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Intergenerational transmission of emotion dysregulation: Part I. Psychopathology, self-injury, and parasympathetic responsivity among pregnant women

Published online by Cambridge University Press:  08 May 2019

Betty Lin ,
Parisa R. Kaliush ,
Elisabeth Conradt ,
Sarah Terrell ,
Dylan Neff ,
Ashley K. Allen ,
Marcela C. Smid ,
Catherine Monk  and
Sheila E. Crowell
Betty Lin
Affiliation:
Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
Parisa R. Kaliush
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA
Elisabeth Conradt
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
Sarah Terrell
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA
Dylan Neff
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA
Ashley K. Allen
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA
Marcela C. Smid
Affiliation:
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
Catherine Monk
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
Sheila E. Crowell*
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, UT, USA Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
*
Author for Correspondence: Sheila E. Crowell, Department of Psychology, University of Utah, 380 South 1530 East, Behavioral Sciences 502, Salt Lake City, UT 84112; E-mail: [email protected].
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Abstract

The World Health Organization recently reported that maternal mental health is a major public health concern. As many as one in four women suffer from psychiatric disorders at some point during pregnancy or the first postpartum year. Furthermore, self-injurious thoughts and behaviors (SITBs) represent one of the leading causes of death among women during this time. Thus, efforts to identify women at risk for serious forms of psychopathology and especially for SITBs are of utmost importance. Despite this urgency, current single-diagnostic approaches fail to recognize a significant subset of women who are vulnerable to perinatal stress and distress. The current study was among the first to investigate emotion dysregulation—a multilevel, transdiagnostic risk factor for psychopathology—and its associations with stress, distress, and SITBs in a sample of pregnant women (26–40 weeks gestation) recruited to reflect a range of emotion dysregulation. Both self-reported emotion dysregulation and respiratory sinus arrhythmia, a biomarker of emotion dysregulation, demonstrated expected associations with measures of mental health, including depression, anxiety, borderline personality pathology, and SITBs. In addition, self-reported emotion dysregulation was associated with blunted respiratory sinus arrhythmia responsivity to an ecologically valid infant cry task. Findings add to the literature considering transdiagnostic risk during pregnancy using a multiple-levels-of-analysis approach.

Keywords

emotion dysregulationpregnancypsychophysiologyself-injurious thoughts and behaviorswomen's mental health
Type
Special Issue Articles
Information
Development and Psychopathology , Volume 31 , Special Issue 3: Emotion Dysregulation and Emerging Psychopathology , August 2019 , pp. 817 - 831
Copyright
Copyright © Cambridge University Press 2019 

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References

Ablow, J. C., Marks, A. K., Feldman, S. S., & Huffman, L. C. (2013). Associations between first-time expectant women's representations of attachment and their physiological reactivity to infant cry. Child Development, 84, 1373–1391.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.). Arlington, VA: Author.Google Scholar
Barker, D. J. (1990). The fetal and infant origins of adult disease. British Medical Journal, 301, 1111.Google Scholar
Barker, D. J. P., & Martyn, C. N. (1994). The maternal and fetal origins of cardiovascular disease. Vascular Medicine Review, 5, 129–137.Google Scholar
Beauchaine, T. P. (2001). Vagal tone, development, and Gray's motivational theory: Toward an integrated model of autonomic nervous system functioning in psychopathology. Development and Psychopathology, 13, 183–214.Google Scholar
Beauchaine, T. P. (2015a). Future directions in emotion dysregulation and youth psychopathology. Journal of Clinical Child and Adolescent Psychology, 44, 875–896.Google Scholar
Beauchaine, T. P. (2015b). Respiratory sinus arrhythmia: A transdiagnostic biomarker of emotion dysregulation and psychopathology. Current Opinion in Psychology, 3, 43–47.Google Scholar
Beauchaine, T. P., & Crowell, S. E. (in press). The Oxford handbook of emotion dysregulation. Oxford: Oxford University Press.Google Scholar
Beauchaine, T. P., & Thayer, J. F. (2015). Heart rate variability as a transdiagnostic biomarker of psychopathology. International Journal of Psychophysiology, 98, 338–350.Google Scholar
Beijers, R., Buitelaar, J. K., & de Weerth, C. (2014). Mechanisms underlying the effects of prenatal psychosocial stress on child outcomes: Beyond the HPA axis. European Child and Adolescent Psychiatry, 23, 943–956.Google Scholar
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society. Series B (Methodological), 57, 289–300.Google Scholar
Bentley, K. H., Cassiello-Robbins, C. F., Vittorio, L., Sauer-Zavala, S., & Barlow, D. H. (2015). The association between nonsuicidal self-injury and the emotional disorders: A meta-analytic review. Clinical Psychology Review, 37, 72–88.Google Scholar
Berntson, G. G., Bigger, J. T., Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., … Van Der Molen, M. W. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34, 623–648.Google Scholar
Berntson, G. G., Quigley, K. S., Jang, J. F., & Boysen, S. T. (1990). An approach to artifact identification: Application to heart period data. Psychophysiology, 27, 586–598.Google Scholar
Berntson, G. G., Quigley, K. S., & Lozano, D. L. (2016). Cardiovascular psychophysiology. In Cacioppo, J., Tassinari, L. G., & Berntson, G. G. (Eds.), Handbook of psychophysiology (pp. 183–216). Cambridge: Cambridge University Press.Google Scholar
Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R. D., Domsalla, M., Chapman, A. L., … Wolf, M. (2009). The short version of the Borderline Symptom List (BSL-23): Development and initial data on psychometric properties. Psychopathology, 42, 32–39.Google Scholar
Braeken, M. A. K. A., Jones, A., Otte, R. A., Widjaja, D., Van Huffel, S., Monsieur, G. J. Y. J., … Van den Bergh, B. R. H. (2015). Anxious women do not show the expected decrease in cardiovascular stress responsiveness as pregnancy advances. Biological Psychology, 111, 83–89.Google Scholar
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behavior Research and Therapy, 44, 371–394.Google Scholar
Christian, L. M. (2012). Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions. Progress in Neurobiology, 99, 106–116.Google Scholar
Cole, P. M., Hall, S., & Hajal, N. J. (2017). Emotion dysregulation as a vulnerability to psychopathology. In Beauchaine, T. P. & Hinshaw, S. P. (Eds.), Child and adolescent psychopathology (3rd ed., pp. 346–386). Hoboken, NJ: Wiley.Google Scholar
Cole, P. M., Martin, S. E., & Dennis, T. A. (2004). Emotion regulation as a scientific construct: Methodological challenges and directions for child development research. Child Development, 75, 317–333.Google Scholar
Crowell, S. E., Butner, J. E., Wiltshire, T. J., Munion, A. K., Yaptangco, M., & Beauchaine, T. P. (2017). Evaluating emotion and biological sensitivity to maternal behavior among self-injuring and depressed adolescent girls using nonlinear dynamics. Clinical Psychological Science, 5, 272–285.Google Scholar
Crowell, S. E., Puzia, M. E., & Yaptangco, M. (2015). The ontogeny of chronic distress: Emotion dysregulation across the life span and its implications for psychological and physical health. Current Opinion in Psychology, 3, 91–99.Google Scholar
Crowell, S. E., Vlisides-Henry, R. D., & Kaliush, P. R. (in press). Emotion generation, regulation, and dysregulation as multilevel transdiagnostic constructs. In Beauchaine, T. P. & Crowell, S. E. (Eds.), The Oxford handbook of emotion dysregulation (Ch. 7). Oxford: Oxford University Press.Google Scholar
Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11, 126–133.Google Scholar
Del Vecchio, T., Walter, A., & O'Leary, S. G. (2009). Affective and physiological factors predicting maternal response to infant crying. Infant Behavior and Development, 32, 117–122.Google Scholar
DiPietro, J. A., Costigan, K. A., & Gurewitsch, E. D. (2005). Maternal psychophysiological change during the second half of gestation. Biological Psychology, 69, 23–38.Google Scholar
DiPietro, J. A., Mendelson, T., Williams, E. L., & Costigan, K. A. (2012). Physiological blunting during pregnancy extends to induced relaxation. Biological Psychology, 89, 14–20.Google Scholar
Doyle, C., & Cicchetti, D. (2018). Future directions in prenatal stress research: Challenges and opportunities related to advancing our understanding of prenatal developmental origins of risk for psychopathology. Development and Psychopathology, 30, 721–724.Google Scholar
Entringer, S., Buss, C., Shirtcliff, E. A., Cammack, A. L., Yim, I. S., Chicz-DeMet, A., … Wadhwa, P. D. (2010). Attenuation of maternal psychophysiological stress responses and the maternal cortisol awakening response over the course of human pregnancy. Stress, 13, 258–268.Google Scholar
First, M. B., Williams, J. B. W., Benjamin, L. S., & Spitzer, R. L. (2015). User's guide for the SCID-5-PD (Structured Clinical Interview for DSM-5 Personality Disorder). Arlington, VA: American Psychiatric Association.Google Scholar
First, M. B., Williams, J. B., Karg, R. S., & Spitzer, R. L. (2016). User's Guide for the SCID-5-CV: Structured Clinical Interview for DSM-5 Disorders, Clinician Version. Arlington, VA: American Psychiatric Association.Google Scholar
Franklin, J. C., Jamieson, J. P., Glenn, C. R., & Nock, M. K. (2015). How developmental psychopathology theory and research can inform the Research Domain Criteria (RDoC) project. Journal of Clinical Child and Adolescent Psychology, 44, 280–290.Google Scholar
Gatzke-Kopp, L. M. (2011). The canary in the coalmine: the sensitivity of mesolimbic dopamine to environmental adversity during development. Neuroscience and Biobehavioral Reviews, 35, 794–803.Google Scholar
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106, 1071–1083.Google Scholar
Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., … Miller, W. C. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes: Summary. Evidence Report/Technical Assessment Number 119. Rockville, MD: Agency for Healthcare research and Quality.Google Scholar
Gillman, M. W. (2005). Developmental origins of health and disease. New England Journal of Medicine, 353, 1848–1850.Google Scholar
Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; What needs to be done. Best Practice and Research Clinical Obstetrics and Gynecology, 28, 25–35.Google Scholar
Glover, V., O'Connor, T. G., & O'Donnell, K. (2010). Prenatal stress and the programming of the HPA axis. Neuroscience and Biobehavioral Reviews, 35, 17–22.Google Scholar
Glynn, L. M., & Sandman, C. A. (2011). Prenatal origins of neurological development: A critical period for fetus and mother. Current Directions in Psychological Science, 20, 384–389.Google Scholar
Glynn, L. M., Schetter, C. D., Hobel, C. J., & Sandman, C. A. (2008). Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychology, 27, 43–51.Google Scholar
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.Google Scholar
Hammen, C., Cheri, A., Gordon, D., Burge, D., Jaenicke, C., & Hiroto, D. (1987). Children of depressed mothers: Maternal strain and symptom predictors of dysfunction. Journal of Abnormal Psychology, 96, 190–198.Google Scholar
Huizink, A. C., Mulder, E. J., & Buitelaar, J. K. (2004). Prenatal stress and risk for psychopathology: Specific effects or induction of general susceptibility? Psychological Bulletin, 130, 115–142.Google Scholar
Joosen, K. J., Mesman, J., Bakermans-Kranenburg, M. J., Pieper, S., Zeskind, P. S., & van IJzendoorn, M. H. (2013). Physiological reactivity to infant crying and observed maternal sensitivity. Infancy, 18, 414–431.Google Scholar
Keenan, K. (2000). Emotion dysregulation as a risk factor for child psychopathology. Clinical Psychology: Science and Practice, 7, 418–434.Google Scholar
Klinkenberg, A. V., Nater, U. M., Nierop, A., Bratsikas, A., Zimmermann, R., & Ehlert, U. (2009). Heart rate variability changes in pregnant and non-pregnant women during standardized psychosocial stress. Acta Obstetricia Et Gynecologica Scandinavica, 88, 77–82.Google Scholar
Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226–239.Google Scholar
Kozak, M. J., & Cuthbert, B. N. (2016). The NIMH Research Domain Criteria initiative: Background, issues, and pragmatics. Psychophysiology, 53, 286–297.Google Scholar
Leerkes, E. M., Su, J., Calkins, S. D., Supple, A. J., & O'Brien, M. (2016). Pathways by which mothers’ physiological arousal and regulation while caregiving predict sensitivity to infant distress. Journal of Family Psychology, 30, 769.Google Scholar
Lewinsohn, P. M., Seeley, J. R., Roberts, R. E., & Allen, N. B. (1997). Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12, 277–287.Google Scholar
Lindahl, V., Pearson, J. L., & Colpe, L. (2005). Prevalence of suicidality during pregnancy and the postpartum. Archives of Women's Mental Health, 8, 77–87.Google Scholar
Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18, 303–312.Google Scholar
Meades, R., & Ayers, S. (2011). Anxiety measures validated in perinatal populations: A systematic review. Journal of Affective Disorders, 133, 1–15.Google Scholar
Mittal, V. A., & Wakschlag, L. S. (2017). Research domain criteria (RDoC) grows up: Strengthening neurodevelopment investigation within the RDoC framework. Journal of Affective Disorders, 216, 30–35.Google Scholar
O'Connor, E., Rossom, R. C., Henninger, M., Groom, H. C., & Burda, B. U. (2016). Primary care screening for and treatment of depression in pregnant and postpartum women: Evidence report and systematic review for the US Preventive Services Task Force. Journal of the American Medical Association, 315, 388–406.Google Scholar
O'Donnell, K. J., & Meaney, M. J. (2017). Fetal origins of mental health: The developmental origins of health and disease hypothesis. American Journal of Psychiatry, 174, 319–328.Google Scholar
Ortega, L. A., & Karch, D. (2010). Precipitating circumstances of suicide among women of reproductive age in 16 US States, 2003–2007. Journal of Women's Health, 19, 5–7.Google Scholar
Ostlund, B. O., Vlisides-Henry, R. D., Crowell, S. E., Raby, L. K., Terrell, S., Brown, M., … Conradt, E. (2019). Intergenerational transmission of emotion dysregulation: Part II. Developmental origins of newborn neurobehavioral risk for psychopathology. Development and Psychopathology, XX, XX–XXGoogle Scholar
Perez, J., Venta, A., Garnaat, S., & Sharp, C. (2012). The Difficulties in Emotion Regulation Scale: Factor structure and association with nonsuicidal self-injury in adolescent inpatients. Journal of Psychopathology and Behavioral Assessment, 34, 393–404.Google Scholar
Porges, S. W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A polyvagal theory. Psychophysiology, 32, 301–318.Google Scholar
Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74, 116–143.Google Scholar
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.Google Scholar
Riem, M. M. E., Bakermans-Kranenburg, M. J., Pieper, S., Tops, M., Boksem, M. A. S., Vermeiren, R. R. J. M., … Rombouts, S. A. R. B. (2011). Oxytocin modulates amygdala, insula, and inferior frontal gyrus responses to infant crying: A randomized controlled trial. Biological Psychiatry, 70, 291–297.Google Scholar
Rini, C. K., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (1999). Psychological adaptation and birth outcomes: The role of personal resources, stress, and sociocultural context in pregnancy. Health Psychology, 18, 333–345.Google Scholar
Rutherford, H. J. V., Wallace, N. S., Laurent, H. K., & Mayes, L. C. (2015). Emotion regulation in parenthood. Developmental Review, 36, 1–14.Google Scholar
Satorra, A., & Bentler, P. M. (2010). Ensuring positiveness of the scaled difference chi-square test statistic. Psychometrika, 75, 243–248.Google Scholar
Schlotz, W., & Phillips, D. I. (2009). Fetal origins of mental health: Evidence and mechanisms. Brain, Behavior, and Immunity, 23, 905–916.Google Scholar
Schlotz, W., Phillips, D. I., & Hertfordshire Cohort Study Group. (2012). Birth weight and perceived stress reactivity in older age. Stress and Health, 29, 56–63.Google Scholar
Schuetze, P., & Zeskind, P. S. (2001), Relations between women's depressive symptoms and perceptions of infant distress signals varying in pitch. Infancy, 2, 483–499.Google Scholar
Scorza, P., Duarte, C. S., Hipwell, A. E., Posner, J., Ortin, A., Canino, G., & Monk, C. (2018). Research Review: Intergenerational transmission of disadvantage: Epigenetics and parents' childhoods as the first exposure. Journal of Child Psychology and Psychiatry, and Allied Disciplines. Advance online publication. doi:10.1111/jcpp.12877Google Scholar
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Van den Bergh, B. R., Mulder, E. J., Mennes, M., & Glover, V. (2005). Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: Links and possible mechanisms. A review. Neuroscience and Biobehavioral Reviews, 29, 237–258.Google Scholar
Vasilev, C. A., Crowell, S. E., Beauchaine, T. P., Mead, H. K., & Gatzke-Kopp, L. M. (2009). Correspondence between physiological and self-report measures of emotion dysregulation: A longitudinal investigation of youth with and without psychopathology. Journal of Child Psychology and Psychiatry, 50, 1357–1364.Google Scholar
Verreault, N., Da Costa, D., Marchand, A., Ireland, K., Dritsa, M., & Khalifé, S. (2014). Rates and risk factors associated with depressive symptoms during pregnancy and with postpartum onset. Journal of Psychosomatic Obstetrics and Gynecology, 35, 84–91.Google Scholar
Vesga-López, O., Blanco, C., Keyes, K., Olfson, M., Grant, B. F., & Hasin, D. S. (2008). Psychiatric disorders in pregnant and postpartum women in the United States. Archives of General Psychiatry, 65, 805–815.Google Scholar
Williams, D. P., Cash, C., Rankin, C., Bernardi, A., Koenig, J., & Thayer, J. F. (2015). Resting heart rate variability predicts self-reported difficulties with emotion dysregulation: A focus on different facets of emotion regulation. Frontiers in Psychology, 10, 261–268.Google Scholar
Wisner, K. L., Sit, D. K. Y., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L., … Hanusa, B. H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70, 490–498.Google Scholar
Yang, C. C., Chao, T. C., Kuo, T. B., Yin, C. S., & Chen, H. I. (2000). Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR. American Journal of Physiology—Heart and Circulatory Physiology, 278, 1269–1273.Google Scholar
Zhong, Q. Y., Gelaye, B., Miller, M., Fricchione, G. L., Cai, T., Johnson, P. A., … Williams, M. A. (2016). Suicidal behavior-related hospitalizations among pregnant women in the USA, 2006–2012. Archives of Women's Mental Health, 19, 463–472.Google Scholar