Parent-Infant Interaction, Bio-Parent-Infant Interaction, Bio-Behavior and Stress Behavior and Stress

Regulation: Theory, Research, Regulation: Theory, Research, and Assessmentand Assessment

David W. Haley, Ph.D.David W. Haley, Ph.D.

Postdoctoral FellowPostdoctoral Fellow

Department of PediatricsDepartment of Pediatrics

University of British ColumbiaUniversity of British Columbia

What Develops? Understanding What Develops? Understanding Assessment in Early Childhood Assessment in Early Childhood

EducationEducation

dhaley@cw.bc.ca

Working AssumptionsWorking Assumptions

• Parent-infant interactions are Parent-infant interactions are regulatory regulatory

• Biological vulnerabilities influence Biological vulnerabilities influence parent-infant interactions/regulatory parent-infant interactions/regulatory systemssystems

• Parent-infant interactions/regulatory Parent-infant interactions/regulatory systems affect how infants interact in systems affect how infants interact in social/cognitive contextssocial/cognitive contexts

Environment I. Parent-infant

II. Alcohol Exposure

III. Premature Birth

RegulationArousalAffect

Attention

PsychologicalDevelopment

Social and Biological Factors that Influence Development

Still-Face Effect Still-Face Effect

• Still-FaceStill-Face– social gazesocial gaze– negative affect negative affect – heart rate heart rate (Weinberg, 1996)(Weinberg, 1996)

(Tronick,(Tronick,

Als, Brazelton,Als, Brazelton,

1978)1978)

Reunion:Reunion:– social gazesocial gaze– negative affect negative affect – heart rateheart rate

(Weinberg, 1996)(Weinberg, 1996)

“ “partial recovery”partial recovery”

ReunionReunion

Still-Face and Reunion Still-Face and Reunion

• Still-FaceStill-Face• (Tronick et al., 1978)(Tronick et al., 1978)

• Reunion as Recovery Reunion as Recovery • (Weinberg & Tronick, 1996)(Weinberg & Tronick, 1996)

• Quality of parent-infant interaction Quality of parent-infant interaction

predicts infant responses predicts infant responses • (Carter & Mayes, 1990; Braungart et al., (Carter & Mayes, 1990; Braungart et al.,

2000)2000)

Infant’s:Infant’s:– social gazesocial gaze

(Kogan & Carter, 1996)(Kogan & Carter, 1996)

– negative affectnegative affect

(Braungart et al., 2001)(Braungart et al., 2001)

Parent BehaviorParent Behavior

AimsAims

Will parent responsiveness moderate Will parent responsiveness moderate the infant’s ability to regulate stress? the infant’s ability to regulate stress?

Will Still-Face Reunion procedure be Will Still-Face Reunion procedure be sufficiently stressful to elicit a cortisol sufficiently stressful to elicit a cortisol response in infants?response in infants?

Independent VariablesIndependent Variables

2 (Parent Responsiveness) x 5 (Episode) with 2 (Parent Responsiveness) x 5 (Episode) with Repeated Measures:Repeated Measures:– Parent Responsiveness: high/low groupsParent Responsiveness: high/low groups– Episode: Episode:

Play Still-FaceII

Still-FaceI

ReunionI

ReunionII

2 min 2 min2 min 2 min2 min

Cortisol response to SFP (N = 43), Cortisol response to SFP (N = 43), F(1,39)=8.30, p<.001F(1,39)=8.30, p<.001

Sample

PostPre

Me

an

Co

rtis

l (u

g/d

l)

.34

.32

.30

.28

.26

.24

.22

.20

Episode

Reunion IIStill-Face IIReunion IIStill-Face IPlay

Me

an

Pe

rce

nta

ge

of

So

cia

l Att

en

d

50

40

30

20

10

0

PR Group

Lo

Hi

Social Attend differs by Group, Social Attend differs by Group, F(1, 39) = 6.10, p<.05. (N = 43)F(1, 39) = 6.10, p<.05. (N = 43)

Episode

Reunion IIReunion IIStill-Face IReunion IPlay

Me

an

Pe

rce

nta

ng

e o

f N

eg

ativ

e A

ffe

ct

50

40

30

20

10

0

PR Group

Lo

Hi

Negative Affect differs by Group x Negative Affect differs by Group x Episode, F(3, 101), p < .05. Episode, F(3, 101), p < .05.

(N=43)(N=43)

Episode

Reunion IIStill-Face IIReunion IStill-Face IPlay

He

art

Ra

te (

bp

m)

154

152

150

148

146

144

PR Group

Lo

Hi

Heart Rate differs by Group x Heart Rate differs by Group x Episode, Episode,

F(3, 98) = 4.31, p < .01. (N=42)F(3, 98) = 4.31, p < .01. (N=42)

ConclusionsConclusions

• Infant HPA, cardiovascular, Infant HPA, cardiovascular, emotional, and social responses emotional, and social responses sensitive to procedure sensitive to procedure

• Infant ability to regulate stress Infant ability to regulate stress decreases with repeated decreases with repeated stressors stressors

• Parent responsiveness moderates Parent responsiveness moderates infant ability to regulate stressinfant ability to regulate stress

Parent-Infant Interaction and Parent-Infant Interaction and Maternal DrinkingMaternal Drinking

University of New MexicoUniversity of New Mexico

Principal InvestigatorPrincipal InvestigatorNancy Handmaker, Psychology

Co-Investigator* & CollaboratorsStan Handmaker*, PediatricsBrittany Raybrun, ObGyRappaport, ObGyJean Lowe, DevelopmentalWilliam Zywiak, Stats Support NIH NIAAA; CRC

Research StaffHillary HeylJanette SchluterResearch AssistantsChen MengAmir WodajoBrandi ProctorMelissa RamseyRrittany RayburnJennifer BennettTraineesSharon McCaul, MAJordan Bell, MS

Background:Background:Effects of Moderate Alcohol Effects of Moderate Alcohol

Exposure Exposure (>0.5 oz absolute alcohol/day)(>0.5 oz absolute alcohol/day)

• Growth deficits• IQ • Learning problems• Behavior problems

• Biobehavior – HPAHPA– Sympathetic Adrenal Medulla– Affect– Attention– Emotional Disorders

Stressors

Hypothalamus

CR

F

Pituitary Gland

AC

TH

Adrenal GlandsCortisol

HPA Axis

Hippocampus

Cortisol

(+)

(+) (-)

(-)SocialCognitivePhysicalEmotional

Drinking from conception to knowledge Drinking from conception to knowledge of pregnancy & awareness until birth of pregnancy & awareness until birth

(N=54) (N=54)

Pre-Pre-awareaware

Post-Post-awareaware

Average # of drinks per dayAverage # of drinks per day 2.27 (3.38) 2.27 (3.38)

[0-22.13][0-22.13].11 (.33).11 (.33)

[0-2.13][0-2.13]

Average # of drinks per drinking Average # of drinks per drinking dayday

6.97 (6.04)6.97 (6.04)

[0-31][0-31]1.80 (4.30) 1.80 (4.30)

[0-29][0-29]

Average blood alcohol content Average blood alcohol content (BAC; mg/dl)(BAC; mg/dl)

37.63 37.63 (55.93)(55.93)

[0-291.33][0-291.33]

1.70 (5.43)1.70 (5.43)

[0-28.34][0-28.34]

Percent of days drinking (%)Percent of days drinking (%) 0.290 (.11)0.290 (.11)

[0-1.00][0-1.00].119 (.03).119 (.03)

[0-.19][0-.19]

Cortisol Reactivity predicted by Cortisol Reactivity predicted by Maternal Drinking (Maternal Drinking (†)†), adjusted , adjusted

R²= .15 (n=38) R²= .15 (n=38)

(†) after adjusting for gender & days until awareness •Removing mothers who continued to drink (n=11), R²= .11•Removing mothers who drank ≥ 5 drinks (n=5), R²= .09

Percent of days drinking (%)

1.0.8.6.4.20.0-.2

Del

ta C

ortis

ol (

ug/d

l)

.4

.3

.2

.1

0.0

-.1

-.2 Rsq = 0.1821

Multiple Stress Systems: Multiple Stress Systems: Heart Rate and Negative Affect by Heart Rate and Negative Affect by

DrinkingDrinking

Percent of days drinking (%)

.8.6.4.20.0-.2-.4

Hea

rt R

ate

(bpm

)

40

30

20

10

0

-10

-20

-30

Heart Rate by drinking, adj. R²= .15, after adjusting for gender and days until aware, (n= 33)

Percent of days drinking (%)

.8.6.4.20.0-.2-.4

Pe

rce

nta

ge

of

tota

l ne

ga

tive

aff

ect

(%

) .6

.4

.2

0.0

-.2

-.4

Negative Affect by drinking, adj. R²= .06 , after adjusting for gender, R²

=.14 (n=50)

ConclusionConclusion

• Moderate to High drinking Moderate to High drinking from conception to awareness from conception to awareness of pregnancy associated with:of pregnancy associated with:– Greater cortisol reactivityGreater cortisol reactivity– Elevated heart rate during Elevated heart rate during

recoveryrecovery– Greater negative affectGreater negative affect

Parent-Infant Interaction Parent-Infant Interaction Assessed via Infant Cognition Assessed via Infant Cognition

(Contingency Learning)(Contingency Learning)

Working AssumptionsWorking Assumptions

Biobehavioral Responses to Biobehavioral Responses to Painful Stressors in Preterm Painful Stressors in Preterm

Infants Infants (Grunau, 2001)(Grunau, 2001)

130135140145150155160165170175180

Baseline Lance Recovery

Hea

rt R

ate

(bpm

)

Preterm

Full-term

•8-month-old (corrected) preterm & full-term•Elevation of heart rate in preterm•Neonatal stress linked to alterations in cardiac & facial activity (r’s .45-.53)

Question?Question?

Given that preterm infants have Given that preterm infants have learning difficulties and show learning difficulties and show biobehavioral differencesbiobehavioral differences– Is contingency learning a biobehavioral Is contingency learning a biobehavioral

challenge for preterms?challenge for preterms?– Is contingency learning more of a Is contingency learning more of a

biobehavioral challenge for slow vs. biobehavioral challenge for slow vs. fast learners? fast learners?

ParticipantsParticipants

3-month-old infants3-month-old infants

47 preterms corrected for age47 preterms corrected for age

54 full-term controls54 full-term controls

Conception

≤ 32 weeks

Full-term

Preterm

36-42 weeks

3 months

Gestation

Kicking by Group x Phase, Kicking by Group x Phase, p<.001p<.001

0.5

1

1.5

2

2.5

3

3.5

4

B L1 L2 L3 E

Kic

ks (%

abov

e bas

elin

e) Preterm

Full-term

Kicking by Group x Speed x Phase, Kicking by Group x Speed x Phase, p<.001p<.001

0

1

2

3

4

5

6

7

B L1 L2 L3 E

Kic

kin

g (%

abov

e bas

elin

e)

Slow PretermSlow Full-termFast PretermFast Full-term

Vagal Tone by Group x Speed, Vagal Tone by Group x Speed, p<.01.p<.01.

2.82.9

33.13.23.33.43.53.63.73.8

B L E

Vag

al T

one

(ln/m

s)

Slow PretermSlow Full-termFast PretermFast Full-term

ConclusionConclusion

• Learning is a biobehavioral Learning is a biobehavioral challenge for infantschallenge for infants

• Learning is a greater Learning is a greater biobehavioral challenge for biobehavioral challenge for preterm and slow learnerspreterm and slow learners

Working Assumptions Working Assumptions RestatedRestated

•Parent-infant interactions are regulatory Parent-infant interactions are regulatory •Biological vulnerabilities influence parent-infant Biological vulnerabilities influence parent-infant interactions/regulatory systemsinteractions/regulatory systems•Parent-infant interactions/regulatory systems affect Parent-infant interactions/regulatory systems affect how infants interact during social/cognitive contextshow infants interact during social/cognitive contexts

University of British University of British ColumbiaColumbia

Primary InvestigatorPrimary InvestigatorRuth Grunau, Psychologist

Co-InvestigatorsMichael Whitfield, NeonatologistTim Oberlander, PediatricianJoanne Weinberg, NeuroscientistAlfonso Solimano, Neonatologist

Graduate Trainees Research StaffLiisa Holsti (CIHR) Mary BeckinghamJulie Petrie-Thomas Zoe Raffard (CIHR, MSFHR)

Co-ordinatorColleen Fitzgerald

Manager, SCN ProjectAdi Amir

Research StaffTaryn FayKristin FayGisela Gosse, RNColleen Jantzen Andrew Macquistan Carol Stephanson

InstitutionsInstitutions

Centre for Community Child Health Research,British Columbia Research Institute,University of British Columbia

Department of Pediatrics,University of British Columbia

Funding Sources: NICHD, CIHR, HELP, MSFHR