Understanding Patterns of Caregiver-Toddler Biological Attunement in a Distress Context

This 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.