The present study was designed to investigate the relationship among physiologic concordance, patient-perceived therapist empathy, and social-emotional process during psychotherapy. Simultaneous measures of skin conductance (SC) were obtained from 20 unique and established patient-therapist dyads during a live therapy session followed by patient ratings of therapist empathy. Paired SC data of hypothetical dyads were used to test the reliability of the proposed measure of SC concordance. Observer microanalyses of social-emotional process were used to compare short segments of high versus low physiologic concordance. Results show a significant positive correlation (r=0.47, p=0.03) between SC concordance and patient ratings of perceived therapist empathy. Microanalyses suggest that during moments of high versus low SC concordance, there were significantly more positive social-emotional interactions for both patients and therapists (p=0.01). The results support a biological model of perceived patient empathy and patient-therapist social-emotional process during psychotherapy.

The authors illustrate how their work on mother-infant "relational psychophysiology" might inform psychotherapy research. They examined psychophysiology in 18 mother-infant dyads (infants' age: 5 months) during normal interaction and a still-face perturbation. They measured respiratory sinus arrhythmia (RSA) as an index of emotion regulation and explored whether skin conductance (SC) concordance, previously linked to therapist empathy, occurs in mothers and infants. During the still-face episode, SC concordance correlated to infant negative engagement. Upon reengagement, when mothers often soothe their infants, concordance instead correlated to behavioral synchrony, an index of maternal sensitivity. Furthermore, maternal RSA became correlated to infant negative engagement. These findings suggest that a mother trying to calm her infant calms herself physiologically and her sensitivity on a behavioral level becomes coherent physiologically. Implications for psychotherapy research are discussed.

Respiratory sinus arrhythmia (RSA) is related to infant emotion regulation and resilience. However, few studies have examined RSA of infants and mothers during a stressful experience. Even fewer studies have measured infant and mother skin conductance (SC), which in part reflects anxiety. This pilot study examined RSA, heart rate (HR), and SC patterns of 12 five-month-old infants and their mothers during normal interaction and a stressful perturbation of the interaction in which the mother does not respond to her infant-the Face-to-Face Still-Face (FFSF) paradigm. Dyads were grouped into four categories by two conditions: whether the infant protested to the Still-Face episode (SF) and whether they "recovered" from the SF by reducing protest when the mother resumed interaction in the Reunion (RE). Infants who recovered from the SF had the largest increase in RSA from SF to RE. Mothers of infants who recovered from the SF showed a decrease in RSA during the RE, suggesting mobilization of infant soothing behaviors. Mothers of infants who did not recover from the SF showed physiologic markers of anxiety in the form of continued increases in RSA and high levels of SC. Furthermore, these mothers behaved in a manner that was not responsive to their infant's disengagement cues. These pilot results demonstrate the feasibility of measuring infant SC, a measure long disregarded in infant research. The findings suggest that maternal psychophysiology may be related to infant resilience and suggest a bidirectional effect of maternal and infant reactivity.

Background Little is known about the impact of prenatal maternal stress (PNMS) on the developmental trajectory of temperament and few studies have been able to incorporate a natural disaster as a quasi-experimental stressor. The current study investigated PNMS related to Superstorm Sandy (‘Sandy’), a hurricane that struck the New York metropolitan area in October 2012, in terms of objective exposure during pregnancy, subjective stress reaction as assessed by maternal symptoms of post-traumatic stress, and their impact on the developmental changes in temperament during early childhood. Method A subsample of 318 mother-child dyads was drawn from the Stress in Pregnancy Study. Temperament was measured at 6, 12, 18, and 24 months of age. Results Objective exposure was associated with greater High-Intensity Pleasure, Approach, Perceptual Sensitivity and Fearfulness, but lower Cuddliness and Duration of Orientation at 6 months. Objective exposure and its interaction with subjective stress reaction predicted developmental changes in temperament. In particular, objective exposure was linked to greater increases in Activity Level but decreases in High-Intensity Pleasure, Approach, and Fearfulness. The combination of objective exposure and subjective stress reaction was also associated with greater increases in Activity Level. Limitations Temperament was measured solely via maternal report. Trimester-specific effects of Sandy on temperament were not examined. Conclusion This is the first study to examine the effects of prenatal maternal exposure to a natural disaster on trajectories of early childhood temperament. Findings suggest that both objective stress exposure and subjective stress reaction in-utero predict developmental trajectories of temperament in early childhood.

The study examined the effects of in-utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using Multivariable General Linear Model. Results show that prenatal maternal depression was associated with lower emotion-regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in-utero Sandy exposure. The study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy, while simultaneously identifying high-risk families who may have suffered from disaster-related traumas in order to provide necessary services. As the frequency of natural disasters may increase owing to climate change, it is important to understand the consequences of in-utero stress on child development and to formulate plans for early identification.