Stress can have beneficial and harmful effects on learning. Due to their individual characteristics and past experiences, different individuals respond differently to similar stressful situations. Beck and colleagues' article entitled "Can stress be good for learning? Pediatric resident perspectives on the beneficial influence of stress on learning and the role of the supervisor" discusses trainee perspectives on supervisor behaviors that can shape better learning experiences. In this Invited Commentary, the authors not only discuss the role of stress in learning, including positive effects as highlighted by Beck et al, but also emphasize the importance of creating an optimal learning environment that incorporates stressful experiences. The authors share insights on how supervisors can model a growth mindset and create a psychologically safe environment in view of ongoing stressors that helps build a trusting and mutually respectful relationship with their learners. This approach can foster an environment that is conducive to trainee's individual learning styles and maximizes their learning.

Background: Interest in the effectiveness of mindfulness-based interventions such as yoga in primary schools has grown. Evidence shows promise, as youth who engage in yoga to promote mindfulness show improved coping skills, increased socio-emotional competence and prosocial skills, academic performance, attention span, and ability to deal with stress. Objective: This study reports the results of a program evaluation of a universal health and wellness curriculum, Pure Power, designed to teach youth yoga techniques, mindfulness, and emotion regulation. Methods: A non-randomized comparison design examined outcomes among participants from schools that completed the intervention with highest fidelity of implementation (n= 461) and from students in matched comparison schools (n= 420). Standard measures of coping, emotion regulation and emotion dysregulation, spelling and math achievement were collected. Results: Analyses suggest the youth in the intervention schools demonstrated relative improvement on measures of emotion regulation, spelling, and math. Conclusions: Challenges in implementation in real life settings are vital to identify. The data provide some real-world evidence for the effectiveness of a universal health and wellness curriculum on emotion regulation and positive academic outcomes. Training school staff to deliver the intervention may foster implementation. Future research should test the effectiveness of who delivers the intervention; for example, teacher delivered groups vs. other wellness personnel.

Research and theory suggest an important role of neuroendocrine function in emotional development, particularly under conditions of elevated stress. We provide empirical data to clarify associations between alpha-amylase (AA) and cortisol as well as test the differential linkages among AA, cortisol, and symptoms of anxiety, depression, and posttraumatic stress in children. Children recruited from a low-income elevated violence community (n = 100; mean age = 10, SD = 0.64; 79% Latino; 67% received free or reduced lunch) were assessed on diurnal levels of AA and cortisol along with assessments of anxiety, depression, and posttraumatic stress symptoms (PTSS). Elevated anxiety symptoms were associated with steeper linear slopes of AA with higher levels of AA in the morning but lower levels of AA in the evening. Depression was associated with differential cubic trajectories of AA when PTSSs were included in the model. Anxiety also predicted differential cubic diurnal trends in cortisol, such that greater anxiety symptoms were associated with relatively higher levels of cortisol in the evening. Again, depression symptoms when PTSS were included predicted diurnal cubic trends with elevated depression associated with lower awakening and midday cortisol that reversed to higher evening cortisol compared to youth with fewer self-reported depression symptoms.

Anxiety and depression symptoms may leave children at risk for lower academic scores, though this unique linkage to academic achievement in underserved youth is less well established. This study aimed to examine how anxiety and depression are uniquely related to spelling and math achievement beyond attention and hyperactivity deficits in children in underserved schools. Children aged 8 to 11 ( n = 1085, 47.3% female) from historically underserved groups (Hispanic 75.3%, American Indian 6.4%, Black 4.9%, and White 1.5%) from 13 schools across two public school districts in California participated in the assessment of emotional and behavioral health symptoms that included a spelling and math assessment. While there was no relationship between anxiety or hyperactivity on spelling and math scores, depression and attention problems were significantly negatively related to spelling and math scores. However, when entered simultaneously, evidence of suppressor effects emerged. Anxiety and hyperactivity both became positively predictive of math. Similarly, anxiety became positively predictive of spelling. Subsample analyses showed that these suppressor effects were only in females. The associations among anxiety, depression, attention, and hyperactivity with spelling and math achievement are complex, and when controlling for depression and attention, anxiety levels and hyperactivity may be motivating some level of achievement in these areas.

Background: Previous studies suggest that improvement in symptoms of posttraumatic stress disorder (PTSD) is accompanied by changes in neural connectivity, however, few studies have investigated directional (effective) connectivity. The current study assesses treatment-related changes in effective connectivity in youth with PTSD undergoing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).Methods: Functional MRI scans before and after 16 weeks of TF-CBT for 20 youth with PTSD, or the same time interval for 20 healthy controls (HC) were included in the analysis. Structural equation modeling was used to model group differences in directional connectivity at baseline, and changes in connectivity from pre-to post-treatment.Results: At baseline, the PTSD group, relative to the HC group, had significantly greater connectivity in the path from dorsal cingulate to anterior cingulate and from dorsal cingulate to posterior cingulate corticies. From pre-to post-treatment, connectivity in these paths decreased significantly in the PTSD group, as did connectivity from right hippocampus to left superior temporal gyrus. Connectivity from the left amygdala to the lateral orbital frontal cortex was significantly lower in PTSD vs HC at baseline, but did not change from pre-to post-treatment.Conclusion: Although based on a small sample, these results converge with previous studies in suggesting a central role for the dorsal cingulate cortex in PTSD symptoms. The direction of this connectivity suggests that the dorsal cingulate is the source of modulation of anterior and posterior cingulate cortex during trauma-focused cognitive behavioral therapy.

Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events. Determinants of resilience include personality traits, genetic/epigenetic modifications of genes involved in the stress response, cognitive and behavioral flexibility, secure attachment with a caregiver, social and community support systems, nutrition and exercise, and alignment of circadian rhythm to the natural light/dark cycle. Therefore, resilience is a dynamic and flexible process that continually evolves by the intersection of different domains in human’s life; biological, social, and psychological. The objective of this minireview is to summarize the existing knowledge about the multitude factors and molecular alterations that result from resilience to stress response. Given the multiple contributing factors in building resilience, we set out a goal to identify which factors were most supportive of a causal role by the current literature. We focused on resilience-related molecular alterations resulting from mind-body homeostasis in connection with psychosocial and environmental factors. We conclude that there is no one causal factor that differentiates a resilient person from a vulnerable one. Instead, building resilience requires an intricate network of positive experiences and a healthy lifestyle that contribute to a balanced mind-body connection. Therefore, a holistic approach must be adopted in future research on stress response to address the multiple elements that promote resilience and prevent illnesses and psychopathology related to stress allostatic load.

Poor sleep impedes children’s cognitive, emotional, and psychosocial development. Pediatric sleep dysregulation is common, and children who live in communities of low socioeconomic status experience additional risk factors for short sleep duration and poor sleep quality. School-based training in mindfulness and yoga-informed practices can improve children’s behavior and well-being, but effects on objectively measured sleep are unknown. Effects of a school-based health and mindfulness curriculum, which taught practices such as paced breathing, on sleep and stress were examined in 115 children (49 girls, ages 8 to 11 at baseline). Fifty-eight children in a community of low socioeconomic status received the curriculum twice weekly for 2 years. Fifty-seven children in a socioeconomic status–matched community engaged in their usual physical education class instead. In-home ambulatory polysomnography and perceived social stress were measured in all children at 3 time points: at baseline (ie, prior to curriculum exposure) and at 2 yearly follow-ups. Children receiving the curriculum gained an average of 74 minutes of total sleep time, and 24 minutes of rapid eye movement sleep, per night over the 2-year study period. Children not receiving the curriculum experienced a decrease in total sleep time averaging 64 minutes per night, with no changes in rapid eye movement sleep. Sleep improved within the first 3 months of curriculum exposure, in a dose-dependent fashion. Higher curriculum engagement (eg, using the breathing exercises outside of class) was associated with larger gains in total and rapid eye movement sleep duration. Aggregate within-group changes in social stress were not significant. However, among children receiving the curriculum, those who experienced larger gains in total and rapid eye movement sleep duration also experienced larger increases in perceived social stress. A school-based health and mindfulness curriculum improved children’s objectively measured sleep over 2 years. Social stress did not mediate these effects; instead, mindfulness training may have increased awareness of environmental stressors, while developing tools to reduce stress vulnerability. Chick CF, Singh A, Anker LA, et al. A school-based health and mindfulness curriculum improves children’s objectively measured sleep: A prospective observational cohort study. J Clin Sleep Med. 2022;18(9):2261–2271.

Los niños son más vulnerables al efecto del trauma o traumas repetidos, por el impacto que produce en sus cerebros en desarrollo. La Terapia de Claves Traumáticas de la Universidad de Stanford es un tratamiento sesión a sesión con evidencia científica, para el tratamiento de estrés postraumático crónico para niños y adolescentes. Se describe el tratamiento en formato combinado: presencial y telemático, de una paciente de 14 años con diagnóstico de estrés postraumático, tratada con dicha psicoterapia. Al final del tratamiento la sintomatología traumática de la paciente disminuye, no cumpliendo criterios clínicos de trastorno de estrés postraumático. La Terapia de Claves Traumáticas de forma combinada, se sugiere como una opción válida de tratamiento del trastorno de estrés postraumático crónico en niños y adolescentes.

Background Identifying neural activation patterns that predict youths’ treatment response may aid in the development of imaging-based assessment of emotion dysregulation following trauma and foster tailored intervention. Changes in cortical hemodynamic activity measured with functional near-infrared spectroscopy (fNIRS) may provide a time and cost-effective option for such work. We examined youths’ PTSD symptom change following treatment and tested if previously identified activation patterns would predict treatment response. Methods Youth ( N = 73, mean age = 12.97, SD = 3.09 years) were randomly assigned to trauma-focused cognitive behavioral therapy (TF-CBT), cue-centered therapy (CCT), or treatment as usual (TAU). Parents and youth reported on youth’s PTSD symptoms at pre-intervention, post-intervention, and follow-up. Neuroimaging data ( N = 31) assessed at pre-intervention were obtained while youth engaged in an emotion expression task. Treatment response slopes were calculated for youth’s PTSD symptoms. Results Overall, PTSD symptoms decreased from pre-intervention through follow-up across conditions, with some evidence of relative benefit of TF-CBT and CCT over TAU but significant individual variation in treatment response. Cortical activation patterns were correlated with PTSD symptom improvement slopes ( r = 0.53). In particular, cortical responses to fearful and neutral facial stimuli in six fNIRS channels in the bilateral dlPFC were important predictors of PTSD symptom improvement. Conclusions The use of fNIRS provides a method of monitoring and assessing cortical activation patterns in a relatively inexpensive and portable manner. Associations between functional activation and youths’ PTSD symptoms improvement may be a promising avenue for understanding emotion dysregulation in clinical populations.

Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique with the potential to enable the assessment of posttraumatic stress disorder (PTSD) brain biomarkers in an affordable and portable manner. Consistent with biological models of PTSD, functional magnetic resonance imaging (fMRI) and fNIRS studies of adults with trauma exposure and PTSD symptoms suggest increased activation in the dorsolateral prefrontal cortex (dlPFC) and ventrolateral PFC (vlPFC) in response to negative emotion stimuli. We tested this theory with fNIRS assessment among youth exposed to traumatic stress and experiencing PTSD symptoms (PTSS). A portable fNIRS system collected hemodynamic responses from (N = 57) youth with PTSS when engaging in a classic emotion expression task that included fearful and neutral faces stimuli. The General Linear Model was applied to identify cortical activations associated with the facial stimuli. Subsequently, a prediction model was established via a Support Vector Regression to determine whether PTSS severity could be predicted based on fNIRS-derived cortical response measures and individual demographic information. Results were consistent with findings from adult fMRI and fNIRS studies of PTSS showing increased activation in the dlPFC and vlPFC in response to negative emotion stimuli. Subsequent prediction analysis revealed ten features (i.e., cortical responses from eight frontocortical fNIRS channels, age and sex) strongly correlated with PTSS severity (r = 0.65, p < .001). Our findings suggest the potential utility of fNIRS as a portable tool for the detection of putative PTSS brain biomarkers.

Imaging methods have elucidated several neurobiological correlates of traumatic and adverse experiences in childhood. This knowledge base may foster the development of programs and policies that aim to build resilience and adaptation in children and youth facing adversity. Translation of this research requires both effective and accurate communication of the science. This review begins with a discussion of integrating the language used to describe and identify childhood adversity and their outcomes to clarify the translation of neurodevelopmental findings. An integrative term, Traumatic and Adverse Childhood Experiences (TRACEs+) is proposed, alongside a revised adverse childhood experiences (ACEs) pyramid that emphasizes that a diversity of adverse experiences may lead to a common outcome and that a diversity of outcomes may result from a common adverse experience. This term facilitates linkages between the ACEs literature and the emerging neurodevelopmental knowledge surrounding the effect of traumatic adverse childhood experiences on youth in terms of the knowns and unknowns about neural connectivity in youth samples. How neuroscience findings may lead directly or indirectly to specific techniques or targets for intervention and the reciprocal nature of these relationships is addressed. Potential implications of the neuroscience for policy and intervention at multiple levels are illustrated using existing policy programs that may be informed by (and inform) neuroscience. The need for transdisciplinary models to continue to move the science to action closes the article. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Back to table of contents Previous article Next article Clinical & ResearchFull AccessBuilding Resilience in Our Children for the Aftereffects of COVID-19Victor G. Carrion, M.D.Victor G. Carrion, M.D.Published Online:21 Oct 2021https://doi.org/10.1176/appi.pn.2021.8.11AbstractChildren and adolescents have the capacity to become resilient and adaptive when we give them the opportunities and resources to do so, but half to two-thirds of those needing mental health services may not have access to them.It has been over a year since the World Health Organization confirmed that we were all living through a global pandemic. Since then, many of us have experienced tragedy, loss, and sustained threat and continue to do so. At times, we are navigating these stressors with uncertainty, limited guidance, and national divisions. Measures necessary to maintain our physical safety have caused isolation. Although technology has helped us maintain a sense of connectedness, its limitations prevent it from sparing us from the full impact of aloneness on our emotional life. Compounding the effects of the isolation that the pandemic has inflicted are additional ravages to our mental and physical well-being in the form of unemployment, academic interruption, and the loss of loved ones.If ever there was a time to prioritize the building blocks of resilience, it is now. Our profession strives to provide resources to strengthen support systems, alleviate burdens, and help those most vulnerable. We have guided our patients in building new coping mechanisms, utilizing technology to engage in therapy, and identifying resources as we were developing these skills for ourselves. We aim to build resilience as individuals face what was once an acute stressor that has become chronic.In truth, we know very little about what constitutes resilience. However, an accurate and humbling acceptance of our developing understanding of resilience can inform our aspirations and target our approach. Resilience is a physics term; it literally means that the spring bounces back to its original form. In our clinical circles, we use the term to refer to the return to prior function and, in a very narrow fashion, to describe the absence of symptomatology or dysfunction.This clinical definition is limited because it does not reflect the possibility of biological and psychological factors that may be bringing the individual closer to a threshold of symptom expression and altered function. In other words, it is below this threshold where the truly resilient live, but also those whose allostatic loads (the cumulative burden of chronic stress and life events) have increased in a clinically unnoticeable manner. Identifying the factors associated with resilience will allow us to better assess the impact of stressors on an individual.Some of the variables that play a role in resilience center on the individual and others in the individual's environment. The presence of a robust support system, a dependable relationship, perseverance, optimism, and a sense of humor all come into play. It is essential to assess these as we evaluate how our patients will bounce back. The possibility for adaptation, bouncing back to an even better stance, should also be a goal.Contrary to popular belief, children and adolescents are not resilient simply by virtue of being young. The opposite is true. They are, in fact, more vulnerable. This is why we take care of them. Developmental dynamics during a period of active neuronal and physiological development may place youth at higher risk. Children and adolescents do have the capacity to become resilient and adaptive when we give them the opportunities and resources to do so. But it is of concern that half to two-thirds of those needing mental health services may not have access to them.Resources for building resilience are crucial because the pandemic has had a significant impact on our youth. According to a report by the Alliance for Excellent Education, more than 8 million children had limited or no internet access, impeding their ability to participate in academic courses during the pandemic. Students have also lost teachers who left the education workforce because of pandemic stressors or death from COVID-19. And according to the Centers for Disease Control and Prevention, between April and October 2020, the proportion of emergency visits related to mental health increased by approximately 24% for children aged 5 to 11 years and 31% for children aged 12 to 17 years.The adverse effects of adult unemployment also touch kids' lives in very direct ways. For every 1% increase in unemployment, there is a 20% increase in child neglect and a 10% increase in abuse of any type, according to a paper published March 19, 2020, by the Social Science Research Network (SSRN).Children from diverse families are particularly affected by the pandemic. According to a report by the United Hospital Fund, Black and Hispanic children in New York experienced the death of a parent or caregiver at twice the rate of Asian and White children. Asian families have faced additional stressors. Although hate crimes overall decreased last year, a report this year by the Center for the Study of Hate and Extremism showed that anti-Asian hate crimes in 16 major U.S. cities had an overall increase of 149%.The mental health challenges of COVID-19 will continue to manifest long after the pandemic is over. The time to develop innovative interventions that build resilience and disseminate treatment delivery and preventive interventions is now. Recognizing functional change is just part of the work. Maximizing resilience and adaptation opportunities that take into account the burden of the pandemic and its associated stressors is essential. Children need advocates who can initiate and lead collaborations with leaders in communities, school districts, technology, among others, to build effective programs and interventions. We need to disseminate these within the systems where our kids socialize, study, and play. Policy work that helps to sustain these resilience-building projects is critical as it recognizes that "resilient" does not mean symptom-free. ■The Alliance for Excellent Education report, "Students of Color Caught in the Homework Gap," is posted here.The CDC report, "Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic—United States, January 1–October 17, 2020," is posted here.The SSRN report, "Child Maltreatment, Unemployment, and Safety Nets," is posted here.Victor G. Carrion, M.D., is the John A. Turner, M.D. Chair of Child and Adolescent Psychiatry, professor and vice chair of the Department of Psychiatry and Behavioral Sciences, and director of the Early Life Stress and Resilience Program at Stanford University. ISSUES NewArchived

Few of the existing evidence-based interventions for child trauma exposure were specifically designed to address experiences and outcomes of complex developmental trauma. Stanford’s cue-centered therapy (CCT) was designed to address this gap by offering a flexible, integrative, and insight-oriented treatment approach that is grounded in principles of neuroscience, developmental trauma, client empowerment, and allostasis. This article reviews the CCT rationale, treatment components, evidence base, and training approach. Studies demonstrate promising outcomes indicating CCT effectiveness in reducing child and caregiver posttraumatic stress, and in improving child functioning. Further research, however, is needed to identify which clients are best-suited for CCT (versus other available child trauma treatments) and to identify which components of CCT are most critical for addressing complex developmental trauma. CCT advances the field of child trauma treatment by offering an intervention approach focused on addressing complex developmental trauma. Positive treatment and training outcomes indicate utility of CCT for clients and clinicians. Innovations in research and training approaches are needed to further dissemination and implementation of CCT and other related child trauma interventions for complex developmental trauma.

The objective of this study was to examine if longitudinal trajectories of hair cortisol concentrations (HCC) measured at two or three yearly time points can identify 1-3 year old children at risk for altered hypothalamic-pituitary-adrenal (HPA)-axis function due to early life stress (ELS). HCC was measured (N = 575) in 265 children using a validated enzyme-linked immunosorbent assay. Hair was sampled in Clinic Visits (CV) centered at years 1, 2, and 3 (n = 45); 1 and 2 (n = 98); 1 and 3 (n = 27); 2 and 3 (n = 95). Log-transformed HCC values were partitioned using latent class mixed models (LCMM) to minimize the Bayesian Information Criterion. Multivariable linear mixed effects models for ln-HCC as a function of fixed effects for age in months and random effects for participants (to account for repeated measures) were generated to identify the factors associated with class membership. Children in Class 1 (n = 69; 9% Black) evidenced declining ln-HCC across early childhood, whereas Class 2 members (n = 196; 43% Black) showed mixed trajectories. LCMM with only Class 2 members revealed Class 2A (n = 17, 82% Black) with sustained high ln-HCC and Class 2B (n = 179, 40% Blacks) with mixed ln-HCC profiles. Another LCMM limited to only Class 2B members revealed Class 2B1 (n = 65, 57% Black) with declining ln-HCC values (at higher ranges than Class 1), and Class 2B2 (n = 113, 30% Black) with sustained high ln-HCC values. Class 1 may represent hair cortisol trajectories associated with adaptive HPA-axis profiles, whereas 2A, 2B1, and 2B2 may represent allostatic load with dysregulated profiles of HPA-axis function in response to varying exposures to ELS. Sequential longitudinal hair cortisol measurements revealed the allostatic load associated with ELS and the potential for developing maladaptive or dysregulated HPA-axis function in early childhood.

An increasing prevalence of early childhood adversity has reached epidemic proportions, creating a public health crisis. Rather than focusing only on adverse childhood experiences (ACEs) as the main lens for understanding early childhood experiences, detailed assessments of a child's social ecology are required to assess "early life adversity." These should also include the role of positive experiences, social relationships, and resilience-promoting factors. Comprehensive assessments of a child's physical and social ecology not only require parent/caregiver surveys and clinical observations, but also include measurements of the child's physiology using biomarkers. We identify cortisol as a stress biomarker and posit that hair cortisol concentrations represent a summative and chronological record of children's exposure to adverse experiences and other contextual stressors. Future research should use a social-ecological approach to investigate the robust interactions among adverse conditions, protective factors, genetic and epigenetic influences, environmental exposures, and social policy, within the context of a child's developmental stages. These contribute to their physical health, psychiatric conditions, cognitive/executive, social, and psychological functions, lifestyle choices, and socioeconomic outcomes. Such studies must inform preventive measures, therapeutic interventions, advocacy efforts, social policy changes, and public awareness campaigns to address early life adversities and their enduring effects on human potential.

This study investigated group differences and longitudinal changes in brain volume before and after trauma-focused cognitive behavioral therapy (TF-CBT) in 20 unmedicated youth with maltreatment-related posttraumatic stress disorder (PTSD) and 20 non-trauma-exposed healthy control (HC) participants. We collected MRI scans of brain anatomy before and after 5 months of TF-CBT or the same time interval for the HC group. FreeSurfer software was used to segment brain images into 95 cortical and subcortical volumes, which were submitted to optimal scaling regression with lasso variable selection. The resulting model of group differences at baseline included larger right medial orbital frontal and left posterior cingulate corticies and smaller right midcingulate and right precuneus corticies in the PTSD relative to the HC group, R2 = .67. The model of group differences in pre- to posttreatment change included greater longitudinal changes in right rostral middle frontal, left pars triangularis, right entorhinal, and left cuneus corticies in the PTSD relative to the HC group, R2 = .69. Within the PTSD group, pre- to posttreatment symptom improvement was modeled by longitudinal decreases in the left posterior cingulate cortex, R2 = .45, and predicted by baseline measures of a smaller right isthmus (retrosplenial) cingulate and larger left caudate, R2 = .77. In sum, treatment was associated with longitudinal changes in brain regions that support executive functioning but not those that discriminated PTSD from HC participants at baseline. Additionally, results confirm a role for the posterior/retrosplenial cingulate as a correlate of PTSD symptom improvement and predictor of treatment outcome.

BACKGROUND:Anxiety and stress reactivity are risk factors for the development of affective disorders. However, the behavioral and neurocircuit mechanisms that potentiate maladaptive emotion regulation are poorly understood. Neuroimaging studies have implicated the amygdala and dorsolateral prefrontal cortex (DLPFC) in emotion regulation, but how anxiety and stress alter their context-specific causal circuit interactions is not known. Here, we use computational modeling to inform affective pathophysiology, etiology, and neurocircuit targets for early intervention.METHODS:Forty-five children (10-11 years of age; 25 boys) reappraised aversive stimuli during functional magnetic resonance imaging scanning. Clinical measures of anxiety and stress were acquired for each child. Drift-diffusion modeling of behavioral data and causal circuit analysis of functional magnetic resonance imaging data, with a National Institute of Mental Health Research Domain Criteria approach, were used to characterize latent behavioral and neurocircuit decision-making dynamics driving emotion regulation.RESULTS:Children successfully reappraised negative responses to aversive stimuli. Drift-diffusion modeling revealed that emotion regulation was characterized by increased initial bias toward positive reactivity during viewing of aversive stimuli and increased drift rate, which captured evidence accumulation during emotion evaluation. Crucially, anxiety and stress reactivity impaired latent behavioral dynamics associated with reappraisal and decision making. Anxiety and stress increased dynamic casual influences from the right amygdala to DLPFC. In contrast, DLPFC, but not amygdala, reactivity was correlated with evidence accumulation and decision making during emotion reappraisal.CONCLUSIONS:Our findings provide new insights into how anxiety and stress in children impact decision making and amygdala-DLPFC signaling during emotion regulation, and uncover latent behavioral and neurocircuit mechanisms of early risk for psychopathology.

Introducción: El artículo describe un modelo de intervención temprana para la prevención de patología, y promoción de la resiliencia, tras los terremotos de la isla de Puerto Rico en enero de 2020. El 7 de enero de 2020 un terremoto de magnitud 6,4 en la escala Richter, sacudió la isla de Puerto Rico. Como consecuencia, gran parte de la población sufrió desplazamientos de sus domicilios y cierres de muchas escuelas. Todo ello sobre lo ya anteriormente vivido, como el Huracán María en 2017, aumentando así su carga de estrés alostática. Tras la ayuda inicial de los cuerpos de rescate, se detecta la necesidad de apoyo psicológico a la población y a profesionales proveedores de dicho apoyo. Métodos: Contando con una precaria infraestructura, se decide realizar una intervención con el objetivo de proporcionar información del impacto del estrés traumático en el organismo, así como ejercicios prácticos de mindfulness dirigidos a dichos profesionales. El programa integra lecciones de la Terapia de Claves Traumáticas y ejercicios del currículo Pure Power. Resultados: Se confirma, a través de un cuestionario de satisfacción, la necesidad de este tipo de programas, y se valora extrapolar el modelo a otras poblaciones de riesgo similares, en términos de evitar las consecuencias del trauma, disminuir la carga alostática, y prevenir y promocionar la salud mental. Se sugiere realizar próximas formaciones de ampliación de este programa, para confirmar su efectividad y mantenimiento en el tiempo.

Background Although mindfulness and yoga interventions for youth continue to gain support, few studies have proposed a systematic way to study the implementation and fidelity of these approaches. Objective The current study developed and tested the feasibility of measurement procedures for a yoga and mindfulness curriculum implemented in schools through a community partnership. This was accomplished in two studies. Method In study 1 we created and analyzed the psychometric properties of a fidelity observation tool using data from 165 observations of students receiving a district-wide school yoga and mindfulness intervention. The findings were subsequently refined and implemented to collect 91 additional observations in study 2. Results In study 1, a principle components analysis revealed a 3-factor solution across items, with 10 of 17 items reliably rated but only 4 of those 10 items rated as satisfactory or better fidelity. The fidelity observation tool was then revised and implemented in study 2, with 13 of 17 items reliably rated and 5 meeting satisfactory or better fidelity. Conclusions The findings from both studies indicated that yoga and mindfulness interventions for youth can be feasibly implemented and reliably measured within school settings, although there were some limitations in measuring both the content and process of such interventions.

Cue-centered therapy (CCT) is a manualized treatment designed to reduce posttraumatic stress symptoms in children exposed to chronic violence. The purpose of this study is threefold: 1) conduct a randomized trial contrasting CCT to trauma-focused CBT (TF-CBT) and treatment as usual (TAU); 2) conduct a longitudinal assessment with evaluations before treatment (T1), midtreatment (T2), and posttreatment (T3), and at 3-month follow-up; and 3) assess for symptomatic improvements, supplementing clinical measures with functional near-infrared spectroscopy (fNIRS) evaluations.