Dyadic Regulation Research Articles

Dynamic self-regulation and coregulation of respiratory sinus arrhythmia in mother-child and father-child interactions: Moderating effects of proximal and distal stressors.

This study examined how proximal and distal familial stressors influenced the real-time, dynamic individual and dyadic regulation of respiratory sinus arrhythmia (RSA) in mother-preschooler and father-preschooler interactions in at-risk families (N = 94, Mage = 3.03 years, 47% males, 77% White, 20% Latinx, data collected 2013-2017). Proximal stressors were operationalized as changing task demands (baseline, challenge, recovery) across a dyadic puzzle task. Distal stressors were measured as parent-reported stressful life events. Multilevel models revealed that greater proximal and distal stressors were related to weaker dynamic self-regulation of RSA in mothers, fathers, and children, and more discordant mother-child and father-child coregulation of RSA. Findings affirm that stress is transmitted across levels and persons to compromise real-time regulatory functioning in early, developmentally formative caregiver-child interactions.

The dyadic regulation approach of coping and illness representations in female cancer patients and their partners.

Adjustment to any illness is a 'dyadic' process whereby patients and their partners mutually determine each other's perceptions, behaviours, and well-being. The present study explored the association between dyadic coping strategies and illness representations in newly diagnosed female cancer patients and their partners. The sample consisted of 92 female cancer patient-partner pairs from 3 oncology hospitals in Greece and Cyprus. The Actor Partner Interdependence Model was applied to test for dyadic regulation effects. The findings revealed that patients' evaluations of dyadic coping were related to their own illness representations and, in some cases, to partners' illness representations of control. However, partner evaluations of dyadic coping were not associated with either patients' or their own illness representations. Relationship satisfaction did not moderate the relationship between dyadic coping and illness representations. The study suggests that patients' perceptions of support provided by themselves and their partners play a significant role in shaping their illness representations. Future research could delve into the underlying reasons for the observed differences in the impact of dyadic coping on illness representations between patients and partners, considering factors such as gender roles and specific gender-related issues.

Breastfeeding at Any Cost? Adverse Effects of Breastfeeding Pain on Mother-Infant Behavior.

Breast milk is considered the ideal infant nutrition, and medical organizations encourage breastfeeding worldwide. Moreover, breastfeeding is often perceived as a natural and spontaneous socio-biological process and one of the fundamental roles of new mothers. While breastfeeding is beneficial, little scientific consideration has been given to its potential psychological challenges. Here, we investigate the phenomenon of breastfeeding pain in mothers and its association with maternal and infant behavioral regulation. During the postpartum weeks, the mother-infant dyad can be considered one allostatic unit directed at infant regulation and development. We hypothesize that pain comprises an allostatic challenge for mothers and will thus impair the capacity for dyadic regulation. To test this, we recruited 71 mothers with varying levels of breastfeeding pain and videotaped them with their infants (2-35 weeks old) during spontaneous face-to-face interactions. We quantified the individual differences in dyadic regulation by behaviorally coding the second-by-second affective expressions for each mother and infant throughout their interactions. We tested the extent to which breastfeeding pain alters affect regulation during mother-infant interactions. We discovered that mothers with severe breastfeeding pain express less affective expressions and less infant-directed gaze during interactive moments of engagement and play than mothers with no or moderate pain. Moreover, infants of mothers experiencing pain during breastfeeding express less affective expressions and more mother-directed gaze while interacting with their mothers than infants of mothers who are not in pain. This demonstrates that the allostatic challenge of maternal pain interferes with the behavioral regulation of both mothers and infants. Since the mother-infant dyad is a codependent allostatic unit, the allostatic challenges of one partner can impact the dyad and thus potentially impact child development, bonding, and mother and infant well-being. The challenges of breastfeeding should be considered in addition to the nutritional advances.

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

BackgroundAssociations between parent and child cortisol levels (“cortisol synchrony”) are often reported and positive synchrony may mark dyadic regulation on a physiological level. Although dyadic behavior during interaction and adolescent borderline personality disorder (BPD) traits are linked with individual and dyadic regulatory capacities, little is known about how both factors influence parent-adolescent cortisol synchrony. We hypothesized that cortisol synchrony would differ depending on behavioral synchrony, i.e., smooth reciprocal dyadic interaction patterns, adolescent BPD traits, and their interactions.MethodsMultilevel state-trait modeling was implemented to investigate associations between concurrent mother-adolescent state cortisol and mother-adolescent average cortisol levels in a community sample of 76 mother-adolescent dyads. Three saliva samples were collected across interaction paradigms. Behavioral synchrony was observed, and adolescent BPD traits were evaluated using clinical interviews.ResultsFirst, behavioral synchrony and absence of BPD traits were linked with positive associations between adolescent and maternal state cortisol (positive synchrony), BPD traits with negative associations (negative synchrony). When interaction effects were examined, results were more nuanced. In low-risk dyads (higher behavioral synchrony, no BPD traits) asynchrony was found. When risk (BPD traits) and resource (higher behavioral synchrony) were combined, synchrony was positive. Lastly, in high-risk dyads (lower behavioral synchrony, adolescent BPD traits), negative synchrony was observed. Average adolescent and maternal cortisol levels were consistently positively associated in dyads with higher risk.ConclusionsPositive dyadic interaction patterns are associated with positive state cortisol synchrony in mother-adolescent dyads and could buffer the effect of BPD traits, possibly supporting the process of physiological regulation.

Positive illusions about dyadic perspective-taking as a moderator of the association between attachment insecurity and marital satisfaction.

Attachment insecurity (i.e., attachment anxiety or avoidance) puts people at risk for dissatisfying relationships. However, the dyadic regulation model of insecurity buffering suggests that an understanding and responsive partner may help insecure individuals to regulate emotions, thus improving couples' relationships. It may also be that perceiving partners as understanding and empathic, especially in an exaggeratedly positive way (i.e., positive illusions) will buffer insecurity. In 196 mixed-gender newlywed couples, we investigated whether spouses' positive illusions about partner's dyadic perspective-taking moderated the association between spouses' attachment insecurity and spouses' and partners' marital satisfaction over two years. Positive illusions generally predicted more satisfying relationships and attachment avoidance consistently predicted more dissatisfying relationships. There were also several instances where multilevel modeling indicated that positive illusions of dyadic perspective-taking buffered the negative effects of attachment avoidance on relationship satisfaction. However, there was also potentiation such that in two instances, positive illusions about dyadic perspective-taking strengthened the association between spouses' insecurity (husbands' attachment anxiety and wives' attachment avoidance) and subsequent marital dissatisfaction. In the moment, positive illusions about dyadic perspective-taking may allow spouses to feel happy in their relationship despite fear of emotional intimacy; however, positive illusions may not continue to buffer effects of insecurity on subsequent relationship satisfaction and may even be harmful in the face of insecurity.

Teaching self-efficacy and its effects on quality of bedside teaching: Findings from a multi-center survey.

Introduction: Evidence suggests that the performance of medical students is affected by the quality of teaching of clinical teachers, and the higher teachers’ teaching quality leads to better students’ clinical performance. Hence, the present research aimed to investigate the association between teaching self-efficacy and quality of bedside teaching among medical teachers.Methods: This is a cross-sectional study. To this end, 242 medical teachers and 830 medical students from 6 universities in different cities were selected using convenience sampling. The medical teachers filled out Physician Teaching Self-Efficacy Questionnaire (α=0.93), and medical students completed the quality of bedside teaching questionnaire (BST) (α=0.91). Confirmatory factor analysis (CFA), Pearson correlation coefficient, and multiple regression were used to analyze the collected data through SPSS 23 and Smart-PLS3 software.Results: The results of confirmatory factor analysis (CFA) demonstrated that all items and measurement models had adequate reliability and validity to enter the final analysis (α>0.7, CR>0.7 AND AVE>0.50). Furthermore, the results showed teaching self-efficacy (r=0.27, p<0.001) and its components including self-regulation (r=0.24, p<0.001), dyadic regulation (r=0.22, p<0.001), and triadic regulation (r=0.33, p<0.001) had a positive and significant relationship with quality of bedside teaching. Also, the results of multiple regression revealed that among the predictor variables, only the triadic regulation variable could predict the quality of bedside teaching of medical teachers (β=0.326, p<0.001). Conclusion: According to the findings, as the medical teachers’ teaching self-efficacy improves, they can provide high-quality teaching to students, which in turn will lead to better learning and, therefore better performance for medical students.

The relation of partners’ illness representations to the coping behaviors of patients with inflammatory rheumatic diseases through patients’ illness representation: A dyadic regulation process

The relation of partners’ illness representations to the coping behaviors of patients with inflammatory rheumatic diseases through patients’ illness representation: A dyadic regulation process

Partners' Consensus About Joint Effort and COVID-19 Prevention Among Sexual Minority Men.

The current study examined the relevance of relationship functioning to partners’ agreement or consensus about joint effort surrounding COVID-19 prevention. Interdependence theory has been widely used to understand how relationship partners influence health behavior, including how sexual minority male (SMM) couples regulate HIV risk. Couples with better relationship functioning tend to be more successful at negotiating joint (shared) goals and subsequently accomplishing them. The study recruited 134 cis-male, SARS-CoV-2 negative adults in relationships with cis-male partners from phone-based social networking applications. Participants completed an online survey assessing relationship functioning (Perceived Relationship Components Questionnaire), COVID-19 prevention behaviors, and risk perceptions. Partners’ consensus around joint COVID-19 prevention effort was assessed using an adapted version of the Preferences for Sexual Health Outcomes scale. Path analyses indicated that consensus for joint prevention effort predicted social distancing (B = 0.23; p = .001) and the number of other COVID-19 prevention behaviors engaged in (B = 0.17; p = .003) above and beyond perceived risk and relationship functioning. Relationship satisfaction predicted higher levels of consensus for joint COVID-19 prevention effort (B = 0.40; p = .029). Findings suggest that the theoretical foundations of successful HIV prevention interventions that utilize joint goal formation may generalize to the prediction of COVID-19 prevention behavior and may be leveraged to mitigate the risk of SARS-CoV-2 infection among SMM in relationships. Interventions that overlook the potential for dyadic regulation of health behavior may miss opportunities to capitalize on shared coping resources and fail to address relational barriers to prevention.

Emotion regulation from infancy to toddlerhood: Individual and group trajectories of full-term and very-low-birthweight preterm infants.

Adaptive emotion regulation begins with infants operating jointly with their parents to regulate their emotions, which fosters the development of independent regulation. Little is known about when or how this transition occurs, or the impact of factors such as parental availability or premature birth status. The current study examined the use of self-soothing, attentional distraction, and dyadic regulation in full-term and healthy very-low-birthweight (VLBW) preterm infant-mother dyads at 5 ½, 12, and 18months of age. At 5 ½ months, dyads participated in the Still-Face procedure. At 12 and 18months, dyads participated in two free-play interactions, a puzzle task, and an interference task. Emotion regulation behaviors were coded using two systematic, observational systems. Results indicated that infants used less self-soothing and attentional distraction and more dyadic regulation as they aged. Increased use of self-soothing at earlier ages predicted increased use of dyadic regulation at subsequent ages. Toddlers used more independent, attention-seeking, and escape behavior during periods of maternal unavailability. There were no significant differences between full-term and VLBW/preterm toddlers' emotion regulation behaviors. Results from the current study contribute to the understanding of normative development of emotion regulation and the risk associated with prematurity.

Examining the Effects of Relationship Education for Same-Sex Couples: A Randomized Control Trial

Relationship education programs are designed to enhance a variety of relationship characteristics related to building knowledge and skills for healthy relationships. Same-sex couples represent a high-risk group that would benefit from relationship education based on unique challenges such as heterosexist discrimination that impact relationships and the mental health of individuals who identity as sexual minorities. The aim of this investigation was to examine the efficacy of relationship education on improving dyadic coping, emotional regulation, and psychological distress for same-sex couples (N = 52) who were enrolled in a randomized control trial testing PREP’s Within Our Reach. Results indicate significant positive effects on individual distress symptoms for couples assigned to the intervention. Implications and suggestions for future research are provided.

A new perspective on dyadic regulation in chronic illness: the dyadic regulation connectivity model

ABSTRACT Several theoretical models have described the ways that patients and partners respond to a health problem. Most of these models are faced with limitations regarding the role of cognitive/emotional appraisals and coping behaviors, and the potential interactions between individual and dyadic variables. Therefore, new theoretical approaches are needed to capture the multiple processes that take place within dyadic adaptation to illness. Here, the major aspects of the dyadic adaptation/dyadic coping models are reviewed and their limitations are outlined. Moreover, a new theoretical approach to the dyadic-regulation processes that are important for adaptation to illness is proposed. The Dyadic-Regulation Connectivity Model emphasizes the concept of system connectivity and the role of central network hubs in dyadic regulation. Network hubs represent the common ‘space’ between intra- and inter-personal processes, and are closely connected to each other. The model posits that dyadic regulation processes evolve over time, all network hubs are fully responsive to changes in any part of the mechanism, while the entire mechanism is nested within the self- and the dyadic-system, the illness, and the broader socio-cultural contexts. The theoretical and research implications of the proposed model are also discussed.

Attachment and sleep: A dyadic intensive longitudinal actigraphy study

Attachment and sleep are linked across the lifespan, but attachment regulation of sleep among couples is understudied. This study aimed to replicate and extend prior research by testing whether romantic partners’ attachment orientations interacted to predict sleep, assessed via self-report and actigraphy over 14 days. Participants ( N = 208 couples) completed measures of attachment anxiety and avoidance and the Pittsburgh Sleep Quality Index. They also wore actigraphy monitors to assess nightly sleep quality and duration. Anxious people self-reported worse sleep quality, replicating two prior studies. In contrast to previous studies, anxious and low-avoidant people slept significantly worse with avoidant partners, while avoidant people slept somewhat better with avoidant partners. Results indicted dyadic regulation of several sleep outcomes and provided new insights regarding how partner avoidance can exacerbate or buffer sleep quality.

Clinical recommendations for psychotherapists working during the coronavirus (COVID-19) pandemic through the lens of AEDP (Accelerated Experiential Dynamic Psychotherapy)

ABSTRACT The coronavirus (COVID-19) pandemic created an unprecedented physical and mental health crisis on an international scale. Clients and therapists alike navigated the fears and uncertainty surrounding the virus, often in an environment of social isolation. The following paper presents a brief overview of the unique stressors and psychosocial factors impacting therapeutic work in the time of the coronavirus pandemic, including fears of the virus and social transmission, relational stressors due to isolation, grieving in isolation, fear of death, financial challenges, and the transition to telehealth. In addition, this paper aims to provide specific interventions and helpful approaches for psychotherapists navigating the novel challenges and demands to their clinical work through an AEDP (Accelerated Experiential Dynamic Psychotherapy) perceptive. This includes finding an entry point for accessing the pain: undoing aloneness; moving through the pain: dyadic affect regulation; and paying close attention to vitality within suffering: searching for transformance. Recommendations for the health and care of the clinician are also discussed, such as attuning to self-needs, anticipating and detecting dysregulation, staying with the good, meaning-making, identifying and responding to burnout, and the importance of receiving personal therapy and clinical supervision.

Regulation between daily exhaustion and support in parenting: A dyadic perspective

The current article serves a dual purpose: to highlight the overlooked and recent concept of parenting-related exhaustion and to propose a specific methodology to test concurrent variations of the parent’s exhaustion with the partner’s exhaustion and her or his perceived and given support. Questionnaire data were collected from 97 mother–father couples over the course of 5 consecutive days. Results from multilevel model analyses revealed day-to-day dyadic variations as well as day-to-day regulation occurring in parental couples. The dyadic variations were shown by the fact that over the week, on the days when one parent felt more exhausted, the other parent’s exhaustion was also high. Dyadic regulation meant that greater exhaustion felt by one parent was associated with greater support from her or his partner. Partner’s extra support was both perceived by the exhausted parent and reported by the support provider (i.e., the partner).

Typologies of dyadic mother-infant emotion regulation following immunization

Mother-infant dyadic emotion regulation – the joint modulation of affective rhythms as interactive partners dynamically respond to each other across time – has been shown to promote social-emotional wellbeing both during and beyond infancy. Although contributions of dyadic regulation to self-regulatory development may particularly apparent during infant distress, studies have traditionally examined dyadic regulation in low-stress contexts. The present study addresses this gap by identifying distinct patterns of mother-infant dyadic emotion regulation following a highly distressing immunization procedure and then examining how these groups differed in mother and infant personality and temperament characteristics. Mother-infant dyads (N = 131) were videotaped during a routine immunization procedure, and infant crying and maternal soothing behaviors were subsequently coded. Cluster analysis was applied to trajectories of latent states representing each dyad’s post-immunization behaviors. Results indicated five typologies of dyadic regulation following infant immunization. These typologies reflected the effectiveness with which the dyad worked together to soothe infant distress, as well as the specific maternal soothing behaviors employed. Differences in maternal personality and infant temperament among clusters indicated that both mothers and infants contributed to the dynamic regulatory process.

Methylation matters: FK506 binding protein 51 (FKBP5) methylation moderates the associations of FKBP5 genotype and resistant attachment with stress regulation.

The parent-child attachment relationship plays an important role in the development of the infant's stress regulation system. However, genetic and epigenetic factors such as FK506 binding protein 51 (FKBP5) genotype and DNA methylation have also been associated with hypothalamus-pituitary-adrenal axis functioning. In the current study, we examined how parent-child dyadic regulation works in concert with genetic and epigenetic aspects of stress regulation. We study the associations of attachment, extreme maternal insensitivity, FKBP5 single nucleotide polymorphism 1360780, and FKBP5 methylation, with cortisol reactivity to the Strange Situation Procedure in 298 14-month-old infants. The results indicate that FKBP5 methylation moderates the associations of FKBP5 genotype and resistant attachment with cortisol reactivity. We conclude that the inclusion of epigenetics in the field of developmental psychopathology may lead to a more precise picture of the interplay between genetic makeup and parenting in shaping stress reactivity.

Psychometric properties of the newly developed Physician Teaching Self-Efficacy Questionnaire (PTSQ).

BackgroundHigh teaching quality and students’ corresponding learning progress are the most important indicators of teachers’ work performance. Theory and numerous empirical studies indicate that self-efficacy, a person’s belief in her or his ability to accomplish a task, is an important predictor of work performance. Accordingly, it can be assumed that teaching self-efficacy also influences teaching performance and students’ learning progress with regard to physicians who teach in undergraduate medical education. Therefore, the aim of this study was to develop and validate an instrument measuring clinical teaching self-efficacy in physicians.MethodsWe developed 16 items reflecting physicians’ beliefs to provide high quality clinical teaching when facing regularly occurring critical teaching situations. These constitute the Physician Teaching Self-Efficacy Questionnaire (PTSQ). For its validation, we used data from a sample of 247 physicians from internal medicine and surgery at six German medical faculties. Regarding factorial validity, we performed exploratory structural equation modelling (ESEM) as well as confirmatory factor analysis (CFA). Regarding criterion validity, correlations with the scales of the Physician Teaching Motivation Questionnaire (PTMQ), teaching experience and perceived teaching involvement were calculated. Additionally, we conducted the same analyses with a short 6-item version.ResultsESEM delivered evidence for a three-factor structure with a superordinate general factor, which was confirmed by local and global fit indicators in CFA (RMSEA = .055, TLI = .939, SRMR = .048, CFI = .948). We identified the following three subfactors: teaching self-efficacy with respect to self-regulation, dyadic regulation involving students, and triadic regulation involving students and patients. Internal consistencies indicated acceptable to excellent reliability for all scales (Cronbach’s alpha = .77–.90). Theory-consistent correlations with the PTMQ scales, teaching experience, and teaching involvement confirmed criterion validity. Besides excellent global fit, the short version of the PTSQ also fulfilled all other validity criteria.ConclusionsThe PTSQ is a valid instrument to assess physicians’ clinical teaching self-efficacy. It could be used in faculty development programmes and for educational research. The short version could be used in situations that are time-critical for physicians in order to ensure high response rates.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0764-4) contains supplementary material, which is available to authorized users.

Partner Buffering of Attachment Insecurity

Compared with securely attached people, insecurely attached people have romantic relationships that are less happy and more unstable, but the quality of their relationships should depend on how their partners regulate them. Some partners find ways to buffer (emotionally and behaviorally regulate) insecurely attached individuals, which helps such individuals feel better and behave more constructively and improves the relationship. Understanding when and how this important interpersonal process works requires a dyad-centered approach. The present research describes core tenets of attachment theory and the two forms of attachment insecurity (anxiety and avoidance) and presents our dyadic regulation model of insecurity buffering, which explains how and why certain types of buffering behaviors soothe the worries and improve the relationship perceptions and behaviors of anxious or avoidant people. Studies that illustrate ways in which partners can successfully buffer the insecure reactions of anxious and avoidant individuals are reviewed, and other traits and social contexts to which our model can be applied are also discussed.

Early experience, structural dissociation, and emotional dysregulation in borderline personality disorder: the role of insecure and disorganized attachment.

Persistent problems in emotional regulation and interpersonal relationships in borderline patients can be understood as developing from difficulties in early dyadic regulation with primary caregivers. Early attachment patterns are a relevant causal factor in the development of Borderline Personality Disorder (BPD).Links between attachment issues, early history of neglect, and traumatic experiences, and symptoms observed in patients with BPD as per the DSM-5 classification (American Psychiatric Association: Diagnostic and statistical manual of mental disorders: DSM-5 (Fifth ed.). Washington, D.C; (2013)) are described in this article, while delineating possible pathways from attachment disruptions to the specific symptomatology of these patients. The theory of structural dissociation of the personality (TSDP) provides an essential framework for understanding the processes that may lead from insecure early attachment to the development and maintenance of BPD symptoms.Dyadic parent–child interactions and subsequent modulation of emotion in the child and future adult are considered closely related, but other factors in the development of BPD, such as genetic predisposition and traumatic experiences, should also be considered in conceptualizing and organizing clinical approaches based on a view of BPD as a heterogeneous disorder.

The self-healing forest: Between self-regulation and dyadic regulation

Throughout the history of body psychotherapy, self-regulation in general and somatic self-regulation in particular were a central concept. This study examines the development of theoretical, clinical and applicatory aspects of self- and dyadic regulation through academic, clinical and personal accounts. It explores the presuppositions behind self-regulation and proposes that dyadic regulation, which is based on intersubjectivity, has both regressive and generative aspects. Thus, this study links psychoanalytic thinking with systemic theory and contemporary body psychotherapeutic principles. This study is based on a talk given in the 13th EABP conference in Cambridge.