Dyadic interactive synchrony rupture repair in maltreating families

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Dyadic interactive synchrony, rupture, & repair in maltreating families Elizabeth A. Skowron, Ph. D.

Dyadic interactive synchrony, rupture, & repair in maltreating families Elizabeth A. Skowron, Ph. D. Associate Professor, Pennsylvania State University Fulbright Scholar, School of Psychology, National University of Ireland at Galway 05/02/2010 NUI Galway School of Psychology Research Seminar Series 1

Overview Child maltreatment (CM) NIMH parenting processes study Rupture-repair processes & CM risk CM

Overview Child maltreatment (CM) NIMH parenting processes study Rupture-repair processes & CM risk CM status & cardiac vagal tone Concluding comments 05/02/2010 NUI Galway School of Psychology Research Seminar Series 2

Child maltreatment: Some things we know • CM is multi-determined – Child Factors –

Child maltreatment: Some things we know • CM is multi-determined – Child Factors – Parent Factors – Environmental Context • CM parents ↑ negative, angry, & controlling ↑ role-reversals ↑ negative attributions re: child intentions ↓ enjoyment of parenting • CM impairs self-emotion regulation in children – Though considerable heterogeneity exists e. g. , Burgess & Conger, 1978; Egeland et al. , 1980; Rogosch et al. , 1995; Trickett, 1998 05/02/2010 NUI Galway School of Psychology Research Seminar Series 3

Meta-analysis of interventions for CM • CM interventions appear effective • ES = 0.

Meta-analysis of interventions for CM • CM interventions appear effective • ES = 0. 54 (95% CI: . 39 to. 69) • Effects heterogeneous • Effects depend on method of outcome assessment • ES =. 53 parent self-report (fail safe N ‘s = 10 – 12) • ES =. 44 child self-report • though, ES =. 21 behavioral observation of child/family (fail safe N ‘s = 0) Skowron & Reinemann, 2005 05/02/2010 NUI Galway School of Psychology Research Seminar Series 4

 • CM interventions do little to improve quality of parent-child interactions or reduce

• CM interventions do little to improve quality of parent-child interactions or reduce recidivism • Parenting processes are typically conceived of in broad dimensions, using global ratings • Relational context of CM—as important as specific acts of abuse/neglect—for… • Predicting children’s developmental outcomes • Guiding design of more effective interventions 05/02/2010 NUI Galway School of Psychology Research Seminar Series 5

NIMH Project Aims 1. Clarify nature of CM parent-child interactions, their underlying physiology, and

NIMH Project Aims 1. Clarify nature of CM parent-child interactions, their underlying physiology, and relations with self-regulation § § § Map patterns of dyadic interactive coordination § synchrony § rupture § repair Children’s self-regulation & behavior Maternal self regulation & parenting Time-synchronized cardiac physiology & behavioral data streams Sequential analyses CM severity & subtype 2. Translate findings into testable CM interventions that target specific latent classes (i. e. , patterns) of interactive disruption 5 R 01 MH 079328 -02: Parent-Child Processes: Negative Self-Regulatory & Behavioral Outcomes 05/02/2010 NUI Galway School of Psychology Research Seminar Series 6

Conceptual Model Environmental stress Parent Characteristics Family Characteristics Parent-Child Interactions Maternal self regulation Child

Conceptual Model Environmental stress Parent Characteristics Family Characteristics Parent-Child Interactions Maternal self regulation Child Outcomes Child Behavior Problems Positive synchrony • warm-affiliation (physiology & behavior) Child Self-regulation • autonomy support • monitoring • emotion Rupture --Repair • physiology • behavior Child Maltreatment Status Severity Subtype (Physical Abuse/Neglect) 05/02/2010 NUI Galway School of Psychology Research Seminar Series 7

Conceptual model of parenting processes & self-regulation • Positive interactive synchrony, punctuated by brief

Conceptual model of parenting processes & self-regulation • Positive interactive synchrony, punctuated by brief ruptures & successful repairs will build self-structure & capacity for self-regulation • Parent-child relationship ruptures that are manageably brief & followed by successful repair… • Enable children’s relational engagement in the midst of interactive stress, • Facilitate over-time internalization of adaptive self-regulatory functions managed relationally in first years of life, and • Support children’s confident pursuit of autonomy-in-connection __________ • Parent-child relationship ruptures -- common, though studies of rupture & repair are scarce (e. g. , Cohen & Tronick, 1987; Harrist & Waugh, 2002) 05/02/2010 NUI Galway School of Psychology Research Seminar Series 8

Conceptual model of parenting processes & self regulation • Experiences of frequent & unrepaired

Conceptual model of parenting processes & self regulation • Experiences of frequent & unrepaired ruptures will account for negative regulatory outcomes in CM children • Resting cardiac vagal tone, and patterns of symmetrical or complementary vagal augmentation/withdrawal under stress will distinguish CM and non-CM mother-child dyads 05/02/2010 NUI Galway School of Psychology Research Seminar Series 9

Operationalizing mother-child ruptures & repairs 05/02/2010 NUI Galway School of Psychology Research Seminar Series

Operationalizing mother-child ruptures & repairs 05/02/2010 NUI Galway School of Psychology Research Seminar Series 10

Structural Analysis of Social Behavior (SASB; Benjamin, 1974, 2003) Focus 1. TRANSITIVE—other 2. Intransitive—self

Structural Analysis of Social Behavior (SASB; Benjamin, 1974, 2003) Focus 1. TRANSITIVE—other 2. Intransitive—self in response EMANCIPATE Separate Affiliation Axis ACTIVE LOVE Reactive Love ATTACK Recoil CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 11

Structural Analysis of Social Behavior (SASB; Benjamin, 1974, 2003) EMANCIPATE Separate Affiliation Axis Interdependence

Structural Analysis of Social Behavior (SASB; Benjamin, 1974, 2003) EMANCIPATE Separate Affiliation Axis Interdependence Axis ACTIVE LOVE Reactive Love ATTACK Recoil CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 12

Structural Analysis of Social Behavior (SASB; Benjamin, 1996, 2001) 1. EMANCIPATE Separate 8. IGNORE

Structural Analysis of Social Behavior (SASB; Benjamin, 1996, 2001) 1. EMANCIPATE Separate 8. IGNORE Wall-Off Disaffiliative Behaviors 2. AFFIRM Disclose 7. ATTACK Recoil Affiliative behaviors 3. ACTIVE LOVE Reactive Love 4. PROTECT Trust 6. CRITICIZE Sulk 5. CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 13

Structural Analysis of Social Behavior (SASB; Benjamin, 1996, 2001) Three decisions 1. Focus (other

Structural Analysis of Social Behavior (SASB; Benjamin, 1996, 2001) Three decisions 1. Focus (other or self) 2. Affiliation (how much) 8. IGNORE 3. Interdependence (how Wall-Off much) Disaffiliative Behaviors 1. EMANCIPATE Separate 2. AFFIRM Disclose 7. ATTACK Recoil Affiliative behaviors 3. ACTIVE LOVE Reactive Love 4. PROTECT Trust 6. CRITICIZE Sulk 5. CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 14

Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded behavior

Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded behavior expressed by child or mom following interactive synchrony + Synchrony M+/C+ C+/M+ Repair: sustained 3 -step+ sequence of “positive” mom & child behaviors, following 1+ “negative” code 05/02/2010 NUI Galway School of Psychology Research Seminar Series 15

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate 8. IGNORE Wall-Off Disaffiliative Behaviors

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate 8. IGNORE Wall-Off Disaffiliative Behaviors 2. AFFIRM Disclose 7. ATTACK Recoil Positive Interactive Synchrony 3. ACTIVE LOVE Reactive Love 4. PROTECT Trust 6. CRITICIZE Sulk 5. CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 16

Rupture Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded

Rupture Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded behavior expressed by child or mom following interactive synchrony M+ C+ M- or C- (rupture) Repair: sustained 3 -step+ sequence of “positive” mom & child behaviors, following 1+ “negative” code 05/02/2010 M- or C- C+/M+ M+/C+ (repair) NUI Galway School of Psychology Research Seminar Series 17

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate R u p t u

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate R u p t u re 8. IGNORE Wall-Off 2. AFFIRM Disclose 7. ATTACK Recoil Positive Interactive Synchrony 3. ACTIVE LOVE Reactive Love 4. PROTECT Trust 6. CRITICIZE Sulk 5. CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 18

Rupture Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded

Rupture Positive Interactive Synchrony: 3 -step+ sequence “positive” SASBcoded mother-child transactions Rupture: negative SASB-coded behavior expressed by child or mom following interactive synchrony M+ C+ M- or C- (rupture) Repair: sustained 3 -step+ sequence of “positive” mom & child behaviors, following 1+ “negative” code 05/02/2010 M- or C- C+/M+ M+/C+ (repair) NUI Galway School of Psychology Research Seminar Series 19

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate 8. IGNORE Wall-Off 2. AFFIRM

Structural Analysis of Social Behavior (SASB) 1. EMANCIPATE Separate 8. IGNORE Wall-Off 2. AFFIRM Disclose 7. ATTACK Recoil Repair 3. ACTIVE LOVE Reactive Love 4. PROTECT Trust 6. CRITICIZE Sulk 5. CONTROL Submit 05/02/2010 NUI Galway School of Psychology Research Seminar Series 20

Examining patterns of mother-child rupture & repair and CM risk 05/02/2010 NUI Galway School

Examining patterns of mother-child rupture & repair and CM risk 05/02/2010 NUI Galway School of Psychology Research Seminar Series 21

No CM-risk group differences in rates of rupture or repair 10 9 8 7

No CM-risk group differences in rates of rupture or repair 10 9 8 7 6 5 4 3 2 1 0 5. 4 4. 8 4. 6 2. 7 Total # Ruptures Low Abuse Risk Total # Repairs High Abuse Risk Skowron, Kozlowski, & Pincus, under review JCP 05/02/2010 NUI Galway School of Psychology Research Seminar Series 22

Group differences in who initiates R/R’s & repair success by CM Risk 100 90

Group differences in who initiates R/R’s & repair success by CM Risk 100 90 80 70 60 50 40 30 20 10 0 92. 7 69. 5 89. 3 71. 9 68. 6 46. 2 31. 4 30. 5 28. 1 7. 3 maternal rupture child rupture maternal repair Low Abuse Risk child repair successful repairs High Abuse Risk Skowron, Kozlowski, & Pincus, under review JCP 05/02/2010 NUI Galway School of Psychology Research Seminar Series 23

Group differences in who initiates R/R’s & repair success by CM Risk 100 90

Group differences in who initiates R/R’s & repair success by CM Risk 100 90 80 70 60 50 40 30 20 10 0 92. 7 69. 5 89. 3 71. 9 68. 6 46. 2 31. 4 30. 5 28. 1 7. 3 maternal rupture child rupture maternal repair Low Abuse Risk child repair successful repairs High Abuse Risk Skowron, Kozlowski, & Pincus, under review JCP 05/02/2010 NUI Galway School of Psychology Research Seminar Series 24

Group differences in who initiates R/R’s & repair success by CM Risk 100 90

Group differences in who initiates R/R’s & repair success by CM Risk 100 90 80 70 60 50 40 30 20 10 0 92. 7 69. 5 89. 3 71. 9 68. 6 46. 2 31. 4 30. 5 28. 1 7. 3 maternal rupture child rupture maternal repair Low Abuse Risk child repair successful repairs High Abuse Risk Skowron, Kozlowski, & Pincus, under review JCP 05/02/2010 NUI Galway School of Psychology Research Seminar Series 25

Repair initiation & success by maternal differentiation 1 0. 86 0. 9 0. 81

Repair initiation & success by maternal differentiation 1 0. 86 0. 9 0. 81 0. 7 0. 6 0. 5 0. 44 0. 29 0. 3 0. 2 0. 14 0. 1 0 Child repairs Maternal repairs high maternal differentiation 05/02/2010 Successful repairs low maternal differentiation NUI Galway School of Psychology Research Seminar Series 26

Summary • Mothers at high-risk for CM are more likely to rupture and less

Summary • Mothers at high-risk for CM are more likely to rupture and less likely to repair • High risk dyads are less likely to successfully repair • Parents who are better able to manage emotional reactivity, & maintain good emotional contact (i. e. , differentiation of self), are more likely to initiate & successfully repair 05/02/2010 NUI Galway School of Psychology Research Seminar Series 27

NIMH Family Study Protocol 1. Home Screening ($25) • • informed consent cognitive &

NIMH Family Study Protocol 1. Home Screening ($25) • • informed consent cognitive & personality assessments, mental health & substance use, demographics 2. Home Visit ($40) • • Continue psychosocial assessments Prep mom for lab visit: orient to HR monitoring, Strange Situation, etc. 3. Lab visit ($60 + $25 bonus) • • • 05/02/2010 Resting baseline, strange situation, mother-child joint tasks, individual child tasks; genetic swabs Synchronized heart rate & digital video data collection Child behavior assessment via parent-report & observation NUI Galway School of Psychology Research Seminar Series 28

Joint mother-child tasks 1. 2. 3. 4. 5. 6. 7. Visit 3 Lab protocol

Joint mother-child tasks 1. 2. 3. 4. 5. 6. 7. Visit 3 Lab protocol Baseline Strange Situation Free Play Clean Up Train Puzzle Duplo Blocks Wait Task Mother task 1. Stroop Child tasks 1. 2. 3. 4. 5. 05/02/2010 Snack Delay Transparent Box Shapes Day/ Night Disappointment Task (one joint component with mother) NUI Galway School of Psychology Research Seminar Series 29

Joint lab tasks & HR monitoring 05/02/2010 NUI Galway School of Psychology Research Seminar

Joint lab tasks & HR monitoring 05/02/2010 NUI Galway School of Psychology Research Seminar Series 30

Joint Task—Duplo Puzzle • Picture deleted to protect participants’ confidentiality… 05/02/2010 NUI Galway School

Joint Task—Duplo Puzzle • Picture deleted to protect participants’ confidentiality… 05/02/2010 NUI Galway School of Psychology Research Seminar Series 31

Cardiac Vagal Tone How measured? : Respiratory Sinus Arrhythmia (RSA) = variability in the

Cardiac Vagal Tone How measured? : Respiratory Sinus Arrhythmia (RSA) = variability in the beat-to-beat intervals in heart rate (HR) associated with inhalation and exhalation Inhale: SNS is turned on & speeds HR (shorter IBI’s) Exhale: PNS turns on & slows HR (longer IBI’s) • Larger amounts of variability in IBI’s across the respiratory cycle = good parasympathetic tone AKA higher cardiac vagal tone (RSA) • Smaller variability scores = lower parasympathetic tone (lower RSA), more difficulty slowing down HR & counteracting cardiac stress response (Porges, 2001; Sapolsky, 2004) 05/02/2010 NUI Galway School of Psychology Research Seminar Series 32

RSA change scores during joint problem solving (RSA baseline – task scores) 1 0.

RSA change scores during joint problem solving (RSA baseline – task scores) 1 0. 8 0. 6 0. 4 0. 2 CM group 0 non-CM controls -0. 2 -0. 4 -0. 6 Mom (train) Mom (duplo) Child (train) Child (duplo) RSA-Augmentation RSA-Withdrawal 05/02/2010 NUI Galway School of Psychology Research Seminar Series 33

Children’s vagal reactivity moderates effects of violence exposure 4 B =. 396, t =

Children’s vagal reactivity moderates effects of violence exposure 4 B =. 396, t = 2. 029, p <. 05 3 Child SDQ Emotional Problems Low RSA-change High RSA-change 2 1 0 05/02/2010 Low Violence Exposure High Violence Exposure Cipriano, Skowron, Gatzke-Kopp, & Van Epps, 2009 & in prep NUI Galway School of Psychology Research Seminar Series 34

Spring-Summer, 2010 • Begin modeling latent patterns of interactive synchrony • Explore patterns of

Spring-Summer, 2010 • Begin modeling latent patterns of interactive synchrony • Explore patterns of complementarity, symmetry, and independence in mother & child autonomic physiology • Examine intra-individual patterns of PNS and SNS reciprocal activation, co-activation, and co-inhibition (e. g. , Berntson, Quigley, & Lozano, 2007; El-Sheikh et al. , 2009) • Map dyadic rupture-repair processes onto patterns of autonomic physiology 05/02/2010 NUI Galway School of Psychology Research Seminar Series 35

Penn State University With Gratitude… Children, Youth, & Families Consortium Child Study Center Family

Penn State University With Gratitude… Children, Youth, & Families Consortium Child Study Center Family Systems Lab Staff & Students • Project Coordinator: Angie Morrison • Graduate students: Elizabeth Cipriano, Jake Van Epps, Petra Rovers, Esra Bir Akturk, Dan Elreda, Jonathan Mc. Clain, Brianne Mintern Collaborators & Consultants § Drs. Lisa Gatzke-Kopp, Eric Loken, Cindy Stifter, Doug Teti, Susan Woodhouse, Sandy Azar & Drs. Robert Ammerman, Lorna Smith Benjamin, & Jody Manley Funders § National Institutes of Health –NIMH § U. S. Administration on Children, Youth and Families 05/02/2010 NUI Galway School of Psychology Research Seminar Series 36

List of Project Measures: Tests/Surveys 1. Demographics 2. Mini-Mental State Exam 3. Brief Symptom

List of Project Measures: Tests/Surveys 1. Demographics 2. Mini-Mental State Exam 3. Brief Symptom Inventory 4. Stanford Binet-5 (Early SB 5)* 5. Wechsler Abbreviated Scale of Intelligence 6. Addiction Severity Index (ASI) 7. Child Abuse Potential Inventory (CAPI) 8. Strengths and Difficulties Questionnaire (SDQ)* 9. Effortful Control (ATQ-EC) 10. Differentiation of Self Inventory (DSI) 11. Life Experiences Survey (LES) 12. Children’s Exposure to Community Violence (CECV)* 13. Conflict Tactics Scale (CTS) 14. Structural Analysis of Social Behavior (SASB) Intrex a) b) c) 05/02/2010 15. Mom Introject (Best/Worst) Mom with her (Mother/Father) age 5 -10 Mom with her child NUI Galway School of Psychology Research Seminar Series Child Behavior Questionnaire* *Child measure 37