Physiological indicators for personalized medicine: Toward optimal behavioral interventions for at-risk children

Personalized healthcare has the potential to optimize the effectiveness of behavioral interventions. Recent research supported by the NICHD and NIDA, and co-funded by the OBSSR, looked at how certain biological factors may influence how youth respond to different formats (group versus individual) of a proven intervention for aggression. Coping Power, a school-based intervention program used to address behavior problems in at-risk youth, has been associated with reductions in the rates of substance use, delinquency, aggression, and improved behavior and social competence. However, based on previous studies, it is likely that a group-based format is not equally effective for all youth and that these differences in response may be partially explained by individual characteristics. Researchers assessed biological markers of sympathetic nervous system (responsible for “fight or flight” behavior) and parasympathetic functioning, by measuring skin conductance level (SCL) and respiratory sinus arrhythmia (RSA). SCL assesses sweat gland activity (an indicator of physiological arousal), while resting SCL is considered a marker of sympathetic nervous system activity. RSA is an index of parasympathetic nervous system functioning and a peripheral marker of self-regulation. Children (n = 360, mean age = 9.7, 64.8 percent boys, 76.4 percent African American) included in this study were recruited from 20 elementary schools for a randomized controlled trial (RCT) examining the relative effectiveness of group and individual formats of the Coping Power intervention. Longitudinal assessments of teacher- and parent-reported proactive and reactive aggression were collected through a 1-year follow-up. Results indicated that children with higher initial levels of aggression and lower parasympathetic functioning showed greater reductions aggression in the individual Coping Power condition compared to the group condition. In contrast, children with high parasympathetic functioning had no differential effect of intervention format. These findings suggest that physiological indicators, such as RSA and/or SCL, may be useful in future studies that examine differential responses of children to different types of interventions.

Citation: Glenn AL, Lochman JE, Dishion T, Powell NP, Boxmeyer C, Kassing F, Qu L, Romero D. 2019. Toward Tailored Interventions: Sympathetic and Parasympathetic Functioning Predicts Responses to an Intervention for Conduct Problems Delivered in Two Formats. Sci. 20(1):30-40.

To be or not to be virtuous; is it in our genes?

Developing a virtuous character (contentiousness and responsibility) in adolescence directly influences well-being, prosocial behavior, and civic engagement in adulthood. It has been well documented that virtuous character development in children is correlated with parenting behavior, but do genetic influences also play a role? In a recent research publication supported by the NIMH, NICHD, Institute of Education Sciences, William T. Grant Foundation, and the John Templeton Foundation, researchers sought to disentangle the underlying mechanisms driving adolescents' character development by using a behavioral genetics approach to determine whether associations among parenting, adolescent responsibility, and young adult conscientiousness have unique and common heritable and/or environmental influences. Researchers used a longitudinal twin/sibling study (Nonshared Environment and Adolescent Development [NEAD]) which has 720 families (48.4 percent female) with same-sex twin and sibling pairs residing in two-parent (married) households. Behavioral measures were collected via self-report and other standardized questionnaires and included zygosity (to determine physical similarity), parental negativity and positivity, adolescent responsibility (conscientiousness, dependability, and responsibility toward others), and conscientiousness. Analyses were conducted using structural equation modeling to disentangle heritable and environmental influences. The findings from this study demonstrate that the associations between parenting style and moral character development have both heritable and environmental influences. Additionally, this study provides contextualization for the development of virtuous character behaviors that are specific for adolescents and young adults. These results have implications for school-based interventions that have been used to facilitate virtuous character development in children and adolescence, which are effective only ~50 percent the time, with the lowest efficacy during adolescence. Results of this study may help to explain the modest efficacy of these interventions since these interventions often are not tailored to account for important parental behaviors during adolescence and/or heritable influences.

Citation: Ramos AM, Griffin AM, Neiderhiser JM; Reiss D. 2019. Did I Inherit My Moral Compass? Examining Socialization and Evocative Mechanisms for Virtuous Character Development. Behav Genet. doi: 10.1007/s10519-018-09945-4. [Epub ahead of print].

Emotional control may be key to managing type 1 diabetes in adolescents

More than 75 percent of adolescents with type 1 diabetes do not meet the American Diabetes Association’s clinical guidelines for glycemic control. This is often due to difficulties in adolescents’ adhering to complex medical regimens, including multiple daily self-monitoring of blood glucose (SMBG). Self-regulation—the ability to modulate cognitions, emotions, and behaviors toward long-term goals—is a key individual difference that has been associated with adherence behaviors in adolescents. Previously, a randomized controlled trial of a novel web-delivered multicomponent intervention for adolescents with type 1 diabetes had positive results, with improved SMBG and improved glycemic control at the 6- and 12-month follow-ups. However, it was not known what mediated these improvements and if the intervention benefited any subgroup of adolescents. In a secondary analysis supported by the NICHD and NIDA, and co-funded by the OBSSR, researchers investigated both a key mediator (changes in SMBG) and moderator (problems with emotional control) of the previously established benefits. Subjects were adolescents with type 1 diabetes and above-target glycemic control (n = 61) and were randomized to receive the 6-month intervention (n = 30) or usual care (n = 31). Emotional control, frequency of SMBG, and measurements of glycemic control (HbA1c) were assessed at baseline and 6 months later. To test if improvements in SMBG mediated the benefits of treatment on lower HbA1c and if those effects were moderated by adolescent problems with emotional control, baseline corrected structural equation models were used. At the 6-month follow-up, improvements in SMBG mediated the treatment effects of the intervention on improved glycemic control (lower average HbA1c). Furthermore, problems in emotional control moderated the benefits of the intervention on improvements in SMBG and in turn HbA1c. Only adolescents who had greater emotional control problems showed improvements in SMBG in response to treatment, which then explained lower HbA1c levels at 6-month follow-up. This multicomponent, web-delivered intervention provided unique benefits for improving SMBG and lowering HbA1c in teens with higher problems in emotional control. The findings of this study suggest that simultaneously targeting biological and psychological processes may be useful in optimizing and targeting interventions for adolescents with type 1 diabetes.

Citation: Lansing AH, Stoianova M, Stanger C. 2019. Adolescent Emotional Control Moderates Benefits of a Multicomponent Intervention to Improve Type 1 Diabetes Adherence: A Pilot Randomized Controlled Trial. J Pediatr Psychol. 44(1):126–136.