Diana Whalen | University of Pittsburgh (original) (raw)
Papers by Diana Whalen
Journal of adolescence, Jan 15, 2015
Despite findings of an association between adolescent psychopathology and perceived parental crit... more Despite findings of an association between adolescent psychopathology and perceived parental criticism, the relation between adolescent borderline personality disorder (BPD) symptoms and perceived parental criticism has not been examined. Given the centrality of interpersonal sensitivity to BPD (relative to other forms of psychopathology), we hypothesized that adolescent BPD symptoms would be uniquely related to perceived caregiver criticism, above and beyond other forms of psychopathology and general emotion dysregulation. Adolescents (N = 109) in a residential psychiatric treatment facility completed self-report measures of BPD symptoms, perceived caregiver criticism, emotion dysregulation, and symptoms of depression, anxiety, and posttraumatic stress disorder. Results revealed a unique relation of adolescent BPD symptoms to perceived caregiver criticism, above and beyond age, gender, and other forms of psychopathology. Findings suggest that adolescent BPD symptoms may have unique...
Journal of Pediatric …, Jan 1, 2011
Objective This study examines relationships between affect and sleep in youth with affective diso... more Objective This study examines relationships between affect and sleep in youth with affective disorders using ecological momentary assessment (EMA). Methods Participants included 94 youth, ages 8-16 (M ¼ 11.73, 53% female) years with an anxiety disorder only (n ¼ 23), primary major depressive disorder (with and without a secondary anxiety diagnoses; n ¼ 42), and healthy controls (n ¼ 29). A cell phone EMA protocol assessed affect and actigraphy measured sleep. Results The patterns of bidirectional relationships between affect and sleep differed across diagnostic groups. Higher daytime positive affect and positive to negative affect ratios were associated with more time in bed during the subsequent night for youth with primary depression and less time in bed for youth with anxiety only. More time asleep was associated with more positive affect for both diagnostic groups the following day. Conclusions This relationship may be important to consider in the treatment of youth affective disorders.
Children of mothers with Borderline Personality Disorder (BPD) should be considered a high-risk g... more Children of mothers with Borderline Personality Disorder (BPD) should be considered a high-risk group given the wide array of poor psychosocial outcomes that have been found in these children. This article describes the parenting strategies that might explain the transmission of vulnerability from mothers with BPD to their offspring, from infancy through adolescence. We conclude that oscillations between extreme forms of hostile control and passive aloofness in their interactions with their children may be unique to mothers with BPD. We provide an overview of interventions that are currently recommended for mothers and family members with BPD, namely attachment therapy and psychoeducational approaches. On the basis of an integration of the empirical findings on parenting and child outcomes, as well as from the review of current approaches to intervention, we conclude with recommendations for treatment targets. We argue that mothers with BPD need psychoeducation regarding child development and recommended parenting practices and skills for providing consistent warmth and monitoring, including mindfulness-based parenting strategies.
Abstract 1. Responds to comments from Alan Fruzzetti (see record 2012-00570-001), Karlen Lyons-Ru... more Abstract 1. Responds to comments from Alan Fruzzetti (see record 2012-00570-001), Karlen Lyons-Ruth (see record 2012-00570-002), Jenny Macfie (see record 2012-00570-003), and Maureen Zalewski and Liliana Lengua (see record 2012-00570-004) on the authors original article Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention (see record 2011-05873-001). Each of these distinguished scholars affords a unique perspective on issues related to parenting with ...
Journal of Experimental …, Jan 1, 2010
This study utilized a new cellular phone ecological momentary assessment approach to investigate ... more This study utilized a new cellular phone ecological momentary assessment approach to investigate daily emotional dynamics in 47 youth with Major Depressive Disorder (MDD) and 32 no psychopathology controls (CON), ages 7 -17. Information about emotional experience in the natural environment was obtained using answer-only cellular phones while MDD youth received an 8 week course of cognitive behavioral therapy and/or psychopharmacological treatment. Compared to CON youth, MDD youth reported more intense and labile global negative affect, greater sadness, anger, and nervousness, and a lower ratio of positive to negative affect. These differences increased with pubertal maturation. MDD youth spent more time alone and less time with their families than CON youth. Although differences in emotional experiences were found across social contexts, MDD youth were more negative than CON youth in all contexts examined. As the MDD participants progressed through treatment, diagnostic group differences in the intensity and lability of negative affect decreased, but there were no changes in the ratio of positive to negative affect or measures of social context. We discuss methodological innovations and advantages of this approach, including improved ecological validity and access to information about variability in emotions, change in emotions over time, the balance of positive and negative emotions, and the social context of emotional experience.
Journal of clinical …, Jan 1, 2009
This study examined Expressed Emotion in the families of children and adolescents who were: (1) i... more This study examined Expressed Emotion in the families of children and adolescents who were: (1) in a current episode of Major Depressive Disorder (MDD), (2) in remission from a past episode of MDD, (3) at high familial risk for developing MDD, and (4) low-risk controls. Participants were 109 mother-child dyads (children ages 8-19). Expressed emotion was assessed using the Five Minute Speech Sample. Psychiatric follow-ups were conducted annually following the Five Minute Speech Sample assessment. Mothers of children with a current or remitted episode of MDD and at high risk for MDD were more likely to be rated high on Criticism than mothers of controls. There were no differences in critical expressed emotion among mothers of children in the current, remitted, or highrisk for depression groups. Higher initial critical expressed emotion was associated with a greater likelihood of having a future onset of a depressive episode in high-risk and depressed participants. Diagnostic groups did not differ in Emotional Overinvolvement. Findings suggest that expressed emotion that is critical in nature may be a relatively stable characteristic feature of the family environments of children with and at high-risk for depression, and may be important in understanding the onset and clinical course of child adolescent depressive disorders.
Journal of pediatric …, Jan 1, 2008
Objective Sleep problems are a cardinal symptom of depression in children and adolescents and caf... more Objective Sleep problems are a cardinal symptom of depression in children and adolescents and caffeine use is a prevalent and problematic issue in youth; yet little is known about caffeine use and its effects on sleep in youth with depression. We examined caffeine use and its relation to sleep and affect in youth's natural environments. Methods Thirty youth with major depressive disorder (MDD) and 23 control youth reported on caffeine use, sleep, and affect in their natural environment using ecological momentary assessment at baseline and over 8 weeks, while MDD youth received treatment. Results Youth with MDD reported more caffeine use and sleep problems relative to healthy youth. Youth with MDD reported more anxiety on days they consumed caffeine. Caffeine use among youth with MDD decreased across treatment, but sleep complaints remained elevated. Conclusions Findings suggest that both sleep quality and caffeine use are altered in pediatric depression; that caffeine use, but not sleep problems, improves with treatment; and that caffeine may exacerbate daily anxiety among youth with depression.
Development and …, Jan 1, 2009
This study investigated pupillary and behavioral responses to an emotional word valence identific... more This study investigated pupillary and behavioral responses to an emotional word valence identification paradigm among 32 pre/early and 34 mid/late pubertal typically developing children and adolescents. Participants were asked to identify the valence of positive, negative, and neutral words while pupil dilation was assessed using an eye-tracker. Mid-to-late pubertal children showed greater peak pupillary reactivity to words presented during the emotional word identification task than pre-to-early pubertal children, regardless of word valence. Mid-to-late pubertal children also showed smaller sustained pupil dilation than pre-to-early pubertal children after the word was no longer on screen. These findings were replicated controlling for participants’ age. Additionally, mid-to-late pubertal children had faster reaction times to all words, and rated themselves as more emotional during their laboratory visit compared to pre-to-early pubertal children. Greater recall of emotional words following the task was associated with mid-to-late pubertal status, and greater recall of emotional words was also associated with higher peak pupil dilation. These results provide physiological, behavioral, and subjective evidence consistent with a model of puberty-specific changes in neurobehavioral systems underpinning emotional reactivity.
Development and …, Jan 1, 2007
This article offers a multilevel perspective on resilience to depression, with a focus on interac... more This article offers a multilevel perspective on resilience to depression, with a focus on interactions among social and neurobehavioral systems involved in emotional reactivity and regulation. We discuss models of cross-contextual mediation and moderation by which the social context influences or modifies the effects of resilience processes at the biological level, or the biological context influences or modifies the effects of resilience processes at the social level. We highlight the socialization of emotion regulation as a candidate process contributing to resilience against depression at the social context level. We discuss several factors and their interactions across levels-including genetic factors, stress reactivity, positive affect, neural systems of reward, and sleep-as candidate processes contributing to resilience against depression at the neurobehavioral level. We then present some preliminary supportive findings from two studies of children and adolescents at high risk for depression. Study 1 shows that elevated neighborhood level adversity has the potential to constrain or limit the benefits of protective factors at other levels. Study 2 indicates that ease and quickness in falling asleep and a greater amount of time in deep Stage 4 sleep may be protective against the development of depressive disorders for children. The paper concludes with a discussion of clinical implications of this approach.
Journal of adolescence, Jan 15, 2015
Despite findings of an association between adolescent psychopathology and perceived parental crit... more Despite findings of an association between adolescent psychopathology and perceived parental criticism, the relation between adolescent borderline personality disorder (BPD) symptoms and perceived parental criticism has not been examined. Given the centrality of interpersonal sensitivity to BPD (relative to other forms of psychopathology), we hypothesized that adolescent BPD symptoms would be uniquely related to perceived caregiver criticism, above and beyond other forms of psychopathology and general emotion dysregulation. Adolescents (N = 109) in a residential psychiatric treatment facility completed self-report measures of BPD symptoms, perceived caregiver criticism, emotion dysregulation, and symptoms of depression, anxiety, and posttraumatic stress disorder. Results revealed a unique relation of adolescent BPD symptoms to perceived caregiver criticism, above and beyond age, gender, and other forms of psychopathology. Findings suggest that adolescent BPD symptoms may have unique...
Journal of Pediatric …, Jan 1, 2011
Objective This study examines relationships between affect and sleep in youth with affective diso... more Objective This study examines relationships between affect and sleep in youth with affective disorders using ecological momentary assessment (EMA). Methods Participants included 94 youth, ages 8-16 (M ¼ 11.73, 53% female) years with an anxiety disorder only (n ¼ 23), primary major depressive disorder (with and without a secondary anxiety diagnoses; n ¼ 42), and healthy controls (n ¼ 29). A cell phone EMA protocol assessed affect and actigraphy measured sleep. Results The patterns of bidirectional relationships between affect and sleep differed across diagnostic groups. Higher daytime positive affect and positive to negative affect ratios were associated with more time in bed during the subsequent night for youth with primary depression and less time in bed for youth with anxiety only. More time asleep was associated with more positive affect for both diagnostic groups the following day. Conclusions This relationship may be important to consider in the treatment of youth affective disorders.
Children of mothers with Borderline Personality Disorder (BPD) should be considered a high-risk g... more Children of mothers with Borderline Personality Disorder (BPD) should be considered a high-risk group given the wide array of poor psychosocial outcomes that have been found in these children. This article describes the parenting strategies that might explain the transmission of vulnerability from mothers with BPD to their offspring, from infancy through adolescence. We conclude that oscillations between extreme forms of hostile control and passive aloofness in their interactions with their children may be unique to mothers with BPD. We provide an overview of interventions that are currently recommended for mothers and family members with BPD, namely attachment therapy and psychoeducational approaches. On the basis of an integration of the empirical findings on parenting and child outcomes, as well as from the review of current approaches to intervention, we conclude with recommendations for treatment targets. We argue that mothers with BPD need psychoeducation regarding child development and recommended parenting practices and skills for providing consistent warmth and monitoring, including mindfulness-based parenting strategies.
Abstract 1. Responds to comments from Alan Fruzzetti (see record 2012-00570-001), Karlen Lyons-Ru... more Abstract 1. Responds to comments from Alan Fruzzetti (see record 2012-00570-001), Karlen Lyons-Ruth (see record 2012-00570-002), Jenny Macfie (see record 2012-00570-003), and Maureen Zalewski and Liliana Lengua (see record 2012-00570-004) on the authors original article Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention (see record 2011-05873-001). Each of these distinguished scholars affords a unique perspective on issues related to parenting with ...
Journal of Experimental …, Jan 1, 2010
This study utilized a new cellular phone ecological momentary assessment approach to investigate ... more This study utilized a new cellular phone ecological momentary assessment approach to investigate daily emotional dynamics in 47 youth with Major Depressive Disorder (MDD) and 32 no psychopathology controls (CON), ages 7 -17. Information about emotional experience in the natural environment was obtained using answer-only cellular phones while MDD youth received an 8 week course of cognitive behavioral therapy and/or psychopharmacological treatment. Compared to CON youth, MDD youth reported more intense and labile global negative affect, greater sadness, anger, and nervousness, and a lower ratio of positive to negative affect. These differences increased with pubertal maturation. MDD youth spent more time alone and less time with their families than CON youth. Although differences in emotional experiences were found across social contexts, MDD youth were more negative than CON youth in all contexts examined. As the MDD participants progressed through treatment, diagnostic group differences in the intensity and lability of negative affect decreased, but there were no changes in the ratio of positive to negative affect or measures of social context. We discuss methodological innovations and advantages of this approach, including improved ecological validity and access to information about variability in emotions, change in emotions over time, the balance of positive and negative emotions, and the social context of emotional experience.
Journal of clinical …, Jan 1, 2009
This study examined Expressed Emotion in the families of children and adolescents who were: (1) i... more This study examined Expressed Emotion in the families of children and adolescents who were: (1) in a current episode of Major Depressive Disorder (MDD), (2) in remission from a past episode of MDD, (3) at high familial risk for developing MDD, and (4) low-risk controls. Participants were 109 mother-child dyads (children ages 8-19). Expressed emotion was assessed using the Five Minute Speech Sample. Psychiatric follow-ups were conducted annually following the Five Minute Speech Sample assessment. Mothers of children with a current or remitted episode of MDD and at high risk for MDD were more likely to be rated high on Criticism than mothers of controls. There were no differences in critical expressed emotion among mothers of children in the current, remitted, or highrisk for depression groups. Higher initial critical expressed emotion was associated with a greater likelihood of having a future onset of a depressive episode in high-risk and depressed participants. Diagnostic groups did not differ in Emotional Overinvolvement. Findings suggest that expressed emotion that is critical in nature may be a relatively stable characteristic feature of the family environments of children with and at high-risk for depression, and may be important in understanding the onset and clinical course of child adolescent depressive disorders.
Journal of pediatric …, Jan 1, 2008
Objective Sleep problems are a cardinal symptom of depression in children and adolescents and caf... more Objective Sleep problems are a cardinal symptom of depression in children and adolescents and caffeine use is a prevalent and problematic issue in youth; yet little is known about caffeine use and its effects on sleep in youth with depression. We examined caffeine use and its relation to sleep and affect in youth's natural environments. Methods Thirty youth with major depressive disorder (MDD) and 23 control youth reported on caffeine use, sleep, and affect in their natural environment using ecological momentary assessment at baseline and over 8 weeks, while MDD youth received treatment. Results Youth with MDD reported more caffeine use and sleep problems relative to healthy youth. Youth with MDD reported more anxiety on days they consumed caffeine. Caffeine use among youth with MDD decreased across treatment, but sleep complaints remained elevated. Conclusions Findings suggest that both sleep quality and caffeine use are altered in pediatric depression; that caffeine use, but not sleep problems, improves with treatment; and that caffeine may exacerbate daily anxiety among youth with depression.
Development and …, Jan 1, 2009
This study investigated pupillary and behavioral responses to an emotional word valence identific... more This study investigated pupillary and behavioral responses to an emotional word valence identification paradigm among 32 pre/early and 34 mid/late pubertal typically developing children and adolescents. Participants were asked to identify the valence of positive, negative, and neutral words while pupil dilation was assessed using an eye-tracker. Mid-to-late pubertal children showed greater peak pupillary reactivity to words presented during the emotional word identification task than pre-to-early pubertal children, regardless of word valence. Mid-to-late pubertal children also showed smaller sustained pupil dilation than pre-to-early pubertal children after the word was no longer on screen. These findings were replicated controlling for participants’ age. Additionally, mid-to-late pubertal children had faster reaction times to all words, and rated themselves as more emotional during their laboratory visit compared to pre-to-early pubertal children. Greater recall of emotional words following the task was associated with mid-to-late pubertal status, and greater recall of emotional words was also associated with higher peak pupil dilation. These results provide physiological, behavioral, and subjective evidence consistent with a model of puberty-specific changes in neurobehavioral systems underpinning emotional reactivity.
Development and …, Jan 1, 2007
This article offers a multilevel perspective on resilience to depression, with a focus on interac... more This article offers a multilevel perspective on resilience to depression, with a focus on interactions among social and neurobehavioral systems involved in emotional reactivity and regulation. We discuss models of cross-contextual mediation and moderation by which the social context influences or modifies the effects of resilience processes at the biological level, or the biological context influences or modifies the effects of resilience processes at the social level. We highlight the socialization of emotion regulation as a candidate process contributing to resilience against depression at the social context level. We discuss several factors and their interactions across levels-including genetic factors, stress reactivity, positive affect, neural systems of reward, and sleep-as candidate processes contributing to resilience against depression at the neurobehavioral level. We then present some preliminary supportive findings from two studies of children and adolescents at high risk for depression. Study 1 shows that elevated neighborhood level adversity has the potential to constrain or limit the benefits of protective factors at other levels. Study 2 indicates that ease and quickness in falling asleep and a greater amount of time in deep Stage 4 sleep may be protective against the development of depressive disorders for children. The paper concludes with a discussion of clinical implications of this approach.