent population with borderline personality disorder (BPD), offered within a stepped-care model. METHODS: Seven adolescents (M=1, F=6, Mage=16.86) diagnosed with either BPD or BPD traits participated in a modified 15-week DBT group. The group was offered within a stepped-care model, which required participants to have previously completed an 8-week distress-tolerance module. Pre/post scores on self-report measures of BPD symptomatology, including impulse control, emotional regulation and awareness, anxiety, depression, and substance use, were collected. RESULTS: Participants showed a post-treatment decrease in anxiety symptoms (large effect size) and disruptive behaviours (medium effect size). There was also an increase in emotional symptoms (medium effect size) and hyperactivity/inattention (medium effect size). CONCLUSION: The modified DBT group shows promise in alleviating symptoms of anxiety and some of the disruptive behaviours associated with BPD. The increase in emotional symptoms may be due to the expressive nature of DBT, and may contribute to their eventual therapeutic processing in the next step of the program.

Chronic postsurgical pain and persistent opioid use following surgery: the need for a transitional pain service.

AIM: To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at the Toronto General Hospital. METHODS: 200 consecutive patients presenting for elective major surgery completed standardized questionnaires by telephone at 3 months after surgery. RESULTS: 51 patients reported a preoperative chronic pain condition, with 12 taking opioids preoperatively. 3 months after surgery 35% of patients reported having surgical site pain and 13.5% continued to use opioids for postsurgical pain relief. Postoperative opioid use was associated with interference with walking and work, and lower mood. CONCLUSION: Chronic postsurgical pain and ongoing opioid use are concerns that warrant the implementation of a Transitional Pain Service to modify the pain trajectories and enable effective opioid weaning following major surgery.

A retrospective chart review: adolescents with borderline personality disorder, borderline personality traits, and controls.

With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%-20% of the patients in mental health outpatient facilities and 15%-40% in mental health inpatient facilities. Further, while 75%-80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.

Successful Treatment of Lower Limb Complex Regional Pain Syndrome following Three Weeks of Hyperbaric Oxygen Therapy.

Hyperbaric oxygen therapy (HBOT) is a treatment that delivers 100% oxygen at increased atmospheric pressures. The efficacy of HBOT for treating pain has been described in various animal pain models and may have clinical efficacy in the treatment of human chronic pain syndromes. We present our experience with posttraumatic Complex Regional Pain Syndrome (CRPS) type 2 in a patient who underwent 15 sessions of HBOT. A 41-year-old male with one-year history of CRPS of left foot followed by left ankle fracture demonstrated less pain, decreased swelling, less allodynia, and improvement in skin color and range of motion of the lower limb after 3 weeks of HBOT. Patient was back to work for the first time in over a year. HBOT may be considered as a valuable therapeutic tool in the treatment of long-standing CRPS.