NEW EXPLANATORY PARADIGMS: SELF-REGULATORY PROCESSES AND IMPLICATIONS FOR PREVENTION
This session was chaired by LeShawndra Price (NIMH). Thomas Boyce (University of British Columbia) presented on the neurobiology of stress and health, showing how children of low socioeconomic status (SES) may develop dental caries from the combination of bacterial exposure due to poor dental hygiene and socially partitioned stress and adversity. Dante Cicchetti (University of Minnesota) presented on stress and resilient functioning—specifically, the role that regulation of adrenal steroid hormones, electroencephalography hemispheric asymmetry, gene-environment interactions, personality functioning, and emotion regulation play in the diverse pathways to competent adaptation in maltreated children. Mark Greenberg (Pennsylvania State University) presented a developmental model that incorporates cognition, emotion, and behavior; and an intervention—the PATHS curriculum—that fosters social and emotional learning using this model. Finally, William Pelham (University at Buffalo, The State University of New York) presented on early intervention for attention-deficit hyperactivity disorder. A highlight of the discussion, moderated by Daniel Shaw (University of Pittsburgh), was that at least one of the following factors affects most children seen in settings designed to provide assistance to the most vulnerable families in the United States: SES, vulnerability to trauma, cortisol/dehydroepiandrosterone, protective effects in the context of maltreatment, inhibitory control, and social and emotional learning. The issue is to tailor these factors into effective interventions.
Stress Neurobiology, Risk and Resilience
W. Thomas Boyce, Ph.D.
Childhood morbidities are non-randomly distributed in the population such that a subset of the population accounts for more than half of biomedical and psychiatric morbidities and health care utilization. Factors that may account for this distribution of health problems—specifically, the interactive effects of biological stress reactivity and social context on child outcomes—are presented. In particular, low socioeconomic status, adverse life events, and family instability are presented as factors that may influence the social partitioning of differences in childhood physical and mental health disorders, through interactions with neurobiological vulnerability. Current research on childhood dental caries is presented to further illustrate how the interplay between stress, biological risk, and social context may affect health outcomes. Individual differences in children’s susceptibility to contextual effects may be an important consideration for designing early childhood interventions that will impact public health.
Stressful Challenges and Resilient Functioning: Illustrations from a Multi-Level Perspective on Child Maltreatment
Dante Cicchetti, Ph.D.
Resilient functioning is the attainment of unexpected competence despite the experience of significant adversity, and is among the most intriguing and adaptive phenomena of human development. Although growing attention has been paid to discovering the processes through which individuals at high risk do not develop maladaptively, the empirical study of resilience has focused predominantly on detecting the psychosocial determinants of the phenomenon. For the field of resilience to grow, efforts to understand underlying processes will be facilitated by more interdisciplinary research that is designed within a developmental psychopathology framework. This type of research would entail a consideration of psychological, biological, and environmental-contextual processes from which pathways to resilience might eventuate (known as equifinality), as well as those that result in diverse outcomes among individuals who have achieved resilient functioning (known as multifinality). Examples are provided of a multi-level perspective on resilience in child maltreatment, which is one of the most severe and stressful challenges children can confront. These include research on the role that the regulation of adrenal steroid hormones, EEG hemispheric asymmetry, gene-environment (GxE) interactions, personality functioning, and emotion regulation play in the diverse pathways to competent adaptation in maltreated children. The possible relation between the mechanisms of neural plasticity and resilience is discussed. This presentation emphasizes the importance of adopting a multiple-levels-of-analysis perspective for designing and evaluating interventions aimed at fostering resilient outcomes in persons facing significant stress and adversity.
Emotion Regulation, Inhibitory Control, and Social Competence
Mark Greenberg, Ph.D.
A developmental model that attempts to integrate processes across cognition, emotion, and language during the preschool and early school-age periods is presented. The model focuses on how optimal development in each of these domains contributes to effective social and emotional competence and how both individual characteristics and environmental difficulties may impact development. Of critical importance to the development of early social and emotional competence are responsive and sensitive adults who care for and model effective social interactions. In addition, a young child's developing ability to use language to express emotional states, and the development of inhibitory control (the ability to stop and calm down and to delay impulsive actions) are key developmental skills that predict social and emotional functioning. The curriculum Promoting Alternative Thinking Strategies, which is based on this theoretical model, is presented, with specific illustrations of how lessons and daily generalization activities and skills, beginning in the preschool years, can effectively build the skills of emotion regulation and inhibitory control. Use of these skills is linked to decreases in both externalizing and internalizing behavior problems in preschool and school-age children. Data are presented to illustrate that improvements in prefrontal abilities mediate improvements in behavior in randomized trials. Finally, the need for a closer integration of research on developmental neuroscience and prevention science is presented.
Early Intervention for ADHD: Targets, Settings, Methods, and Mechanisms
William Pelham, Ph.D.
This presentation describes what is known about treatment for ADHD in childhood, particularly for young children. Issues of target behavior in assessment and outcome measurement (DSM symptoms versus impairment) and settings in which treatment must be provided are discussed. Four recently completed or ongoing treatment studies, including one focusing exclusively on early intervention (psychosocial treatment as prevention for medication) with ADHD children in kindergarten and first grade are described. Suggestions for improving understanding of putative underlying mechanisms of psychopathology by including measures of these constructs in intervention studies are presented along with constraints.