Developmental and experiential heterogeneity associated with caregiving-related early adversities (crEAs) poses a major challenge to identifying replicable, generalizable findings. Here conditional random forests evaluated the importance of unique crEA experiences for estimating risks to mental health in 306 children, 6–12 years of age, with heterogeneous crEA experiences (different forms of caregiver-involved abuse and/or neglect or permanent/substantial parent–child separation). The better that crEAs improved the accuracy of symptom estimates in held-out, never-before-seen children, the more important and generalizable they were considered. Here we show that earlier timing and longer duration of crEAs was especially important for elevated general psychopathology (p-factor scores). The mere presence (versus absence) of crEAs was more valuable for estimating symptom risk than were specific adversities in a broad sample. Specific adversities became more important when only looking within the crEA-exposed subsample, with adversities of an interpersonal-affective nature being the most likely to increase transdiagnostic symptom risk. Concurrent consistent caregiving also had high importance, motivating consideration of later-occurring environmental experiences in future studies of early adversity. Using a machine learning approach to improve risk estimates across heterogeneous samples, the authors demonstrate patterns of increased transdiagnostic symptom risk in children who have experienced caregiving-related early adversities.

OBJECTIVE:Neurosurgeons demonstrate some of the highest levels of burnout among surgeons, yet little research has been done to understand the underlying stressors that neurosurgeons and trainees experience and the emotional responses to them. Our goal was to conduct a feasibility study identifying job stressors and emotional responses among neurosurgeons rather than generalize findings across the profession. METHODS:Emphasizing a qualitative approach in this feasibility and descriptive study, we strategically selected a small sample of neurosurgical attendings, residents, and fellows at 2 United States academic neurosurgical departments to ensure an in-depth analysis laying the groundwork for future extensive research. Participants were asked to complete a questionnaire regarding work-related stressors and high- and low-arousal emotional responses to these stressors, as well as a standardized Depression, Anxiety, and Stress Scale. Both quantitative and qualitative analyses evaluating types of stressors and emotional responses reported were assessed based on participant training level. RESULTS:Participants identified 3 main stressors: 1) administrative deficiencies; 2) delivering bad news/saving lives; and 3) work-life balance. A low frequency of negative emotional responses was reported, but those reported were mainly high-arousal emotions. Limited prior training in coping strategies was also reported. We also found that residents, fellows, and faculty surgeons reported about work stressors and coping strategies differently. CONCLUSIONS:The results of our study provide an understanding of neurosurgical professionals' unique emotional landscape, emphasizing the need for reforms in administrative practices, enhanced, healthy coping strategies, and career stage-specific mental health support.

Cognitive science has demonstrated that we construct knowledge about the world by abstracting patterns from routinely encountered experiences and storing them as semantic memories. This preregistered study tested the hypothesis that caregiving-related early adversities (crEAs) shape affective semantic memories to reflect the content of those adverse interpersonal-affective experiences. We also tested the hypothesis that because affective semantic memories may continue to evolve in response to later-occurring positive experiences, child-perceived attachment security will inform their content. The sample comprised 160 children (ages 6-12 at Visit 1; 87F/73 M), 66% of whom experienced crEAs (n = 105). At Visit 1, crEA exposure prior to study enrollment was operationalized as parental-reports endorsing a history of crEAs (abuse/neglect, permanent/significant parent-child separation); while child-reports assessed concurrent attachment security. A false memory task was administered online ∼2.5 years later (Visit 2) to probe the content of affective semantic memories-specifically attachment schemas. Results showed that crEA exposure (vs. no exposure) was associated with a higher likelihood of falsely endorsing insecure (vs. secure) schema scenes. Attachment security moderated the association between crEA exposure and insecure schema-based false recognition. Findings suggest that interpersonal-affective semantic schemas include representations of parent-child interactions that may capture the quality of one's own attachment experiences and that these representations shape how children remember attachment-relevant narrative events. Findings are also consistent with the hypothesis that these affective semantic memories can be modified by later experiences. Moving forward, the approach taken in this study provides a means of operationalizing Bowlby's notion of internal working models within a cognitive neuroscience framework. RESEARCH HIGHLIGHTS: Affective semantic memories representing insecure schema knowledge (child needs + needs-not-met) may be more salient, elaborated, and persistent among youths exposed to early caregiving adversity. All youths, irrespective of early caregiving adversity exposure, may possess affective semantic memories that represent knowledge of secure schemas (child needs + needs-met). Establishing secure relationships with parents following early-occurring caregiving adversity may attenuate the expression of insecure semantic memories, suggesting potential malleability. Affective semantic memories include schema representations of parent-child interactions that may capture the quality of one's own attachment experiences and shape how youths remember attachment-relevant events.

INTRODUCTION: Although anecdotal evidence points to high levels of stress among neurosurgeons and trainees, there is little systematic research documenting the nature of stress in detail. METHODS: We conducted a detailed survey of neurosurgeons and trainees, obtaining 22/26 responses (85% response rate) with 2 responses removed for missingness. Participants were purposefully sampled from two academic center neurosurgery programs. RESULTS: Participants reported more high-arousal negative emotions (particularly frustration and anxiety) than low-arousal negative emotions (e.g., helplessness, discouragement), suggesting relatively high levels of motivation. Within training levels, sources of stress varied considerably, suggesting the need for tailored approaches to stress management. Attendings reported quite a lot of stress from patient expectations and administrative constraints, whereas trainees focused more on teamwork and difficult patients. A focus on processes and specific mechanisms of problems at work was associated with more high-arousal emotions, whereas a focus on outcomes was associated with low-arousal emotions; this pattern is consistent with prior research on other populations. As expected, residents were most likely to use coping strategies that reflected a lack of control over one’s schedule (e.g., immersing oneself in work) whereas attendings were most likely to use healthy strategies, particularly physical exercise. Only one of the 20 participants reported seeking professional support due to stress; residents were most likely to attribute this to a lack of time or resources but most participants did not feel a need to seek professional help. Attendings were least likely to report ideas for what education or training they could have benefited from to better cope with stress. CONCLUSIONS: This work points to key ways dealing with failure and stress contributes to individual well-being as well as neurosurgical culture.

Inculcating the capacity to adapt successfully to failures is essential for talent development in science, technology, engineering, and mathematics (STEM) fields. Despite its importance, this capacity to learn from failure is among the least understood processes in the field of talent development. This study aims to investigate how students conceptualize and react to failures and whether there is a correlation between students' conceptualizations of failure, emotional reactions to it, and academic performance. We invited 150 high-achieving high school students to share, interpret, and label their most memorable struggles in their STEM classes. Most of their struggles focused on the learning process itself, such as poor understanding of the subject matter, insufficient motivation or effort, or adopting ineffective learning strategies. Poor performance outcomes, such as poor test scores and bad grades, were not mentioned as frequently as the learning process. Students who labeled their struggle experiences as failures tended to focus more on performance outcomes, whereas students who labeled their struggle experiences as neither failures nor successes focused more on the learning process. Higher-achieving students were also less likely to label their struggles as failures than less-high achievers. Implications for classroom instruction are discussed with a particular focus on talent development in STEM fields.

Early psychosocial adversities exist at many levels, including caregiving-related, extrafamilial, and sociodemographic, which despite their high interrelatedness may have unique impacts on development. In this paper, we focus on caregiving-related early adversities (crEAs) and parse the heterogeneity of crEAs via data reduction techniques that identify experiential cooccurrences. Using network science, we characterized crEA cooccurrences to represent the comorbidity of crEA experiences across a sample of school-age children (n = 258; 6-12 years old) with a history of crEAs. crEA dimensions (variable level) and crEA subtypes (subject level) were identified using parallel factor analysis/principal component analysis and graph-based Louvain community detection. Bagging enhancement with cross-validation provided estimates of robustness. These data-driven dimensions/subtypes showed evidence of stability, transcended traditional sociolegally defined groups, were more homogenous than sociolegally defined groups, and reduced statistical correlations with sociodemographic factors. Finally, random forests showed both unique and common predictive importance of the crEA dimensions/subtypes for childhood mental health symptoms and academic skills. These data-driven outcomes provide additional tools and recommendations for crEA data reduction to inform precision medicine efforts in this area.