Psychology (Functional Area: Clinical-Developmental)
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Browsing Psychology (Functional Area: Clinical-Developmental) by Subject "Acute pain"
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Item Open Access An Examination of the Factor Structure of the Neonatal Facial Coding System and the Modified Behaviour Pain Scale(2018-03-01) Di Lorenzo, Miranda Gabrielle; Riddell, RebeccaDiverse behavioural cues have been proposed to be useful indicators of infant pain, but there is a paucity of evidence based on formal psychometric evaluation to establish their validity for this purpose. We aimed to examine two widely-used pain scales, the Neonatal Facial Coding System (NFCS) and the Modified Behaviour Pain Scale (MBPS), by examining their factor structures with factor analysis. The results indicated that an item reduced NFCS scale with three items produced a one-factor pain model that maintained the good psychometric properties of the 7-item scale. In addition, it was found that MBPS also has challenging internal consistency, with items that are weakly correlated and highly redundant. Redefinition of MBPS with a single indicator was suggested. This analysis provides new iterations of NFCS and MBPS that improve construct validity and internal consistency. These versions also increase the feasibility of both measures and improve their potential for clinical use.Item Open Access An investigation of parenting responses to toddler distress: Interactions between parent physiology, behaviour, and socioemotional context(2023-12-08) Badovinac, Shaylea Danica; Pillai Riddell, RebeccaThis dissertation examined physiological, behavioural, and psychological aspects of parents’ responses to children’s distress across infancy and toddlerhood through a series of three studies. Study 1 is a systematic review and narrative synthesis of the literature that characterized parents’ physiological responses to infants’ and toddlers’ (0-3 years) distress during experimental and naturalistic distress paradigms and examined concurrent associations between parents’ physiological and behavioural responses. General trends in parents’ physiological responses varied as a function of methodological factors including the physiological outcome (i.e., cortisol, cardiac outcomes, skin conductance, salivary alpha amylase), distress paradigm (e.g., fear-related distress, frustration-related distress), and baseline comparison condition used. Studies 2 and 3 used data from a sample of caregiver-toddler dyads (N=234) studied in a naturalistic high-distress context (i.e., toddler routine vaccination) to address the limitations and gaps in the literature identified in Study 1. Study 2 described the validation of a measure of insensitive (i.e., distress-promoting) caregiver behaviour during routine vaccination. Measure validity and reliability were investigated with correlations and autoregressive cross-lagged path analysis. Study 3 characterized the trajectory of caregivers’ physiological (i.e., high-frequency heart rate variability) responses during routine vaccination and associations of the trajectory with parents’ concurrent behaviour and psychological stress. Findings across all three studies are discussed in the context of the extant literature and relevant theoretical models. Clinical implications and directions for future research are offered.Item Open Access Investigating the Convergence of Cardiac and Behavioural Indicators of Distress Regulation in Toddlerhood(2020-11-13) Waxman, Jordana; Riddell, RebeccaThe ability to respond and regulate from distress is critical to everyday functioning for children and adults. Profiles of distress responding have been linked with individual differences in psychological and cognitive outcomes across development. However, no studies to date have examined the longitudinal patterns of both physiological and behavioural distress responding within a high distress context (i.e., pain) in toddlerhood. This dissertation consists of three studies examining the development of behavioural and physiological distress regulation in the second and third years of life as well as the convergence between these distress indicators over time. Study 1 is a published systematic review (Waxman, DiLorenzo, & Pillai Riddell, 2020) that synthesizes the direction and magnitude of the relation between behavioural and cardiac indicators of distress in toddlerhood (12 to 47 months of age). Study 1 revealed that the magnitude of the association between behavioural and most cardiac indicators of distress might be smaller than previously expected (i.e., Cohens d < 0.2). However, methodological differences may also be responsible for study heterogeneity. Study 2 (Waxman et al., 2020) and Study 3 (Waxman et al., in press) were based on an ongoing longitudinal cohort of caregiver-infant dyads observed during vaccination appointments during the second year of life (12-month vaccination [N=158], 18-month vaccination [N=122]). Study 2 used path analyses to investigate the predictive and concurrent relations between toddlers pain-related behavioural distress and cardiac (i.e., heart rate [HR], respiratory sinus arrhythmia) responses during 12- and 18-month vaccinations. Study 2 demonstrated that behavioural and cardiac indicators of pain-related distress during 12- and 18-month vaccinations reflect unique aspects of the nociceptive response. Study 3 utilized parallel-process growth mixture modeling to describe patterns of distress responses to vaccinations as indexed by both pain-related behavioural distress and HR at 12 and 18 months. Study 3 revealed developmental differences and increasing variability in behavioural and cardiac distress responses across the second year of life. Clinical implications and suggestions for future research are discussed.Item Open Access Understanding Patterns of Caregiver-Toddler Biological Attunement in a Distress Context(2022-12-14) Di Lorenzo, Miranda Gabrielle; Riddell, RebeccaThis dissertation consists of three studies that examine caregiver-toddler biological attunement within distress contexts in toddlerhood. Study 1 is a published systematic review (Di Lorenzo et al., 2021) that synthesizes the direction and magnitude of the relations between caregiver and young child (0 to 3 years of age) biological outcomes according to different methodology used to measure distress. Majority of articles examined cortisol outcomes of caregivers and their children in distress contexts. The magnitude of the association between caregiver and child cortisol indicators were moderate to large; however, results differed depending on the analysis used and measurement epochs examined. Relations between caregiver and child cardiac, saliva alpha amylase (sAA), and electroencephalography (EEG) outcomes were generally weak or inconsistent. Limitations of methodological approaches used to study caregiver-child attunement likely contribute to the heterogeneity of findings. To address limitations highlighted in Study 1, we used parallel process growth mixture modelling in Study 2 (Di Lorenzo-Klas et al., 2022a) to capture the dynamic nature of the attunement process and discern various patterns of caregiver-toddler coregulatory trajectories in a vaccination context during the second year of life. Three groups of dyads were discerned, with one group (80% of the sample) that demonstrated an adaptive regulatory attunement pattern (i.e., most regulated), and two groups (20% of the sample) that showed either a lack of attunement or misattunement between dyad members which demonstrated less adaptive child regulation from pain-related distress. To better understand what is driving the patterns of regulatory attunement, Study 3 (Di Lorenzo-Klas et al., 2022b) examined whether caregiver distress (operationalized as caregiver worry associated with their toddler's vaccination) and child distress (operationalized as behavioural pain-related distress) are associated with patterns of caregiver-toddler attunement discerned in Study 2. Findings from Study 3 revealed that caregivers who experience higher distress associated with their toddlers' vaccination demonstrated higher probability of being associated with groupings reflecting lack of attunement or misattunement with their toddlers during vaccination, and these toddlers are at risk of experiencing higher levels of behavioural pain-related distress. Clinical implications and suggestions for future research are discussed.