Pediatric chronic pain is surprisingly common and impactful, prospectively predicting poorer mental and physical health outcomes. Internalizing symptoms represents one such outcome. It is the most common cluster of symptoms in children, it is related to poorer child functioning, and it has been linked to future functioning/psychopathology. The psychosocial mechanisms through which child pain may impact internalizing have yet to be fully elaborated, but withdrawal from social engagement with peers has been proposed as one possible mechanism. Additionally, sibling relationships may play a role in enhancing or diminishing a child’s social engagement while they are in pain. The current study aimed to examine whether child social engagement at age 8 mediates the relation between child chronic pain at age 8 and internalizing symptoms at age 9. Further, the study tested whether sibling warmth and sibling conflict act as moderators between child chronic pain and child social engagement. The physical and emotional health, quality of sibling relations, and extracurricular social engagement of 491 twin children from 247 families were assessed at age 8 and age 9 via surveys completed by the children’s primary caregivers. Findings showed that child pain at age 8 did not predict lower levels of social engagement, and social engagement did not predict child internalizing at age 9. Sibling warmth, but not conflict, significantly moderated the pain—social engagement relation. Together, these findings indicate that the relation between chronic pain and internalizing functions differently in children than in adults through a variety of cognitive, environmental, and social factors. More longitudinal research in this area will help establish changes in the relation between pain and internalizing from childhood into adulthood.

Experiencing poor, unrefreshing sleep is a common occurrence for individuals with chronic pain. Sleep disturbance predicts not only greater pain and disability, but also heightened negative affect and reduced positive affect in individuals with chronic pain. Such fluctuations in affect have been linked with more negative and fewer positive social events. For those with chronic pain, negative social relations can exacerbate pain, whereas positive social interactions can help decrease disability. Thus, exploring the sleep‒social functioning process in chronic pain may be one way to improve daily functioning and quality of life. The current study examined positive and negative affect as two parallel mediators of the within-day relations between sleep quality and positive and negative social events in individuals with chronic pain. For 21 days, electronic daily diary reports were collected from 220 individuals with fibromyalgia, a condition characterized by widespread chronic pain. Within-person relations among reports of last night’s sleep quality, afternoon affects and pain, and evening social events were estimated via multilevel structural equation modeling. Findings showed that positive affect mediated both the sleep quality‒positive social events and sleep quality‒negative social events relations. That is, greater than usual sleep disturbance last night predicted afternoon reports of lower than usual positive affect. Low positive affect, in turn, predicted evening reports of fewer than usual positive social events and more than usual negative social events that day, controlling for the effects of afternoon pain. In addition, negative affect mediated the sleep quality‒negative social events link. That is, greater than usual sleep disturbance last night predicted afternoon reports of higher than usual negative affect, which, in turn, predicted evening reports of more than usual negative social events that day, controlling for the effects of afternoon pain. Of the three significant mediated paths, the sleep quality‒positive affect‒positive social events path was the strongest in magnitude. Thus, a night of poor sleep can have an impact on social events the next day in those with chronic pain by dysregulating affect. Further, findings highlight the key role of positive affect in the sleep‒social functioning process and potential socio-affective benefits of sleep interventions in chronic pain.

The goal of this study was to examine whether there is any effect of phonotactic probability during the early phases of novel word recognition. In order to determine this, I performed two experiments. In Experiment 1, 33 adult monolingual English speakers learned 24 novel word-object pairings, half of which were high English phonotactic probability words and the other half were low English phonotactic probability words. I additionally included three conditions that varied the amount of exposures to each novel word-object pairing (i.e. One Exposure Condition, Two Exposures Conditions, and Five Exposures Condition). Experiment 2 was designed to clarify results found in Experiment 1, with improved randomization and fewer conditions (i.e. One Exposure Condition and Five Exposures Condition). The findings from both experiments were statistically significant in accuracy for Training condition, but not statistically significant for phonotactic probability nor for an interaction between phonotactic probability and Training condition. Although participants demonstrated learning across conditions there is no indication of a relationship between high and low phonotactic probability and novel word recognition. Collectively, these findings suggest that future studies will be necessary to determine if there is indeed an effect of phonotactic probability on early novel word recognition.

Child chronic pain is both common and consequential and identification of malleable risk factors is a critical step towards developing effective interventions. Existing evidence points to the possibility that parent behavior may play a significant role in the development of children’s chronic pain through modeling of pain-related behaviors. An important parental trait that predicts parent behavior in pain contexts is parental pain catastrophizing, which has been linked to child pain outcomes as well as to increased facial pain behavior in both parents and their children during pain induction. Existing research has examined facial pain behavior in aggregate, summarizing facial expressions over the course of an entire dyadic interaction, which does not allow for evaluation of the dynamic interplay between a parent and child. The current study aimed to test the hypothesis that higher parental catastrophizing would predict decreased flexibility in emotional dynamics between parent and child (reflected in facial affect during a parent-child interaction that occurs within the context of child pain-induction), which would in turn predict fewer child chronic pain symptoms. The approach used dynamic systems analysis of facial behaviors during the parent-child interaction during the child’s performance of a pain inducing cold pressor task to assess dyadic emotional flexibility. Nine-year old children from a larger sample of twins (N = 30) were video recorded during a cold-water pain task while their parents observed them. Videos of the children and their parent from these interactions were analyzed using facial action unit software (AffDex), into positive, neutral, and negative facial emotional expressions. Synchronized parent and child coded facial data were then analyzed for flexibility using GridWare (version 1.1). Parents completed the Pain Catastrophizing Scale (PCS) to assess parental trait pain catastrophizing and the Body Pain Location/Frequency scale to assess child chronic pain symptoms during the prior three months. Contrary to prediction, parental catastrophizing was related to higher levels of flexibility, and flexibility was unrelated to child chronic pain. Exploratory analyses indicated that children with higher levels of effortful control had more emotionally flexible interactions with their parent during the cold pressor, and emotionally flexible interactions predicting lower levels of children’s negative emotional responses to the acute pain task. suggesting some promising avenues for future research.

Research on self-regulatory variables like mindfulness and effortful control proposes strong links with physical and mental health outcomes across the lifespan, from childhood and adolescence to adulthood and old age. One pathway by which self-regulation may confer health benefits is through individual differences in reports of and emotional responses to daily negative and positive events. Mindfulness is broadly defined as non-reactivity to inner experiences, while effortful control is broadly defined as attentional and behavioral regulation. Mindfulness and effortful control have both been conceptualized to exert their beneficial effects on development through their influence on exposure/engagement and emotional reactivity/responsiveness to both negative and positive events, yet few empirical studies have tested this claim using daily-diary designs, a research methodology that permits for examining this process. With a sample of community-dwelling adults (n=191), this thesis examined whether dispositional mindfulness (i.e., non-reactivity of inner experience) and effortful control (i.e., attention and behavioral regulation) modulate reports of and affective reactivity/responsiveness to daily negative and positive events across 30 days. Results showed that mindfulness and effortful control were each associated with reduced exposure to daily stressors but not positive events. They also showed that mindfulness and effortful control, respectively, predicted smaller decreases in negative affect and smaller increases in positive affect on days that positive events occurred. Overall, these findings offer insight into how these self-regulatory factors operate in the context of middle-aged adults’ everyday life.

Asthma is one of the most common chronic diseases affecting children, and investigators have identified a number of risk factors that worsen asthma symptoms. Most prior studies have concluded that there is an association between one risk factor, poor sleep quality, and asthma; however, whether sleep quality predicts future asthma symptoms, asthma symptoms predict future sleep quality, or the relation is reciprocal is still unclear. The methodology of studies examining the asthma-sleep association has consisted of actigraphy and parent report to determine children's sleep duration and sleep efficiency, and lung function assessments with a spirometer on the participants to determine children's overall lung function. The purpose of the proposed study is to determine the strength of the cross-sectional and longitudinal associations between indicators of sleep quality and asthma. The proposed study plans to use a combination of actigraphy, sleep diaries, and lung function assessments using a spirometer to determine sleep quality and lung function, respectively. Future directions include determining the directionality of the association between sleep quality and asthma as well as strength of association.

Early childhood environment is critical to subsequent physical health in children and is influenced by children's primary caregivers \u2014 typically mothers. Maternal stress, one aspect of a child's environment, may shape the functioning of the child's physiological stress response system, which has been linked to later health outcomes, including pain. The current study evaluated whether: 1) early maternal stress, defined as maternal depressive symptoms and low socio-economic status, predicts later child pain; 2) early maternal stress relates to later child daily cortisol output; and 3) child's cortisol output across the day mediates the relation between early maternal stress and child pain. Maternal stress was assessed via questionnaires at twin age 12-months. At twin age seven years, twins' salivary cortisol was collected three times per day for three days. At twin age nine years, twins rated how often they experienced stomach, headache, and back pain weekly or more frequently. Results of multilevel linear and logistic regression analyses showed that early maternal stress did not predict later children's daily cortisol output or extent of child pain. Therefore, findings were inconsistent with the proposed mediation model. However, there was a marginally significant negative relation between child daily cortisol output and later extent of child pain. Current findings suggest that functioning of the stress response system, reflected in cortisol output, may have implications for the development of child pain. Future work evaluating intensely stressful early environments may provide clues about the links between a child's early environment and the development of his/her stress response system.

Cognitive reappraisal, or redefining the meaning of a stressful circumstance, is useful in regulating emotional responses to acute stressors and may be mobilized to up- or down- regulate the stressors’ emotional salience. A conceptually-related but more targeted emotion regulation strategy to that offered by cognitive reappraisal, termed positive cognitive shift, was examined in the current study. Positive cognitive shift (“PCS”) is defined as a point of cognitive transformation during a chronic, stressful situation that alters the meaning and emotional salience of the situation for the individual. Key aspects of the PCS that differentiate it from the broader reappraisal construct are that it 1) is relevant to responses to chronic (versus acute) aversive events, 2) is deployed when there is a mismatch between coping and stressors, and 3) involves insight together with redefinition in meaning of the situation generating stress. The current study used qualitative and quantitative analyses to 1) examine whether PCS is an observable, reliable, and valid experience in response to a stressful event that occurred in the past year, and 2) test whether PCS moderates the relations between the number of past-year stressful life circumstances and subsequent emotional well-being and functional health. A community sample of 175 middle-aged individuals were interviewed regarded a past chronic stressor and completed questionnaires regarding number of past year stressors and health outcomes. Theory-based coding of interviews was conducted to derive reliable scores for PCS, and findings indicated that PCS was evident in 37.7 % of participant responses. Furthermore, PCS scores were related positively to openness, personal growth from one’s most difficult lifetime event, and affect intensity-calm, in line with predictions. Also in line with prediction, PCS moderated the relations between number of past-year life events and health outcomes, such that the deleterious relations between past year stressful events and cognitive functioning, wellbeing, positive affect, and negative affect were weaker among individuals higher versus lower in PCS. Of note, PCS moderation effects diminished as the number of stressful events increased.

The rates of anxiety, depression, and attempted suicide for transgender individuals are extremely elevated relative to the general population. Yet, little research has been conducted about the transgender population regarding social transition (an individual presenting as their authentic/true gender, one different than the gender they were assigned at birth, in the context of everyday life) and parental acceptance. Both of which have been shown to impact the mental health of transgender individuals. The purposes of this study were: (1) To characterize a sample of transgender adults on their age of awareness of their authentic gender identity and their age of social transition. (2) Examine whether age of social transition, (3) parental acceptance, and (4) the gap in time between age of awareness and age of social transition (awareness-transition gap) were related to mental health. (5) Examine whether parental acceptance was related to age of social transition or to awareness-transition gap. (6) Examine whether age of social transition or awareness-transition gap interact with parental acceptance as correlates of mental health. The sample consisted of 115 transgender adults, ages 18 to 64. Measures were separated into 7 subheadings: demographics, transgender
on-cisgender identity, age of awareness, age of social transition, primary caregiver acceptance, secondary caregiver acceptance, and mental health. Hypotheses were partially supported for age of social transition with mental health, parental acceptance with mental health, and awareness-transition gap with parental acceptance. This study investigated under studied concepts of social transition and parental acceptance that appear to have an effect on the mental health of transgender adults.

Sibling interactions are natural contexts for learning about the appropriate expression of emotions. The emotionally charged nature of sibling interactions creates a convenient context to explore emotional reactivity and regulation. The purpose of this study was to examine the relations among parent-reported sibling relationship quality, observed sibling prosocial and antisocial behaviors displayed when playing a competitive marble game, and children's emotions coded from videotape. The sample consisted of 58 twin children who are currently participating in the longitudinal Arizona Twin Project. Parents completed the Sibling Relationship Questionnaire online at 5 and 8 years. Additionally, a competitive marble game interaction between the siblings took place in the home at 8 years and was videotaped for objective coding of prosocial, antisocial, and control behavior. Facial expressions were also coded from videotape using Emotient FACET software across the marble game interaction. Three mean composites of emotion were created, including positive and negative emotional facial expressions. Results showed that parent reported warmth did not predict the occurrence of positive emotions during the sibling interaction. However, siblings with high conflict showed less fear during the interaction. Parent reports of warmth predicted the extent to which siblings differed on emotion expression, however conflict did not. Parent ratings of conflict and warmth did not predict the extent to which the sibling dyad was emotionally intense. Findings regarding genetic and environmental effects were in line with previous reports of genetic influence on prosocial behavior and negative emotion, and expressions of joy being influenced by the environment. This study investigated noteworthy aspects of the sibling relationship that appear to promote children's adaptive development.