Given the severity and suicide risk of patients typically treated by Dialectical Behavior Therapy (DBT) and the absence of guidelines regarding delivery of DBT via telehealth, it is crucial that the DBT treatment community gather and rapidly disseminate information about effective strategies for delivering DBT via telehealth. The current study surveyed DBT providers (N = 200) to understand challenges and lessons learned as they transitioned to conducting DBT via telehealth during the COVID-19 pandemic. Open-ended responses to challenges and lessons-learned were coded. Most frequently noted challenges were Therapy-Interfering Behaviors and elements related to the provision of Individual Therapy and Skills Training Group. The majority of providers offered advice for implementing group skills training, avoiding or overcoming therapist burnout, and emphasized continued adherence to treatment principles, even in the context of this new treatment modality. Overall, this qualitative study marks a starting point on identifying best practices delivering DBT via telehealth for which it is anticipated that clinical recommendations in this area will evolve, informed by clinician, researcher, and consumer input.

Warm caregiving is associated with concurrent hypothalamic-pituitary-adrenocortical (HPA) axis function, although the persistence of this association over time is less established. Using longitudinal and intervention studies, this meta-analysis examined the enduring association of parental warmth (measured when children were ages < 1 through 15 years) with basal cortisol, reactivity and recovery (measured when children were ages < 1 through 25 years; k = 38; N = 6,608). These studies demonstrate no overall associations between parenting and children's HPA axis; instead there are small associations that vary based on moderators such as socioeconomic status, developmental stage, study design and stressor type, though many moderators are confounded. This first wave of studies indicates that the enduring association between parenting and cortisol is small and only understood in the context of other factors, and directly informs four sets of methodological and theoretical recommendations to strengthen this literature.

Children’s inflammation may be an important link between parenting behaviors and health outcomes. The aims of this systematic review were to: 1) describe associations between parenting behaviors and child inflammatory markers, and 2) evaluate the relevance of existing literature to the review question. Database searches identified 19 studies that included a measure of positive or negative parenting behaviors and a marker of child inflammation, 53% of which measured parental responsiveness/warmth. Greater parental responsiveness/warmth was associated with lower levels of child pro-inflammatory markers in 60% of studies. Across studies, the association between parenting and child inflammation varied as a function of parenting construct, inflammatory measure, and sample characteristics. Studies were highly relevant, with 42% rated 5+ out of 6 for study’s ability to address links between parenting behavior and child inflammation. If future research uncovers causal effects of parenting behaviors on inflammation, parenting interventions could be employed as a preventative tool.

Although children of mothers who have elevated borderline personality disorder (BPD) features are a high-risk group, there remains little research examining developmental mechanisms that place these offspring at risk for emerging psychopathology. The current study included 68 mother–preschooler dyads, in which mothers with elevated BPD features were oversampled. Preschoolers (aged 3 and 4 years) completed a battery of executive functioning (EF) and theory of mind (ToM) measures. Accounting for several covariates (family income, maternal depression, child age, and child cognitive ability), maternal BPD features were associated with preschoolers' poorer EF and, although not associated with the overall ToM measure, were associated with affect perspective taking, a component of ToM.

Maternal emotional and physiological dysregulation has been found to influence child stress physiology. This study characterizes diurnal cortisol and basal heart rate variability (HRV) patterns in a predominately high-risk sample of mothers with a full range of emotion dysregulation and assessed the magnitude of concordance (N = 68 motherpreschooler dyads). Overall, dyads exhibited concordance in evening salivary cortisol levels, but not for morning levels or HRV. Maternal emotion dysregulation was associated with maternal and child evening cortisol levels, child morning cortisol levels, and maternal HRV. Bootstrapping analyses showed that maternal emotion dysregulation was associated with higher child evening cortisol levels through its impact on mother evening cortisol levels. This study offers preliminary evidence for understanding child stress physiology and dyadic concordance in a sample of mothers with a range of emotion regulation capabilities. Highlights • Maternal physiology may explain the association between maternal emotion dysregulation and child physiological patterns. • Emotionally dysregulated mothers were oversampled and mothers and children's heart rate variability and cortisol were collected, with findings showing dyadic concordance in evening cortisol. • This work highlights the importance of transdiagnostic approaches for examining concordance and child stress physiology.