From adverse childhood experiences to harsh parenting: Psychological symptoms as a mediator.

BACKGROUND: Research evidence has demonstrated a direct link between ACEs and harsh parenting. However, the mechanisms linking paternal ACEs to harsh parenting have remained largely unexplored among Asian populations. OBJECTIVE: In the current study, we examined the relationships between parental ACEs and harsh parenting and explored the potential mediating effect of psychological symptoms on the relationship between parental ACEs and harsh parenting. PARTICIPANTS AND SETTING: A total of 6195 Taiwanese parents of children aged 6 to 12 were recruited from 58 primary schools in the Taiwanese cities of Taipei and New Taipei. METHOD: Using probability-proportional-to-size sampling and a self-report survey, we collected data relating to parental ACEs, psychological symptoms, and child-rearing behaviors. A hierarchical regression analysis was completed to examine the effects of parental ACEs and psychological symptoms on harsh parenting. In addition, we tested the potential mediating effects of psychological symptoms on the relationship between parental ACEs and harsh parenting by employing a simple mediation model (PROCESS) with a bootstrapping procedure. RESULTS: We found that both parental ACEs and psychological symptoms were significant predictors for mothers' and fathers' adoption of harsh parenting behaviors. Moreover, after adjusting for covariates, we discovered the unique finding that psychological symptoms mediated the relationship between parental ACEs and harsh parenting among Taiwanese parents. CONCLUSIONS: The study revealed a direct link between parental ACEs and harsh parenting, with psychological symptoms serving as a mediator. Our findings suggest that trauma-recovery programs should promote regular screening and interventions for parents with ACEs.

Emotion recognition in doctor-patient interactions from real-world clinical video database: Initial development of artificial empathy.

BACKGROUND AND OBJECTIVE: The promising use of artificial intelligence (AI) to emulate human empathy may help a physician engage with a more empathic doctor-patient relationship. This study demonstrates the application of artificial empathy based on facial emotion recognition to evaluate doctor-patient relationships in clinical practice. METHODS: A prospective study used recorded video data of doctor-patient clinical encounters in dermatology outpatient clinics, Taipei Municipal Wanfang Hospital, and Taipei Medical University Hospital collected from March to December 2019. Two cameras recorded the facial expressions of four doctors and 348 adult patients during regular clinical practice. Facial emotion recognition was used to analyze the basic emotions of doctors and patients with a temporal resolution of 1 second. In addition, a physician-patient satisfaction questionnaire was administered after each clinical session, and two standard patients gave impartial feedback to avoid bias. RESULTS: Data from 326 clinical session videos showed that (1) Doctors expressed more emotions than patients (t [326] > = 2.998, p < = 0.003), including anger, happiness, disgust, and sadness; the only emotion that patients showed more than doctors was surprise (t [326] = -4.428, p < .001) (p < .001). (2) Patients felt happier during the latter half of the session (t [326] = -2.860, p = .005), indicating a good doctor-patient relationship. CONCLUSIONS: Artificial empathy can offer objective observations on how doctors' and patients' emotions change. With the ability to detect emotions in 3/4 view and profile images, artificial empathy could be an accessible evaluation tool to study doctor-patient relationships in practical clinical settings.