Flexibility and attractors in context: family emotion socialization patterns and children's emotion regulation in late childhood.

Familial emotion socialization practices relate to children's emotion regulation (ER) skills in late childhood, however, we have more to learn about how the context and structure of these interactions relates to individual differences in children's ER. The present study examined flexibility and attractors in family emotion socialization patterns in three different conversational contexts and their relation to ER in 8-12 year olds. Flexibility was defined as dispersion across the repertoire of discrete emotion words and emotion socialization functions (emotion coaching, dismissing, and elaboration) in family conversation, whereas attractors were defined as the average duration per visit to each of these three emotion socialization functions using state space grid analysis. It was hypothesized that higher levels of flexibility in emotion socialization would buffer children's ER from the presence of maladaptive attractors, or the absence of adaptive attractors, in family emotion conversation. Flexibility was generally adaptive, related to children's higher ER across all contexts, and also buffered children from maladaptive attractors in select situations. Findings suggest that the study of dynamic interaction patterns in context may reveal adaptive versus maladaptive socialization processes in the family that can inform basic and applied research on children's regulatory problems.

Justifiable Psychopharmacology or Overzealous Prescription? Examining Parental Reports of Lifetime Prescription Histories of Psychiatrically Hospitalised Children.

BACKGROUND: This research investigated parent reports of pre-admission psychotropic medication histories of psychiatrically hospitalised children in the United States. The emphasis was on identifying factors related to potentially overzealous medication use. METHOD: Diagnosis, insurance type, and demographics for 170 consecutive admissions were assessed via research case conference and chart review. An extreme group of children with lengthy medication histories (n = 20) was also identified, and prescription and diagnostic patterns for this group were compared to other medicated children in the sample (n = 100). Cumulative medication history, rather than specific polypharmacy, was examined. RESULTS: Psychopharmacotherapy was common (71%). Privately insured children, children with previous psychiatric hospitalisations, and children with Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD), and the specific comorbidities of ODD/ADHD, and ODD/Parent Child Relational Problems had more past medication trials. Depressed children had fewer. Analyses of the extreme group suggest that young, privately insured, oppositional children with parent-child relationship problems were at highest risk for overmedication (including multiple trials of stimulants, as well as mood stabilisers, central adrenergic agonists, and antipsychotics). CONCLUSIONS: Results raise important questions about the role of health care pressures on clinical practice in the United States.