Emotion in Memory and Development: Biological, Cognitive, and Social Considerations

Emotion and Memory in Development

Series in Affective Science Series Editors RICHARD J. DAVIDSON and KLAUS R. SCHERER The series was founded in 1982 by Paul Ekman and Klaus R. Scherer. The Nature of Emotion: Fundamental Questions Edited by Paul Ekman and Richard J. Davidson Boo! Culture, Experience, and the Startle Reflex Ronald Simons Emotions in Psychopathology: Theory and Research Edited by William F. Flack Jr. and James D. Laird What the Face Reveals: Basic and Applied Studies of Spontaneous Expression Using the Facial Action Coding System (FACS) Edited by Paul Ekman and Erika Rosenberg

Appraisal Processes in Emotion: Theory, Methods, Research Edited by Klaus R. Scherer, Angela Schorr, and Tom Johnstone Music and Emotion: Theory and Research Edited by Patrik N. Juslin and John A. Sloboda Nonverbal Behavior in Clinical Settings Edited by Pierre Philippot, Robert S. Feldman, and Erik J. Coats Memory and Emotion Edited by Daniel Reisberg and Paula Hertel Psychology of Gratitude Edited by Robert A. Emmons and Michael E. McCullough

Shame: Interpersonal Behavior, Psychopathology, and Culture Edited by Paul Gilbert and Bernice Andrews

Thinking about Feeling: Contemporary Philosophers on Emotions Edited by Robert C. Solomon

Affective Neuroscience: The Foundations of Human and Animal Emotions Jaak Panksepp

Bodily Sensibility: Intelligent Action Edited by Jay Schulkin

Extreme Fear, Shyness, and Social Phobia: Origins, Biological Mechanisms, and Clinical Outcomes Edited by Louis A. Schmidt and Jay Schulkin Cognitive Neuroscience of Emotion Edited by Richard D. Lane and Lynn Nadel The Neuropsychology of Emotion Edited by Joan C. Borod Anxiety, Depression, and Emotion Edited by Richard J. Davidson Persons, Situations, and Emotions: An Ecological Approach Edited by Hermann Brandstätter and Andrzej Eliasz Emotion, Social Relationships, and Health Edited by Carol D. Ryff and Burton Singer

Who Needs Emotions? The Brain Meets the Robot Edited by Jean-Marc Fellous and Michael A. Arbib What the Face Reveals: Basic and Applied Studies of Spontaneous Expression Using the Facial Action Coding System (FACS), Second Edition Edited by Paul Ekman and Erika L. Rosenberg The Development of Social Engagement: Neurobiological Perspectives Edited by Peter J. Marshall and Nathan A. Fox Handbook of Emotion Elicitation and Assessment Edited by James A. Coan and John J. B. Allen Emotion and Memory in Development: Biological, Cognitive, and Social Considerations Edited by Jodi A. Quas and Robyn Fivush

Emotion and Memory in Development Biological, Cognitive, and Social Considerations

Edited by Jodi A. Quas Robyn Fivush

1 2009

1 Oxford University Press, Inc., publishes works that further Oxford University’s objective of excellence in research, scholarship, and education. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam

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9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper

Preface Jodi A. Quas, University of California, Irvine Robyn Fivush, Emory University

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he question of how well children can recall and discuss emotional experiences is one that has received considerable attention, not only in scientific research, but also in clinical contexts, in the legal system, and by the public. Knowledge concerning the role of emotions generally and emotional distress specifically in children’s emerging cognitive abilities has implications for understanding how children attend to and process information, how children react to emotional information, and how that information affects their development and functioning over time. Of practical importance, increasing numbers of children have been involved in legal settings as victims or witnesses to violence, highlighting the need to determine the extent to which children’s eyewitness reports of traumatic experiences are accurate and complete. Also, in educational contexts, children may be asked to perform under conditions of heightened emotional arousal (e.g., when they are spontaneously called upon to recount their knowledge in front of classmates). The emotion that results from teacher and peer evaluations has implications for children’s performance and perceived competence. Finally, in clinical contexts, the ability to recount emotional events is emerging as a significant predictor of psychological outcomes. How children learn to describe emotional experiences and the extent to which they can do so coherently may play a critical role in their well-being. Clinicians must be aware of children’s emerging ability to describe stressors in order to develop and implement appropriate interventions. Given the broad range of implications that relate to understanding how emotions affect children’s memory, it is not surprising that a considerable amount of theorizing, research, and writing has been devoted to the topic of when and how emotions, particularly emotional distress and trauma, influence children’s memory. In 2006, we (Fivush and Quas) decided that it was time to bring together leading scientists conducting this research to discuss the current state of knowledge in this field. We thus held a small conference, supported by Emory University through the Emory Cognition Project, focused on emotion and memory v

in development. At the conference, more than a dozen top scientists in the United States and abroad whose work was relevant to the study of emotion and memory came together. We discussed our research, integrated findings, shared ideas, and elaborated on the theoretical and practical significance of the evidence to date. What emerged was not only a broader understanding of the state of the field, but also the clear need to incorporate findings from numerous related fields as we launch the next wave of research in this important field of inquiry. The current volume represents the outcome of the conference. Scientists expanded upon their ideas to address broad questions concerning how emotions and stress affect memory across development. One key question addressed by the volume’s contributors concerns why children react so differently to emotional experiences and subsequently come to understand those experiences differently. Contributors addressed this question by studying sources of individual differences that influence children’s emotional reactions, coping, and emotional understanding (Compas, Campbell, Robinson, & Rodriguez; Laible & Panfile), narrative processes (Oppenheim & Koren-Karie; Sales), and event memory (Baker-Ward, Ornstein, & Starnes; Chae, Ogle, & Goodman; Peterson & Warren). Of importance, sources range from those at the individual level (e.g., biological) level to those at the social-contextual level (e.g., parentchild discourse, attachment relationships, living with a chronic illness, living in an abusive environment) in which children’s lives are embedded. Thus, consistent with models of studying developmental phenomena at all levels of analysis, or “from neurons to neighborhoods” (Alexander & O’Hara), scientists interested in children’s memory for emotional events must consider multiple sources of influence across different levels. A second key question that appears across numerous chapters in this volume focuses on the precise emotional nature of the stressful event that children are remembering, or at least being asked to remember. That is, researchers have conceptualized and studied “emotion” and “stress” in different ways. For instance, some researchers who study emotion and memory investigate how well children remember discrete arousing or fear-eliciting events (e.g., tornados, invasive medical procedures) (Chae, Ogle, & Goodman; Peterson & Warren). Other researchers examine how exposure to chronic stress affects children’s memory functioning, including their general autobiographical memory (Greenhoot, Johnson, Legerski & McCloskey; Wiik & Gunnar), and the neurological structures underlying memory functioning (Carver & Cluver). A third approach, often taken by researchers interested in children’s physiological responses, attachment, or parent-child communication, involves investigating children’s and families’ reactions to and narratives about mildly arousing negative events (e.g., interpersonal conflicts, laboratory and naturalistic challenges, and/or brief encounters that evoke anger, sadness, or disgust) (Laible & Panfile; Sales; Oppenheim & Koren-Karie). Finally, in the neurobiological field, researchers interested in stress have studied the effects of stress on neurological and physiological processes linked to memory encoding, consolidation, and retrieval (Carver & Culver; Wallin, Quas, & Yim; and Wiik & Gunnar). The different foci have implications for evaluating children’s interpretations of and responses during vi

PREFACE

particular events and their later ability to recount those events accurately and completely (Bauer; Salmon & Conroy). As such, it is imperative to merge findings across the different conceptualizations and more clearly articulate the specific topics being studied to better understand the role of emotions broadly and distress and trauma specifically in children’s memory. A final key question raised by many of the contributors concerns how memories of emotional, especially traumatic, events are similar to and different from memories of everyday or mundane events (Chae, Ogle, & Goodman). Answers to this question remain elusive, especially in the developmental literature. One reason for this uncertainty stems from whether research focuses on group or individual differences. That is, when children recalling an emotional event (e.g., an inoculation) are compared to children recalling a nonemotional event (e.g., a well-child visit), emotional events are almost always recalled better than mundane events. However, when recall among children who have all experienced the same emotional event is examined, huge individual differences emerge in children’s understanding of the event, the magnitude of their emotional reactions, and the extent and accuracy of children’s memory (Baker-Ward, Ornstein, & Starnes). Thus, it is imperative to look beyond the general question “What are the overall effects of emotion on memory?” and instead ask “Why do individual children react differently to particular events and how (and when) do these reactions affect their later narrative processes and memory?” (Bauer; Fivush; Thompson).

Individual Chapter Overview Our volume is heuristically organized into four parts, although as will be evident quite quickly, the ideas presented overlap across the parts. However, the topics are often approached from different perspectives across the chapters, and, by taking these perspectives into account, novel insights into individual children’s memory for emotional events can be gleaned. In Part I, leading researchers who have studied emotion, primarily distress, and memory describe the current state of the field. Three research teams (Baker-Ward, Ornstein, & Starnes; Chae, Ogle, & Goodman; Peterson & Warren) who have examined how children remember a range of discrete distressing personal experiences. These teams describe their ongoing programs of research. Chae, Ogle, and Goodman open by outlining how attachment may influence children’s emotional reactions to and later memory for personally distressing experiences. Next, Baker Ward, Ornstein, and Starnes describe how children’s understanding of emotional events, both before events take place and as they unfold (what the authors termed extended encoding), affects children’s later memory. Peterson and Warren then describe findings from an ongoing line of work focused on children’s memory for injuries and hospital visits. The work has been instrumental in testing how stress, in conjunction with multiple individual-difference characteristics, relates to children’s memory. In the final chapter of the part, Greenhoot, Johnson, Legerski and Preface

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McCloskey review the state of research concerning stress and autobiographical memory development. They describe mechanisms that may underlie poor general autobiographical abilities among adolescents formerly exposed to trauma and present data from their ongoing longitudinal research that has tested several of these mechanisms. Overall, the chapters in Part I not only review current findings, but also draw explicit links to the topics discussed in subsequent Parts (e.g., attachment; chronic stress) and highlight the applications of the findings to theories concerning autobiographical memory development more broadly and to applied questions concerning children’s eyewitness abilities and developmental psychopathology. Part II comprises four chapters that highlight first the interrelations among coping, emotion regulation, attachment, and parent-child reminiscing; and second, the potential relations of these factors to children’s memory for stressful experiences. Although such topics have traditionally not been a primary focus in studies of children’s memory for stressful events, the literature reviewed in the chapters certainly demonstrates the relevance of coping, emotion regulation, and attachment for understanding how well parents and children reminisce about past negative events and children’s memory. Compas, Campbell, Robinson, and Rodriguez begin the part with a description of their dual process model of coping. They then discuss how executive functioning, especially working memory, may affect children’s use of controlled coping strategies, and how different coping processes may influence the occurrence of automatic intrusive memories. Oppenheim and Korens-Karie provide an overview of the secure-base function of attachment figures. The authors then describe several studies concerning parent-child discourse about emotional events. Findings suggest that emotionally matched narratives are reflective of a psychological secure base between a caregiver and child, and that these narratives have implications for a range of child outcomes. Third, Laible and Panfile discuss how parent-child conversations about emotional experiences, particularly after they occur, shape children’s emotion understanding, regulation capabilities, and well-being generally. Laible and Panfile further argue that it is critical to consider not only parent-child conversations, but also parent-child attachment, when evaluating how children come to understand negative emotional experiences. Finally, Sales describes how, via parent-child conversations, children find meaning in stressful events. She also discusses findings from several studies that indicate children’s coping and parent-child attachment may moderate the process by which parents and children talk about both discrete stressful experiences and chronic life stressors. Part III contain four chapters, each focused on different aspects of neurobiological and physiological stress-response systems and the implications of activation of these systems for children’s memory. First, Alexander and O’Hara, in a compelling chapter, integrate psychobiological processes with other elements of the developmental context to illustrate the complexity of the relations between emotion and memory. The researchers specifically argue that it is not enough to take into account the nature of the emotional stimulus or characteristics of the individual. Instead, a transactional model approach is needed to understand more viii

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fully how emotional experiences are retained in memory across development. In the next two chapters, Wiik and Gunnar, followed by Carver and Cluver, review in considerable detail evidence from several fields (e.g., nonhuman animal studies, investigations of adults’ physiological responses) concerning how children’s stress reactivity and exposure to chronic stress likely affect neurological and cognitive systems. Wiik and Gunnar focus on how stress likely affects children’s hypothalamic pituitary adrenal axis functioning, a key neuroendocrine regulatory system in humans. Carver and Cluver focus primarily on stress effects on brain structures involved in memory encoding and consolidation in children. In the fourth chapter, Wallin, Quas, and Yim describe how discrete stress responses according to multiple physiological systems, directly and in conjunction with sociocontextual factors, may influence children’s memory for stressful experiences. Overall, these chapters highlight the utility of considering biological factors, in conjunction with sociocontextual factors, to understand the many ways in which stress affects children’s memory, both broadly and for specific incidents. Finally, a critical feature of the volume is the final parts, which contains four integrative chapters each written from a somewhat different theoretical and applied perspective. These authors comment on the fi ndings discussed in the prior chapters, and, in doing so, synthesize the different literatures reviewed. Fivush takes a broad approach to integrating the chapters, further demonstrating the need to consider multiple levels of analysis when studying children’s memory. She persuasively argues that, not only are developmental level and individual differences complexly intertwined across time, but both are modulated by socioemotional contexts that provide the framework for the development and expression of memory and emotion. She then systematically combines evidence presented across the chapter to demonstrate this point and to suggest several important next steps for research. The next three authors in this part review specific issues raised across the volume. Thompson focuses on the important role that parent-child relationships play in children’s emotional reactions to, understanding of, and, later memory for, negative experiences. Thompson also describes key questions that arise when attempting to integrate literature across the chapters, questions whose answers will provide much-needed insight into the mechanisms that likely underlie the influence of close relationships on emotion and memory across development. Bauer provides perhaps the most critical evaluation of the research presented in the volume. She emphasizes that researchers, in their attempt to focus on specific influences on children’s memory for stressful events, have often oversimplified what is a complex, multifaceted phenomenon: how children attend to, interpret, and later reconstruct prior stressful experiences. As she clearly articulates, if the field is to continue to advance, future research must take a more comprehensive approach in studying stress and memory across development. Finally, Salmon and Conroy change directions somewhat and highlight the practical implications of research to date in two critical areas. These researchers describe the forensic relevance of the research for evaluations of child witnesses’ accounts of traumatic events to which they were exposed. The researchers then turn to the clinical relevance Preface

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of the research for, most notably, clinical evaluations of the effects of emotion on children’s event memory, but also for how emotional memories affect children’s functioning over time and for treatment possibilities of these effects.

Conclusions The overarching purpose of both the Emory Cognition Project Conference and this volume was to bring together researchers from diverse fields whose work had implications for understanding the complex links between emotion and memory in development. We hoped that, through the different authors’ presentations, interactions, discussions, and writing, common trends would be evident. And, from these common trends, we anticipated that a new, innovative research agenda would emerge. As is evident from the contributions of this volume, we have achieved success. The different contributors, from varying perspectives, provide valuable insight not only into the complex ways in which emotions likely affect memory, but also into the powerful mediating and moderating roles of children’s age and biological response proclivities, parental and familial influences, and the broader context within which children recount prior emotional autobiographical experiences. This insight lays the foundation for the next wave of research in this arena, and we look forward to taking part in this endeavor for years to come.

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PREFACE

Contents

Contributors xiii I

Stress and Memory, Empirical Evidence

1. Remembering Negative Childhood Experiences: An Attachment Theory Perspective 3 Yoojin Chae, Christin M. Ogle, and Gail S. Goodman 2. Children’s Understanding and Remembering of Stressful Experiences 28 Lynne Baker-Ward, Peter A. Ornstein, and Lauren P. Starnes 3. Injuries, Emergency Rooms, and Children’s Memory: Factors Contributing to Individual Differences 60 Carole Peterson and Kelly L. Warren 4. Stress and Autobiographical Memory Functioning 86 Andrea Follmer Greenhoot, Rebecca J. Johnson, John-Paul Legerski, and Laura A. McCloskey II Stress, Coping, and Parent-Child Narratives 5. Coping and Memory: Automatic and Controlled Processes in Adaptation to Stress 121 Bruce E. Compas, Laura K. Campbell, Kristen E. Robinson, and Erin M. Rodriguez 6. Mother-Child Emotion Dialogues: A Window into the Psychological Secure Base 142 David Oppenheim and Nina Koren-Karie xi

7. Mother-Child Reminiscing in the Context of Secure Attachment Relationships: Lessons in Understanding and Coping with Negative Emotions 166 Deborah Laible and Tia Panfile 8. Creating a Context for Children’s Memory: The Importance of Parental Attachment Status, Coping, and Narrative Skill for Co-Constructing Meaning Following Stressful Experiences 196 Jessica McDermott Sales III

Stress, Physiology, and Neurobiology

9. An Integrated Model of Emotional Memory: Dynamic Transactions in Development 221 Kristen Weede Alexander and Karen Davis O’Hara 10. Development and Social Regulation of Stress Neurobiology in Human Development: Implications for the Study of Traumatic Memories 256 Kristen L. Wiik and Megan R. Gunnar 11. Stress Effects on the Brain System Underlying Explicit Memory 278 Leslie J. Carver and Annette Cluver 12. Physiological Stress Responses and Children’s Event Memory 313 Allison R. Wallin, Jodi A. Quas, and Ilona S. Yim IV Integration and New Directions 13. Co-constructing Memories and Meaning over Time Robyn Fivush 14. Relationships, Stress, and Memory Ross A. Thompson

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15. Complications Abound, and Why That’s a Good Thing Patricia J. Bauer

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16. Emotion and Memory in Development: Clinical and Forensic Implications 394 Karen Salmon and Rowena Conroy Author Index 415 Subject Index 427

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CONTENTS

Contributors

Kristen Weede Alexander Department of Child Development California State University Sacramento, CA

Yoojin Chae Department of Psychology University of California Davis, CA

Lynne Baker-Ward Department of Psychology North Carolina State University Raleigh, NC

Annette Cluver Department of Psychology University of California San Diego, CA

Patricia J. Bauer Department of Psychology Emory University Atlanta, GA

Bruce E. Compas Department of Psychology and Human Development Vanderbilt University Nashville, TN

Laura K. Campbell Department of Psychology and Human Development Vanderbilt University Nashville, TN

Rowena Conroy Royal Children’s Hospital Melbourne, Australia Robyn Fivush Department of Psychology Emory University Atlanta, GA

Leslie J. Carver Department of Psychology University of California San Diego, CA

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Gail S. Goodman Department of Psychology University of California Davis, CA Andrea Follmer Greenhoot Department of Psychology University of Kansas Lawrence, KS Megan R. Gunnar Institute of Child Development University of Minnesota Minneapolis, MN Rebecca J. Johnson Children’s Mercy Medical Center Kansas City, MO Nina Koren-Karie Department of Psychology University of Haifa Mr. Carmel, Israel Deborah Laible Department of Psychology Lehigh University Bethlehem, PA John-Paul Legerski Department of Psychology University of Kansas Lawrence, KS Laura A. McCloskey Institute for Research on Women and Gender University of Michigan Ann Arbor, MI Christin M. Ogle Department of Psychology University of California Davis, CA xiv

CONTRIBUTORS

Karen Davis O’Hara Department of Child Development California State University Sacramento, CA David Oppenheim Department of Psychology University of Haifa Mt. Carmel, Israel Peter A. Ornstein Department of Psychology University of North Carolina Chapter Hill, NC Tia Panfile Department of Psychology Lehigh University Bethlehem, PA Carole Peterson Department of Psychology Memorial University of Newfoundland St. John’s, Canada Jodi A. Quas Department of Psychology and Social Behavior University of California Irvine, CA Kristen E. Robinson Department of Psychology and Human Development Vanderbilt University Nashville, TN Erin M. Rodriguez Department of Psychology and Human Development Vanderbilt University Nashville, TN

Jessica McDermott Sales Department of Behavioral Sciences and Health Education Emory University Atlanta, GA

Allison R. Wallin Department of Psychology and Social Behavior University of California Irvine, CA

Karen Salmon School of Psychology Victoria University of Wellington Wellington, New Zealand

Kelly L. Warren Department of Psychology Memorial University of Newfoundland St. John’s Canada

Lauren P. Starnes Department of Psychology North Carolina State University Raleigh, NC

Kristen L. Wiik Institute of Child Development University of Minnesota Minneapolis, MN

Ross A. Thompson Department of Psychology University of California Davis, CA

Ilona S. Yim Department of Psychology and Social Behavior University of California Irvine, CA

Contributors

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I

Stress and Memory, Empirical Evidence

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1 Remembering Negative Childhood Experiences An Attachment Theory Perspective Yoojin Chae Christin M. Ogle Gail S. Goodman

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ttachment theory provides a powerful framework for understanding children’s memory and suggestibility for emotional life experiences. In particular, attachment theory can serve as a basis for predictions about individual differences in the ways children respond to and remember stressful incidents. Beginning with research on children’s memory for distressing medical procedures (Goodman, Hepps, & Reed, 1986; Goodman, Bottoms, Schwartz-Kenney, & Rudy, 1991; Goodman, Hirschman, Hepps, & Rudy, 1991) and extending more recently to research on children’s memory for criminal victimization (e.g., Bidrose & Goodman, 2000; Hershkowitz, Lanes, & Lamb, 2007; Leander, Christianson, & Granhag, 2007), several decades of scientific study on children’s memory for stressful events have quickly elapsed. A substantial body of empirical knowledge has thus accumulated. It is now time for the field to turn to theory testing. In our own research, for theoretical guidance, we find that attachment theory offers substantial insights This chapter is based on work supported in part by the National Science Foundation (grant 0545413). Any opinions, findings, conclusions, or recommendations expressed in this article are those of the authors and do not necessarily refl ect the views of the National Science Foundation. We thank Stephanie Head for editorial assistance. Address correspondence to Dr. Gail S. Goodman, Department of Psychology, University of California, 1 Shields Avenue, Davis, CA 95616 ([email protected]).

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about memory for distressing childhood experiences, in particular, those that activate the attachment system. In this chapter, we first provide a brief overview of attachment theory, and then review empirical findings from various laboratories on significant relations of attachment with children’s memory and suggestibility for emotional, attachment-evoking information, focusing on (1) associations between children’s attachment and their memory/suggestibility for attachment-related information, and (2) associations between parents’ attachment and children’s memory/suggestibility for such information. Following this, we consider potential mechanisms underlying the relations. We also discuss the information-processing stages (e.g., encoding, retrieval) during which the attachment effects may be operative. We then turn to a more in-depth description of our studies.

Attachment Theory Attachment theory was formulated by John Bowlby (1958) to explain the importance of early caregiver-child relationships for personality development and emotion regulation. Based on the degree to which their caregivers are available and provide support when needed, infants form expectations or internal working models (IWMs), which are viewed, theoretically, as fairly stable mental representations of the self and the caregiver (Bowlby, 1980; Bretherton & Munholland, 1999). These IWMs are then used to interpret others’ intentions and actions, anticipate future behaviors, and regulate responses, particularly in times of stress (Bowlby, 1969). The Strange Situation, which consists of a series of separations from and reunions with a caregiver, is a laboratory situation developed to assess the quality of infant-caregiver attachment (Ainsworth, Blehar, Waters, & Wall, 1978). Specifically, the Strange Situation consists of eight phases, involving, for example, the parent and child being in an unfamiliar room, a stranger entering, the parent leaving, and the parent and child reuniting. Based on infant behaviors in the Strange Situation, infant-caregiver attachment styles were originally categorized into three patterns: secure, insecure-avoidant, and insecure-anxious. Securely attached infants have IWMs reflecting available and responsive caregivers in stressful or threatening situations. These infants seek proximity, contact, and communication with their caregivers during reunions, are easily soothed by the caregiver, and generally cope with stress effectively. Insecure-avoidant infants represent their caregivers as unwilling or unavailable to soothe negative affect and thus tend to avoid or ignore the caregivers upon reunions despite experiencing a great amount of distress during separations. Insecure-anxious infants represent their caregivers as 4

STRESS AND MEMORY, EMPIRICAL EVIDENCE

inconsistently available or inconsistently supportive and thus sometimes cling excessively to a caregiver to avoid separation but also display angry, resistant behavior upon reunion. A fourth category, disorganized/ disoriented, was later conceptualized for infants who fail to maintain a coherent attachment strategy for dealing with reunion and exhibit sequences of behavior that seem to lack a clear goal or that evince a collapse of strategy (Main & Solomon, 1990). These four attachment patterns were first defined for infants, but similar attachment patterns have been identified in children at preschool age (Main, Kaplan, & Cassidy, 1985), although more stressful events (e.g., starting kindergarten) may be needed to evoke distress in children after infancy (Quas, Murowchick, Bensadoun, & Boyce, 2002). Attachment theory can also be applied to adults’ intimate relationships. Based on what appears to be continual effects of attachment styles on affectional bonds and behaviors in close relationships (e.g., with romantic partners) in adulthood, Hazan and Shaver (1987) expanded the theory to encompass adults’ attachment, which is hypothesized to be based on experiences with primary attachment figures (e.g., parents). Adult attachment styles (and parent-child attachment styles as well; Fraley & Spieker, 2003) are characterized by two relatively independent dimensions, avoidance and anxiety (Fraley & Shaver, 2000). Attachment avoidance, reflected by discomfort with closeness and intimacy (Brennan, Clark, & Shaver, 1998; Fraley, Davis, & Shaver, 1998; Fraley & Shaver, 1997), refers to attempts to deactivate, down-regulate, or inhibit attachment-system activation (Edelstein & Shaver, 2004). Avoidant attachment is further divided into a dismissing avoidant style (i.e., purporting not to need or like closeness and interdependence) and a fearful avoidant style (i.e., desiring closeness while also fearing some of its consequences). Attachment-anxiety, involving preoccupation with the availability and responsiveness of attachment figures (preoccupied attachment; Mikulincer, Birnbaum, Woddis, & Nachmias, 2000; Mikulincer, Gillath, & Shaver, 2002), is characterized by hyperactivation of the attachment system (Cassidy, 2000). Adults who score low on both avoidance and anxiety dimensions are considered securely attached. Individual differences in adult attachment have been associated with parenting behaviors, for example, with high scores on avoidance and/or anxiety being related to negative models of parenthood and parent-child relationships, such as stricter, harsher disciplinary practices, lower levels of warmth, tendencies to be easily aggravated by children, less perceived ability to relate to children, and colder relations with children (Rholes, Simpson, & Blakely, 1995; Rholes, Simpson, Blakely, Lanigan, & Allen, 1997). These models in turn influence children’s strategies of affect regulation, as evident, at least under stressful situations, in more severe Remembering Negative Childhood Experiences

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emotional reactions demonstrated by children of insecure parents than by children of secure parents, who might expect their parents to provide safety and protection (Goodman, Quas, Batterman-Faunce, Riddlesberger, & Kuhn, 1994, 1997). Indeed, when children experience stressful or attachment-activating incidents, such as a painful medical procedure, adults’ attachment styles have important implications for responsiveness to and support of children (Edelstein et al., 2004).

Attachment and Memory Attachment theorists have proposed that attachment styles, and associated IWMs, affect not only relationship behavior but also children’s memory for attachment-related experiences (for a review, see Alexander, Quas, & Goodman, 2002). Individual differences in children’s own attachment and parents’ attachment may influence the kinds of information and extent to which children encode, elaborate on, and later retrieve and report the information. As one example, avoidant children whose bids for care have been rejected or belittled are theorized to develop a nonconscious strategy, called “defensive exclusion,” which limits processing of stressful events, with the goal of preventing activation of the attachment system, such as the negative affect associated with reminders of attachmentrelated loss or extended separations (Bowlby, 1980; Main, 1990). Such limits on processing have implications for memory. In contrast, anxious children are theorized to be hypervigilant to attachment-related stressors because of their overconcern for attachment-related issues (Mikulincer et al., 2000, 2002). However, studies have demonstrated inconsistent findings regarding the anxiety dimension and memory. Attachment orientation has also been related to children’s suggestibility. Bruck and Melnyk (2004) conclude, in a review of individual differences in suggestibility, that attachment shows promise of being consistently related to suggestibility: Children who are insecurely attached or whose parents are insecurely attached are more suggestible than their secure counterparts. This topic is particularly important in view of evidence that abused children, who are often questioned in forensic settings, are likely to have high rates of insecure attachment (Barnett, Ganiban, & Cicchetti, 1999). We make several basic assumptions in our research program on attachment and memory. First, we assume that many traumatic and stressful events trigger the attachment system. We further propose that internal working models (IWMs) act as sets of expectations that influence levels of distress and memory performance in attachment-related stressful situations. We also assume, based in part on our empirical 6

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findings, that parental attachment is relevant to how children cope with stressful situations during and after they occur, which affects children’s memory and resistance to false suggestion. Finally, we assume that individual differences in attachment are important moderators of the extent to which threatening information is attended and processed, and thus remembered.

Children’s Attachment and Memory/Suggestibility Studies have shown that children’s attachment to a caregiver may be a valuable predictor of their memory for attachment-relevant information. Kirsh and Cassidy (1997) investigated associations between threeyear-olds’ attachment orientations, assessed in infancy using the Strange Situation procedure, and memory for attachment-related stimuli. Children were read stories in which mothers’ reactions to their children’s requests for help varied to correspond to three different attachment-related IWMs (i.e., secure mothers responded sensitively; avoidant mothers rejected their children; anxious mothers provided exaggerated responses). On a subsequent cued-recall test about the stories’ content, secure children recalled both responsive and rejecting stories better than did avoidant and anxious children, even with general cognitive functioning controlled statistically. Alexander and Edelstein (2001) also found that attachment security assessed by the Attachment Q-sort (Waters & Deane, 1985), completed by an adult familiar with the child’s behavior, was positively related to threeto five-year-olds’ memory for attachment-related stories, even with statistical control of age and temperamental characteristics. Overall, across these studies, the findings underscore the importance of attachment orientations in predicting children’s memory for attachment issues, over and above contributions of age, general cognitive functioning, and temperament. However, when to-be-remembered information did not evoke attachment concerns, a different pattern regarding attachment and memory was revealed. Alexander and Edelstein (2001) found no significant relations between children’s memory for a nonattachment-related play event (e.g., making hot chocolate) and their attachment security. Also, in a study by Belsky, Spritz, and Crnic (1996), which investigated relations between boys’ attachment styles assessed in the Strange Situation at 12 months and recognition memory at three years for details from nonattachmentrelevant puppet shows (e.g., receiving a birthday present, spilling juice), boys with secure attachment histories remembered more positive than negative information, whereas boys with avoidant- or anxious-attachment histories recalled more negative than positive information. Fewer studies have been published on children’s attachment and suggestibility. Quas, Qin, Schaaf, and Goodman (1997) proposed that Remembering Negative Childhood Experiences

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insecure children might be particularly susceptible to the demand characteristics of an interview (i.e., social pressure to agree with an interviewer) because they might be emotionally needy or nervous and therefore more likely to comply with an interviewer in an effort to receive approval and thus less likely to report their own memory. Indeed, Clarke-Stewart, Malloy, and Allhusen (2004) observed significant associations between children’s attachment at 15 months, assessed in the Strange Situation, and suggestibility for nonattachment-related activities (e.g., administration of standard developmental assessments) at 5 years: Children lacking a secure attachment relationship with their mothers displayed increased suggestibility (e.g., agreements that the examiner had undressed them). This finding implies that the link between children’s attachment security and suggestibility exists even for information not directly related to attachment issues, possibly because insecurely attached children are more nervous and distressed in social interactions with an unfamiliar adult.

Parental Attachment and Memory/Suggestibility Based on reasoning and research supporting the intergenerational transmission of attachment (Benoit & Parker, 1994; Steele, Steele, & Fonagy, 1996), parental attachment has at times been used as a proxy measure for children’s attachment. However, there are reasons to be interested in parental attachment itself as an influence on children’s memory and suggestibility. Parents’ mental representations of attachment may be related to their sensitivity and responsiveness to their children’s attachment signals (e.g., their children’s distress, needs for comfort; Edelstein et al., 2004; Goodman et al., 1997; Van IJzendoorn, 1995). Research has shown the functional role of parental attachment in children’s memory and suggestibility for stressful incidents. As discussed in greater detail later in this chapter, in a series of studies on children’s recollections of medical procedures, such as well-child inoculations and an invasive medical test (i.e., voiding cystourethrogram fluouroscopy, also called VCUG), we found that children of avoidantly attached parents provided more inaccurate memory reports and displayed heightened suggestibility, particularly under high levels of distress, compared to children of securely attached parents. In contrast, Alexander and Schaaf (2001) reported that parental attachment was not significantly related to children’s memory for a less stressful, nonattachment-related play event. Thus, as is the case for children’s attachment style and children’s memory/suggestibility, parental attachment style and children’s memory/suggestibility seem to be particularly interrelated in regard to events that evoke attachment issues.

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As implied by the intergenerational transmission of attachment, parental attachment style predicts children’s attachment style. Secure parents may be better able to perceive their child’s attachment signals accurately and react adequately. Avoidant parents may rebuff their child’s attachment behavior, because they prefer not to encounter strong emotions and close contact. Anxious parents may be overly focused on their own attachment experiences and thus respond inappropriately and at times excessively. According to theory and evidence, these differences in parents’ responsiveness to their children may in turn determine children’s attachment to their parents (Ainsworth et al., 1978; Bowlby, 1969; Campbell et al., 2004; DeWolff & Van IJzendoorn, 1997; Van IJzendoorn, 1995). Hence, sensitive and responsive parents are more likely to have securely attached children, whereas insensitive and unresponsive parents run a higher risk of having insecurely attached offspring. Consequently, the documented associations between parents’ attachment and children’s memory/ suggestibility for attachment-evoking events may be due to the quality of children’s attachment to their parents. However, significant relations between parental and child attachment have not always been demonstrated (e.g., Fivush & Sales, 2006). Thus, the link between the two attachment orientations cannot yet be assumed to be underlying the relations between parental attachment and children’s memory/suggestibility. Other mediators relevant to parental attachment might be responsible for the relations.

Mechanisms Underlying Attachment-Memory/ Suggestibility Relations Although mechanisms underlying attachment-memory/suggestibility relations await elucidation, researchers have proposed possible mediators. These include attentional focus, parent-child rehearsal, and sensitivity to interview context. Based on a review of previous theory and evidence, we discuss the role of these potential mediators in the mnemonic processes of encoding, storage, and retrieval.

Encoding Attachment-related IWMs and associated mental strategies likely act as affective and cognitive filters that influence preattentive processing and selective attention. This is a way in which attachment theorists retain the psychoanalytic notion of “defense” (Thompson, Laible, & Ontai, 2003). More specifically, based on Bowlby’s notion of defensive exclusion, avoidant children, who have learned to associate attachmentsystem activation with rejection and distress, are thought to regulate their

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attention to (i.e., defend against) materials with emotional, attachmentrelated themes. If potentially upsetting information is not fully processed, the attachment system is less likely to be activated, thus reducing psychological pain or discomfort but at the same time impairing memory. Findings from the few studies of attachment-related differences in attention are consistent with this idea. In the study by Kirsh and Cassidy (1997) referred to earlier, when children were shown several sets of drawings depicting different mother-child dyads engaged in positive, negative, and neutral interactions, avoidant children looked away from the drawings more than did secure and anxious children. In addition, when shown different sets of drawings depicting mother-child dyads engaged in positive interactions and adult dyads expressing neutral affect, avoidant and anxious children looked away from the mother-child drawings more than did secure children. Additional evidence comes from a study by Main et al. (1985), which showed that infant attachment classification predicted six-year-olds’ attention to family photographs: Avoidant children were more likely than secure or anxious children to avoid looking at the photographs and actively turned away from them. In short, extant studies provide support for the theoretical link between children’s insecure, particularly avoidant, attachment and inattention or avoidance of attention to attachment-related information. Findings from research with adults provide enticing hints regarding the extent to which insecure children’s memory deficits and suggestibility result from restricted attention at encoding. Fraley, Garner, and Shaver (2000) examined adult avoidant attachment in relation to encoding of attachment-related information and decay of the information over time. In Fraley and colleagues’ study, some participants were interviewed about attachment-related issues immediately after encoding (about 3 minutes); other participants were interviewed at various delay intervals (3–21 days). Results suggested that, compared to individuals low in avoidance, highly avoidant individuals were less attentive to attachmentrelated information initially. However, the two groups forgot the encoded information at a similar rate. These findings imply that encoding and attentional mechanisms underlie avoidant adults’ memory deficits, as opposed to subsequent repression or lack of elaboration. If these findings generalize to children, memory deficits of avoidant children may be due to limited attentional processes at encoding similar to those used by avoidant adults. Parental attachment style also has implications for the amount and type of information children encode in attachment-eliciting situations, which may be mediated by parents’ responsiveness and support. As described in greater detail later in this chapter, Edelstein et al. (2004) found that parents high in avoidant attachment were less supportive 10

STRESS AND MEMORY, EMPIRICAL EVIDENCE

toward their children during an inoculation if their children were highly upset, whereas this pattern was reversed for less avoidant parents. These variations in parental behaviors in challenging situations may influence children’s distress level and ability to cope with stress, which in turn may affect children’s focus of attention. However, further research is necessary to make clear the mediating role of attentional processes at the encoding phase in the relations between attachment and memory/ suggestibility.

Storage Attachment also has implications for children’s retention of information in memory. Secure children who have developed IWMs of a responsive and supportive caregiver may feel comfortable thinking about stressful experiences and be able to handle aversive emotions. In contrast, avoidant children are likely to eschew attachment-related elaboration, desiring to keep the attachment system from being strongly activated. In addition, they may suppress or distort the details of attachment-related information to regulate their emotions (Bowlby, 1958; Bretherton & Munholland, 1999). Anxious children may have difficulties in dealing with negative emotions evoked by thoughts about stressful incidents, excessively focusing on the stressors and themselves. Thus, overall, insecure compared to secure children might be less able to think back to distressing incidents in a coherent and organized way. A study by Mikulincer and Orbach (1995) with adults provides support for these theoretical ideas. When asked about early childhood experiences associated with certain emotions, such as anxiety, sadness, or happiness, and asked to rate how they had felt at the time of the event, avoidant individuals reported less intense emotions than did anxious individuals in the sadness and anxiety episodes. Secure people fell in between the two insecure groups but did not significantly differ from them. In addition, anxious individuals were unable to repress negative affect or to inhibit emotional spreading, whereas secure people accessed negative memories easily without being overwhelmed. Insecure individuals’ discomfort with emotional issues might further contribute to lack of coherency in parent-child discourse concerning stressful information (Bretherton, 1990, 1996; Thompson, 2000). Indeed, research has established that the style and content of parent-child rehearsal are a function, at least in part, of the attachment status of the parent and child (Newcombe & Reese, 2004; Reese & Farrant, 2003). Specific to emotional issues, due to difficulty in confronting and coping with negative emotions, insecure mother-daughter dyads avoid elaborating on such emotions, whereas secure dyads openly expand on both positive Remembering Negative Childhood Experiences

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and negative emotions (Farrar, Fasig, & Welch-Ross, 1997). Similarly, secure mother-child dyads discuss a potentially threatening topic (e.g., misbehavior) with more emotional openness than insecure dyads (Laible & Thompson, 2000). Of interest, in a study conducted by Laible (2004), although secure, compared to insecure, dyads discussed negative emotions more frequently, attachment security was not significantly related to the discussion of positively valenced emotions during memory conversations. Also, a study by Fivush and Vasudeva (2002), in which the majority of the mother-child dyads talked about highly positive experiences, revealed that the attachment status of mother-child dyads was not significantly related to their tendency to openly discuss emotions. Hence, attachment orientations seem to matter most when parents and children discuss negative emotions and negative experiences (Bowlby, 1988). These differences in reminiscing conversations may in turn shape children’s storage of information and subsequent recollection of that information (Fivush, 1994; Hudson, 1990; Nelson, 1993). Talking openly and fluently about emotions may make emotions and emotion-related memories more accessible and less threatening for children when they reflect on previous emotional experiences. Children may also learn communication patterns and emotional content, as reflected in their own use of emotion references, affective perspective taking, and early conscience development, through shared-memory talk with their parents (Laible, 2004; Laible & Panfile, this volume; Laible & Thompson, 2000; Leichtman, Skowronek, & Pillemer, 2005; Oppenheim & Waters, 1995). A study by Favez (1997) showed that mothers who included both memory prompts (e.g., “And then what happened?”) and affective prompts (e.g., “Were you sad?”) about a stressful separation video had children who remembered the video content better than did mothers who included only memory prompts.

Retrieval Sensitivity to interview context as a function of attachment style is another possible mediator of the attachment-memory/suggestibility relations. Although children are generally hesitant to confront and/or talk about highly negative incidents (Engelberg & Christianson, 2002), insecurely attached children and/or children of insecure parents, who are more nervous and distressed with an adult interviewer, may be particularly reluctant to share emotionally distressing experiences. Furthermore, such children may be more likely to simply accept interviewers’ suggestions, compared with their secure counterparts.

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Some empirical evidence implies that an unfamiliar or nonsupportive interviewer may raise attachment concerns in children, contributing to poor performance among insecurely attached children, even when tobe-remembered events are unlikely to have evoked attachment issues. Davis et al. (1998) found that children of insecurely attached parents were more suggestible when interviewed about a play event by a cold, professional interviewer than by a warm, supportive interviewer, whereas the performance of children of secure parents did not vary as a function of the interviewer’s level of support. The authors reasoned that children of insecure mothers might be similarly insecure, thus being more apprehensive and distressed during the interview and having more difficulty resisting a neutral interviewer’s suggestions. That is, attachment style may not affect children’s memory per se, but rather, through children’s generalized IWM of relationships, attachment style may influence sensitivity to social interactions with an unfamiliar and/or nonsupportive adult.

Our Research on Attachment and Memory/ Suggestibility In this section, we delve into greater detail about our research on attachment, memory, and suggestibility. In doing so, we hope to illustrate the specific influence on memory/suggestibility of parental as well as child attachment. Before considering the research, a few general points about stress and memory are essential to address. Substantial debate exists as to whether, in the face of stressful, or even traumatic, experiences, memory accuracy suffers or benefits. Based on a comprehensive review, Christianson (1992) proposed that, during highly distressing events, memory for main stressors is strengthened, whereas memory for peripheral details is impaired. Others have argued that memory accuracy peaks for moderately arousing events and declines when events are so distressing as to activate defensive processes (Deffenbacher, Bornstein, Penrod, & McGorty, 2004). Both of these views may be true, at least to a certain extent, regarding memory for stressful childhood experiences. Our research reveals that overall, Christianson’s (1992) formulation applies well to a majority of people (e.g., more secure individuals) when interviewed about stressful events that likely activate the attachment system, but that Deffenbacher et al.’s (2004) ideas may be applicable to a subset of individuals (e.g., avoidant individuals), specifically those for whom the processing of stressful, attachment-related information is characterized by defensive exclusion.

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Parental Attachment, Parental Responsiveness, and Child Memory/Suggestibility for VCUG The first study to uncover significant relations between parental attachment and children’s memory concerned 3- to 10-year-olds’ recollections of VCUG (Goodman et al., 1994, 1997). This medical test is at times ordered by doctors when a child has urinary track problems (e.g., bladder infections, excessive bed wetting). The procedure involves the following: The child and parent go to the Radiology Department of a hospital, at which point the child undresses, puts on a hospital gown, and lies on an x-ray table. Next, an x-ray technician enters and takes initial x-rays. A nurse then arrives to wash the child’s genitals. With the child forcibly held down, the nurse catheterizes the child through the urethra, which can be painful and scary. Then, in some hospitals, the standard procedure is to require the child’s parent to leave the room before a doctor enters to take additional x-rays. Finally, the parent is reunited with the child. This medical procedure, in some of its formal characteristics, has certain similarities to the Strange Situation. Although the VCUG entails direct assault (penetration) of the child’s body, whereas the Strange Situation does not, both procedures involve a parent and child in an unfamiliar setting, strangers and the parent entering and leaving the room, and a parent-child reunion. Thus, it was of interest to include an attachment measure in the study. However, given the age range of the children tested (3 to 10 years), a single child attachment measure was not feasible. Fortunately, an adult attachment measure that could be easily administered to the parents was available (Bartholomew & Horowitz, 1991; Hazan & Shaver, 1987), and the parent completed it a few weeks after the VCUG, when the child’s memory and suggestibility regarding the invasive medical procedure was also tested. As would be expected based on an attachment-theory orientation, parental attachment style was correlated with children’s level of distress and later suggestibility. Parents with a more avoidant attachment style had more suggestible children, whereas parents with a relatively secure attachment style had children who made fewer errors to misleading questions. In multivariate path models, parental attachment was a stronger predictor of child memory errors than was child distress. Remarkably, parental attachment was an even stronger predictor than child age for some memory measures. We further found that the avoidant parents were more likely than secure parents to report that they had not prepared the child for the VCUG, had not talked much to the child about it after, avoided physically comforting the child, and did not have time to attend to the 14

STRESS AND MEMORY, EMPIRICAL EVIDENCE

child’s feelings. Despite these relations, a mediational analysis (Baron & Kenny, 1986) indicated that these factors did not mediate the correlations between parental attachment and child memory performance. In a second VCUG study, Quas et al. (1999) also showed that parental insecurity was predictive of inaccuracies in three- to 13-year-olds’ reports about VCUG even when the medical procedure had been experienced months to years earlier. Children of fearful-avoidant parents made more errors to specific questions and fewer do-not-know responses to misleading questions. In addition, children of dismissingly avoidant parents displayed heightened suggestibility. These first two studies showed important relations between parental attachment, children’s distress, and children’s memory. It was crucial to determine, however, if the results would generalize to other stressful situations. We also wondered if we could capture differences in parents’ reactions to children’s distress while the stressful event was unfolding. We thus turned to videotaping children while they received inoculations as a regular part of their health care. In this way, we could also include a wider range of families.

Parental Attachment, Parental Responsiveness, and Child Memory/Suggestibility for Inoculations Edelstein et al. (2004) examined relations between adult attachment and parental responsiveness toward 3- to 7-year-olds during well-child inoculations. Compared to VCUGs, inoculations are typically less stressful. However, for some children (e.g., those who receive six shots in one sitting), inoculations can be quite upsetting. We hypothesized that relations between attachment and parental responsiveness would be most evident for the children who became particularly distressed during inoculations. Previous research indicated that the amount of emotional support provided to a romantic partner is predicted by an interaction between attachment-related avoidance and partner distress (Fraley & Shaver, 1998; Simpson, Rholes, & Nelligan, 1992). Specifically, avoidant individuals became less emotionally supportive of their partners when those partners became more distressed. To the extent that adults’ self-reported attachment styles reflect their relationship orientations more generally, an interaction between parental avoidance and children’s levels of distress was expected to predict parental responsiveness. That is, as children become more upset, more avoidant parents were anticipated to become less supportive, whereas the opposite was expected for more secure parents. It was important to ensure, however, that the findings were not due to child temperament or parental personality. Given the possible relations Remembering Negative Childhood Experiences

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among child temperament, parental personality, and children’s reactions to stressful events, these factors were also considered in predicting parental responsiveness. In the study, parent-child dyads were observed while children received doctor-ordered inoculations at a county immunization clinic. The event was videotaped and coded independently for children’s distress and parental responsiveness. Distress was evaluated before, during, and immediately following the inoculation. In addition, a global evaluation of children’s overall reaction was made. Parental responsiveness was assessed using the Emotional Availability Scales (Biringen, Robinson, & Emde, 1998), which measure the affective quality of parent-child interactions along four emotional availability dimensions: sensitivity, structuring, nonintrusiveness, and nonhostility. Parental attachment style was measured using the Relationship Scales Questionnaire (RSQ, Griffin & Bartholomew, 1994), children’s temperament was assessed by the Children’s Behavior Questionnaire (Ahadi, Rothbart, & Ye, 1993), and parental personality was measured using the NEO Five-Factor Inventory (Costa & McCrae, 1992). These are all well-regarded, standardized measures used frequently in psychological research. A positive relation was found between adult avoidant attachment and children’s distress during the inoculation such that having a parent who scored higher on attachment avoidance was predictive of more child distress during the inoculation. Hierarchical regression revealed that the influence of parental avoidance on children’s distress remained significant after controlling for parental personality and children’s temperament. Attachment anxiety was unrelated to children’s distress. Significant relations also emerged for adult avoidant attachment and parental responsiveness. Parents scoring higher on attachment avoidance were rated as less responsive to their children during the inoculation. An interaction between adult avoidant attachment and children’s emotional reaction predicted parental responsiveness, such that parents scoring high on avoidance were less responsive to their children, especially when their children were highly distressed. It thus appeared that we could capture attachment-related differences in parental behavior toward children during a stressful event itself. Put simply, as the children became more distressed during the inoculations, secure parents became nicer to their children, and avoidant parents became less positively (and often more negatively) engaged. Given that stress level and parental responsiveness during a distressing incident might influence children’s attention to the stressor at the encoding phase and thus affect memory accuracy, we wondered if parental attachment would predict children’s memory and suggestibility about the inoculations. 16

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Thus, Alexander et al. (2002a) investigated relations between adults’ self-reported attachment and their children’s memory and suggestibility for the inoculation event studied by Edelstein et al. (2004). It was predicted that children of parents with secure adult attachment orientation would have better memory for the inoculation and greater resistance to suggestion than children of insecurely attached parents. Moreover, it was expected that for most children, greater distress would be associated with better memory for the inoculation (Christianson, 1992), but that for children of avoidant parents, greater distress would be associated with worse memory (Deffenbacher et al., 2004). Regarding the latter association, not only might defensive exclusion be involved but several additional factors might be at work as well. For example, our VCUG studies (Goodman et al., 1997) indicated that children of avoidant parents were less likely to have been prepared for the procedure, which might contribute to poorer encoding, and less likely to have received parental help to cope emotionally afterwards, that is, at the storage phase. Moreover, during the inoculation event, Edelstein et al.’s (2004) results showed that the children of avoidant adults had to deal with a hostile parent in addition to the shots, thus perhaps encoding less information about the inoculation. Children between the ages of three and seven were interviewed about getting their shots approximately two weeks after the shots had taken place. Memory interviews included free-recall questions, and direct and yes/no questions that were either specific or misleading in nature. Selfratings of parental attachment styles were obtained using the Relationship Questionnaire (RQ; Bartholomew & Horowitz, 1991) and the RSQ (Griffin & Bartholomew, 1994). Results revealed a positive relation between children’s distress and the accuracy of their memory reports. However, this relation was found only for children of parents who scored low on attachment avoidance, that is, parents who were more secure. Children of parents with high avoidant-attachment scores tended to show poor memory for free recall and yes/no questions about the inoculation, especially when the children had been highly distressed. The memory findings of Alexander et al. (2002a) thus mirrored the parental responsiveness fi ndings of Edelstein et al. (2004). The results suggest that the beneficial effect of stress on memory (Christianson, 1992; Goodman et al., 1991) may not extend to children of parents with high scores of attachment avoidance. The findings described thus far demonstrate the usefulness of attachment theory in predicting and understanding children’s memory for medical procedures. It was important to determine if the findings would extend beyond this domain. We were fortunate to be able to test the generalizability of our findings to the realm of adults’ and adolescents’ memory for childhood trauma, specifically the trauma of child sexual abuse. Remembering Negative Childhood Experiences

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Attachment and Memory for Child Sexual Abuse Edelstein et al. (2005) examined the relation between adult attachment and long-term memory for child sexual abuse. The adults and adolescents had participated in a longitudinal study of the emotional outcomes for child sexual-abuse victims involved in the legal system (Quas et al., 2005). As already mentioned, previous research indicated that, although emotion generally enhances memory, individuals with avoidant-attachment styles may have memory deficits for highly emotional information. Thus, an interaction between child sexual abuse severity and attachment avoidance was hypothesized: Individuals low on avoidant attachment were expected to demonstrate the most accurate memory for severe child sexual abuse, whereas individuals high on attachment avoidance were expected to show worse memory for more severe abuse. The nature of the victims’ abuse experiences varied widely, including on dimensions of severity (e.g., from less severe child sexual abuse, such as fondling over the clothes, to highly traumatic child sexual assault, such as kidnap with rape at gunpoint), which permitted a test of the hypothesis that individuals’ with avoidant attachment styles would show greater memory deficits for particularly negative and severe abuse incidents. For the study, adults and adolescents with documented histories of child sexual abuse were interviewed 12 to 21 years after the alleged abuse ended. Detailed information (derived from prosecutors’ files, police reports, etc.) regarding participants’ prior abuse experiences was examined to assess memory accuracy for the abuse. That is, memory accuracy was evaluated based on discrepancies between the memory reports in comparison to the original documentation of sexual abuse during the victims’ childhoods. Abuse severity was calculated based on factors such as abuse duration, extent of sexual contact, and degree of force and injury sustained, and was used as an index of the emotional intensity of the abuse incident. The degree to which participants discussed their abuse experiences with friends and family members was also assessed. Adult attachment was measured using the RQ (Bartholomew & Horowitz, 1991). Regression analyses revealed the expected interaction between abuse severity and avoidant attachment. Child sexual-abuse victims with low scores on avoidant attachment showed greater memory accuracy for cases of severe abuse, whereas victims scoring high on avoidant attachment demonstrated worse memory for severe abuse. Furthermore, avoidant individuals were less likely to have discussed the abuse with others. Frequency of discussion was related to memory accuracy for the abuse, such that the less one talked about the abuse, the less accurate was memory for the abuse. Attachment anxiety was unrelated to memory 18

STRESS AND MEMORY, EMPIRICAL EVIDENCE

accuracy, irrespective of abuse severity. These fi ndings demonstrate the importance of understanding the influence of attachment in investigations of memory for real-life traumas. Similar to Alexander et al.’s (2002a) results on parental attachment and children’s memory for stressful events, the findings suggest that the beneficial influence of emotion on memory may not extend to individuals with avoidant attachments. Also, despite differences in whose attachment orientations were being measured across studies (i.e., parental attachment or victims’ own attachment), consistent findings emerged.

Attachment and False Memory Thus far, we have discussed memory for childhood events that were truly experienced. Does attachment also relate to memory for what has not occurred? That is, can attachment theory help us understand false memory? Although we are in the early phases of research on this topic, some promising leads have emerged. In our first foray into this area, we examined possible relations between false autobiographical memory and adult attachment (Qin, Ogle, & Goodman, in press). Based on research, as reviewed in this chapter, showing associations between insecure parental attachment and children’s memory inaccuracies (e.g., Quas et al., 1999), it was predicted that adult insecure attachment styles would be associated with higher levels of false autobiographical memory in adults. Similar to the “lost in the mall” false memory paradigm first employed by Loftus and Pickrell (1995), our paradigm involved asking parents of adult participants to supply information regarding various childhood events (e.g., going to the hospital for an injury) either experienced or not experienced by the adult participants before age five. Participants were then asked to recall details of three true events supplied by their parents and one false event. Adult attachment styles were measured in both parents and adult participants using the RQ (Bartholomew & Horowitz, 1991). Of particular relevance to the present chapter, the results showed that parents’ fearful-avoidant attachment predicted their adult children’s higher false memory scores. Parental attachment style was not significantly associated with participants’ true memory for autobiographical events. Of interest, adult participants’ own attachment styles were not predictive of true or false autobiographical memory reports. In our second attachment and false memory study, Schaaf, Alexander, and Goodman (2008) investigated relations between false memory, suggestibility, and attachment style in three- to five-year-olds. Of particular interest were potential mediators between parental attachment and children’s false memory resistance. Again using a procedure similar to Loftus Remembering Negative Childhood Experiences

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and Pickrell’s (1995) “lost in the mall” paradigm, parents were fi rst interviewed to verify four true and four false events for their children. Children were then questioned repeatedly (in a single session) about true and false events by one interviewer in a leading fashion and after that by another interviewer who asked direct (nonleading) questions. Parental attachment was measured using the RQ (Bartholomew & Horowitz, 1991) and an adapted version of the RSQ (Griffin & Bartholomew, 1994), on which parents rated their level of agreement with statements concerning close relationships. To assess children’s parent-child attachment security, parents also completed the Attachment Q-Sort, which consists of a large number of cards, each describing a child’s specific secure-base behavior (Waters & Deane, 1985). Finally, children’s behavioral problems were measured using the Child Behavior Checklist (Achenbach & Edelbrock, 1983). It was hypothesized that higher attachment security for both children and parents would predict greater resistance to suggestion. Path analyses revealed parental insecure attachment predicted children’s insecure attachment. The latter predicted behavioral problems in the children, which predicted suggestibility. At last, a possible mediator of parental attachment and child memory errors was identified. However, findings concerning attachment and behavior problems in this study must be interpreted with caution, given that both parent and child attachment scores, as well as the behavioral adjustment scores, were based on parental ratings. We are currently conducting research to remediate this potential problem (e.g., Chae et al., 2007).

Remaining Questions The study of attachment and memory is still in its infancy, but it shows great promise for furthering scientific understanding of children’s memory and suggestibility for emotional events. Numerous issues remain; we mention just a subset of them here. Clearly, further work is needed to identify mediators of the attachment and memory relations we and others have uncovered. Moreover, although in this chapter we have focused on avoidant attachment and defensive exclusion, interesting relations may exist between anxious attachment and memory (Alexander et al., 2002a; Melinder et al., 2008). It is also important to examine the specificity of attachment-memory relations; for example, research is needed to determine if attachment orientation predicts memory mainly for attachmentrelated information or other types of information as well. Finally, the field would profit from additional research concerning whether attachment influences encoding, storage, and/or retrieval processes.

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Practical Implications We emphasized theory in this chapter, but practical implications should be addressed as well, albeit with caution given that developmental science on attachment and memory is still relatively new. In regard to the legal context, maltreated children and their parents are likely to have insecure attachments (Carlson, Cicchetti, Barnett, & Braunwald, 1989; Cicchetti & Manly, 2001). Our findings may thus have implications for forensic interviews and courtroom testimony. For example, insecurely attached children may need additional rapport building so that sufficient trust can be established to aid resistance to misleading questions. Furthermore, experts who testify in court should be informed that important individual differences exist in trauma memory. There are also clinical implications of attachment and memory research. Given the potential importance of parental support for children’s mental health, clinicians may need to help avoidant parents better deal with children’s distress. Children who themselves are more avoidant might also profit from intervention regarding their ability to process rather than defend against memories of stressful experiences.

Conclusion Scientists have, for many decades, debated the mechanisms underlying memory for stressful childhood events. We believe attachment theory offers a viable explanatory framework for predicting important individual differences in memory for distressing experiences, at least those that activate the attachment system. When we are frightened or hurt, we are biologically programmed to want our loved ones to protect us. Expectations about whether or not we will receive protection may pervade encoding, storage, and/or retrieval of distressing childhood memories.

References Achenbach, T. M., & Edelbrock, C. (1983). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington, VT: University of Vermont, Department of Psychiatry. Ahadi, S. A., Rothbart, M. K., & Ye, R. (1993). Children’s temperament in the US and China: Similarities and differences. European Journal of Personality, 7, 359–377. Ainsworth, M. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Potomac, MD: Erlbaum.

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Alexander, K. W., & Edelstein, R. S. (Eds.). (2001). Children’s attachment and memory for an experienced event. Poster presented at the biennial meeting of the Society for Research in Child Development, Minneapolis, MN. Alexander, K. W., Goodman, G. S., Schaaf, J. M., Edelstein, R. S., Quas, J. A., & Shaver, P. R. (2002a). The role of attachment and cognitive inhibition in children’s memory and suggestibility for a stressful event. Journal of Experimental Child Psychology, 83, 262–290. Alexander, K. W., Quas, J. A., & Goodman, G. S. (2002b). Theoretical advances in understanding children’s memory for distressing events: The role of attachment. Developmental Review, 22, 490–519. Alexander, K. W., & Schaaf, J. M. (2001). Individual differences in children’s recounting of stressful events. Paper presented at the biennial meeting of the Society for Research in Child Development, Minneapolis, MN. Barnett, D., Ganiban, J., & Cicchetti, D. (1999). Maltreatment, negative expressivity, and the development of Type D attachments from 12 to 24 months of age. Monographs of the Society for Research in Child Development, 64, 97–118. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226–244. Belsky, J., Spritz, B., & Crnic, K. (1996). Infant attachment security and affective-cognitive information processing at age 3. Psychological Science, 7, 111–114. Benoit, D., & Parker, K. C. H. (1994). Stability and transmission of attachment across three generations. Child Development, 65, 1444–1456. Bidrose, S., & Goodman, G. S. (2000). Testimony and evidence: A scientific case study of memory for child sexual abuse. Applied Cognitive Psychology, 14, 197–213. Biringen, Z., Robinson, J. L., & Emde, R. N. (1998). The Emotional Availability Scales, 3rd Edition. Unpublished coding manual, Department of Human Development and Family Studies, Colorado State University. Bowlby, J. (1958). The nature of the child’s tie to his mother. International Journal of Psycho-Analysis, 39, 350–373. Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York, NY: Basic Books. Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. New York, NY: Basic Books. Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London, England: Routledge. Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York, NY: Guilford Press. Bretherton, I. (1990). Open communication and internal working models: Their role in the development of attachment relationships. In 22

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parental responsiveness during a stressful event. Attachment and Human Development, 6, 31–52. Edelstein, R. S., Ghetti, S., Quas, J. A., Goodman, G.S., Alexander, K., Redlich, A., & Cordon, I. (2005). Avoidant attachment and memory for child sexual abuse. Social and Personality Psychology Bulletin, 31, 1549–1560. Edelstein, R. S., & Shaver, P. R. (2004). Avoidant attachment: Exploration of an oxymoron. In D. Mashek & A. Aron (Eds.), Handbook of closeness and intimacy (pp. 397–412). Mahwah, NJ: Lawrence Erlbaum Associates. Engelberg, E., & Christianson, S. A. (2002). Stress, trauma, and memory. In M. L. Eisen, J. A. Quas, & G. S. Goodman (Eds.), Memory and suggestibility in the forensic interview (pp. 143–163). Mahwah, NJ: Lawrence Erlbaum Associates. Farrar, M. J., Fasig, L. G., & Welch-Ross, M. K. (1997). Attachment and emotion in autobiographical memory development. Journal of Experimental Child Psychology, 67, 389–408. Favez, N. (1997). Patterns of maternal emotional regulation and the narratives of an affective event by preschoolers. Poster presented at the biennial meeting of the Society for Research in Child Development, Washington, DC. Fivush, R. (1994). Constructing narrative, emotion and self in parent-child conversations about the past. In U. Neisser & R. Fivush (Eds.), The remembering self: Accuracy and construction in the life narrative (pp. 136–157). New York, NY: Cambridge University Press. Fivush, R., & Sales, J. M. (2006). Coping, attachment, and mother-child narratives of stressful events. Merrill-Palmer Quarterly, 52, 125–150. Fivush, R., & Vasudeva, A. (2002). Remembering to relate: Socioemotional correlates of mother-child reminiscing. Journal of Cognition and Development, 3, 73–90. Fraley, R. C., Davis, K. E., & Shaver, P. R. (1998). Dismissing avoidance and the defensive organization of emotion, cognition, and behavior. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 249–279). New York, NY: Guilford Press. Fraley, R. C., Garner, J. P., & Shaver, P. R. (2000). Adult attachment and the defensive regulation of attention and memory: Examining the role of preemptive and postemptive defensive processes. Journal of Personality and Social Psychology, 79, 816–826. Fraley, R. C., & Shaver, P. R. (1997). Adult attachment and the suppression of unwanted thoughts. Journal of Personality and Social Psychology, 73, 1080–1091. Fraley, R. C., & Shaver, P. R. (1998). Airport separations: A naturalistic study of adult attachment dynamics of separating couples. Journal of Personality and Social Psychology, 75, 1198–1212. Fraley, R. C., & Shaver, P. R. (2000). Adult romantic attachment: Theoretical developments, emerging controversies, and unanswered questions. Review of General Psychology, 4, 132–154. Fraley, R. C., & Spieker, S. (2003). Are infant attachment patterns continuously or categorically distributed? A taxometric analysis of strange situation behavior. Developmental Psychology, 39, 387–404.

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Goodman, G. S., Bottoms, B. L., Schwartz-Kenney, B. M., & Rudy, L. (1991). Children’s testimony about a stressful event: Improving children’s reports. Journal of Narrative & Life History, 1, 69–99. Goodman, G. S., Hepps, D., & Reed, R. S. (1986). The child victim’s testimony. In A. Haralambie (Ed.). New issues for child advocates. Phoenix, AZ: Arizona Council of Attorneys for Children. Goodman, G. S., Hirschman, J., Hepps, D., & Rudy, L. (1991). Children’s memory for stressful events. Merrill-Palmer Quarterly, 37, 109–158. Goodman, G. S., Quas, J. A., Batterman-Faunce, J. M., Riddlesberger, M., & Kuhn, J. (1994). Predictors of accurate and inaccurate memories of traumatic events experienced in childhood. Consciousness and Cognition, 3, 269–294. Goodman, G. S., Quas, J. A., Batterman-Faunce, J. M., Riddlesberger, M. M., & Kuhn, J. (1997). Children’s reactions to and memory for a stressful event: Influences of age, anatomical dolls, knowledge, and parental attachment. Applied Developmental Science, 1, 54–75. Griffin, D., & Bartholomew, K. (1994). Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of Personality and Social Psychology, 67, 430–445. Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 59, 270–280. Hershkowitz, I., Lanes, O., & Lamb, M. E. (2007). Exploring the disclosure of child sexual abuse with alleged victims and their parents. Child Abuse & Neglect, 31, 111–123. Hudson, J. A. (1990). The emergence of autobiographical memory in motherchild conversation. In R. Fivush & J. A. Hudson (Eds.), Knowing and remembering in young children (pp. 166–196). New York, NY: Cambridge University Press. Kirsh, S., & Cassidy, J. (1997). Preschoolers’ attention to and memory for attachment relevant information. Child Development, 68, 1143–1153. Laible, D. J. (2004). Mother-child discourse in two contexts: Links with child temperament, attachment security, and socioemotional competence. Developmental Psychology, 40, 979–992. Laible, D. J., & Thompson, R. A. (2000). Mother-child discourse, attachment security, shared positive affect, and early conscience development. Child Development, 71, 1424–1440. Leander, L., Christianson, S-V., & Granhag, P. (2007). A sexual abuse case study: What children remember and report. Psychiatry, Psychology, & Law, 14, 120–129. Leichtman, M. D., Skowronek, J. S., & Pillemer, D. B. (2005). Talking or not about events of the day: Effects on preschoolers’ long-term memories. Poster presented at the biennial meeting of the Society for Research in Child Development, Atlanta, GA. Loftus, E. F., & Pickrell, J. E. (1995). The formation of false memories. Psychiatric Annals, 25, 720–725. Main, M. (1990). Cross-cultural studies of attachment organization: Recent studies, changing methodologies, and the concept of conditional strategies. Human Development, 33, 48–61. Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In I. Bretherton & E. Waters (Eds.), Growing points in attachment theory and research. Remembering Negative Childhood Experiences

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Monographs of the Society for Research in Child Development, 50 (1–2, Serial No. 209), 66–104. Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In M. T. Greenberg & D. Cicchetti (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121–160). Chicago, IL: University of Chicago Press. Melinder, A., Alexander, K. W., Goodman, G.S., Cho, Y. I., Thorensen, C., Lonnum, K., & Magnussen, S., (2008). Children’s eyewitness memory: A comparison of two interviewing strategies. Manuscript submitted for publication. Mikulincer, M., Birnbaum, G., Woddis, D., & Nachmias, O. (2000). Stress and accessibility of proximity-related thoughts: Exploring the normative and intraindividual components of attachment theory. Journal of Personality and Social Psychology, 78, 509–523. Mikulincer, M., Gillath, O., & Shaver, P. R. (2002). Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology, 83, 881–895. Nelson, K. (1993). The psychological and social origins of autobiographical memory. Psychological Science, 1, 1–8. Newcombe, R., & Reese, E. (2004). Evaluations and orientations in motherchild narratives as a function of attachment security: A longitudinal investigation. International Journal of Behavioral Development, 28, 230–245. Oppenheim, D., & Waters, H. A. (1995). Narrative processes and attachment representation: Issues of development and assessment. Monographs of the Society for Research in Child Development, 60, 1076–1081. Qin, J. J., Ogle, C. M., & Goodman, G. S. (in press). Adults’ memories of childhood: True and false reports. Manuscript submitted for publication. Journal of Experimental Psychology: Applied. Quas, J. A., Goodman, G. S., Bidrose, S., Pipe, M.-E., Craw, S., & Ablin, D. S. (1999). Emotion and memory: Children’s long-term remembering, forgetting, and suggestibility. Journal of Experimental Child Psychology, 72, 235–270. Quas, J. A., Goodman, G. S., Ghetti, S., Redlich, A., Edelstein, R., Alexander, K., Cordon, I., & Jones, D. P. H. (2005). Childhood sexual assault victims: Long-term outcomes of testifying in criminal court. Monographs of the Society for Research in Child Development, Vol 70, Serial No. 280. Quas, J. A., Murowchick, E., Bensadoun, J., & Boyce, W. T. (2002). Predictors of children’s cortisol activation during the transition to kindergarten. Journal of Developmental and Behavioral Pediatrics, 23, 304–313. Quas, J. A., Qin, J., Schaaf, J. M., & Goodman, G. S. (1997). Individual differences in children’s and adults’ suggestibility and false event memory. Learning and Individual Differences, 9, 359–390. Reese, E., & Farrant, K. (2003). Social origins of reminiscing. In R. Fivush & C. A. Haden (Eds.), Connecting culture and memory: The social construction of an autobiographical self (pp. 29–48). Mahwah, NJ: Lawrence Erlbaum Associates. 26

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Rholes, W. S., Simpson, J. A., & Blakely, B. S. (1995). Adult attachment styles and mothers’ relationships with their young children. Personal Relationships, 2, 35–54. Rholes, W. S., Simpson, J. A., Blakely, B. S., Lanigan, L., & Allen, E. A. (1997). Adult attachment styles, the desire to have children, and working models of parenthood. Journal of Personality, 65, 357–385. Schaaf, J., Alexander, K. W., & Goodman, G. S. (2008). Children’s false memory and true disclosure in the face of repeated questions. Journal of Experimental Child Psychology, 100, 157–185. Simpson, J. A., Rholes, W. S., & Nelligan, J. S. (1992). Support seeking and support giving within couples in an anxiety provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62, 434–446. Steele, H., Steele, M., & Fonagy, P. (1996). Associations among attachment classifications of mothers, fathers, and their infants. Child Development, 67, 541–555. Thompson, R. A. (2000). The legacy of early attachments. Child Development, 71, 145–152. Thompson, R. A., Laible, D. J., & Ontai, L. L. (2003). Early understandings of emotion, morality, and self: Developing a working model. In R. V. Kail (Ed.), Advances in child development and behavior (Vol. 31, pp. 139–171). San Diego, CA: Academic Press. Van IJzendoorn, M. H. (1995). Adult attachment representations, parental responsiveness and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 117, 387–403. Waters, E., & Deane, K. E. (1985). Defining and assessing individual differences in attachment relationships: Q-methodology and the organization of behavior in infancy and early childhood. Monographs of the Society for Research in Child Development, 50, 41–65.

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2 Children’s Understanding and Remembering of Stressful Experiences Lynne Baker-Ward Peter A. Ornstein Lauren P. Starnes

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n a discussion of realism and abstraction in art, Georgia O’Keeffe (1922) focused on the transformation of experience and observed: “Nothing is less real than realism. Details are confusing. It is only by selection, by elimination, by emphasis that we get at the real meaning of things.” These constructive activities—so critical for the artist—are at the core of our efforts to understand and remember the events that we experience. Indeed, we are not passive observers of the events that make up our lives. Our impressions of our experiences are influenced by our expectations, our goals, and our knowledge of the world (Baker-Ward, Ornstein, & Principe, 1997; Bartlett, 1932; Paris & Lindauer, 1976). These impressions, moreover, are reflected in the ways in which our experiences come to be represented in memory, and the encoding processes that lead to the construction of these representations can be quite extended in time (see Baker-Ward et al., 1997). Indeed, after the initial encoding of an event, a variety of factors that arise from both endogenous (e.g., our own “internal” cognitive processes) and exogenous (e.g., our interactions with others) sources may transform our understanding and consequently alter the memory representation. From this perspective, autobiographical memory involves a set of constructive processes that can continue long after an experience has ended but which nonetheless influence our understanding and memory of the events 28

of our lives (see Fivush & Baker-Ward, 2005). In this chapter, we consider these constructive processes as they impact children’s understanding of emotionally significant experiences and their subsequent memory for these events.

Extended Encoding of Personal Experiences A Constructivist Account of Memory The constructivist perspective that is central to much research on cognition and its development emphasizes the active involvement of an individual in seeking to understand his or her experiences. From this point of view, understanding an event as it unfolds involves the application of underlying knowledge—broadly defined—to modify and embellish the “objective stimulus” record, in the process “going beyond the information given,” to use Bruner’s (1957) celebrated phrase. As we see it, both semantic (i.e., generic) and episodic (i.e., specific) memory representations are used in the interpretive process—sometimes quite unconsciously— as are self-schemata (e.g., internal working models of relationships with parents—see Oppenheim & Koren-Karie, this volume) and an individual’s vast storehouse of domain-specific knowledge (e.g., of the rules of soccer or chess). To a considerable extent, understanding involves the transformation of an “objective” event that may be experienced by a group of participants, i.e., Underwood’s (1963) nominal stimulus, into a personally relevant experience, i.e., Underwood’s functional stimulus. The roots of the constructivist position as it applies to explorations of memory can be seen in Binet and Henri’s (1894a, 1894b) studies of children’s superior recall of sentences, in comparison to their memory for words, and Bartlett’s (1932) explorations of adults’ recall of unfamiliar folk tales. Binet and Henri found that the basic idea underlying a long passage was more resistant to forgetting than were the actual words, leading them to suggest that the children in their studies were abstracting the underlying meaning of the material on the basis of their existing knowledge. Moreover, in an influential exploration of reconstructive processes in remembering, Bartlett (1932) reported that English adults distorted aspects of the North American folk tales that they were asked to remember, interpreting this difficult-to-understand material in terms of their own cultural experiences and then remembering their interpretations. Consistent with Bartlett’s findings of knowledge-based distortions, other researchers (e.g., Paris & Lindauer, 1977) have shown that the recall of meaningful prose passages can often be characterized by transformations and omissions of the original material. These effects reflect Understanding and Remembering of Stressful Experiences

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the operation of constructive processes that are set in motion by underlying knowledge and can be seen in the integration of ideas both within and across sentence boundaries (Barclay & Reid, 1974; Bransford & Franks, 1972) and in the inferences that are imposed on the material (e.g., Paris & Lindauer, 1976).

The Impact of Constructive Processes There is ample evidence that these constructive processes operate at every phase of the information processing sequence, i.e., from initial encoding through memory storage, retrieval, and reporting (Baker-Ward et al., 1997). An individual’s prior knowledge is used routinely—most often unconsciously, but sometimes deliberately—to interpret ongoing events, with the resulting interpretations impacting the deployment of attention and the encoding of information in memory. Thus, the initial representation of an experience that is established in memory is driven clearly by knowledge-based constructive processes. However, it is also important to indicate that these processes can be quite extended in time and can lead to changes in understanding and interpretation. Indeed, both endogenous (e.g., reflection and rumination) and exogenous (e.g., conversation and exposure to misleading information) factors can affect the extended encoding of an experience, with corresponding modifications of the representation. Moreover, later in the information-processing sequence, the impact of knowledge can affect remembering as the details of a specific experience fade over time and generic information is used to supplement what can be remembered (Myles-Worsley, Cromer, & Dodd, 1986; Ornstein, Merritt, Baker-Ward, Furtado, Gordon, & Principe, 1998). Further, changes over time in general knowledge can lead to a reworking of what is remembered, as memory for a specific experience may be transformed on the basis of current understanding and beliefs (Greenhoot, 2000; Ross, 1989).

Constructive Processing over Time Although constructive processes influence all aspects of remembering— from “stimulus” input to retrieval and reporting—the impact of forces from within and “outside” the child during the retention interval is of special importance for the underlying memory representation. In terms of endogenous forces, personal reflection on recently experienced events can certainly alter one’s perspective, as can rumination and efforts to make sense of one’s personal experiences (Bruner, 1990), and thus modify the state of representations in memory (Baker-Ward et al., 1997). As discussed below, such internally driven, postevent processing may be most likely to occur when the experiences in question are infused with 30

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emotion. Moreover, individuals may be aware of the operation of this processing, at least at some points in the retention interval, and may even initiate them deliberately (e.g., as in an attempt to understand how an injury occurred or why a relationship ended). On the other hand, the modification of a representation in memory may result from the spread of activation in semantic memory or other knowledge-based processes of which the individual is unaware, as is the case with instances of autosuggestion (Binet, 1900; see also Baker-Ward et al., 1997). The DeeseRoediger-McDermott (DRM) Illusion (Roediger & McDermott, 1995), in which participants erroneously report having seen a target word (e.g., “sleep”) as part of a list of stimuli with which the word was highly associated (e.g., “bed” and “dream”), provides one example. Complementing these endogenous influences on the underlying memory representations are exogenous forces that also serve to extend the encoding process. For example, conversations with others (peers or adults) about an experience, particularly one that is not entirely understood, can lead to changes in interpretation that impact the representation (Principe et al., 2006), as can access to accounts in the media or family photo albums and videotapes of similar experiences (Ornstein, Larus, & Clubb, 1991; Principe, Ornstein, Baker-Ward, & Gordon, 2000). In addition, memory distortions that arise from the presentation of contradictory information, as in the “misinformation effect” in the area of eyewitness testimony (Loftus, 1993), can be seen as reflecting the processes that are ordinarily involved in extended encoding. Moreover, related to studies of the misinformation effect are investigations of suggestibility in which the aim is that of simulating the use of misleading or coercive questioning of child witnesses (see Bruck & Ceci, 1999). The extensive literature on memory distortion notwithstanding, both endogenous and exogenous forces may also operate to maintain and enhance as well as to diminish the accuracy of the recollection of personal experiences. Based on research in cognitive psychology, it seems reasonable to expect that at least under some conditions the addition of information can make event representations more accessible and more likely to be maintained over long delays (see Baker-Ward et al., 1997; Fivush & Baker-Ward, 2005). For example, if initially unrelated aspects of an event are subsequently connected by the discovery of a causal relation between them, a more interconnected representational structure would be created in memory. As a consequence, thinking about one of the components should activate the other in memory, thereby increasing the accessibility and long-term maintenance of the information in memory. In addition, forgetting over time can be reduced considerably when information in memory is reactivated during the retention interval through repeated exposure to aspects of the original, a phenomenon Understanding and Remembering of Stressful Experiences

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described as reinstatement (Brainerd & Ornstein, 1991; Campbell & Jaynes, 1966; Hudson & Sheffield, 1999). Within this perspective, then, the representation of an experience in memory begins, but certainly does not end, with the initial encoding of an event. Information acquired after an experience may change the meaning of that experience, rendering salient details that subsequently remain in memory but that might otherwise have been forgotten. Hence, a technologist’s decision to repeat an x-ray or a physician’s worried expression may be retained as components of the individual’s personal narrative if a medical condition is subsequently diagnosed, but may be readily forgotten if the patient is later given a clean bill of health. Similarly, a child who discovers that Santa Claus is mythical may reinterpret and remember the shopping bags discovered in a closet or the parental voices overheard on Christmas Eve, which now become central rather than peripheral components of the holiday experience. Moreover, two recent studies of adults’ story recall indicate that simply retelling a story prior to a later recall assessment can have a substantial effect on the underlying memory representation, consistent with the notion of extended encoding. Marsh (2007) reported that memory for the stories changed after initial encoding and storage, and Wang and Ross (2005) concluded that individuals’ memory representations eventually become amalgams of the original information and additional content derived from their retellings, and even their thoughts.

Stress, Emotion, and Extended Encoding Among children as well as adults, the events that comprise our everyday lives are not infrequently associated with some degree of stress, defined in terms of physiological and emotional reactions to threats from the outside world. Whereas traumatic events involve by definition (DSM-IV) a realistic threat to life itself, the threats experienced in more typical situations constitute real or perceived risks to one’s sense of safety (e.g., in experiencing a painful but necessary medical procedure) or status and self-worth (e.g., in experiencing a blocked goal) (see McEwan, 2000). Within the context of the “same” event (e.g., getting cut from the team), different individuals may experience alternative emotional reactions as a consequence of their varying interpretations of the experience (Lazarus, 1977), which are derived in part from their individual temperaments and personal histories. In response to these divergent emotions, different courses of action may be undertaken (Campos, Mumme, Kermonian, & Campos, 1994). A child who reacts to a stressful experience with anger, for example, may respond with aggression, whereas another who experiences sadness may withdraw from the scene. As a consequence of these diverging 32

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approaches to a situation, alternative aspects of the event may become more or less relevant (Dolan, 2002; Easterbrooks, 1959). The individual who becomes hypervigilant in preparing to defend the self, for example, may focus on different aspects of the situation than will a child who withdraws from the scene and “shuts down.” In this regard, emotion can be expected to affect encoding and consequently determine to some extent the representation of an event in memory. It is also the case that alternative emotional experiences and expressions are likely to be associated with different opportunities and motivation for constructive processing over time as an individual reappraises a changing situation. For example, a child’s pride in her accomplishment could provide the impetus for extensive discussions with others about the details of the positive experience, resulting in an augmented representation in memory. In contrast, a child who feels shame regarding her performance could avoid revisiting the episode in question with others. Similarly, the sequelae of emotionally salient events may include multiple opportunities for the reinstatement or augmentation of memory (see Sales, this volume). For example, a child’s emotional displays may evoke explanations and reassurances from adults, or, alternatively, opportunities for interpretation and understanding may be limited if an episode such as sexual assault is silenced by the community (Fivush, 2000). It is also possible that events accompanied by self-conscious emotions, such as pride or guilt, may be distorted or reinterpreted over time (see Ross, 1989). Hence, emotion has implications for remembering at each point in the information-processing sequence (see Gordon, Schroeder, Ornstein, & Baker-Ward, 1995; Ornstein, Larus & Clubb, 1991).

An Approach to the Investigation of Extended Encoding Knowledge-based constructive processes thus play an important role in children’s memory for personally experienced events and may be especially salient when the events being remembered are emotional in tone. As such, our focus here is on understanding and remembering emotionally charged experiences among boys and girls between 3 and 10 years of age. To illustrate these processes, we present several investigations from our own research programs, focusing on (a) children’s understanding of personally significant experiences as they unfold and their subsequent memory for these events, and (b) the influences on remembering that may transpire after these events have occurred. Our discussion will highlight some of the ways in which emotions may affect understanding, extended encoding, and consequently remembering, in development. Understanding and Remembering of Stressful Experiences

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Finally, we present some directions for further investigation and examine some implications of our work for forensic and clinical practice. For over 15 years, in collaboration with our late colleague Betty N. Gordon and a number of talented students and postdoctoral fellows, we have studied children’s memory for naturally occurring, personally significant experiences. In most of these investigations, our work has been motivated by questions regarding young children’s capacity to serve as witnesses in legal proceedings. Assuming that what cannot be remembered cannot be reported, we have charted young children’s retention of the details of their medical experiences over extended periods of time as a function of varied conditions of reporting. For overviews of this research, see Ornstein, Baker-Ward, Gordon, and Merritt (1997) and Gordon, Baker-Ward, and Ornstein (2001); see also Peterson (this volume) for a discussion of another research program involving children’s memory for medical treatment. For several reasons, we decided to use medical procedures as the tobe-remembered events in our studies. First, these procedures can serve as analogue events for the experiences about which children are often called upon to testify in legal proceedings. Consider, for example, the fact that during a physical examination of a child (a) is in partial and/ or complete states of undress, (b) is handled by an adult who is often unknown and of the opposite sex, and (c) can experience some degree of stress and pain. Of course, we readily acknowledge the important distinctions between such parent-ally sanctioned events and episodes of abuse; see Sales, this volume, for a discussion of the role of the parent in children’s responses to emotional experiences. Importantly, because the procedures that we observed were medically indicated, they provided an ethically appropriate venue for the investigation of children’s memory for stressful experiences. Second, through the cooperation of parents and medical professionals, it was possible to specify the components and details of each individual child’s medical experience. Hence, we were able to determine the accuracy of the child’s report of the event. Third, although the children’s involvement in the research did not affect their medical care, we could assess and in some cases manipulate a variety of factors that could impact recall, including the child’s prior knowledge of the specific medical procedure(s) and the timing of the memory interviews (e.g., Ornstein, Baker-Ward, Gordon, Pelphrey, Tyler, & Gramzow, 2006). Although much of our work has involved routine pediatric examinations (e.g., Baker-Ward, Gordon, Ornstein, Larus & Clubb, 1993; Greenhoot, Ornstein, Gordon, & Baker-Ward, 1999; Ornstein et al., 2006), we have also carried out studies of children’s memory for other medically related events, when they seemed appropriate for addressing 34

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specific particular research questions. These events have included dental examinations and restorations (Vandermaas, Hess, & Baker-Ward, 1993), a urinary bladder catheterization procedure (Merritt, Ornstein, & Spicker, 1994), and emergency room treatment following a facial laceration (Burgwyn-Bailes, Baker-Ward, Gordon, & Ornstein, 2001). Moreover, recently we have augmented our research on children’s memory for medical experiences with investigations involving young participants’ reports of another event that has significance in their lives, namely, a final game in a season-ending soccer tournament (e.g., Baker-Ward, Eaton, & Banks, 2005). This work was initiated specifically to explore the effects of emotion on remembering across a delay interval. Although members of both the winning and losing teams participated in the same activity, at least at the level of the nominal stimulus, their experiences were typically quite divergent with regard to the emotions that accompanied the outcome of the game. Hence, within this setting, we could explore the effects of alternative emotions on aspects of the encoding and subsequent retrieval and reporting of the details of the game. The experiences examined in this chapter thus range from painful diagnostic procedures to recreational athletic competitions. The same general approach, however, characterized each investigation. Working with expert informants (physicians, dentists, nurses, and radiological technologists; coaches and referees), we defined on an a priori basis the standard components or “features” that comprise each type of experience, i.e., those aspects of the event that would be typically be encountered by each participant. Whereas the majority of these features were integral components of the event, across individual children there were some variations in the experiences. (For example, although most children receiving pediatric check-ups would have their vision screened, this typical aspect of the examination might be omitted for children who receive services from ophamologists.) Hence, to enable an examination of the accuracy of the children’s memory reports, observers recorded as each medical procedure unfolded the presence or absence of each of the event features that were listed on checklists. When possible, these records were augmented with video recordings. Children’s memory reports were obtained in individual interviews, in which an experienced examiner began with very general, open-ended questions (“Tell me what happened . . . ”) to elicit the child’s narrative account of the experience. In the investigations of medical procedures, the retention of each feature was assessed with a hierarchically organized protocol, such that increasingly specific prompts (closed questions to yes/no probes) were presented to the child when information was not forthcoming in response to more general queries. Consistent with the increased focus on children’s emotional responses and interpretation of their experiences, the interview Understanding and Remembering of Stressful Experiences

35

protocols for the soccer studies were modified somewhat, with increasing support provided for the generation of a narrative account of the experience, and with wh- questions addressing all features (including those provided in the narrative) presented in a separate portion of the interview. All interviews also included some plausible questions about actions that were not components of the event. Included in each study was a measure of the child’s level of arousal and/or emotional reactions to the event, although the nature of these measures varied across investigations. In some cases, it was possible to augment ratings of the children’s levels of stress with behavioral analyses of their video-recorded responses during the procedures. The studies presented below (cf. Merritt et al., 1994) are limited in that they did not include assessments of the multiple response systems through which stress may effect remembering (see Wallin, Quas, & Yim; and Wiik & Gunnar; this volume, for a discussion of the importance of obtaining such data in understanding the stress-memory linkage). In future research, we plan on devoting attention to the multiple pathways through which arousal, as moderated by knowledge, coping, and other variables, affects children’s memories for the important things that happen to them.

Studies of Extended Encoding and Remembering Prior Knowledge and Memory for a Pediatric Examination A recent investigation from our laboratory illustrates the facilitative effects of domain-relevant knowledge on children’s recall of a medical check-up (Ornstein et al., 2006). In most studies of the impact of prior knowledge on memory, knowledge has been explored by contrasting the performance of groups of individuals who differed in expertise in domains such as chess (e.g., Chi, 1978) or soccer (Schneider, Körkel, & Weinert, 1989). Moreover, in a few investigations, the feature of a salient event such as a visit to the doctor (as opposed to the participant) has been taken as the unit of analysis, with the critical question being that of the differential recall of event components that varied along a scale of children’s understanding, as defined by normative data (Clubb, Nida, Merritt, & Ornstein, 1993; Ornstein et al., 1997). In contrast to these approaches, Ornstein et al. (2006) included a knowledge assessment at the individual level and thus could compare knowledge and memory scores within the same participants. To assess the children’s knowledge, half of the sample of four-toseven-year-olds was interviewed regarding the components of a pediatric examination prior to their own medical check-ups; the remaining half 36

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was assigned to a control condition to verify that the knowledge interviews did not affect subsequent recall performance. All of the children were asked to report the component features of their physical examinations immediately after their check-ups, and then again after a delay of six months. As shown in Figure 2–1, knowledge of the details of routine physical examinations increased with age, and the children’s knowledge scores predicted both initial, r = .53, p < .001, and delayed recall, r = .30, p = .05. The results of regression analyses indicated that knowledge accounted for a significant proportion of the variance in open-ended recall at the initial interview, even after age and vocabulary scores had been entered into the model.

A First Dental Visit: Preparation and Recall

80%

80%

60%

60% Memory Scores

Memory Scores

Given this demonstration of the impact of knowledge on children’s memory for a familiar physical examination, is it possible to observe knowledge effects on three-year-olds’ reports of a novel and possibly stressful procedure? To examine this issue, Baker-Ward and Ornstein (in preparation) recruited a sample of 46 three-year-old children who were scheduled for their very first dental examination. Through the cooperation of their dentist, we set out to manipulate the children’s preparation (and, presumably, their knowledge) for this initial experience. With the assistance of the parents, we were also able to explore the effects of naturally occurring preparation, including their deliberate attempts to increase their children’s understanding of the nature and importance of dental treatment, as well as the children’s incidental exposure to relevant information.

40%

R Sq Linear = 0.092

40%

20%

20% R Sq Linear = 0.277

0%

0% 0%

20%

40%

Knowledge Scores

60%

0%

20%

40%

60%

Knowledge Scores

Figure 2–1. Scatterplots illustrating the associations between knowledge and open-ended recall at the immediate (left panel) and six-month (right panel) interviews. Note that when participants have identical scores, their data points overlap. (Adapted from Ornstein et al., 2006, Figure 3. Used by permission from the American Psychological Association.) Understanding and Remembering of Stressful Experiences

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Three experimental conditions were established, and the children were randomly assigned to one of three groups that differed with regard to the materials they received from us about two weeks before their checkups. The families in the first group were mailed a specially prepared video that showed two child models receiving complete dental treatments by the children’s dentist and a dental hygienist. Those in the second group, a manipulation control condition, were mailed our own production of “Healthy Snacks for Healthy Teeth.” This video was comparable to the experimental tape in length and with regard to parents’ ratings of its appeal, but it conveyed no knowledge relevant to the dental visit. Moreover, the families assigned to third group, a baseline control condition, received only a letter confirming their participation in the research. To determine the impact, if any, of our videos, the children’s knowledge of the features to be included in the dental examination was assessed briefly when they arrived at the dentist’s office. This interview consisted only of a very general prompt (“What will happen when you see the dentist?”), and the children provided little information about their expectations. Even though the parents in both video conditions indicated that they complied with our instructions to play the videos on at least two occasions (M = 2.33), the performance of the three groups on this knowledge assessment was quite similar. Indeed, the children in the knowledge, control, and baseline conditions reported only 1.87, 1.25, and 0.86 features of the examination, respectively. The children’s dental treatment, which included an examination, teeth cleaning, and the application of fluoride, was video-recorded, but was otherwise unaffected by their participation in the research. Six weeks after the visit, all of the children were interviewed at a university laboratory. We used a protocol consistent with our general approach, as described above. The questions were again hierarchically structured, with very general, open-ended questions followed by increasingly specific probes, and the children’s retention of standard features of the visit was assessed. In contrast to expectations—but consistent with the failure to find significant differences in children’s knowledge, as a function of the videotape manipulation—no overall group effects were present; the experimenter-provided preparation did not enhance recall. Although our experimental manipulation of information in an attempt to differentially prepare children for their fi rst dental examination was not successful, we were quite aware that the children were prepared for the check-up in other ways. Did such preparation—which we assume results in more knowledge—affect retention? To examine this question, we tabulated all the preparation activities reported by the parents on the questionnaires they completed at the dentist’s office. Parents reported a total of 12 different types of preparation activities (e.g., reading books 38

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about dentists). We then asked a group of nine experts, all of whom were practicing dentists, to rank-order the preparation activities in terms of their presumed effectiveness. Attesting to the potential importance of naturally occurring experiences, the preparation we provided, viewing a specially prepared video, ranked behind visiting the dental office in advance and observing a sibling’s dental treatment. On the basis of these rankings, we reconstituted the groups. The High Preparation condition was composed of the 16 children who had experienced one or more of the three most effective techniques, whereas the Medium Preparation group included 10 children who had had exposure to one or more of the next three techniques. The remaining 20 children in the Low Preparation Group received no specific preparation at all. Interestingly, as can be seen in Figure 2–2, these post hoc groups did differ with regard to memory performance, with the participants in the High Preparation group recalling significantly more of the features than did the children in either the Medium or Low Preparation groups, whose performance did not differ. Hence preparation that presumably resulted in greater understanding of the event was associated with higher levels of memory performance, at least when naturally occurring experience is considered. Of course, quasi-experimental findings must be interpreted cautiously. We can, however, rule out a number of potential alternative explanations for the effect, including preparation group differences in months of age, trait anxiety, and child temperament, as assessed by parental questionnaires. In addition, there were no between-group similarities in responses to questions about actions that were not part of the dental visit, making it seem unlikely that the High Preparation group’s better recall

0.6

Proportion Recall

0.5 0.4 0.3 0.2 0.1 0 High

Medium Preparation Group

Low

Figure 2–2. Proportion of standard features of their first dental examinations recalled by three-year-old children in three post hoc preparation conditions.

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performance can be attributed to a response bias that could have influenced the measure of total recall. It is also the case that the preparation effect cannot be attributed to reductions in anxiety. An original purpose of the investigation was to lower anxiety during an event in order to assess the effects on memory. However, the children were quite relaxed during their dental examinations, as indicated by parents’ and hygienists’ ratings and by an observational measure of anxiety, the Behavioral Profile Rating Scale (BPRS; Melamed & Lumley, 1988), and no overall group differences in anxiety were found. Finally, one additional limitation of the present research design must be noted: because we did not assess memory immediately after the dental visit, it is possible that the effects of preparation observed here operated during the retention interval instead of at encoding, although there is no evidence for this effect.

The Provision of Information During an Invasive Procedure An additional investigation in our laboratory was carried out by Ornstein, Principe, Hudson, Gordon, and Merritt (1997) to examine the effects of children’s understanding of what is happening to them on their subsequent memory of a highly stressful experience. In this follow-up to a previous study (Merritt et al., 1994), 24 children between three and eight years of age were observed as they underwent an invasive radiological procedure involving urinary bladder catheterization and were interviewed on three occasions about their experience. The procedure was a voiding cystourethrogram (VCUG), which is performed when a physician needs an evaluation of the urinary tract, as is often the case in children with repeated bladder infections. The 20 to 30 minute VCUG procedure begins with the child being placed on a table beneath the fluoroscopy camera. The genital area is then uncovered and cleansed, and a catheter is inserted into the urethra and passed into the urinary bladder. Contrast fluid is infused until the bladder is filled to capacity, and fluoroscopic filming is then performed. The procedure ends with the child being instructed to urinate on the table, a process that leads to the forced expulsion of the catheter. Following our standard procedures, we identified 10 specific features of the VCUG and used a hierarchically structured interview protocol to assess the retention of these features at each of three memory interviews. Half of the children were interviewed immediately after the VCUG; all of them were questioned in their homes at both six and 16 weeks after the procedure. Although the children and their families did not receive a uniform orientation to the procedure, the technologists provided some patients with more information than others. The technologists’ talk to the young 40

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patients was classified as including a procedural narrative when they were provided with an account containing a description of (a) the catheter and its insertion, (b) the infusion of contrast fluid, and (c) the filling of the bladder. Following up Principe et al.’s (1996) reanalysis of Merritt et al.’s (1994) data, we thought it possible that presentation of information in this narrative form may have permitted the child to better understand the event as it unfolded. With an enhanced understanding of the experience, the child could construct a more elaborated representation of the event, which could serve as a foundation for subsequent remembering. Moreover, because the features addressed in the procedural narrative must have taken place in order for some other components to occur (e.g., the child’s bladder must be filled before it can be emptied), information regarding these “enabling” features could be expected to affect the child’s understanding of other components of the VCUG as well. Two post hoc groups were formed, consisting of 12 children who received a procedural narrative from their technologists and 12 who were not given this initial overview of the procedure. As shown in Figure 2–3, children who received the procedural narrative reported a greater proportion of the features of the event at each occasion. As it turned out, however, the technologists were more likely to provide the procedural narrative to the older children, whom, we suspect, they thought would benefit from the information. The post hoc Narrative Group had a mean age of 76 months, compared with only 53 months for the children in the No Narrative Group. When the recall data were statistically adjusted for age, the facilitative effect of the procedural narrative on recall remained at the initial interview, but was no longer significant at the delayed assessments. It is possible that participation in the memory interview itself served to enhance remembering across occasions among the children who had not received a procedural narrative and may have had little understanding of what had happened to them. Indeed, the interview could have provided additional information or assisted the child in creating an organization structure that could support subsequent reports. Providing some support for this possibility, Starnes and Baker-Ward (under review) found that four-year-olds who received an immediate interview following an experimenter-provided, novel play event evidenced enhanced recall and greater resistance to retroactive interference from an intervening experience than did children who were not interviewed after the experience. Alternatively, it is possible that the enhancement provided by the procedural narrative in the VCUG study resulted in more extensive but weaker encoding, and hence the additional information was not maintained in memory. Nonetheless, these data provide further evidence that children’s understanding of an experience facilitates their encoding of the event. Understanding and Remembering of Stressful Experiences

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Narrative

No Narrative

1 0.9

Proportion Recall

0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 Initial

6-Week

16-Week

Timing of Interview

Figure 2–3. Proportion of standard features of the VCUG procedure recalled at three different delay intervals by children in two post hoc narrative conditions.

Changing Expectations and Memory of a Soccer Match In another investigation from our laboratory, Eaton (2003) explored the ways in which children’s changing understanding of an experience may alter their goals and hence their deployment of attention during an event. In her dissertation research, Eaton examined the memory of 69 ten-year-old athletes of their final game in an end-of-season soccer tournament that culminated in a league championship. The details of play were noted during the match by observers who had varsity-level soccer experience, and video recordings were made to provide a means of verifying additional information. Memory for details of the match was assessed immediately after the game in interviews conducted in tents set up on the periphery of the field, and six weeks later in the children’s homes. The interviews began with a request for a narrative account of the match, followed by the set of wh- questions regarding predefined game components. The player’s free recall reports were divided into propositions, which were classified as reflecting central or peripheral game components. Applying Peterson and Bell’s (1996) definitions, central propositions referred to aspects of the game that directly affected play

42

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or the outcome, whereas peripheral components were outside the match or did not affect play. The standard set of wh- questions referenced predetermined match components, and these elicited recall probes were similarly comprised of items addressing central features (e.g., “What was the final score?”) and peripheral features (e.g., “What color uniform did the other team wear?”). In addition to the memory assessments, each player also provided ratings of the importance of the event, perceived performance (both individual and for the team as a whole), and an estimate of the point at which the participant was confident of the outcome of the game. In addition, the children’s emotional reactions prior to and subsequent to play were obtained, using a context reinstatement technique based on the Cognitive Interview (see Fisher, Brennan, & McCauley, 2002). Participants on the winning and losing teams did not differ in their reported desire to win the game, and the ratings confirmed our expectation that the game was of great important to the young athletes. Indeed, more than a quarter of the children in the sample endorsed the statement: “I wanted to win as much as I’ve ever wanted anything in my life.” Not surprisingly, the participants on the winning teams reported that they were not confident of the outcome of the game until the second half, or even the final minutes of play. In contrast, the players from the losing teams could be classified into informal groups of those who identified the first half, second half, and end of play as the point at which they were certain that their team would lose. We predicted that children who believed a victory was still possible would be more vigilant and hence more focused on the central components of play than would those had believed that a loss was inevitable. At both the initial and delayed interviews, the results were consistent with this prediction. As illustrated in Figure 2–4, the players on the losing teams who reported believing into the second half or at the end of the game that a win was possible responded correctly to more wh- questions regarding central components of play (e.g., “How many times was a player called for off-sides?”; “How many times did the other team score on a penalty kick?”) than did those who thought the outcome had been decided in the first half. Some additional evidence supports the interpretation that the group differences arose from the deployment of attention. The groups did not differ significantly in their responses to questions addressing peripheral components of the game (e.g., “How many times did a ball from another game come onto your field?”), suggesting that the between-group differences in central recall cannot be attributed to a general disengagement among the children who saw the outcome as a foregone conclusion.

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0.8

Proportion Central Recall

0.7

Initial 6-Week Delay

0.6 0.5 0.4 0.3 0.2 0.1 0 1st Half

2nd Half

End

Knowledge of Outcome

Figure 2–4. Proportion of central game components reported by the children on losing teams who reported knowing the game outcome at alternative points in play.

Further, we compared the recall performance of the players on both losing and winning teams who reported that they did not know what the outcome of the game would be until the very end of play. These groups did not differ with regard to their recall of either the central or peripheral components of their games. This pattern of results suggests that the deployment of attention may mediate the relation between memory and arousal in children’s memory for salient experiences, at least under some conditions (see Easterbrook, 1959). The investigations described in this section are clearly limited by their quasi-experimental designs and by their small sample sizes. Nonetheless, taken as a whole, the work provides evidence for the importance of children’s understanding of their experiences on their encoding and subsequent retention of the event. More specifically, our studies of children’s memory for a physical examination and dental check-up indicate that prior knowledge influences performance, and our exploration of the VCUG provides evidence for the importance of recently acquired procedural information. In contrast, the soccer match study indicates clearly that children’s evolving understanding of the situation can affect the deployment of attention and hence subsequent recall; although all players were exposed to the same nominal stimulus—i.e., the tournament game—their differing perceptions of the

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likely outcome led to contrasting functional stimuli, with corresponding differences in remembering.

A Novel Pediatric Examination: Expectations and Long-Term Recall Whereas the research reported above addresses the role of knowledge and understanding on the encoding of events as they transpire, these investigations did not include an examination of changes in the memory representation as a result of extended encoding. In this section, we explore the implications of some additional research for the understanding of possible knowledge-driven mechanisms through which these representations may be altered—in ways that may either disrupt or enhance veridical recall—after events have taken place. It has long been known that constructive processes driven by generic knowledge may alter children’s reports of their experiences over time. A study from our own research program illustrates the ways in which children’s expectations, based on their own past experiences, can affect their reports over an extended delay interval. Ornstein et al. (1998) presented four- and six-year-old children with a specially designed medical examination, administered by a licensed pediatrician in her office, in which some expected, typical features of the check-up were omitted and other novel features were included. Hence, for example, the physician omitted checking the child’s heart, but added the unusual component of measuring the child’s head circumference. Both at the initial and the 12-week delayed interview, the children were more successful in reporting the typical as compared with the atypical features in response to open-ended prompts. However, at the delayed interview, the children experienced difficulty in differentiating between typical features that had and had not been in the mock examination than they did with atypical present versus omitted components. Further, in contrast to previous investigations in which spontaneous intrusions are quite rare, the children reported a number of features that had not been included in the specially constructed examination, all of which were typically included in routine pediatric check-ups. Moreover, the older children, who presumably had more generic knowledge regarding the event, generated the majority of these intrusions. These findings are consistent with investigations of children’s reliance on generic representations such as scripts as episodic memory fades (Myles-Worsley, Cromer & Dodd, 1986) and with research examining the effects of event repetition on children’s suggestibility (e.g., Roberts & Powell, 2006). In addition to changes in memory over time that arise from the activation of existing knowledge, it is possible that knowledge-based Understanding and Remembering of Stressful Experiences

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reasoning and interpretive processes may contribute to changes over time in the underlying memory representation. At present, few studies have documented the mnemonic consequences of such cognitive activity for children’s event recall. Tsethlikai and Greenhoot (2006) recently explored these issues in the context of nine- to 11-year-olds’ recall of stories. These children initially heard a story that they were told to imagine had happened to them. The participants subsequently heard either a control story or one in which another person’s perspective on the events in the story justified a change in its original interpretation. In response to the provision of this alternative perspective, the children in the experimental condition substantially changed their initial recall by presenting a character in a more positive light and attempting to reconcile details from both perspectives by adding new information to their reports. Some recent work in our laboratory, although by no means definitive, has implications for examining the ways in which changes in understanding an emotionally salient experience may alter its memory. We begin with the presentation of some findings from our investigations of children’s memory for soccer games. The data, we believe, provide evidence for a dynamic relationship between understanding and remembering over time.

Constructive Activity among Soccer Players on Winning vs. Losing Teams The findings from another study of soccer players’ recall of the details of an important match suggest a linkage between constructive activity and the emotion associated with the game. Baker-Ward, Eaton, and Banks (2005) asked 48 ten-year-old girls who participated in a soccer tournament to rate their individual performance on a 1 (“My worst game ever”) to 5 (“My best game ever”) Likert scale, both at an initial interview conducted within one week of the final game and at a delayed interview five weeks later. Not surprisingly, the players on winning teams rated the quality of their individual performance significantly higher than did their less-successful opponents. Interestingly, there was an interaction between team outcome and time. The children who enjoyed a victory rated their performance slightly higher at the second interview than at the first, whereas the young athletes who coped with a loss saw themselves as having played more poorly as time progressed. Additional results from this investigation indicate that the emotional valence of an experience is associated with the opportunity for extended encoding. At the delayed interview, a subset of the young soccer players was asked, “How often did you talk with someone about the game?” These respondents had all participated in the same tournament game 46

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as members of opposing teams; hence, differences in their engagement in conversations about the event should be due to the game outcome, rather than to extraneous variations in their experiences (such as extreme weather or the attendance of a local celebrity at the game). The children who played on the winning team reported that they had discussed the game with others an average of 4.67 times over the five weeks between the match and the delayed interview. In contrast, the players from the losing team reported only about half as many conversations (M = 2.25). Given the importance of parent-child conversations about salient experiences on children’s memory (see Sales, this volume) and research on the effects of story retellings on adults’ recall performance (Marsh, 2006), it seems reasonable to predict that a different propensity to engage in conversations about an experience would affect long-term memory for the event. Moreover, although we do not have access to the specifics of these conversations, it seems likely that members of winning as opposed to losing teams talked about different aspects of the match.

Evaluations of Play and Extended Coding among Young Athletes As discussed above, Eaton (2003) demonstrated that children’s changing perceptions of the likelihood of winning or losing a soccer match influenced attentional deployment and the encoding of game-related information. Further results from this study suggest a linkage between the players’ personal evaluations of their team’s performance and their postgame focus over an extended period of time on alternative components of the match. As a general indicator of the young athletes’ reaction to the game the players rated their team’s performance (as well as the quality of their individual play) on a scale of 1 (“Worst game ever”) to 7 (“Best game ever”). Four groups were formed on the basis of these ratings, with ns ranging from 10 to 29 children. Because of the infrequent use of very negative ratings, children who reported one of the lower three ratings were included in one group who perceived team play during the match as “OK” to “Worst Ever.” Additional groups perceived team play as “Pretty Good,” “Really Good,” or “Best Ever.” Rating category was independent of the game outcome. The children’s memory for details of the match was assessed immediately after play and again after a delay of six weeks. As discussed above, the young players first provided a narrative account of the match, and then responded to a series of standard wh- questions regarding predefined game components. The free-recall reports were divided into propositions, which were classified as reflecting central or peripheral game components. In an analysis of the proportion of central propositions in the children’s Understanding and Remembering of Stressful Experiences

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game narratives, the 19 children who rated the tournament game as their team’s “best game ever” differed across time from the groups who saw the game as less salient. These participants used a greater proportion of central propositions at the second interview (M = .61, SD = .27) than they did at the first (M = .42, SD = .29), whereas the children who evaluated play less positively did not differ over time in the proportion of central propositions they included in their reports. The groups did not differ with regard to the length of the narratives, eliminating a possible confounding variable. Moreover, they did not differ with regard to their rates of inclusion of propositions coded as peripheral information. With regard to elicited recall, the groups who rated team performance higher also tended (ps < .06) to respond correctly to a greater proportion of wh- questions addressing both central game components than did the other groups, although this effect did not change across time. Although the above findings reflect the operation of extended encoding processes, there are a number of reasons to expect that extended encoding may be limited in children’s reflection on the outcomes of recreational sports competitions. In remembering soccer games, the children in our investigations reported an expected, familiar experience. Moreover, although the soccer tournaments in which they took part were clearly important occurrences for the participants at the time at which they took place, the outcome is unlikely to have had a continuing effect on the young players’ lives. The tournaments in which they competed were organized by their recreational league, in which participation and good sportsmanship rather than winning were emphasized. In addition, the young athletes had extensive exposure to wins and losses. Parents of the participants in one of our soccer studies reported that their 10-year-old children had, on average, more than five years of experience in playing organized soccer. And, for these young players as well as sports fan everywhere, “there is always next year.” Consequently, understanding the experience in most cases may not require extended reflection or the provision of additional information from others. In contrast, other experiences, such as events that result in blocking the individual’s goals (see Stein & Liwag, 1997) or experiences that impose threats to the individual’s sense of selfworth or that are inconsistent with previous perceptions of others (see Ross, 1989) may be more likely to activate extended encoding.

Changes in Children’s Injury Reports over a One-Year Delay To explore the possibility of an increased likelihood of extended encoding in more emotionally challenging situations, we returned to the data obtained in a previous investigation of children’s memory for the details 48

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of emergency treatment following a facial laceration (Burgwyn-Bailies et al., 2001). In this study, 24 three- to seven-year-olds experienced an injury that required treatment by a plastic surgeon, and we assessed their memory within two days of the accident and after delays of six weeks and one year. Although our interview protocol included open-ended and wh- questions regarding the children’s accidents as well as their surgical treatment, the report by Burgwyn-Bailes et al. (2001) focused only on the minor surgeries; indeed, the children’s accounts of their accidents have not been previously systematically examined. Of relevance to the present issue, the accidents had consequences for the children’s subsequent experience in at least some cases, as caregivers implemented new rules or strategies to insure their children’s future safety. For example, a six-year-old who cut his cheek with his new Cub Scout knife had to surrender his “whittling chip” and could no longer participate in some den activities. In other instances, the aftermath of the injury included questions of blame or fault. The children’s reports of 15 components of the injuries that they experienced were obtained, including nine central (e.g., the ongoing activity at the time of the injury) and six peripheral (e.g., weather, clothing the child was wearing) features. The initial reports were accurate and fairly extensive, with the young participants reporting an average of 10.8 of these 15 components. Few changes in these reports were observed at the six-week interview, but after the one-year delay the children reported about 70% of the features of the accidents that had been reported initially, omitting an average of 1.79 of the features. Little new information was provided after a year; the children reported a mean of only 0.49 previously undisclosed accident components. Interestingly, there were some contradictions in long-term recall such that each participant on the average altered the report by 1.38 components in a manner that was inconsistent with the original report. Although about two-thirds of these contradictions involved peripheral information, central features of the experience were also altered, including something as basic as the cause of the injury. Indeed, 10 children’s accounts included at least one such potentially consequential contradiction across the one-year interval. To illustrate, a second grade student provided this account of his injury one day after it occurred: I was playing basketball with my teacher and I was trying to steal. She sort of accidentally . . . you know, she was running and I just came across like this and we sort of collided. And she outweighed me. I got the worst of it and hit my head on the pavement.

One year later, the child gave us this report of his injury:

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I was playing pass the ball with my teacher. The ball hit the rim. I ran to get it and the teacher . . . I tripped over her foot. I fell and hit my head against the ground.

Note that the teacher’s role in the incident has been altered in the delayed report. She is described at the first interview as the unintentional agent of the injury, having inadvertently knocked down her student when they collided. In contrast, the child describes her role as passive in the delayed report; it is his own action in tripping over her foot that caused his fall. Could it be that serving as an agent of an injury that required emergency treatment, even inadvertently, was inconsistent with this child’s perception of a nurturing teacher, prompting a reconstruction of this episode? The complexity involved in the development of the understanding of intentional versus unintentional actions in assigning blame (Kohlberg, 1976) could increase the likelihood of such reworking of the experience. Of course, examples such as this one can only yield hypotheses, not conclusions. To explore more fully the impact of changing understanding over time on children’s memory, future research efforts should explore changes in memory for complex experiences that have consequences that extend beyond the temporal duration of the events themselves.

Future Directions In this chapter, we have suggested that the processes involved in the encoding of information in memory are knowledge-driven and extended in time. Children’s understanding of the events that they experience is critical for subsequent remembering, and comprehension is driven by both endogenous and exogenous forces that may operate long after an event has ended. In turn, our understanding of children’s abilities to remember events, especially those that are emotionally laden, requires an analysis of the factors that influence the establishment and modification—through extended encoding—of representations in memory. We readily acknowledge the limitations in the research examples that we have presented, including the post hoc nature of a number of the analyses, the small sample sizes in many studies, and, significantly, our limited measurement and conceptualization of emotion and stress (see Alexander and O’Hara, this volume, for discussion of the operationalization of stress and emotion). These important qualifications notwithstanding, we have provided evidence for the importance of exposure to various sources of understanding on children’s encoding of an experience. These influences include adults’ efforts to prepare children for specific events and children’s perceptions of critical aspects of an 50

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experience as it unfolds. Regarding the effects of preparation on understanding, further studies should examine the changes in children’s knowledge representations that result from these efforts (see Baker-Ward et al., 1997). An understanding of the dynamics of changing memory representations should facilitate more precise explorations of linkages between understanding and remembering. In addition, our preliminary examination of the relation between presumed changes in children’s goals during a soccer match and the encoding of the details of this experience suggests the importance of developing methods for “on-line” assessments as events unfold. The initial explorations of children’s extended encoding provided here suggest that participants’ varying emotional reactions to an event can influence the likelihood of subsequent experiences that can, in turn, alter understanding and memory. Young soccer players who enjoyed a victory reported that they were more likely to engage in retellings of the game than were those who endured a defeat. Moreover, individuals’ perceptions of their own performance during the game were altered as a consequence of the game outcome. Further, some preliminary data suggest that young athletes who evaluated their play more positively, regardless of the outcome of the competition, focused more over time on central components of the event. Clearly, the hypotheses resulting from these findings must be tested in investigations designed specifically for this purpose. Such additional research must document children’s precise emotional reactions and assess contemporaneously their diverse experiences in revisiting the target event. To elucidate the processes involved in extended encoding, it will be important to explore changes in children’s understanding in the context of compelling experiences that have continuing significance for the individual. Even a championship recreational league match may have few continuing consequences, but a competition that results in a decision about the direction of a young athlete’s further athletic career (e.g., progressing to a competitive travel league or remaining on a recreational league) may require further interpretation and reassessment. Much remains to be learned about linkages between understanding and memory across development. Given our commitment to a constructivist approach to memory, we have focused on age-related changes in domain-relevant knowledge as contributors to corresponding changes in remembering (see Ornstein et al., 1998, for a review). We still continue to examine knowledge as one of a number of mediators of developmental change (Ornstein et al., 2006), but our perspective on knowledge has been broadened, and we find it useful to emphasize that understanding involves more than knowing. In addition to the contributions of expertise, our emerging perspective mandates that we direct our attention to a number of additional domains of development. For example, changes Understanding and Remembering of Stressful Experiences

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across age in children’s general reasoning abilities contribute in important ways to developmental changes in understanding, as the capacity to link components of an experience in a logical method may enhance subsequent remembering (Baker-Ward et al., 1997). In addition, developmental transitions in the likelihood of the occurrence of “efforts after meaning,” individuals’ propensity to revisit and reinterpret emotionally significant events, must be examined to determine changes over time in understanding (see Fivush & Baker-Ward, 2005). Although few developmental analyses are currently available, Pennebaker and Stone’s (2003) identification of changes in language use over the lifespan supports the importance of such explorations. Children between eight and 14 years of age, in contrast to a group of 15- to 24-year-old participants, mentioned fewer cognitive processes—including causal and insight terms—in their personal narratives. It also seems likely that younger children’s exposure to external sources of information, including conversations with caregivers, has particular significance for their understanding of emotional experiences, both before and after they transpire. Clearly, cross-sectional and ultimately longitudinal analyses of children’s understanding and remembering are needed.

Implications for Practice Researchers in children’s memory, particularly those whose work is motivated in part by the needs of clinical and legal professionals in interpreting eyewitness testimony, have long been interested in the relation between levels of stress at encoding and the extent of recall and suggestibility (see, e.g., Gordon et al., 1995). The chapters in this volume attest to the complexity of the issues involved in addressing the stress-memory linkage and the importance of examining moderators of performance. Clearly, one of these important moderators is the child’s understanding of the event as it unfolds. Research on the linkage between children’s understanding and their subsequent memory of stressful experiences has relevance for both forensic development and pediatric psychology. Given the need for future research, as discussed above, we outline here two basic implications of our work. First, assessments of children’s testimony must incorporate an evaluation of the child’s understanding of the to-be-reported event. At the time that an experience transpires, variations in children’s understanding may partially mediate age differences in performance. Even younger preschoolers, in the presence of domain-relevant information, may provide relatively extensive accounts of what has happened to them. Without such understanding, their reports may be limited, particularly with regard 52

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to free recall, and more extensive cueing may be needed to elicit the information that was encoded. Given the risks of response bias, especially among very young children (see Baker-Ward, Ornstein, Gordon, Follmer, & Clubb, 1995), such cueing must be provided cautiously, with a reliance on closed rather than specific questions whenever possible. The conceptualization of encoding as a process that extends beyond the event also conveys the importance of examining experiences that may maintain or augment memory, as well as those that may disrupt recall. Some apparent inconsistencies in children’s reports over time, for example, may represent changes in the understanding of the relevance of aspects of an experience, and hence may not constitute evidence of memory contamination (see Gordon & Follmer, 1994). Opportunities for retelling a story about an experience in informal situations as well as formal interviews must also be examined. Further, the extent to which therapeutic interventions may have transformed a child’s perspective on an experience, and hence the underlying memory representation, must be carefully evaluated. Second, enhancing children’s understanding of a forthcoming experience can be expected to affect the likelihood that they will experience anxiety during the event. In general, greater levels of understanding will certainly decrease overall anxiety, and a recent investigation by Salmon, McGuigan, and Pereira (2006) provides direct support for this generalization. These researchers extended our analysis of the effects of information provided by the technologists in conjunction with an invasive VCUG procedure (Principe et al., 1997), as discussed above. Young children were randomly assigned to conditions differing with regard to the provision of information about the procedure both before it was implemented and as it unfolded. The participants who received complete information as well as distraction, in comparison to groups receiving only partial information and distraction or no psychosocial intervention, demonstrated lower levels of observed behavioral distress during the VCUG procedure and better memory performance after a delay of a week. The findings suggest an effective and efficient means of decreasing children’s anxiety and increasing their compliance during medical procedures. It should be emphasized, however, that building understanding rather than simply providing knowledge is necessary to obtain such benefits. Salmon (2006), in an application of laboratory-based research to the preparation of children for medical procedures, concludes that information must be specifically rather than generally related to the event. Hence, parental discussions that convey reassurance and general instructions for behavior may not prepare children in an effective manner. It may also be the case that preparation has a cost, at least during the initiation of a medical procedure. In our investigation of the effects of preparation on children’s memory for a first dental visit as Understanding and Remembering of Stressful Experiences

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discussed above (Baker-Ward & Ornstein, in preparation), children in the High Preparation group actually had significantly greater levels of anxiety during the first portion of the examination, as measured through a behavioral-observation coding scheme, than did children receiving less preparation. Of course, the post hoc nature of the design mandates caution in interpreting this finding, and it is possible that parents provided more preparation to children whom they perceived as more anxious. However, parental ratings of child trait and state anxiety and temperament did not differentiate the preparation groups. It must be emphasized that overall levels of anxiety were low and that the children were quite compliant during the dental examination. Potential collaborations with pediatric psychologists, child-life specialists, and medical professionals offer opportunities to establish causal linkages between stress and remembering. Whereas ethical practice prohibits creating high levels of anxiety in most situations involving children, it is certainly appropriate to work toward reducing children’s stress when they face painful medical procedures. Preparation has long been recognized as a means of alleviating anxiety, and it is apparent that effective preparation enhances understanding. In addition to identifying the variables associated with the most effective interventions, research addressing children’s preparation for difficult experiences can enable the determination of the pathways through which stress at encoding and during retention impacts on remembering. But one thing is clear: the complex relations between stress and memory can be elucidated only when children’s changing understanding of challenging experiences is addressed.

Acknowledgment: The research on children’s memory for medical procedures discussed in this chapter was supported in part by grant HD 32214 to Peter A. Ornstein from the United States Public Health Service. We also extend our appreciation to the medical professionals who cooperated with these investigations, the recreation program staff members and community volunteers who facilitated our efforts, and the parents and children who willingly participated. The research we review represents the continuing involvement of members of our laboratory groups at UNC-CH and NC State, and we gratefully acknowledge their contributions to our research programs. Kimberly L. Eaton’s valued collaboration made possible the research on children’s memory for soccer games. Thanks are also due Elaine Burgwyn-Bailes and Mary Koenig Styers for their assistance in the preparation of this chapter.

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Burgwyn–Bailes, E., Baker-Ward, L., Gordon, B. N., & Ornstein, P. A. (2001). Children’s memory for a minor medical emergency procedure after one year: Individual differences in recall and suggestibility. Applied Cognitive Psychology, 15, 1–24. Campbell, B. A., & Jaynes, J. (1966). Reinstatement. Psychological Review, 73, 478–480. Campos, J. J., Mumme, D. L., Kermoian, R., & Campos, R. G. (1994). A functionalist perspective on the nature of emotion. Monographs of the Society for Research in Child Development, 59 (2–3. Serial No. 240), 284–303. Chi, M. T. H. (1978). Knowledge structures and memory development. In R. S. Siegler (Ed.), Children’s thinking: What develops? (pp. 73–96). Hillsdale, NJ: Lawrence Erlbaum Associations. Clubb, P. A., Nida, R. E., Merritt, K. & Ornstein, P. A. (1993). Visiting the doctor: Children’s knowledge and memory. Cognitive Development, 8, 361–372. Dolan, R. J. (2002). Emotion, cognition, and behavior. Science, 298 (5596), 1191–1194. Easterbrook, J. A. (1959). The effect of emotion on cue utilization and the organization of behavior. Psychological Review, 66, 183–201. Eaton, K. (2003). Memory and emotion: The influence of valence on children’s memory for a salient event. Unpublished doctoral dissertation, NC State University, Raleigh. Fisher, R. P., Brennan, K. H., & McCauley, M. R. (2002). The cognitive interview method to enhance eyewitness recall. In M. L. Eisen, J. A. Quas, & G. S. Goodman (Eds.), Memory and suggestibility in the forensic interview (pp. 265–286). Mahwah, N. J.: Lawrence Erlbaum Associates. Fivush, R. (2000). Accuracy, authorship, and voice: Feminist approaches to autobiographical memory. In P. Miller & E. Scholnick (Eds.), Towards a feminist developmental psychology (pp. 85–106). New York, NY: Cambridge University Press. Fivush, R. & Baker-Ward, L. (2005). The search for meaning: Developmental perspectives on internal state language in autobiographical memory. Journal of Cognition and Development, 6, 455–462. Goodman, G. S., Quas, J. S., Batterman-Faunce, J. M., Riddlesberger, M. M., & Kuhn, J. (1997). Children’s reactions to and memory for a stressful event: Influences of age, anatomical dolls, knowledge and parental attachment. Applied Developmental Science, 2, 54–74. Gordon, B. N., & Follmer, A. (1994). Developmental issues in judging the credibility of children’s testimony. Journal of Clinical Child Psychology, 23, 283–294. Gordon, B. N., Schroeder, C. S., Ornstein, P. A., & Baker-Ward, L. (1995). Clinical implications of research on memory development. In T. Ney (Ed.), Child sexual abuse cases: Allegations, assessment and management (pp. 99–124). New York, NY: Brunner/Mazel. Gordon, B. N., Baker-Ward, L., & Ornstein, P. A. (2001). Children’s testimony: A review of research on memory for past experiences. Clinical Child and Family Psychology Review, 4, 157–181. Greenhoot, A. F. (2000). Remembering and understanding: The effects of changes in underlying knowledge on children’s recollections. Child Development, 71, 1309–1328. 56

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representation: Bridging fictional and actual events (pp. 129–235). Mahwah, NJ: Lawrence Erlbaum Associates. Tsethlikai, M., & Greenhoot, A. F. (2006). The influence of another’s perspective on children’s recall of previously misconstrued events. Developmental Psychology, 42, 732–745. Underwood, B. J. (1963). Stimulus selection in verbal learning. In C. N. Cofer & B. S. Musgrave (Eds.), Verbal behavior and learning: Problems and processes (pp. 33–75). New York, NY: McGraw-Hill. Vandermaas, M. O., Hess, T. M., & Baker-Ward, L. (1993). Does anxiety affect children’s reports of memory for a stressful event? Journal of Applied Cognitive Psychology, 7, 109–127. Wang, Q., & Ross, M. (2005). What we remember and what we tell: The effects of culture and self-priming on memory representations and narratives. Memory, 13, 594–606.

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3 Injuries, Emergency Rooms, and Children’s Memory Factors Contributing to Individual Differences Carole Peterson Kelly L. Warren

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he relationship between children’s emotional reactions to stressful events and their subsequent memory of those events is an important one, playing a role in both clinical and forensic situations. Considerable research has shown that children’s emotional reactions during an event are major contributors to how well it is later remembered. In a review of children’s recall for autobiographical events, whether or not there was robust long-term recall of these events was highly related to emotionality, and highly negative events seem to be particularly well-remembered (Peterson, 2002). As contrasting examples, preschoolers recalled approximately 20–30% of the features of a living-room camping trip when interviewed one day or three weeks later (Boland, Haden, & Ornstein, 2003; Haden, Ornstein, Eckerman, & Didow, 2001; Ornstein, Haden, & Hedrick, 2004), but 75% of the features of facial surgery events (caused by injuries) when they were interviewed a full year later (Burgwyn-Bailes, Baker-Ward, Gordon, & Ornstein, 2001). It should be noted, however, that the latter events involved acute stress; one cannot assume that similar relationships between stress and memory hold when stress is chronic versus acute. This issue is explored by Greenhoot, Johnson, Legerski, and McCloskey (this volume). In this chapter, we will first present some recent theoretical discussion of the relationship between stress and memory, and then summarize a body 60

of research conducted in our laboratory that has explored children’s recall of naturally occurring stressful events, specifically injuries serious enough to require hospital emergency-room treatment. In particular, we will focus on potential sources of individual variation in children’s recall of real-life stressful events, both in research conducted in our laboratory and in related research conducted by other investigators. Finally, we will discuss the practical significance of this work for clinical and legal contexts.

Theoretical Considerations There has been considerable debate about the relationship between acute stress and memory in children with various studies differing in empirical findings. According to a recent meta-analytic review of this research, part of this variation may be attributable to the nature of the distressing events (Deffenbacher, Bornstein, Penrod, & McGorty, 2004). Deffenbacher et al. (2004) distinguish between events that elicit an arousal mode of attention control (i.e., an orienting response, or high level of attention focused on the event) and ones that elicit an activation mode of attention control (i.e., a defensive response such as the well-known fight or flight response). A defensive response is elicited by events that threaten bodily integrity or self-esteem, and thus involve considerably higher degrees of distress than events that elicit an orienting response. Deffenbacher et al. argue that some studies investigating the relationship between stress and memory had procedures that elicited an orienting response while others elicited a defensive response. Thus, it may be difficult to compare the effects of stress on memory when there is such variation in what constitutes the “high stress” category in different research studies. As an example of this variation, Peters (1997) exposed children to an unexpected fire alarm. Although children in his highest stress group had elevated blood pressure and pulse rates, none of the children cried or showed hysterical distress. In contrast, in a series of studies of children who suffered an unexpected and very painful injury (such as a broken bone, crushed fingers, or deep laceration), the high stress group was composed of children who suddenly began to scream in pain and were typically described by their parents as extremely upset or hysterical (Peterson, 1999; Peterson & Bell, 1996; Peterson & Whalen, 2001). In their review, Deffenbacher et al. (2004) propose a theoretical model of how stress affects memory; they suggest that as stress increases, memory for those details that are the focus of participants’ attention are increasingly recalled. However, when stress levels become very high, there is a catastrophic drop in memory performance. This model fits the data from extant studies of how accurately adults can recall event Injuries, Emergency Rooms, and Children’s Memory

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details when the target events meet the authors’ criteria for eliciting a defensive response. Surprisingly, in the smaller number of studies that involved children, they found no relationship between stress and recall accuracy in children. The other outcome measure Deffenbacher et al. assessed was how accurately children and adults could identify faces from line-ups. Parallel to their findings on accuracy of event detail recall, they found that adults showed increases in recall as stress increased, until high levels of stress occurred. At that point, there was a similar sharp drop in the accuracy of face line-up identification. And, again, parallel to their findings for accuracy of event detail recall, there was no relationship between stress and how well children could identify faces from line-ups. However, Deffenbacher et al. did not assess the amount of information recalled about target events. The focus of this chapter is on children, and although (as those authors suggest) the accuracy of what children recall may not be compromised under high stress conditions, it is possible that how much they recall is. Overall, their model may fit data from adult studies but the relationship between stress and memory in children is still very unclear. In the next sections, we review research from our laboratory on children’s recall of high-stress events.

Children’s Recall of Injuries Requiring Emergency-Room Treatment Over the past decade, I and my colleagues have been exploring children’s recall of naturally-occurring events that are highly salient to children and that elicit a lot of distress, namely personal injuries such as bone fractures and lacerations that are serious enough to require hospital emergency-room treatment. In this research, children and their families are recruited during their emergency-room visit and, over the years, around 80% have agreed to participate. Because this research has been conducted in Canada, where medical care is paid for by the government and all children receive equivalent treatment regardless of their socioeconomic circumstances, the children represent a cross-section of their community. Although we could recruit families from the emergency room, ethically we could not interview them until they had had time to read our information and consider it at their leisure, so all child and parent interviews took place approximately a week later. And in order to get cooperation from most families, we had to go to them, in their homes, which is where all interviews have taken place. In this entire body of research on emergency-room injuries, it is clear that many of the children were extremely upset. Many were described by parents as hysterical. In the words of one child, “I never cried—I 62

STRESS AND MEMORY, EMPIRICAL EVIDENCE

just screamed.” A parent describing a three-year-old said, “He was screaming! Bawling! Lots of blood!” Many children also perceived their bodies to be threatened. To quote another child, “The blood was just flying everywhere.” So we were confident that we had an event that was highly distressing for at least some children, and as well, other children were not so upset. According to the differentiation made by Deffenbacher et al. (2004), between distressing events that elicit an orienting versus a defensive response, we are confident that for some of our children, the defensive response was elicited, on the basis of both parental and child self-descriptions of how distressed the children were. How to capture the child’s recall has been a perennial issue. The problem is that there was not a standardized event that all children experienced. Rather, each bone fracture, laceration, dog bite, or crushed finger differed in details. Probably the one that was most divergent was a four-year-old who had a wasp fly up her nose and got thoroughly lodged in the upper nasal passage. The wasp of course stung her painfully from the inside, and was sufficiently stuck that it had to be removed with forceps at the hospital. The child, not surprisingly, was hysterical the whole time. So, how to capture this variation and allow comparison across children? We devised a standardized prototype of typical injury and hospital treatment events, and children were scored on the proportion of these prototype components that they recalled with parental witnesses determining which components of the prototype were applicable. Examples of prototype components include where and when the injury took place, who was there, what led to the injury, how the child reacted, who first got to them, what that person did, and so on. Children were scored on whether or not they provided information relevant to each applicable prototype component. Thus, we could assess the completeness or exhaustiveness of children’s recall, in terms of the proportion of the relevant prototype components that they actually recalled. We could also assess the accuracy of their recall, again by comparing their recall with witness reports. Others who have studied children’s recall of naturally occurring stressful events (such as hurricanes) have looked at the absolute amount of information that children have recalled by counting the number of new or unique units of information (Bahrick, Parker, Fivush, & Levitt, 1998; Fivush, Sales, Goldberg, Bahrick, & Parker, 2004), and so in some studies we used this measure too. This has a different focus than the completeness measure described above. In assessments of completeness, each component of a prototypical experience is scored as present or not, regardless or how much detail the child provides about that component. In contrast, when the amount of new information is assessed, each new detail is separately counted. Compare “we were in the backyard” with “we were in the backyard down by that hole in the fence Injuries, Emergency Rooms, and Children’s Memory

63

where the mud is.” These are equivalent under the prototype completeness scoring (they both specify where events took place), but the latter contains considerably more new units of information. There are two things we should qualify. First, we have often checked to see if the nature of the injury, whether a bone fracture, laceration requiring sutures, or other injury, makes a difference, and it does not. The second qualification, however, does turn out to be important: in every study, children recalled significantly more about the details of their injury experience than about their hospital treatment, even though parental ratings showed that children were often as upset in the hospital as they were at the time of injury. There could be several potential explanations for this difference in how well these two events are recalled. For one thing, the injury is a unique event, whereas these children have visited this emergency room numerous times (see Peterson & Bell, 1996, for relevant data) since it serves as the after-hours clinic for all physicians in the region. As well, it is likely that children have a better understanding of the temporal and causal connections between successive injury than hospital components, since many probably do not understand

Injury

Hospital

100 90

% Components Recalled

80 70 60 50 40 30 20 10 0 Initial

5 year 12–13

8–9

Initial 5–6

3–4

5 year 2

Figure 3–1. Percentage of relevant prototype components recalled by children initially and five years later about their injury and hospital treatment. 64

STRESS AND MEMORY, EMPIRICAL EVIDENCE

why they go to one place in the hospital and wait, talk to someone there, and then get taken to another place (e.g., x-rays) and wait, then get taken somewhere else for another treatment component. In the next section, we will review the results of this series of studies, focusing on potential sources of individual variation.

Stressful Events are Well-Remembered Events A host of research demonstrates the robust nature of children’s recall for stressful events. For example, investigators who have studied children’s memory for highly stressful experiences that included painful medical procedures such as voiding cystourethrograms (VCUG) (Goodman, Quas, Batterman-Faunce, Riddlesberger, & Kuhn, 1994, 1997; Merritt, Ornstein, & Spicker, 1994; Quas et al., 1999; Salmon, Price, & Pereira, 2002) and natural disasters such as hurricanes (Bahrick et al., 1998; Fivush et al., 2004), have repeatedly shown that children have extensive memory for these stressful, highly salient events. Injuries serious enough to require hospital emergency room treatment are also well-recalled events. We have found, for completeness of recall, that children recalled on average (across all age groups) 75% of the prototype components of their injuries when interviewed a week after they occur, and 73% of those components a full five years later (Peterson & Whalen, 2001). They did not recall as many prototype components of their hospital treatment (57% initially and 50% five years later, see Figure 3–1), but recollection is still considerably better than for more mundane events that are often not recalled at all, or require considerable cuing (Peterson, 2002). For accuracy, children’s recall is quite accurate shortly after the target events occurred (averaging 94% accuracy for both events), and although accuracy deteriorates over time, accuracy of injury and hospital recall still averages 86% and 78%, respectively, five years later (see Figure 3–2). Although decreases were found five years later in the completeness and accuracy of recall, a different pattern was found for the amount of new information children provide, which increased over time. Children provided on average 52 new units of information initially about their injury and 46 new units about hospital treatment, and five years later they averaged 71 and 54 units of new information for their injury and hospital treatment, respectively (see Figure 3–3). This increase over time in the number of new units of information has been found by others as well (Fivush et al., 2004), and may reflect children’s improved vocabularies and narrative skills. As they get older, they provide more descriptive detail about the components of their experiences. In summary, stressful events are typically well-remembered events. Nevertheless, the relationship between stress and memory is more Injuries, Emergency Rooms, and Children’s Memory

65

Injury

Hospital

100 90 80

% Accuracy

70 60 50 40 30 20 10 0 Initial

5 year 12–13

Initial 8–9

5–6

5 year 3–4

2

Figure 3–2. Percentage of children’s recall about their injury and hospital treatment that is accurate, both initially and five years later.

complex than this because researchers have documented considerable individual variation between children’s recall of identical events. Because this relationship is complex, it is necessary to use a range of perspectives, from neurobiological (see Carver & Cluver, this volume, and Wiik & Gunnar, this volume) to physiological (see Wallin, Quas, & Yim, this volume, and Alexander & O’Hara, this volume), to children’s cognitive understanding (see Baker-Ward, Ornstein, & Starnes, this volume, Compas, Campbell, Robinson, & Rodriguez, this volume, and Laible & Panfile, this volume), to socioemotional perspectives (see Chae, Ogle, & Goodman, this volume, McDermott-Sales, this volume, Laible & Panfile, this volume, and Oppenheim & Koren-Karie, this volume, as well as research presented here). Below, we show via our data the well-known importance of the child’s age for how well events are recalled; we then discuss a number of other individual difference variables that have been investigated in our laboratory.

Importance of Children’s Age One factor that must be taken into account is the child’s age. Even when the target events being recalled seem equivalent, how old the child 66

STRESS AND MEMORY, EMPIRICAL EVIDENCE

is at the time of event occurrence makes a difference (Peterson, 2002; Quas et al., 1999; Salmon et al., 2002). Children less than two years of age when the events happened typically recall little or nothing of even highly stressful events, and what little they may recall tends to be fragmentary (Peterson & Rideout, 1998; Terr, 1988; see review in Peterson, 2002). Importantly, it is children’s age at the time of event occurrence rather than age at the time of event recall that is key; older children seem to retain only fragments of target events that occurred when they were very young, although some of them may weave these fragments together with memories from other related events to provide coherent narratives, even though these narrative accounts may be amalgamations of a number of separate events. We found this in our five-year follow-up interviews of injured former one- and two-year-olds (Peterson & Parsons, 2005). By the time children are three years of age, their recall of stressful events can be quite extensive and robust. However, it still becomes better with age, as researchers who have investigated a range of target events have found (Burgwyn-Bailes et al., 2001; Goodman et al., 1997; Peterson, 1999; Peterson & Bell, 1996; Peterson & Whalen, 2001; Salmon et al., 2002; Shrimpton, Oates, & Hayes, 1998). Figures 3–1 to 3–3 demonstrate age differences in how complete, accurate, and informative children’s recall of emergency-room injuries is across a wide age variation. The figures also show how recall changes over five years. For older children, it becomes less complete with age. However, this is not necessarily the case for younger children, particularly two-year-olds, who recall a greater proportion of injury components five years later. This increase is probably an artifact of how difficult it is to interview twoyear-olds. As anyone who has tried to interview children this young knows, they are much more interested in playing than sitting and talking, but five years later, they are cooperative seven-year-olds. These data on the completeness and accuracy of recall have been presented elsewhere (Peterson, 2002; Peterson & Whalen, 2001) and are reprinted here for comparison with data on the informativeness of children’s recall. As is apparent in Figure 3–3, children of all ages provide more descriptive detail five years later, particularly about injury components, even if they recall fewer of those prototype components. This increase in informativeness after delays spanning years has been found by others as well. For example, Fivush et al. (2004) found that children provided more new units of information about a destructive hurricane six years later than they had initially. These findings are consistent with the notion that memory and language are different although interacting skills. Although language can be used to encode as well as communicate aspects of memory, it is unlikely to capture the entirety of any given Injuries, Emergency Rooms, and Children’s Memory

67

Injury

Hospital

100 90 80

# Information Units

70 60 50 40 30 20 10 0 Initial

5 year 12–13

8–9

Initial 5–6

3–4

5 year 2

Figure 3–3. Number of new units of information provided initially and five years later.

memory. As children’s linguistic ability increases, the same memory may become verbally conveyed with more linguistic complexity, more descriptive detail, and so on. Thus, even though long-term recall may become less complete and less accurate, it nevertheless may contain more information.

Variation in Stress How to measure the degree of distress experienced by a child during stressful events has been a contentious issue. Some investigators advocate using only physiological measures (Peters, 1997), but these are not practical for naturally occurring events. Others have used externally validated measures such as the amount of damage done to one’s home by a destructive hurricane (Bahrick et al., 1998; Fivush et al., 2004). However, it is not clear that this is a good measure of the amount of distress experienced by an individual child. One child whose house’s damage is classified as moderate may have been terrified while another whose house fell into the same category of damage may have been much less upset. In our research with children recruited from the emergency room we have asked parents (who were witnesses to the child’s experience) 68

STRESS AND MEMORY, EMPIRICAL EVIDENCE

to rate their child’s distress on a Likert scale ranging from not at all distressed to extremely distressed. This rating was completed not only for the time of injury but also while the child was being treated at the hospital. Although the number of choices on the distress scale varied slightly, essentially we classified children’s level of stress as low, moderate, or high. But what about the child’s own version of how distressed he or she was? Steward et al., in their 1996 monograph concerning interviewing children about body touch during medical exams, stress the importance of looking at children’s own feelings about what happened to them. Unfortunately, with the exception of one study, we did not ask children for their own estimates of distress. However, all of them were asked about whether or not (and how much) they had cried. A child who stated that she had been “very very crying,” or another who replied to the question “What happened in the hospital?” with “Well, I was screeching a lot” are communicating considerable information about their emotional state at the time of event occurrence, as are children who stated that they didn’t cry. (By the way, we had parental confi rmation on crying.) We classified children’s level of distress on the basis of their selfdescriptions of crying as low, moderate, or high, and the correlations between children’s self-descriptions of crying and their parents’ ratings of children’s distress were quite high: for the injury, Pearson’s r = .58 and for hospital treatment, r = .72 (both ps < .001). Furthermore, we did regression analyses (see below) on the relationship between recall and our stress measures (both parental ratings and children’s self-descriptions of crying, independently), and the results were the same, regardless of which measure of stress we used. There was, however, one study in which Rees, Fivush, Sales and I used the Faces Pain Scale that was used by Steward and her colleagues (1996) to get children’s self-ratings of distress. There were 62 children between two and six years of age who provided this scale, and the correlations between their self-ratings of distress on the Faces Pain Scale and parental ratings of how distressed their children were, on a verbal Likert scale, were r = .24 (p < .05) for distress during the injury event and r = .30 (p < .01) for distress during hospital treatment. Although these are statistically significant, the correlations are nevertheless rather low. Furthermore, correlation and regression analyses found little relationship between children’s Faces Pain Scale judgments and their recall, while there were such relationships for both parental ratings and children’s self-descriptions of crying. Thus, having children make judgments on the basis of line drawings of faces may not be a particularly good way of measuring children’s distress, at least when children are this young. On the other hand, looking at children’s selfInjuries, Emergency Rooms, and Children’s Memory

69

descriptions of their emotional reactions, such as how much they cried, does seem to hold promise as a measure of children’s distress about real-world events that are stressful enough to elicit what Deffenbacher et al. (2004) term a defensive mode of response, when there are no research investigators around who could collect other measures. In the research in which we collected parental Likert ratings of child distress as well as children’s self-descriptions of crying, we looked at the relationship between children’s degree of distress and their recall. We had 201 children between two and 13 years of age who had both an initial and one-year follow-up interview, as well as 145 with a twoyear follow-up. Overall, for the injury, approximately 50% of the children were rated as highly upset and 40% moderately upset, with 10% in the low stress category. For hospital treatment, approximately 30% of the children were classified as highly stressed and about the same for moderately stressed, while about 40% were classified in the low stress category. Repeatedly we have found that there is no correlation between children’s distress at the time of injury and their age—older children were as likely to be highly distressed as younger children. However, stress ratings were correlated with age for hospital stress in that younger children were more likely to be highly distressed during hospital treatment than were older children. Both partial correlations (age partialled out) and stepwise regressions were calculated between children’s distress and their recall, using both children’s self-descriptions and parental ratings separately. For the accuracy of children’s recall, stress played no significant role in either their initial or follow-up interviews. This agrees with the conclusions derived by Deffenbacher and his colleagues in their review of the effects on stress on memory. In that review, they found that, although the accuracy of adults’ recall was compromised by high degrees of distress, children’s accuracy was unimpaired. In contrast, Salmon et al. (2002) found that children who cried during a voiding cystourethrogram had less accurate recall. Our findings for both the completeness of children’s recall and the amount of new information provided were quite different than for accuracy, however. During their initial interview, as stress increased, children became less complete in their accounts. For the number of new units of information, children who were least distressed consistently provided more information in their initial interview than did those who were most distressed. (See Table 3–1.) Salmon et al. (2002) also found crying associated with less information recalled by children. In contrast to the results described above, children who recalled a destructive hurricane recalled more new units of information if they were placed in the moderately distressed group rather than either the 70

STRESS AND MEMORY, EMPIRICAL EVIDENCE

Table 3–1. Percentage Completeness of Recall in Initial Interview as a Function of Distress (Child Self-Descriptions and Parent Ratings Averaged) Degree of Stress Low Event

Mean

Moderate

High

SD

Mean

SD

Mean

SD

17.4 23.2

72.6% 57.3%

18.5 19.2

71.5% 48.6%

15.7 21.2

29.3 29.9

46.5 49.2

23.6 24.4

48.3 39.9

21.4 24.4

Recall Completeness (percentage) Injury Hospital

75.0% 63.6%

Number of New Units of Information Injury Hospital

56.9 48.8

low- or high-stress groups (Bahrick et al., 1998). However, there are numerous differences between that study and ours: not only did they differ in terms of the nature of the event and the delay before an initial interview took place (several months in the hurricane study), but classification of stress level was done on the basis of damage to the children’s houses rather than how the children themselves emotionally reacted. Furthermore, children in the moderate stress group lived with house renovations and repairs caused by hurricane damage, while other children either had to move out or had little house damage. Thus, children in the moderate-stress category may have had more extended reminders of the event or may have included more information on the aftermath of the hurricane. To summarize the results of our emergency-room injury studies, children who were highly distressed had worse recall during their initial interview, both in terms of recall completeness and the amount of information provided. Thus, children’s recall seems to be compromised under conditions of high stress. This relationship is consistent with what Deffenbacher et al. (2004) found with adults, who also had poorer recall when they experienced high degrees of distress. However, what the children in our study did recall remained just as accurate regardless of how distressed they were, unlike what Deffenbacher et al. found for adults.

Variation in Language Competence Some investigators have suggested that children’s language competence may play a role in how well children recall events. As suggested by Boland et al. (2003), children with better language skills at the time of an event might be better at verbally encoding the details, which in turn might help them remember it later. Although better verbal skills have Injuries, Emergency Rooms, and Children’s Memory

71

sometimes been shown to help children recall the details of nonstressful events (Boland et al., 2003; Gordon et al., 1993; Simcock & Hayne, 2002), little research has looked at this variable when target events were stressful. An exception is Burgwyn-Bailes et al., (2001) who assessed three- to seven-year-olds’ recall of details surrounding facial surgery for lacerations. They found that children’s receptive vocabulary (as measured by the Peabody Picture Vocabulary Test) was predictive of younger children’s recall, although not that of older children. We also investigated variation in language competence using the Peabody Picture Vocabulary Test. This work involved 95 children (46 girls and 49 boys) between two and six years of age, and was done in collaboration with Rees, Fivush, and Sales. In contrast to the findings of Burgwyn-Bailes et al. (2001), this same measure of receptive language was unrelated to how complete, how informative, or how accurate children’s recall of their injury or subsequent hospital treatment was.

Variation in Temperament It has also been suggested that children’s behavioral style, or temperament, may influence how they recall a stressful event. For example, Merritt et al. (1994) found that children who had higher adaptability and were higher on the approach/withdrawal dimension had better open-ended as well as total recall about a VCUG procedure. In contrast, BurgwynBailes et al. (2001) and Greenhoot, Ornstein, Gordon, & Baker-Ward (1999) found little or no relationship between children’s recall of details of their treatment of facial lacerations or of pediatric examinations and the temperament dimensions measured by the Temperament Assessment Battery for Children. In the same study of two- to six-year-olds mentioned above, in collaborative work with Rees, Sales, and Fivush, we assessed child temperament using the Emotionality, Activity, and Sociability Temperament Survey. We found no relationship between children’s recall of injury and emergency room treatment and any of the measured dimensions of temperament.

Parental Conversational Style A socioemotional factor that is beginning to receive attention is the way that parents habitually discuss past events with their children. Considerable research has shown that parents differ in the way they talk with their children about past experiences (e.g., Fivush, 1991; Fivush & Fromhoff, 1988; Haden, Haine, & Fivush, 1997; Harley & Reese, 1999; McCabe & Peterson, 1991; Peterson & McCabe, 2004; Reese & Fivush, 1993—see Fivush, Haden, & Reese, 2006, for a review). Some parents 72

STRESS AND MEMORY, EMPIRICAL EVIDENCE

engage in much more of this “memory talk” than others (McCabe & Peterson, 1991), and the structure of these conversational exchanges differs in systematic ways. A dimension of conversational exchange differences that has been frequently studied is that of parental elaboration. When parents use an elaborative conversational style while discussing past events with their children, they elaborate on what their children say as well as encourage their children to provide more elaboration about target events in their own turns at talk. Specifically, elaborative parents (compared to nonelaborative) provide more information in their turns at talk and encourage and support their children’s contributions. They ask open-ended questions and encourage extended, dyadic discussion of target events. Other parents, in contrast, ask a few formulaic questions and engage in little of this elaborative exchange. In short, parents differ in the frequency as well as structure of conversations about events in their children’s past. These parental differences in reminiscing style have repeatedly been shown to be related to how much information children later provide in their open-ended memory conversations with both parents and researchers (see reviews in Fivush et al., 2006; Nelson & Fivush, 2004; Peterson & McCabe, 2004; and Reese, 2002). However, the increased contribution to memory conversations by children of elaborative parents may reflect only an increased willingness to keep on talking. It is another matter to suggest that memory itself for past events may be better for children whose parents engage in this elaborative style of interaction. Recently, this is exactly what some investigators are suggesting. They have found that mothers who engaged in elaborative talk while a target event was ongoing, such as museum visits, video viewings, or living-room camping trips, had children who recalled more about those experiences later (Boland et al., 2003; Low & Durkin, 2001; Tessler & Nelson, 1994). Importantly, such talk can even have a facilitative effect on children’s memory when it takes place after the event is over (Conroy & Salmon, 2006; Leichtman, Pillemer, Wang, Koreishi & Han, 2000; McGuigan & Salmon, 2004). For example, Leichtman et al. (2000) recorded the visit of a former preschool teacher who visited her class after her baby was born and engaged in a series of activities with the children. Later that day, mothers (who were not present and did not know the details of the visit) talked with their children about their former teacher’s visit. Mothers who were elaborative in these memory conversations had children who recalled more about the visit three weeks later. In summary, mothers who engage in elaborative memory conversations with their children about both everyday and distinctive nonstressful events, not only during the event but also later, have children who in turn seem to recall more detail about those events. But to our knowledge, there Injuries, Emergency Rooms, and Children’s Memory

73

has been little investigation of whether parental reminiscing style affects children’s memory for highly stressful events which by their nature have high memorability. To explore the question of whether parents’ styles of talking to their children about past experiences is related to children’s recall of a stressful event, 67 parents of two- to six-year olds were provided with a tape recorder and asked to talk with their children about the target injury/hospital treatment events in as natural a manner as possible, while the researcher left the room (Peterson, Sales, Rees, & Fivush, 2007). The elaborativeness of the parents’ talk was coded by breaking parental utterances into propositional units and then coding each unit as one of the following: (a) memory question elaborations, in which a question tried to elicit new information from the child as well as incorporated new information within the question; (b) memory question repetitions, in which a question tried to elicit new information from the child but did not itself contain any new information; (c) yes-no question elaborations, in which the child was required to confirm or negate the new information provided by the parent; (d) yes-no question repetitions, in which the child was required to confi rm or negate previously mentioned information; or (e) evaluations, which were statements that confirmed or negated the child’s previous utterance. After this, we created a composite score for each parent. This composite score was derived as follows: the number of elaborations plus evaluations was divided by the number of all utterance types to provide an elaboration ratio. This ratio was then entered in statistical analyses to assess the relationship between an elaborative parental style and their children’s memory. As seen in Table 3–2, the relationship between age and all of the memory measures except accuracy of injury recall was highly significant. For the relationship between the elaboration ratio and the memory measures (with age partialled out), virtually all partial correlations were significant for the initial interview. For the two-year follow-up interview, the completeness of both injury and hospital recall as well as the accuracy of hospital recall were still significantly related to the parental elaboration ratio calculated from parent-child talk two years previously. Next, we did a series of hierarchical regression analyses, one on each of our recall outcome measures: amount of information, completeness, and accuracy, separately for the injury and hospital events. We removed the variance attributable to age, gender, the elaboration ratio, and the age x elaboration interaction, in that order. For the two-year follow-up data, we did the same, except that variance attributable to the child’s prior recall during the initial interview was removed fi rst. Our results are displayed in Figure 3–4. 74

STRESS AND MEMORY, EMPIRICAL EVIDENCE

Table 3–2. Correlations between Children’s Memory Measures and Age, and Partial Correlations (Age Partialled Out) between Memory Measures and Parental Elaboration Ratio Measure

Event

Initial Interview Information Completeness Accuracy 2-Year Interview Information Completeness Accuracy

Age

Elaboration

Injury Hospital Injury Hospital Injury Hospital

.59*** .54*** .70*** .59*** .21 .43***

.25* .34** .25* .36** –.11 .38***

Injury Hospital Injury Hospital Injury Hospital

.57*** .54*** .48** .52*** .16 .38*

.24 .21 .32* .39* .12 .38*

* p < .05 ** p < .01 *** p < .001.

Initial Recall Regressions Information <.001

Injury

.046

Hospital

.005

<.001

Age

<.001

Completeness

.070

Injury

.003

<.001

Hospital .036

.054

Gender .006

Accuracy Injury

Elaboration

.073 .077

.001

Age X Elaboration

.001

Hospital

Figure 3–4. Factors significant in hierarchical regression analyses (initial interview).

Age of course was a powerful predictor, and gender was only significant for the completeness of children’s recall of the hospital (girls had more complete recall of hospital treatment). But parental elaboration also played a significant role, for all three outcome measures and for both events. The elaboration ratio predicted the amount of information and the recall completeness of injury events as well as the amount Injuries, Emergency Rooms, and Children’s Memory

75

of information, recall completeness, and accuracy of the hospital event. Means during their initial interview for children of low versus high elaborators (using a median split) are shown in Table 3–3. The age x elaboration interaction (for the accuracy of children’s hospital recall and recall completeness of both events) showed that it was the younger preschoolers for whom parental elaboration made the most difference. That is, when there is an age x elaboration interaction, it is the recall of the youngest children that is helped most by having a parent with an elaborative conversational style. In the two-year follow-up data, regression analyses showed that the children’s prior recall was the critical variable that removed most of the variance for all data sets, and other variables played little additional role. In summary, children of parents who used a highly elaborative style of conversing with them about past events had more informative, complete, and accurate recall during their initial interview. This was true even when all variance attributable to age was removed first. With the exception of children’s accuracy about injury details, having elaborative parents was helpful for children’s recall of both their injury and hospital experiences. Parental elaborative style played much less of a role in children’s twoyear recollections over and above the variance accounted for by previous recall. Instead, parental conversational style may help the child create a more elaborated representation initially, which is reflected by their better recall during their first interview. This more elaborated representation is then better recalled over time. Such an explanation, that earlier conversations mediate recall by affecting children’s representations, would account for why parental elaborative style is correlated with better recall in both children’s initial and two-year interview, but largely drops out of the regression analyses at two years since the variance related to prior recollection has already been removed. Why might a topic-extending, elaborative parental style of reminiscing facilitate children’s memory? First, as documented in prior research (McCabe & Peterson, 1991; Snow & Dickinson, 1990), such

Table 3–3. Means for Children of Low vs. High Elaborators (Initial Interview) Type of Data

Event

Amount of info

Injury Hospital Injury Hospital Hospital

Completeness Accuracy

76

Low Elab. Ratio 16.5 units 10.9 units 63.5% 44.8% 81.5%

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High Elab. Ratio 23.1 units 21.3 units 72.8% 61.1% 89.3%

parents more frequently carry on memory conversations in everyday life. Secondly the memory conversations of parents with an elaborative style are more extensive than those of nonelaborative parents (Fivush & Fromhoff, 1988; Haden et al., 1997; Harley & Reese, 1999; McCabe & Peterson, 1991; Reese & Fivush, 1993). The former parents ask more questions that require memory responses, and flesh out the details with contributions from their own memory. In other words, children are given more opportunity to rehearse more aspects of the experiences and are reminded about various components of it, and such reinstatement has frequently been shown to assist long-term retention (Pressley & Schneider, 1997). As well, such conversations seem to help children organize their recollections, and also provide a scaffold that guides children in terms of what sorts of information they should remember and report about an event (Peterson & McCabe, 2004). In addition, daughters in particular have been shown to mirror their mothers in terms of how they construct accounts of prior events (Peterson & Roberts, 2003). In the present study, we were unable to assess how frequently parents talked with their children about these target events, but we could assess how elaboratively they did so when given a tape recorder and asked to discuss them. And elaborated parent-child memory conversations were related to better child recall, even for the kind of stressful events that are likely to be recalled anyway, such as personal injury.

Summary of Individual Difference Factors A summary of the various factors we have looked at is shown in Table 3–4. These included children’s age, amount of distress (rated by parents and self-descriptions of emotional response by children), parents’ style of reminiscing with their children (elaborativeness of conversational style), receptive language ability (Peabody Picture Vocabulary Test-Revised), and temperament (Emotionality, Activity, and Sociability Temperament Survey—the EAS). It is also possible that the socioeconomic status of the family may be correlated with memory since it has been shown to be a predictor of the richness of children’s linguistic home environment (Hart & Risley, 1995). Because parental education attainment provides some indication of socioeconomic status, we evaluated that too. In addition, the number of siblings in the home was assessed, since the number of children among whom parents need to spread verbal attention may also be predictive of child memory. The outcome variables that we looked at included measures of completeness, accuracy, and informativeness of children’s memory accounts. Age of course was an important variable, but so was the way that parents talked with their children and how distressed their children Injuries, Emergency Rooms, and Children’s Memory

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Table 3–4. Summary of Analyses between Memory Measures and Various Factors Factor

Initial Interview

2-Year Interview

Age Stress Parental elaboration Language (PPVT) Temperament (EAS Scale) Maternal education Paternal education # siblings in home

Sig. effect Sig. effect Sig. effect No effect No effect No effect No effect No effect

Sig. effect No effect Mediated effect No effect No effect No effect No effect No effect

were. In contrast, receptive language ability, temperament, and a couple of measures of socioeconomic status seemed to have little effect on recall. Others have highlighted different individual difference factors that seem to play an important role, and, in particular, the attachment relationship between parent and child (see Chae, Ogle, & Goodman, this volume). Both attachment and parental conversational style represent different aspects of the dyadic relationship between parents and children, and these socioemotional factors seem to influence children’s ability to recall stressful events.

Implications There are a number of forensic and clinical implications of this work. First, it is clear that children do have substantial memory for distressing events. Furthermore, this memory is robust and long-lasting. In addition, it retains remarkable accuracy after the passage of several years. When you consider how young some of the children in our studies were when they were injured, it is impressive that recall is so accurate after such a long period of time. After the passage of five years (a substantial proportion of their lifetimes!), three-quarters of the injury-event information provided by children who were less than five years of age at the time of injury was still accurate. Older children had even higher accuracy rates. Although the big picture painted by children’s recall after five years was the most provided information that was correct, not all details were. For example, a few children claimed in their five-year follow-up interviews that among the onlookers to their injury were siblings who were not yet born. Although children did not provide as much information or remain as accurate about the hospital treatment event, there are some reasonable explanations about why this may be so. Foremost among them is the fact that visits to this hospital emergency room were not unique events, 78

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unlike the injury experiences. Because this emergency room serves as the after-hours clinic for virtually all physicians in the region, children are taken there for the flu, for bad colds, for infections, and for anything else that occurs in the evenings or on weekends. Children had been there an average of a dozen times for various reasons by the time they were injured (Peterson & Bell, 1996), and undoubtedly were there multiple times during the subsequent five years. Children’s most common memory errors about the hospital event involved mixing up different visits. This of course has serious implications for children who experience repeated stressful events, such as repeated abuse. Our research participants had a harder time keeping straight the events of the target hospital visit that was precipitated by their injury, but found it much easier to retain accurate recall about the unique injury event. Another possible contributor to their poorer recall of hospital details is that that event is less logically ordered—at least to a young child. Another implication of this research is that stress is not devastating to children’s recall. Some of the children in our research were completely hysterical with pain and fear, with considerable screaming. Nevertheless, the accuracy of their recall was not compromised. Although children in our highest stress category did have less complete recall and provided fewer units of new information, the decrement was remarkably little, given the amount of emotional distress these children were experiencing. Furthermore, this decrement associated with high levels of distress mostly characterized their initial but not their later interviews. Although it is a truism to say that the age of the children makes a difference, nevertheless these age differences provide a difficult challenge. Children who are barely two years of age or younger at the time of event occurrence seem to have very problematic recall, if they remember anything at all. Recall that unknowing amalgamates of multiple experiences is forensically useless (or worse). For preschoolers, although they may recall a lot of detail about stressful events, they often require considerable prompting to provide relevant information (Ceci & Bruck, 1995). In contrast, older children are likely to provide much more information after open-ended prompts. This has important implications for forensic and clinical situations: in order to get a lot of information from preschoolers one often has to ask a lot of questions, which may increase the possibility of tainted recall. The finding that elaborative parent-child conversations help children’s long-term recall of event details is both intriguing and promising. Furthermore, these elaborative conversations seem to especially help younger children—who are the ones most likely to have abbreviated responses to questions and for whom more prompting is generally required. In other words, elaborative conversations are most helpful for Injuries, Emergency Rooms, and Children’s Memory

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the children who need it most. As a clinical therapist who is regularly seeing a child client, one might adopt the role of an elaborative conversational partner, or one might train parents to be more elaborative in their conversational interactions with their children. Researchers have found that one can train parents to be more elaborative in their memory conversations with their children, with resultant improvements in children’s recall (e.g., Boland et al., 2003; Peterson, Jesso, & McCabe, 1999). Even more encouraging is the fact that an elaborative conversational style may make a difference even when that conversation takes place after a period of time has elapsed. For example, Leichtman et al. (2000) found that mothers who used an elaborative style when talking with their children about the visit of a former preschool teacher, even though that conversation took place later and even though the mothers had no detailed knowledge of the events being discussed, had children who recalled more information three weeks later. Not only mothers, but elaborative experimenters too can have a facilitative effect on children’s recall. For example, elaborative researcher-child conversations that took place after a staged event was over helped children’s recollection of event details (Conroy & Salmon, 2006; McGuigan & Salmon, 2004). But even a detailed, chronologically and logically organized interview may help. In other research in our laboratory, we delayed some children’s initial interview about emergency room injuries for a year, and we found that children who had been three to four years old at the time of injury had poorer recall in their one-year follow-up interview than did their age-mates who had a detailed interview shortly after their injury (Tizzard-Drover & Peterson, 2004). However, the presence of an early interview made no difference for older school-aged children. We interpreted these findings as showing that detailed and organized interviews can help preschoolers organize the details of the event in their minds. The interriews may also remind children of the minutia of the experience. Interestingly, when these former preschoolers were interviewed again two years after injury, their recall was equivalent to that of other children who had been interviewed initially as well as after a year (Peterson, Pardy, Tizzard-Drover, & Warren, 2005). In other words, having that detailed interview delayed for a year did not seem to compromise their long-term recall. The earlier interview was equally helpful, whether it took place within a few days or after a year. What all of this suggests is that having a supportive, elaborative interviewer who engages in a chronologically and logically organized interview can help younger children’s long-term recall. Overall, it is clear that children’s recall of stressful events is impressive, but it is also clear that it is influenced by a number of factors. 80

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Some of these are inherent to the child (for example, age at the time), but others can be manipulated (for example, a partner’s elaborative conversational style). There are undoubtedly other factors that play important roles in influencing children’s recall besides the ones investigated here, and many of these are discussed in other chapters in this volume. It is apparent that any attempt to understand the relationship between stress and memory needs to be a multi-factor, complex one. There remain a number of questions that need to be answered, however. First, it is not clear how the nature of the event to be remembered influences children’s recall. The events that we studied are public events. Although they cause distress at the time, they are ones that may confer a lot of positive attention later. Everyone, from Aunt Bessie to neighbors and friends, tends to be told about these events, and many children bear bandages, casts, or sutures that elicit widespread comment and concern. Such is not the case with private events such as abuse. Here, children are forbidden to talk about the events rather than verbally rehearse them with everyone. As well, the injury event was a unique event rather than a repeated event. This has important implications for memory. Although we did not explicitly investigate the issue of repeated versus unique events, it is probable that some of the difficulty children had recollecting their hospital experience is that it could be mixed up with other hospital visits. Indeed, such confusions were identified by parents as the source of many of children’s errors. Because we did not have documentation on other visits, we could not explicitly investigate how frequently children made these source errors, and so this too is beyond the scope of this chapter. There are also important differences between what we can do as researchers and what police interviewers can do, and some of the work described above on the role of an elaborative conversational style may not be applicable to forensic situations. Interviewers are constrained in terms of how they can question children, and they certainly cannot do the sort of elaborative additions to conversations that elaborative parents (or researchers) typically do. Elaborative conversational partners typically embellish children’s recollections with additions of their own, and this would be problematic for forensic interviewers since what they say may be seen as suggestive or incorporated into children’s later recall. However, the interviews conducted by Tizzard-Drover and her colleagues (Tizzard-Drover & Peterson, 2004; Peterson et al., 2005) did not add new information to the children’s accounts. However, they were systematic, organized, chronological, and logical. So even without the additions that elaborative conversational partners typically make, these interviews helped younger children’s long-term recall a year later. Injuries, Emergency Rooms, and Children’s Memory

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In summary, children who are over two years of age have robust and long-term recall about injuries they have sustained that require hospital emergency room treatment. Even if these events were highly stressful, causing enormous emotional distress at the time, children could recall a lot, and this recall was primarily accurate. Nevertheless, individual difference variables play a role, and it seems that some variables may be able to be deliberately altered to help children’s recall. In particular, the socioemotional context of parent-child and experimenter-child conversations seems to play an important role. In other words, one cannot forget that children are embedded in a socially and emotionally complex and important world, and this world even implications for memory.

References Bahrick, L.E., Parker, J.F., Fivush, R., Levitt, M. (1998). The effects of stress on young children’s memory for a natural disaster. Journal of Experimental Psychology: Applied, 4, 308–331. Boland, A.M., Haden, C.A., & Ornstein, P.A. (2003). Boosting children’s memory by training mothers in the use of an elaborative conversational style as an event unfolds. Journal of Cognition & Development, 4, 39–65. Burgwyn-Bailes, E., Baker-Ward, L., Gordon, B.N., & Ornstein, P.A. (2001). Children’s memory for emergency medical treatment after one year: The impact of individual difference variables on recall and suggestibility. Applied Cognitive Psychology, 15, 25–48. Ceci, S.J., & Bruck, M. (1995). Jeopardy in the courtroom. Washington, DC: American Psychological Association. Conroy, R., & Salmon, K. (2006). Talking about parts of a past experience: The impact of discussion style and event structure on memory for discussed and nondiscussed information. Journal of Experimental Child Psychology, 95, 278–297. Deffenbacher, K.A., Bornstein, B.H., Penrod, S.D., & McGorty, E.K. (2004). A meta-analytic review of the effects of high stress on eyewitness memory. Law & Human Behavior, 28, 687–706. Fivush, R. (1991). The social construction of personal narratives. MerrillPalmer Quarterly, 37, 59–82. Fivush, R., & Fromhoff, F.A. (1988). Style and structure in mother-child conversations about the past. Discourse Processes, 11, 337–355. Fivush, R., Haden, C., & Reese, E. (2006). Elaborating on elaborations: Role of maternal reminiscing style in cognitive and socioemotional development. Child Development, 77, 1568–1588. Fivush, R., Sales, J.M., Goldberg, A., Bahrick, L., & Parker, J. (2004). Weathering the storm: children’s long-term recall of Hurricane Andrew. Memory, 12, 104–118. Goodman, G.S., Quas, J.A., Batterman-Faunce, J.M., Riddlesberger, M.M., & Kuhn, J. (1994). Predictors of accurate and inaccurate memories of traumatic events experienced in childhood. Consciousness and Cognition, 3, 269–294. 82

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Goodman, G.S., Quas, J.A., Batterman-Faunce, J.M., Riddlesberger, M.M., & Kuhn, J. (1997). Children’s reactions to and memory for a stressful event: Influences of age, anatomical dolls, knowledge, and parental attachment. Applied Developmental Science, 1, 54–75. Gordon, B.N., Ornstein, P.A., Nida, R.E., Follmer, A., Crenshaw, M.C., & Albert, G. (1993). Does the use of dolls facilitate children’s memory of visits to the doctor? Applied Cognitive Psychology, 7, 459–474. Greenhoot, A.F., Ornstein, P.A., Gordon, B.N., & Baker-Ward, L. (1999). Acting out the details of a pediatric check-up: The impact of interview condition and behavioral style on children’s memory reports. Child Development, 70, 363–380. Haden, C.A., Haine, R.A., & Fivush, R. (1997). Developing narrative structure in parent-child reminiscing across the preschool years. Developmental Psychology, 33, 295–307. Haden, C.A., Ornstein, P.A., Eckerman, C.O., & Didow, S.M. (2001). Mother-child conversational interactions as events unfold: Linkages to subsequent remembering. Child Development, 72, 1016–1031. Harley, K., & Reese, E. (1999). Origins of autobiographical memory. Developmental Psychology, 35, 1338–1348. Hart, B., & Risley, T.R. (1995). Meaningful differences in the everyday experience of young American children. Baltimore, MD: P.H. Brookes Pub. Co. Leichtman, M.D., Pillemer, D.B., Wang, Q., Koreishi, A., & Han, J.J. (2000). When baby Maisy came to school: Mothers’ interview styles and preschoolers’ event memories. Cognitive Development, 15, 99–114. Low, J., & Durkin, K. (2001). Individual differences and consistency in maternal talk style during joint story encoding and retrospection: Associations with children’s long-term recall. International Journal of Behavioral Development, 25, 27–36. McCabe, A. & Peterson, C. (1991). Getting the story: A longitudinal study of parental styles in eliciting narratives and developing narrative skill. In A. McCabe & C. Peterson (Eds.), Developing narrative structure (pp. 217–253). Hillsdale, NJ: Erlbaum. McGuigan, F., & Salmon, K. (2004). The time to talk: The influence of the timing of adult-child talk on children’s event memory. Child Development, 75, 669–686. Merritt, K.A., Ornstein, P.A., & Spicker, B. (1994). Children’s memory for a salient medical procedure: Implications for testimony. Pediatrics, 94, 17–23. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social cultural developmental theory. Psychological Review, 111, 486–511. Ornstein, P.A., Haden, C.A., & Hedrick, A.M. (2004). Learning to remember: Social-communicative exchanges and the development of children’s memory skills. Developmental Review, 24, 374–395. Peters, D.P. (1997). Stress, arousal, and children’s eyewitness memory. In N.L. Stein, P.A. Ornstein, B. Tversky, & C. Brainerd (Eds.), Memory for everyday and emotional events (pp. 351–370). Mahwah, NJ: Erlbaum. Peterson, C. (1999). Children’s memory for medical emergencies: Two years later. Developmental Psychology, 35, 1493–1506. Peterson, C. (2002). Children’s long-term memory for autobiographical events. Developmental Review, 22, 370–402. Injuries, Emergency Rooms, and Children’s Memory

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Peterson, C., & Bell, M. (1996). Children’s memory for traumatic injury. Child Development, 67, 3045–3070. Peterson, C., Jesso, B., & McCabe, A. (1999). Encouraging narratives in preschoolers: An intervention study. Journal of Child Language, 26, 49–67. Peterson, C., & McCabe, A. (2004). Echoing our parents: Parental influences on children’s narration. In M.W. Pratt & B.H. Fiese (Eds.), Family stories and the life course: Across time and generations (pp. 27–54). Mahwah, NJ: Erlbaum. Peterson, C., Pardy, L., Tizzard-Drover, T., & Warren, K. (2005). When initial interviews are delayed a year: Effect on children’s 2-year recall. Law & Human Behavior, 29, 527–541. Peterson, C., & Parsons, B. (2005). Interviewing former 1- and 2-year-olds about medical emergencies five years later. Law & Human Behavior, 29, 743–754. Peterson, C., & Rideout, R. (1998). Memory for medical emergencies experienced by one and two year olds. Developmental Psychology, 34, 1059–1072. Peterson, C. & Roberts, C. (2003). Like mother, like daughter: Similarities in narrative style. Developmental Psychology, 39, 551–562. Peterson, C., Sales, J.M., Rees, M., & Fivush, R. (2007). Parent-child talk and children’s memory for stressful events. Applied Cognitive Psychology, 21, 1057–1075. Peterson, C., & Whalen, N. (2001). Five years later: Children’s memory for medical emergencies. Applied Cognitive Psychology, 15, 7–24. Pressley, M., & Schneider, W. (1997). Introduction to memory development during childhood and adolescence. Mahwah, NJ: Erlbaum. Quas, J.A., Goodman, G.S., Bidrose, S, Pipe, M-E., Craw, S., & Ablin, D.S. (1999). Emotion and memory: Children’s long-term remembering, forgetting, and suggestibility. Journal of Experimental Child Psychology, 72, 235–270. Reese, E. (2002). Social factors in the development of autobiographical memory: The state of the art. Social Development, 11, 124–142. Reese, E., & Fivush, R. (1993). Parental styles of talking about the past. Developmental Psychology, 29, 596–606. Salmon, K., Price, M., & Pereira, J.K. (2002). Factors associated with young children’s long-term recall of an invasive medical procedure: A preliminary investigation. Developmental & Behavioral Pediatrics, 23, 347–352. Shrimpton, S., Oates, K., & Hayes, S. (1998). Children’s memory of events: Effects of stress, age, time delay and location of interview. Applied Cognitive Psychology, 12, 133–143. Simcock, G., & Hayne, H. (2002). Breaking the barrier? Children fail to translate their preverbal memories into language. Psychological Science, 13, 225–231. Snow, C.E., & Dickinson, D.K. (1990). Social sources of narrative skills at home and at school. First Language, 10, 87–103. Steward, M.S., Steward, D.S., Farquhar, L., Myers, J.E.B., Reinhart, M., Welker, J., Joye, N., Driskill, J., & Morgan, J. (1996). Interviewing

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young children about body touch and handling. Monographs of the Society for Research in Child Development, 57 (4–5, Serial No. 248). Terr, L. (1988). What happens to early memories of trauma? A study of twenty children under age five at the time of documented traumatic events. Journal of American Academic Child and Adolescent Psychiatry, 27, 96–104. Tessler, M., & Nelson, K. (1994). Making memories: The influence of joint encoding on later recall by young children. Consciousness & Cognition, 3, 307–326. Tizzard-Drover, T., & Peterson, C. (2004). The influence of an early interview on long-term recall: A comparative analysis. Applied Cognitive Psychology, 18, 1–17.

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4 Stress and Autobiographical Memory Functioning Andrea Follmer Greenhoot Rebecca J. Johnson John-Paul Legerski Laura A. McCloskey

I

n the last two decades, controversy surrounding memory and testimony for traumatic childhood events like abuse has stimulated a profusion of research on the relation between stress and memory in children. Most of this work has investigated how the stress associated with a particular event influences memory for that event, focusing on children without histories of child abuse or trauma. Recently, however, memory researchers have begun to ask whether chronic exposure to stressful events might actually alter the course of autobiographical memory development or memory functioning. This issue is of considerable relevance to the debate over memory for abuse and other traumas and is also clinically significant, as autobiographical memory contributes to many aspects of human functioning and well-being including selfconcept, social problem-solving, and emotion regulation processes (e.g., John & Gross, 2004; Nelson & Fivush, 2004). In this chapter, we investigate the possibility that chronic or traumatic stress may influence autobiographical memory development or memory functioning. We begin by reviewing the empirical literature regarding memory disturbances in children and adults with trauma histories. Next, we turn to a discussion of the possible explanations for trauma-related memory patterns, focusing in particular on the hypothesis that they are linked to emotion-regulation processes. We then present our own 86

research on these issues, carried out as part of a longitudinal study of family violence. Finally, we revisit existing explanatory frameworks, and attempt to recast them from a developmental standpoint.

Trauma and Memory Functioning Much of the interest in the relation between stress and general autobiographical memory functioning has been generated by reports in the clinical literature that adults with childhood trauma histories seem to have difficulty remembering their childhoods. Herman and Schatzow (1987), for example, found that many members of a therapy group for women survivors of child sexual abuse were unable to remember large portions of their childhoods. Edwards and her colleagues (Edwards, Fivush, Anda, Felluti, & Nordenberg, 2001) have confirmed this association between abuse and self-reported memory loss in a large, nonclinical sample of adults with and without histories of childhood abuse. Both women and men who reported a history of child sexual or physical abuse were more than twice as likely as other individuals to report large gaps in their memories of childhood (after age four). Research using more objective memory assessments also shows that trauma history is associated with disturbances in autobiographical memory (Brittlebank, Scott, Williams, & Ferrier, 1993; Kuyken & Brewin, 1995; Park, Goodyer, & Teasdale, 2002). For instance, adults who report childhood abuse histories have been shown to have more difficulty than nonabused controls remembering autobiographical facts from childhood, such as the names of significant people from their childhoods (Hunter & Andrews, 2002). A number of the investigations of trauma-related memory problems have evaluated autobiographical memory with an Autobiographical Memory Test (AMT) in which participants are given a limited amount of time (e.g., one minute) to generate a specific memory (i.e., a personal memory that refers to a single event) in response to each of several cue words. The most robust finding in this literature is that, compared to nontraumatized controls, adults who report childhood trauma histories tend to generate “overgeneral” memories that summarize a category of events (e.g., “My parents were always fighting.”) instead of specific memories that describe individual episodes (e.g., “On my ninth birthday, my parents got into a bad fight.”). There is also considerable evidence that difficulty retrieving or reporting specific personal memories is also associated with depression (see Williams et al., 2007, for a comprehensive review). Nevertheless, there is widespread agreement that trauma-related autobiographical memory disturbance is not a simple epiphenomenon of depression, as childhood trauma is related Stress and Autobiographical Memory Functioning

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to poor memory specificity even when controlling for depression (de Decker et al., 2003; Henderson, Hargreaves, Gregory, & Williams, 2002; Kuyken, & Brewin, 1995; Kuyken, Howell, & Dalgleish, 2006). The vast majority of these studies has revealed trauma-related memory problems on the AMT, but it should be noted that this pattern has not been uniformly supported. A few investigations have found no association between childhood trauma and performance on the AMT (e.g., Arntz, Meeren, & Wessel, 2002; Wessel, Meeren, Peeters, Arntz, & Merckelbach, 2001), and a study by Peeters et al. (Peeters, Wessel, Merckelbach, & Vermeeren, 2002) found that reports of childhood trauma actually predicted greater specificity in response to cue words. These discrepant findings may partly reflect variations in the levels of abuse experienced by participants in different studies, as there is evidence that the duration and severity of trauma are negatively related to memory specificity among trauma survivors (Burnside, Startup, Byatt, Rollinson, & Hill, 2004). Consistent with this argument, Wessel et al. (2001) reported that the childhood trauma reported in their sample tended to fall in the minimal to moderate range. Although autobiographical memory problems are frequently observed in adults who retrospectively report histories of childhood trauma, whether such trauma-related memory disturbances actually appear during childhood or adolescence is less clear. Eisen et al. (2001) found no differences between maltreated and nonmaltreated children’s memory and suggestibility for a medical examination. Similarly, in their longitudinal study of domestic violence, Orbach and colleagues (Orbach, Lamb, Sternberg, Williams, & Dawud Noursi, 2001) reported that the specificity of children’s memories for family disagreements was unrelated to their exposure to family violence. On the other hand, Orbach et al. noted that children who had been exposed to family violence rarely discussed past family conflict in the memory interviews at all, and this pattern could reflect memory disturbances. Moreover, a study of adolescent psychiatric inpatients found that teens who reported a trauma history, like adults, produced more overgeneral memories on an AMT than teens without such histories (de Decker, Hermans, Raes, & Eelen, 2003). Potential explanations for the trauma-related memory disturbances that have been observed in adolescents and adults are considered in the section that follows.

Explanations for Trauma-Related Memory Patterns One explanation for trauma-related autobiographical memory disturbances that has received relatively little attention in the autobiographical memory 88

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literature is that the disturbances are attributable to stress-induced damage to the hippocampus and general memory impairments. According to this argument, conditions of high stress lead to elevated production of the stress hormone cortisol (Stansbury & Gunnar, 1994; Wiik & Gunnar, this volume), which impairs the functioning of the hippocampus (Anderson & Teicher, 2004; Bremner, 1999; Fillipini, Gijsbers, Birmingham, & Dubrovsky, 1991; Gould, Tanapat, McEwen, Flugge, & Fuchs, 1998; Nelson & Carver, 1998; Sapolsky, 1996; Squire, 1992). Prolonged exposure to high stress and elevated cortisol may lead to hippocampal atrophy and more permanent memory problems (Bremner, 2005; Bremner & Narayan, 1998; Kitayama, Vaccarino, Kutner, Weiss, & Bremner, 2005). The hippocampus is believed to be involved in a wide range of memory processes, including the consolidation and retrieval of verbal declarative memory representations, as well as implicit memory and spatial memory (Bremner et al., 2003; Bremner, Vythilingam, Vermetten, Vaccarino, & Charney, 2004; Chun & Phelph, 1999; de Quervain, Roozendaal, & McGaugh, 1998; Elzinga, Bakker, & Bremner, 2005; Maguire, Frackowiak, & Frith, 1997; Squire, 1992). Thus, this explanation predicts broad memory deficits in nonautobiographical declarative memory, as well as autobiographical memory, among individuals with trauma histories. Most of the evidence for stress-induced hippocampal impairment comes from research with nonhuman animals, in which experimental inductions of high cortisol levels or high stress cause hippocampal deterioration and/or memory impairments (Gould et al., 1998; Sapolsky & McEwen, 1986). In humans, the neuroanatomical evidence in support of these mechanisms is less clear. Some studies report that adults with histories of child physical or sexual abuse have decreased hippocampal volume relative to adults without trauma histories (Bremner et al., 1997; Stein, Koverola, Hanna, Torchia et al., 1997; Vythilingam et al., 2002), but these differences in brain structure seem to be linked to trauma-related psychological disorders such as Post-Traumatic Stress Disorder (PTSD) (Bremner, 2001; Bremner et al., 1997; Bremner et al., 2003; Kitayama et al., 2005) and depression (Bremner et al., 2000; Sheline, Sanghavi, Mintun, & Gado, 1999), not the trauma per se. Indeed, in a recent meta-analysis Kitayama et al. (2005) found that across nine MRI studies, adults with chronic PTSD had smaller hippocampal volume than healthy controls and traumatized adults without PTSD. It is also not clear whether the preadult brain is susceptible to stress-related hippocampal damage, as most of this work has been conducted with adult samples. One pilot study of a child sample, however, found no variations in brain structure between maltreated children with PTSD diagnoses and healthy nonmaltreated children (DeBellis, Hall, Boring, Frustaci, & Moritz, 2001). Further, in light of the correlational Stress and Autobiographical Memory Functioning

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nature of this literature, several researchers have questioned the causal direction of the association between stress and apparent hippocampal atrophy, suggesting that smaller hippocampal volume may actually be a risk factor for the development of psychological disorders in response to trauma (Gilbertson et al., 2002; Sapolsky, 1996; Stein et al., 1997). To date there is also little behavioral evidence to support the argument that trauma-related memory problems reflect broader memory deficits associated with stress-induced hippocampal damage. Although PTSD has been associated with short-term memory deficits (Bremner, Scott, Delaney, & Southwick, 1993; Uddo, Vasterling, Brailey, & Sutker, 1993; Vasterling, Brailey, Constans, & Sutker, 1998), only a few studies have examined the relations between trauma exposure per se and nonautobiographical declarative memory measures. A recent study by Raes et al. (2006) showed that depression-related overgeneral memory on the AMT was related to poorer source memory for nonautobiographical information, but was unrelated to several other measures of semantic and episodic memory. Similarly, measures of immediate and delayed story recall were unrelated to autobiographical memory specificity in de Decker et al.’s (2003) study of adolescent psychiatric inpatients. Finally, Howe, Cicchetti, and Toth (2006) examined performance on the Deese Roediger McDermott false memory paradigm in maltreated and nonmaltreated children and found no differences according to maltreatment status. In sum, although more extensive investigation seems warranted, the existing literature suggests that trauma-related autobiographical memory problems cannot be entirely explained by broader memory deficits. Another explanation for trauma-related memory problems focuses on current memory retrieval conditions and constraints on information processing. Kuyken and Brewin (1995) suggested that intrusive ruminative thoughts about traumatic experiences, and efforts to avoid these thoughts, deplete cognitive resources and lead to the truncation of the memory search process before a specific episode has been retrieved. In line with this view, PTSD, which is characterized by intrusive traumatic memories, is also associated with poor memory specificity (McNally, Lasko, Macklin, & Pitman, 1995). Moreover, measures of intrusive memories and efforts to avoid them (i.e., the intrusion and avoidance subscales of the Impact of Events Scale, or IES) predict overgeneral memory in both trauma victims (Wessel et al., 2002) and depressed adults (Brewin, Reynolds, & Tata, 1999; Kuyken & Brewin, 1995). Experimental manipulations of rumination have also been shown to affect the specificity of memory retrieval (Park, Goodyer, & Teasdale, 2004; Watkins & Teasdale, 2004; Watkins, Teasdale, & Williams, 2000). On the other hand, the depletion of cognitive resources does not seem to completely account for the autobiographical memory patterns seen in trauma 90

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survivors. Although studies of nontraumatized adults suggest that the reduction of cognitive resources does increase the likelihood of overgeneral memories (e.g., Williams, Chan, Crane, & Barnhofer, 2006), individual differences in cognitive resources (e.g., working memory measures) have not been shown to mediate the differences in memory performance between adults with trauma histories and controls (de Decker et al., 2003; Raes et al., 2006). For years, the most commonly cited explanation for trauma-related memory specificity problems has been J.M.G. Williams’ (1996) affect regulation hypothesis. This model suggests that aversive experiences during childhood lead to the development of an enduring cognitive style that involves avoiding thinking and talking about the details of past experiences so as to blunt potentially negative affect. In support of this hypothesis, individuals who retrieve fewer specific memories on the AMT report lower mood disturbance following a lab induced stressor (Raes, Hermans, & Eelen, 2003; Raes et al., 2006). Although such functional avoidance of negative details may reduce distress in the short term, this cognitive style is thought to increase vulnerability to depression in the long-term because it impairs problem solving ability (Pollock & Williams, 2001; Raes et al., 2006; Van Minnen, Wessel, Verhaak & Smeenk, 2005; Williams, Barnhofer, Crane, & Duggan, 2006). Consistent with the argument that trauma-related memory patterns reflect a cognitive style, individual differences in memory specificity appear to be relatively stable in adults (e.g., Brittlebank et al., 1993; Williams & Dritschel, 1988). Researchers have yet to demonstrate that avoidant emotionregulation processes actually account for trauma-related memory patterns, but there is evidence that poor memory specificity is related to measures of cognitive avoidance, such as the White Bear Suppression Inventory (Wegner & Zanakos, 1994), and “repressive” coping style among nontraumatized, nondepressed adults (Hermans, Defranc, Raes, Williams, & Eelen, 2005; Raes et al., 2006). One problem with the affect regulation explanation, however, is that it emphasizes early adverse experiences at the expense of attention to current retrieval conditions. Yet manipulations of current retrieval conditions, such as rumination inductions, do affect the specificity of autobiographical memory. Thus, it seems possible that a tendency to avoid remembering details to blunt affect when presented certain cues could also represent a more transient or flexible strategy adopted in response to current conditions or recent events (see Johnson, Greenhoot, Glisky, & McCloskey, 2005, for elaboration of this argument). A recent reformulation of the affect regulation hypothesis by Williams and his colleagues (2007) places greater emphasis on the role of current conditions in trauma- and depression-related autobiographical memory Stress and Autobiographical Memory Functioning

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problems. The model further specifies the information-processing mechanisms that might underlie poor memory specificity and suggests that cognitive resources, intrusive memories, and ruminative thoughts all may moderate the application of functional avoidance in autobiographical memory retrieval. The framework draws heavily on Conway and Pleydell-Pearce’s self-memory model (2000), which proposes that autobiographical memories are dynamic patterns of activation constructed from an autobiographical knowledge base that is organized hierarchically into three levels of representation: lifetime periods (e.g., “When I was young . . . ”), intermediate or general event representations (“My parents used to argue about money.”), and event-specific knowledge (e.g., “The time my mom walked out because my dad lost his job.”). A voluntary or top-down memory search is viewed as a staged process that begins at the level of the lifetime period or the general event representation and is followed by activation of event-specific details. According to Williams et al. (2007), when the retrieval process begins to elicit event-specific details related to past traumatic experiences, the search may be prematurely aborted in order to limit exposure to aversive details and reduce negative affect. As a result, the search produces a memory at the intermediate, rather than specific, event level. This strategy of avoiding event-specific details is reinforced over time and, as emphasized by the original affect regulation explanation, can become an enduring cognitive style. But the new model posits that this pattern of functional avoidance can be intensified by several other conditions that are typical in adults with trauma histories and/ or depression, such as rumination, elaborate repertoires of negative selfrepresentations, intrusive memories, and executive-resource deficits. For example, rumination tends to activate abstract negative self-representations, and when these representations are elaborate, the individual can become “captured” at this intermediate, conceptual level of representation, and attention will be diverted from the retrieval of specific memories. Executive resource deficits (e.g., Zacks & Hasher, 1994) may also contribute to poor autobiographical memory specificity because of the cognitive effort involved in the staged search process. Such deficits may also disrupt the inhibition of ruminative thoughts, further increasing the likelihood of overgeneral memories. Similarly, the efforts of traumatized individuals to suppress intrusive, involuntarily activated memories may place excessive demands on executive resources, thus further exacerbating the tendency to remain at the general level when engaging in a deliberate memory search. This reformulation of the affect regulation model accommodates much of the existing data on memory disturbances that are associated with trauma and trauma-related psychopathology. Nevertheless, one 92

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limitation of the extant literature is that virtually all of the work documenting trauma-related autobiographical memory problems has focused on participants’ own global judgments of autobiographical memory loss or measures of memory specificity on the AMT. Assessments of other dimensions of autobiographical or episodic memory would provide more information about the scope of trauma-induced memory problems and the implications of these problems for human functioning outside of the laboratory. Research on the breadth of trauma-related memory problems might also elucidate the underlying mechanisms. In this regard, such work would permit a more effective assessment of the contribution of general memory impairments to autobiographical memory problems, and could also enrich the prevailing affect regulation framework. For instance, the retrieval of emotional details figures centrally in this model, but little is actually known about the way that emotional details are represented in the memories of individuals with trauma histories. Another limitation of the existing research base is that it is not clear when and how trauma-related memory problems develop. In spite of the theoretical interest in early trauma, most investigations have sampled adult populations. Indeed, almost all of the data on early trauma exposure in this literature come from adult retrospective reports of child abuse. Therefore the effects of early exposure to trauma are confounded with adults’ current willingness or ability to report it. In other words, it is not clear whether the autobiographical memory disturbances that are associated with childhood trauma stem from the trauma itself or from an adult response to current retrieval conditions or frame of mind. Furthermore, although much work has focused on the cognitive processes that underlie trauma-related memory patterns, less attention has been paid to the developmental processes that give rise to them.

Our Research Program on Family Violence and Memory Functioning We have been addressing these issues, and others, by examining memory functioning in a subset of adolescents participating in a larger longitudinal study of family violence. The longitudinal project was originally designed to assess the impact of spousal violence and child abuse on women’s and children’s mental health and involved tracking an ethnically diverse sample of battered and nonbattered women, and one of their children, over an eight-year period (see McCloskey, Figueredo, & Koss, 1995). Over the years, this project has yielded a rich database for examining both memory for exposure to family violence per se (see Stress and Autobiographical Memory Functioning

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Greenhoot, McCloskey, & Glisky, 2005) and the impact of such exposure on memory functioning in general. The analyses presented in this chapter focus on data collected during the initial assessment when the children were six to 12 years old (M = 9 years) and after a six-year delay when they were 12 to 18 years old (M = 15 years). The initial assessment evaluated 363 mother-child dyads who were recruited through announcements asking for women who had “been abused by a partner in the last year” (for the battered group) or who wanted to participate in “a study of the family” (for the comparison group) (see McCloskey et al., 1995 for a full description of the recruitment procedures). Eighty-two percent of these dyads (n = 296) were retained for the six-year follow-up assessment. Both assessments involved separate two- to three-hour interviews with each member of the dyad to evaluate the children’s and mothers’ social, emotional, and cognitive functioning. At both time points, the Conflict Tactics Scale (Straus, 1979) was used to question the children about their exposure in the previous year to motherdirected spousal abuse (e.g., mother being beaten or choked) and childdirected physical punishment or abuse (e.g., child being hit with an object or kicked) by the mother’s partner. The mothers’ independent responses to the same questions (and more) were used to corroborate the children’s disclosures. At the initial interview, the participants were also asked, with their mothers’ corroboration, to report whether they had ever been sexually abused. At the six-year follow-up only girls (and their mothers) were questioned in depth about sexual abuse (see Bailey and McCloskey, 2005 for details regarding the coding of sexual abuse). As summarized in Table 4–1, participants disclosed a broad range of abuse exposure, from no exposure to moderate exposure to frequent and severe exposure, at the childhood interview. Levels of aggression and abuse were lower at the adolescent assessment, in part because many of the women had ended their relationships with their partners at the time of initial assessment. The six-year follow-up (i.e., adolescent) interview also included several measures of the teens’ memories. The teens were questioned specifically about their memories for childhood experiences with family violence, as well as several nontraumatic events documented at the same time, but these data are not the focus of the analyses presented in this chapter. An adaptation of the AMT was administered to provide a broader assessment of memory for childhood. Participants were given three minutes to generate as many specific childhood memories (from before the age of nine) as possible in response to each of six cue words varying in valence: two positive cues (playing, present), two negative cues (arguing, punishment), and two neutral cues (car, shopping). Finally, there was also an assessment of nonautobiographical episodic memory consisting of immediate and delayed recall of 10 verbally presented paired associates. 94

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Table 4–1. Number of Participants who Reported Different Forms of Abuse, and Average Reported Frequency of Each, at Childhood and Adolescent Assessments Group

# of Reports

Mean Frequency in Previous Year

Range of Frequency Estimates

194 228 46

18.6 9.1 —

0–150 0–79 —

100 91 21

1.1 4.9 —

0–17 0–505 —

Childhood Interview (N = 363) Mother-Directed Aggression Child-Directed Aggression Sexual Abuse Adolescent Interview (N = 299) Mother-Directed Aggression Child-Directed Aggression Sexual Abusea

Note. The three abuse categories were not mutually exclusive because participants could report more than one type of aggression or abuse during any given year. a In the Adolescent Interview, only girls were interviewed in depth about sexual abuse experiences.

We have conducted a series of investigations of the relations between abuse and memory functioning in this longitudinal sample, and in the sections that follow we describe three of these studies. In contrast to most previous research on trauma and memory functioning, the longitudinal design of this project permitted prospective documentation of both early (childhood) and recent (adolescent) exposure to abuse. As a result, we have been able to separate the effects of childhood abuse exposure from those of current frame of mind or recent stressors that may be correlated with childhood abuse histories. Our investigations also extend previous work by looking at a broader range of memory measures than has typically been examined, including nonautobiographical episodic memory and multiple aspects of autobiographical memory such as the affective qualities of recollections. Finally, in our most recent set of analyses we have begun to explore questions about the developmental mechanisms that might contribute to trauma-related memory patterns.

Abuse and the Specificity of Autobiographical Memories In our first investigation of the relations between autobiographical memory and abuse exposure, Johnson, Greenhoot, Glisky, and McCloskey (2005) sought to extend previous research on trauma-related specificity problems to an adolescent sample. The study was designed to examine multiple indices of the accessibility of specific autobiographical memories and the relations between these measures and childhood exposure Stress and Autobiographical Memory Functioning

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to abuse, recent exposure to abuse, and current depressive symptoms. To this end, we examined AMT performance in a subset of 134 participants whose mothers had corroborated their accounts of family violence and whose memory narratives were transcribed and available for this analysis.1 Spousal violence and child-directed aggression were combined into overall measures of childhood family violence and recent (adolescent) family violence. Like previous research using the AMT, we coded each memory that was produced as specific (i.e., a personal memory that refers to a single event) or overgeneral (i.e., a memory that summarizes a category of events). But we also noted the number of interviewer prompts required to elicit each specific memory and the length of each memory (the number of words) as additional indicators of the participants’ abilities or willingness to generate specific memories. In addition, we coded the valence of each memory as negative or nonnegative, as information about the affective quality of teens’ memories might be useful in evaluating the role of affect regulation processes. Finally, to evaluate whether AMT performance was related to broader memory deficits, we also included a paired-associates recall test as a measure of nonautobiographical episodic memory. Preliminary analyses indicated that our measure of nonautobiographical episodic memory (paired associates recall) was unrelated to AMT performance and abuse exposure, and this variable was therefore removed from the final models. The major analyses focused on the degree to which multiple measures of AMT performance were predicted by childhood exposure to family violence, adolescent (recent) exposure to family violence, sexual abuse, and depressive symptoms, as measured by the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). As summarized in Table 4–2, adolescent exposure to family violence was associated with shorter memories for all cue types, fewer negatively valenced memories in response to neutral cues, and more overgeneral memories in response to neutral cues.2 Additionally, higher rates of childhood family violence predicted more interviewer prompting across cues. Finally, consistent with research on the links between depression and autobiographical memory, teens with clinically significant symptoms of depression generated more overgeneral memories across cues than participants without clinically significant symptoms of 1 The selection of participants for transcription was random and unrelated to the variables of interest in this study, and this subset was almost identical to the remainder of the sample in demographics and family violence exposure. 2 Although the univariate tests indicated that the effect of recent family violence on overgeneral memories for neutral cues fell short of significance, the test of the interaction between recent family violence and cue type in the repeated measures model was statistically significant, F(2, 119) = 4.15, p = .018.

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Table 4–2. Standardized Regression Coefficients from General Linear Models Predicting Measures of Adolescent Memory Performance on AMT # Prompts

Memory Length

# Overgeneral Memories

% Negative Memories

.078 .039 — — — .096

.094 — .021 .180* .300*** –.158

–.014 .165 — — — –.037

–.052

–.195*

—

—

— — — –.037 –.121 — — — —

— — — .142 .004 –.177 † — — —

Variable Sexa Age Positive Cues Negative Cues Neutral Cues Childhood Family Violence Adolescent Family Violence Positive Cues Negative Cues Neutral Cues Sexual Abuse Depression Unintelligible Memories Memory Length Prompts Specific Memories

–.224* .062 — — — .253**

–.126 .064 .164 † .074 .220 * — –.111 .328 *** –0.06

.086 .134 –.237* .119 .119 — — —

Note. Parameter estimates are presented by cue type only when there was a significant interaction between a predictor and cue type. a Male = 0; female = 1. † p < .06 *p < .05 **p < .01 ***p < .001.

depression. Sexual abuse was unrelated to memory performance, but it may be that the number of participants with sexual abuse histories was too small to detect an effect, as only 14% of our sample reported sexual abuse at any time-point. The fact that paired associates performance was not associated with trauma or autobiographical memory patterns argues against the hypothesis that trauma-related memory patterns are attributable to impairments in basic memory function. The overall pattern of results seems to be more in line with the reformulated affect regulation framework (Williams et al., 2007). The findings that teens with abuse exposure not only produced shorter and more generic memories, but generated fewer negative memories in response to neutral cues, provide convergent evidence that teens with abuse exposure may have been engaging in functional avoidance of potentially aversive memories or memory content. The association between childhood abuse exposure and interviewer prompting is also consistent with functional avoidance and suggests that although abused teens may have stored specific memories, they were less willing or able to retrieve or report them. But our data also suggest Stress and Autobiographical Memory Functioning

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that avoidance is a dynamically applied strategy adopted in response to current stressors (e.g., recent violence or depressive symptoms), rather than an enduring cognitive style that stems from early experience. The argument that current conditions moderate the application of avoidance is bolstered by the fact that some of the effects of recent violence were specific to neutral cues. One explanation for this pattern is that neutral cues activate weaker associations with episodic details than positive and negative cues, thus the combination of the higher effort involved in the retrieval process and the potential for retrieval of aversive content may increase the likelihood that the search stops short of a specific memory. Nevertheless, ours is the first study to use neutral cues as part of the AMT, and previous findings on cue valence effects have been inconsistent (e.g., de Decker et al., 2003; Henderson et al., 2002; Kuyken & Brewin, 1995). Therefore, additional research is needed to better evaluate the ways in which semantic and affective characteristics of memory cues might moderate trauma-related memory patterns.

Abuse and Internal States Language Our next analysis of the links between abuse and memory examined affect in the recollections of teens with and without past histories of abuse (Greenhoot, Johnson & McCloskey, 2005). The affect regulation hypothesis motivated our analyses: if individuals with abuse histories avoid remembering and talking about aversive past events, they may also be prone to forgetting or failing to report details within episodic memories that are especially likely to be aversive (e.g., negative emotional and perceptual details). This analysis was further motivated by theory and research suggesting that the recall of internal states serves important functions in relationships and self-understanding. Recalling how one felt or thought about past events may help people make sense of experiences, especially negative experiences. Research on nontraumatized samples, for example, shows that children increase their internal states language when recalling negative, stressful events (Fivush, Hazzard, Sales, Safarti, & Brown, 2003). For our study we coded internal states language in the AMT autobiographical narratives provided by the adolescents during the sixyear follow-up. Using an adaptation of a coding scheme developed by Bauer, Stennes, and Haight (2003), we coded the transcripts for the frequency of words referring to cognitions (e.g., thought), perceptions (e.g., saw), physiological states (e.g., tired) and emotions (e.g., afraid). We were especially interested in comparing the emotional content of childhood recollections elicited by the negative and nonnegative cues, and whether any differences were moderated by abuse history. To this 98

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end, we constructed two groups of participants according to childhood abuse exposure (excluding those with only occasional exposure to family violence). Participants who reported severe spousal violence, child physical abuse, and/or sexual abuse at the childhood assessment (Year 1) were coded as having a childhood abuse history (n = 47; the Childhood Abuse Exposure group). Those in the No Childhood Exposure group (n = 24) reported no aggression or abuse whatsoever. Twenty-one of these 71 participants reported abuse exposure at the adolescent interview; all but five were in the Childhood Abuse Exposure group. It is important to point out that, although we used dichotomous abuse variables to simplify these analyses, a comparable set of analyses using continuous abuse variables and including participants with moderate abuse exposure yielded very similar results. We found that the only category of internal states that differed between youth with and without childhood abuse exposure was emotion, and this difference was found even after we controlled for memory length, age, and gender. Of special interest was our discovery of an interaction between cue type and child abuse, as illustrated in Figure 4–1. As can be seen, controls without childhood abuse exposure showed elevated emotional language in response to negative cues relative to nonnegative cues. Analyses of the content of the memories in response to negative cues confirmed they were almost uniformly negative and related to the cues themselves (arguing and punishment). For the nonabused controls, therefore, the increased emotional language to negative cues converges with prior evidence that children express more emotions and other internal states when recalling negative events than when recalling positive events (Fivush, Hazzard et al., 2003).

# Emotion Terms/Cue

No Childhood Abuse Exposure

Childhood Abuse Exposure

1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 Positive Cues

Negative Cues

Neutral Cues

Figure 4–1. Mean number of emotion terms produced per memory, as a function of childhood abuse exposure and cue type. Stress and Autobiographical Memory Functioning

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Surprisingly, teens with child abuse histories showed no such increase in emotional expression when discussing confl ict-related childhood memories. Even though their childhood experiences related to arguing and punishment were likely to be more emotionally arousing, the abused youth generated less emotional language in response to these cues than nonabused adolescents. These abuse-related patterns of emotional language are consistent with the affect regulation framework; abused youth may be avoiding painful memory content by limiting recall or disclosure of emotion. The affect regulation model is typically applied to the pattern of overly generic autobiographical memories in people with trauma histories. But it seems possible that when a retrieval search activates a specific memory, individuals who have developed avoidant memory tendencies in response to trauma may extend such strategies in order to “sanitize” aversive memories by screening out emotions and other unpleasant episodic details. Another possibility is that individuals with abuse histories encode very little affective detail in the first place. Conflict-related events may be especially confusing for children from violent homes, making it hard for them to fully appraise and label their own and others’ emotions related to these events. Yet a further explanation for the lower levels of emotion language among abused youth is that they have become somehow desensitized to conflict through repeated exposure, such that confl ict-related events were actually less emotionally arousing to them than to individuals without abuse histories. It should be noted, however, that the psychophysiological evidence regarding desensitization versus hypersensitization among abused children is mixed (Carrey, Butter, Persinger, & Bialik, 1995; El-Sheikh, 1997; Hennessy, Rabideau, Cicchetti, & Cummings, 1994; Laumakis, Margolin, & John, 1998). Unlike childhood abuse exposure, exposure to family violence during adolescence (i.e., recent abuse) was unrelated to internal states language. Admittedly, exposure during adolescence was less frequent and severe than exposure during childhood; therefore we may have lacked the statistical power to detect recent abuse effects. But the fact that recent abuse did predict memory functioning in the Johnson et al. (2005) analyses of memory specificity argues against this interpretation. Moreover, recent abuse exposure was unrelated to emotional language even when the analyses were conducted on the entire sample of adolescents for whom we had transcribed AMTs. Another explanation is that it reflects differences in the types of events being remembered (i.e., how easily events can be appraised): the teens were asked to recall memories from childhood, and those with recent abuse did not necessarily have abusive experiences during childhood. Therefore, if reduced emotional language

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reflects difficulty appraising experiences related to abuse, effects of recent abuse might be more likely to be observed in recent memories. An additional possibility is that the effects of abuse on autobiographical memory vary with age, and one limitation of our study is that autobiographical memory was assessed only at the follow-up interviews. Further research on the developmental sequence of abuse-related memory problems would shed new light on these issues. To summarize, the Johnson et al. (2005) and Greenhoot et al. (2005) findings, and those of others, suggest that many adolescents and adults with abuse histories exhibit memory disturbances. These disturbances appear to be specific to autobiographical memory and to be linked to patterns of emotional processing. Nevertheless, it remains to be seen whether these memory problems are actually part of a broader emotion regulation system in the individual. There is evidence that memory specificity is negatively related to measures of thought suppression and repressive coping style among nontraumatized individuals (Hermans et al., 2005; Raes et al., 2006), but researchers have yet to demonstrate that emotion-management strategies account for the poor specificity observed in people with abuse histories. Another limitation of the existing literature is that it has focused primarily on the cognitive mechanisms that underlie abuse-related memory patterns, and far less is known about the developmental processes that give rise to these patterns. For example, people whose lives are replete with bad memories may learn to avoid or “suppress” them, but how might such strategies be learned in the first place? Research on autobiographical memory and emotion regulation suggests that more adaptive responses to stress involve cognitively reframing and attempting to find meaning in memories of negative experiences (e.g., Compas & Boyer, 2001; Fivush, Berlin, Sales, Mennuti-Washburn, & Cassidy, 2003; John & Gross, 2004; Sales, Fivush, & Peterson, 2003). Therefore, we need to explain why individuals with abuse histories respond to negative past experiences with reduced memory specificity rather than attempts at meaning making. Some insights into this issue are offered by the developmental literatures on memory and emotion regulation, which suggest that the way children remember and cope with negative experiences is influenced by socialization experiences with their parents and other adults (Fivush, Berlin et al., 2003; Kliewer, Fearnow, & Miller, 1996; Sales et al., 2003). One implication is that atypical socialization experiences in abusive families may contribute to the patterns of autobiographical memory often observed in abuse victims. In the section that follows, we present the results of some recent exploratory analyses of the longitudinal sample that address this possibility.

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Emotion Management, Socialization, and Abuse-Related Memory Patterns In these analyses, we sought to identify additional variables that may help explain abuse-related differences in autobiographical memory functioning and individual differences within traumatized groups. One aim was to explore the role of socialization processes in abuse-related memory patterns. These analyses were informed by overlapping literatures on autobiographical memory development and emotional development, which suggest that children’s relationships, particularly with their parents, are a powerful source of information about how to process and remember emotional experiences. For example, the structure and content of parentchild conversations about past events influence children’s general autobiographical memory and narrative skills, as well as their understanding and memories of specific past experiences (Fivush, Berlin et al., 2003; Fivush, Haden, & Reese, 1996; McCabe & Peterson, 1991). Similarly, parent-guided conversations that focus on emotions are thought to promote the development of children’s skills in understanding and regulating emotion (e.g., Denham, Zoller, & Couchaud, 1994; Dunn, Brown, & Beardsall, 1991; Kliewer et al., 1996). Moreover, much of this emotion socialization is thought to occur in the context of conversations about past experiences (Fivush & Nelson, 2006). There is also evidence that autobiographical memory and emotion-socialization experiences vary according to the quality of parent-child relationships. For example, securely attached parent-child dyads have more elaborative and emotional conversations about past events than insecurely attached dyads (Fivush & Vasudeva, 2002; Laible & Thompson, 2000; Reese & Farrant, 2003). Taken together, these findings suggest that abuse-related patterns of memory specificity and emotional content could be partly attributable to atypical socialization experiences in abusive families. For instance, differences in emotional language associated with abuse exposure could be related to the way that parents talk about emotional events, either as they are happening or after they have occurred. Children may be especially reliant on adults to help them interpret negative events like family conflict, but adults in abusive families may be unlikely to discuss these events with their children, or may even socialize their children not to discuss their feelings about these experiences. Similarly, poor memory specificity could be related to a parental style of talking about past events that “teaches” children to avoid specific episodic details, or to the socialization of more general avoidance strategies for coping with stressful events. To explore these possibilities in this investigation, we looked at whether measures of mother-child relationship quality and conversation could explain abuse-related autobiographical memory patterns. The 102

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relationship quality indices included child report of maternal warmth and rejection at both assessments (Parent Perception Inventory; Hazzard, Christensen, & Margolin, 1983) and mother perception of motherchild closeness at the adolescent assessment (Parent-Adolescent Child Relationship Scale; Stuewig & McCloskey, 2005). Conversation measures included child/adolescent report of problem-focused conversations with the mother (i.e., “How often do you talk with your mother about things that bother you?”) at both assessments, as well as child report (at the initial assessment) of having discussed family conflict with the mother. The second aim of these analyses was to determine whether abuserelated memory patterns are related to individuals’ broader abilities to understand and manage emotion. We addressed this goal by examining the degree to which measures of adolescent emotional awareness and emotion-management skills accounted for abuse-related memory patterns. Lane’s Emotional Awareness Scale (Lane, Quinlan, Schwartz, Walker, & Zeitlin, 1990) was used to measure adolescent emotion understanding and the Adult Attachment Scale (Brennan, Clark, & Shaver, 1998) served as an indicator of how the teens managed their emotions in their romantic relationships. We were particularly interested in the avoidance subscale, which asks individuals about their comfort with intimacy and emotional openness in relationships (e.g., “I prefer not to show my boyfriend/ girlfriend how I feel deep down.”). Preliminary analyses indicated that three of these measures were related to adolescent autobiographical memory patterns: child report of mother-child discussion of family conflict collected during the childhood assessment, teens’ scores on the Avoidance subscale of the romantic attachment measure, and teen’s reports of maternal warmth. Further analyses focused on whether these three emotion-management and relationship variables mediated or moderated the effects of abuse exposure on autobiographical memory patterns. In other words, we were interested in whether these variables accounted for differences between groups of teens with and without abuse exposure, and whether they accounted for individual differences within these groups. The analyses revealed that the emotion-management and/or relationship variables helped to explain variation in both the number of overgeneral memories and the frequency of emotion terms. As in the Johnson et al. (2005) analyses, older age, more interviewer prompts and recent family violence exposure (i.e., reported at the adolescent interview) were associated with more overgeneral childhood memories. But the effect of recent abuse was qualified by an interaction with teen attachment avoidance; the effect of recent violence on overgeneral memory depended on avoidance tendencies (regardless of cue type). We illustrate this interaction in Figure 4–2, which presents estimated regression lines, representing Stress and Autobiographical Memory Functioning

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# Overgeneral Memories/Cue

avoidance regressed on overgeneral memories, for teens with and without recent abuse exposure. As shown in Figure 4–2, recent abuse was associated with more overgeneral memories only among teens who also displayed high avoidance in their romantic relationships. At high levels of avoidance (i.e., at one standard deviation above the mean), recent abuse exposure was associated with significantly more overgeneral memories, whereas at low levels of avoidance (i.e., at one standard deviation below the mean), there was no effect of recent abuse exposure. These results demonstrate that the adolescents’ autobiographical memory specificity is related to the way they manage intimacy and emotion in their relationships. Teens who avoided getting close and revealing their feelings to romantic partners produced more generic memories on the AMT than teens who were less avoidant in their relationships, but only if they had been exposed to child abuse or mother-directed violence in the recent past. One interpretation is that avoidance in relationships has a direct effect on the strength and retrievability of personal memories. Individuals with avoidant attachments are probably less likely to share personal memories with others, thereby reducing opportunities for the rehearsal and reinstatement of episodic details. But this argument cannot easily explain the fact that avoidance was unrelated to memory specificity among individuals without recent abuse exposure. It seems more likely that the increased overgeneral memories associated with avoidant attachment reflect avoidant strategies for regulating the negative affect associated with abuse exposure: teens with avoidant tendencies respond to stressors by avoiding potentially aversive episodic memory details. Our findings provide an important extension to previous work on abuse and memory specificity by showing that it was the combination

1.00 0.80 0.60 No Adolescent Abuse Exposure Adolescent Abuse Exposure

0.40 0.20 0.00 –1

0

1

Attachment Avoidance Figure 4–2. Predicted number of overgeneral memories, as a function of recent abuse exposure and attachment avoidance. 104

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of broader avoidant tendencies and abuse exposure, rather than abuse alone, that led to overgeneral memories. The analyses of emotional language indicated that there were interactions between childhood abuse and mother-child discussion of family conflict for positive and negative cues, but not for neutral cues. As illustrated in Figure 4–3, mother-child discussion of family conflict during the childhood interview was associated with greater emotional language in response to positive and negative memory cues, but only for teens without childhood abuse histories. Furthermore, the differences in emotional language related to childhood abuse status depended on motherchild discussion; teens without childhood abuse histories who did not discuss family conflict with their mothers had levels of emotional language comparable to those of teens with childhood abuse histories. The control group produced more emotional language than the abused group only when the children and their mothers had reported discussion of family conflict during the childhood interview. Therefore, the differences between teens with and without childhood abuse exposure were attributable to the differential effects of mother-child discussion for each group. Further analyses indicated that these patterns were limited to negative, as opposed to positive, emotion terms. One explanation for these patterns is that for children in nonabusive homes, mother-child discussion of family conflict may be associated with more open and affect-laden discussion of emotional events in the family. More open and emotional discussion of events, in turn, may increase children’s tendencies to emotionally evaluate their experiences, increase the salience of affective information, and socialize emotional disclosure in recollections. Indeed, there is considerable evidence that parents who

No Childhood Abuse/No Discussion Childhood Abuse/No Discussion

No Childhood Abuse/Discussion Childhood Abuse/Discussion

# Emotion Terms/Cue

1.40 1.20 1.00 0.80 0.60 0.40 0.20 0.00 Positive Cues

Negative Cues

Neutral Cues

Figure 4–3. Mean number of emotion terms produced per memory, as a function of cue type, childhood abuse exposure, and mother-child discussion of family conflict. Stress and Autobiographical Memory Functioning

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use more emotions when conversing with their children about past events have children who use more emotions as well (Adams, Kuebli, Boyle, & Fivush, 1995; Fivush et al., 2003a; Sales, Fivush, & Peterson, 2003). The finding that mother-child discussion did not have the same effect on emotional language in children from abusive homes suggests that the content or style of their conversations about conflict and other emotional events differed from those in nonabusive homes. Unfortunately, we have no direct measures of the content or quality of mother-child discussions in this study, but our findings do suggest that an analysis of parent-child conversation about emotional events in abusive families could be one key to understanding the origins of abuse-related memory disturbances. One unexpected finding was that teen report of maternal warmth (at the adolescent assessment) was negatively related to emotional language in their memories, for all cues, and regardless of violence history. This pattern, moreover, was consistent regardless of the valence or experiencer of the emotion. This finding is quite surprising because both maternal warmth and emotional disclosure are generally viewed as positive qualities, and warm, sensitive parenting is thought to promote mother-child closeness and emotional disclosure. These results are clearly in need of replication and there are several potential explanations, but one possibility is that “more is not always better” with regard to emotional expression, particularly for children and adolescents. In fact, some recent work has suggested that in some contexts, children who express more emotions or other internal states may actually display higher levels of psychological symptoms than children who express fewer internal states (Legerski, Vernberg, & Greenhoot, 2007; Sales & Fivush, 2005). Thus, it is possible that warm, sensitive parents promote moderate levels of emotional content by helping their children modulate their emotions during, or shortly after, emotional events, and/or by discouraging “venting” or inappropriately high levels of emotion expression. These patterns may also be related to typical patterns of adolescent development and autonomy-seeking. Further investigation of the relation between emotional expression and parent-child relationships across development may help clarify these findings.

Conclusions Our data add to the mounting evidence of autobiographical memory dysfunctions in individuals exposed to abuse. Collectively, these analyses suggest that models of the effect of stress on memory need to account for not only the stress associated with the to-be-remembered event, but each individual’s history of exposure to traumatic stress as 106

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well. Our results extend previous work on trauma-related memory problems by illustrating that these deficits appear by at least adolescence and that abuse affects the affective qualities of memories in addition to their specificity and accessibility. Furthermore, our prospective documentation of abuse exposure has enabled us to disentangle the effects of childhood abuse from current frame of mind and recent stressors, revealing that both early and recent experiences with abuse are associated with atypical autobiographical memory function. One of the most important findings of our research program is that atypical memory patterns are not explained by abuse alone, but are also products of the teens’ broader emotion-management tendencies and socialization histories. Some of our findings suggest that abuse-related patterns of memory specificity and emotional language may reflect different underlying processes. The memory patterns associated with recent abuse in our first study (Johnson et al., 2005)—shorter, more overgeneral, and fewer negative memories—are highly consistent with the widely cited affect regulation hypothesis. This explanation is bolstered by the results of our exploratory analyses, which revealed that recent abuse led to overgeneral memories only among teens who exhibited avoidant tendencies in their relationships. These findings suggest that poor specificity could be only one of many avoidant behaviors in these individuals, with these responses making up a broader emotion-management system. When teens with avoidant tendencies are exposed to negative experiences like abuse, they may respond with reduced memory specificity, as opposed to more adaptive responses like cognitive reframing and meaning making. We were not able to determine the origins of avoidant tendencies in our sample, but attachment research and theory suggests that adult attachment is built on early attachment relationships to parents as well as more recent relationships with peers and significant others (e.g., Simpson, Collins, Tran, & Haydon, 2007). Thus, examination of early relationship patterns and socialization history may further explain autobiographical memory patterns in individuals with abuse histories. The fact that recent abuse was a consistent predictor of specificity problems in childhood memories suggests that these abnormalities are probably best characterized as comprising a flexible response to recent or current stressors as opposed to an enduring style that stems from early adverse experiences. In other words, although some individuals may be more likely to use functional avoidance than others, its application varies with current conditions. Additional support for this hypothesis comes from our own and others’ findings that memory specificity fluctuates according to retrieval conditions such as the type of memory cue (Johnson et al., 2005) or the presence of intrusive thoughts (e.g., Wessel et al., 2002). These patterns also permit some speculation as Stress and Autobiographical Memory Functioning

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to the temporal locus of abuse-related memory problems. Specifically, they suggest that poor memory specificity reflects atypical processes that occur during recollection, rather than during encoding or consolidation, although it is not clear whether they reflect retrieval problems or unwillingness to disclose. In contrast, the Greenhoot et al. (2005) findings, combined with the results of our exploratory analyses, suggest that abuse-related patterns of emotional language may have to do with the way emotional events were processed during childhood, rather than screening processes that take place at the time of retrieval. Some support for this argument comes the fact that conditions reported at the childhood assessment (i.e., abuse exposure and mother-child discussion of family conflict), rather than the adolescent assessment, predicted patterns of emotional language six years later. The finding that abuse-related differences in emotional language were mediated by mother-child discussion suggests that abuse-related emotional language patterns may reflect differences in the way emotional events are discussed and evaluated in abusive and non-abusive families. In other words, abuse-related emotional language patterns may reflect atypical emotion-socialization processes that took place during childhood, possibly preventing affective content from being integrated into the children’s memories in the first place. A logical next step would be to directly examine mother-child discussion of emotional events in dyads with and without exposure to family violence and abuse. The counterintuitive findings related to maternal warmth also highlight the need to look more directly at mother-child interactions during adolescence and how they relate to memory. Although our findings provide some insight into the developmental processes that may contribute to abuse-related memory problems, it is still unclear how early in development these problems might emerge. Few studies in this literature have examined memory functioning during childhood, and in our longitudinal study, autobiographical memory was not assessed until the adolescent interview. Further investigation to track the developmental sequence of abuse-related memory problems may strengthen the arguments that can be made about the underlying processes. The developmental course of trauma-related specificity problems that reflect strategic avoidance of negative memory content may depend on age-related change in emotion regulation strategies (e.g., Brenner & Salovey, 1997) as well as cognitive resources and executive control. Thus, it is possible that functional avoidance and poor memory specificity appear later in childhood or adolescence, in response to negative thoughts about past experiences. On the other hand, if abuse-related variations in emotional language are attributable to early socialization

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of emotion regulation and autobiographical memory processes, these patterns may appear in early childhood. Our research program suggests that abuse exposure is associated with a broader range of autobiographical memory abnormalities than previously known, but more research is needed to examine the scope of these patterns. Although our work suggested that the autobiographical memory abilities of individuals with trauma histories were unrelated to measures of nonautobiographical episodic memory (e.g., paired-associates memory or story recall), only a handful of studies has examined broader declarative memory abilities in individuals with abuse histories (de Decker et al., 2003; Wessel et al., 2002). Thus, more thorough evaluation of the contribution of general memory impairments to trauma-related autobiographical memory patterns seems warranted. Another limitation of the existing literature is the almost exclusive reliance on the AMT to measure autobiographical memory functioning. On the one hand, reliance on a common assessment facilitates cross-study comparison, but it also limits the generalizability of the findings. In other words, it is not clear whether abuse-related patterns are specific to a timed cue-word task or would also be evident under conditions that more closely resemble everyday recollection and allow for greater elaboration and reflection. Additional research using a broader range of autobiographical memory assessments will be critical to understanding how these abuse-related memory deficits relate to recollective processes outside of the laboratory. An additional issue that we are investigating concerns whether any of these memory problems is related to an involuntary, automatic form of avoidance or disengagement from stress-related information. Indeed, the dual process model of responses to stress developed by Compas and his colleagues (see Compas Campbell Robinson, & Rodriguez, this volume) suggests that disengagement from stress-related stimuli may occur at either a strategic, voluntary level or an automatic, involuntary level. Compas’s research program (e.g., Compas & Boyer, 2001) indicates that these two response levels are dissociated and are differentially related to well-being. Although abuse-related avoidance has been assumed to be strategic (e.g., Williams et al., 2007), it seems possible that abuse could affect engagement/disengagement patterns at the automatic level, and these might have implications for memory. In conclusion, exposure to traumatic events like abuse may alter the course of autobiographical memory development or memory functioning, but the full significance of trauma-related memory patterns for everyday human functioning has yet to be determined. Williams and others (e.g., Williams, 2007) have argued that the memory specificity problems observed in abuse victims may reduce distress in the short term, but can

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increase vulnerability to depression in the long term because they impair problem-solving abilities. Consistent with this claim, autobiographical memory problems have been linked to deficits in interpersonal problemsolving and poorer outcomes for individuals in therapy (Brittlebank, Scott, Williams, & Ferrier, 1993; Evans, Williams, O’Loughlin, & Howells, 1992; Pollock & Williams, 2001; Sidley, Whitaker, Calam, & Wells, 1997). Similarly, a considerable amount of research and theory on emotion expression suggests that low levels of emotional expression are maladaptive, and emotional disclosure reflects coping and leads to improved well-being (e.g., Fivush, Berlin et al., 2003; Larson & Chastain, 1990; Pennebaker et al., 1997; Smyth, 1998). Nevertheless, most of this work has focused on adult populations, and it is possible that highly specific or emotional memories are not always adaptive for children or adolescents. We observed in the longitudinal sample that poor memory specificity was associated with higher concurrent rates of depression, but the causal direction of this association is unclear. Reduced emotional language on the AMT was unrelated to measures of depression or other psychopathology, but other studies (e.g., Legerski et al., 2007; Sales & Fivush, 2005) have shown that increased emotional language in children’s memories of specific events is associated with more symptoms of psychopathology. Thus, future research should evaluate the consequences of abuse-related autobiographical memory patterns for well-being, and the degree to which these consequences vary across development.

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5 Coping and Memory Automatic and Controlled Processes in Adaptation to Stress Bruce E. Compas Laura K. Campbell Kristen E. Robinson Erin M. Rodriguez

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uccessful adaptation to stress involves interactions among a complex set of psychological, biological, and interpersonal processes. Central among these processes is the role of memory. Memory serves as a resource to facilitate more-effective coping and adaptation to stress, but memory can also contribute to adverse outcomes associated with stress. Thus, memory is a double-edged sword in stress and coping, carrying significant costs and benefits for individuals as they struggle to adapt to and cope with acute and chronic stress. There are multiple intersections among stress, coping, and memory. Learning and memory form the foundation for the development and acquisition of coping responses (Skinner & Zimmer-Gombeck, 2007). Memory serves as a resource to facilitate more-effective coping and responses to stress, in part by consolidating prior learning and experience in similar stressful situations (Shors, 2006). However, some aspects of memory facilitate adaptation to stress, whereas other components of memory interfere with and constrain adjustment. For example, working memory

Preparation of this chapter was supported in part by grants R01MH069940 from the National Institute of Mental Health and R01CA118332 from the National Cancer Institute, and a gift from Patricia and Rodes Hart.

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is an important process that facilitates several aspects of cognitive coping responses, such as the ability to reappraise or reframe a stressor (Ochsner, Bunge, Gross, & Gabrielli, 2002). On the other hand, automatic, intrusive memories can interfere with adaptive coping and trigger prolonged, problematic responses to stress. Chronic and acute stress may have contrasting effects on memory. Specifically, chronic stress appears to adversely affect some aspects of memory whereas acute stress may accentuate memory processes (e.g., Kleen, Sitomer, Killeen, & Conrad, 2006; Smeets et al., 2006). However, these relations are complicated, as different aspects of memory (e.g., verbal vs. spatial) appear to be affected by various types of stress in contrasting ways (Shors, 2006). Further, different coping responses have varied effects on memory. Most pronounced is the detrimental effect of the broad category of disengagement coping (including avoidance, denial, and wishful thinking) on memory. In this chapter we describe a dual-process model of responses to stress as a framework for understanding stress, coping, and memory (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001). This model includes both automatic and controlled responses to stress that involve engagement with or disengagement from sources of stress and one’s emotions. Controlled responses to stress, which we equate with the concept of coping, are then considered within the broader cognitive processes of executive functions and memory (Compas, 2006). We then use two examples from our research on children and adults with cancer to show the diverse relations among these processes—the relations between controlled, working memory processes and coping, and the interplay between disengagement coping and intrusive, automatic memories. Finally, directions for future research on the role of memory in coping with stress are outlined.

Coping and Responses to Stress: A Dual-Process Model Adaptation to stress involves two closely related but distinct processes. One set of responses to stress is reflected in rapid, automatic reactions to stressors that are driven by innate, biologically based processes and learned processes acquired through associative and operant conditioning (Compas et al., 2001). These processes may occur within or outside of conscious awareness but are not under conscious control. A second set of stress responses are controlled, effortful, and purposeful and are typically captured within the construct of coping. Automatic and controlled processes have been studied relatively independently in the past, as reflected in the separate literatures on stress reactivity and coping. However, integration of these two processes is essential for a complete understanding of adaptation 122

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to stress. Moreover, because memory encompasses both automatic and controlled processes, it is important to examine the role of memory in adaptation to stress within the context of these dual processes.

Automatic Responses to Stress: Stress Reactivity There are strong individual differences in automatized responses to stress, and these individual differences may have important implications for the role of memory in stress. Central in determining rapid, automatic responses to stress is the sympathetic branch of the autonomic nervous system (ANS) that initiates a series of responses to prepare the individual for physical responses to sources of threat, including the prototype of the “fight or flight response.” This includes increases in heart rate and blood pressure, pupilary dilation, and inhibition of salivation and digestion. Conversely, the parasympathetic arm of the ANS functions to automatically down-regulate stress responses by, for example, decreasing blood pressure and heart rate. Responses of the ANS are closely tied to other automatic cognitive, behavioral, and emotional responses to stress. Individuals who are highly reactive to and slow to recover from stress are more likely to experience prolonged physiological and emotional arousal after exposure to a stressor (e.g., Davidson, 2003). Activation of the ANS in response to stress has implications for memory, as prolonged stress reactions may impede retrieval of previously learned information and behavior from memory that was acquired prior to the stressor (Kleen et al., 2006). Patterns of stress reactivity are evident early in development as reflected in individual differences in temperament, and these differences are associated with later variations in stress reactivity in childhood and adolescence (Kagan, Reznick, & Gibbons, 1989; Kagan, Reznick, & Snidman, 1987). For example, children characterized early in development as having an inhibited temperament react to novelty and threat with greater physiological arousal and emotional distress than uninhibited children. Kagan et al. (1987) have described “behavioral inhibition to the unfamiliar” as characterized by the predisposition to be irritable as an infant, unusually shy and fearful as a toddler, and quiet, cautious, and withdrawn in the preschool and early school-age years, with marked behavioral restraint and physiological arousal in unfamiliar situations. Early differences in behavioral inhibition have lasting implications, as they are predictive of the onset of anxiety disorders in late childhood (Kagan, Snidman, Zentner, & Peterson, 1999). The association between early temperament and later anxiety may be due in part to individual differences in ways of reacting to stress, as stress is an important trigger for anxiety symptoms and anxiety disorders. Coping and Memory

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Temperamental differences are also evident in the ability to sustain focus of attention and to shift attention in response to situational demands (Posner & Rothbart, 2007). Individual differences in attention include biases in attention to threatening information that can trigger activation of emotional and physiological arousal. For example, compared with nonanxious individuals, anxious individuals display a rapid, nonconscious, automatic bias to attend to threatening information (Bar-Heim et al., 2007). Studies using both the emotional Stroop task (a measure of interference in attention as a function of emotional content of stimuli) and the dot probe detection task (a measure of biases of allocation of attention to emotional stimuli) have found evidence of biases in attention to threat (Bar-Heim et al., 2007). This pattern has been identified in children with anxiety (Dalgleish et al., 2003), and a similar bias to attend to pain and threatening information has been observed in children with chronic pain (Boyer et al., 2006). Environmental cues are capable of triggering automatic, unwanted, anxiety-provoking memories that intrude on awareness. A bias to threatening information in the environment may lead to chronic activation of cognitive, emotional, and physiological systems, including intrusive memories, that are involved in stress responses. Further, these biases may also be linked with biased recall of negative memories that can further contribute to chronic activation of stress response systems, as memory and inhibitory control processes are associated with the anterior attentional control network (Rueda, Posner, & Rothbart, 2005).

Controlled Responses to Stress: Coping Coping research has been shaped by the landmark work of Lazarus and Folkman, with the most notable impact arising from their articulation of a transactional model of coping over 20 years ago (Lazarus & Folkman, 1984). They defined coping as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal resources of the person” (Lazarus and Folkman, 1984, p. 141). Within this model, types of coping were distinguished in terms of their function or goal, with the broad distinction made between efforts to act on the source of stress (problem-focused coping) or one’s emotional response to stress (emotionfocused coping). Coping theory and research have made considerable progress since the foundational work of Lazarus and Folkman. In a comprehensive review of coping research and theory, Skinner et al. (2003) delineated multiple levels of analysis of coping processes, including specific categories of coping responses (e.g., distraction, emotional expression), broader families of coping (e.g., problem-solving, accommodation), and even broader 124

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adaptive processes (e.g., coordinating actions and contingencies in the environment). The complexity of and, perhaps, problems in the field are reflected by more than 400 specific categories of coping responses identified in the literature by Skinner et al. Progress has been made toward consensus on understanding the varied aspects of coping during childhood and adolescence (e.g., Compas et al., 2001; Skinner et al., 2003; Skinner & Zimmer-Gombeck, 2007). Skinner et al. (2003) point to the contribution of top-down, theorydriven research that has used confirmatory factor analysis to test models of coping as an important alternative to early work that relied on bottom-up methods using exploratory factor analysis to examine rather disparate sets of coping responses. Top-down methods are reflected in the work of Ayers et al. (1996), Tobin et al. (1999), and Walker et al. (1997), as well as our own research on coping as part of a dual process model of responses to stress (e.g., Connor-Smith et al., 2000). A shared feature of these models of coping is the recognition that coping is a form of self-regulation that is activated under stress. We define coping as “conscious volitional efforts to regulate emotion, cognition, behavior, physiology, and the environment in response to stressful events or circumstances” (Compas et al., 2001, p. 89). Similarly, Skinner and Zimmer-Gemberck (2007) define coping as “action regulation under stress” (p. 122), and Eisenberg et al. (1997) identify coping as “involving regulatory processes in a subset of contexts—those involving stress” (p. 42). Regulation under stress involves a broad array of responses, including efforts to (a) initiate; (b) terminate or delay; (c) modify or change the form or content; (d) modulate the amount or intensity of a thought, emotion, behavior, or physiological reaction; or (e) redirect thought or behavior toward a new target (Compas et al., 2001). These regulatory processes both draw on and are constrained by the biological, cognitive, social, and emotional development of the individual. As noted above, the development and acquisition of coping skills involve learning and memory of prior responses to stress and drawing on those memories to select coping responses when new stressors are encountered.

Integrating Automatic and Controlled Processes: Dual Process Model The broad array of controlled and automatic responses to stress is further distinguished along a dimension of engagement versus disengagement (Compas et al., 2001; Connor-Smith et al., 2000). Engagement responses involve orienting or directing responses toward the source of stress or one’s emotional responses to a stressor, whereas disengagement responses Coping and Memory

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orient away from the stressor or one’s reaction to it. Automatic engagement responses include emotional and physiological arousal, intrusive cognitions, and impulsive action. Disengagement responses that occur automatically in response to stress include escape behavior, emotional numbing, and cognitive interference. In contrast to automatic responses to stress, three types of controlled (coping) responses have been identified. Drawing on developmental models of perceived control and the importance of these perceptions in responses to stress (e.g., Rudolph, Dennig, & Weisz, 1995), controlled engagement responses are further differentiated as primary control coping and secondary control coping (Connor-Smith et al., 2000). Primary control coping is characterized by responses aimed at resolving the source of stress or direct attempts to change one’s emotional responses to a stressor, including problem-solving, controlled (regulated) expression of emotions, and emotion modulation. Examples of primary control coping responses include making a plan of action and following it, seeking information about a problem, expressing emotions through writing or disclosure to another, and keeping emotions in check until it is an appropriate time and place to express them. Primary control coping is hypothesized to be best suited to stressors that are experienced as under personal control. Secondary control coping involves efforts to adapt to a stressor and is, therefore, best suited to stress that is experienced as beyond personal control. Secondary control coping includes acceptance, distraction, cognitive restructuring, and optimistic thinking. Specific examples of secondary control coping responses include taking things as they are, finding a silver lining in a problem, and engaging in positive activities as a source of distraction. Controlled disengagement responses represent disengagement coping, which includes avoidance, denial, and wishful thinking. Disengagement coping may reflect a sense of relinquished control in which the individual no longer believes that control over the source of stress or one’s emotions is possible. As part of the pursuit of the underlying neurobiology of emotion regulation, recent research has identified brain structures, functions, and physiology associated with perceptions of control (Declerck, Boone, & Branander, 2006), suggesting that it may be possible to map the neuroanatomy of a control-based model of coping. The dual process model of coping and stress reactivity has been tested using adolescent self-reports and parents’ reports about adolescents on the Responses to Stress Questionnaire (Connor-Smith et al., 2000). This model has been supported using confirmatory factor analyses in diverse samples of adolescents and adults coping with a wide range of different types of stress including Euro-American adolescent coping with social/interpersonal stress (Connor-Smith et al., 2000), a sample of older adolescents in Spain (Connor-Smith & Calvete, 2004), Navajo adolescents 126

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coping with social/interpersonal stress (Wadsworth et al., 2003), children and adolescents coping with recurrent pain (Compas et al., 2006a), and women coping with the diagnosis and treatment of breast cancer (Compas et al., 2006b). Findings from these studies suggest that this model is robust and replicable across a wide range of different types of stress, different age groups, and diverse cultural and ethnic groups. This model has been supported in latent variable analyses combining parent and adolescent reports of adolescents’ coping, indicating that it is not limited to self-report measures (Compas et al., 2006a). This model has emphasized active forms of engagement coping as reflected in efforts to regulate the source of stress and one’s emotions in primary control coping and one’s cognitions and attention in secondary control coping. However, passive forms of engagement coping as represented by ruminative coping (e.g., focusing on one’s negative emotions) are also important (Nolen-Hoeksema, 2004). Rumination includes self-reflection (e.g., “analyzing recent events and trying to understand why I am upset”; “writing down what I am thinking and analyzing it”) and brooding (e.g., “thinking about how alone I feel”; “thinking about how upset I feel”). Much of the ruminative process involves the replaying and analyzing of self-related events that have occurred and are now stored in memory. In examining the role of coping and memory, it may be valuable to integrate other models of coping in children and adolescents that specifically identify ruminative coping responses.

Coping, Executive Function, and Memory Coping responses are regulated by a larger cognitive system that is responsible for complex cognitive functioning. Executive function is a general term used to describe a variety of higher-order cognitive processes that are involved in the coordination and execution of a wide range of cognitive tasks (e.g., Aron, 2008). Executive function includes processes such as cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions, and inhibiting inappropriate actions, and selecting relevant sensory information (Aron, 2008). These processes involve the integration of two or more basic cognitive processes, including attention and working memory (Luna & Sweeny, 2004). Because executive function involves the integration of basic cognitive processes, it activates brain regions that are engaged during those basic processes, such as the regions of the hippocampus and the anterior cingulate. However, because executive function requires the integration of these processes, it also involves activation in regions of the prefrontal cortex that are involved in the integration of information from and communication with other regions of the brain. Numerous imaging studies Coping and Memory

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have shown that the dorsolateral, ventrolateral, and medial regions of the prefrontal cortex are activated in executive function processes (Davidson, 2000). Despite evidence that executive function processes activate specific prefrontal regions, these processes are difficult to define operationally because the distinction between higher-order and basic processes lies on a continuum (Hughes & Graham, 2002). Hughes and Graham argue that, especially in adults, complex processes that require higher-order processing when they are novel can become automatic when well learned (e.g., driving). Hence, the point at which a process becomes automatic cannot be pinpointed, and there will be individual differences on performance and executive function activation during real-life tasks. Coping involves the activation of executive functions under a specified set of conditions; i.e., in response to acute stressful events or chronic stressful conditions. Some of the central features of executive functions are reflected in our definition of coping, including the importance of conscious volitional responses that are goal directed and experienced by the individual as under conscious control. Both primary and secondary control coping involve higher-order, nonautomatic cognitive processes to cope with a stressor. As such, executive functions serve as the platform on which coping responses are built. For example, Copeland and Compas (2007) examined the role of one domain of executive functioning, executive inhibition, in the coping responses of children with attention and externalizing problems. Executive inhibition refers to the ability to suppress dominant prepotent or previously reinforced responses to stimuli (Roberts & Pennington, 1996). In this study, inhibitory control was measured using three standardized tests of the ability to delay and inhibit behavioral responses (a go-no go task, a Stroop color-naming task, and a delay of gratification task). Copeland and Compas found that engagement coping strategies, including primary control and secondary control coping, were associated with greater inhibitory control, while disengagement coping was associated with poorer inhibitory control. Further, primary control coping responses mediated the association between inhibitory control and externalizing behavior problems. That is, poor inhibitory control was related to more externalizing problems in part because of deficits in the use of primary control coping strategies. This study provided initial evidence that executive inhibition is important in the development and execution of effective coping strategies.

Working Memory One aspect of executive function that has significant implications for coping is working memory. Working memory can be defined as the capacity 128

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to store information in short-term registers and to simultaneously manipulate it online (Scherf, Sweeny, & Luna, 2006). It is a crucial cognitive function for human thought processes such as reasoning, learning, and comprehension, facilitating the momentary maintenance and manipulation of task-relevant information. Working memory involves both attentional and short-term memory/rehearsal processes. One widely used paradigm to assess one aspect of working memory, visual working memory, is the n-back task. In the n-back task, one must respond according to a rule (e.g., when a letter is repeated immediately after itself, one letter after itself, two letters after, etc.). Previously presented letters must be rehearsed in short-term memory while responding according to the current rule, making it a test of working memory. A parametric version of the visual n-back task (Barch, Sheline, Csernansky, & Snyder, 2003) has been developed, which involves increasingly difficult sequences of uppercase consonants. In the 0-back condition, participants are instructed to respond to a single target (e.g., M). In the 1-back condition, participants are instructed to respond only when the consonant is identical to the one preceding it (e.g., M, M). In the 2-back condition, participants respond only when the consonant is identical to the one presented two trials prior (e.g., M, T, M), and in the 3-back condition, participants respond when the consonant is identical to the one presented three trials prior (e.g., M, T, F, M). The n-back is related to activation in the dorsolateral prefrontal cortex, and damage to this region has been associated with decrements in performance on the n-back task and with limits in working memory capacity (Owen, MacMillan, Laird, & Bullmore, 2005). Functional neuroimaging studies have shown that working memory tasks such as the visual n-back activate a number of brain regions. For example, the dorsolateral prefrontal cortex (e.g., Broadman area 9) appears to play a central role in responding to a visual n-back task (Owen et al., 2005).

Memory, Stress Reactivity, and Coping We now consider the relation between memory and stress responses in more detail. Two salient examples from research on memory and stress responses are illustrative of the potential importance of this relationship— the relations between working memory and secondary control coping (specifically, cognitive reappraisal) and the associations among disengagement coping and intrusive, automatic thoughts and memories.

Working Memory and Secondary Control Coping Because working memory is a fundamental skill that involves holding information in short-term memory while simultaneously acting on this Coping and Memory

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information, it may have implications for coping processes that also involve the simultaneous processes of holding stress relevant information online while manipulating that information. A salient example of this type of coping process has been variously called cognitive reappraisal, cognitive restructuring, or cognitive reframing (e.g., Connor-Smith et al., 2000; Ochsner et al., 2002). Cognitive reappraisal uses working memory to view a stressor in a different, less-threatening way, by holding the stressor in mind while reappraising or changing one’s interpretation of the stressor. Two recent studies in our lab provide evidence for the potential importance of working memory in the process of cognitive reappraisal. In the first study we examined executive function, coping, and emotional and behavioral problems in children and adolescents who had completed treatment for acute lympocytic leukemia (ALL) and a matched control sample of healthy children (Campbell, Scaduto, Van Slyke, Niarhos, Whitlock, & Compas, 2008). In a second study we used functional neuroimaging methods to identify specific brain regions that may reflect deficits in ALL survivors in response to a working memory task (Robinson, Livesay, Campbell, Scaduto, Cannistraci, Whitlock, & Compas, 2008). Our work with survivors of pediatric cancer has provided an interesting opportunity to examine the relations between working memory and coping, and the effects of cancer treatments on working memory capacity. Although its base rate is low compared to many other childhood diseases, cancer remains the leading cause of disease-related death of children in the United States. Approximately 1,560 children are expected to die from cancer this year, and an estimated 9,500 children under the age of 14 will receive a new cancer diagnosis (American Cancer Society, 2006). ALL is the most common form of childhood cancer, accounting for nearly one-third of all diagnoses (American Cancer Society, 2006). An invariably fatal disease prior to 1960 (Mulhern, 1994), ALL now has a five-year survival rate of over 80% owing to the introduction and ongoing modification of powerful treatment protocols, which not only destroy leukemic cells in the bone marrow, and organs, but also prevent disease relapse in the central nervous system through the prophylactic administration of chemotherapeutic drugs directly into the cerebral spinal fluid (e.g., Smith, Ries, Gurney, & Ross, 2004). As a result of these advances in treatment, the majority of children diagnosed with ALL are living well into adulthood, and the issue of managing the long-term sequelae of treatment and preserving quality of life of childhood ALL patients and survivors has become a major focus of research and clinical practice. Known long-term effects of treatment for childhood ALL can include hormone deficiencies, infertility, pulmonary fibrosis and inflammation, kidney disease, osteopenia, cardiac 130

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complications, dental abnormalities, and even the development of second cancers (American Cancer Society, 2006). The Childhood Cancer Survivorship Study, a multicenter cohort study that has provided the largest data on the late effects of childhood cancer treatment, found that adult survivors of childhood ALL reported experiencing significantly more overall physical and mental health problems, activity limitations, and functional impairment compared to adult siblings with no history of cancer (Ness et al., 2005; Hudson et al., 2003; see Robison et al., 2005 for a review). One important long-term consequence of ALL treatment that has been observed is impaired neurocognitive functioning. Declines in overall intellectual ability (e.g., Mulhern, Ochs, & Fairclough, 1992), academic performance (e.g., Anderson et al., 2000), memory and learning (e.g., Hill et al., 1997), attention and concentration (e.g., Lockwood, Bell, & Colegrove, 1999), information-processing speed (Cousens et al., 1991), visuospatial skill (e.g., Espy et al., 2001), psychomotor functioning (e.g., Kaleita et al., 1999), executive functioning (e.g., Anderson et al., 1997), and language skills (e.g., Buttsworth, Murdoch, & Ozanne, 1993) are among the adverse neurocognitive outcomes reported in the literature. We recently completed a meta-analytic review of the literature on the neurocognitive effects of treatment for childhood ALL and found that when compared to control groups composed of healthy peers, siblings, or children treated for solid tumors or other chronic illness, ALL survivors experienced significant declines in both global and specific domains of neurocognitive function (Campbell, Scaduto, Sharp, Dufton, Van Slyke, Whitlock, & Compas, 2007). The effect sizes ranged from small to moderate (g = –.34 to –.71) and were in the negative direction, indicating consistent deficits for groups of children treated for ALL across all nine neurocognitive domains assessed: Overall Cognitive Functioning (which includes scores on measures of verbal, performance, and fullscale intelligence), Academic Achievement, Attention, Executive Function, Verbal Memory, Visuospatial Memory, Visuospatial Skill, Psychomotor Skill, and Information Processing Speed. Based on these findings, Campbell et al. (in press) hypothesized that, compared to healthy controls, childhood ALL survivors would show poorer executive functioning. Further, because we view coping as closely tied to executive function, we expected that ALL survivors would display more maladaptive patterns of coping with stress, and greater internalizing and externalizing behavior problems than healthy controls. Because adaptive coping relies on intact executive functions, we also hypothesized that poorer executive functioning would be associated with greater use of maladaptive patterns of coping; that is, greater reliance on disengagement coping and less use of primary and secondary control coping, Coping and Memory

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particularly in ALL survivors. Participants included 30 children and adolescents between 10 and 20 years of age who completed treatment for ALL and 30 healthy controls matched on age, sex, and when possible Socio-Economic Status (SES). Both ALL and healthy control participants were administered behavioral tests of four domains of executive function (working memory, cognitive flexibility, behavioral inhibition, and selfmonitoring), and their parents were administered a questionnaire asking them to report on their children’s executive function in these domains. In addition, both participants and their parents completed questionnaires on the children’s coping and behavioral/emotional problems. Consistent with our recent meta-analytic review (Campbell et al., 2007), Campbell et al. (in press) found that ALL survivors performed more poorly than healthy controls on several domains of executive function, including working memory. Survivors’ self reports and parents’ reports of adolescents’ primary control and secondary control coping were positively correlated with certain measures of executive functioning, including working memory, while maladaptive coping (i.e., disengagement coping) was negatively correlated with these measures. Additionally, survivors’ coping was related to their internalizing and externalizing behavior problems. Specifically, survivors’ greater use of primary and secondary control coping was related to fewer emotional and behavioral problems, while survivors’ greater use of disengagement coping was associated with more emotional and behavioral problems (Campbell et al., in press). The results of this study provide preliminary evidence that some survivors of childhood ALL are susceptible to impaired executive function and therefore experience difficulties in coping effectively with stressful life events, leading to emotional distress and behavior problems (Campbell et al., 2008). The findings of this study support the hypothesis that the ability to employ adaptive coping skills is dependent on intact executive functioning, including the domains of working memory, cognitive flexibility, self-monitoring, and behavioral inhibition. When the ability to perform these higher-level cognitive tasks is impaired, children and adolescents appear to rely more heavily on maladaptive patterns of coping, such as denial and avoidance, and less on strategies considered more adaptive, such as problem-solving, acceptance, and cognitive restructuring. In a subsequent study, we selected a sample of ALL survivors who displayed impaired performance on standardized tests of working memory in the Campbell et al. (2008) study and along with their age- and gender matched-controls used functional magnetic resonance imaging (fMRI) to examine their performance on a visual n-back task (Robinson et al., 2008). Survivors and healthy controls performed similarly on the 132

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working memory task conducted during the neuroimaging session, based on both accuracy scores and reaction time scores. However, comparison of the two groups on the more complex levels of the task (2-back and 3-back) indicated that the difference between the groups approached significance, with the ALL survivors performing more poorly on this task than controls. Analyses of fMRI data revealed that, although similar regions were activated in working memory processing in these two groups, survivors of ALL recruited greater amounts of oxygenated blood to the dorsolateral prefrontal cortex and the dorsal anterior cingulate cortex during the task, specifically at greater levels of task difficulty. This suggests that, although these regions may still be functional in survivors, greater energy is required to perform to the same level as peers. These findings are consistent with theories of inefficient functioning or compensatory activation, in which it is hypothesized that individuals with deficits in executive functions may overcompensate for these deficits through recruitment of a greater supply of resources (i.e., oxygen) to facilitate task completion (e.g., Sweet, Rao, Primeau, Durgerian, & Cohen, 2006). These processes have been examined successfully in phenotypically similar populations (e.g., Multiple Sclerosis) using similar tasks and targeting the same brain regions (Audoin et al., 2003; Sweet et al., 2006). Staffen and colleagues (2002) suggested that this compensation indicates cerebral pathology, and serves to preserve functioning by connecting integrated parts of the systems of error processing and response inhibition. Based on these suggestions, functional connectivity MRI may be a useful tool for examining the extent of reliance on multiple cortical areas by adolescents with potential deficits and their possible association with deficits in secondary control coping. It is noteworthy that the regions in the prefrontal cortex which are involved in working memory and may be important in processes of coping with stress are also adversely affected by chronic stress (Compas, 2006). Substantial evidence suggests that stress takes a double toll on the ability of children and adolescents to sustain resilience in the face of prolonged stress and adversity. Psychosocial stress initiates a series of biological and psychological processes captured by the concept of allostatic load (McEwen, 1998). Allostatic load, or the cost of wear and tear on the body produced by repeated activation of biological stress response systems, contributes to physical disease and emotional and behavioral disorder. The effects of allostatic load include a second less-wellrecognized but pernicious process that is reflected in the toll that stress takes on specific brain regions, including the hippocampus and the regions of the prefrontal cortex (McEwen, 2003). Further, the brain regions most adversely affected by chronic stress are the very portions of the brain that are most responsible for effective coping and adaptation Coping and Memory

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to stress (Compas, 2006). Thus, the direct effects of chronic stress may be compounded by impairments in the ability to effectively cope with stress. The PFC, hippocampus, and amygdala all are densely populated with receptors that, when stimulated, down-regulate the hypothalamus and decrease production of corticotrophin-releasing hormone. Although glucocorticoids act on the brain through both mineralocorticoid receptors and glucocorticoid receptors, glucocorticoid receptors are most centrally involved in the regulation of stress responses, as they modulate other biological stress responses and facilitate recovery from stress through return to baseline (pre-stress) functioning. The HPA and SAM axes operate optimally only in response to acute, short term stressors. Chronic stress, or prolonged allostatic load, however, takes a significant toll on these systems. Prolonged exposure to chronic stress, and concomitantly, prolonged activation of the stress axes, is linked to neural degeneration in specific brain regions, most notably areas of the PFC and the hippocampus. The seminal work of McEwen and colleagues has shown that prolonged exposure to stress leads to atrophy and impaired neuronal function in the hippocampus and the medial prefrontal cortex. For example, Radley et al. (2005) showed that repeated restraint stress in rats led to significant loss of dendritic spine density and length in pyramidal neurons in the medial PFC. Similarly, Isgor et al. (2004) found that chronic variable stress leads to decreased hippocampal volume in peripubertal rats. Both of these regions contain high levels of glucocorticoid receptors and when stimulated these receptors lead to down-regulation of the HPA. However, these studies suggest that if the system remains activated by repeated and prolonged exposure to stress, the system breaks down leading to neuronal atrophy and cell death. Perhaps even more importantly, the effects of prolonged stress on the brain are not random, as most pronounced effects occur in brain regions that are responsible for higher-order executive functions that are central in successful adaptation to stress.

Stress Reactivity, Disengagement Coping, and Intrusive Memories A second potentially important area of research on memory, stress, and coping involves the role of automatic, intrusive memories in response to stressful or traumatic events. As noted earlier, memories of traumatic stress can plague survivors for months or years following a stressful event. These memories are experienced as unwanted and intrude on consciousness in an often unpredictable and unexpected way. Memories can 134

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occur in the form of highly emotional dreams that awaken the individual from sleep in a distressed and anxious state, in response to stimuli in the environment that may or may not be in the awareness of the individual, or as a result of ruminative coping efforts in which the individual’s efforts to dwell or focus on the stressor (or on the negative emotions associated with the stressor) then trigger uncontrollable ruminative thoughts and images. An illustrative example of these processes also comes from research with cancer patients, although the majority of these studies have been conducted with adult patients. Intrusive thoughts and memories have been documented at high rates among cancer patients during active treatment and for some patients, long after treatment has been completed. A pernicious pattern characterizes some patients who respond to these memories by trying to avoid reminders of their disease and suppress or avoid memories and emotions. Disengagement coping efforts of this type are associated with the paradoxical effect of increasing the unwanted memories that they are intended to avoid (e.g., Wegner, 1994). For example, several studies have reported a strong and significant correlation (r = .50 or greater) between intrusive thoughts/memories and efforts to avoid these thoughts (e.g., Epping-Jordan, Compas, & Howell, 1994; Primo, Compas, Oppedisano, Epping-Jordan, Howell, & Krag, 2000). This likely reflects a cyclical process in which an intrusive memory triggers efforts to avoid the memories. However, the cognition “don’t think about cancer” has the unintended effect of focusing on the unwanted thought because it is imbedded in the cognitive command. Further, avoidance interferes with other potentially adaptive responses such as reappraising or accepting the problem, or even distracting oneself from the problem by refocusing attention on other more positive stimuli and thoughts (Compas et al., 2001). The pattern of intrusive memories and disengagement coping has detrimental and far-reaching consequences. Patients who experience intrusive memories and try to avoid these thoughts report significantly higher symptoms of anxiety and depression (e.g., Primo et al., 2000). This is not surprising given that intrusive thoughts and avoidance are cardinal symptoms of Post-Traumatic Stress Disorder (PTSD) and anxiety disorder, but it underscores the importance of these responses even when they do not meet full diagnostic criteria for PTSD. Epping-Jordan et al. (1994) reported a more dramatic consequence of intrusive memories and avoidance. Epping-Jordan et al. examined intrusive thoughts and memories and avoidance of these cognitions in a sample of men and women with cancer within the fi rst weeks after receiving a cancer diagnosis. Intrusive thoughts/memories and avoidance were strongly correlated near the time of diagnosis, and both were positively correlated with Coping and Memory

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symptoms of anxiety and depression. The most striking finding, however, was that avoidance of intrusive thoughts about cancer near diagnosis was a significant predictor of a cancer recurrence or death from cancer one year later, after controlling for a panel of relevant medical variables (e.g., cancer diagnosis and stage, patient age, treatments). Patients who were above the median on avoidance were more than twice as likely as patients who were low in avoidance to have died or experience a recurrence of their cancer one year later (Epping-Jordan et al.). These findings suggest that intrusive thoughts and memories may set in motion a pattern of coping characterized by avoidance and other forms of disengagement (denial, wishful thinking). Disengagement coping may be associated with failure to engage in appropriate health behaviors, including monitoring of symptoms of recurrence and follow-up treatments. High rates of intrusive thoughts and memories have also been reported in parents of children with cancer (Bruce, 2007). For example, Kazak et al. (2004) in a sample of mothers and fathers of pediatric cancer patients found that 68% of mothers and 57% of fathers had moderate to severe symptoms of posttraumatic stress. Mothers were more severely affected than fathers, with more symptoms of intrusive thoughts, avoiding reminders of the treatment, and more irritability, perhaps even anger. These results were compared with those of previous studies that looked at other parents after their child’s treatment had been completed and found that parents’ symptoms were worse during treatment. In one of the few studies of intrusive memories in children with cancer, Stuber et al. (1997) followed 18 childhood-cancer survivors ages eight through 20 years, off of treatment for more than one year, and their parents completed questionnaires. Significant, independent predictors of persistent intrusive memories and other posttraumatic stress symptoms included (a) the survivor’s retrospective subjective appraisal of life threat at the time of treatment, and the degree to which the survivor experienced the treatment as “hard” or “scary”; (b) the child’s general level of anxiety; (c) history of other stressful experiences; (d) time since the termination of treatment (negative association); (e) female gender; and (f) family and social support. Mother’s perception of treatment and life threat contributed to anxiety and subjective appraisal for the survivor, but did not independently contribute to posttraumatic stress symptoms. In summary, studies of adult cancer patients and children with cancer and their parents provide a vivid example of the possible negative consequences of automatic memories of a stressful or traumatic experience. Although memories of prior stressful events can serve as an important basis for learning to cope with subsequent stress, it appears that memories that intrude on awareness in an automatic fashion are highly problematic. Further, the potentially damaging effects of intrusive memories 136

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are compounded by the use of disengagement coping responses in an effort to avoid or suppress the unwanted memories.

Summary and Future Directions Research on the complex relations among stress, coping, and memory is in its early stages. However, current work clearly suggests important directions for future research. First, recent reviews of research on coping in children and adolescents reflect a glaring absence of research on the relationship between coping and memory in young people (e.g., Compas et al., 2001; Skinner & Zimmer-Gombeck, 2007). It will be important for coping researchers to consider the role of memory and introduce measures of potentially important memory processes into future work. Second, the converse is also true, as researchers concerned with children’s memories of stressful events have given relatively little attention to the role of coping and other stress responses. Researchers concerned with children’s memory and the relations between memory and stress can draw on the emerging evidence for children’s coping to better understand how memory is involved in adaptation to stress. Third, the costs and benefits of memory need to be examined in children’s adaptation to stress. This is most pronounced in the possible effects of automatic, intrusive memories as compared with more actively, purposefully recalled memories through focused efforts to reminisce. Finally, the full range of memory processes, from short-term working memory to long-term storage and retrieval, needs to be examined. The role of memory in adapting to acute stress and the adverse effects of chronic stress on memory offer rich opportunities for continued investigation.

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Skinner, E. A., & Zimmer-Gembeck, M. J. (2007). The development of coping. Annual Review of Psychology, 58, 119–144. Skinner, E. A. et al. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129, 216–269. Smeets, T., Jelicic, M., Merckelbach, H., Peters, M., Fett, A., Tavermiers, J., Henquet, C., & Dautenzenberg, J. (2006). Enhanced memory performance on an internal-internal source monitoring test following acute psychosocial stress. Behavioral Neuroscience, 120, 1204–1210. Stuber, M. L., Kazak, A. E., Meeske, K., Barakat, L., Guthrie, D., Garnier, H., et al. (1997). Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics, 100, 958–964. Sweet, L. H., Rao, S. M., Primeau, M., Durgerian, S., & Cohen, R. A. (2006). Functional magnetic resonance imaging response to increased verbal working memory demands among patients with multiple sclerosis. Human Brain Mapping, 27, 28–36. Tobin, D. L., Holroyd, K. A., Reynolds, R. V., & Wigal, J. K. (1989). The hierarchical factor structure of the Coping Strategies Inventory. Cognitive Therapy and Research, 13, 343–361. Wadsworth, M. E., Rieckmann, T., Benson, M. A., & Compas, B. E. (2004). Coping and responses to stress in Navajo adolescents: Psychometric properties of the Responses to Stress Questionnaire. Journal of Community Psychology, 32, 391–411. Walker, L. S., Smith, C. A., Garber, J., & Van Slyke, D. A. (1997). Development and validation of the pain response inventory for children. Psychological Assessment, 9, 392–405. Wegner, D.M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.

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6 Mother-Child Emotion Dialogues A Window into the Psychological Secure Base David Oppenheim Nina Koren-Karie

M

other-child conversations about the past, including dialogues about distressing events experienced by the child, play an important role in the development of children’s autobiographical memory. In a recent comprehensive account regarding the emergence of autobiographical memory, Nelson and Fivush (2004) stated that “there is now abundant evidence that the way in which parents, and especially mothers, structure conversations about past events with their preschool children has strong and enduring influences on how children come to construct their own narrative life history” (p. 497). The evidence that supports this conclusion comes from correlational and experimental studies that have shown that early maternal elaboration during conversations about the past contributes to richer and more detailed autobiographical memory in the child (Fivush, Haden, & Reese, 2006). But do mother-child co-constructions of narratives about the past also have implications for children’s emotional regulation and well-being? Are certain types of dialogues particularly beneficial for children’s capacity to integrate emotional experiences, particularly those that are distressing, into emotionally coherent internal representations? Attachment theory suggests that dialogues that constitute a “psychological secure base” for the child promote such representations by supporting children’s confident exploration of their inner worlds. The goal of this chapter is to describe our studies of such dialogues and review findings that point to their importance. We begin with a review of the 142

“secure base” concept and discuss its implications for the importance of parent-child dialogues.

The Psychological Secure Base The concept of secure base is foundational in attachment theory, and many will agree that it represents the core of the theory (Waters & Cummings, 2000). It refers to a dynamical system involving the infant or child and the attachment figure, most typically the parent. Within this system children use their attachment figures as a secure base from which to venture into the world and explore the environment, and to which they return as a haven of safety in times of emotional need. The secure base consists of a dynamical balance between attachment and exploratory behaviors, so that when one is in the foreground the other is in the background and vice versa. Thus, when the child feels secure the attachment system recedes to the background and the exploratory system dominates. This is reflected in the child’s distancing from the parent and exploring the environment. When the child’s sense of security is threatened, however, the child’s attachment system dominates and the exploratory system recedes to the background. This is reflected in a range of emotional signals and attachment behaviors, all intended to increase the proximity between the child and the caregiver. While these general characteristics apply to all child-parent attachments, there are also important individual differences (or, more precisely, dyadic differences) in the secure base pattern as a function of whether the attachment relationship between child and parent is secure or insecure (Ainsworth, Blehar, Watere, & Wall, 1978). The hallmarks of a secure attachment are smooth transitions between exploration and attachment in which the child flexibly moves from one to the other in accordance with his or her needs. In insecure attachments, on the other hand, there are limitations and imbalances in the secure base pattern. In insecure/ambivalent-resistant attachments exploration is constrained and limited, whereas in insecure/avoidant attachments, expressions of the child’s attachment needs may be subdued or inhibited. Finally, in disorganized attachments there are temporary collapses of the child’s behavioral strategy in the face of stress. In describing the secure base concept we focused on the child, distancing from the attachment figure and returning for emotional refueling. However, children’s secure base behavior is closely linked to the responses and availability of the caregiving partner. The secure base concept is inherently dyadic, and the behavior of the child and the parent are interwoven and linked to one another. This reciprocity does not imply symmetry, however, due to the developmental differences in the Mother-Child Emotion Dialogues

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needs of infants and parents. Attachment theory emphasizes the role of the parent in supporting the child’s exploration by being physically and emotionally available, encouraging the child’s forays, and protecting the child from danger. The complementary role of the parent involves supporting the child’s need for closeness, comfort, and regaining a feeling of security. For the secure base pattern to operate optimally, parents are expected to match their behavior to the fluctuations in the child’s exploratory and attachment behaviors and to the child’s emotional signals. The secure base is considered pertinent not only in infancy but throughout development, and, in fact, throughout life, although its manifestations change with development (Ainsworth, 1989). While during the early year or two of life many of the interactions that constitute the secure base are mediated through nonverbal emotional signaling, verbal interactions assume an increasingly important role in the following years. During the preschool years and later, as children’s verbal communication becomes more effective and important cognitive skills, such as perspective taking, emerge, the secure base pattern continues to develop. Bowlby described the parent-child relationship at this stage of development as a partnership (Bowlby, 1982), in which the child’s security is enhanced and maintained by knowledge regarding the parent’s availability and the capacity to coordinate the plans and goals of parent and child through verbal exchanges (Marvin & Britner, 1999). In this new stage parent-child dialogues, particularly those revolving around personal and emotional experiences, begin to assume central importance (Etzion-Carasso & Oppenheim, 2000). The matching of the fluctuations in the child’s emotional needs continues to be as important as in the early years, when exploration of the physical world was the focus. But now exploration expands to new arenas, far beyond the child’s immediate environment: It involves the psychological exploration of the past and the future, not only the present; of real worlds but also ones that are imagined; of events that are hoped and yearned for, but also those that are dreaded and feared (Wolf, 2003). The complement to the child’s exploration, namely, the parent’s emotional availability, supportive presence, and sensitive guidance also continue to be as important as they were when exploration of the physical environment was central (Matas, Arend, & Sroufe, 1978; Biringen, 2000). Through the myriad of brief, everyday verbal exchanges as well as more significant and meaningful parent-child dialogues, conversations increasingly become the arena in which attachment-related affective signaling and negotiations take place. This is not to say that physical proximity and distance are no longer significant for attachment. They always are, as common observations of separations and reunions in airport terminals attest. But to this level a new one is added, one that involves 144

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psychological exploration and psychological proximity and safety, and in these parent-child dialogues play a major role. What are some of the characteristics of parent-child dialogues that can be considered as a “psychological secure base” for children? Bowlby (1988) described secure dyads as those in which there is free-flowing communication between the partners, and in which the entire spectrum of the child’s emotional signals is accurately perceived and sensitively responded to by the parent (Bretherton, 1990, 1993). Bowlby also gave considerable attention to the conditions under which distorted communication occurs between parents and children. Here he was guided primarily by clinical studies, and he summarized his view in a moving chapter titled “On knowing what you are not supposed to know and feeling what you are not supposed to feel” (Bolwby, 1988.) In this chapter he discusses the pressure some children face to change and even distort their perception of reality to conform to parental views and, ultimately, in order to maintain their attachments to them. Bowlby (1988, p. 101) writes: “Children not infrequently observe scenes that parents prefer they did not observe; they form impressions that parents would prefer they did not form; and they have experiences that parents would like to believe they have not had. Evidence shows that many of these children are aware of how their parents feel and proceed to conform to their parents’ wishes by excluding from further processing such information.” Bowlby explains that children do not only distort their perceptions because they are aware how their parents feel and how their parents would like them to perceive reality. Rather, parents may also attempt to directly shape their child’s perceptions by discrediting his perceptions, ridiculing the child, or by insisting that the child confused reality with what he had seen on television, what he dreamed, or what he feared. Other distorted communications have to do more with what is not said than what is said. For example, Bowlby describes the context of sexual abuse in which there is a cognitive split between the respected and even loved father of daytime and the very different father of the nighttime. Bowlby poignantly describes how the child looks to her father for confirmation during the daytime of her perceptions and experiences of the nighttime trauma but receives no such response. In such a situation children may lose confidence in their capacity to perceive and think accurately, to distinguish between fact and fantasy, and in essence to trust their own thinking and feeling.

Associations Between Attachment and Mother-Child Dialogues: Research Evidence Attachment studies of normative samples have also shed light on the importance of parent-child dialogues. The fi rst study on this issue was Mother-Child Emotion Dialogues

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conducted by Strage & Main (1985). It involved six-year-olds whose attachment to their mothers was assessed during infancy, and showed that mother-child dyads in which children were secure in infancy had fluent and balanced conversations, included expressions of emotions, and elaborated on a variety of topics, whereas dyads whose children were insecure as infants had restricted or dysfluent dialogues, had frequent pauses between conversational turns, showed little elaboration of topics, and asked rhetorical and repetitive questions. Along similar lines EtzionCarasso and Oppenheim (2000) showed that 4 ½ -year-old boys who were securely attached as infants were likely to have open communication with their mothers following a separation, characterized by coherent and fluent conversations, maternal guidance and pleasure, and child cooperation and directness. Disorganized children of both genders were less likely to show such communication. Klann-Delius and Hofmeister (1997) examined relations between quality of attachment at age 12 months and later mother-child communication when children were 17-, 23-, 30-, and 36-months of age in a sample of 25 children. Compared to avoidant dyads, secure dyads were more active and were better able to maintain smooth turn-taking in a stressful situation. Other studies measured attachment and dialogues concurrently and they too contribute to our understanding of how security can be expressed in dialogues. Farrar, Fasig, and Welch-Ross (1997) observed mother-child memory conversations and found that secure mother-daughter dyads elaborated more on both positive and negative emotional themes than insecure dyads; the latter elaborated primarily on positive themes. No consistent associations were found for boys. Laible and Thompson (2000) assessed dialogues between mothers and their four-year-olds about an incident in which the child behaved well and an incident in which the child misbehaved. Secure dyads made more references to feelings and had more moral evaluatives than insecure dyads. Finally, Fivush and Vasudeva (2002) found that mothers who were more elaborative during reminiscing also reported that their children were more secure in their attachments than children of mothers who were less elaborative. Taken together, these studies point to the characteristics of mother-child dialogues that are associated with security or insecurity in the mother-child relationship. As mentioned above, in our own work, we focused primarily on the secure-base function of mother-child dialogues (Koren-Karie et al., 2003; Etzion-Carsso & Oppenheim, 2000). Based on an attachment approach, we hypothesized that in the context of emotional dialogues and coconstruction of narratives revolving around affective themes, the parent’s emotional availability to the child when discussing a wide range of emotions is critical, as is the parent’s structuring and organization 146

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of the dialogue and facilitation of the child’s free talk about topics the child chooses. In addition, parents facilitate the psychological exploration of their children by containing their negative feelings, maintaining their involvement in the dialogue, and by enabling them to discuss memories of difficult, challenging emotional events in ways that are likely to lead to feelings of confidence and success. Such an emotional climate fosters children’s exploration of a wide range of emotional experiences. This climate is likely to be experienced by the child as a secure base from which to explore the world of emotion freely, backed by the knowledge that the parent will be emotionally available as a safe haven if needed. Such availability promotes trust that the parent will not let the child be overwhelmed by negative memories and emotions, but rather will show and encourage adaptive and useful ways of dealing with such emotions. Therefore, the child is likely to contribute to the conversation when prompted and cooperate with the task at hand. This theorizing was the basis for our studies of mother-child dialogues (e.g., Oppenheim et al., 2007; Gini et al., 2007; Etzion-Carasso & Oppenheim, 2004). In our studies, we examined various types of mother-child dialogues, with those studied most frequently involving mother-child reminiscing about emotional events experienced by the child (following Fivush, 1991). In this task, referred to as the Autobiographical Emotional Event Dialogue (AEED), mothers and children are presented with four cards. On each, a name of a feeling is written, and a pictorial representation of a face expressing the feeling is drawn. The four feelings are happy, mad, sad and scared (we recently added “secure and protected” following Roger Kobak’s work). Dyads are asked to remember an event in which the child felt each of the feelings and to jointly construct a story about each of the events. Conversations typically last between five and 15 minutes, and the coding approach we describe next is based solely on transcripts of the dialogues.

Coding Mother-Child Emotion Dialogues Our coding system consists of seven maternal and seven parallel child scales as well as two scales pertaining to the narrative produced by mother and child. Based on these scales, transcripts are classified into an Emotionally Matched category presumably reflecting a “psychological secure base”, or one of three Nonemotionally Matched categories (Excessive, Flat, or Inconsistent) presumably showing lack of a “psychological secure base.” Rating of the transcripts is done by marking indicators for the various scales as they appear throughout the transcript, and then assigning Mother-Child Emotion Dialogues

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a score on each of the scales based on both the frequency and the strength of these indicators. The scales range from one to 9, with high scores indicating high levels of the behavior tapped by the scale (in all scales except for hostility high scores reflect positive behaviors; see Table 6–1 for description of the scales). As mentioned above, the rating scales serve as a basis for the classification of the transcripts into four categories. A detailed manual provides descriptions of the central features of each of the categories (see summaries below) and the possible variations within each category. The

Table 6–1. Autobiographical Emotional Events Coding System Maternal rating scales Focus on the task Clear boundaries

Tolerance Involvement and reciprocity Hostility Containment of negative feelings Structuring Child rating scales Focus on the task Maintaining child role

Acceptance Involvement and reciprocity Hostility Closure of negative feelings Elaboration Narrative scales Congruence of the stories Coherence

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High ratings indicate . . . . Mother is focused on completing the task; she does not shift the focus to irrelevant details Mother accepts the child’s perspectives and experiences; she does not force her own ideas or emotions and does not become overwhelmed by the child’s themes Mother enables the child to express a wide range of emotional themes without being defensive or judgmental Mother is positively engaged in the task and shows genuine interest in the child and the stories Mother shows hostility, anger or derogation Mother guides stories with negative themes toward positive resolutions that emphasize the child’s coping, strength, and well-being Mother facilitates the child in narrating rich and coherent stories High ratings indicate . . . . Child is focused on completing the task; s/he does not shift the focus to irrelevant details Child does not assume a parental role, e.g., by refraining to talk about an event that might distress the mother, promising to protect the mother, or act in a controlling, punitive manner Child accepts mothers’ suggestions and guidance willingly Child is positively engaged in the task and in the interaction Child shows hostility, anger, or negative affect toward the mother Child completes stories involving negative themes with positive resolutions that emphasize successful coping Child tells rich and detailed stories High ratings indicate . . . . The stories are well-differentiated from one another and match the emotions or themes they are intended to describe Mother and child construct stories that are coherent, fluent and clear

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categories are based on the dimensions tapped by the scales but represent a higher level of analysis that captures the overall pattern of communication exhibited by the dyad. To facilitate coding, the description of each category also includes profiles that consist of ranges of scores on each scale that characterize each classification.

Emotionally Matched (EM) The main characteristic of these dyads is their capacity to tell, in a comfortable and accepting atmosphere, coherent stories with a clear and believable link between the emotion requested and the story provided. The stories can be short, but the reader understands the event and how it evoked the feeling in the child. Both mother and child are involved in constructing the story. When discussing a negative event the mother guides the child toward a story ending that promotes feelings of being in control, strength, and self-confidence. The voices of both child and mother are clearly heard so that the interaction is not dominated by one of the partners. Both show patience and acceptance of each other’s ideas and suggestions. It is important to note that warmth and positive feelings are not necessary features of this category (although emotional coldness precludes it). Rather, the critical features are maternal structuring and organization and child cooperation and elaboration.

Nonemotionally Matched—Excessive (Ex1) Dyads in this category are characterized by stories that are poorly organized, confused, and may be flooded with negative emotional themes. This results in incoherent stories that may be hard for the reader to follow. The dialogues are characterized by shifts to irrelevant details, repetitiveness, digressions, and excessive and over-dramatized talk. Mothers in these dyads often fail to pace their contributions to the child’s rhythm. In many cases one of the partners dominates the conversation and is impatient and unreceptive to the other’s contributions. In most cases there is inappropriate closure of the stories and no resolution for negative affects. Some dyads in this category show unusual, extreme and potentially irrational dialogues. These include behaviors such as maternal helplessness (e.g. admitting that she feels helpless when facing the child’s fears), maternal frightening behavior (e.g. adding unnecessary terrifying details to the child’s story), and out-ofcontext aggressive themes.

1

In Koren-Karie et al. (2003) this category was labeled Exaggerated.

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Nonemotionally Matched—Flat (Fl) Dyads in this category are characterized by limited dialogue and poor development of the stories. In addition, lack of involvement and interest in the task are central features. Both mother and child may mention the names of emotions or events that happened but there is almost no development of the idea or the story. The mother does not guide the child and does not encourage the child to develop the ideas that the child has raised. The resulting narrative consists of emotion labels without real substance.

Nonemotionally Matched—Inconsistent (In) In this category there is a wide gap between the styles of talk of the partners. For example, one of the partners adheres to the instructions and is cooperative and coherent whereas the other partner blocks the dialogue, directs the conversation to irrelevant details, confuses, or expresses hostility and anger. An additional type of inconsistency can emerge when mother and child construct full and matched stories in response to some of the emotions or themes but with regard to the others they become confused, digress, and fail to develop a story. Inter-rater reliabilities of the AEED scales assessed in the studies using this coding system ranged between .80 and .92 with a median of .86. Inter-rater reliability on the four-way dialogue classifications has been assessed in all studies using the AEED and the average reliability has been κ = .89.

Research Findings Using the AEED We describe next the distributions of the four AEED classifications in various samples ranging in age, risk status, and nationality.

Proportion of the EM Classifications in Low-Risk Samples The percentage of low-risk preschooler-mother dyads classified as Emotionally Matched is quite consistent: 36% in the Etzion-Carasso (2004) Israeli study and 33% in the Samish-Nemlich (2003) USA Study (see Table 6–2). The Oppenheim et al. (2007) figure (21%) is lower but this sample was a subsample of a larger sample selected to overrepresent insecure children by close to a 2:1 ratio (i.e., in the original sample 70% of the children were classified secure whereas in the subsample only 39% were secure). If dialogues classified EM reflect secure 150

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attachments, a decreased proportion of securely attached children should be associated with a parallel decreased proportion in dyads classified as EM. Following this rationale the corrected percentage of dyads classified EM in the Oppenheim et al. (2007) study should be 37%, similar to the figures in the other samples. The studies reviewed above all involved preschoolers and young school-aged children. In one study that involved older children the percentage of dyads classified EM was higher: 50% of the dialogues between 16-year-old adolescent females and their mothers were classified as EM (Segal, 2007).

Stability over Time of the AEED Classifications Two longitudinal samples show stability over time in the AEED classifications (stability was reported at the level of an EM/non-EM split). 74% of the dyads received the same classification at ages 4.5 and 7.5 in the Oppenheim et al. (2007) study (LR = 11.60, p = .001) and 76% of the dyads received the same classification at 4.5 and 5.5 in the SamishNemlich (2003) study (LR = 10.59, p = .001.) In the Oppenheim et al. (2007) study, in which there was a three-year time difference between the two assessments, there was also an increase in the percentage of

Table 6–2. Distribution of AEED Classifications in Various Studies (Distribution Figures Represent Percentages) Sample

Country Reference

Low risk longitudinal Preschool School age

Israel

Low risk longitudinal

Israel

Etzion-Carasso, 2004

Low risk longitudinal Age 4.5 Age 5.5

USA

Samish-Nemlich, 2003

N

Oppenheim et al., 2007 Gini et al., 2007

Mean Age EM

Ex

Fl

In

124 119

4.5 7.5

20 30

48 48

18 11

13 12

103

4

36

32

16

17

45 48

4.5 5.5

33 40

51 42

7 10

9 8

45 36

4.5 5.2

11 33

44 25

16 11

29 31

Preschoolers with USA behavior problems Before Treatment After Treatment

Oppenheim et al., 2004; Ganor, 2005

Children of Israel mothers with abuse background

Koren-Karie et al., 2004

33

7

18

45

9

27

Adolescent females

Segal, 2007

71

16

50

27

17

7

Israel

Note. EM = Emotionally Matched; Ex = Excessive; Fl = Flat; In = Inconsistent

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dyads classified EM with age: from 20% to 30% between the ages 4.5 and 7.5 (p = .054 using the McNemar test). In the Samish-Nemlich study, in which there was only a one-year difference between the two assessments, there was also an increase in the percentage of dyads classified as EM (from 33% to 40%) but this increase was not statistically significant. Thus there appears to be an age-related increase in the proportion of dyads classified as EM, which may be due to the improvement in children’s linguistic skills with age. In almost all of the studies in which language assessments were available (typically the vocabulary subscale from the WPPSI or a similar measure) results showed that children in dyads classified EM had better language skills than those in dyads not classified EM. This was true for the age 7.5 assessment in the Oppenheim et al. (2007) study, the age 5.5 assessment in the Samish-Nemlich (2003) study, and in the EtzionCarasso (2004) study (although the association here was only marginally significant). Thus, not surprisingly, children’s linguistic skills appear to play a role in parent-child narrative co-constructions, so that children with higher skills are more likely to be part of emotionally matched dialogues. Because language skills improve with age, this may also explain not only within age individual differences but also the increase with age of the proportion of dyads classified as EM.

AEED Classifications and Risk Status Studies of the AEED also showed associations between the AEED classifications and children’s risk status: Findings show that the proportion of dyads classified as EM was lower in studies of children at high socioemotional risk. In the Oppenheim et al. (2004) study of preschoolers in treatment for behavioral and emotional problems only 11% were classified into the EM category prior to treatment (Ganor, 2005), and in the Koren-Karie et al. (2004) study of children of mothers who were in treatment for the sexual abuse they experienced as children only 18% of the dyads were classified as EM. Taken together these findings suggest that approximately one-third of the dyads in low-risk samples were classified as EM during the preschool years, and that this percentage increases with age. Our findings with adolescent females suggest that it can reach up to 50%, but this does not necessarily represent a ceiling. In addition, the longitudinal samples suggest that AEED classifications show stability over time, at least in low-risk samples. Thus, the picture is of a gradual increase in the proportion of EM classifications with increasing age together with relative stability over time. The two findings may appear contradictory because increase in the proportion of dyads classified EM necessitates some level 152

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of instability (due to non-EM dyads becoming EM), but because the increase is gradual it does not appear to contradict moderate stability. The findings also point to a link between risk status and a lower proportion of the EM classification, as expected if this classification is an index of the psychological secure base, and more generally, of good socioemotional functioning of the mother-child relationship. Finally, the results obtained in studies in the USA and in Israel appear to be comparable. Among the non-EM classifications the Excessive classification appears to be the most frequent, followed by the Flat and Inconsistent classifications. If we order the EM, Ex, and Fl classifications on an emotion regulation continuum, we can say that the EM classification reflects optimal regulation, the Ex classification represents underregulation, and the Flat classification represents overregulation. Thus the main type of difficulty mothers and children appeared to have experienced when discussing emotional experiences involved underregulation, as reflected in the emotional flooding, poor organization, and dysregulated negative themes characteristic of the Excessive classification. Only a small group evinced difficulties from the other extreme of the emotion regulation continuum, namely, the emotional detachment characteristic of the Flat classification. The inconsistent classification represents a different, possibly orthogonal dimension: Here the issue is not the emotion regulation strategy characteristic of the dyad but what appears as a lack of consistent strategy either across emotions or between the two speakers. Based on the theorizing regarding disorganized attachment that similarly involves lack of a consistent strategy (Lyons-Ruth & Jacobvitz, 1999), the Inconsistent classification was thought to reflect the most severe difficulties in mother-child dialogues, and this speculation received some support from the relatively high frequency of this classification in the two clinical samples we studied (Ganor, 2005; Koren-Karie et al., 2004).

Studies on Attachment and Mother-Child Emotion Dialogues The AEED was conceptualized as reflecting the “psychological secure base,” and therefore it was important to examine its associations with child-mother attachment. To address this question we conducted two studies in which attachment was assessed in infancy and mother-child dialogues were assessed later in development. In the first study (Oppenheim et al., 2007), we assessed children’s attachment at the age of one year using the Strange Situation Procedure (SSP; Ainsworth, Blehar, Waters, & Wall, 1978), and mother-child AEED dialogues at ages 4.5 and 7.5. The study’s first question involved predicting children’s AEED dialogues at Mother-Child Emotion Dialogues

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4.5 and 7.5 from their attachment classifications (dichotomized for these analyses into secure versus insecure categories). Using logistic regressions we found that, controlling for children’s vocabulary, secure infant attachment predicted the EM classification and insecure infant attachment predicted the non-EM classification in both ages. The second study question was whether age 4.5 dialogues mediated the association between infant attachment and age 7.5 dialogues, or whether infant attachment predicts age 7.5 dialogues beyond the prediction offered by age 4.5 dialogues. The latter possibility turned out to be supported by the data. Results showed that infant attachment predicted age 7.5 dialogues controlling for children’s vocabulary and beyond the prediction offered by age 4.5 dialogues. We see this as a very meaningful finding supporting the validity of the AEED classifications, particularly at the age of 7.5, as reflecting the psychological secure base. The AEED dialogues obtained at age 7.5, although more distant temporally from the infant attachment assessments than age 4.5 dialogues, were more strongly associated with infant attachment than age 4.5 dialogues. Detailed follow-up analyses showed that the results were due to the fact that some dyads with secure histories were classified as non-EM at 4.5, and only at age 7.5 were classified into the predicted, EM classification. Perhaps some of the dyads with secure histories were not able to conduct emotionally matched dialogues at 4.5 due to limitations in children’s linguistic and conversational skills. With age, as children mastered the necessary skills, their dialogues revealed the underlying secure organization. In a second study from our laboratory (Etzion-Carasso, 2004) with a similar design, attachment was assessed in the SSP at one year and mother-child AEED dialogues were assessed at age four. This study failed to replicate the longitudinal links between attachment and the AEED dialogues: No associations were found between attachment and mother-child dialogues. We see two possible reasons for this replication failure. First, as the Oppenheim et al. (2007) results suggest, the sensitivity of the AEED dialogues to detect attachment-related differences increases with age. Age four may represent a time point too early to effectively use the AEED: Variability in AEED dialogues at this age may have more to do with variability in children’s linguistic/conversational skills and less with variability related to attachment. A second explanation involves the differential attrition of insecure children in this sample. The attrition of mother-child dyads in which children had insecure attachments was significantly higher than the attrition of dyads with securely attached children, and this may have led to insufficient power in the follow-up time point for detecting attachment-related differences. Taken together the studies suggest that, at least when the design was sufficiently powerful, there was support for the idea that the AEED 154

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dialogues reflect individual differences in security related to children’s attachment histories, and thus can be seen as reflecting the secure base as expressed in the dialogic context. An important strength of the findings is the use of the Strange Situation to assess attachment. Not only is this procedure considered as the “gold standard” for assessing attachment, it is based on behavioral observations and does not involve verbal discourse; therefore it has little if any shared method variance with the AEED. In addition, in some of the studies there was a significant time interval—six years—between the attachment and AEED assessments. Not only was the interval long, but it involved the transition between infancy and the preschool and early school years, in which children go through very significant developmental changes involving all aspects of development. Therefore, finding continuity across these years is of particular significance. Importantly, as is true of many studies demonstrating developmental continuity, this continuity does not necessarily indicate continuity in the child but could also represent continuity in the mother-child relationship. It is possible that the same maternal emotional capacities, such as sensitivity (Ainsworth et al., 1978) and insightfulness (Oppenheim & Koren-Karie, 2002), that are important for the development of secure attachments in infancy are also important for the facilitation of emotionally matched dialogues, and that this also accounts for the continuity we observed (Harris, 1999). This chapter focuses on a specific type of mother-child emotion dialogue, one that involves reminiscing about past emotional events. Our longitudinal findings support the notion that these dialogues reflect the security of the child-mother relationship. Would similar fi ndings emerge if other types of emotion dialogues were observed, or is there something unique to reminiscing? One way to address this question is to compare reminiscing dialogues with other emotion dialogues not involving reminiscing. Two questions can be addressed: (a) are dyads consistent in their dialogue style across dialogues? and (b) would the nonreminiscing emotion dialogues also be associated with attachment? For this purpose we observed the dyads from the Oppenheim et al. (2007) study in two additional dialogues: The first was the Separation-Reunion Narrative Co-Construction (SRNCC; Oppenheim, Nir, Warren, & Emde, 1997), in which mothers and children were asked to jointly develop a narrative, using dolls and props, about parents leaving their children for the weekend and then returning (for full details see Oppenheim et al., 2007). The SRNCC was coded using the same coding system used for the AEED. The second was the Joint Storytelling Task (JST), in which mothers and children were asked to jointly develop a narrative based on a wordless picture book that showed a child returning home after school and discovering that the door is locked, and that the mother who Mother-Child Emotion Dialogues

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was supposed to be at home is not there. Although this episode was coded using a somewhat different coding system (see Gini, Oppenheim, & Sagi-Schwartz, 2007) it also yielded overall dialogue classifications hypothesized to be associated with attachment and similar to the AEED classifications: a “Mutual-Balanced” classification presumed to reflect a secure attachment history, and “Overwhelming” or “Disengaged” classifications, presumed to reflect an insecure attachment history. We first looked at the associations between the AEED and the two additional dialogues, the SRNCC and the JST. Results showed that dyads classified as EM in the AEED were also likely to be classified as EM in the two additional dialogues (LR = 9.11, df = 1, p = .003 for the SRNCC; LR = 10.30, df = 1, p < .001 for the JST). We then examined the associations between the SRNCC and the JST and the attachment assessments of the children obtained when they were infants. The results showed that the same attachment-dialogue associations that we found when we used the AEED were obtained using the SRNCC and the JST. Children who were securely attached as infants were more likely to be partners in dyads classified as emotionally matched in the SRNCC (LR = 5.86, df = 1, p = .01) and as Mutual-Balanced in the JST (LR = 8.69, df = 1, p < .003; see Gini et al., 2007). These findings suggest that the associations we found between early attachment and later mother-child dialogues about past emotional experiences are not unique to such dialogues. Similar findings were obtained when other types of dialogues revolving around emotional themes were used. This does not suggest that there is nothing unique to each dialogue context. For example, the AEED involves biographical events and the SRNCC and JST involve hypothetical events. What we are suggesting is that when the focus is on the co-constructive dialogic process between parent and child, the specific and unique content of the dialogue appears less important and the more pervasive interactive patterns characterizing the mother-child dyad assume salience. This finding is perhaps analogous to the findings that the coherence of adult narratives about the past, much more than the specific content of the narrative, is indicative of security (Hesse, 1999).

Mother-Child Dialogues and Parental and Child Risk Status As discussed earlier, our interest in mother-child dialogues about distressing past events stemmed from an attachment perspective. Therefore, our first research goal was to examine the associations between such dialogues and attachment. However, mother-child emotion dialogues are 156

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not only interesting and important as outcomes of early attachment. As attachment theorists have argued, open, coherent, and emotionally regulated co-constructed dialogues are of importance because they are one of the prime arenas in which parents and children can form and maintain narratives about distressing experiences. Furthermore, when such narratives form a psychological secure base, they can contribute to children’s emotional and behavioral regulation, and vice versa: When such narratives form an insecure base, they are likely to be associated with emotional and behavioral dysregulation. Thus we would expect, for example, that children experiencing behavioral and emotional problems might have difficulties engaging in emotionally matched dialogues with their mothers, and that intervention may increase their capacity to engage in such dialogues. This was examined in our study of young children enrolled in a therapeutic preschool (Oppenheim et al., 2004). The sample of this study consisted of children manifesting high levels of behavioral and emotional symptoms. Many of the children had been expelled from several preschools and had a history of abuse and/ or exposure to violence. Many of the mothers were single and experienced multiple stressors involving poverty, physical and sexual abuse, and drug abuse. The intervention involved a therapeutic preschool program based on attachment principles and designed to enhance children’s feelings of security and their capacity to express their positive and negative emotions while challenging their negative expectations from others (Oppenheim et al., 2004; Goldsmith, 2007). In addition, mothers met with therapists to discuss parenting issues and strategies to support children’s therapeutic progress. As shown in table 6–2, in the AEED only 11% of the dyads showed emotionally matched dialogues prior to treatment, but 33% of the dyads showed such dialogues following 7 months of treatment, close to its termination. This increase was statistically significant (p < .05). The main improvements were in shifts from the Ex classification to the EM classification, indicating improved organization, emotional regulation, and coherence in the dialogues. There are limitations to this study: Because both children and mothers received intervention we do not know whether improvements in the mothers or improvements in the children led to the increase in the number of emotionally matched dialogues. And, because this study did not employ a control group we do not know if the improvements are a function of treatment or other factors. Nonetheless the results are consistent with our expectations that when the parentchild relationship is disturbed, such as when children experience significant behavioral and emotional disturbances, the capacity to engage in emotionally matched dialogues is very limited, and that with treatment this capacity improves. The association between children’s symptoms and Mother-Child Emotion Dialogues

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nonemotionally matched dialogues could be because children’s symptoms are an outcome of the disrupted communication patterns they have with their parents, because these symptoms interfere with engagement in a harmonious dialogue, or because disrupted communication maintains dysfunctional interactive patterns. Clearly more research is needed on mother-child dialogues as both indicators of disturbance and improvement and as one of the important mechanisms through which therapeutic gains may be achieved. For example, facilitation of emotionally open, coherent, and regulating mother-child dialogues is one of the goals of Lieberman’s Child-Parent Psychotherapy Model (Lieberman & Van Horn, 2005; Oppenheim, 2006). This study examined mother-child dialogues in the context of risk factors associated with the child. But what happens if the risk is associated with the parent? We examined this issue in a study of mothers in treatment for the sexual abuse they experienced as children (KorenKarie, Oppenheim, & Getzler-Yosef, 2008). The mothers were recruited from agencies specializing in the treatment of adults with a history of sexual abuse. They were observed in the AEED with one of their children, and in addition completed several questionnaires assessing the extent to which they have resolved the trauma they endured, their general psychiatric symptoms as well as symptoms of dissociation, intrusion, and avoidance of the trauma that are characteristic of many adults who have experienced trauma. As shown in Table 6–2, only 18% of the dyads showed emotionally matched dialogues. Without a control group it is not possible to determine whether this relatively low percentage is specific to dyads in which mothers experienced a history of trauma or whether this reflects clinical samples more generally. Nonetheless this finding coheres with the general notion that mother-child emotional dialogues are sensitive to the emotional functioning and well-being of both mother and child. While only a minority of the dyads showed emotionally matched dialogues these results indicated that there were nonetheless individual differences within this sample, with some dyads showing more optimal dialogues than others. Our next question was therefore which of the factors characterizing mothers’ emotional functioning and wellbeing would be associated with their dialogues with their children. Based on an attachment perspective, we focused on resolution of the trauma (Hesse & Main, 2000), which we measured using a self-report measure (Berkeley Leiden Adult Attachment Questionnaire; Main, van IJzendoorn, and Hesse, 1993) and expected that the effects of childhood trauma on later parenting would be moderated by processes of resolution. Thus, the impact of the trauma was expected to be less evident among mothers who were resolved with respect to the trauma and more evident among 158

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mothers who were unresolved. We could not use the AEED categories to examine this question because too few of the dialogues were classified as emotionally matched. We therefore formed three aggregate dialogue scores based on the AEED scales: These were based on the mean of the maternal, child, and narrative scales (see description of scales above), respectively, and were labeled Maternal Sensitive Guidance, Child Cooperation and Exploration, and Emotionally Coherent Narrative. The findings highlighted the importance of resolution, as hypothesized: Mothers who were more resolved guided the dialogues more sensitively, had children who were more cooperative and exploratory, and produced with their children narratives that were more emotionally coherent when compared with mothers who were less resolved. These results appeared specific to resolution of the trauma and were not explained by mothers’ symptomatology, dissociation, intrusion or avoidance, which were all unrelated to the AEED aggregates. Finally, various parameters related to the severity of the abuse such as its length, frequency, and age of onset were also unrelated to the AEED aggregates. These results support the significance of the AEED as a window into the parent-child relationship, particularly in terms of the capacity of both parent and child to negotiate difficult and distressing emotional themes. It seems that, when the parent brings a background of abuse and trauma, this may disrupt their capacity to engage in dialogues that promote security in the child, perhaps because negative emotional themes that come up in the discussion with the child trigger overwhelming painful traumatic memories from the past (Koren-Karie et al., 2004). The findings suggest that this transmission may take place in some, but not all cases: When mothers were resolved with respect to the trauma their functioning was less impaired. The resolution of the trauma may act as a buffer, helping mothers separate the present interactive context and its emotional demands from past experiences.

Future Research Directions Taken together, the research reviewed in this chapter suggests that the metaphor of a “psychological secure base” proved of much heuristic value for our understanding of the emotional significance of motherchild dialogues. The findings from the longitudinal studies including both low- and high-risk samples highlighted the importance of the dialogues that evolve between mothers and children when they discuss children’s memories of emotional events. Within this context, mothers’ sensitive guidance and structuring of the dialogues and children’s openness and cooperation while jointly negotiating the narrative emerged as Mother-Child Emotion Dialogues

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particularly meaningful. While the findings are encouraging, they leave many important questions open for future research. In the fi nal section of this chapter we discuss such research directions, particularly those in which the focus will be on mother-child dialogues, not only as outcomes of early developmental processes but also as antecedents of later developmental sequalae. We discuss two directions: The first involves the role of mother-child dialogues in children’s coping with stress and trauma, and the second involves the contribution of mother-child dialogues to children’s representations of attachment years later, in adulthood. A central hypothesis of attachment theory is that secure attachments act as buffers against stressors and traumas. The assumption is that like all children, securely attached children will experience distress and some level of dysregulation in response to a significant stressor or trauma. However, aided by their open emotional processing and communication and their trust in their caregivers, they are expected to cope more competently with the stress, use the resources available to them more effectively, and recover more quickly and fully when compared to children with insecure attachments (Fivush & Sales, 2006). Consequently, while the stress or trauma may remain part of their experience, the long-term adverse effects on their emotional well-being should be minimal. Based on this theorizing it would be interesting to link children’s capacity to engage in emotionally matched dialogues with their caregivers to their subsequent responses to stress or trauma. The hypothesis is that the psychological secure base offered by emotionally matched dialogues will provide the conditions for more optimal coping. One difficulty in designing studies that can test this hypothesis is that major stressors and traumas are by their nature unpredictable, and therefore it is very difficult to obtain assessments of children prior to the trauma or stressful event. A common research strategy has been to approach children after they have experienced the adverse event. The problem in such studies is that assessments of mother-child dialogues obtained following the event cannot be considered as antecedents: They are equally likely to reflect the way the mother and the child coped with the trauma as is the child’s response which they are supposed to explain. A different strategy for examining the importance of mother-child dialogues in promoting children’s coping involves intervention studies. If children who receive an intervention that focuses on enhancing emotionally matched dialogues with their mothers show gains in their emotional and behavioral regulation, this would provide support for the hypothesis regarding the causal role of such communication patterns in enhancing children’s effective coping. While studies of this kind have not yet been conducted, the Child-Parent Psychotherapy model developed by Lieberman (Lieberman & Van Horn, 2005) includes as a major 160

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component the development and encouragement of emotionally regulated, accepting, and security-building dialogues. This is particularly salient in Lieberman’s work with children who have witnessed domestic violence and other violent and extremely frightening parental behavior. Within Lieberman’s model one of the main goals of the intervention is to foster the co-construction of a narrative between the mothers and the children that would enable them both to talk about and accurately represent the terrifying events, while at the same time integrate them into a coherent and hopeful narrative. Beneficial narratives emphasize trust and open the way to the belief that the future will be better than the past. The impressive empirical evidence regarding the efficacy of Lieberman’s model (Lieberman, Ghosh-Ippen, & Van Horn, 2006) provides indirect support for the importance of mother-child dialogues in children’s coping. However, because the intervention includes additional components, it is not possible to attribute the positive outcomes obtained by Lieberman solely to the improvements in mother-child communication. A first step to support the role of the improvements in the narratives in the therapeutic gains made by the child would be to document that motherchild dialogues actually improved following treatment, as was found in Oppenheim et al. (2004). The second direction for future studies involves the role of parentchild dialogues as antecedents of the coherence of the child’s attachment representations assessed in adulthood. In other words, here we focus on the contribution of parent-child dialogues in childhood on the retrospective narrative the child produces years later, as an adult, regarding his or her childhood experience. Research on adults’ representations of attachment using the Adult Attachment Interview (AAI; Main, Kaplan, & Cassidy, 1985) has highlighted the coherence of the narrative produced by adults regarding their past experiences as the crucial marker of secure working models and as the major predictor of the adults’ capacity to provide a secure base for their offspring. While there is strong evidence for this link—that is, for the influence of the adults’ attachment representations on the child-parent relationship (van IJzendoorn, 1995)—we know little about the antecedents of these representations. A few longitudinal studies looked for the roots of adult representations in the attachment relationships the adults experienced when they were children, and some found moderate continuity in attachment across this time span (Waters, Weinfield, & Hamilton, 2000). Clearly, however, there is much room for both continuity and discontinuity between infancy and adulthood. One intervening process between these two time points could be parent-child dialogues. We focus on such dialogues because attachment representations are assessed in adulthood through the narratives produced by adults regarding their past histories, and thus it seems plausible that Mother-Child Emotion Dialogues

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the coherence and openness of early parent-child dialogues would be associated with the coherence and openness of later AAI narratives. Mother-child dialogues can serve as either mediators or moderators between early infant-mother attachment and later attachment representations. As mediators, early secure attachments can contribute to later emotionally matched dialogues, as was found in Oppenheim et al. (2007), which in turn may pave the way for the coherent independent narration of the child as an adult, such as the narration obtained in the AAI. Dialogues can also serve as moderating variables disrupting continuity both positively and negatively. Emotionally matched dialogues can act as buffers, limiting the effects of early insecure attachment and helping transform an insecure attachment into a secure attachment. The reverse may also be possible: Nonmatched dialogues may have a negative effect on adult attachment representations, limiting the positive effects of an early secure attachment relationship. While in most cases we are likely to see continuities across development, conditions of discontinuity such as these can highlight the significance of parent-child dialogues on the later capacity of adults to form an emotionally coherent life narrative.

References Ainsworth, M. D. S. (1989). Attachments beyond infancy. American Psychologist, 44, 709–716. Ainsworth, M. D. S., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum. Biringen, Z. (2000). Emotional availability: Conceptualization and research findings. American Journal of Orthopsychiatry, 70, 104–114. Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment. New York, NY: Basic Books. Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London, UK: Routledge. Bretherton, I. (1990). Open communication and internal working models: Their role in attachment relationships. In R. Thompson (Ed.), Socioemotional development. Nebraska Symposium on Motivation, 36, (pp. 57–113). Lincoln NE: University of Nebraska Press. Bretherton, I. (1993). From dialogue to representation: The intergenerational construction of self in relationships. In C. A. Nelson (Ed.), Minnesota Symposia on Child Psychology: Vol. 26. Memory and affect in development (pp. 237–263). Hillsdale, NJ: Erlbaum. Etzion-Carasso, A. (2004). The role of attachment security at 12 months in Goal Corrected Partnership during the preschool years. Unpublished doctoral dissertation, Department of Psychology, University of Haifa, Israel. Etzion-Carasso, A., & Oppenheim, D. (2000). Open mother-preschooler communication: Relations with early secure attachment. Attachment & Human Development, 2, 347–370. 162

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Farrar, M. J., Fasig, L. G., & Welch-Ross, M. K. (1997). Attachment and emotion in autobiographical memory development. Journal of Experimental Child Psychology, 67, 389–408. Fivush, R. (1991). The social construction of personal narratives. MerrillPalmer Quarterly, 37, 59–82. Fivush, R., Bohanek, J., Robertson, R., & Duke, M. (2004). Family narratives and the development of children’s well-being. In M. W. Pratt and B. H. Fiese (Eds.), Family stories and the life course: Across time and generations (pp. 55–76). Mahwah, NJ: Erlbaum. Fivush, R., Haden, C. A., & Reese, E. (2006). Elaborating on elaborations: Role of maternal reminiscing style in cognitive and socioemotional development. Child Development, 77, 1568–1588. Fivush, R., & Sales, J. M. (2006). Coping, attachment and mother-child narratives of stressful events. Merrill-Palmer Quarterly, 52, 125–150. Fivush, R., & Vasudeva, A. (2002). Remembering to relate: Social-emotional correlates of mother-child reminiscing. Journal of Cognition and Development, 3, 73–90. Ganor, G. (2005). Mother-child dialogues about emotions: Are they associated with positive therapeutic change in high risk population? Unpublished Masters Thesis, University of Haifa, Israel. Gini, M., Oppenheim, D., & Sagi-Schwartz, A. (2007). Negotiation styles in mother-child narrative co-construction in middle childhood: Associations with early attachment. International Journal of Behavioral Development. Goldsmith, D. F. (2007). Challenging children’s negative internal working models: Utilizing attachment based treatment strategies in a therapeutic preschool. In D. Oppenheim and D. F. Goldsmith (Eds.), Attachment theory in clinical work with children: Bridging the gap between research and practice (pp. 203–225). New York, NY: Guilford. Harris, P. L. (1999). Individual differences in understanding emotion: The role of attachment status and psychological discourse. Attachment & Human Development, 1, 307–324. Hesse, E. (1999). The adult attachment interview: Historical and current perspectives. In J. Cassidy and P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application. (pp. 395–433). New York, NY: Guilford Press. Hesse, E., & Main, M. (2000). Disorganized infant, child, and adult attachment: Collapse in behavioral and attentional strategies. Journal of the American Psychoanalytic Association, 48, 1097–1127. Klann-Delius, G., & Hofmeister, C. (1997). The development of communicative competence of securely and insecurely attached children in interactions with their mothers. Journal of Psycholinguistic Research, 26, 69–88. Koren-Karie, N., Oppenheim, D., & Getzler, R. (2004). Mothers who were severely abused during childhood and their children talk about emotions: Co-construction of joint narratives in light of maternal trauma. Infant Mental Health Journal, 25, 300–317. Koren-Karie, N., Oppenheim, D., Haimovich, Z., & Etzion-Carasso, A. (2000). Autobiographical emotional event dialogues: Classification and scoring system. Unpublished manual, University of Haifa, Haifa, Israel. Koren-Karie, N., Oppenheim, D., Haimovich, Z., & Etzion-Carasso, A. (2003). Dialogues of seven-year-olds with their mothers about emotional Mother-Child Emotion Dialogues

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events: Development of a typology. In R. N. Emde, D. P. Wolf, and D. Oppenheim (Eds.), Revealing the inner worlds of young children: The MacArthur Story Stem battery and parent-child narratives (pp. 338–354). New York, NY: Oxford University Press. Koren-Karie, N., Oppenheim, D., & Getzler-Yosef, R. (2008). Shaping children’s internal working models through mother-child dialogues: The importance of resolving past maternal trauma. Attachment and Human Development, 4, 465–483 Laible, D. J., & Thompson, R. A. (2000). Mother-child discourse, attachment security, shared positive affect, and early conscience development. Child Development, 71, 1424–1440. Lieberman, A. F., Van Horn, P. (2005). Don’t hit my mommy. Washington, DC: Zero to Three Press. Lieberman, A. F., Van Horn, P. J., & Ghosh Ippen, C. (2005). Toward evidence based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1241–1248. Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. In J. Cassidy and P. Shaver, (Eds.), Handbook of attachment: Theory, research and clinical applications. (pp. 520–554). New York, NY: The Guilford Press. Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood and adulthood: A move to the level of representations. In I. Bretherton & E. Waters (Eds.), Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50, (1–2, Serial No. 209), 66–104. Marvin, R. S. & Britner, P. A. (1999). Normative development: The ontogeny of attachment. In J. Cassidy and P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 44–67). New York, NY: Guilford. Matas, L., Arend, R. A., & Sroufe, L. A. (1978). Continuity of adaptation in the second year: The relationship between quality of attachment and later competence. Child Development, 49, 547–556. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social cultural developmental theory. Psychological Review, 111, 486–511. Oppenheim, D. (2006). Child, parent, and parent-child emotion narratives: Implications for Developmental Psychopathology. Development and Psychopathology, 18, 771–790. Oppenheim, D., Goldsmith, D., & Koren-Karie, N. (2004). Maternal insightfulness and preschoolers’ emotion and behavior problems: Reciprocal influences in a day-treatment program. Infant Mental Health Journal, 25, 352–367. Oppenheim, D. & Koren-Karie, N. (2002). Mothers’ insightfulness regarding their children’s internal worlds: The capacity underlying secure childmother relationships. Infant Mental Health Journal, 23, 593–605. Oppenheim, D., Koren-Karie, N., & Sagi-Schwartz, A. (2007). Emotion dialogues between mothers and children at 4.5 and 7.5 years: Relations with children’s attachment at 1 year. Child Development. 78, 38–52.

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Oppenheim, D., Nir, A., Warren, S., & Emde, R. N. (1997). Emotion regulation in mother-child narrative co-construction: Associations with children’s narrative and adaptation. Developmental Psychology, 33, 284–294. Oppenheim, D., & Waters, H. A. (1995). Narrative processes and attachment representations: Issues of development and assessment. In E. Waters, B. E. Vaughn, G. Posada & K. Kondo-Ikemura (Eds.), Caregiving, cultural, and cognitive perspectives on secure-base behavior and working models: New growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 60, 197–215. Reese, E., Haden, C., & Fivush, R. (1993). Mother-child conversations about the past: Relationships of style and memory over time. Cognitive Development, 8, 403–430. Samish-Nemlich, T. (2003). Mothers and their preschool children talk about autobiographical emotional events: Is there stability over a one-year period? Unpublished MA thesis, School of Social Work, University of Haifa, Haifa, Israel. Segal, Y. (2007). Perceived parenting style and emotional communication: Associations with conflict among adolescent girls and their mothers. Unpublished Master’s thesis, Department of Psychology, University of Haifa, Israel. Strage, A., & Main, M. (1985). Attachment and parent-child discourse patterns. Presented at the biennial meeting of the Society for Research in Child Development, Toronto. Thompson, R. A. (2000). The legacy of early attachments. Child Development, 71, 145–152. van IJzendoorn, M. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 117, 387–403. Waters, E. & Cummings, E. M. (2000). A secure base from which to explore close relationships. Child Development, 71, 164–172. Waters, E., Weinfield, N., & Hamilton, C. E. (2000). The stability of attachment security from infancy to adolescence and early adulthood: General discussion. Child Development, 71, 703–706. Wolf, D. P. (2003). Making meaning from emotional experience in early narratives. In R. N. Emde, D. P. Wolf, and D. Oppenheim (Eds.), Revealing the inner worlds of young children: The MacArthur Story Stem battery and parent-child narratives (pp. 27–54). New York, NY: Oxford University Press.

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7 Mother-Child Reminiscing in the Context of Secure Attachment Relationships Lessons in Understanding and Coping with Negative Emotions Deborah Laible Tia Panfile

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oung children’s ability to cope with the negative emotion inherent in any stressful situation is likely intimately related to their ability to understand negative emotion. A number of researchers have argued for the idea that emotional understanding and knowledge is especially important in children’s ability to regulate emotion (Denham, l998; Stegge & Terwogt, 2007). Children who have more knowledge about negative emotion, including understanding its causes and consequences and understanding strategies to cope with it, are likely more successful in regulating their own negative emotion both during and after stressful situations. Unfortunately, very little research has examined children’s understanding of and coping with negative emotion in the context of either mildly stressful situations, such as trips to the doctor to get shots, or during more stressful situations, such as hurricanes or trips to the emergency room. Fortunately, however, the body of research looking at factors contributing to children’s understanding and regulation of emotion independent of stressful contexts is rich, and there are good reasons to believe that this literature can help inform us on children’s understanding of emotion during stressful encounters.

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As a result, the goals of this chapter are to briefly review the literature that focuses on the development of emotional understanding in children, particularly their understanding of negative emotion, and to provide insight into how children cope with negative emotion during and after stressful experiences. Much of this work supports the importance of early family experiences for shaping children’s developing ability to understand and regulate negative emotion, and one avenue in particular through which children gain emotional understanding is via parents’ discussions of emotion with their children. Such discussions help children understand the causes and consequences of negative emotion, as well as provide children with strategies to cope with negative emotion. In this chapter, we argue that discussions about children’s past negative emotions in particular have important consequences for children’s ability to understand and cope with negative emotion. Ultimately, parentchild reminiscing about children’s past stressful (and negative emotional) experiences has implications for how children understand and remember stressful events after the fact, as well as how they cope with future stressful experiences. By talking with children about their past negative emotional experiences, parents are giving the children the psychological insight they need to understand the emotions involved in the event and are providing them with coping strategies on how to manage negative emotions in the future. The chapter is organized as follows. We open with a brief discussion of children’s emotional understanding and its likely importance for children’s ability to cope with negative emotion both during and after stressful experiences. We then highlight the importance of parent-child discourse, particularly parent-child reminiscing, for fostering children’s understanding of negative emotion, and we review recent research on this topic. Next, we turn to a discussion of attachment theory in an attempt to understand individual differences in the quality of parent-child communication surrounding emotional and stressful experiences. We highlight the research that suggests that having a secure attachment facilitates open communication between caregivers and children, especially regarding difficult or negative experiences. Finally, we discuss the importance of open, high-quality mother-child reminiscing for promoting children’s understanding of stressful experiences as well as their psychological well-being.

Coping with and Understanding Negative Emotion: The Role of Parent-Child Discourse Children’s ability to cope with stressful events likely buffers them against the negative effects that stressful events can have on psychological

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adjustment and well-being. Researchers have argued that coping involves children’s ability to regulate their thoughts, emotions, and behaviors in response to stressful events (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001). Researchers have also argued for the centrality of emotion in coping with stressful events (e.g., Skinner & ZimmerGembeck, 2007). Although coping involves a number of important skills (e.g., the ability to cognitively reappraise situations or seek support), emotion regulation is considered to be one important component of coping (Bridges & Grolnick, 1995; Eisenberg, Fabes, & Guthrie, 1997). Emotion regulation has been defined as consisting “of the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one’s goals” (Thompson, 1991, pp. 27–28). Research suggests that there are remarkable individual differences in children’s ability to regulate emotion and that these differences have been linked with children’s well-being and adjustment. Young children who are good emotion regulators are socially competent, while those who are poor regulators are at risk for adjustment problems, including externalizing and internalizing behavior (Rydell, Thorell, & Bohlin, 2008; Shields & Cicchetti, 1998; Spinrad, Eisenberg, Cumberland, Fabes, Valiente, Shepard, Reiser, Losoya, & Guthrie, 2006). Successful emotion regulation involves a number of important skills that are closely connected to emotional understanding, including the ability to adequately process emotionaly laden information; to monitor, reflect upon, and understand one’s own emotional states; to access past experiences that inform adaptation in the current situation; and to successfully generate and implement emotion regulation strategies (Saarni, 1999; Stegge & Terwogt, 2007; Wranik, Barret, & Salovey, 2007). These types of sophisticated emotion understanding skills do not develop until the preschool years (and beyond), which helps explain why, prior to the advent of emotional knowledge, children often struggle with emotion regulation. Thus, prior to the preschool years, when emotional understanding and regulation develop, young children are often primarily dependent upon the direct interventions of caregivers to regulate emotion (Thompson & Meyer, 2007). With the advent of some degree of emotional knowledge, however, including the ability to understand, label, and discuss emotion, as well as understanding the causes and consequences of emotion, preschool children gradually take greater responsibility for regulating their own emotional expressions. As their emotional knowledge improves, so too does their ability to control and modify their emotional expressions (Saarni, 1999). Young children’s development of emotional understanding involves both an understanding of emotions that are experienced by the self and 168

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an understanding of emotions experienced by others (Harris & Saarni, 1989). Throughout the preschool years, children make enormous strides in emotional understanding, including their abilities to understand and label their own emotions and those of others, and in their ability to generate and enact strategies of emotion regulation (Stein & Levine, 1999; Thompson & Lagattuta, 2006). Although original theories of the acquisition of emotional understanding suggested that children acquire a selfunderstanding of their own emotions first through self-observation and then extrapolate that understanding onto others’ emotional expressions and awareness (see e.g., Harris & Olthof, 1982; Smiley & Huttenlocher, 1989), modern theories emphasize children’s predispositions toward social interaction and suggest that children gather important information about emotion and how to cope with emotion through interacting with social partners and observing these individuals’ displays of emotion (Denham, Mitchell-Copeland, Strandberg, Auerbach, & Blair, 1997; Thompson & Lagattuta, 2006). Although there is little doubt that children become attuned to the emotional experiences in their world, this readiness to learn about emotion is complemented by extensive learning opportunities within the context of close relationships in the family. Children’s experiences within the family involve rich exposure to emotion, and as a result, it seems likely that the emotion expressed in these relationships impacts young children’s growing understanding of emotion (Halberstadt, Crisp, & Eaton, 2003; Halberstadt & Eaton, 2002). Overall, family life provides children with a variety of affective experiences on which to base their developing understanding of emotions, especially the role that emotion plays in human relationships. For example, the relationship between the parent and the child is inherently emotional and evokes both strong positive and negative emotions on the behalf of both partners in the relationship (Dix, 1991). Beyond the intense emotion that children are exposed to in their primary attachment relationships, children are also frequent witnesses to the emotion inherent in other significant family relationships (e.g., in the marital and parent-sibling relationships) (Papp, Cummings, & GoekeMorey, 2002). Lastly, children are frequently exposed to the spontaneous displays of emotion from family members as a result of the everyday frustrations and joys of life (Halberstadt, 1991). Similarly, conversations with caregivers are also an important arena in which young children learn about emotions (Brown & Dunn, 1996; Denham, 1992; Denham, Zoller, & Couchoud, 1994). Within the context of everyday discourse, parents help clarify the aspects of relational experiences that are not always visible and are often confusing for young children; these aspects often involve emotion (Thompson, Laible, & Ontai, 2003). Indeed, conversations between mothers and toddlers about Mother-Child Reminiscing

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emotion begin early in development and continue throughout the preschool years (Dunn, Brown, & Beardsall, 1991; Capatides & Bloom, 1993; Beeghly, Bretheron, & Mervis, 1986). By talking about emotion with young children, parents can elucidate the causes and consequences of emotion, which are important components of emotional understanding (Eisenberg, Cumberland, & Spinrad, 1998). Therefore, it is not surprising that individual differences in the amount of emotional discourse between mothers and children appear to have important consequences for children’s understanding of emotion (Brown & Dunn, 1996; Dunn et al., 1991; Denham et al., 1994). Early in the preschool years, young children struggle in particular with understanding and regulating negative emotion (Laible & Thompson, 1998). As a result, conversations about negative emotion might be especially influential in helping children differentiate between the varieties of negative emotion and manage their consequences. In fact, research has supported the idea that discourse about negative emotion between caregivers and children is especially rich, particularly when compared to discourse regarding positive emotion. For example, talk about negative emotion involves more frequent discussion of the causes of emotions, more talk about other people and mental states, and more sophisticated linguistic skills (Lagattuta & Wellman, 2002; Hudson, Gebelt, Haviland, & Bentivegna, 1992; Hughes & Dunn, 1999). It is probably not surprising that discourse about negative emotion is more complex than discourse about positive emotion between caregivers and young children, given the fact that young children (and their caregivers) are often struggling to manage and make sense of the negative or problematic emotions. In addition, a number of researchers have argued and found empirical support for the idea that parents who coach children in how to deal with negative affect in the context of discourse have children who are more emotionally competent (Gottman, Katz, & Hooven, 1996; Ramsden & Hubbard, 2002). Emotion coaching involves not only parents being aware of the negative emotion that their children experience, but also parents being willing to validate, label, openly discuss and problem-solve with their children about how to deal with negative emotion (Gottman et al., 1996). Thus, children whose parents are willing to directly coach them on how to cope with negative emotion acquire scripts on how to manage and handle negative emotions (Dunsmore & Halberstadt, 1997). Parents who are more dismissing of their children’s negative emotional experience (by either ignoring it or denying it) miss important opportunities to help their children learn to cope with negative emotions. Although parents do discuss negative emotions with their children as these emotions occur, there are reasons to believe that the discussion of children’s past negative emotional experiences in particular might 170

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be especially important for children’s developing ability to understand and regulate negative affect. That is, discussions of negative emotions that occur “on line” as a child is actually experiencing negative emotion are likely problematic in promoting understanding. For one, when a child is experiencing strong negative emotion, many of the child’s cognitive resources are occupied with regulating and managing the emotion (Thompson, 1990). As a result, the child’s negative affect may interfere with his or her processing of any parental messages conveyed in the context of these discussions (Laible & Thompson, 2000). Second, when confronted with a child’s negative emotions, a caregiver may not feel willing or able to engage in complex or elaborative discussions with the child over emotion. Instead, parents are probably more concerned with immediately managing their children’s negative emotion (e.g., through comforting the children) than necessarily teaching the children about emotion. As a result, discussions about the child’s negative emotions after the fact, when the child’s negative emotions have dissipated, may prove more fruitful for promoting the child’s understanding of emotions than conversations that occur as the child experiences negative emotion (Laible & Thompson, 2000). By discussing the child’s experiences with negative emotion, for example, later in the day and after the child’s negative emotions have dissipated, a child is more likely to have the cognitive resources to reflect upon and appropriate the parental messages that are conveyed in the context of reminiscing. In addition, reminiscing about the child’s prior negative emotion might also be especially potent for promoting the child’s emotional understanding because of the links that reminiscing shares with the development of autobiographical memories and self-concept (Fivush, 1998; Fivush & Haden, 1997). Reminiscing is believed to shape a child’s self-concept because it helps to shape memories of personal experiences. Thus, by discussing the child’s past emotional experiences, parents help to shape a child’s developing emotional self-concept, including their emotional self-definition (e.g., “I am mostly a happy child”) and the role that the child’s emotion plays in influencing others (e.g., “When I am angry, mom is also upset”) (Fivush et al., 2003). Conversational stories about shared past experiences start as soon as children are capable of producing language and these conversations are inherently social (Reese, 2002; Fivush & Vasudeva, 2002; Laible & Song, 2006). Initially, parents provide the narrative structure for these past-event conversations and direct these conversations (Hudson, 1990; Fivush, 1993; Nelson, 1996). Preschool children, however, ultimately internalize the narrative structure of these early conversations and use that structure both to recall their memories of personal experiences and Mother-Child Reminiscing

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to guide their subsequent conversations about past events with caregivers and others (Farrar, Fasig, & Welch-Ross, 1997; Nelson, 1996). Through these shared conversations with caregivers, children are learning how to discuss and evaluate their past experiences, including those that were emotional in nature (Miller, Potts, Fung, Hoogstra, & Mintz, 1990; see also Sales and Oppenheim & Koren-Karie, this volume). Specifically, these reminiscing conversations are one important arena in which children learn to evaluate and think about their past emotional experiences. Research has suggested that mothers and children frequently discuss emotional issues when talking about the past (Fivush & Vasudeva, 2002). In addition, researchers have found evidence that reminiscing about negative emotional experiences between parents and children is actually more frequent than reminiscing about positive emotional experiences (Fivush, 1991; Lagattuta & Wellman, 2002), supporting the idea that children and parents are especially concerned with making sense of children’s past negative emotional experiences. Furthermore, when discussing children’s past emotional experiences, mothers are also concerned with helping children resolve their previous negative emotions, especially those that involved distress and fear (Fivush et al., 2003). Finally, mothers appear concerned with making sure that children understand the causes of their negative emotions in the context of reminiscing conversations that involve negative emotion (Fivush et al., 2003). Despite these general trends, there are differences in the way that parents reminisce about past experiences with their children (including differences in the style and content of the parent-child discourse), and these differences have consequences for a child’s emotional and cognitive development. First, researchers have discovered that mothers vary in the richness of background detail that they use when discussing the past with their children (Hudson, 1990; Fivush & Fromhoff, 1988; Reese, Haden, & Fivush, 1993; Reese & Fivush, 1993). Elaborative mothers tend to provide rich detail about the event being discussed and tend to ask numerous complex, open-ended questions of their children when discussing the past. In contrast, repetitive mothers tend to add little background to the event discussed and tend to ask many repetitive “yes/no” types of questions. Research suggests that children of elaborative mothers have more detailed memories of their past experiences than those of repetitive mothers (Hudson, 1990; Reese, Haden, & Fivush, 1993; Reese & Fivush, 1993). It seems likely, therefore, that having an elaborative mother helps children form strong secondary representations of their past experiences (including past emotional experiences). These secondary representations are representations of experiences that are not formed through direct experience, but instead are created after the experience itself (e.g., through discourse or reflection) (Thompson, Laible, & Ontai, 172

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2003). These secondary representations, in turn, promote children’s reflection upon and understanding of their past experiences. Second, mothers also seem to vary with regards to both the amount and the way that emotion is discussed during reminiscing (Fivush et al., 2003; Laible & Song, 2006; Laible, 2004), and these differences also appear to have consequences for a child’s current emotional and relational understanding. For instance, in early reminiscing conversations, it is primarily the parents who raise the discussion of emotion, as well as the causes, consequences, and resolution of emotion (Laible, 2004; 2007). Although children discuss emotion when it is raised, they seldom initiate the discussion of emotion in the context of a reminiscing conversation (Laible, 2004). Thus, parents are ultimately responsible for raising the discussion of emotion during reminiscing. Mothers who are willing to raise emotion (and to discuss its causes and consequences) in the context of reminiscing can help to clarify their children’s emotions (and those of others) during the shared event. In contrast, mothers who avoid or restrict their discussion of emotion during reminiscing likely do little to promote children’s understanding of their past emotional experiences or to shape their children’s emotional self-concept. Such discussion between secure children and their mothers not only promotes children’s understanding of their own emotional experiences, but also likely promotes children’s development of affective perspective taking, especially when confronted with divergent perspectives (Laible & Song, 2006; Thompson et al., 2003). In the end, no empirical research has been done that examines how mother-child reminiscing about moderately or severely stressful events relates to children’s understanding of those events. However, there are several good reasons to believe that our research can help to inform the literature on the benefits of reminiscing about moderately stressful events. First, for young children (who are not yet proficient regulators of emotion), most experiences that involve negative emotion also involve some degree of stress. Thus, the negative event conversations that we have collected in our lab across the years surround at a minimum mildly stressful experiences for children. Second, although we did not ask mothers specifically to discuss moderately stressful events with their children in any of the studies (e.g., trips to the doctor to get shots), these types of conversations frequently emerged in our research. Consider the following example of a reminiscing conversation between a four-year-old daughter and her mother that emerged from a recent study (Laible, Panfile, & Eye, 2008): Mother: Do you remember last week when we went for ice cream with Daddy? We went in Mommy’s old car, Mommy’s white car, and you climbed up on a what? Mother-Child Reminiscing

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Daughter: Picnic table. Mother: Picnic table, and what happened? Daughter: Fell boom. Mother: You fell boom. Daughter: Yeah. Mother: And where did we go? Daughter: To the doctor’s. Mother: We didn’t actually go to the doctor’s office. We went to the what? Daughter: The hospital. Mother: The hospital. Daughter: Did they have to keep me? Mother: No. And what did they do? They took you into a room. Daddy went in with you and they took a what? Daughter: What? Mother: Do you remember what it was called? When they took a picture of your head, do you remember what they said it was called? An X . . . Daughter: Ray. Mother: An x-ray, and did they tell you to smile when they took your picture? Well, and um, after they took a picture, then what happened? The doctor looked at the picture to see if there was anything wrong, right? Daughter: And then he said that I’m all done. Mother: You’re all done, and what did the man at the x-ray place give you? Daughter: Ummm. Mother: Two things. Daughter: Um, he said that I have to um, I have a confession and . . . Mother: You have a what? Say it louder. Daughter: That I have a confession. Mother: You have a confession? Daughter: Yeah. Mother: Well how about this, it’s a concussion. That means you hit you head really bad. Now did they give you . . . . oh, what color was the medicine at the hospital? Daughter: Um, orange. Mother: Orange, very good, and was it a doctor or was it a lady nurse that gave you the medicine? Daughter: Um, a doctor. Mother: No, who came in and gave you the orange medicine? Daughter: A lady. Mother: (nods) Daughter: What’s her name? Mother: I don’t remember. She was just a nurse, and when you fell what did you do? Did you laugh? Daughter: (distracted by pillow in the room) Mother: Emily, come on. I’m trying to talk to you. Did you laugh when you fell, or what happened? Daughter: I um, I cried. Mother: You cried? Did you cry a lot? 174

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Daughter: Yep. Mother: Yeah, you were pretty sad. Were you scared? Daughter: Yeah. Mother: Yeah? What were you scared of? Daughter: Of the big booboo. Mother: You were scared of the booboo? Were you scared to go to the hospital? Daughter: (nods) Mother: What were you afraid of? Daughter: To go to the hospital. Mother: But you knew that Mommy and Daddy were going to stay with you, right? And that we wouldn’t leave you, right? Daughter: (nods)

In this reminiscing conversation, the mother is able to help the child not only understand a fairly traumatic event—a trip to the emergency room—but also help clarify the child’s emotional experience during the event (i.e., that the girl was as scared of being at the hospital as she was sad about hitting her head). In addition, the mother confirms the child’s negative emotions as valid (e.g., “yeah, you were pretty sad”) and attempts to resolve the child’s negative emotional experience by reassuring her that her mother and father would not leave her alone in the hospital. It seems likely that the mother’s willingness to acknowledge her daughter’s feelings as legitimate contributes to her daughter’s willingness to remain engaged in the conversation and to process maternal messages conveyed in this context. In addition, because these stressful events are relatively noteworthy, these types of events are discussed frequently by children and their caregivers. Across time, these conversations shape the children’s memory of the events and their understanding of their own emotions and those of others involved in the events. It also seems likely that these children might appropriate messages from parents (e.g., “mommy and daddy wouldn’t leave you”) that may assist with their future coping in similar stressful situations. Thus, it is not surprising that our lab has also found that it is often the open discussion of negative emotion by the dyad in the context of reminiscing that relates to the children’s level of emotional understanding (Laible, 2007). By openly discussing negative emotion in the context of reminiscing (as this mother did), mothers are helping children to cope with and understand their past negative emotional experiences, especially in the context of highly stressful situations where negative emotions are particularly overwhelming.

Summary Most modern theories of coping ultimately see emotion regulation as central to the coping process (Skinner, & Zimmer-Gembeck, 2007). Mother-Child Reminiscing

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Although numerous factors likely relate to children’s ability to cope with negative emotions in stressful events, a number of researchers have suggested that children learn about emotion, including strategies to regulate it, within the context of the family. Ultimately, children learn about emotion, not only by observing the displays of emotion that are an inherent part of family life, but also through conversing with caregivers about emotion. These conversations are especially influential in helping children to understand and regulate negative emotions, which are particularly confusing to young children. In addition, conversations about negative emotion after the fact may be more powerful in socializing emotional understanding than those that occur during the stressful event itself. In the context of a stressful event (or an event that involves negative emotion), a child’s ability to process and attend to maternal messages is likely impaired by the presence of the child’s own negative affect. Conversations about emotion after the fact, however, once the child’s negative emotions have dissipated, likely promote the child’s reflective thinking and understanding of the event itself. Thus, the parent’s ability and willingness to openly discuss the child’s past stressful experiences with him/her ultimately influences his/her ability to both understand and regulate negative emotion and to cope with future stressful events.

Attachment Theory and Links with Open Communication Attachment theorists have long argued that close relationships with parents are foundational in children’s development of emotional competence and their ability to regulate negative emotion. Attachment theory, which was originally developed to explain the bond between infants and their caregivers, has become an important theory to explain the lasting influence of close relationships on an individual’s social and emotional development. The basic premise of attachment theory is that children’s experiences with the emotional availability of caregivers in their lives shape their feelings of felt security and trust in other people (Bowlby, 1980). As a result of their early experiences with sensitive or insensitive caregivers, children construct internal working models of themselves, others, and relationships, which they use to guide their expectations in subsequent close relationships (Bretherton, 1990). Children whose caregivers have been emotionally responsive, especially when children are distressed, construct positive internal working models of the self as worthy, others as trusting, and relationships as worthwhile and important. Conversely, children with a history of caregiver insensitivity are presumed to construct internal working models of the self as unworthy, others as not trustworthy, and relationships as threatening or negative. 176

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According to Bowlby (1980), internal working models are consolidated over time and not only guide children’s expectations regarding their caregivers’ future behavior, but also their self-referential beliefs, expectations for close relationships, and their beliefs about other people’s intentions and motives (Bowlby, 1980; 1988). These models provide the bridge between early experiences with sensitive or insensitive care and subsequent sociopersonality development (Thompson et al., 2003). Internal working models contribute to feelings of security (or insecurity) and affect how children respond to their caregivers (and other significant relational partners in their lives) in situations of distress, stress, or uncertainty. Over time, these internal working models become interpretative filters by which children reconstruct new relational experiences in ways that are consistent with their past experiences and internal working models. Because internal working models also contain implicit (or unconscious) rules for relating to others, internal working models also influence children’s approach to other significant relationships (e.g., peer relationships). For example, secure children respond to others with warmth and affection and, as a result, receive from others a similar response that further confi rms their positive expectations of others. In contrast, insecure children respond to others with distance or unfriendliness, which in turn, causes others to respond with similar disinterest or negativity. This serves to confirm the negative relational expectations that insecure children are presumed to have. There is growing recognition that the preschool years might be an especially important time for the development of these internal working models, due in part to the cognitive and representational advances that come with children’s increasing ability to use language (Thompson et al., 2003). Children’s growing language sophistication allows for them not only to reflect upon and remember their past experiences, but also to discuss their past experiences with caregivers, siblings, and others. As a result, children’s internal working models are likely shaped by direct experiences with the quality of parental care and thus primary representations of those events, as well as by children’s secondary representations of these attachment-related events created in the context of conversations with others (Thompson et al., 2003). Thus, discourse with others not only shapes children’s memories of early attachment experiences with parents, but also their understanding of those experiences, as children are able to reflect upon their previous experiences with the assistance and insight of caregivers during these shared conversations. As Bretherton (1990, 1991) has argued, children’s internal working models of attachment relationships are shaped by the quality of communication between the caregivers and their children about attachment related issues. The internal working models of secure children are shaped by Mother-Child Reminiscing

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open, fluent, and candid conversations of feelings in the context of trusting relationships. In contrast, insecure relationships are characterized by limited emotional sharing, particularly emotions that either partner finds disturbing (especially negative emotions), which are frequently defensively excluded from internal working models. A number of attachment theorists have argued that one central feature of a secure attachment relationship is open communication (Bowlby, 1980; Bretherton, 1990; Etzion-Carraso & Oppenheim, 2000). Open communication between a parent and child is assumed to involve the open sharing and discussion of emotion, especially when discussing issues related to the relationship. This open sharing is presumed to begin in infancy. Mothers of secure children are sensitive and are aware of their infants’ emotional signals, interpret these signals correctly, and respond to them appropriately (Ainsworth, Bell, & Stayton, 1974). As a result, secure infants develop the expectation that their emotional signals will be responded to sensitively and therefore feel free to share and express their emotions, including those that are negative, with their caregivers (Cassidy, 1994). Infants who are insecurely attached, in contrast, are more likely to mask or restrict their range of emotional expressiveness, because they lack the expectation that their caregivers will respond appropriately to their signals of distress. Research has generally supported the idea that at least one group of insecure infants and children in particular (i.e., avoidant children) mask negative emotions when interacting with mothers and others (Malatesta, Culver, Tesman, & Shepard, 1989; Spangler & Grossmann, 1993). Beyond infancy, openness of verbal communication with caregivers appears to be critical in distinguishing between securely and insecurely attached children. For example, early research by Main, Kaplan, & Cassidy (1985) found that secure preschool children and their parents communicated more openly following a brief separation. Securely attached dyads were not only more fluent in their discourse than insecure dyads, but the former also tended to discuss a wider range of topics with each other. In contrast, insecurely attached dyads were both more restricted in their discourse with mothers during the reunion and often tended to avoid personal topics. Similarly, Main (1995) reported an observational study in which children who were securely attached in infancy had communication patterns at age six that were fluent and balanced with caregivers. Insecure dyads were less fluent in their discourse (involving more pauses between conversational turns), had conversations that were mother-dominated, and tended to avoid interpersonal topics. More recent research by Etzion-Carasso & Oppenheim (2000) has replicated the results of these two studies, but only for boys. Mothers of secure boys in Etzion-Carasso & Oppenheim’s (2000) study were more 178

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likely to follow the children’s lead in conversations that occurred after a separation and were more likely to center their conversations on exploring related topics. Insecure-disorganized children of both genders showed particularly poor dyadic communication following the separation. However, links between other insecure attachment patterns and communication in this study were lacking. Research has also revealed links between mother-child reminiscing and children’s attachment security. Farrar, Fasig, & Welch-Ross (1997) found that mothers and secure daughters were more likely to have a balanced discussion of emotion during reminiscing conversations, raising and discussing both positive and negative emotional themes. Specifically, once negative themes were raised in the context of reminiscing, secure mother-daughter dyads were more likely to explore these emotions, whereas insecure mother-child dyads were more likely to drop the conversation. By integrating the discussion of both positive and negative emotional themes during reminiscing, secure mothers are likely to help their children explore and cope with a wide range of emotions. Such openness of secure mother-child dyads to explore both negative and positive emotional themes likely enhances the child’s willingness to broach and discuss any emotional topic with caregivers. In addition, our own lab has found consistent links between attachment and the quality of mother-child reminiscing (Laible & Thompson, 2000; Laible, 2004; Laible & Song, 2006; Laible, 2007). That is, across multiple reminiscing contexts (including the discussion of the child’s past positive and negative emotional experiences), our lab, like several others (Reese, 2002; Fivush & Vasudeva, 2002), has found that mothers of secure children are more elaborative with their children than mothers of insecure children. In particular, we have found that the link between maternal elaboration and attachment security is especially strong for conversations involving the child’s past negative emotional experiences (Laible, 2007). Overall, these patterns of findings suggest that, when reminiscing about children’s past emotional experiences, mothers of secure children are more likely to be elaborative with them, providing them with rich background details about the event discussed and asking them rich open-ended questions about their past emotional experiences. Mothers of insecure children are more repetitive in their narrative style with their children and seem less willing to openly explore their children’s past emotional experiences in any depth, especially past negative experiences. Findings from our studies further suggest that the unwillingness by insecure mothers to explore emotional themes in any depth in reminiscing with young children has important consequences for children’s development of emotional and relational understanding. In several of our Mother-Child Reminiscing

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studies (Laible, 2004; Laible & Song, 2006), children’s level of emotional understanding and their representations of relationships were linked with maternal narrative style. Mothers who were highly elaborative when reminiscing with their preschool children about their past emotional experiences had children who showed higher levels of emotional understanding and who were more likely to depict prosocial representations of relationships in a doll story completion task designed to tap children’s social schemes. By elaborating on their children’s past emotional experiences, mothers do several important things that influence children’s developing emotional and relational schemes. First, maternal elaboration likely creates a warm interpersonal atmosphere that increases children’s willingness to process and internalize parental messages about emotion conveyed in the context of reminiscing (Laible & Thompson, 2000). This warm interpersonal atmosphere also facilitates children’s construction of prosocial representations of relationships (Laible & Song, 2006). Second, maternal elaboration (as already mentioned) helps children to create strong secondary representations of their past emotional experiences and these strong secondary representations give children more to draw on in their current understanding of emotions and relationships. Third and finally, it is important to note that, just like Farrar et al. (1997), we have found that maternal discussion of emotion in the context of reminiscing varies depending on the attachment security of the child. In particular, mothers of secure children appear more willing to openly discuss negative emotions with their children in the context of reminiscing (Laible, 2004; Laible 2007). Not only do mothers of secure children make more frequent references to negative emotion in the context of reminiscing (Laible, 2004), but these mothers are also more likely to discuss negative emotion in more sophisticated ways than mothers of insecure children (Laible, 2007). In fact, in a recent study, we found that mothers of secure children were more likely to discuss the causes of negative emotion and to confi rm their children’s negative emotional experiences (e.g., “yes, you were sad”) than mothers of insecure children (Laible, 2007). Confirming the child’s negative emotional experiences seems especially important in promoting the child’s willingness to explore topics that would otherwise be threatening to discuss. Interestingly, we have found fewer links between attachment security and dyadic discussion of positive emotions in the context of reminiscing than links between attachment security and discussion of negative emotions. This is probably not surprising given that positive emotional experiences are relatively easy and nonthreatening for both insecure and secure mother-child dyads to discuss. Surprisingly, little work has examined maternal attachment style and mothers’ ability to communicate effectively with their children beyond 180

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infancy. The work done with adult attachment patterns and emotional communication with infants, however, is roughly similar to the work done with strange situation classifications and infant communication and provides relevant insight. Mothers who are securely attached in the Adult Attachment Interview (AAI) have been shown to be more responsive to a wide range of infant emotions, more accepting of their infants’ negative emotions, and more likely to help their infants with emotion regulation than mothers who were insecure in the AAI (Crandell, Fitzgerald, & Whipple, 1997; Haft & Slade, 1989). Mothers who have been classified as dismissing in the AAI are less likely to express the full range of emotions with their infants and more likely to withdraw when their own infants express negative emotion than do secure mothers (Haft & Slade, 1989; Goldberg, MacKay-Soroka, & Rochester, 1994). Finally, preoccupied mothers tend to be inconsistently responsive to their infants’ emotional cues and may attend more to their infants’ signals of distress than to their infants’ positive emotional expressions (Goldberg et al., 1994; Haft & Slade, 1989). Although there is little work looking at maternal attachment style and mothers’ emotional communication post-infancy, Fivush and Sales (2006) have examined maternal attachment style and mother-child reminiscing surrounding an acute asthma attack. Contrary to expectations, it was the mothers who were anxiously attached (i.e., preoccupied) and not securely attached who were more engaged and explanative when discussing the past stressful event (i.e., the asthma attack) with their children. Despite this increased discussion, however, children of anxious mothers were more likely to be experiencing adjustment difficulties. In addition, for children of anxiously attached mothers, parent-child narratives were not related to children’s functioning. Thus, although these mothers may have had richer narratives with their children when discussing the past life-threatening event, the mothers clearly were not fostering the children’s coping or understanding in these narratives. Perhaps instead, these mothers were more ruminative and less constructive with their explanations. Clearly, more research is needed to examine if the content of these types of stressful event narratives varies as a function of maternal attachment style. Finally, it is important to keep in mind that the links between attachment and mother-child reminiscing about emotional events are bidirectional for children. Thus, although secure or insecure internal working models shape the nature of communication between mothers and children, the reverse possibility is also probably true. Because of the importance of communication for shaping the nature of children’s internal working models (Thompson et al., 2004), there are also good reasons to believe that conversations surrounding young children’s past negative Mother-Child Reminiscing

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emotional experiences (especially surrounding stressful events) also influence children’s feelings of felt security, and concurrently their internal working models. Thus, caregivers can enhance or erode the feelings of felt security through conversations surrounding negative and stressful events depending on the tactics caregivers use in discussing the events. A caregiver who is willing to acknowledge the child’s feelings as legitimate in reminiscing conversations and who provides constructive ways to reframe the child’s experiences (for example, by providing ways to cope with negative feelings) likely enhances the child’s feelings of security and feelings of self-efficacy. In contrast, a caregiver who dismisses the child’s feelings as either not legitimate (e.g., “you should not have been scared”) or who ruminates on the negative emotions involved in the event without providing ways to cope with the negative emotions or reframe the experience, likely erodes feelings of felt security in the child.

Summary The preliminary work that has been done on attachment security and mother-child communication supports the idea that a secure attachment promotes emotionally open, fluent, and coherent communication between mothers and children, especially when discussing negatively charged or threatening events. In infancy, both partners of a secure relationship communicate in a way that is emotionally open; infants express a wide range of emotions and caregivers respond to that wide range of emotions. In insecure relationships, infants either minimize or maximize their expression of negative emotion and insecure caregivers do not respond appropriately to the range of the infant’s emotions. Beyond infancy, both partners in secure dyads continue to communicate more openly, particularly about events that involve negative emotion, than partners in insecure dyads. Overall, the research supports the idea that the discussion of stressful events might be more common, open, and coherent within secure dyads than within insecure dyads.

Implications of Open Reminiscing for Children’s Health and Well-being The ability to openly discuss a traumatic event after the fact likely has important consequences for not only how the event is remembered by the child, but also how the event is understood by the child. Just like adults, children need to make sense of stressful and traumatic events, and this is especially true of young children who do not yet have the experience to understand the events as they unfold. In the midst of the stressful event itself, children’s negative emotions may interfere with them asking 182

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questions. Even if parents communicate well during the stressful event, children may not process the information being conveyed. Afterwards, however, adults can assist children with understanding exactly what happened during a stressful event and can coach children on how to cope with similar events (just as the mother did with her young daughter in the conversation surrounding the emergency room visit). Because of their trust in the responsiveness of their caregivers, secure children should feel more capable of openly discussing these types of stressful events with caregivers, including asking questions and being willing to openly express their fears and concerns to the caregivers. In addition, the adult literature suggests that disclosing stressful events to others has important consequences for the physical and mental health of individuals who have experienced traumatic events (Pennebaker, 1997). Individuals who have confided in others about stressful events tend to have fewer mental and physical health problems in the long term, even though the initial experience of disclosing the traumatic event (e.g., through writing or discourse) might be emotionally arousing (Pennebaker, 1997; Pennebaker & Hoover, 1986; Pennebaker & O’Heeron, 1984). By talking about past stressful events, it often makes these experiences less threatening to reflect upon (Pennebaker & Seagal, 1999). In addition, by confiding in others about stressful events, it provides opportunities for adults and children to seek advice on coping, to receive sympathy, and to have others help make sense of the stressful event. Pennebaker and Seagal (1999) have argued that, by reflecting upon stressful events, individuals can cognitively reframe these experiences and integrate them into their self-concept. According to these researchers, merely discussing or confiding the stressful event to someone else is not enough to make self-disclosure effective in promoting mental and physical health. Instead, it is important that the individual is able to translate the traumatic event into a coherent narrative, especially one that helps make sense of the event, and one that is essentially assimilated into the individual’s self-concept in ways that are constructive. For a young child, who is less capable of understanding the traumatic event, this reframing process is likely guided by parents, who help the child make sense of what happened during and after the stressful event. In the context of a secure relationship, where both mothers and children are capable of openly discussing the traumatic event and where mothers are able to acknowledge and confirm their children’s emotional experiences, the children are likely to be successful in reframing the stressful experience in ways that are constructive and healthy. In the context of insecure relationships, where the dialogue about the stressful event is restricted or potentially ruminative, the children’s reframing process is likely to be less successful. Mother-Child Reminiscing

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A number of researchers have begun to illuminate the important qualities of a trauma narrative that promote individual’s psychological adjustment following a stressful event in adulthood (see e.g., Pals, 2006; King, Scollon, Ramsey, & Williams, 2000). For instance, subjective well-being in adulthood is associated with narratives surrounding a traumatic event that are both coherent and provide a sense of emotional resolution. King et al. (2000) found that parents of children with Down syndrome exhibited higher levels of life satisfaction if they produced narrative stories about the child’s diagnosis that involved a sense of closure, a degree of foreshadowing (which is an element of narrative coherence), and a positive ending to their stories. Similarly, McAdams, Reynolds, Lewis, Patten, and Bowman (2001) found that frequent redemption sequences in autobiographical memories of adults, which are those experiences in which a negative event is followed by a positive outcome, were related to several indicators of subjective well-being. Although it is not clear whether similar types of autobiographical narratives would translate into improvements in children’s adjustment following stressful events, some preliminary research supports this idea. Sales, Fivush, Parker, and Bahrick (2002) found that preschool children who used more positive emotion terms and included more information when narrating events about a devastating hurricane shortly after it occurred were less likely to show symptoms of posttraumatic stress six years after the event. These findings are in line with Pennebaker’s (1997) arguments that individuals’ ability to produce coherent narratives (with positive elements) about stressful events after the fact is related to their ability to cope (see also King et al., 2000). The Sales et al. (2002) study suggests that this is also true for extremely young children. Although it is not clear why, in Sales et al.’s (2002) sample, some children were able to produce more coherent and positive narratives than others, extant findings from our lab might provide some relevant insight. Specifically, it is plausible that the children who were likely to produce relatively positive and complete narratives of such a stressful event (such as the hurricane) were likely raised in the context of secure attachment relationships with parents, where reminiscing surrounding negatively charged emotional events was both frequent and open. It seems likely that these children had already internalized some of the narrative structure involved in discussing past stressful experiences (which aided in producing a coherent narrative), and with the assistance of a sensitive caregiver, were already beginning to reframe their recollection of the hurricane in ways that were constructive and more positive. Very little research has directly examined how the reminiscing conversations between young children and their caregivers about stressful 184

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events may impact children’s developing emotional understanding, coping, and well-being. The work that has been done suggests that these conversations are extremely rich between parents and children and likely influence the ways in which children recount and remember stressful events. Ackil, Van Abbema, and Bauer (2003) compared mother-child reminiscing conversations about a nontraumatic event and a traumatic event (i.e., a tornado) that involved children of a wide age range (two to 11 years of age) and their mothers. Mother-child reminiscing conversations surrounding the tornado were twice as long as conversations about the nontraumatic event, involved more detail, and were more coherent than the conversations surrounding the other event. These findings are important and support the idea that parents and children are trying to make sense of highly traumatic events through reminiscing. Given the length and detail of these conversations, it also suggests that it may be much harder for parents and children to attempt to make sense of past stressful events than other less threatening past events. Furthermore, Sales and Fivush (2005) examined maternal discussions of both an acute stressor with children (i.e., a trip to the emergency room because of an asthma attack) and a chronic stressor (i.e., children’s ongoing management of their asthma). Interesting differences emerged between mothers’ discussions of the two events. Mothers used more causal and explanatory language when discussing the chronic stressor, which suggests that mothers were perhaps more concerned with fostering children’s ongoing general coping with asthma to reduce future trips to the emergency room rather than fostering children’s coping during the actual hospital visit. Interestingly, it was the discussion of causal and emotional language during conversations about the chronic stressor that predicted children’s socioemotional well-being. Mothers who used more emotional and causal explanatory language (which are markers of coherent narratives, see Smyth, 1998) when discussing the chronic stressor with their children had children who scored higher on emotional wellbeing. Surprisingly, maternal explanation during discussions of the acute trauma was not related to child adjustment.

Summary Research with adults suggests that their ability to integrate stressful life experiences into their life story in a way that is coherent, meaningful, and that has a sense of emotional closure impacts their well-being. Unfortunately, young children often lack the ability to independently construct a coherent narrative that involves a sense of emotional closure. Thus, ultimately, children need the guidance of a supportive caregiver to guide their co-constructions of past stressful events in ways that facilitate Mother-Child Reminiscing

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their understanding of the stressful experience and the emotions involved in it, thereby possibly benefiting their later well-being. Although only a couple of studies with children have examined reminiscing conversations about stressful events, those studies suggest that parents through reminiscing are trying to help children find meaning in stressful events and to teach them how to cope with future similar events.

Conclusions and Directions for Future Research Although numerous researchers have examined how stress impacts children’s memory (e.g., Fivush, Hazzard, Sales, Sarfati, & Brown, 2002; Sales et al., 2005), very little work has focused on how parents help children make sense of stressful events after the fact (for exceptions see Ackil et al., 2003; Bauer, Stark, Lukowski, Rademacher, & Van Abbema, 2005). Stressful events of varying intensities (e.g., moderately stressful, such as emergency room visits, and highly stressful, such as hurricanes and tornadoes) are noteworthy and highly salient to both young children and their caregivers. As a result, it seems that these are probably frequent topics of conversation between caregivers and young children, both immediately following the event and long afterwards. More importantly, however, it seems that these conversations are a critical avenue through which children make sense of stressful events. Ultimately, children are socialized through reminiscing in how to think about negative and traumatic events (Bauer et al., 2005) and in how to cope with and understand the negative emotions that arise during them. In the end, as Sales et al. (2005) argue, how children eventually make sense of stressful events may be far more crucial for children’s adjustment than whether children’s memories of stressful events are accurate. Because of this, securely attached children have the advantage over insecurely attached children in making sense of traumatic events. First, secure children have been shown to have more advanced socioemotional understanding and coping skills (Greenberger & McLaughlin, 1998; Laible & Thompson, 1998; Thompson, 2006; Weinfield, Sroufe, Egeland, & Carlson, 1999), which should assist in their understanding of negatively charged emotional experiences during and after stressful events. Second, secure children should also have more coherent and positive internal working models that allow them to integrate stressful experiences more constructively into their self-concept than do insecure children. Finally, as our lab findings suggest (Laible, 2004; 2007), compared with insecure children, secure children are more likely to have the assistance of a sensitive caregiver who can help them make sense of traumatic and stressful experiences after the fact. 186

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Because virtually no research has examined the links between attachment security and parent-child reminiscing about highly distressing events, a number of fundamental questions need to be addressed. For example, although we know that secure dyads appear to be more open and fluent when discussing the child’s past negative emotional experiences, does this also mean that secure dyads are more open when discussing more traumatic past experiences? Theoretically, the links between attachment security and reminiscing about stressful events should be more apparent, because the attachment system is assumed to be most strongly activated in the context of stressful experiences (Bowlby, 1980). In addition, is it that insecure parent-child dyads are not only less elaborative when discussing traumatic events, but also that they tend to avoid such discussions altogether because of the threatening nature of these conversations? Alternatively, however, it may be that insecure dyads do in fact discuss past stressful events with equal frequency as secure dyads, but that they may discuss these events in ways that are less constructive. Thus, for example, parents in insecure dyads may ruminate more on negative emotions in the context of reminiscing without providing ways for children to resolve or cope with these emotions. This might help to explain why insecure children are more at risk for depression and anxiety disorders (Greenberg, 1999). In the end, the possibility arises that the amount of negative emotion discussed by the dyad may be less related to attachment security than the ways in which negative emotions are discussed. All of these issues, however, need to be examined empirically. In addition to attachment, several other relational, child, and maternal characteristics likely also influence the ability of both parents and children to reminisce openly about stressful experiences. Family climate, such as parental warmth and emotional expressiveness, for example, influence the degree of trust that children have in parents, as well as the open nature of communication between them (Laible, 2007). In addition, children’s temperamental characteristics not only influence children’s ability to effectively communicate with their parents (Laible, Panfile, & Makariev, 2008), but also the parents’ ability to communicate with them (Laible, 2004; Laible, Panfile, & Eye, 2008). Parents not only adapt their reminiscing and communication style based upon their perception of their children’s temperament (Lewis, 1999; Laible, 2004), but the amount of energy and resources that parents have to dedicate to communication is directly related to the temperamental characteristics of their children. Thus, children who are difficult in their temperamental profile may drain the energy and patience of even sensitive caregivers (Goldsmith, Buss, Plomin, Rothbart, Thomas, Chess, Hinde, & McCall, 1987), making high-quality communication in the context of reminiscing less likely. Finally, it seems likely that maternal personality characteristics influence Mother-Child Reminiscing

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the ability of mothers to openly communicate with children during reminiscing about stressful events. Maternal openness might facilitate mothers’ ability to explore both positive and negative themes with children when discussing past traumatic events. Much of this is speculative given the lack of empirical research on these issues, and all are fruitful areas for future research. A final consideration for future research is the need for greater attention to be paid toward the potential ways in which parent-child reminiscing about highly stressful events might differ from parent-child reminiscing regarding other negatively valenced events. The only study so far that has compared parent-child reminiscing about a traumatic event with a nontraumatic event (i.e., Ackil et al., 2003) did not compare parent-child discussions of negatively valenced events (e.g., being upset when teased by a sibling) to the discussion of the traumatic event. Instead Ackil et al. (2003) compared reminiscing conversations surrounding relatively positive events (e.g., a birthday party) to the discussion of the traumatic event. It is less surprising, then that this study found strong differences between the two types of conversations (these differences actually parallel some of the differences that we have found in our lab between positively and negatively valenced reminiscing conversations). Discussing positively valenced events is much easier and less threatening for both members of the dyad, and, with positive events, there is less to make sense of. Thus, the fact that conversations about highly stressful events are longer and more coherent than positive event conversations is less surprising. Ultimately, there are good reasons to believe that the psychological consequences of highly stressful events (such as a child’s trip to the emergency room) on parents likely influence their ability to discuss the event with their children, and how those conversations unfold. Thus, it is possible that discussions of highly traumatic events might be more variable between parent-child dyads than those of less-negative events, based upon how well parents adjust following the stressful event. Also, because young children have less-developed coping skills, they might be especially prone to becoming emotionally upset during reminiscing conversations surrounding a traumatic event. Thus, the negative emotion inherent in these discussions may lessen the quality of the communication between parents and children when discussing highly stressful or traumatic events. Finally, just like with adults, children seem to want to understand traumatic events. Given the possibility that children are especially likely to be confused during the chaos of traumatic events, it seems that they are likely to ask more questions during these discussions, or, comparably, that parents will spend more time trying

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to explain to young children during reminiscing conversations what happened regarding traumatic events. In closing, in order to truly understand the links between stress, wellbeing, and memory in children, it is critical to understand the nature of parent-child reminiscing conversations, parent-child attachment, and children’s emotional understanding. That is, given the emotional salience of stressful and traumatic experiences, it is likely these events are discussed by parents and children. The amount and content in that discussion vary considerably, and this variation has implications (for better or worse) for children’s memory. Future scientific knowledge concerning children’s memories of stressful experiences will need to consider the nature of reminiscing about stressful events between parents and young children, as well as the number of factors that affect this reminiscing. It is only with this broad, complex knowledge that insight into stress and memory across development will continue to be advanced.

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Saarni, C. (1999). The development of emotional competence. New York, NY: Guilford Press. Sales, J. M., & Fivush, R. (2005). Social and emotional functions of motherchild Reminiscing about stressful events. Social Cognition, 23, 70–90. Sales, J. M., Fivush, R., Parker, J.F., & Bahrick, L. (2005). Stressing memory: Long-term relations among children’s stress, recall, and psychological outcome following Hurricane Andrew. Journal of Cognition and Development, 6, 529–545. Sales, J. M., Fivush, R., & Peterson, C. (2003). Parental reminiscing about positive and negative events. Journal of Cognition and Development, 4, 185–209. Shields, A., & Cicchetti, D. (1998). Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation. Journal of Clinical Child Psychology, 27, 381–395. Skinner, E. A., & Zimmer-Gembeck, M. J. (2007). The Development of Coping. Annual Review of Psychology. 58, 119–144. Smiley, P. & Huttenlocher, J. (1989). Young children’s acquisition of emotion concepts. In C. Saarni & P. Harris (Eds.), Children’s understanding of emotion (pp. 27–49). New York, NY: Cambridge University Press. Spangler, G. & Grossmann, K. E. (1993). Behavioral organization in securely and insecurely attached infants. Child Development, 64, 1439–1450. Spinrad, T. L., Eisenberg, N., Cumberland, A., Fabes, R. A., Valiente, C., Shepard, S. A., Reiser, M., Losoya, S. H., & Guthrie, I. K. (2006). Relation of emotion-related regulation to children’s social competence: A longitudinal study. Emotion, 6, 498–510. Stegge, H. & Terwogt, M. (2007). Awareness and regulation of emotion in typical and atypical development. In J. Gross (Ed.), Handbook of emotion regulation (pp. 269–286). New York, NY: Guilford Press. Stein, N. & Levine, L. (1999). The early emergence of emotional understanding and appraisal: Implications for theories of development. In T. Dalgleish & M. Power (Eds.), Handbook of cognition and emotion (pp. 383–408), New York, NY: John Wiley. Tessler, M. & Nelson, K. (1994). Making memories: The influence of joint encoding on later recall by young children. Consciousness and Cognition, 3, 307–326. Thompson, R. A. (1990). Emotion and self-regulation. In R. A. Thompson (Ed.), Socioemotional development. Nebraska Symposium on Motivation, Vol. 36 (pp. 383–483). Lincoln, NE: University of Nebraska Press. Thompson, R. & Lagattuta, K. (2006). Feeling and understanding: Early emotional development. In K. McCartney & D. Phillips (Eds.), Blackwell handbook of early childhood development (pp. 318–337). Malden, MA: Blackwell Publishing. Thompson, R., Laible, D., & Ontai, L. (2003). Early understandings of emotion, morality, and self: Developing a working model. In R. V. Kail (Ed.), Advances in Child Development and Behavior, Vol. 31 (pp. 137– 171). San Diego, CA: Academic. Thompson, R. & Meyer, S. (2006) Socialization of emotion regulation in the family. In J. Gross (Ed.), Handbook of emotion regulation (pp. 249–268). New York, NY: Guilford Press.

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Weinfield, N., Sroufe, A., Egeland, B., & Carlson, E. (1999). The nature of individual differences in infant-caregiver attachment. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 68–87). New York, NY: Guilford Press. Wranik, T., Barrett, L., & Salovey, P. (2007). Intelligent emotion regulation: Is knowledge power? In J. Gross (Ed.), Handbook of emotion regulation (pp. 393–407). New York, NY: Guilford Press.

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8 Creating a Context for Children’s Memory The Importance of Parental Attachment Status, Coping, and Narrative Skill for Co-Constructing Meaning Following Stressful Experiences Jessica McDermott Sales

E

very person, regardless of age, is susceptible to stress. Exposure to serious stressors is a common aspect of growing up in today’s world. Specific to children raised in the United States, 40% of children experience divorce of their parents, 22% of children live in poverty, 19% of children experience chronic illness or physical disability, 3% experience the death of a parent, and 6.6 million children live with an alcoholic parent (Sandler, Wolchik, MacKinnon, Ayers, & Roosa, 1997). Fortunately, children as well as adults have developed ways to make sense of the world and to cope in the aftermath of life’s stressors. Research indicates that narratives play an important role in the process of creating meaningful accounts of stressful events in the service of coping and protecting psychological well-being. However, the extent to which children can create meaning following stressful experiences and ultimately successfully cope with such experiences varies greatly with age and level of cognitive, emotional, social, and physical development (Davies, 1999). Furthermore, it is not clear how children learn to create meaningful accounts of past stressful experiences across development. One possibility is that 196

children learn the meaning-making process from the more experienced people around them, namely their parents, during conversations about past stressful experiences. Thus, the major objective of this chapter is to explore how parent-child conversations about past stressful events may facilitate children’s meaning-making following stressful events, and to present findings demonstrating the importance of meaning-making for psychological well-being in the aftermath of stressors. Additionally, I will explore two factors that contribute to differences in parents’ ability to scaffold elaborative and emotionally integrated co-constructed narratives of past stressful events with their children: their attachment status and coping ability. Before addressing how parents may influence children’s meaningmaking, I begin with a description of the concept of parental scaffolding (Vygotsky, 1978), a concept which has guided a great deal of work pertaining to children’s autobiographical memory development (Fivush, Haden, & Reese, 2006). Then I review the literature on parental scaffolding of children’s autobiographical memories for both positively and negatively valenced events. I then describe Lazarus and Folkman’s coping theory and how coping may play a role in parental scaffolding ability, followed by a description of attachment theory and a discussion on how the attachment context may influence the quality of parental scaffolding as well. Next, I describe recent findings from research we have conducted with asthmatic children and their parents, examining how coping and attachment status relate to the structure, quality, and content of parental scaffolding during parent-child conversations about stressful events. Finally, I discuss the importance of narrative research as a mechanism for exploring issues related to memories of stressful events as well as for better understanding of how the meaning-making process ultimately impacts psychological well-being.

Parental Scaffolding of Children’s Narratives Narratives are the way in which we make sense of human experience, and therefore children’s narratives of emotional events have become an important context for examining developmental processes related to emotional organization, emotion regulation, and meaning-making (Fivush & Sales, 2003; Oppenheim et al., 1997; Reynolds, Brewin, & Saxton 2000; Thompson, 1994). A common theme throughout this research is that children use emotion words and emotional expressions to organize and understand personally salient emotional experiences, to communicate their feelings to others, and to regulate their feelings and behavior. Moreover, children may first be learning these emotional expression and regulation skills in parent-scaffolded narrative interactions. Creating a Context for Children’s Memory

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The enormous impact of the social context on children’s narratives of personally salient and emotional past events is clearly demonstrated by memory research examining parental scaffolding of past emotional experiences (see Nelson & Fivush, 2004; and Pratt & Fiese, 2004, for overviews). A great deal of this research was guided by Vygotsky’s theory of development and the concept of scaffolding. Although Vygotsky did not use the term scaffolding, the notion of scaffolding was first described by Vygotsky’s (1978) sociocultural theory of development. He believed that information was relayed to children through social interactions or joint activities with more competent others. He conceptualized this transmission of information as a process often referred to as “the zone of proximal development.” Vygotsky defined the zone of proximal development as the distance between children’s “actual developmental level as determined by independent problem solving” and the higher level of “potential development as determined through problem solving under adult guidance or in collaboration with more capable peers” (1978, p. 86). A more competent person collaborates with a child to succeed at a developmental task the child could not accomplish alone. Thus, the more skilled adult, often the parent, builds on or “scaffolds” the competencies the child already has and supports her during activities that are at a level of competence just beyond where she is without assistance. It is important to emphasize that scaffolding is only beneficial to a child if they are developmentally capable of using the information the adult is trying to convey. Hence, “the zone of proximal development defines those functions that have not yet matured but are in the process of maturation, functions that will mature tomorrow but are currently in an embryonic state” (Vygotsky, 1978, pp. 86–87). Furthermore, learning within the zone of proximal development is possible in part because of intersubjectivity, or a shared understanding, based on a common focus or a common goal, between a child and a more competent person. Moreover, Vygotsky proposed a mechanism by which children incorporate what they learn through interactions with adults. He hypothesized that the interaction between children and adults on the intermental (between-minds) plane becomes internalized into children’s minds, or the intramental (within-mind) plane. Thus, the external becomes the internal. For example, children will eventually internalize the mode of problem solving that was supported by their mother while assisting the child with a problem. Vygotsky believed that children would “grow into the intellectual life of those around them” (1978, p. 88), by gradually taking more and more of the responsibility for problem solving and becoming more self-regulated rather than other-regulated (Miller, 1993). Although Vygotsky’s theory does not explicitly address how parents would influence the autobiographical memory development of children, it 198

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suggests that parents may scaffold the cognitive and emotional aspects of past experiences by providing cues and prompts during the course of parent-child reminiscing about the past. These cues and prompts provided by parents enable their children to recall more information than they could on their own. Over time, this added support teaches children how to independently cue themselves so that they can recall more information on their own at a later time. However, parent-child reminiscing provides children with more than a way of cueing memories. Young children are also learning a great deal about how to narratively structure past experiences from the comments and questions that adults pose during these conversations (Fivush, 1991). This co-constructed organization may facilitate children’s comprehension of events, thus allowing memories to remain accessible for conscious recall over time. Through sharing their past with others, children are learning both the forms and functions of remembering (Fivush, Haden, & Reese, 1996). However, not all parents reminisce with their children in the same manner. A substantial body of research has established clear and enduring individual differences in parental reminiscing styles (Fivush & Fromhoff, 1988; Harley & Reese, 1999). Some parents are highly elaborative, providing a great deal of rich embellished details about the past, whereas other parents are less elaborative, tending to repeat the same questions over and over. Of importance, children of highly elaborative parents come to independently tell more richly detailed, coherent, and more evaluative stories of their own past than children of less elaborate parents. However, the vast majority of this research was based exclusively on parent-child reminiscing about past positively valenced experiences. Only recently have a few studies addressed parental reminiscing about past emotionally negative events. This is a particularly important question because if joint reminiscing helps children organize and recall positive emotional events, then the ways in which parents discuss negative experiences with their children may play a critical role in how they come to remember stressful events and, perhaps more importantly, come to understand (i.e., make meaning or make sense of) and cope with the stressful experiences of their lives. Findings in the adult literature indicate that detailed and coherent narratives of stressful events are related to higher levels of coping and well-being (Pennebaker, 1997). As with adults, a more detailed memory of negative events may facilitate children’s understanding and, ultimately, coping with such events. Thus, an elaborative parental reminiscing style may help children create meaning and cope with stressful life experiences. One of the few studies to examine how parents and children discuss highly stressful experiences was conducted by Ackil, Van Abbema, & Bauer (2003). They compared mother-child conversations about a Creating a Context for Children’s Memory

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devastating tornado that leveled their town to conversations about a nontraumatic event. Tornado conversations included more mention of negative emotions and information about the causes and consequences of the event than did the conversations about the nontraumatic events. This suggests that mothers are using the negative conversations as an opportunity to facilitate children’s understanding of the overwhelming tornado event. However, the focus of this study was to assess the content of parent-child reminiscing and did not assess parental reminiscing style. As mentioned previously, elaborative parents facilitate the development of more detailed and embellished autobiographical narratives in their children. If parental reminiscing style remains consistent across positive and negative emotional events, children of elaborative parents should produce more detailed narratives about negative past events as well. In the first study of its kind, we examined both reminiscing style and the content of parent-child conversations about two emotionally laden events: an injury requiring emergency medical treatment and an individually nominated positively valenced experience (Sales, Fivush, & Peterson, 2003). As in previous reminiscing research, we defi ned parental reminiscing style as extent of elaboration provided by the parent. Parental reminiscing style was consistent across the two emotional conversations, such that parents who were more highly elaborative when reminiscing about the positive event were also more elaborative when reminiscing about the negative event. Further, parents with a highly elaborative style had children who reported more new information during these conversations. However, there were notable differences in parental style for positive and negative event conversations. When reminiscing about stressful events, parents asked a higher proportion of open-ended memory questions to their children, which required children to provide information in response, whereas when reminiscing about the positive experience, parents asked a higher proportion of yes/no questions, which only required children to confirm or negate the questions. Parents also focused more on emotion when discussing positive events with their children and more on causal explanations when discussing the stressful experiences. These differences suggest that parents may have different underlying goals in these two different emotional conversations. Reminiscing about shared positive experiences serves to create, maintain, and strengthen emotional bonds, as well as create a shared history, which is the basis for family identity (Fivush et al., 1996). Thus, in emotionally positive conversations, parents engage in co-constructing the experience with their children, with each conversational partner contributing unique information about the shared event to the collaborative narrative. Moreover, 200

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a greater focus on the positive emotion of the event may highlight how the event was meaningful to the parent-child relationship. In contrast, discussing stressful events may serve more of a didactic function. Parents are concerned with teaching their children how to cope with life’s stressors and to avoid similar stressful experiences in the future. To facilitate their children’s thinking about what happened and why, parents try harder to elicit their children’s recall of details of the event rather than providing this information themselves and simply asking for their confirmation. In support of this interpretation, Ackil et al. (2003) found that parents focused on the causes of negative events more so than of positive events. Focusing on causal information helps children understand how and why stressful events occurred, thereby making the event more comprehensible and perhaps providing a lesson on how to cope. Thus, the function of reminiscing about negative events, whether they are everyday hassles or more serious and even traumatic events, seems to differ from the functions of reminiscing about emotionally positive experiences. These recent findings regarding parent-child reminiscing about stressful past experiences suggest the importance of narratives for creating meaningful accounts of stressful events in the service of coping and protecting psychological well-being in the aftermath of stressful events. These findings are also consistent with a growing body of research with adults indicating that the coherence and context of memories of stressful experiences relates to psychological well-being. Specifically, adults who produce more emotional and coherent accounts of stressful events have lower anxiety, less depressive symptoms, a higher sense of positive wellbeing, and higher immune system functioning than individuals who use less of this kind of language (see Pennebaker, 1997, for an overview). Pennebaker and colleagues have consistently found that the inclusion of emotional language (the inclusion of both positive and negative emotional words) and causal explanatory language (words such as “because,” “thus,” and “understand”) in one’s recall of past negative experiences is particularly important because this language is indicative of greater depth of processing of the stressful event and suggests that individuals have actively worked to understand and make sense of the event and its role in their life. Such processing tends to result in better psychological well-being. Intriguingly, emotional and causal and explanatory language seems related to Lazarus and Folkman’s model of coping. Lazarus and Folkman (1984) classified coping processes into two main categories: problemfocused coping and emotion-focused coping (see the Compas, Campell, Robinson, & Rodriguez, this volume, for a more detailed discussion of coping strategies). Problem-focused coping is a direct attempt to manage Creating a Context for Children’s Memory

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or change the source of stress, as opposed to emotion-focused coping, which is intended to regulate the individual’s emotional response to a stressor. Examples of problem-focused coping include active coping strategies such as direct problem solving, cognitive restructuring, seeking understanding, positive thinking, control, support for actions, and cognitive decision making (Carver, Scheier, & Weintraub, 1989; Sandler, Tein, & West, 1994). In contrast, examples of emotion-focused coping include physical release of emotion, acceptance, denial, distracting actions, avoidant actions, repression, wishful thinking, and support for feelings (Folkman & Lazarus, 1985; Sandler et al., 1994). By including causal and explanatory as well as emotional language in narratives of stressful events, individuals may be engaging in proactive coping by way of trying to better understand, situate, acknowledge, and manage the emotions stemming from the stressful experience. In other words, this type of language may represent a “language of coping” which can be identified in an individual’s narratives of past stressful experiences.

Factors Contributing to Individual Differences in Parental Reminiscing Ability Just as individual differences have been identified in the parental reminiscing literature, individual differences exist in adults’ ability to engage in the “language of coping” when narrating past stressful events. Thus the question remains, why might some adults be better able to effectively engage in the “language of coping” when narrating stressful events, either alone or during the course of conversations with children? We have proposed two interrelated factors: general coping skills and attachment status of the parent (see Fivush & Sales, 2006). Specifically, we propose that children are learning to create more explanatory and more emotionally expressive narratives in the context of parent-scaffolded reminiscing, and that the structure, content, and quality of parent-child reminiscing would be a function, at least partially, of the coping skills and attachment status of the parent. Additionally, parents that are better able to assist their children in creating coherent, explanatory, and emotionally integrated narratives of stressful events would have children with higher levels of psychological well-being in the aftermath of stressors. Given the similarity between Lazarus and Folkman’s model of coping and the language of coping expressed in narratives, we have argued that parents with better coping skills would be better able to assist their children in constructing explanatory and emotionally rich narratives of stressful experiences. In turn, following from Pennebaker’s work (1997), the co-construction of more explanatory and emotional narratives would 202

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be associated with children’s coping and well-being following stressful experiences (Fivush & Sales, 2006; Sales & Fivush, 2005). In thinking about why some parents may be better able to cope with aversive events as well as discuss them with their children in more coherent and emotionally integrated ways, we have argued that parental attachment status will also play a role (see Fivush & Sales, 2006). Attachment is a fundamental construct in developmental psychology and, at its most simple level, attachment refers to the emotional tie between caregiver and child (Bowlby, 1988). A central component of attachment theory, of particular importance for autobiographical memory, is that of the internal working model. Through continuous interactions with caregivers, children develop internal working models (or concepts of the world) that incorporate models of the caregiver and the self as well as their relationship. These models about self and others are then used to guide future behaviors and expectancies, especially in times of stress. As is well documented, significant individual differences exist in the quality of attachment relationships between caregiver and child, and these differences impact the way that children represent their caregivers and the self (Ainsworth et al., 1978). For instance, securely attached individuals (who experienced sensitive and responsive caregiving early in life) develop internal working models of the caregiver as available and competent, the self as worthy, and the world as a secure and safe place. Conversely, insecurely attached individuals (who experience less sensitive and responsive caregiving early in life) represent their caregivers as either unreliable or unavailable in times of need or stress. Thus an internal working model based upon a secure attachment relationship provides a cognitive context in times of stress that allows for self-regulation of emotion and the ability to engage in active coping strategies. Indeed, evidence supports this speculation by demonstrating that securely attached children show better emotional understanding and better emotion regulation than insecurely attached children (Laible & Thompsen, 1998; Koren-Karie, Oppenheim, Haimovich, & Etzion-Carasso, 2003). Main and colleagues (Main, Kaplan & Cassidy, 1985) have extended the attachment construct into adulthood. They argue that a secure internal working model developed in childhood will evolve into a secure internal model for adulthood. This adult internal working model will be evident in the way in which the individual approaches all emotionally meaningful relationships during adulthood. The majority of evidence supporting their argument comes from using a procedure called the Adult Attachment Interview, where they have found securely attached adults are able to provide coherent and emotionally integrated narratives of their own experiences in close relationships, while insecurely attached adults give overgeneralized, emotionally flat, and incoherent narratives of Creating a Context for Children’s Memory

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their relationships (Main, Kaplan & Cassidy, 1985). Additionally, research employing the Experiences in Close Relationships Inventory (ECRI), a questionnaire assessing adult attachment behaviors which shows reasonable correlations with the Adult Attachment Interview (Shaver & Mikulincer, 2002), has identified two dimensions (anxiety and avoidance) that are important for determining adult attachment style within close romantic relationships. Based on the association between these two adult attachment measures, it seems likely that adults scoring low in attachment avoidance and anxiety on the ECRI would be better able to construct coherent and more emotionally elaborative narratives of their experiences in close relationships. Taken together, given that parental reminiscing takes place within the context of the preexisting attachment relationship, which, among other things, defines the emotional climate of the relationship in times of stress, the adults’ attachment status in particular may directly influence the quality of parent-child conversations about stressful experiences. Specifically, a secure adult attachment status could provide a basis for elaborated, emotionally integrated, and coherent reminiscing about the shared past with their children. Bretherton & Mulholland (1999) and Thompson (2000) have extended the relation between adult attachment status and narrative coherence to include the manner in which mother-child dyads are able to discuss stressful experiences together. These recent theoretical approaches have argued that, whereas the early attachment bond is based on sensorimotor associations, over time these interactions become internalized as working models, or narratives of relationships. According to their perspective, emotionally open parent-child communication patterns affect the structure and organization of children’s memories of emotional events, in addition to the content of their recall. Additionally, parents influence the development of secure internal working models of self, parent, and the social world by sensitively scaffolding their children’s narrative accounts of the past. Thus, from this perspective, attachment status is theoretically related to the construct of scaffolding (Meins, 1997; Vygotsky, 1978). In the reminiscing literature, mothers who are highly elaborative and evaluative when reminiscing about past emotional events with their children, and who include mention of emotions and explanations, are thought to be providing a scaffold that assists their children independently to construct more coherent personal narratives (Fivush, 1991). Following from an attachment framework, mothers who are securely attached will be better able to discuss stressful experiences with their children in more coherent and emotionally open ways thereby providing a scaffold for emotional understanding. 204

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Only recently have a select few researchers begun to empirically examine the relations between attachment status and the emotional content of parent-child conversations about past emotional events (see Laible and Panfile, this volume). Koren-Karie, Oppenheim, Haimovich, and Etzion-Carasso (2003) examined the emotional match or mismatch between parents and children in co-constructed narratives about past emotional experiences. They found that securely attached dyads early in development were better able to co-construct coherent, emotionally attuned accounts of past emotional experiences than insecurely attached dyads. This finding indicates a link between attachment status and quality of parent-child communication about arousing experiences. The authors suggested that internal working models of securely attached children depict their mother as a secure base from which they can explore their emotions freely, knowing that their mother will be emotionally available to them if needed. Furthermore, they add that securely attached children trust that their mother will not let them feel overwhelmed by the emotion of the situation, and will show them useful ways to deal with powerful emotions. Thus, parent-child conversations about emotional experiences provide an important context for examining the attachment relationship, as well as an avenue for investigating how parents scaffold children’s constructions of internal working models. Additionally, examining parent-child conversations about emotional experiences allows one to observe how parents scaffold children’s management of emotional situations and the arousal elicited during stressful experiences. Specific to reminiscing, Fivush and Vasudeva (2002) found that mothers of more securely attached preschool children discuss past experiences in more elaborative and evaluative ways. Recent longitudinal findings indicate that mothers of securely attached 19-month-old children engaged in higher levels of evaluation during reminiscing than mothers of insecurely attached age matched children. Evaluations are statements made by mothers that either confirm or negate children’s comments. Additionally, mothers of securely attached children are more consistent in their levels of evaluative reminiscing across the preschool years, and securely attached children later created more detailed and evaluative narratives of their personal past than did insecurely attached children. Higher levels of elaborations and evaluations suggest that more securely attached dyads are more engaged in the process of co-constructing narratives of the past. However, all of these studies examining the relationship between attachment and parent-child conversations of past events have only measured the child’s attachment status. Other research has found that children of less securely attached mothers independently recall less information overall about stressful events, and are more prone to memory Creating a Context for Children’s Memory

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errors and suggestibility in recall (see Alexander, Quas & Goodman, 2002, for a review). In summary, we propose that children are learning to create coherent, emotionally expressive narratives in the context of parent-guided reminiscing about stressful events, and that structure and content of parent-child reminiscing about such events would be, at least partially, a function of the coping skills and attachment status of the parent. To date, little is known about whether parental attachment status will influence their ability to provide an appropriate scaffold for recalling stressful events with their child.

Adult Attachment Status, Coping, and Parental Scaffolding Ability In order to explore the relations among parental attachment, parental coping, and parent-child co-constructed narratives of stressful events we examined how maternal attachment status and general coping skills related to the structure, content, and quality of the narratives mothers scaffolded with their children regarding two stressful events resulting from the child’s asthma (Fivush & Sales, 2006; Fivush & Sales, 2005; Sales & Fivush, 2005). Because narratives are multifaceted and there are both theoretical and empirical reasons to believe that attachment and coping would be related to different facets of narratives, we predicted that maternal coping ability and attachment status would be related to different dimensions of the narratives they scaffolded with their children. For instance, following from the work of Pennebaker and others we believed that coping would be related to specific aspects of narrative structure (i.e., number of elaborations and coherence) and specific aspects of narrative content (i.e., explanations and emotion). However, attachment status would likely be related to the quality of the narrative interaction between mother and child in addition to being associated with the emotional content of the narratives. In order to assess these hypotheses, we examined mothers and their preadolescent children with asthma. We chose to examine children with asthma for several reasons. Unfortunately, chronic childhood illness is quite frequent, affecting 19% of children living in the United States. Among these children living with chronic illness, asthma is by far the most common and affects approximately nine million children in the United States, with four million children having had an asthma attack in the previous year (Summary Health Statistics for U.S. Children, 2004), and 12.8 million days of school are missed annually due to asthma (American Lung Association, 2005). As unhealthy environmental factors increase in urban areas the number of children affected by chronic 206

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illnesses such as asthma continues to rise. Specifically, asthma rates in children under five have increased more than 160% from 1980 to 1994 (Centers for Disease Control and Prevention, 1998). Additionally, asthma, like other chronic illnesses, is a chronic stressor requiring daily management, but that is also characterized by acute, highly salient stressful episodes such as asthma attacks, which resulted in 1.9 million asthmarelated visits to emergency departments in 2002 and 12.7 million physician office visits in 2003 (American Lung Association, 2005). Thus we were able to assess mother-child conversations about both a chronic stressor (i.e., conflict between the parent and child stemming from the child’s asthma; such as activity restrictions, no pets, or cannot go on sleepovers) and an acute stressful experience (i.e., the last time the child had to visit the emergency room because of an asthma attack). Our participants were 27 mother-child dyads with eight- to 12-year-old children who had moderate to severe asthma and who had been to the emergency room due to an asthma attack within the past two years. All dyads were asked to talk about two events: an acute stressful event and a chronic stressful event. For all dyads the acute stressful event was the last time they went to the emergency room because of an asthma attack. To give you an example of how extremely stressful this event was for dyads, 14 participants were hospitalized by the attack and one child was rushed to the hospital via helicopter for emergency treatment. The chronic stressful conversation pertained to an ongoing conflict that occurred between the mother and child because of the child’s asthma. Most conflicts nominated by the dyads resulted from behavioral restrictions placed on the child by the parent, such as no summer camps, no sleepovers, or no pets. In addition to the conversations, mothers completed several questionnaire measures. Specifically, mothers completed the Experiences in Close Relationships Inventory (ECRI; Brennan, Clark, & Shaver, 1998) and the COPE (Carver, Scheier, & Weintraub, 1989) to assess general coping ability pertaining to four coping dimensions; active coping (e.g., problem solving), cognitive coping (e.g., cognitive restructuring of events), social support coping (e.g., relying on others when in need), and avoidance (e.g., avoid the stressor or denies being stressed). In order to ascertain the structure, content, and quality of the motherchild narratives, the two mother-child co-constructed narratives were coded separately to obtain separate event specific scores. We employed a variety of coding schemes to accurately capture the three narrative dimensions of structure, content, and quality of interaction (Fivush & Fromhoff, 1989; Fivush, Berlin, Sales, Mennuti-Washburn, & Cassidy, 2003; Gini, Oppenheim, & Sagi-Schwartz, 2003). In all coding, higher scores reflect a higher degree of that specific code. Creating a Context for Children’s Memory

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Narrative structure (i.e., the form of the narrative) consisted of three separate scores:

(1) Elaboration: The richness of the narrative in terms of elaborations and relevant details. (2) Emotional coherence: The extent to which the narrative portrayed a reliable, coherent, and emotionally integrated account of the event. (3) Emotional resolutions: The extent to which either coping strategies or resolutions are integrated into the narrative so that it has a clear ending or resolution. The content of the narratives was coded for three separate domains:

(1) Facts: Information about the factual aspects of the event (who, what, where) (2) Explanations: Explaining the reason behind a course of action or the causes and/or consequences of the illness or attack. (3) Emotions: Any mention of emotion or emotion-related behavior such as crying. The quality of the dyadic interaction during narrative co-construction was scored along three aspects:

(1) Intersubjectivity: Quality of the dyads “togetherness,” and the extent to which mother and child united to co-construct the narrative from a common frame of mind. (2) Communication: Quality of the mother-child dialogue, and the extent to which the dialogue was mutual, fluent, and flowing. (3) Collaboration: The extent to which both mother and child collaboratively constructed the narrative, with each partner providing meaningful contributions to the narrative. We conducted a series of correlations in order to examine the relations between maternal coping and attachment status and the structure of the narratives scaffolded by the mother for both the acute and chronic events separately. As shown in Figure 8–1, we found that mothers who used more positive coping strategies (i.e., active, cognitive, or social support) were more elaborative and emotionally coherent during their reminiscing about both the emergency room and conflict events, and they also provided more resolutions during the conflict narratives. Unexpectedly, more anxiously attached mothers were more elaborative during the emergency room conversation. Additionally, we conducted a series of correlations in order to examine the relations between maternal coping and attachment status and the content of the narratives scaffolded by the mother for both the acute and chronic events. As shown in Figure 8–2, mothers who used more social support-seeking strategies to cope included more emotion and 208

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Emergency Room Event Maternal variables

Structure Codes

.35

Maternal Anx. Attach.

Elaboration

Maternal Avoid Att. .38 .31 Maternal Active Coping Maternal Cog. Coping

Emotional Coherence

Emotional Resolution

Maternal Soc Supp Coping Maternal Avoid Coping

Conflict Event Maternal variables

Structure Codes

Maternal Anx. Attach.

Elaboration

Maternal Avoid Att. .32 Emotional Coherence

.31 Maternal Active Coping

.48

.43

Maternal Cog. Coping Maternal Soc Supp Coping

Emotional Resolution .55

Maternal Avoid Coping

Figure 8–1. Significant correlations between maternal attachment and coping and structure codes by event type.

explanatory language in their reminiscing about the conflict event. Also, more anxiously attached mothers were more explanatory during the emergency room narrative co-construction. In a final set of correlations, we examined relations between maternal coping and attachment status and the quality of both co-constructed narratives. As shown in Figure 8–3, mothers who were more avoidantly attached engaged in interactions that were less attuned, less communicatively fluent, and less collaborative during the co-construction of the emergency room narratives. Also, mothers who were more avoidantly attached engaged in less communicatively fluent interactions during the conflict event narrative. Finally, mothers who used more cognitive Creating a Context for Children’s Memory

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Emergency Room Event Maternal variables

Content Codes

Maternal Anx. Attach.

Facts

Maternal Avoid Att. .57 Emotions Maternal Active Coping Maternal Cog. Coping

Explanations

Maternal Soc Supp Coping Maternal Avoid Coping

Conflict Event Maternal variables

Content Codes

Maternal Anx. Attach.

Facts

Maternal Avoid Att. Emotions Maternal Active Coping

.33

Maternal Cog. Coping Maternal Soc Supp Coping

Explanations .33

Maternal Avoid Coping

Figure 8–2. Significant correlations between maternal attachment and coping and content codes by event type.

strategies to cope were more communicatively fluent during the emergency room narrative co-construction. In regard to our specific hypotheses generated from theory and prior empirical findings, we predicted that maternal coping would be related to all three aspects of narrative structure and to the emotional and explanatory content of both co-constructed narratives. Based on our fi ndings, it appears that maternal coping ability was related to all five of these predicted aspects of narrative for the conflict conversations, but only two aspects of the emergency room narratives. Turning to attachment, we confirmed our predictions that attachment would be highly associated with the three aspects pertaining to narrative quality, but only during the highly stressful emergency room event narrative. Additionally, 210

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Emergency Room Event Maternal variables

Quality codes

Maternal Anx. Attach.

–.34

Maternal Avoid Att.

Intersubjectivity

–.38 Communication

–.38 Maternal Active Coping

.34

Maternal Cog. Coping

Collaboration

Maternal Soc Supp Coping Maternal Avoid Coping

Conflict Event Maternal variables

Quality codes

Maternal Anx. Attach.

Intersubjectivity

Maternal Avoid Att.

–.36 Communication

Maternal Active Coping Maternal Cog. Coping

Collaboration

Maternal Soc Supp Coping Maternal Avoid Coping

Figure 8–3. Significant correlations between maternal attachment and coping and quality codes by event type.

attachment status was related to two aspects of structure and content for the emergency room event narrative, but in the direction against what we expected, such that more anxiously attached mothers were more elaborative and explanatory during these conversations. Thus, overall, the majority of our hypotheses were supported, but different patterns of association were observed for the emergency room and conflict event narratives.

Conclusions and Implications On the basis of prior empirical findings, theory, and the findings from our mother-child asthma narratives, I argue that narratives are an Creating a Context for Children’s Memory

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important context for parents to help children understand and possibly cope with past stressful events. Moreover, individual parent’s ability to successfully scaffold narratives that foster meaning-making by the child are associated with parental attachment status and general coping ability. Following from the culmination of findings presented in this chapter, it appears that parental scaffolding of co-constructing narratives of stressful events is a potentially critical mechanism by which parents teach children to engage in the “language of coping” through their scaffolding of coherent, emotionally integrated accounts of past stressful experiences containing resolutions to the situation. Based upon Vygotsky’s theory (1978), this joint co-construction will likely facilitate children’s internalization of the ability to engage in the “language of coping” independently later in time. However, at this time, this question has not been addressed empirically. Specific to the construct of attachment, mother-child co-constructed narratives both express and construct, through the quality of the dyadic interaction, aspects of the attachment status of the co-creators. Specifically, maternal attachment status is expressed through the quality of the interaction she scaffolds regarding a highly stressful experience. As speculated by Bretherton and Mulholland (1999) and Thompson (2000), this interaction may then help construct and maintain the attachment relationship between the mother and child. For example, we have found in the same asthmatic sample described in this chapter that mothers and children with a secure attachment relationship (according to the child’s attachment status) engaged in high quality interactions regarding the stressful emergency room experience, which then could possibly reinforce their emotional connection and their perspective of their relationship (Fivush & Sales, 2005). In addition to findings supporting our hypotheses regarding attachment, we found two findings that went against prediction which deserve mention. Specifically, we found that mothers with a more anxious attachment status are more elaborative and explanatory during the highly stressful emergency room conversation. Upon closer examination of the narratives of such mothers we observed that these mothers were highly elaborative, especially in regard to the emotion of the situation, and no clear resolutions were provided for managing the high level of emotion elicited by the experience. This finding was especially intriguing to us given that all of the research until this study has demonstrated that maternal “elaborativeness” or creating a highly elaborative narrative is a good thing. But our unexpected finding suggests that elaborations may be qualitatively different in the context of highly stressful emotional events. It will be an interesting and important next step to follow up this finding by more systematically exploring how elaboration interacts 212

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with content and other narrative dimensions during the course of parentchild reminiscing about various stressful events. As we speculated earlier, mother-child narratives also express and construct the coping skills of the co-creators. Specifically, mothers who are more proactive regarding how they cope with life’s everyday stressors are able to scaffold more elaborative, coherent, emotional, and explanatory mother-child narratives pertaining to common everyday stressors. Based on prior research demonstrating that mothers who use more emotional and explanatory language during the co-construction of narratives about stressful events have children who report more flexible coping abilities and fewer internalizing and externalizing behaviors (Sales & Fivush, 2005; Fivush & Sales, 2006), it is highly likely that a scaffolded proactive coping style will impact how children independently manage and address future stressful situations (Kliewer et al., in press, Sales & Fivush, under review). At this time, only a few studies have begun to empirically explore the possible pathways (including narrative socialization) by which parents may be influencing the coping abilities of their children. Thus, much more research is necessary in this area. Additionally, our findings point to the importance of assessing multiple dimensions of narratives, especially narratives of stressful events, given that different aspects of narratives are theoretically and empirically related to different aspects of parent’s social-emotional and cognitive skills. Our data nicely demonstrate this point, as we found that the coping ability of the mother was related to the structure and content of the scaffolded narratives of stressful experiences, whereas her attachment status was related to the quality of the interaction she scaffolded during narrative co-construction. This is an under studied area in the stress and memory literature which deserves a great deal more research attention. Related to this, it is important to note that in our study the type of stressful events being scaffolded mattered for how attachment status and coping skills of the mother related to the co-constructed narratives produced by the dyads. For instance, more stressful and uncontrollable events, such as unexpected middle of the night asthma attacks, may activate social-emotional aspects of emotion regulation during subsequent parent-child conversations about the experiences, but this type of event may not lend itself to the discussion of problem-based aspects of coping because, in a lot of cases, no amount of problem solving or proactive coping could change the event from occurring. Conversely, more common, everyday stressful events, which are usually controllable, may facilitate the inclusion of more problem-based aspects of emotion regulation during the co-construction of these experiences, but may not be threatening enough to activate the social-emotional aspects of the relationship (i.e., the attachment system). Thus the type of event being narrated may, Creating a Context for Children’s Memory

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in part, determine the structure and content of the subsequently co-constructed narrative. Future research should focus on defining theoretically important dimensions along which events may vary and examining how mothers and children co-construct events varying along these dimensions as a function of attachment status and coping skills. In sum, how parents influence children’s remembering of the stressful events of their lives is important not just for understanding processes related to memory, but also for understanding how children create meaningful accounts of stressful events in the service of coping and preserving psychological well-being in the aftermath of stressful experiences. It has been well documented that through parent-scaffolded reminiscing about the past, parents are indeed influencing how children come to independently recall and create meaning about the past, yet little is known about why some parents are better able to scaffold their children during the course of such conversations. Our research has begun to examine two factors, parent coping ability and attachment status, that seem to contribute to individual differences in parental reminiscing ability. Thus far, our results are provocative in suggesting ways in which parental attachment status and coping skills may influence how parents scaffold co-constructed conversations about stressful events with their children and how these conversations might provide an important socialization process by which children are learning to understand and cope with such experiences.

References Ackil, J. K., Van Abbema, D. L., & Bauer, P.J. (2003). After the storm: Enduring differences in mother-child recollections of traumatic and nontraumatic events. Journal of Experimental Child Psychology, 84, 286–309. Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum. Alexander, K.W., Quas, J.A., & Goodman, G. S. (2002). Theoretical advances in understanding children’s memory for distressing events: The role of attachment. Developmental Review, 22, 490–519. American Lung Association. (2005). Trends in asthma morbidity and mortality: Epidemiology and statistics unit, research and program services. New York, NY: American Lung Association. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic Books. Brennan, K. A., Clark, C. L, & Shaver, P. R. (1998). Self-report measurement of adult romantic attachment: An intergrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York, NY: Guilford Press. 214

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Bretherton, I., & Mulholland, K. A. (1999). Internal working models in attachment relations: A construct revisited. In J. Cassidy, & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 89–111). New York, NY: Guilford Press. Carver, C., Scheier, M., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283. Centers for Disease Control and Prevention. (2003). National Center for Health Services. Morbidity and Mortality Weekly Report. Davies, D. (1999). Child development: A practitioner’s guide. New York, NY: Guilford Press. Fivush, R. (1991). The social construction of personal narratives. MerrillPalmer Quarterly, 37, 59–82. Fivush, R., Berlin, L., Sales, J. M., Mennuti-Washburn, J., & Cassidy, J. (2003). Functions of parent-child reminiscing across negative events. Memory, 11, 179–192. Fivush, R., & Fromhoff, F. (1988). Style and structure in mother-child conversations about the past. Discourse Processes, 11, 337–355. Fivush, R., Haden, C., & Reese, E. (1996). Remembering, recounting, and reminiscing: The development of autobiographical memory in social context. In D. Rubin (Ed.), Reconstructing our past: An overview of autobiographical memory (pp. 341–359). New York, NY: Cambridge University Press. Fivush, R., & Sales, J. M. (2003). Children’s memories of emotional events. In D. Reisberg & P. Hertel (Eds.), Memory and emotion (pp. 242–271). Oxford, England: Oxford University Press. Fivush, R., & Sales, J. M. (April, 2005). Mother-child reminiscing, attachment, and psychological wellbeing. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Atlanta, Georgia. Fivush, R., & Sales, J. M. (2006). Coping, attachment, and mother-child narratives of stressful event. Merrill-Palmer Quarterly, 52(1), 125–151. Fivush, R., & Vasudeva, A. (2002). Remembering to relate: Socioemotional correlates of mother-child reminiscing. Journal of Cognition and Development, 3, 73–90. Gini, M., Oppenheim, D., & Sagi-Schwartz, A. (2003). Negotiation styles in mother-child narrative co-construction at age 7½ years: Associations with early patterns of attachment. Poster presented at the Biennial meeting of the Society for Research and Child Development, April, Tampa, FL. Kliewer, W., Adams Parrish, K., Taylor, K. W., Jackson, K., Walker, J. M., & Shivy, V. A. (in press). Socialization of coping with community violence: Influence of caregiver coaching, modeling, and family context. Child Development. Koren-Karie, N., Oppenheim, D., Haimovich, Z., & Etzion-Carasso, A. (2003). Dialogues of seven-year-olds with their mothers about emotional events: Development of a typology. In R. N. Emde, D. P. Wolf & D. Oppenheim (Eds.), Revealing the inner worlds of children: The MacArthur Story Stem Battery and parent-child narratives (pp. 338–354). New York, NY: Oxford Press.

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Laible, D. J., & Thompson, R. (1998). Attachment and emotional understanding in preschool children. Developmental Psychology, 34, 1038–1045. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer. Main, M., Kaplan, K., & Cassidy, J. (1985). Security in infancy, childhood and adulthood: A move to the level of representation. In I. Bretherton & E. Waters (Eds.), Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50 (1–2, Serial No. 209), 66–104. Meins, E. (1997). Security of attachment and the social and emotional development of cognition. East Sussex, UK: Psychology Press. Miller, P. (1993). Theories in developmental psychology. New York, NY: W. H. Freeman and Company. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social cultural developmental theory. Psychological Review, 111, 486–511. Oppenheim, D., Nir, A., Warren, S., & Emde, R. N. (1997). Emotion regulation in mother-child narrative co-construction: Associations with children’s narrative and adaptation. Developmental Psychology, 33, 284–294. Pennebaker, J. W. (1997). Opening up. New York, NY: Guilford Press. Pratt, M. W., & Fiese, B. H. (2004). Family stories and the life course. Rahway, NJ: Erlbaum. Reese, E., Haden, C., & Fivush, R. (1993). Mother-child conversations about the past: Relationships of style and memory over time. Cognitive Development, 8, 403–430. Reynolds, M., Brewin, C. R., & Saxton, M. (2000). Emotional disclosure in school children. Association for Child Psychology & Psychiatry, 151–159. Sales, J. M., & Fivush, R. (2005). Social and emotional functions of mother-child reminiscing about stressful events. Social Cognition, 23, 70–90. Sales, J. M., & Fivush, R. (under review). Socialization of children’s coping through mother-child narratives about stressful events. Sales, J. M., Fivush, R., & Peterson, C. (2003). Parental reminiscing about positive and negative events. Journal of Cognition and Development, 4, 185–209. Sandler, I., Tein, J., & West, S. (1994). Coping, stress, and psychological symptoms of children in divorce: A cross-sectional and longitudinal study. Child Development, 65, 1744–1763. Sandler, I. N., Wolchik, S. A., MacKinnon, D., Ayers, T. S., & Roosa, M. (1997). Developmental linkages between theory and intervention in stress and coping processes. In S. Wolchik & I. Sandler (Eds.), Handbook of children’s coping: Linking theory and intervention. Issues in clinical child psychology (pp. 3–40). New York, NY: Plenum Press. Shaver, P. R., & Mikulincer, M. (2002). Attachment-related psychodynamics. Attachment & Human Development, 4, 133–161. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2002. Series 10, Number 221. 2004–15.49.

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Thompson, R. (1994). Emotion regulation. A theme in search of definition. Monographs of the Society for Research in Child Development, 59 (2–3, Serial number 240). Thompson, R. (2000). The legacy of early attachment. Child Development, 71, 145–152. Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.

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9 An Integrated Model of Emotional Memory Dynamic Transactions in Development Kristen Weede Alexander Karen Davis O’Hara

“We turned and saw a giant wave, taller than our school building, was coming to hit us. I held my brother tightly, but the wave separated us. I survived . . . while my brother couldn’t make it. I miss him very much . . . .” (UNICEF, 2005) “My parents were always yelling. That night, I just cried as loud as I could, but nobody heard me. I heard a noise and then the door slammed and my mom was crying. I haven’t seen my dad since then.” (Anonymous)

T

he recollections of the 11-year-old boy who lost his brother to a tsunami and the 7-year-old girl who lost her father due to marital problems are similar in that both events involved loss and evoked deep emotion; however, they also differ on several dimensions, including the context of the event and characteristics of the children involved, both of which are critical in predicting children’s memory. Much of the developmental research on emotional memory has focused on single measures of emotion or arousal, and not the emotional processing within the individual that occurs before, during, and after the event, or the child’s psychobiological, emotional, and cognitive resources. This chapter presents a model of emotional memory that integrates psychobiological processes with other elements of the developmental context to illustrate that the relation between emotion and memory is far more 221

complex than can be explained by the nature of an emotional stimulus or characteristics of the individual alone. The current chapter focuses on the state of research and theory concerning relations among emotion, developmental context, and memory in development, with a particular emphasis on how psychobiological processes play an integral role in these relations. Because memory is a skill relying heavily on a variety of cognitive (e.g., Kail, 1990), social (Alexander, Quas, & Goodman, 2002), and biological factors (Schacter, 1994), we posit that a dynamic systems framework is essential to understanding the development of memory for emotional and stressful experiences. We thus begin this chapter with an overview of this theoretical framework in the context of emotional memory. The focus then turns to factors within the dynamic model by providing an overview of the psychophysiological systems involved in emotional memory. With this lens, memory for emotional experiences is further considered, beginning with the nature of the emotional event itself. Next, developmental and individual differences related to children’s processing of emotional experiences are reviewed, with a focus on individual differences related to social and cognitive processes and emotion regulation. The chapter concludes with applications of this model to clinical and legal domains and suggestions for new directions of future research.

Theoretical Framework Dynamic Systems Theory In recent decades, there has been a movement away from studying memory and development in isolation to working toward an understanding of the individual in the context of a dynamic interplay of genes, neurons, individuals, families, relationships, and cultures. Dynamic systems theory was developed with the idea that, to understand the development of behavior and thinking, researchers must consider all levels of analysis (e.g., Ford & Lerner, 1992). In fact, although not focusing specifically on memory, the most recent edition of the Handbook of Child Psychology contained several theoretical chapters underscoring the notion that children develop within a set of “systems,” each of which has an impact upon the other (e.g., Bronfenbrenner & Morris, 2006; Fischer & Bidell, 2006; Gottlieb, Wahlsten, & Lickliter, 2006; Lerner, 2006; Thelen & Smith, 2006). Together these models highlight the necessity of skepticism when faced with overly reductionistic explanations of growth and development. Likened to a pebble thrown in a pool, the cascade of ripples leaves no part of the pool unchanged. Similarly, no single factor in a child’s biological structure or environment can separately create an 222

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outcome, as that factor is nested within a host of other qualities and characteristics that forever alter its potential impact. Despite such interest in integrating theoretical models and consideration of dynamic systems from a theoretical point of view, Ayoub and Fischer (2006) have argued that studies of development still tend to focus on fragments of the organism (e.g., genes, cognition, or culture), causing an understanding of development lacking the integrated whole. Not only must the context of development be considered, but also the intersections among multiple domains, in what the researchers termed the “developmental web.” Relevant to the current discussion are the dynamic and integrated systems of physiology, cognition, and emotion.

Memory and Emotion as Dynamic Systems Early research revealed a wide array of variables that influences memory, such as intelligence, attention, and distress. Transactional models organize these variables for systematic examination of the ways in which memory both impacts and is impacted by other developmental factors and how they change over time. Few researchers would refute the notion that memory is linked with emotion and that this connection has a strong basis in shared neural circuitry (e.g., Davidson, 2003). In practice, however, little research has examined multiple domains simultaneously. As will be discussed later, emotion itself is a system composed of both biological and behavioral components. Hormonal and neurological responses that regulate behaviors are borne out of the complex interplay between genetic predispositions and environmental influences. Thus, when considering emotional memories, one must include the dynamic transaction of integrated systems of emotion and of memory. Memory itself involves the integration of biological, cognitive, and emotional systems for encoding, manipulating, maintaining, and retrieving details about experiences. These systems inherently rely on biological function. Neural processes underlying memory are shared with emotional arousal (e.g., Eichenbaum, 1997), novelty detection (Knight, 1996; Tulving, Markowitsch, Kapur & Habib, 1994), and self-representation (Levine et al., 2004). In many cases, the processes work in complement, as when an individual is at an optimal level of arousal, or when events and stimuli are consistent with cognitive representations of past experiences or current mood state (Eich & Macaulay, 2000; Perrig & Perrig, 1988). However, in other situations (e.g., chronic stress, depression), these common systems can act in conflict with one another. In this manner, emotion can be seen to improve memory of some dimensions of emotional experience and to interfere with memory in others. An Integrated Model of Emotional Memory

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Because information stored in memory is not an exact replica of that experienced (e.g., Bartlett, 1932), memory systems rely on prior experiences and cognitive structures, in part, to encode, retain, and retrieve memories. Through life, individuals develop general ideas about the structure of experiences and tools that are used to organize and retain incoming information and develop expectations about upcoming events. Piaget and Inhelder (1969) termed these structures “schemas,” the concept of which has been applied to elucidate the complex process of knowledge organization (Mandler & DeForest, 1979) and memory reconstruction (e.g., Fivush, Kuebli, & Clubb, 1992; Hudson & Nelson, 1986). As the result of amassing experiences, humans form schemas about events (e.g., what happens at birthday parties), emotions and emotional meanings (e.g., how one feels following a success), and the self and others in relationships (e.g., how mothers respond to children’s needs). Schemas not only guide initial encoding of events, but also cognitive processing, such that over time memories might change to more closely resemble previously formed schemas (e.g., attachment, Feeney & Cassidy, 2003). Schemas thus provide causal and temporal information that guide processing of, and memory for, emotional experiences. Schemas are also used for interpretation of emotional experiences. Although defining emotions can be difficult, most researchers would agree that emotions involve at least three major components: cognitive appraisal of an event or stimulus, physiological response and regulation, and subjective feelings and expression of emotion (Adolphs, Fellous, & Arbib, 2005). In this manner, events are not themselves emotional, but rely on the perception and interpretation within the individual. This interpretation, or appraisal (Lazarus, 1993), depends on the cognitive schemas and expectations of the individual, but also upon the physiological state before, during, and after the event. Furthermore, this physiological state is interpreted by the individual to influence subjective state, including mood. Prior knowledge and expectations are in continual transaction with physiological state, within a developmental context containing characteristics from biologically rooted dispositions to cultural milieu. Developmental timing of emotional experiences is also important. Biological, cognitive, and social and emotional systems continue to develop according to different timelines from the moment of conception. Although integrated from the beginning, the ways in which the systems transact over time are highly dependent upon the cumulative expression of genes and experiences (Waddington, 1959). Bronfenbrenner and Morris (1998) proposed that development occurs primarily through “proximal processes,” which involve active, reciprocal interaction with tools in the immediate environment and become increasingly complex over time. As 224

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individuals engage in proximal processes, they form schemas and scripts, internal working models, and coping strategies that guide their appraisal of events and hence affect their emotional memories. These continual processes of appraisal, emotion regulation, and schema transformation establish the foundation for emotional memories across the lifespan. Figure 9–1 presents an integrated model of emotional memory. Primary to this model is the idea of the developmental context, which evolves as children mature and amass experiences. The developmental context is composed of several dynamic systems and includes the transaction among biological, social, emotional, and cognitive domains over time (Gottlieb et al., 2006). At the innermost layer are characteristics of the individual, such as genetic predispositions, temperament, and age. These transact with qualities of primary social relationships, such as attachment and parent-child interaction styles. Both of these layers transact with the larger culture of development (e.g., Bronfenbrenner & Morris, 1998; Rogoff, 1990; Vygotsky, 1978). Importantly, embedded within these layers are psychobiological factors such as neural and hormonal activity, which rely on and are relied upon to regulate other characteristics of the developmental context (Gross & Thompson, 2007; see also Wiik & Gunnar, this volume). When an event occurs, the objective reality takes place with the developmental context as a backdrop. Thus, children’s appraisal of the event depends on factors such as their psychobiological reactions, temperamental predispositions, and representations of relationships. Such factors transact during all levels of processing emotional experiences (i.e., encoding, storage, retrieval) to predict memory. The dependent measure

Developmental Context Culture, Society Primary Social Relationships (e.g., attachment, parent-child interactions) Child Characteristics (e.g., genes, age, temperament, reactivity)

Event (intensity, valence, relevance)

Appraisal

Psychophysiology (e.g., frontal activation, cortisol, cardio-reactivity)

Memory (e.g., implicit, autobiography, schemas)

Figure 9–1. Integrated model of emotional memory. An Integrated Model of Emotional Memory

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in much of the research presented in this chapter is this memory output. Note, however, that memory is not only an output, but also provides feedback to systems within the developmental context in forms such as implicit memory, schemas, and autobiographical memories, which may then predict future mnemonic processing. Our presentation of evidence for this model begins with a brief overview of the physiological systems shared between memory and emotional systems and how they are linked with differences in memory.

Neurophysiological Processes Underlying Emotion and Memory A large body of research on the physiological and neurological mechanisms involved in memory suggests mechanisms by which their functions are influenced by emotional arousal. These studies have illustrated that variation in the physiological processes involved in different stages of mnemonic processing (e.g., encoding, consolidation/storage, and retrieval; Lupien & Lepage, 2001), as well as in different levels of emotion (e.g., arousal versus chronic stress; Buchanan & Adolphs, 2004), help to explain the sometimes contradictory findings on memory for emotional events. As such, exploration of psychophysiological mechanisms integrating emotion/stress and memory helps to organize knowledge about these relations in a more elaborated and sophisticated manner. Central to the discussion of neurophysiology shared between emotion and memory is the role of the medial temporal lobe, including the amygdala and hippocampus. These structures lie within the subcortical limbic system, with vast interconnections with one another (Habib, McIntosh, Wheeler & Tulving, 2003; Roozendaal, 2002), with neuroendocrine structures (e.g., hypothalamus and adrenal glands; Cahill & McGaugh, 1998), and with higher-level functions of the frontal lobe (for review, see McGaugh, 2004). Recent research has shown that the structures have very different roles in the emotion-memory relation, and their distinction gives insight into the findings that emotion has both enhancing and deleterious effects on memory (Buchanan & Adolphs, 2004). Although it is tempting to reduce these subcortical limbic structures to the “home” or “loci” of emotional memories, research has shown clearly that they exert their influence not in isolation, but in concert with other areas of the brain (e.g., McGaugh, Cahill, & Roozendaal, 1996), including the temporal and frontal lobes and the hormonal regulation centers, parricularly the hypothalamic-pituitary-adrenal (HPA) axis, which modulates cortisol and other stress hormones (Payne, Natel, Britton, & Jacobs, 2004). One mechanism through which these neural structures interact with one another and other systems in the organism is through release 226

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of stress hormones (among other neurochemicals) involved in emotional arousal, which provide a medium of communication about the emotional state of the organism.

Physiological Systems Underlying Emotion and Memory Amygdala Much research has focused on the role of the amygdala, a small subcortical structure in the medial temporal lobe, in the modulation of emotional memory. The amygdala contributes to the relation between stress hormones indicative of arousal during emotional events and memory for those events (Cahill et al., 1996; McGaugh, 2004). Moreover, the role of the amygdala in memory seems to be limited to emotional memories. For example, bilateral amygdalar lesions were shown to impair memory for emotional, but not neutral, events (Cahill, Babinsky, Markowitsch & McGaugh, 1995). Similarly, imaging studies revealed that activation of the amygdala corresponds to the degree of subjective arousal reported, and this combination was significantly predictive of memory for those emotional events (Cahill et al., 1996; Canli, Zhou, Brewer, Gabrielli & Cahill, 2000). A potential explanation for the association between amygala activity and memory is its involvement in defensive and appetitive reactions, usually in the face of fearful or threatening stimuli (Amaral, 2002; LeDoux, 2000). Moreover, its role in memory appears to be largely due to modulation of other brain functions. At encoding, reactivity of the amygdala signals and recruits a wide neurological network (Roozendaal, 2002), which has been found to increase memory for the central details of an event at the same time as decreasing memory for the “gist” (Cahill, 2003). Further, activation of the amygdala (specifically the basolateral nucleus) following an emotional event has been found to increase neural plasticity in other areas of the brain, and hence to facilitate the neurological underpinnings of memory consolidation or storage (Pelletier, Likhtik, Filali, & Pare, 2005). One of the primary mechanisms through which the amygdala modulates emotion-memory associations via activation of stress hormones. Research has pointed most specifically to the role of epinephrine and norepinephrine (NE) and of glucocorticoids (e.g., cortisol) as integral in this emotion-memory link (Cahill & Alkire, 2003; McGaugh et al., 1996). Studies with rodents have shown that epinephrine injections improved memory, but this improvement was absent when reception in the amygdala was blocked or with lesions to adrenergic pathways from the amygdala (preventing epinephrine and NE). Further studies have indicated a direct role of NE on amygdalar influence on memory (see McGaugh, 2004, for review). An Integrated Model of Emotional Memory

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Epinephrine, however, does not cross easily from the periphery of the body into the brain and instead appears to exert its effect indirectly via the peripheral vagal nerve connections. This indirect route has been supported by experiments showing that interference with vagal functioning decreases memory enhancement from stress (Talley, Clayborn, Jewel, McCarthy, & Gold, 2002). Furthermore, models of the vagal system have illustrated its role in the monitoring of circulating blood catecholamines and in modulation of other nervous and organ systems (e.g., heart, lungs, immune system) during stress (Mravec, 2005; Mravec, 2006). This is an important point, as research on indicators of vagal functioning (e.g., respiratory sinus arrhythmia or RSA) has identified links between such functioning and both emotional variations in temperament (Doussard-Roosevelt, Montgomery, & Porges, 2003) and variations in working memory (Clark, Krahl, Smith & Jensen, 1995; Hansen, Johnsen & Thayer, 2003). Additionally, during emotional arousal, the human body releases glucocorticoids, which have been found to improve memory when released during encoding, but decrease memory when present at retrieval (Roozendaal, 2002). In adult women, administration of oral cortisol was found to negatively impact retrieval of negative words but not neutral words (Kuhlmann, Kirschbaum, & Wolf, 2005). These findings point to the importance of the timing of physiological arousal in the mnemonic process. Finally, insight into the sometimes contradictory relationship between emotion and memory is derived from findings that stress hormones have a concentration-dependent, curvilinear effect on memory. Injections of epinephrine immediately following training tasks in mice increased cellular evidence of learning (or long-term potentiation: LTP) positively to a certain peak concentration, after which there was a negative correlation (e.g., Diamond, Bennett, Fleshner & Rose, 1992). Furthermore, extended duration of the exposure to corticosteroids has been found to decrease learning in rats (Pavlides, Watanabe, & McEwen, 1993), and high and sustained levels of glucocorticoids in humans have been associated with decreased memory function and decreased cellular functioning in the hippocampus, a structure we discuss next (e.g., Sapolsky, 1992).

Hippocampus As a source of memory formation, the hippocampus has been extensively researched on account of its role in LTP, the neurocellular process most associated with learning and memory (Bliss & Collingridge,

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1993). In many animal studies, cellular changes indicative of LTP are the dependent measures by which learning or improved memory performance is operationalized. Furthermore, because of the high volume of receptors for stress hormones such as glucocorticoids (e.g., cortisol) and NE, in the hippocampus, researchers have specifically focused on the role that these hormones (or blocking of these hormones) has on both cellular LTP and behavioral indicators of memory, hereafter referred to generally as “memory.” Similar to other studies on the relation between stress and memory, many of these studies have provided mixed results, some showing a positive emotion-memory relation, and others showing a negative relation. To some extent, explication of these variable results hinges on the role that the hippocampus plays in the different phases of memory. For example, in the encoding process, the hippocampus has been found to play a significant role in discrimination of novelty (Habib et al., 2003; Tulving et al., 1994) and activation of cortico-limbic and limbic-limbic connections (Knight, 1996; but for alternate theories, see Cohen et al., 1999). Therefore, specific encoding of stimuli that are novel or unexpected may depend greatly on hippocampal functioning. Furthermore, the hippocampus has been found to be extensively involved in working memory, specifically in the process of establishing contextual cues of an event, such as pairing novel with familiar aspects, ordering the temporal dimension of events, and orientation of objects in space (e.g., Moses, Sutherland, & McDonald, 2002). The hippocampal memory system has been found to mediate the negative effects of stress on memory in studies of experimentally induced stress (i.e., injections of high levels of cortisol) and in studies of groups suffering from extreme and chronic stress (e.g., childhood abuse and neglect, posttraumatic stress disorder; Payne et al., 2004). Underlying this relation appears to be glucocorticoids, and specifically the effect of stress on the hypothalamic-pituitary-adrenal axis (HPA-axis). This “negative feedback loop” functions to help the organism modulate stress and the activation of cortisol. The hippocampus and the frontal lobe appear to be key components in this feedback system. When the HPA-axis becomes taxed with extreme or chronic stress, glucocorticoids have negative effects on the cellular structure and LTP creation in the hippocampus (Pavlides et al., 1993). Much research has focused on this mechanism as the core system that mediates the negative effect of stress on memory (e.g., Payne et al., 2004). The role of the HPAaxis in memory is also important due to enduring effects of the early caregiving environment and temperamental stress reactivity on cortisol in children (Gunnar, 2006; see Wiik & Gunnar, this volume), and its interconnection with the frontal lobes of the cortex. An Integrated Model of Emotional Memory

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Frontal Cortex As alluded to in previous sections, the frontal cortex of the brain plays an important role in the relation between emotion and memory in every phase of memory, largely through its role as an “executive manager” of attention and cognitive representation, and with its bidirectional interconnections with the amygdala and hippocampus. Although a full review of the functions of the frontal lobe is outside the realm of this chapter (but see Alvarez & Emory, 2006; Faw, 2003, for reviews), here we point to some findings that give insight to the potential role of developmental context on frontally mediated relations between emotion and memory. Previous research on the function of the frontal lobe has illustrated its primary role in mental representations and higher-order executive functions (for review, see Prabhakaran, Narayanan, Zhou, & Gabrieli, 2000). A review by Wall and Messier (2001) on the role of the frontal lobe in declarative memory posited that, in coordination with the hippocampus, the prefrontal cortex is specifically engaged in an “attentional monitoring system,” whereby the frontal lobes serve to hold a representation of the recent past, and the hippocampus serves as the “discrepancy detector.” When discrepancy is found, the frontal lobe functions to engage in goal-directed behavior to reconcile the present with the representations of the past. This theory is supported by numerous lines of evidence including the finding that hippocampal damage is associated with a decrease in activation in the frontal lobe, as well as a decrement in the normal emotional response to novel versus expected control stimuli (Knight, 1996). Evidence from functional neuroimaging studies of human memory have indicated that the frontal lobes are involved specifically in selfreferential and autobiographical memory (Cabeza et al., 2004), and in episodic memory as guided by visual attentional processes (Cabeza, Locantore, & Anderson, 2003). In particular, the research has suggested that the two regions of the frontal lobe are lateralized (left versus right) for different aspects of emotional memory. Christianson, Saisa, and Silfvenius (1995) found that memory for emotional information was remembered better when the left hemisphere (as opposed to the right) was deactivated using a sodium-amytal test. This finding supports the large body of research illustrating the asymmetrical involvement of the frontal lobe in emotion regulation (for review, see Davidson & Irwin, 1999). The left frontal region is theorized to be more associated with motivation to approach and engage (e.g., interest, joy, and anger; Dawson, 1994; Harmon-Jones & Allen, 1998), whereas the right has been associated with greater motivation to withdraw from novelty and arousing stimuli (e.g., disgust, sadness; Davidson, 230

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2003). Although to our knowledge little attention has specifically been focused on frontal asymmetry during emotional processing to differences in children’s memory (but see Alexander, O’Hara, & Kraft, 2007), there is evidence for asymmetrical involvement of the frontal lobes in attention and emotion (Yamasaki, LaBar, & McCarthy, 2002). Further, with the proposed asymmetrical connectivity of the frontal lobes with the amygdala (left) and hippocampus (right; Tucker & Derryberry, 1992), this measure of frontal function is a potentially powerful indicator of developmental mechanisms underlying memory for emotional events.

Further Questions: Neurobiology, Emotion, and Memory Although amazing strides have been made in the last 15 years on understanding the neurophysiological mechanisms involved in emotion and memory, new studies continue to emerge, elucidating new connections and disproving existing theories about proposed functions and mechanisms. Therefore, during the evolution of this knowledge, we must remain open to the wide range of other possible mechanisms for establishing this link. To illustrate, evidence is now pointing with increased consistency to the role of the anterior cingulate cortex (ACC) in the integration of cognitive and emotional functions. Nestled between the corpus callosum and the prefrontal cortex, the ACC serves the primary role of integrating “bottom-up” arousal with “top-down” executive direction of the more evolutionarily advanced prefrontal cortex. Bush, Luu, and Posner (2000) reported that the ACC is functionally divided into two subregions: one is “primarily involved in assessing the salience of emotional and motivational information and the regulation of emotional responses” (p. 216), whereas the other subregion has primary connections with the prefrontal cortex and motor areas, is involved in a “distributed attentional network,” and modulates attention, planning, and error-detection. Although the specific contribution the ACC makes to emotion and memory is yet unclear, these findings should be examined with a keen eye to its role within a developmental framework. Furthermore, research linking the dynamic development of emotion and memory systems is only in its beginning stages. A body of developmental research suggests that both the hippocampus and frontal lobes follow an extended developmental gradient, with structural changes occurring into late adolescence or early adulthood (e.g., Couperus & Nelson, 2006; Krasnegor, Reid Lyon, & Goldman-Rakic, 1997). Moreover, effects of stress hormones on regulation and cognition are lasting and may change with development (see Carver & Cluver, this volume, and Gunnar, 2006, An Integrated Model of Emotional Memory

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for review). It is not well understood, however, how these changes are linked with changes in mnemonic processing of emotional experiences, and thus research with a developmental systems approach is necessary.

Transactions Predicting Memory for Emotional Experiences According to the integrated model of emotional memory proposed here, dynamic biological, cognitive, and social/emotional systems must be considered in the developmental context to fully understand children’s memory for emotional events. However, no single event will be appraised in exactly the same way for every individual, and is instead dependent upon features of the event in transaction with the physiological, individual, and social systems operating within the developmental context. Some factors related to the context of the event are discussed next, followed by characteristics of the individual in developmental context.

Qualities of the Event Research examining the relation between emotion and memory has focused a great deal on the nature of the emotional stimulus, showing that certain qualities of events or stimuli are linked with general differences in memory. For example, more intense emotional stimuli have been related to greater arousal and increased recall of central details, but decreased memory for peripheral details (e.g., Christianson, 1992; Otani, Libkumen, Widner, & Graves, 2007). Strange, Hurlemann, and Dolan (2003) found that physiological systems involved in enhancing memory for emotional events were also involved in degrading memory for peripheral information. Specifically, emotional arousal accompanying a target emotional word was linked with a combined increase in memory for the arousing word and decrease in memory for the word that directly preceded it in a word-list presentation. This finding was reversed when arousal to emotional words was pharmacologically blocked; emotionally arousing words were remembered less, whereas memory for the neutral word preceding the emotional stimulus was enhanced. There was no effect, however, on neutral words. In another study that involved inducing general arousal (i.e., via increased cortisol response), adults in the stress and control groups recalled equally well positive and negative words, but the stress group recalled significantly fewer neutral words (Smeets et al., 2006). Further, the stress group made more commission errors in recall. 232

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Evidence suggests that activation of different neural regions during the processing of positive and negative stimuli were associated with memory performance. Canli, Zhou, Desmond, Glover, and Gabrielli (1999) found that activation of many regions of the limbic system and cortex (specifically right prefrontal cortex) were associated with increased memory for negative events, whereas activation of only the left prefrontal cortex was associated with increased memory for positive events. The subjective experience of emotional events is dependent not only upon the salient qualities of the event, but also on the interaction between child and event characteristics. For example, children may not appraise events as do adults (e.g., Pollak, Cicchetti, & Klorman, 1998; Saarni, Mumme, & Campos, 1998), and therefore age must be considered as part of the dynamic developmental context predicting emotional memory. Further, schemas and implicit memories about emotional experiences, relationship models, and/or regulatory strategies affect appraisal of such experiences. Therefore, experience has the potential to influence mnemonic processing at encoding, storage, and retrieval. For instance, studies using animal models have shown that even a single exposure to a stressor led to adaptation of the HPA-axis and increased reactivity in subsequent exposures (Marti, Garcia, Velles, Harbuz, & Armario, 2001). Further, research indicates that an individual’s experiences in attachment relationships are related to memory of events and stimuli that evoke feelings about relationships and thus activate the attachment system (e.g., Alexander, Hafer, Bortfeld, O’Hara, & Kraft, 2007a). This will be discussed further in a later section. Appraisal may not only be affected by enduring qualities of prior experiences, but also by current disposition. For example, Eich and Macaulay (2000) found evidence of “mood-congruent memory” enhancement, in that positive mood at encoding increased memory for positive stimuli, whereas negative events were recalled better when encoding occurred during a negative mood. This research is consistent with a model of memory that suggests that state of mind and expectations influence attentional deployment toward specific stimuli. Thus, valence of the event may be less important than whether it is consistent or at odds with the viewer’s expectations. This research is particularly relevant when discussing the role of emotion in memory for psychiatric patients who have consistent elevations in arousal or depressed mood. Research on depression has indicated a decrease in the specificity of autobiographical memory (Kuyken & Dalgleish, 1995), even when this depressed mood was experimentally induced (Yeung, Dalgleish, Golden, & Schartau, 2006). It is interesting to note the bidirectionality of this association between emotion and memory; in depressed patients, memory suppression predicts depressed reactions to An Integrated Model of Emotional Memory

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trauma (Burnside, Startup, Byatt, Rollinson, & Hill, 2004; van Minnen, Wessel, Verhaak, & Smeenk, 2005), and is related to decreases in cortisol (Barnhofer, Kuehn, & de Jong-Meyer, 2005) and to differences in frontal lobe function (Keedwell, Andrew, Williams, Brammer, & Phillips, 2005). In addition to underscoring some clinical implications of this research, findings such as these point to the importance of emotion regulation, and not just emotional responding, in understanding emotion and memory, and thus highlight the importance of considering qualities of the event in transaction with child characteristics.

Qualities of the Child In many studies where stress is measurable, children’s distress is measured at the time of the event behaviorally (e.g., Alexander, Goodman, Schaaf, Edelstein, Quas, & Shaver, 2002) or physiologically (e.g., Quas, Carrick, Alkon, Goldstein, & Boyce, 2006). Children’s processing of the stressor over time, however, may not necessarily reflect their initial processing of the event, and as discussed earlier, the developmental context of the individual has the potential to enhance or interfere at any point during the memory process. Thus, how children’s narrative is constructed over time is related to characteristics of the context of development, such as cognitive ability, temperament, attachment, and interaction style. Such characteristics contribute to the foundational schemas through which experiences are appraised and processed over time and provide tools through which children learn to regulate emotion and cope with their experiences. In the following, we review some of the crucial tools children use to remember emotional experiences.

General Cognitive Ability In the past, measures of cognitive ability, be it general intelligence, working memory, or developmental level, have been central in evaluating children’s memory. Although researchers have broadened the scope to incorporate a more integrated model of emotional memory, individual differences in cognitive ability remain important. For example, developmental shifts in neural organization occur in concert with behavioral changes in cognitive ability (Thatcher, 1994). These shifts coincide with age-related developmental increases in myelinization and functional organization of core cognitive neural structures (Fischer & Rose, 1996). Thus, cognitive developmental shifts highlight the importance of an integrated memory model at which the child and developmental context are at the core. Cognitive measures related to memory include executive functions, such as working memory and inhibitory skills, that rely heavily on 234

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the frontal lobe (e.g., Diamond, Prevor, Callender, & Druin, 1997) and are integral to general memory. For instance, Schaaf, Alexander, and Goodman (in press) found that children’s inhibitory control explained their memory inaccuracies for emotional experiences, in coordination with other developmental measures (e.g., attachment, behavior problems). Specifically, in a structural equation model, inhibition directly and inversely predicted memory inaccuracies, whereas additional pathways leading from children’s behavior problems predicted their memory inaccuracies. Furthermore, studies with children (e.g., Perez-Edgar & Fox, 2003) and adults (e.g., Zeijlmans van Emmichoven, van IJzendoorn, de Ruiter, & Brosschot, 2003; Edelstein, 2006) have revealed patterns of basic information processing and working memory that differ for emotional and neutral information. Importantly, measures of general cognitive ability not only help to explain processing and memory for emotional experiences, but also do not diminish associations with other measures of the developmental context.

Temperament and Reactivity Individual differences in temperament are theorized to be biologically rooted dispositional characteristics of reactivity and self-regulation (Rothbart, Ellis, & Posner, 2005). As such, these relatively enduring characteristics of emotional and cognitive behavior are consistently correlated with psychobiological patterns of emotional processing and reactivity, including cardiovascular reactivity (e.g., vagal tone; DoussardRoosevelt et al., 2003), cortisol (see Gunnar, 2006, for review), and frontal asymmetry in infants (e.g., Calkins, Fox, & Marshall, 1996) and preschoolers (e.g., Theall-Honey & Schmidt, 2006). One aspect of temperament that has been extensively studied is temperamental “reactivity” or “behavioral inhibition” (see Marshall & Stevenson-Hinde, 2005, for review). Behaviorally “inhibited” children (i.e., high in reactivity and negative affect) exhibit heightened levels of attention in novel situations and have difficulty shifting attention (Martin & Fox, 2006). Similar patterns have been observed in adults (Derryberry & Reed, 2002). Such effects of temperament, as part of the developmental context, have implications for emotional memory by orienting and/ or maintaining attention to certain aspects of the situation. These biases in attention are fairly enduring patterns of reactivity, and therefore may guide the development of emotional schemas that may also uniquely affect memory for emotional experiences. Temperament is not only related to children’s reactions to novel situations, but also to physiological and behavioral patterns of emotion regulation in novel and emotionally arousing situations (Kagan, Snidman, Arcus & An Integrated Model of Emotional Memory

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Reznick, 1994; Moehler et al., 2006). For instance, Theall-Honey and Schmitt (2006) found temperamental differences in children’s frontal asymmetry while viewing emotional video clips. Specifically, shy children (versus non-shy children) showed greater right frontal asymmetry while viewing a fear-eliciting video, indicating motivation to withdraw. Because children were processing novel stimuli, these brain activation patterns are similar to those expected during encoding of novel events. A related body of research links children’s physiological reactivity (e.g., cortisol, heart rate) to temperamental characteristics (e.g., see Martin & Fox, 2006, for review) and memory for arousing experiences. In one study directly linking temperamental reactivity with memory, Quas et al. (2006) examined four- to eight-year-old children’s cardiovascular reactivity during a series of laboratory stressors, including a fire alarm incident. Memory was tested later during the session, and results indicated that, in addition to young children generally displaying poorer memory, older children who exhibited higher vagal reactivity (baseline to task) evinced poorer memory. Because behavioral measures of temperament approximate children’s reactivity and regulation, such factors may also relate to memory. For example, emotion regulation involves a variety of strategies (e.g., Gross, 2002), such as reappraisal of the event or suppression of emotional expression, which have been related to impaired memory (Gross, John & Richards, 2000; Richards & Gross, 2006). Similarly, children’s temperament has been linked to their coping and regulation (Salmon & Pereira, 2002) and to their memory. Specifically related to memory are temperament characteristics such as effortful control (Alexander et al., 2002a), adaptability (Alexander et al., 2007a), approach, persistence, and sensory awareness (Switzer, 2006). Specifically, in a study of three- to seven-yearold children, Alexander and colleagues (2002a) asked children to recall an inoculation experience. They found effortful control, as measured by parent report, positively predicted aspects of children’s memory. Because effortful control has been described as being controlled by the neural mechanisms for executive attention (Rothbart, Posner, & Kieras, 2006), it is not surprising such a measure of temperament would predict memory. The contributions of temperament, however, were independent of other important characteristics of the developmental context, such as attachment, which we turn to shortly. Combined, this literature supports the idea that temperament has its roots in biological systems and interacts over time with children’s social, emotional, and physiological experiences to influence emotion regulation (Tobin & Graziano, 2006). Insofar as temperament is indicative of emotion regulation, it is an integral component of the developmental context influencing processing of emotional information. 236

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Qualities of the Caregiving Environment Processing emotional information further relies on the developmental context of primary social relationships. Patterns of interaction within the family have implications for relational schemas formed in infancy and maintained throughout life (i.e., internal working models: IWMs) and for regulation of practices, knowledge, and discussion relevant to experiences. As such, and as many of the chapters in this volume demonstrate, the caregiving environment has the potential to greatly impact the context of development at all ages, and thus processing of information and memory, particularly that of relational or emotional relevance (Alexander et al., 2002b; Andersen, Reznik, & Chen, 1997; Collins & Allard, 2004; Pietromonaco & Barrett, 1997).

Attachment Through repeated interactions with caregivers, infants gradually form IWMs, which are stable mental representations of the self and other in relationships (Bowlby, 1969/1982) and concern expectations of the degree to which others are available, trustworthy, and able to provide necessary comfort and security (Bretherton & Munholland, 1999). Creation of an IWM of the self as valued and competent is thought to occur in a developmental context in which caregivers are emotionally available and supportive of exploration. Alternatively, when caregivers reject or ignore children’s bids for care and/or interfere with or disallow exploration, children are thought to develop IWMs of the self as devalued or incompetent (Bretherton & Munholland, 1999). Once formed, infants use IWMs like they use other cognitive schemas to interpret others’ intentions and actions, predict future behaviors, and guide their own responses, particularly in times of stress and when individuals are in need of comfort or support (Bowlby, 1969/1982). Although working models are relatively stable because of their roots in early relationships, IWMs mature with development as thinking develops and transforms (Ayoub & Fischer, 2006) and continue to shape response patterns and guide processing of emotional and interpersonal experiences into adulthood (e.g., Baldwin, 1995; Collins, Guichard, Ford, & Feeney, 2004; Fivush, 2006). Evidence suggests that emotion regulation underlying attachment patterns have neurobiological bases, as differences in social relationships and attachment security have been directly linked to psychobiological variation, particularly for processing of relational information (e.g., Amini, Lewis, Lannon, & Louie, 1996; Gunnar, 2006; Marshall & Fox, 2006). For example, Davis O’Hara (2003) found more insecurely An Integrated Model of Emotional Memory

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attached preschoolers exhibited patterns of greater left-frontal asymmetry when viewing attachment-relevant videos, indicating neuropsychological approach, possibly due to angry responses. Given the associations between frontal lobe function and memory, it will be important to determine whether memory differences related to attachment patterns are mediated by associated physiological patterns of emotion regulation. Not only does attachment relate to children’s patterns of physiological activation, it is also associated with appraisal of arousing experiences. That is, emotion regulation occurs in the context of attachment relationships (van der Kolk, Pelcovitz, Roth, & Mandel, 1996) and is important for interpreting and regulating reactions to experiences evoking the attachment system (e.g., Lynch & Cicchetti, 1998). For instance, more secure children (Switzer, 2006) and children of more secure parents (e.g., Alexander et al., 2002a; Quas et al., 1999) tend to exhibit less distress during stressful medical situations. As a foundation for processing of arousing experiences, attachment thus serves as an essential component of the developmental context. Individuals’ representations of the self and other predict ongoing processing of novel emotional situations and attachment behaviors. Recent research has shown that measures of parental attachment predict children’s memory for emotional experiences (e.g., Alexander et al., 2002a; Goodman, Quas, Batterman-Faunce, Riddlesberger, & Kuhn, 1997; Quas et al., 1999). Furthermore, attachment in children and adults is linked to attention and memory for a variety of real-life (e.g., Edelstein et al., 2006), laboratory simulated (Belsky, Spritz, & Crnic, 1996), and experimental stimuli (Edelstein, 2006; Kirsh, 1996; Kirsh, & Cassidy, 1997; Zeijlmans van Emmichoven et al., 2003). Some studies reveal attachment-schema consistent patterns of information processing and memory (e.g., adults, Miller, 1999; Miller & Noirot, 1999; children, Belsky et al., 1996). For example, Lynch and Cicchetti (1998) examined the effects of child maltreatment on children’s representational models of caregivers and memory for attachment-relevant words. Results revealed the greatest number of negative attachment-relevant words was recalled by maltreated children with insecure mental models of the caregiver, revealing a schema-consistent pattern of processing information. In contrast, other studies show an overall positive relation of attachment security, or negative relation of attachment insecurity, with memory for a variety of experiences (e.g., Kirsh & Cassidy, 1997; Alexander et al., 2007a). For example, in a study of adults assessing attachment, emotional processing, and emotional memory for words Zeijlmans van Emmichoven and colleagues (2003) found a greater Stroop response latency for threatening words in secure than in insecure adults. They 238

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concluded that secure individuals may be more open to process threatening information (see also Edelstein & Gillath, 2007). Further, participants with secure attachment recalled more emotion words overall. Similar research shows accuracy of children’s reports is related to both children’s (Alexander et al., 2007a; Switzer, 2006) and parents’ (Alexander et al., 2002a; Goodman et al., 1997) attachment. As illustrated here, attachment does not uniformly predict memory, even in the realm of emotional experiences. Importantly, transactions with other characteristics of the event and of the individual must be considered. In one study, memory for emotional stimuli was measured following an induced negative or neutral state. Following the negative mood induction, secure individuals remembered more positive stimuli, whereas anxious individuals recalled more negative stimuli (Pereg & Mikulincer, 2004). Furthermore, Alexander and Edelstein (2001) examined attachment as related to children’s memory for a more attachmentevoking story stem completion task versus a mildly arousing laboratory event. Results revealed children’s attachment was related only to memory for the highly attachment relevant experience. Similar results were found using laboratory stimuli varied in attachment relevance: Children’s attachment predicted memory for separation-related stimuli, but not other types of equally arousing stimuli (Alexander, O’Hara, & Kraft, 2007). Although these results with children were based on small samples, they underscore the importance of considering the transaction among characteristics of the event, child, and caregiving environment to understand emotional memory. In addition to further research exploring these transactions, it is necessary to systematically examine the point at which attachment plays a role in memory. In avoidant adults, the memory deficit seems to be linked to defensive processes at encoding rather than retention or retrieval (Fraley, Garner, & Shaver, 2000), and may also be due in part to working memory deficits specific to high attachment-related emotional stimuli (Edelstein, 2006; Obegi, 2006). Although limited research has examined children’s attention and attachment (e.g., Kirsh & Cassidy, 1997), almost no developmental research has investigated other aspects of encoding, maintenance, retrieval, and executive function in relation to emotion and attachment.

Parent-Child Interaction Style The developments of children’s understanding of, coping with, and memory for emotional experiences are intertwined, involve psychobiological processes, and occur in the context of parent-child interactions. Although little research has examined the psychobiological connections between An Integrated Model of Emotional Memory

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parent-child interaction and memory for emotional events (but see Alexander et al., 2007b), parent-child interaction is related to emotion regulation (e.g., Valiente & Eisenberg, 2006; Parke, McDowell, Cladis, & Leidy, 2006), which has psychobiological underpinnings. Furthermore, research on maternal emotional availability and maternal depression gives some insight into how qualities of the early caregiving environment might also indirectly influence emotional memory. Studies of social stress in perinatal rodents (Vallee, Mayo, Dellu, & Le Moal, 1997) and primates (Levine & Mody, 2003) have shown a significant impact on HPA-axis regulation and behavioral stress, even years later. In line with this evidence, research on infants of depressed mothers has shown that mother’s emotional unavailability was linked with children’s depressed affect (Field, 1992), decreased vagal tone and more variable heart rate (Field, Pickens, Fox, Nawrocki, & Gonzalez, 1995), and greater right frontal asymmetry indicative of emotion dysregulation or motivation to withdraw (Dawson, 1994; Field, 1994; Jones, Field, Davalos & Pickens, 1997). Maternal depression also interacted with attachment security, in that insecurely attached children of depressed mothers were the most physiologically and emotionally dysregulated (Dawson, Klinger, Panagiotides, & Hill, 1992; Dawson et al., 2001). Further research is needed on specific effects of maternal depression on the development of emotional communication. We now turn to discussion of the development of emotion talk in nonclinical populations. The way in which children communicate about emotional events changes with age (Bretherton, Fritz, Zahn-Waxler, & Ridgeway, 1986) and is associated with parent-child interaction patterns. In fact, through the processing of interacting and reminiscing with others, children learn how to discuss emotions, gauge the feelings of others, and construct narratives about their past (e.g., Eisenberg, 1999). For instance, parent-led conversations about emotional experiences help children form schemes of emotional experiences that can be used to interpret and discuss future emotional situations (Fivush, 1993; Miller & Sperry, 1987). Moreover, depending on the form and frequency of interactions, are which also related to parents’ and children’s attachment security, children’s narrative quality may vary (Reese & Farrant, 2003). Research has shown that frequency of emotion-related conversations is associated with children’s emotional understanding and emotion talk (e.g., Beeghly, Bretherton, & Mervis, 1986; Denham, Zoller, & Couchoud, 1994; Dunn, Brown, Slomkowski, & Tesla, 1991; Howe, 1991). As children mature, mothers refer more to feelings and emotional states (Brown & Dunn, 1991), and children begin to talk more about internal emotional states (Dunn & Brown, 1993), better understand the source of emotional states (Flavell, Flavell, & Green, 2001), more accurately decode 240

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emotional statements (Bortolotti, D’Elia, & Whissell, 1993), and use a greater variety of emotion words in conversations with parents (Kuebli, Butler, & Fivush, 1995). Although developmental improvements in emotion understanding and communication are evident, the quality of talk about emotion in childhood is relatively stable (Hughes & Dunn, 1998; Kuersten-Hogan & McHale, 2000), perhaps due in part to enduring representational models of relationships (Newcombe & Reese, 2004). For example, research shows that parents reporting their children as more secure also reported their children initiated and engaged in significantly more discussion about an inoculation (Switzer, 2006). Further, secure, as compared to insecure, preschool-aged children discussed more freely a range of emotions with their mothers (Farrar, Fasig, & Welch-Ross, 1997), used more evaluations, and showed more consistency in style over time (Newcombe & Reese, 2004). Parental communication patterns also predict children’s coping. Not surprisingly, parents who promote children’s coping behaviors, particularly through talking about other things during a distressing experience, have children with more effective coping skills (Salmon & Pereira, 2002). Further, it has been suggested that children depend on adults to learn how to cope with and talk about difficult experiences (Salmon & Bryant, 2002). Thus, the behavior of important adults in the child’s environment likely has important influences over expression of emotion, selection of coping strategies, and construction of narratives about emotional experiences. Caregivers thus help children manage emotions by attending to their distress, monitoring experiences, and providing information to help them interpret experiences (Eisenberg, 1999; Salmon & Bryant, 2002). Finally, through provision of experiences and knowledge, caregivers help children form the schemes through which they interpret emotional information. In addition to providing a developmental context for experiences, parent-child interaction plays an important role during and following emotional experiences. Specifically, parents providing more knowledge prior to a planned event, discussion during the event, and/or rehearsal opportunities following the event may enhance children’s memory. Although the history of these interactions provides the developmental context for emotional memories (e.g., Fivush, Reese, & Haden, 2006), current processing may also rely on parent qualities directly related to the event, particularly when shared. With shared events, conversational partners may scaffold new information, whereas with unshared events, partners may aid more in creating a context for the event and for rehearsal, but not specific event details. In this way, event features may further interact with characteristics of the child and parent-child relationship history. An Integrated Model of Emotional Memory

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Conclusions Interwoven throughout the chapter are numerous theoretical and practical implications of this research. For clinicians, understanding the psychobiological underpinnings of emotion regulation, early social-emotional context, and emotional information processing is crucial. It is necessary to consider the dynamic transaction among biology, cognition, and emotion, and the bidirectional relation between memory and psychological outcomes. That is, the nature of the event, appraisal and regulation related to the event, and the developmental context provide important organizational schemas, which guide the formation of functional or dysfunctional emotional memory processes. Likewise, memories of traumatic experiences and dysfunctional interactions contribute to ongoing development of organizational schemas. This body of literature also has implications for understanding memory in the forensic context. Given the multiple predictors of memory, interviewing techniques must be developed to provide developmentally appropriate practices that elicit the most accurate and complete reports from child victims and witnesses. Importantly, such practices may be different for children of different ages and different abilities, and thus a single “gold standard” interviewing technique may not be feasible. Furthermore, consideration of the nature of the event along with individual differences in how it might be appraised is important (e.g., Alexander et al., 2005). As presented, the integrated model needs further testing, and several questions remain. However, the framework presented lays the groundwork for a research agenda calling for more interdisciplinary research on this topic. Furthermore, it mandates that future research operates under the assumption that memory development can only be understood within a model allowing for multidirectional and multidimensional influences; that is, a transactional model with a developmental approach. Several testable questions arise from this integrated model of emotional memory. Because research integrating attachment with some important other elements is lacking, it is difficult to determine exactly how or why attachment is related to memory. The current model advocates for integrating aspects of the developmental context (i.e., temperament, attachment) with current biological function. Further, because the developmental context changes over time, studying developmental processes underlying all components of the model is crucial. That is, rather than focusing on age differences alone, investigators must consider the differential contributions of child characteristics at different developmental phases, and how a change in one domain may cause a cascade of changes in other developmental domains. 242

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Factors of the developmental context that contribute simultaneously or sequentially to children’s memory for emotional events should be examined in coordination with one another. For example, does the early caregiving environment form the foundation for neural and physiological processing of emotional experiences, thus mediating the relation between emotion and memory? If so, what aspects of the early caregiving environment most strongly mediate this relation? What is the role of child characteristics and schema development on executive functioning in relation to memory for emotional events? Can use of metacognitive strategies assist in these mnemonic processes, and if so, what is the implication for clinical populations? The types of emotional events studied need to be carefully considered. We argue that the term “emotional memory” is too general for the state of current research. Rather, researchers must also consider the developmental factors impacting the individual’s appraisal of the event (e.g. personal relevance, attachment-system activation) that may play a role in memory for the event. Children’s use of schemas involved in emotional processing has not been systematically considered as a way to differentiate emotional events. Further, many studies have overlooked potentially different contributions of emotion that underlie encoding, storage, and retrieval, and thus relations between event and child characteristics are nonspecific. In considering the integrated model of emotional memory along with specific factors of the event in question, explanations for inconsistencies in previous research may emerge. Importantly, development does not end in childhood. Changes in the developmental context continue throughout life, and differences in processing of emotional information continue to transform through old age (e.g., Thomas & Hasher, 2006). Although the focus of the current volume is on children’s emotional memories, the integrated model of emotional memory continues to apply beyond childhood, and research examining developmental changes across the lifespan continues to be important to our theories of memory development. Although it is beyond the scope of this chapter, the social and cultural contexts of development are also crucial to a complete understanding of emotional memory. The formation of schemas involves detecting regularities through consistent interactions with “experts” as guides (Vygotsky, 1978). The first “experts” are primary caregivers in the familial context, then peers, teachers, and other adults. Further direct and indirect influences on emotion and memory come from multiple layers of society and culture (Bronfenbrenner & Morris, 1998). The extent to which features of the society and culture affect children’s representations of and communication about emotion, neurological and physiological reactions, and relations with others has implications for children’s memory for An Integrated Model of Emotional Memory

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emotional experiences. These effects must be further examined within a model including biology, cognition, and emotion. A final note regarding future research concerns methodology. Variation in the measurement and type of neurological and physiological reactions yield different associations with memory (e.g., Quas et al., 2006; see Wallin, Quas, & Yim, this volume). Further, the most reliable method for assessing child and infant temperament (e.g. physiologically, observationally, or parent-report) has long been debated. Similarly, attachment is a difficult construct to study because the measurement strategies change across developmental phases (Solomon & George, 1999) and because of debate regarding construct validity of attachment measurement in general. Moreover, parent-child interaction coding systems are not universal, and variables derived from coding of parent-child interactions have not been agreed upon in the field. Additionally, qualities of these interactions at different phases of development are yet unclear, and only recently have psychologists begun to address issues in variability in measurement across development (e.g., Fivush et al., 2006). It is imperative that these methodological concerns are considered in designing and executing future research and in interpreting new findings. In closing, the purpose of this chapter was to review evidence supporting an integrated model for understanding emotional memory applicable to theory and practice, and to underscore the importance of considering multiple aspects of the emotional experience, specifically those that may interact with physiological (e.g., frontal lobe activation), child characteristics (e.g., temperament), and primary social relationships (e.g., attachment). Furthermore, transactions among features of the event and characteristics of the individual must be considered. Neurophysiological mechanisms underlying both regulation of emotion and the formation of memory provide a basis for discussion of the complex manner in which developmental context at all levels impacts the relation between emotion and memory. Cognitive schemas guiding emotion regulation and event expectations are formed and transformed throughout childhood and greatly influence the transactions among physiological, cognitive, and emotional systems involved in encoding, storage, and retrieval of emotional memories. This model has implications for clinical and legal settings, and for further research elaborating our understanding of children’s memories for emotional experiences.

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10 Development and Social Regulation of Stress Neurobiology in Human Development Implications for the Study of Traumatic Memories Kristen L. Wiik Megan R. Gunnar

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tudies in animals and human adults clearly implicate the hypothalamic-pituitary-adrenocortical (HPA) axis in declarative memory, including memory for emotionally charged experiences. A few researchers have begun to examine salivary measures of cortisol in studies of children’s memories for fear-eliciting events. However, adequate study of the role of the HPA axis in traumatic memories in children must take into account evidence that activity of the HPA axis undergoes marked developmental changes from infancy through adolescence and is powerfully regulated by social relationships throughout this

Preparation of this manuscript was supported by a predoctoral fellowship from the Center for Neurobehavioral Development, University of Minnesota to the first author and an NIMH K05 Distinguished Investigator Award to the second author. Correspondence should be addressed to Professor Megan R. Gunnar, Institute of Child Development, 51 East River Rd., University of Minnesota, Minneapolis, Minnesota 55455.

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period. Moreover, basic elements of HPA axis physiology and mechanisms through which activity of the axis affects biological processes involved in memory must be considered in any discussion of the links between HPA axis activity and memory processes. Therefore, the purpose of this chapter is to explore the impact of HPA axis activity and glucocorticoids on memory processes while emphasizing the importance of developmental processes and characteristics of HPA axis functioning in childhood. Toward this goal, a brief overview of human HPA axis anatomy and physiology will fi rst be provided and regulation of glucocorticoid production and glucocorticoid receptor activity will be discussed. Second, animal and human research regarding the impact of glucocorticoids on learning, memory consolidation, and memory retrieval will be presented as a foundation for understanding the effects of stress on memory processes. Next, developmental changes in HPA axis activity and the social regulation of children’s developing HPA axis functioning by caregivers will be discussed as central factors to consider in the study of stress neurobiology and memory in children. Finally, implications of the developmental timing and social context of stressors in childhood on memory processes will be presented.

Anatomy and Physiology of the HPA System The activation of physiological stress systems and the resulting production of stress hormones are essential for the adaptive response to stress in mammals. The mammalian stress system consists of two physiological systems, the sympathetic-adrenomedullary (SAM) system and the hypothalamic-pituitary-adrenocortical (HPA) axis (see for review, Gunnar & Quevedo, 2007). These stress systems act in concert to coordinate necessary physiological responses to stress, although they differ in the speed and duration of their stress responses. The SAM system, which is part of the sympathetic arm of the autonomic nervous system, rapidly mobilizes physiological responses to acute stress through the production of the catecholamine epinephrine (adrenaline) from the adrenal medulla (Gunnar & Quevedo, 2007). In contrast, the HPA axis more slowly produces steroid hormones known as glucocorticoids (predominantly cortisol in humans and corticosterone in rodents), which are secreted from the cortex of the adrenal gland. Production of glucocorticoids is stimulated through a cascade of events beginning with the synthesis and release of corticotrophin-releasing hormone (CRH) and arginine vasopressin (AVP) from parvocellular neurons within the paraventricular nuclei of the hypothalamus (see for

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review, Charmandari, Tsigos, & Chrousos, 2005). Once released from the hypothalamus, CRH and AVP stimulate the release of adrenocorticotropic hormone (ACTH) from the anterior pituitary (Cone, Low, Elmquist, & Cameron, 2003). This release of ACTH is largely driven by CRH, although AVP plays a synergistic role in this process (Charmandari et al., 2005). ACTH then binds with receptors in the adrenal cortex, where the production and release of glucocorticoids occurs. The basal activity of the HPA axis in human adults exhibits a diurnal rhythm with a peak level of glucocorticoids occurring shortly after awakening in the morning, and the lowest levels of glucocorticoids, or nadir of the rhythm, shortly following the onset of nighttime sleep; this pattern is reversed for nocturnal animals (Daly & Evans, 1974). As a result, the time of day must be carefully considered in interpretations of glucocorticoid levels. Glucocorticoids exert their effects through binding with their receptors, which are located within cells throughout the body (Gunnar & Quevedo, 2007). As steroid hormones, glucocorticoids can easily pass through the blood-brain barrier into the cytoplasm of target cells within the brain. After binding with a receptor, glucocorticoids enter into the nucleus of the cell and bind to the promoter regions of target genes, therefore regulating the transcription of glucocorticoid-responsive genes (Charmandari et al., 2005). The short-hand term for this route of impacting neural activity is termed “genomic effects.” Because genomic effects involve gene transcription, it takes an hour or so following the onset of a stressor for these effects to begin to take place (Sapolsky, Romero, & Munck, 2000). Recently, nongenomic actions of glucocorticoids have been identified that occur within moments after exposure to a stressor (e.g., Karst et al., 2005). Clearly, understanding the impact of glucocorticoids as stress hormones on memory involves not only examining the physiological level of the hormonal effects, but also the timing of the effects of interest and the particular mechanisms through which the hormone is exerting its effects. In addition to the feed-forward effects evident in the HPA axis production of glucocorticoids, the HPA axis is also regulated through negativefeedback mechanisms. Specifically, the presence of glucocorticoids acts to inhibit the production of CRH in the hypothalamus and ACTH in the pituitary, thus limiting tissue exposure to glucocorticoids (Charmandari et al., 2005). These inhibitory mechanisms are important in preserving the health of the organism as prolonged exposure to high levels of glucocorticoids has been associated with neuronal death, the suppression of growth hormone (GH) and growth factors, lowered immune response, and the presence of mood disorders such as anxiety and depression (Vázquez, 1998; Charmandari et al., 2005). Chronic exposure to elevated

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glucocorticoids also is often followed by down-regulation (reductions) in hypothalamic CRH and/or pituitary ACTH through mechanisms that help to maintain glucocorticoid levels within normal bounds and to protect organs and tissues, including neurons, from excess glucocorticoids. Within the brain, glucocorticoids have been found to be active in the hippocampus, amygdala, and prefrontal cortex and appear to influence many cognitive functions, including attention, learning, and consolidation and retrieval of information (Erickson, Drevets, & Schulkin, 2003). Critically, when considering emotional memories, the impact of glucocorticoids depends on the presence and activity of monoamine neurotransmitters, most notably norepinephrine. The synergy between glucocorticoids and norepinephrine in the formation of emotional memories is discussed below. In addition to the interaction of glucocorticoids with monoamines, the impact of glucocorticoids on brain functions also depends on glucocorticoid receptor binding and occupation.

Glucocorticoid Receptors Glucocorticoids operate within the brain through interaction with two types of receptors, mineralocorticoid receptors (MR) and glucocorticoid receptors (GR), which mediate often-opposing functions. MR are characterized as having a high affinity for glucocorticoids. These receptors serve to mediate the “promotive” effects of glucocorticoids that support adaptation through functions such as maintaining electrical current for neural responses to neurotransmitters, facilitating cerebral glucose utilization, and stabilizing neurons (Gunnar & Vazquez, 2006). Conversely, GRs mediate the “suppressive” effects of glucocorticoids through actions that often interfere with or reverse physiological changes that occur as part of the “fight/flight” response (de Kloet, 2004). Consistent with “suppressive” effects, the binding of glucocorticoids to GRs in the hypothalamus, hippocampus, and medial frontal cortex serves to inhibit CRH production by the hypothalamus, thus providing negative feedback to return glucocorticoids to basal levels following a stress response (Gunnar & Vazquez, 2006). The effects of glucocorticoids are dependent on whether MRs or GRs are bound, the location of the receptors, and the ratio of bound MRs to bound GRs (de Kloet, 1991). In rodents, GRs have been found throughout the brain (PVN, cerebellum, hippocampus, cortex, brain stem nuclei) with MRs being limited to hippocampal and septal neurons. In humans and other primates, the distribution of MRs appears to be much broader with MR mRNA being found in the frontal cortex suggesting that MR may play a role in higher order processing in humans (see Lopez, Akil,

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& Watson, 1999). Thus, the effects of glucocorticoids also likely depend on the species being studied. Compared to GRs, MRs show a much higher affinity for binding to natural glucocorticoidss, although GRs do show increased affinity for synthetic glucocorticoids such as dexamethasone (de Kloet, Reul, & Sutanto, 1990). Due to the higher affinity of MRs for corticosteroids, glucocorticoids are bound first by MRs, followed by GRs once MRs have been saturated. Thus when glucocorticoid levels are in the basal ranges, MRs are approximately 80 to 90% occupied. GRs only become occupied when glucocorticoid levels increase as a result of stress or at the peak point in the diurnal cycle (Gunnar & Vazquez, 2006). This balance of MR and GR binding is necessary to maintain the normal basal rhythm of glucocorticoid activity as well as the capacity to respond adaptively to stressors. The opposing effects of MR and GR binding result in an inverted U-shape dose-response curve for the effects of glucocorticoids. Because of the promotive effects of MR, prolonged periods of very low glucocorticoid levels and corresponding low levels of MR binding and activity have been associated with physical, cognitive, and emotional impairments. Similarly, because of the suppressive effects of GR, prolonged periods of very high glucocorticoid levels and corresponding GR binding have also been associated with physical, cognitive, and emotional impairments (McEwen, 2000). Specifically, prolonged or frequent and high occupation of GRs has been associated with alterations in hippocampal activity including dampened neuronal excitability and impairment in memory formation (see for review, Gunnar & Vazquez, 2006). In contrast, moderate levels of glucocorticoids characterized by the complete binding of MRs and short-term moderate binding of GRs have been associated with a termination of stress effects and successful recovery from stress (Sapolsky, 1997). Although GRs are the receptors involved in mediating glucocorticoid effects in response to stressors, this is only true when genomic effects are being considered. Nongenomic and rapid effects of stress-levels of glucocorticoids appear to operate through MR. In response to noxious or stressful stimulation, it is believed that some MR move out of the cytoplasm and into the cell membrane, where they bind with glucocorticoids and mediate fast, nongenomic effects of glucocorticoids on neuronal activity including enhanced transmission of glutamate within the hippocampal region in rodents (Karst et al., 2005). Although these nongenomic processes and effects are still being elucidated, this research suggests that glucocorticoids have rapid effects on brain function in addition to more delayed effects mediated through gene transcription. As these processes become better understood, some of the conclusions of research reviewed below may change. 260

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Impact of Glucocorticoids on Learning, Consolidation, and Retrieval of Memory Research on the impact of glucocorticoids on memory functions has been primarily completed through animal models and research with adult subjects. The current literature has largely relied on the randomized administration of placebos versus glucocorticoids and selective agonists or antagonists of MR and GR. As a result, little of this research has been completed with children, leaving much unknown regarding the impact of glucocorticoids on developing memory capacities in children. In addition, there is tension in the field over whether glucocorticoids are seen as impairing declarative memory, including memory for stressful events, or as enhancing declarative memory. In part, this tension reflects differences along several dimensions: (a) the timing of glucocorticoid exposure during learning, consolidation or retrieval, (b) whether the content is nonemotional or emotional, and in a related vein, (c) whether elevated glucocorticoids occur in the context of elevated levels of brain norepinephrine or not. We will first review recent data regarding the role of glucocorticoids in learning, consolidation, and retrieval of memories and then will consider additional research on the differential impact of glucocorticoids on nonemotional and emotional memory. Finally, a brief discussion of research on the connections between norepinephrine and glucocorticoids in memory processes will be presented.

Learning A meta-analysis of research investigating the impact of glucocorticoids on adult learning indicates that glucocorticoids have differential effects on learning depending on the time of day and the timing of the glucocorticoid administration (before learning or before retrieval) (Het, Ramlow, & Wolf, 2005). All studies administered glucocorticoids either orally or intravenously. Results of the meta-analysis revealed that when glucocorticoids were administered in the morning a significant impairment in memory was found, yet when they were administered in the afternoon a significant, but small, improvement in memory resulted. These findings are consistent with the inverted U-shaped curve of glucocorticoid effects when examined in the context of the HPA circadian rhythm. When basal levels of glucocorticoids are high, such as in the morning for humans and other primates, there may already be significant MR occupation and GR occupation. Therefore, increasing glucocorticoid levels likely results in even higher GR occupation, leading to memory impairments. In the afternoon for humans and other primates, the basal diurnal pattern would result in low endogenous glucocorticoid levels and MR occupation compared to morning levels. As a result, addition Development and Social Regulation of Stress Neurobiology

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of exogenous glucocorticoids may produce increased occupation of MRs and only moderate occupation of GRs, therefore facilitating memory functions (see for review, Het et al., 2005). Research with two-year-old children provides further support for the association between moderate levels of glucocorticoids and optimal memory, as children with higher basal cortisol levels during training on a spatial maze task showed better performance during the recall trial (Stansbury, Haley, & Koeneker, 2000).

Memory Consolidation Rodent research provides the basis for much of our current understanding of the role of glucocorticoids in memory consolidation. Based on this research it appears that activation of GRs in the basolateral nucleus of the amygdala (BLA) may play an important role in mediating the impact of glucocorticoids on memory consolidation in rats (Roozendaal, 2000). In particular, administration of a GR agonist directly into the dorsal hippocampus immediately following training on an inhibitory avoidance task has been associated with increased memory consolidation in rats. Lesion of the BLA blocks the memory-enhancing effects of a GR agonist as well as the memory impairing effects of a GR antagonist within the hippocampus. Therefore, it appears that the BLA may play an important role in the interaction between glucocorticoids and memory consolidation within the hippocampus (see for review, Roozendaal, 2000). GR occupancy has been assumed to be the primary contributor to alterations in memory consolidation in response to glucocorticoids because MRs are nearly saturated at basal levels of glucocorticoids. Moreover, this hypothesis has been supported by findings that the level of GR occupancy exhibits an inverted U-shaped relationship with spatial memory performance in rats, while the level MR occupancy does not (see for review, Roozendaal, 2002). Finally, administration of glucocorticoids to rats following a stressful water-maze task has been found to impair memory consolidation for the task, while glucocorticoid administration following a less stressful inhibitory avoidance task enhances memory. Together these results again suggest that exposure to high levels of glucocorticoids (and presumably corresponding high occupancy of GRs) following training is associated with impairment in memory consolidation while moderate levels of glucocorticoids following training are associated with improved consolidation (see for review, Roozendaal, 2003). Many studies of the impact of glucocorticoids on learning, memory consolidation, and retrieval have administered exogenous natural or synthetic glucocorticoids. While this method offers researchers the ability to control the precise level of glucocorticoids, there may be differential 262

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effects of exogenous versus endogenous glucocorticoids on memory processes. Moreover, this research requires careful consideration of the quantity of exogenous glucocorticoids, which should be administered to accurately mimic a physiological stress reaction. For these reasons, researchers have also been interested in examining the memory impacts of endogenous increases in glucocorticoids. For example, Andreano & Cahill (2006) investigated the impact of increases in endogenous cortisol on the consolidation of memory in adults through use of a coldpressor stressor task immediately following exposure to a neutral story. Individuals who experienced the cold-pressor task exhibited a significant increase in salivary cortisol following the stressor and showed increased recall of the story a week later. The significant improvement in recall was found only for male participants who experienced the cold-pressor task and not for female participants, even though no sex differences were found in the cortisol response, thus suggesting that sex may serve as a moderator for the enhancing effects of cortisol on memory consolidation. Moreover, among the male participants an inverted U-shaped curve was found for the relationship between cortisol increase and the number of items correctly recalled from the story. Men exhibiting moderate increases in cortisol showed the largest enhancement in memory for the neutral story (Andreano & Cahill, 2006). Additional research on the impact of glucocorticoids on the consolidation of memory has suggested the importance of considering the relative timing of exposure to information and the stress-induced increase in glucocorticoids (Elzinga, Bakker, & Bremner, 2005). Specifically, in a study completed with young adult women, participants were presented with verbal and spatial memory items before and after exposure to a stressor task. Participants remembered significantly more of the information presented before the stressor compared to the information presented after the stressor. In addition, a negative correlation was found between delayed recall performance on information presented after the stressor and poststressor salivary cortisol. These results suggest that stress-induced increases in glucocorticoids may be particularly detrimental for the longterm consolidation of declarative memory, particularly when information is presented poststressor (Elzinga et al., 2005). However, it may also be that immediately following the stressor, the women were not as attentive to the information and that this, rather than effects of glucocorticoids on hippocampal memory processes explained the effects of the study. Despite differences in methods and species, a review of the literature on memory consolidation indicates fairly consistent patterns of relationships between glucocorticoids and declarative memory. In both human adults and rats, exposure to moderate levels of glucocorticoids immediately following training appears to contribute to optimal Development and Social Regulation of Stress Neurobiology

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memory consolidation and to enhance later recall. In contrast, exposure to extremely high levels of glucocorticoids following training appears to impair memory consolidation. Finally, exposure to stressed-induced increases in glucocorticoids prior to training also appears to impede memory consolidation.

Sleep, Glucocorticoids, and Memory Consolidation In addition to the timing of glucocorticoid exposure, sleep also appears to play an important role in regulating the consolidation of both declarative and emotional memory through differential effects on glucocorticoid receptors. Slow-wave sleep (SWS) appears to be particularly important in facilitating the consolidation of hippocampal-dependent declarative memory for neutral information (Wagner, Degirmenci, Drosopoulos, Perras, & Born, 2005). SWS predominates early in the night when the level of glucocorticoids are very low, at the nadir of the diurnal rhythm. Laboratory manipulations of plasma cortisol levels during SWS have shown that the administration of cortisol during SWS increases the occupation of GRs and significantly blocks the formation of declarative, hippocampal dependent memory (Plihal & Born, 1999). In addition, the pharmacologic blockade of cortisol production and corresponding underactivation of MRs also impaired the consolidation of neutral, declarative, hippocampal-based memory (Wagner et al., 2005). Therefore, the consolidation of declarative memory appears to be dependent on both the absence of GR occupation as well as sufficient occupation of MRs during SWS (Plihal & Born, 1999; Wagner et al., 2005). Rapid eye movement (REM) sleep tends to occur with greatest frequency near the end of the nighttime (in humans and primates) sleep period. This also corresponds to when glucocorticoid levels begin to rise towards the early morning basal peak. There is some suggestion that the early morning rise in cortisol interferes with the consolidation of amygdala-dependent emotional memories. The early morning rise in cortisol during REM may serve a protective role in dampening the intensity of emotional memories and preventing overconsolidation of memory for emotional events. Pharmacologic blockade of this early-morning cortisol rise has been found to result in a large increase in the consolidation and recall of emotional information, providing support for the importance of glucocorticoids in dampening emotional memory (Wagner et al., 2005). Interestingly, one effect of chronic stress for many individuals may be to lower early morning cortisol levels (Heim, Ehlert & Hellhammer, 2000; Gunnar & Vazquez, 2001), thus perhaps increasing the likelihood that chronically stressed children and adults will retain information about emotionally charged events from the previous day. 264

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Memory Retrieval A meta-analysis on the effects of glucocorticoids on memory suggests that glucocorticoids appear to significantly impact memory retrieval, particularly when there are increases in glucocorticoids immediately before retrieval (Het et al., 2005). For example, healthy adult men and women were found to exhibit poorer 24-hour recall of words they when they were administered glucocorticoids as opposed to a placebo one hour prior to the retrieval task (de Quervain, Roozendaal, Nitsch, McGaugh, & Hock, 2000). Interestingly, glucocorticoid exposure did not impact recognition memory, suggesting there may be differential effects of glucocorticoids based on retrieval demands. In addition, the testing context has been found to play a role in determining the effects of glucocorticoids on memory retrieval. For example, research conducted with young women indicates that when glucocorticoids are administered in a nonarousing and relaxed testing context the negative effects of glucocorticoids on memory retrieval are eliminated (Kuhlman & Wolf, 2006a). If similar processes are operating in children, this might help explain evidence that children remember information and are less suggestible to misleading cues when retrieval is examined under supportive as opposed to nonsupportive examination conditions (e.g. Quas, Wallin, Papini, Lench, & Scullin, 2005).

Nonemotional versus Emotional Events Events and information may be processed and stored as memory in different ways, depending on their emotional content. The above discussion of consolidation mechanisms during sleep has presented considerable evidence for differences in consolidation and the impact of glucocorticoids on this process for emotional and nonemotional memory (Wagner, et al. 2005). Additional research suggests that the administration of glucocorticoids prior to exposure to emotional and nonemotional visual images results in differential consolidation and retrieval, with increased consolidation and long-term recall of emotional more so than nonemotional information one week after exposure (Buchanan & Lovallo, 2001). Similar results were found in a study of young men who completed a delayed visual recall task 24 hours after exposure to emotional and nonemotional images. Again, these results indicated that cortisol administration prior to stimuli exposure is associated with greater recall of emotional images compared to nonemotional images (Kuhlmann & Wolf, 2006b). Together, this research suggests that glucocorticoids, even at fairly high levels, may play an important role in supporting memory processes for emotional information. If so, this requires some explanation. What Development and Social Regulation of Stress Neurobiology

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is different about memory processes for emotional material that might allow glucocorticoids to enhance consolidation even when glucocorticoid concentrations rise to levels that might impair memory for nonemotional material? The answer may lie in interactions of glucocorticoids and the production of norepinephrine in the brain.

Norepinephrine and Glucocorticoids in Emotional Memory In addition to glucocorticoids, the release of catecholamines including norepinephrine is also stimulated by exposure to acute stress. While catecholamines produced by the sympathetic nervous system and adrenal medulla do not cross the blood brain barrier, the events that trigger peripheral sympathetic responses also often increase production of norepinephrine (NE) in the brain. Central NE is produced by noradrenergic neurons in the locus coeruleus (see for review, Van Bockstaele, Bajic, Proudfit, & Valentino, 2001). NE activity within the lateral nucleus of the amygdala during an acutely traumatic event has been associated with greater memory consolidation, while pharmacologic blockade of this noradrenergic activity in the amygdala reduces the consolidation and retention of traumatic memories in rodents (Debiec & LeDoux, 2006). Notably, the effect of NE on memory consolidation is enhanced in the presence of glucocorticoids (Roozendaal, 2002). And, memory enhancing effects of glucocorticoids are only observed in the presence of NE activity. So, for example, a blockade of NE activity through administration of a ß-adrenoceptor antagonist prevented enhanced memory retention effects associated with glucocorticoids (Roozendaal, Okuda, Van der Zee, & McGaugh, 2006). This research reveals the importance of carefully considering interactions between glucocorticoids and NE activity in producing trauma-associated memory effects.

Applications of Findings Research clearly suggests that the impact of glucocorticoids depends on the balance of MR to GR occupation. Moreover, MR and GR activation may influence hippocampal- and amygdala-dependent memory processes differently, therefore emotional and nonemotional/neutral memories are not consolidated or processed in the same manner. In addition, review of the literature indicates that glucocorticoids impact learning, consolidation, and retrieval differently depending on the timing of administration or stress-induced increase in glucocorticoids. Overall, it appears that high levels of glucocorticoids and, hence, high GR occupancy have memoryimpairing effects, unless the information to be remembered is emotional and/or is associated with elevations in central NE. Glucocorticoids also 266

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tend to impair memory retrieval and, when high during periods of REM sleep, may impair reconsolidation of memories during sleep. Combined, these findings have led the idea of treating posttraumatic stress disorder (PTSD) by administering glucocorticoids. That is, individuals with PTSD are troubled by intrusive memories from their traumatic experiences. These same individuals often exhibit chronically low levels of basal cortisol production (Yehuda, 2000). There is now some evidence that administrating glucocorticoids to survivors of trauma significantly decreases their PTSD symptoms (Shelling et al., 2006). Whether this would help children with PTSD who suffer from intrusive memories is not known and may depend on developmental changes in HPA axis reactivity and regulation.

Developmental Changes in HPA Activity during Childhood In order to examine the impact of glucocorticoids on memory functions in children it is necessary to elucidate the developmental changes in HPA activity from infancy through puberty. These changes include the development of the HPA axis diurnal rhythm, as well as changes in reactivity and regulation of the HPA system.

Development of HPA Basal Rhythm The normal circadian rhythm of the HPA axis emerges over the first five years of life as children begin to adhere to a more adult-like daily schedule. In the earliest weeks of life, newborns typically exhibit two peaks in cortisol production 12 hours apart which are not in sync with any particular day or night schedule. By the fi rst month newborns begin to exhibit the early morning peak and evening nadir, yet the timing of the peak and nadir remains inconsistent across days (see for review, Watamura, Donzella, Kertes, & Gunnar, 2004). This consistency improves over first six months of life until it becomes more stable by preschool age. The adult-like HPA rhythm, with mid-afternoon cortisol levels lower than mid-morning levels appears to emerge around the time when children give up their afternoon nap and remain awake and active throughout the day (Watamura et al., 2004).

HPA Hyporesponsive Period A hyporesponsive period for HPA reactivity has been clearly observed in rodents. This period in the rodent is not present at birth, but emerges by about the third day of life. The hyporesponsive period is a time Development and Social Regulation of Stress Neurobiology

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when glucocorticoid levels tend to be low and it is difficult to elevate glucocorticoid levels to many, although not all, stressors (see for review, Levine, 2001). Although additional investigation is necessary, research suggests the potential presence of a comparable period of human development. Similar to the rodent, the HPA axis is not hyporesponsive at birth. Indeed, during the immediate postnatal period, human newborns generally exhibit a high level of HPA axis reactivity in response to stimulation and are able to mount cortisol and ACTH responses to stressors such as physical exams, blood draws, and minor surgery (Gunnar, 1989; Gunnar & Vazquez, 2006). However, the strong HPA responsivity observed in newborns declines over the first year of life. For example, by approximately three months of age, infants no longer exhibit a significant rise in cortisol in response to mild stressors, such as a physical exam (Larson et al., 1998). Around 12 months of age, even more significant stressors, such as vaccinations and 30 minutes of maternal separation in the presence of a relatively nonresponsive babysitter, cease to produce elevations in cortisol in most children (see for review, Gunnar & Donzella, 2002). These findings therefore suggest that an HPA hyporesponsive period in humans may emerge during the first year of life as infants’ HPA activity is buffered by social regulation from sensitive and responsive caregivers. Strikingly, children who continue to produce elevations in cortisol during this period tend to have a history of lesssensitive and responsive care. For example, when exposed to potentially scary events in the presence of their parent, young children with secure relationships do not display elevated cortisol, while those who are insecurely attached to the parent who is with them do display cortisol elevations (see for review, Gunnar & Donzella, 2002). In short, relationships become powerful regulators of the HPA axis over the first year of life and in the presence of supportive adults, children remain relatively buffered from stress activations of the HPA axis. In the absence of such supportive and reliable care, as observed for young children in the foster care system, disturbed activity of the HPA axis is often evident (Dozier et al., 2006).

Developmental Changes in HPA Responsivity Developmental changes in HPA responsivity can be observed throughout childhood. Generally speaking, basal levels of cortisol decrease from birth to approximately one to two years of age and remain low throughout childhood. While children may show small increases in cortisol to cognitive tasks and other challenges, it is still often difficult during early and middle childhood to evoke large increases in cortisol to laboratory stressors. For instance, using an airblast-startle paradigm, 268

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Ashman and colleagues (2002) were unable to provoke elevations in cortisol among most of their seven-year-old subjects, even though many of them had mothers who had been clinically depressed during periods of their development. Likewise, Boyce and colleagues (W. Thomas Boyce, personal communication, January, 2008) exposed preschoolers to a battery of stress-inducing tasks and failed to provoke significant increases in cortisol for most children in their sample. Part of the reason for this apparent hyporesponsivity may be that the tasks used are not sufficiently stressful or threatening to stimulate an HPA response (Clemens Kirschbaum, personal communication, August, 2006). However, there is evidence that, with the transition to adolescence, it becomes easier to activate the HPA axis to psychosocial stressors in the laboratory. In addition, basal-level changes in cortisol are also observed during the period of puberty. A rise in basal cortisol levels around the pubertal transition has now been seen in a number of studies, both cross-sectional and longitudinal (see for review, Gunnar & Vazquez, 2006). Puberty also appears to mark a significant transition towards increased responsivity of the HPA axis to stressors. Specifically, recent research with children suggests that 15-year olds and pubertal 13-year olds show a significant increase in salivary cortisol in response to laboratory stressor tasks, including both performance stressors (i.e. speaking in front of judges) and social rejection stressors (Gunnar, 2006; Stroud, 2006). These results clearly indicate the important role of pubertal development and its accompanying physiological changes in the development of increased HPA axis reactivity. In summary, HPA activity is immature in the developing child. Children’s basal levels and dynamics of cortisol activity do not develop into a full adult pattern until sometime in adolescence. During childhood, HPA responsivity patterns to laboratory testing tend to exhibit a very mild response pattern, with adult responsivity developing over the transition into adolescence.

Social Regulation of the HPA Axis in Children Throughout infancy and childhood, children develop within the context of a social environment characterized by the child’s close relationship to one or several primary caregivers. Interactions between child and caregiver inherently and necessarily contribute to the cognitive, biological, and social development of the child, including the development and activity of the HPA axis. Therefore, any examination of the impact of glucocorticoids and stress on the development of memory functioning in childhood requires careful attention to the central role of the caregiver-child relationship, which serves as a social regulator of the Development and Social Regulation of Stress Neurobiology

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child’s developing HPA axis physiology. As briefly mentioned above, the quality of this dyadic relationship, or attachment relationship, between caregiver and child has been found to be influential in regulating the child’s HPA axis activity and release of glucocorticoids in response to stressful situations. In contrast, although the caregiver-child relationship may serve as a protective factor against negative impacts of acute or chronic stress on children’s developing HPA axis physiology, the absence of a sensitive and responsive relationship may contribute to long-term alterations in HPA axis functioning. Although the impact of these alterations on specific domains of cognitive functioning such as memory is not yet known, the role and quality of the caregiver-child relationship must be carefully considered. In support of this argument, the following section will discuss research findings pertaining to the importance of the caregiver-child relationship as a regulator of HPA activity and glucocorticoid release in children. In addition, research conducted with children who have experienced adverse care, such as abuse, neglect, or care in an institutional setting, may provide important insights into the developmental impact of the social environment on children’s HPA functioning.

Impact of the Attachment Relationship on HPA Axis Functioning As noted, over the first year of life, the developing HPA axis in humans becomes strongly regulated by close relationships. Sensitive, responsive caregiving serves as a significant buffer against the activation of the HPA axis and increases in glucocorticoids. Secure attachment to a primary caregiver appears to buffer toddlers from elevations in glucocorticoids following exposure to a threatening and fear-inducing situation (e.g. a live, boisterous clown approaching the child to play) (Nachmias et al., 1996). Specifically, mother-child attachment status served as a moderator in the relationship between behavioral inhibition and HPA response to the fearful-clown stimuli. A high level of behavioral inhibition was found to be associated with increased salivary cortisol in response to the threatening stimuli only for children in mother-child dyads classified as insecure (anxious-resistant or anxious-avoidant) based on the Strange Situation. These results indicate that secure mother-child attachment buffers children from exhibiting significant HPA activation to threatening stimuli even when the children exhibit more fearful temperaments and greater behavioral inhibition (Nachmias et al., 1996). While secure attachment acts as a buffer for HPA axis activity, disturbances in close relationships provoke marked responses in HPA activity and levels of glucocorticoids. Children exhibiting disorganized attachment (D-attachment classification) behavior show significantly higher cortisol 270

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levels after completion of the Strange Situation procedure than do children with non-D classification (secure, anxious-avoidant, anxious-resistant) (Hertsgaard, Gunnar, Erickson, & Nachmias, 1995). These results suggest that repeated separation and reunion with the caregiver may be particularly stressful for children within mother-child dyads exhibiting disorganized attachment. Moreover, it is clear that the presence of the mother in these disorganized dyads does not buffer the child from significant increases in cortisol. Instead, children classified as exhibiting disorganized attachment behavior show relatively large increases in cortisol in response to brief maternal separation, suggesting the presence of significant HPA reactivity and maladaptive coping (Hertsgaard et al., 1995). The role of adult-child relationships in regulating reactivity of the HPA axis extends to children’s relationships with babysitters and other surrogate caregivers. This has been documented through studies of children in full-day out-of-home childcare where rising levels of cortisol often have been observed, particularly for children in poorer-quality care settings and/or when children receive less support and nurturance from the care provider (see for review, Gunnar and Donzella, 2002).

Period of Social Buffering versus Period of Vulnerability During childhood, the HPA system appears to be strongly buffered and regulated by responsive caregivers. Children who receive sensitive and responsive care likely experience few periods of significantly elevated cortisol in response to both physical and social stressors. It is assumed that this social buffering of the HPA axis serves to promote healthy brain development, including the development of brain regions involved in learning and memory. However, this period of social buffering may also be a period of vulnerability to stressors if the social regulatory buffer is disturbed or dysfunctional, such as occurs with abusive or neglectful caregivers (Dozier et al., 2006). Similarly, research conducted with children raised in institutional or orphanage care provides an unfortunate but natural experiment in which children are largely cared for by rotating staff, and therefore deprived of a consistent caregiver-child relationship. As a result, institutionalized and postinstitutionalized children represent an important population in which to study the effects of chronic instability in caregiver-child relationships on stress neurobiology and HPA axis functioning. Overall, research on the developmental and physiological impact of experiences of abuse, neglect, and institutional care in childhood have generally revealed two patterns of disturbance in HPA axis activity: atypical patterns of diurnal cortisol production and elevated set-points Development and Social Regulation of Stress Neurobiology

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for the basal cortisol level. The first has been demonstrated more often in children living under chronically neglectful care while the second has been documented in children exposed to adverse or abusive care several years after removal from the abusive environment. In regard to diurnal cortisol production, results of research conducted with children living in orphanages have indicated the presence of a flat rhythm in cortisol production over the day (Carlson & Earls, 1997). A relative lack of the normal diurnal pattern of cortisol production has also been noted for many infants and preschoolers who have been removed from their families because of neglect or other failures of the caregiving system (Dozier et al., 2006; Gunnar & Fisher, 2006). In regard to basal cortisol level, elevations in basal levels of cortisol across the day appear to persist as a long-term effect of early abuse or chronic instability in care. For example, children with chronic PTSD due to childhood abuse have been found to exhibit elevated basal cortisol levels over the day several years after termination of the abuse (Carrion, Weems, Ray, Glaser, Hessl, & Reiss, 2002; De Bellis, Baum, Birmaher, Keshavan, Eccard, Boring et al., 1999). Likewise several studies have documented elevated basal cortisol levels for children from severely deprived orphanage conditions years after being removed from orphanage care, although the diurnal pattern has been found to be intact (Gunnar, Morison, Chisholm, & Schuder, 2001; Kertes, Gunnar, Madsen, & Long, 2008). These results suggest that chronic experiences of adverse care may be associated with a long-term alteration in HPA activity, with a higher basal cortisol rhythm across the day. However, how these alterations in typical basal activity of the HPA axis relate to brain development and children’s abilities to learn and remember both emotional and nonemotional content is not yet known.

Implications for the Study of Traumatic Childhood Memories The Importance of Timing As reviewed, the activity and responsivity of the HPA axis and its effects on cognitive processes such as memory and broader physiological functioning is dependent on many layers of timing. First, the age of the child and developmental and physical maturity greatly impact the activity of the HPA axis. For example, the impact of an acute stressor, its activation of the HPA system, and the cascade of effects from HPA activity likely vary depending on whether the child is pre- or postpubertal. Second, the time of day at which an individual is exposed to an acute stressor has been shown to be an important factor in determining 272

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the cognitive effects of HPA activity and glucocorticoids (Het et al., 2005). In particular, the timing of exposure relative to the circadian, diurnal HPA rhythm and basal glucocorticoid levels may greatly impact the MR and GR occupation, which occurs in response to stress-induced increases in glucocorticoids. Corresponding alterations in MR and GR receptor binding create differential physiological effects (Gunnar & Vazquez, 2006). Third, the timing of acute stress-induced increases in glucocorticoids can have significant impact on the learning, consolidation, and retrieval of information and memories. Specifically, the administration of moderate amounts of glucocorticoids immediately following training appears to improve memory consolidation, while glucocorticoid exposure immediately before retrieval impairs memory (Roozendaal, 2002). Finally it is important to consider the importance of the nocturnal period (including slow-wave sleep and rapid eye movement sleep) in supporting the consolidation of memories. Therefore, the quantity and type of sleep (SWS, REM) must be considered in an examination of memory processes in children.

Relationships and Buffering The effects of trauma exposure on reactivity of the HPA axis and on memory likely also depends on the child’s relationship history and the availability of sensitive and responsive adults during and following the traumatic event. Not only may adults with whom the child experiences security buffer reactivity of the HPA axis, but their consistent and predictable care may preserve the child’s daily pattern of activities such as sleep. This in turn may help to protect important physiological regulatory mechanisms including SWS and REM sleep necessary for consolidation of declarative memory and the dampening of disruptive and negative emotional memories (Wagner et al., 2005).

Traumatic Experiences in the Context of Chronic Stress Finally, experiences of neglect, abuse, and chronic stress may have longlasting effects on the HPA axis and contribute to increased risk for psychopathology (De Bellis et al., 1999; Heim & Nemeroff, 2001). Chronic stress may also alter brain regions involved in memory and adaptive function. Research on child maltreatment provides an opportunity to examine patterns of HPA axis activity and declarative memory for emotional and neutral contexts together. Such research would facilitate a more complete understanding of the interaction between the developing HPA axis and memory functions in children, thus informing treatment strategies for children and adults who experience significant trauma and stress. Development and Social Regulation of Stress Neurobiology

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Conclusions Despite the large body of research on glucocorticoids and memory in animals and the growing literature in human adults, we know relatively little about the role of glucocorticoids in memory in children. Nonetheless, the animal and adult literature clearly suggests that knowing more about how the HPA axis influences children’s processing, retention, and retrieval of emotional information should help us better understand how to intervene to support children who experience trauma.

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Gunnar, M., & Vazquez, D. (2001). Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Development and Psychopathology, 13, 515–538. Gunnar, M., & Vazquez, D. (2006). Stress neurobiology and developmental psychopathology. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology: Developmental neuroscience (pp. 533–577). New York, NY: Wiley. Heim, C., Ehlert, U., & Hellhammer, D. K. (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25, 1–35. Heim, C. & Nemeroff, C. B. (2001). The role of childhood trauma in the neurobiology of mood and anxiety disorders: Preclinical and clinical studies. Biological Psychiatry, 49, 1023–1039. Hertsgaard, L., Gunnar, M., Erickson, M. F., & Nachmias, M. (1995). Adrenocortical responses to the Strange Situation in infants with disorganized/disoriented attachment relationships. Child Development, 66, 1100–1106. Het, S., Ramlow, G., & Wolf, O. T. (2005). A meta-analytic review of the effects of acute cortisol administration on human memory. Psychoneuroendocrinology, 30, 771–784. Karst, H., Berger, S., Turiault, M., Tronche, F., Schütz, G., & Joëls, M. (2005). Mineralocorticoid receptors are indispensable for nongenomic modulation of hippocampal glutamate transmission by corticosterone. Proceedings of the National Academy of Sciences, 102, 19204–19207. Kertes, D. A., Gunnar, M., Madsen, N. J., & Long, J. (2008). Early deprivation and home basal cortisol levels: A study of internationally-adopted children. Development and Psychopathology, 20, 473–491. Kuhlmann, S., & Wolf, O. T. (2006a). A non-arousing test situation abolishes the impairing effects of cortisol on delayed memory retrieval in healthy women. Neuroscience Letters, 399, 268–272. Kuhlmann, S., & Wolf, O. T. (2006b). Arousal and cortisol interact in modulating memory consolidation in healthy young men. Behavioral Neuroscience, 120, 217–223. Larson, M., White, B. P., Cochran, A., Donzella, B., Gunnar, M. R. (1998). Dampening of the cortisol response to handling at 3-months in human infants and its relation to sleep, circadian cortisol activity, and behavioral distress. Developmental Psychobiology, 33, 327–337. Levine, S. (2001). Primary social relationships influence the development of the hypothalamic-pituitary-adrenal axis in the rat. Physiology & Behavior, 73, 255–260. Lopez, J. F., Akil, H., & Watson, S. J. (1999). Role of biological and psychological factors in early development and their impact on adult life: Neural circuits mediating stress. Biological Psychiatry, 46, 1461–1471. McEwen, B. S. (2000). Protective and damaging effects of stress mediators: Central role of the brain. Progress in Brain Research, 122, 25–34. Nachmias, M., Gunnar, M., Mangelsdorf, S., Hornik Parritz, R., & Buss, K. (1996). Behavioral inhibition and stress reactivity: The moderating role of attachment security. Child Development, 67, 508–522. Plihal, W. & Born, J. (1999). Memory consolidation in human sleep depends on inhibition of glucocorticoid release. NeuroReport, 10, 2741–2747.

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Quas, J. A., Wallin, A. R., Papini, S., Lench, H., & Scullin, M. H. (2005). Suggestibility, social support, and memory for a novel experience in young children. Journal of Experimental Child Psychology, 91, 315–341. Roozendaal, B. (2000). Glucocorticoids and the regulation of memory consolidation. Psychoneuroendocrinology, 25, 213–238. Roozendaal, B. (2002). Stress and memory: Opposing effects of glucocorticoids on memory consolidation and memory retrieval. Neurobiology of Learning and Memory, 78, 578–595. Roozendaal, B. (2003). Systems mediating acute glucocorticoid effects on memory consolidation and retrieval. Progress in NeuroPsychopharmacology and Biological Psychiatry, 27, 1213–1223. Roozendaal, B., Okuda, S., Van der Zee, E. A., & McGaugh, J. L. (2006). Glucocorticoid enhancement of memory requires arousal-induced noradrenergic activation in the basolateral amygdala. Proceedings of the National Academy of Sciences, 103, 6741–6746. Sapolsky, R. M. (1997). McEwen-induced modulation of endocrine history: A partial review. Stress, 2(1), 1–12. Sapolsy, R. M., Romero, M., & Munck, A. U. (2000). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocrine Review, 21, 55–89. Schelling, G., Roozendaal, B., Krauseneck, T., Schmoelz, M., de Quervain, D., & Briegel, J. (2006). Efficacy of hydrocortisone in preventing posttraumatic stress disorder following critical illness and major surgery. Annals of the New York Academy of Sciences, 1071, 46–53. Stansbury, K., Haley, D., & Koeneker, A. (2000). Higher cortisol values facilitate spatial memory in toddlers. Annals of the New York Academy of Sciences, 911, 456–458. Stroud, L. (2006). Physiological response to stress over the adolescent transition: Performance versus social rejection stress. Paper presented at the American Psychosomatic Society, Denver, CO. Vázquez, D. M. (1998). Stress and the developing limbic-hypthalamicpituitary-adrenal axis. Psychoneuroendocrinology, 23, 663–700. Van Bockstaele, E. J., Bajic, D., Proudfit, H., & Valentino, R. J. (2001). Topographic architecture of stress-related pathways targeting the noradrenergic locus coeruleus. Physiology and Behavior, 73, 273–283. Wagner, U., Degirmenci, M., Drosopoulos, S., Perras, B., & Born, J. (2005). Effects of cortisol suppression on sleep-associated consolidation of neutral and emotional memory. Biological Psychiatry, 58, 885–893. Watamura, S. E., Donzella, B., Kertes, D., & Gunnar, M. R. (2004). Developmental changes in baseline cortisol activity in early childhood: Relations with napping and effortful control. Developmental Psychobiology, 45 (3), 125–133. Yehuda, R. (2000). Biology of Posttraumatic Stress Disorder. Journal of Clinical Psychiatry, 61(Suppl.7), 15–21.

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11 Stress Effects on the Brain System Underlying Explicit Memory Leslie J. Carver Annette Cluver

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n this chapter, we review the literature on the development of event memory and the brain system that underlies it. We describe what is known about the explicit memory system and its development, as well as areas in which more could be understood about the development of the system. We review the literature on effects of stress on the development of the explicit memory system, and propose ways in which timing and plasticity could play a role in long-term effects of stress on the brain basis of memory. The purpose of this chapter is to outline the brain system that underlies memory and what is known about its development. We will focus on the system that underlies long-term, explicit memory. A substantial literature using both neuroscience and behavioral techniques has emerged in the past 20 years that suggests that this brain system undergoes extensive development during the fi rst years of life, and continues to develop through childhood. Advances in neuroscientific methods, such as Event-Related Potentials (ERP) and functional Magnetic Resonance Imaging (fMRI), and their application to the study of development, have greatly added to our knowledge about the maturation of this system. In concert with previously established methods (e.g., comparative studies), application of these methods to behavioral development has expanded our knowledge of brain development in infants and young children. In addition, in recent years, behavioral paradigms have been developed demonstrating that even young infants possess greater mnemonic 278

abilities than we have previously given them credit for. Identifying how the abilities and limitations of memory change throughout typical development is essential for understanding the potential short- and long-term effects of early experience and stress on memory. The relation between the development of the memory and the stress system is important for at least two reasons. First, as is evident in many of the other chapters in this volume, stress can affect the way specific events that are related to the stressor are recalled (see for example Baker-Ward, Ornstein, & Starnes; Chae, Ogle, & Goodman, this volume). For example, several studies have examined memory in both children and adults for highly stressful events (see also Christianson, 1992; Terr, 1988; der Kolk, 1998). These studies, combined with animal models of the effects of stress on specific brain systems involved in memory, suggest that one of the factors that affects memory is how chronic (as opposed to acute) the stressful event is. This factor may also mediate the effects of stress on the brain system involved in memory. A second important reason for understanding the interaction between stress and memory systems comes from the effects of those stressors on the development of the memory system more generally. In other words, stress may not only impact how specific events are experienced, but chronic stress may affect the development of the memory system itself. Components of the brain system involved in explicit memory are especially vulnerable to the effects of corticosteriods released in response to stress. Long-term exposure to these hormones may have a deleterious long-term effect on the development of the system and, consequently, on general memory abilities. In addition to describing what is known about the timing of the development of the brain system that underlies memory, we will review in brief the literature on the development of explicit memory, focusing in particular on the development of episodic and autobiographical memory. We will also describe landmarks in the emergence of the brain system that underlies explicit memory, and discuss how stressors experienced at these critical time points may be especially significant for later development and functioning. Finally, we will review research on effects of chronic and acute stress on the development of brain systems involved in memory. We will conclude by describing future directions and yet to be answered questions in this area.

Development of Explicit Memory Explicit memory refers to memories of specific stimuli that can be called into conscious awareness. Explicit memory includes recall of specific Stress Effects on the Brain System Underlying Explicit Memory

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events and facts, and recognition of people, places, and objects. Explicit memory can be differentiated from implicit or procedural memories, in which prior experience affects later behavior due to priming, conditioning, or motor learning (Squire, 2004). Relevant to the present volume, explicit memory includes recall of episodes (labeled episodic memory) as well as facts or recognition memory for stimuli without recall of the specific incident in which the stimuli were previously encountered (semantic memory). Episodic memory involves recalling a specific past incident. When episodic memory is relevant to one’s own past, it also can be termed autobiographical memory. Autobiographical memory is necessarily episodic (as it reflects recall of episodes that compose the narrative of one’s own life). Episodic memory, in contrast, may or may not be autobiographical. An individual can recall past events without incorporating them into a personal history. Traditionally, memory for events, especially autobiographical memory, has been thought to be late developing. Because most people do not remember events from before around their third year, infants were thought not to be able to form event memories. Recently, methods have been developed that allow for measuring infants’ memory for events over long delays (Carver & Bauer, 1999; Meltzoff, 1988). Studies using imitation have measured explicit memory in infants as young as six months of age (Barr, Dowden, & Hayne, 1996) and for delays as long as one month in nine-month-olds (Carver & Bauer, 1999, 2001). In imitation studies, infants are presented with a brief demonstration of an event enacted with props. After the imposition of a delay, infants are given the props again. Of interest is whether they replicate the action or actions that had been demonstrated. Production of the actions is thought to reflect explicit memory for several reasons (see Bauer, 1995; Meltzoff, 1990, for arguments that support this idea), but it is less clear whether infants retain memory for the original events (episodic memory) or simply learn facts about the events (semantic memory). In other words, infants may recall the specific experience of seeing the event demonstrated (a form of autobiographical memory), they may recall the event without relating it to a personal narrative (episodic memory), or they may recall only factual information about the props and how they work (semantic memory), including possibly simple recognition of the props and actions they afford. Because infants do not talk, it was initially difficult to determine which type of memory infants show in imitation tasks. Yet, numerous important task manipulations have been done that together are highly suggestive of infants actually recalling events (Bauer, 2004; Bauer & Dow, 1994). For example, in some studies, infants are shown multiplestep events, and their imitation of actions in the previously modeled 280

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order is measured (Bauer, Hertsgaard, Dropik, & Daly, 1998; Bauer & Mandler, 1989, 1992; Carver & Bauer, 2001). Imitation of order information is more sophisticated than imitation of actions. Actions may be cued by the props, but the order in which actions are to occur can only be recalled by retrieving a representation of the event that includes temporal information. Thus, although we cannot definitively ascertain that infants recall specific episodes, demonstrations of recall of order suggest some memory for the details of events in infants under one year of age (Carver & Bauer, 1999, 2001). Despite the apparent ability of even young infants to recall events before the end of the first year of life, it is clear that most adults do not remember events that happened to them before about the age of three. This “infantile amnesia” suggests that whatever form of explicit, event memory is available to young infants, autobiographical memory is later to emerge. Several theories have been developed to explain infantile amnesia and the development of autobiographical memory (see Peterson, 2002, for review). According to one view (Howe & Courage, 1993), the development of “autonoetic awareness,” or the understanding of the self as distinct from others underlies the onset of autobiographical memory abilities. According to another perspective, the ability to form a narrative about one’s past and relate this narrative to others underlies the onset of autobiographical memory (Fivush & Nelson, 2006). How adults talk about the past with their children is related to how infants report and recall their past experiences (Fivush, Haden, & Reese, 1996). In one study, these self-awareness and social narrative views were directly contrasted (Harley & Reese, 1999). Harley and Reese followed children from 19 to 32 months of age. At each of three visits between these ages, they measured self-recognition, deferred imitation, and comments about memory. Children with more elaborative mothers in conversations about memory recalled more detail in their memory narratives than children with less elaborative mothers. In addition, children who recognized themselves earlier, as indexed by a mirror recognition task, also elaborated more on their memories than later self-recognizers. The contributions of these milestones were independent, suggesting that both factors are important for the development of autobiographical memory. In summary, memory undergoes considerable development during the first few years of life. Convincing evidence now exists demonstrating that, by at least one year of age, infants are capable of forming explicit memories of prior experiences. However, it is likely not until slightly later that young children are competent at forming and retaining autobiographical memories. Both an emerging sense of self and narrative co-construction contribute to children’s early autobiographical memory formation. However, as we discuss next, the neurological structures Stress Effects on the Brain System Underlying Explicit Memory

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involved in explicit memory also undergo considerable developmental change, and this change also affects children’s emerging memory abilities.

Development of the Brain System Underlying Explicit Memory Development A long history of research has established fairly clear identification of the brain system that underlies explicit or declarative memory in adults (Squire, 1986, 2004). The components that comprise this circuit seem to act together in most aspects of encoding, storage, and retrieval of memories. Thus, development in all aspects of the system is needed for adult-like memory performance. Because the literature on the development of this brain system has been reviewed in detail recently (Bauer, 2004), we provide here an abbreviated summary of development in the relevant brain areas. Early research with adult patients, such as H.M., who experienced the loss of the medial temporal lobes, established those areas, in particular the hippocampus and surrounding areas, as important for the formation of new memories (Squire, 1992, 2004; Zola-Morgan & Squire, 1990). Later research has confirmed that the hippocampus is important for memory formation (Squire, 1992), and some studies suggest that it may also play a role in retrieval of information (Gilboa, Winocur, Grady, Hevenor, & Moscovitch, 2004). Regardless of its specific role, the hippocampus is clearly a critical structure for mnemonic functions, and its development is critical for the development of memory. Given that the hippocampus is especially vulnerable to the effects of stress (see below), it is important to consider its developmental status when thinking about long-term effects of stress on memory. Recent research has focused on molecular events in the hippocampus that may be related to memory formation (Hawkins, Kandel, & Bailey, 2006; Mayford et al., 1996). Studies have identified events involved in long-term potentiation (LTP), a type of synaptic plasticity that is thought to be an important contributor to memory formation. In LTP, glutamate receptors change their configuration in response to an initial stimulus. The effect of subsequent activations is an enhanced, long-lasting response. Recent research has identified gene products that are important for maintaining this response (for review see Silva, 2003). Recent research has also identified gene products that are important for the consolidation of memory traces (Matynia, Kushner, & Silva, 2002; Silva, 2003). Although our knowledge of genetic events involved in memory formation and consolidation is increasing, little is known about the developmental time course of the functionality of this system. 282

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However, research on the development of the hippocampus suggests that, in large part, it matures quite early. Studies of cell formation suggest that the majority of the neurons in most of the hippocampus are in place by the end of the gestational period, although the dentate gyrus demonstrates small amounts of neurogenesis postnatally (Seress, 2001; Seress, Abraham, Tornoczky, & Kosztolanyi, 2001), and continues to develop during the first years of life. Despite hippocampal neurons being largely in place by birth, however, important developments in cell morphology and synapse formation extend through infancy and childhood (Seress, 2001). In addition, connections between the dentate gyrus and cortical association areas that are important for the storage of memories are relatively late to mature (Seress, 2001; see Bauer, 2004, for review). Storage of long-term memories is thought to occur in the association cortices. Memories appeared to be retrieved via a process of interaction between frontal areas important for retrieval (see below), association areas involved in storage, and the hippocampus (at least for recent memories, and possibly for old memories as well, Gilboa et al., 2004). The timing of the development of these association areas varies, but, in general, they are thought to be slower to develop than medial temporal lobe structures, but less delayed in their development than frontal structures important for retrieval. Developments in these association areas are likely to be important for both storage and retrieval of memories, given that they are active when memories are formed, with these activations being “reinstated” when memories are retrieved. The final brain system that is likely to be important for memory development is the frontal cortex. This area is important for retrieval of memory from long-term stores, and patients with frontal lesions have impairments in recovering old memories (Moscovitch & Melo, 1997). Thus, the frontal cortex is thought to be a critical area for explicit memory, and for autobiographical memory in particular (Addis, McIntosh, Moscovitch, Crawley, & McAndrews, 2004; Markowitsch, Calabrese, Neufeld, Gehlen, & Durwen, 1999). The frontal cortex is the latest part of the brain to develop. Peak synaptogenesis occurs after the first year of life, and greater synapse density than in adulthood is maintained through adolescence (Huttenlocher, 1990; Huttenlocher & Dabholkar, 1997). In addition, the frontal cortex is late to myelinate, with myelination continuing through as many as several decades of life. Thus, although some aspects of the explicit memory system are clearly mature early in development (e.g., cell morphology in most of the hippocampus), complete functionality of the entire system likely proceeds on a protracted schedule. This protracted progression of development likely leads to the developmental changes in memory ability that have been found. For example, although infants as young as six months of age Stress Effects on the Brain System Underlying Explicit Memory

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show evidence of explicit memory, as indexed by deferred imitation (Barr et al., 1996), performance is fragile at that age, with infants requiring a large number of exposures to recall a small amount of information after only 24 hours. By about nine months of age, around 45% of infants are able to recall events after delays of up to one month (Bauer, Wiebe, Waters, & Bangston, 2001; Carver & Bauer, 2001). By 10 months of age, infants are able to encode events and recall them after delays of three and possibly even up to six months. The robustness and accessibility of memories continues to increase throughout early childhood, until toddlerhood, when most infants can recall events after delays as long as several months (Bauer, Wenner, Dropik, & Wewerka, 2000). These changes in memory performance likely have at their source developments in several brain systems. At the end of the first year, brain developmental data suggest that connections between the dentate gyrus and cortical association areas are being established. Combined with behavioral and ERP data (Bauer et al., 2006; Bauer, Wiebe, Carver, Waters, & Nelson, 2003), these events point to an improvement in consolidation and storage of memories as a critical skill affecting memory in this age range. By school age, children are increasingly able to remember the source of remembered information (Drummey & Newcombe, 2002) and details of personal experiences (Hudson & Nelson, 1986). Maturation of associations cortices and frontal lobes may further contribute to these improvements in children’s ability to retrieve memories of personal experience.

Relations Between Brain and Memory Development There is a relatively small amount of research that directly assesses the relations between changes in brain development and memory. In one paradigm (Carver, Bauer, & Nelson, 2000), events to be remembered are demonstrated for infants in a deferred imitation paradigm. After some delay, brain activity is measured, using ERPs, in response to pictures of stimuli that had been used in the imitation procedure, or new stimuli. Differentiation between previously seen stimuli and new stimuli is taken as evidence for memory (most likely recognition memory) for the imitation stimuli. Using this paradigm, we (Carver, Bauer, & Nelson, 2000) have shown that individual differences in memory performance at nine months of age are accompanied by individual differences in brain development. In addition, Bauer and colleagues (Bauer et al., 2006) found that whereas all infants showed evidence of encoding (i.e., their brain activity differentiated previously encountered from new events when tested immediately after exposure), only those infants who would later recall the events (after a delay of one month) showed delayed differentiation of the events. These results implicate developments in storage, 284

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consolidation, or retrieval as important in the transition that appears to occur at about nine months of age (Carver & Bauer, 2001). In addition, Bauer and colleagues (Bauer et al., 2003) tested nine- and 10-montholds longitudinally using the same paradigm. In this study, encoding improvements were evident along with changes in storage abilities, suggesting that both functions continue to improve at the end of the first year of life. Based on brain development, patterns of recall, and savings in relearning, Bauer (Bauer, 2005; Bauer, 2006) has argued that changes in encoding, storage, and consolidation are more likely to be involved in changes in memory ability seen at this age than are changes in retrieval.

Known Effects of Stress on Memory Function and the Underlying Brain System Hippocampal and Other Limbic Structures Stress and the associated rise in levels of endogenous glucocorticoids (GC) impact explicit memory by altering the morphology and functioning of the brain system that underlies explicit memory. Specifically, the effect of stress exposure on the organism depends critically on the severity, duration, and the timing of the stress during development (Bremner & Narayan, 1998). Whereas mild, acute stress may in fact enhance memory by facilitating synaptic plasticity, it is now becoming increasingly clear that chronic and severe stress may lead to maladaptive changes in the organism that may damage brain areas of the explicit memory system and impair memory functioning (Bremner & Narayan, 1998; Luine, Martinez, Villegas, Magarinos, & McEwen, 1996; Luine, Villegas, Martinez, & McEwen, 1994). Limbic and frontal structures that underlie explicit memory are especially vulnerable to stress-induced injury. Stress affects the structure, neurochemistry, and function of the hippocampus and surrounding structures, including the amygdala as well as areas in prefrontal cortex (Brown, Henning, & Wellman, 2005; Kanitz, Otten, Tuchscherer, & Manteufel, 2003; Murmu et al., 2006; Schin, Rauch, & Pitman, 2006). In particular the hippocampus, which is characterized by a high density of glucocorticoid receptors (GR), represents a target area for corticosterone related damage (Akirav & Richter-Levin, 2002). Interestingly, moderate levels of GCs are important for hippocampal health. In the absence of GC exposure, for example due to adrenalectomy, cells in the dentate gyrus atrophy and die (Sloviter, Sollas, Dean, & Neubort, 1993). However, excessive levels of GCs induce damage in hippocampal areas. Morphological changes in the hippocampus include decreases in the size and structure of cells, neuronal connectivity, and Stress Effects on the Brain System Underlying Explicit Memory

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alterations in synapse structure (Watanabe, Gould, & McEwen, 1992). Studies using animal models have found decreased neurogenesis, neural proliferation, and differentiation of hippocampal pyramidal and granule cells in response to stress (Tanapat, Hastings, Rydel, Galea, & Gould, 2001). Existing hippocampal pyramidal cells may exhibit shrinkage, a decrease in the length and branching of apical dendrites and even cell death in response to prolonged stress (Watanabe et al., 1992). Whereas neurogenesis is impacted by acute stress, atrophy within hippocampal regions is seen in response to chronic stress (McLaughlin, Gomez, Baran, & Conrad, 2007; Tanapat et al., 2001; Vyas, Mitra, Shankaranarayana Rao, & Chattararji, 2002). In adult humans, for example, atrophy of the hippocampus has been observed in humans following the experience of a severely traumatic event (Bremner et al., 1995). Stress-induced morphological changes in limbic structures may also have a more indirect effect on memory by altering the functioning of the HPA axis. In particular chronic and uncontrollable stress may lead to a long-term down-regulation of GRs in the hippocampus (Kanitz et al., 2003). Such down-regulation can result in impairments in the regulatory response of the HPA axis, as hippocampal GRs mediate negative feedback within the axis (Jacobson & Sapolsky, 1991). This adaptation to chronic stress then leads to altered basal levels of GCs and enhanced reactivity of the HPA-axis when stress is encountered later in life (Weinstock, Matlina, Maor, Rosen, & McEwen, 1992). These effects of stress on the brain indicate that prolonged stress may shape the structure and functioning of the hippocampus, which in turn may impact neuronal processes underlying explicit memory. Indeed, numerous studies in humans and animals have reported that performance on hippocampal-dependent tasks, such as recall, spatial navigation, and the regulation of the anxiety response, are negatively affected by high levels of exposure to stress and injection of exogenous GCs (Becker, Abraham, Kindler, Helmeke, & Braun, 2007; Buss, Wolf, Witt, & Hellhammer, 2004).

Emotion and the Amygdala Another critical limbic area affected by exposure to corticosterone is the amygdala. The basolateral nucleus of the amygdala (BLA) in particular is thought to play a modulatory role on synaptic activity in the hippocampus and surrounding structures, for example, by facilitating or impairing LTP, thereby affecting consolidation (Kim, Lee, Han, & Packard, 2001; McGaugh, McIntyre, & Power, 2002). Modulation of hippocampal activation is associated with arousal, as is BLA activity and thereby the modulatory influence on hippocampal plasticity rises in response to emotional 286

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events and to stress (Cahill & van Steegeren, 2003). Emotional stimuli, such as pictures of emotional events or faces, are often remembered better than are neutral stimuli (Cahill & van Steegeren, 2003). Applying a mild and short-lasting stress postlearning of emotional and neutral stimuli has an interesting effect, as the stress appears to interact with the level of arousal during encoding. When the material to be learned is emotional (e.g., pictures of car accidents) the level of arousal at encoding is heightened and the stressor selectively enhances memory for these stimuli, presumably by facilitating consolidation. Memory for neutral stimuli that fail to alter arousal remains unaffected by the same kind of postlearning stress (Cahill & van Steegeren, 2003). Cahill and van Steegeren’s results indicate that the level of arousal during the encoding of the event and postlearning stress interact in affecting consolidation. These modulatory effects are thought to be mediated by activation of the BLA. Because the amygdala is so closely involved in the emotional explicit memory processes, stress induced damage affecting the structure and function of the amygdala may therefore also affect explicit memory. GR are located throughout the BLA. There is now evidence pointing to a critical involvement of GCs at these receptor sites in the modulatory effect of BLA activity on memory processes (Roozendaal & McGaugh, 1997). Similar to postlearning stress, administering a GR agonist into the BLA directly postlearning enhances retention whereas administration of a GR antagonist prior to training leads to decreased retention (Roozendaal & McGaugh, 1997). Though short-term stress heightens activity of the BLA, synaptic plasticity is inhibited in response to stress and a rise in plasma cortisol levels (Kavushansky & Richter-Levin, 2006).

Prefrontal Cortex Less is known about effects of stress and accompanying GC exposure on prefrontal cortex (PFC). As mentioned previously, the PFC plays a central role in explicit memory processes such as event memory retrieval and source memory. Of relevance to the current chapter, the PFC is also involved in regulating negative feedback in the HPA-axis (Mizoguchi, Ishige, Aburada, & Tabira, 2003). As in the hippocampus, chronic stress can lead to atrophy of pyramidal neurons in areas of PFC (Radley et al., 2004). Consistent with this observation, compared to healthy controls, patients with posttraumatic stress disorder (PTSD) have smaller PFC volume, show abnormally low activity in the PFC when processing affective faces, and exhibit hypersensitive patterns of activity in the amygdala (Shin et al., 2005). These responses have been interpreted as suggesting that chronic stress may impact areas involved in the processing of Stress Effects on the Brain System Underlying Explicit Memory

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affective and in particular fearful stimuli. Also, changes in prefrontal areas due to chronic stress may act in concert with hippocampal dysfunction to exacerbate the abnormal HPA axis functioning (Mizoguchi et al., 2003).

Stress Effects on the Immature Brain: The Influence of Timing and Duration Though stress can affect the brain and behavior at any age, because of the developing brain’s high degree of plasticity, it is particularly vulnerable to glucocorticoid-induced damage, including that caused by environmental influences. Thus, the immature brain may be at increased risk for sustaining severe and long-lasting effects in response to adverse experience. However, the high degree of plasticity also implies that recovery from stress-induced damage may be more likely if a stressful experience is followed by development in a healthy and nurturing environment. As in adults, stress effects during development depend on the severity and the chronicity of the stressor, as well as on the developmental stage at which exposure to stress occurs (Vallee et al., 1999). However, due to the malleability of the brain during maturation, milder and less chronic stress may nonetheless have a profound impact on sculpting the brain. Perinatal brain maturation is characterized by the highest level of neural plasticity (Rakic, 1995). During this period the brain exhibits massive neurogenesis and neural migration, almost all of which take place prenatally. On the other hand, the postnatal period is marked by synaptic and dendritic growth and by axonal myelination, which continues well into adolescence and adulthood (Rakic, 1995). It is now clear that early exposure to stress can have short- and long-term structural and functional effects on the brain, leading to HPA axis abnormalities, cognitive deficits, and hyperactivity in later childhood (Grunau et al., 2007; Gutteling et al., 2006; Kapoor & Matthews, 2005). However, there is some evidence that timing of stress is critical and pre- and postnatal exposure to stress may have different effects on development (Vallee et al., 1999). For example, Sandman and colleagues have shown that prenatal stress exposure early in gestation has a more profound effect on birth outcomes than stress experienced later in gestation (Glynn, Wadhwa, Dunkel-Schetter, Chicz-Demet, & Sandman, 2001).

Prenatal Effects of Stress and Glucocorticoid Exposure There are two principal ways in which the human fetus can be exposed to elevated levels of glucocorticoids. First, stress experienced by the 288

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mother during pregnancy will lead to a rise of endogenous glucocorticoid levels in the fetus that may lead to adverse effects on fetal brain development (Huizink, Robles de Medina, Mulder, Visser, & Buitelaar, 2003; Vallee et al., 1999; Weinstock, 2001). Maternal stress may also exert a negative influence on fetal brain development as stress hormones constrict blood vessels and may thereby decrease proper delivery of oxygen and nutrients to the fetus (Myers, 1975). However, GCs are involved in mediating at least some of the detrimental effects of maternal stress on the fetus, as these effects are abolished when dams were adrenalectomized prior to stress exposure (Zagron & Weinstock, 2006). A second source of prenatal exposure to elevated levels of glucocorticoids is via synthetic corticosteroids (betamethsone, dexamethasone), that are commonly given to mothers at risk for preterm labor. Pregnant mothers receive either single or repeated doses of corticosteroids to promote fetal lung development and reduce the incidence of Respiratory Distress Syndrome (RDS) and neonatal death (Roberts & Dalziel 2007). Though this procedure is successful in terms of increasing neonatal survival, there is some controversy surrounding the use of this treatment in light of evidence suggesting that synthetic glucocorticoids, especially when given in repeated doses, may have negative effects on cognitive and behavioral development (Schoener, Baig, & Page, 2006; Spinillo et al., 2004). Much of what is currently known about the effects of exposure to endogenous and exogenous GC has been learned from studies using animal models, primarily rats, nonhuman primates and other mammalian species (Kanitz et al., 2003; Weinstock et al., 1992). Though there are certainly differences in brain maturation between animals and humans, in particular with respect to the time-course of maturational events, there is also evidence to suggest substantial parallels in the patterns of brain development between humans and these animal species (Zola-Morgan & Squire, 1990), thus highlighting the utility of nonhuman animal models for understanding potential short- and long-term outcomes for infants exposed to elevated levels of glucocorticoids. The hippocampus and surrounding structures, which have the highest sensitivity to corticosteroids, seem to be negatively affected by prenatal exposure to elevated levels of GCs (Coe, Rosenberg, & Levine, 1988; Vallee et al., 1999). In both rhesus monkeys and rats, prenatal stress leads to a decrease in neurogenesis, proliferation, and differentiation of cells in the hippocampus and affects synaptic plasticity by attenuating LTP (Coe et al., 1988; Lemaire, Lamarque, Le Moal, PierVincenzo, & Abrous, 2006). Similarly, exposure to exogenous GCs, especially in high doses, is associated with the depletion and shrinkage of pyramidal neurons across subregions of the fetal hippocampus and Stress Effects on the Brain System Underlying Explicit Memory

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decreased hippocampal volume in adulthood (Brunson, Chen, AvishaiEliner, & Baram, 2003). Other components that are affected by prenatal exposure are neurotrophins, neuronal growth factors that are critical components in the regulation of neuronal survival, differentiation, and synaptic strengthening (Kang & Schuman, 1995) and may play a role in memory formation (Roceri, Hendriks, Racagni, Ellenbroek, & Riva, 2002; Schaaf et al., 2001). Changes in the density of hippocampal GRs have also been observed in animals subjected to prenatal stress, which could impact feedback regulation of the HPA system (Jacobson & Sapolsky, 1991). Some of the memory impairments seen as a result of prenatal stress, however, can be prevented if postnatal care is provided by a nonstressed mother, suggesting that these prenatal changes are not necessarily permanent (Brabham et al., 2000). Interestingly, adult offspring of female rats who experienced mild, short-term stress during late pregnancy in fact show improvements in learning (Fujioka et al., 2001). However, more severe levels of prenatal stress seem to induce long-term adaptive changes that may result in elevated stress responsiveness and learning difficulties (Szuran, Pliska, Pokorny, & Welzl, 2000). In humans, fetal exposure to both endogenous and synthetic glucocorticoids has been linked to later cognitive, behavioral and physiological deficits, such as intellectual and learning impairments, hyperactivity and changes in HPA axis functioning (Gutteling et al., 2005; Gutteling et al., 2006; Huizink et al., 2007). For example, infants whose mothers were treated with corticosteroids during pregnancy exhibit higher levels of attentional deficits, learning difficulties, and emotional problems (Yeh et al., 2004) than infants of mothers not treated with these steroids. Behavioral and emotional problems have been reported in infants and children whose mothers experienced psychological stress during gestation (Gutteling et al., 2005; Huizink et al., 2003). Factors that appear to play a role in determining the developmental outcome of prenatal exposure to stress and exogenous GCs include the frequency and timing of stress exposure. Furthermore, with respect to synthetic corticosteroids, the type of steroid (i.e., Betamethasone or Dexamethasone) seems to influence the outcome of treatment. Several studies in animals and humans indicate that chronic stress and/or repeated doses of GCs administered prenatally lead to a worse outcome than a single dose (Setiawan, Jackson, MacDonald, & Matthews, 2007; Spinillo et al., 2004). Mid- to late gestation appears to represent a kind of critical period for the influences of maternal stress and exogenous GCs, though with respect to maternal stress, some effects have also been found after exposure during the first trimester (Schneider, Roughton, Koehler, & 290

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Lubach, 1999). The third trimester is a period in brain development that is marked by neural proliferation, synapse formation, and myelination (Rakic, 1995). As discussed above, glucocorticoids have been found to interfere with each of these important processes of brain maturation (Dunlop, Archer, Quinlivan, Beazley, & Newnham, 1997). Infants whose mothers experienced stress early during pregnancy tend to have low birth weight and express attentional and temperament related difficulties (Davis et al., 2007; Schneider et al., 1999). In contrast, infants whose mothers report having experienced stress and anxiety during mid-pregnancy score lower on measures of mental and psychomotor development at eight months of age than infants of mothers who did not report stress during the same time frame (Huizink et al., 2003). In particular, fear of giving birth during mid-gestation had an impact on the infants’ developmental outcome. Although attentional and emotional problems seem to be a consistent consequence of prenatal stress (Huizink et al., 2007; O’Connor, Heron, Golding, Beveridge, & Glover, 2002), in particular following stress during mid- to late gestation, learning and memory problems have not been found as consistently (Gutteling et al., 2006). It is possible that children show some impairment early on, but recover with age and good maternal care. While perinatally stressed eight-month-old infants exhibited lower scores on tests of memory, learning and memory deficits were not found in prenatally stressed children at age six, though they did exhibit higher levels of attentional problems (Gutteling et al., 2006). In sum, the key factor in whether prenatal stress affects learning and memory seems to be the timing of the exposure, rather than the mere presence of stressors.

Early Postnatal Exposure In rodents, the first few weeks of life are known as the “stress hyporesponsive period” (SHRP), during which concentrations of circulating GCs are very low and are not elevated by mild stressors (Gould, Woolley, & McEwen, 1991). It has been proposed that low concentrations of GCs are necessary for healthy early brain development, and that the SHRP represents a kind of buffer against the potential effects of mild stressors (de Kloet & Oitzl, 2003). Humans undergo a period similar to the postnatal SHRP in rats that lasts for the first 12 months of life (Gunnar & Donzella, 2002). Interestingly, maternal behavior appears to be critical in maintaining the SRHP, and it has been found that mimicking maternal behavior such as gonadal licking in rats separated from their mothers has the same effect on maintaining low levels of GCs (Levy, Melo, Galef, Stress Effects on the Brain System Underlying Explicit Memory

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Madden, & Fleming, 2003). Though the SHRP represents a buffer against mild elevations of GCs, it cannot protect against an excessive rise in the level of stress hormones during this period. If the young organism experiences such a rise in GCs, either in result to a strong stressor or due to the injection of exogenous GCs, severe brain damage may result. In rats, injection of exogenous GCs during the hyporesponsive period can alter vital processes of brain maturation, such as neural cell death (pruning), neural migration and neurogenesis (Roskoden, Linke, & Schwegler, 2005). However, the effects of exogenous corticosteroid exposure on memory depends on whether it is acute versus chronic. Roskoden and colleagues (2005) report enhanced performance on a spatial working memory task in rats temporarily exposed to exogenous corticosterone during the SHRP (Roskoden et al., 2005), whereas Sousa, Lukoyanov, Madeira, Almeida, and Paula-Barbosa, 2000) reported impairments in spatial working memory following postnatal exposure to corticotropin releasing hormone (CRH). The administration of CRH may more closely mimic the endogenous stress response compared to administration of exogenous corticosteroids. This suggests that in the absence of stress, exogenous corticosteroids may not have the same effect on the developing memory system as exposure to stress. Early-experienced psychological stressors seem to have a more pronounced effect on brain morphology and behavior than later stressors. Maternal deprivation (MD) is considered the animal model of neglect, with both MD and neglect being extremely stressful for the offspring. MD early in life is associated with elevated endogenous levels of GCs (Ladd, Owens, & Nemeroff, 1996). It also enhances later stress responsiveness in the adult via changes affecting stress hormone secretion and GR densities in the hippocampus and hypothalamus (Becker et al., 2007). Finally, early MD affects learning and memory. In rats, for example, maternal separation for just 24 hours is associated with poorer learning and more limited memory performance, not only in young rats, but across the rats’ lifespan, including into adulthood (Oitzl, Workel, Fluttert, Frösch, & de Kloet, 2000). Hippocampal mineralocorticoid receptors (MRs) are believed to play an important role in mediating proactive feedback in the HPA axis (see Wiik & Gunnar, this volume), whereas hippocampal glucorticoids (GRs) mediate negative feedback on the stress response. Prolonged periods of early stress appear to increase the density of hippocampal MR receptors, while decreasing the density of the hippocampal GR receptors. Early stress (elevated endogenous glucocorticoids) may also interfere with early synaptic development and lead to lasting structural changes in the hippocampus, although structural changes in the prefrontal cortex and amygdala have not been observed (Andersen & Teicher, 2004). 292

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Roceri and colleagues (Roceri et al., 2004) found that prolonged and repeated MD in rats led to transient increase in the expression of brainderived neruotrophic factor (BDNF) expression in the hippocampus and in PFC. As adults, formerly repeatedly MD rats evidenced lower basal levels of BDNF protein and failed to show the normal decrease in BDNF mRNA in response to stress. On the one hand, these changes may be an adaptive response to the early stress exposure. On the other, however, down-regulation of BDNF gene expression in PFC may underlie some of the stress-related cognitive and emotional impairments that may arise from a decrease in neural plasticity (Roceri et al., 2004). Similarly, a decrease in neural proliferation and the production of immature neurons has been observed in the hippocampus of adult animals with a history of early postnatal stress (Mirescu, Peters, & Gould, 2004). Of interest, some researchers have found positive outcomes in rats experiencing maternal separation or even complete isolation after birth (Blaise, Koranda, Chow, Haines, & Dorward, 2008; Faure, Uys, Marais, Stein, & Daniels, 2007). Blaise and colleagues, for instance, found enhanced LTP and LTD in adult rats that had experienced periods of maternal separation after birth (Blaise et al., 2008). Faure and colleagues found that the stress response in adult animals subjected to maternal separation was attenuated compared to non-MS rats (Faure et al., 2007). Interestingly, stress that occurs postnatally through handling appears to have a protective effect against stress in later life. Postnatal handling involves daily periods during which the pup is picked up by an experimenter and briefly placed in isolation, thereby separating the pup from the dam (Weinberg & Levine, 1977). Rats handled postnatally demonstrate adaptation and a later attenuation of the stress response compared to controls (Meaney, Aitken, Sharma, Viau, & Sarrieau, 1989). As adults, the formerly handled rats secrete less GCs in response to stress and also exhibit lower basal levels of circulating GCs than do nonhandled rats (Meaney et al., 1989). Increased expression of frontal and hippocampal GR genes, which may enhance the negative feedback inhibition on the HPA functioning, has also been associated with postnatal handling (Meaney et al., 2000). These effects are not due to an absence of the stress response at the time of handling. On the contrary, the handling procedure is generally stressful for the young rat, as is evidenced by increases in cortisol levels and stress-related behavior, though it is considered a rather mild form of stress (Brunson et al., 2003). Still, it seems surprising that even a mild stress may bring about protective benefits with respect to stress experienced later in life. This phenomenon has been explained by the intense maternal care, involving licking and grooming behavior, that follows postnatal separation once mother and pup are reunited. Stress Effects on the Brain System Underlying Explicit Memory

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Even in the absence of stress, proper maternal care during the postnatal period promotes healthy brain development, and has been associated with enhanced synaptic development in the hippocampus and improved learning and memory (Liu, Dorio, Day, Francis, & Meaney, 2000). Conversely, poor maternal care permanently increases anxiety-like behaviors and decreases memory function in adolescent and adult male offspring (Toki et al., 2007). Tactile stimulation associated with grooming behavior is thought to be mediating the beneficial effects of grooming on development, as it is associated with increased release of serotonin and growth hormone (Meaney et al., 1989). Supporting evidence for this comes from studies in which maternal care behavior is mimicked by stroking pups separated from their mothers with a moist brush. This tactile stimulation is known to prevent some but not all adverse effects of maternal separation (Levy et al., 2003). Levy and colleagues report that completely maternally deprived pups receiving “licking-like” behavior during the postnatal period were unimpaired in spatial learning but still showed problems in social learning, such as the acquisition of food preference (Levy et al., 2003). There are of course several issues with extending results from studies of rats to humans. However, these results suggest that even in situations where human neonates are stressed, some of the effects might be able to be reversed through high-quality interventions. In sum, evidence from research of stress effects during the perinatal period points to a period of vulnerability for suffering long-term effects of early stress; however, a majority of the early stress induced damage may be reversible via proper social care.

Exposure in Childhood and Adolescence Children and adolescents may become victims of traumatic experiences such as childhood maltreatment (e.g., physical and sexual abuse, neglect) or war (Bremner et al., 2005; De Bellis & Keshavan, 2003). These early adverse experiences have been associated with increased incidence of depression, anxiety disorders such as (PTSD) and cognitive deficits later in life (Brewin, 2001). PTSD in particular is considered a debilitating clinical condition, which develops in some victims of severe and/ or chronic trauma. Only a subset of individuals experiencing trauma develop PTSD; however, the incidence among child victims of trauma is particularly high, and young age at the time of trauma has been considered a risk factor for developing PTSD (Brewin, 2001). It is important to point out that the type of stress that causes PTSD is generally severe and often chronic in nature, and is therefore the most likely to have an 294

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impact on development. Not much research has been conducted on the consequences of acute and mild stress in children and adolescents. Thus, the focus of this section will be on the outcome of severe and chronic stress experiences during later childhood and adolescents. Trauma experienced by children and adolescents may have a variety of detrimental and potentially long-lasting effects on the development of the explicit memory system. The hippocampus in particular undergoes important maturational processes, such as myelination, well into adolescence (Rakic, 1995), and in animals, elevated levels of exogenous corticoids have been found to interfere with myelination (Dunlop et al., 1997). The hippocampus also represents one of the most plastic structures in the brain, as processes such as neurogenesis continue into adulthood (Kornack & Rakic, 1999). Given the persistent plasticity of this structure, and the central role it plays in memory, the explicit memory system in the child and adolescent brain remains at risk for suffering-stress induced damages. Chronic stress, such as that resulting in PTSD, may have longterm effects on brain areas involved in memory (Bonne et al., 2001). Impairments in memory and other cognitive deficits are common symptoms of PTSD (Bremner et al., 1995). Children with PTSD have shown performance deficits on tests assessing everyday memory and show a heightened incidence of learning disorders (Moradi, Doost, Taghavi, Yule, & Dagleish, 1999). Women diagnosed with PTSD resulting from a history of childhood sexual abuse exhibit impairments in verbal declarative memory and memory for emotional words (Bremner et al., 2005; Bremner et al., 1993). These behavioral impairments among PTSD patients relative to others are associated with morphological abnormalities in the neural system underlying explicit memory function (Bremner, Bronen, Seibyl, & Southwick, 1997). For example, some researchers have found decreases in hippocampal volume in individuals diagnosed with PTSD, as suffered in adulthood (Bremner et al., 1995; Bremner et al., 1993; Gurvits et al., 1992), adolescence, and childhood (Carrion, Weems, & Reiss, 2007; Stein, Koverola, Torchia, & McCarty, 1997). However, not all findings are consistent with the above. Some researchers have found a decrease in hippocampal volume following exposure to stress (Carrion et al., 2007); others have found a volume increase in this structure in children with PTSD (Tupler & DeBellis, 2006). These inconsistencies may be related to different processes such as synaptic pruning and neuronal growth that may be impacted by stress (see Compas et al. this issue). In addition, given that timing of stress exposure is a critical factor in determining the effects of stress earlier in development, it is possible that small differences in the age of the children in these studies may be reflected in contrasting findings. Stress Effects on the Brain System Underlying Explicit Memory

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Carrion and colleagues found a decrease in volume of the right hippocampus of children with PTSD resulting from chronic stress. This decrease in size was positively correlated with the severity of the trauma (Carrion et al., 2007). Smaller volumes of prefrontal cortex and the right temporal lobes have also been found in children and adolescents with PTSD (De Bellis et al., 2002). Interestingly, the authors reported that males seemed to be particularly vulnerable for developing this effect. More recent studies with children and adolescents with PTSD indicate that these volume changes can be measured relatively soon after the stressful experience (12 to 18 months) and may be a direct and longlasting response to chronic stress (Tupler & DeBellis, 2006). As a final note, there has been some debate about the causal order of the associations between stress and hippocampal volume. On the one hand, given that the animal literature indicates atrophic changes in pyramidal cells and their dendrites, as well as an interference with myelination, the decreased brain volume may be a direct result of chronic exposure to elevated levels of glucocorticoids. On the other, however, smaller hippocampal volume may not necessarily be a result of stress, but instead be an innate risk factor for a hyperresponsiveness to stress and the development of clinical disorders (Gilbertson et al., 2002). Recent evidence from a study on human children and adolescents with a diagnosis of PTSD suggests that reductions in hippocampal volume are at least in part a consequence rather than a risk factor in the etiology of PTSD (Carrion et al., 2007), providing at least some support for the former rather than latter causal interpretation.

Gender Differences Clinical research indicates that women may be more susceptible to suffer serious and long-term psychopathological consequences following stress compared to men (Holbrook, Hoyt, Stein, & Sieber, 2002). Girls have a higher incidence of PTSD symptomatology following trauma exposure, and more women than men exhibit a lifetime prevalence of this disorder. In general, being female is considered a risk factor for developing PTSD (Brewin, 2001). Several sex-related differences may be relevant to understanding the effects of stress on memory. First, stress-induced changes in the brain may be sexually dimorphic (De Bellis & Keshavan, 2003), a pattern also reported for stress-induced effects/impairments in memory. Second, gender plays a role in explicit memory functioning (Cahill & van Steegeren, 2003) and influences the morphology of the neural substrate underlying explicit memory (Caviness, Kennedy Jr., Richelme, Rademacher, & Filipek, 1996). For example, in studies investigating gender differences 296

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in a number of implicit and explicit memory tests, women and girls often outperform men on a test assessing episodic memory and verbal recall (Boman, 2004), whereas men generally perform better on tasks of spatial memory (Postma, Jager, Kessels, Koppeschaar, & van Honk, 2004). However, it is not clear whether these differences reflect differences in memory ability per se or are side effects of differences in verbal and spatial abilities between genders (Silverman & Eals, 1992). More recent studies however, have found that performance differences between men and women decrease or disappear during the menstrual phase of the menstrual cycle when circulating estrogen levels are low (Postma, Winkel, Tuiten, & van Honk, 1999). Numerous studies in rats have found gender-dependent effects of stress on the stress response system and on memory (Setiawan et al., 2007; Weinstock et al., 1992). Weinstock et al. (1992) found that prenatal stress selectively altered HPA axis functioning in the female but not the male rat. Moreover, the timing of exposure to stress may further interact with gender to affect specific behavioral outcomes (Mueller & Bale, 2007). In rats, prenatal stress during early gestation has been associated with enhanced long-term recall in males and females, but enhanced short-term memory only in females. In partial contrast, early gestational stress impaired the short-term memory performance of adult males on a spatial memory task, but enhanced the short-term memory performance of females. Interestingly, long-term recall in both genders was enhanced with respect to controls (Mueller & Bale, 2007). Shors and colleagues found that acute stress caused by intermittent tail shocks improved learning and hippocampal spine density in adult male rats, but had the opposite effect in females (Shors, Chua, & Falduto, 2001). Galea and colleagues (1997), in contrast, found that prolonged restraint stress on the hippocampal morphology of adult rats affected males and females differently. Male rats showed a decrease in dendritic length whereas females demonstrated a decrease in dendritic branching. Sex steroids may be involved in mediating some of these effects. Areas such as the hippocampus and the amygdala contain high numbers of estrogen receptors, but also include testosterone receptors (Pfaff, 1968). Both estrogen and testosterone have been found to affect explicit memory (Janowsky, Chavez, & Orwoll, 2000). Estrogen has been associated with both morphological and functional changes related to the explicit memory system. In female rats, dendritic spine density of pyramidal neurons in hippocampal area CA1 is dependent on circulating levels of estrogen, with levels of spine density decreasing during estrous, when levels of estrogen are low (Gould, Woolley, Frankfurt, & McEwen, 1990; Warren, Humphreys, Juraska, & Greenough, 1995). This Stress Effects on the Brain System Underlying Explicit Memory

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hormone-dependent synaptic plasticity may underlie heightened levels of LTP and the performance improvement on memory tests during proestrous, when circulating levels of estrogen are highest (Warren et al., 1995). Estrogen may exert a negative effect on spatial memory (Postma et al., 1999; Silverman & Eals, 1992). Silverman and Eals (1992) found that rising gonadal hormone levels in prepubertal children increase performance differences between boys and girls on spatial memory tasks, with boys’ performance becoming increasingly better than that of girls. In rats, Potsma and colleagues (1999) found that levels of estrogen, but not testosterone, modulated spatial memory performance. Interestingly, prolonged stress is known to reduce levels of circulating estrogen in females, and this in turn may have an indirect effect on hippocampal morphology (Galea et al., 1997). Sex hormone-related effects on memory have also been observed in human adults. Levels of endogenous sex steroids decrease with age, especially in postmenopausal women (Janowsky et al., 2000). Administration of estrogen to postmenopausal women has been associated with enhancement in verbal memory and a decreased risk for developing Alzheimer’s disease (Kampen & Sherwin, 1994). In elderly men, testosterone helps lessen the normal decline in working memory, which depends on prefrontal structures (Janowsky et al., 2000). For the purposes of the current volume, it is particularly interesting that gender differences in memory performance are particularly pronounced when the event to be remembered is of an emotional nature. Cahill and colleagues have found that women, but not men, show enhanced memory for emotional over neutral pictures, and credit women’s superior performance on emotional events to the influence of emotional arousal (Cahill et al., 2001; Cahill & van Steegeren, 2003). The amygdala may play a central role in mediating this effect of arousal on memory. As mentioned above, activity in the amygdala, in particular the BLA, increases in response to emotional arousal and this activity is involved in modulating memory consolidation (Duvarci & Pare, 2007). Effects of emotional events on amygdala activation in seem to be lateralized differently in men and in women (McGaugh, Cahill, & Roozendaal, 1996). In women, emotional arousal from looking at a negatively valenced video clip is associated with enhanced activity in the left amygdala and better memory for peripheral details of the clip. The opposite effect is observed in men, where the emotional video elicits greater activity in the right hemisphere and better memory for the central aspects of the video. These results suggest that in adults, gender may play an important role in how individuals are affected by stress, mediated by hormonal effects on the amygdala and the HPA axis. We turn next to how these

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gender effects might lead to developmental differences between genders in the effects of prenatal and postnatal stress on memory.

Gender-Dependent Effects on Development There is some evidence that gonadal steroids may be involved in early organization of the brain (Williams, Barnett, & Meck, 1990). In rats, for example, receptors for gonadal steroids are present in limbic regions during the perinatal period. Males also experience a surge in testosterone early in life (Williams et al., 1990). Exposure to gonadal hormones early in life seems to influence later memory performance in adult life (Williams et al., 1990). However, of relevance to the present volume is whether gender interacts with stress during development to affect later outcomes, including mnemonic outcomes. Evidence from both human and animal studies suggests that gender does influence the consequences of early stress. In rodents, prenatal stress leads to permanent changes in HPA axis functioning in adult females but not males (Weinstock et al., 1992). Adult females subjected to prenatal stress exhibit elevated basal levels of GCs, a decreased number of GC binding sites in the hippocampus and a slowed return to baseline levels of circulating GCs following a stressful event (Weinstock et al., 1992). Thus, the HPA axis in females may be more likely to suffer long-lasting effects of prenatal stress, causing a heightened physiological response to stressors encountered later in life. Morphological changes resulting from prenatal stress also demonstrate sexual dimorphism. Prenatal stress reduces the number of hippocampal granule cells that play a role in working memory (Jeltsch, Bertrand, Lazarus, & Cassel, 2001) in female but not in male rats (Schmitz et al., 2002). In adult female guinea pigs, prenatal exposure to synthetic GCs is associated with postnatal abnormalities in hippocampal synaptic plasticity and elevations in MR- and GR-proteins, patterns that have not been found in males (Setiawan et al., 2007). However, it is not so simple to say that females are generally more susceptible to the effects of stress than are males. Which effects are sex-dependent and what underlying mechanisms mediate these gender-related outcomes is just beginning to be understood, and findings remain inconsistent. For example, in some behavioral studies, prenatally stressed males perform more poorly compared to prenatally stressed females. Male, but not female, juvenile rats exposed to prenatal stress show a heightened startle response and poorer learning capacity compared to nonstressed controls (Nishio, Kasuga, Ushijama, & Harada, 2001).

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This suggests that gender may interact with other factors, such as timing of stress, in determining the effects on the organism. Indeed, Mueller and Bale (2007) recently found a sexual dichotomy in the effect of prenatal stress on memory functioning. Whereas in males, prenatal stress during early gestation leads to impaired short-term memory, females show improved learning, with these differences possibly being due to gender differences in the timing of neural development. Of note, gender differences in physiological and behavioral responses to prenatal stress appear to last, in some cases, into adulthood (O’Connor et al., 2002; Weinstock et al., 1992). O’Connor and colleagues (2002) found that behavioral and emotional problems in four-year-old children prenatally exposed to stress differed between boys and girls. In boys, prenatal stress was associated with heightened levels of hyperactivity and attentional deficits, whereas both boys and girls showed higher levels of total emotional and behavioral problems. In summary, several studies indeed indicate that the effects of early stress exposure may well vary between males and females. Whether sex differences in stress effects extend to memory, however, is not yet clear given the paucity of studies focused specifically on this topic. Clearly further research in this vein is needed.

Conclusion Exposure to stress and glucocorticoids can have long-lasting structural and functional effects on the brain system that is involved in memory, and these effects are only beginning to be understood. Certainly considerable advances in knowledge concerning effects of stress on some aspects of memory have been made, however, numerous questions remain. For instance, the effects of stress on areas outside of the hippocampus in the memory system are not clear, and little is known about developmental aspects of molecular events involved in memory. Another question concerns precisely how cellular mechanisms of memory develop, and how stress affects those mechanisms. Finally, questions remain concerning the extent to which males’ and females’ biological reactions to stress differ, and how these differences affect brain functioning and memory initially and across development. We reviewed several studies of the effects of stress on synaptic plasticity, cell function, and behavior both before and after birth. Many of the findings from these studies are necessarily from animal models, and one must exercise caution in generalizing from these animal models to humans. The greatest challenge in relating these findings to humans is that there are critical developmental differences, in particular in the 300

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timeline of maturational events between humans and the other mammalian species on which much of the research has been conducted. Nonetheless, there are also substantial parallels (Dobbing & Smart, 1974), and results of such studies do provide insight into possible mechanisms by which stress affects the brain and memory in humans. The timing of exposure to stressors is likely an important factor determining outcomes. Because many of the important functions of the explicit memory system develop around the time of birth (e.g., many aspects of hippocampal function) the perinatal period may represent a risk period for adverse stress effects. In addition, the perinatal period is when the brain likely has the most capacity for plasticity. Plasticity could be a disadvantage, in that the system may be more vulnerable to external influences, but also a protective factor, facilitating development, especially, for example, if stress exposure is followed by intense maternal attention. We close with a final question concerning whether and how stress affects individual memories versus the development of the long-term memory system. The severity and duration of stressors are probably important for the effects of stress on the developing brain system involved in memory, just as severity and duration are important for individual memory formation, storage, and retrieval. The interplay between the developing HPA axis and structures involved in memory functioning is complex. Several other chapters in this volume (see Alexander & O’Hara; Greenhoot Johnson, Legerski, & McCloskey; Wallin, Quas, & Yim; Wiik & Gunnar) review, in detail, how chronic and acute stress affects memory processes generally, biological stress responses, and discrete memory for specific events. The current chapter adds to the knowledge provided in these other chapters to further highlight the complex number of factors, including those within the brain system, that may be affected by stress and that, once affected, may influence children’s (and possibly adults’) memory abilities.

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12 Physiological Stress Responses and Children’s Event Memory Allison R. Wallin Jodi A. Quas Ilona S. Yim

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s already described, both in the other chapters contained in this volume (e.g., Baker-Ward & Ornstein; Goodman; Peterson) and in prior reviews (e.g., Alexander, Quas, & Goodman, 2002; Fivush & Sales, 2004), scientific interest in children’s ability to recount stressful experiences has burgeoned during the past two decades. An initial wave of studies, conducted in the 1980s and early 1990s, focused on identifying whether stress helped or hindered children’s memory. Results were variable, with some findings suggesting stress enhances children’s memory (e.g., Goodman, Hirschman, Hepps, & Rudy, 1991), and others suggesting that stress inhibits or is unrelated to children’s memory (e.g., Bugental, Blue, Cortez, Fleck, & Rodriguez, 1992; Merritt, Ornstein, & Spicker, 1994; Vaandermaas, Hess, & Baker-Ward, 1993). A second wave of studies, conducted largely in the past 15 years, has become increasingly complex in terms of the types of to-be-remembered events examined, how stress is measured, and the assessment of individual-difference characteristics that may moderate the associations between stress and memory (e.g., Alexander et al., 2001; Burgwyn-Bailes, Baker-Ward, Gordon, & Ornstein, 2001; Peterson & Bell, 1996). Together, these studies have contributed to a much improved understanding of the conditions under which stress is likely to be related to children’s memory. However, the studies also raise important new questions about the precise nature

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of children’s stress responses and when and how these responses relate to their memory. The purpose of the present chapter is to review evidence relevant to these new questions. Our particular focus concerns the role children’s physiological stress responses play in memory, a topic often overlooked in this line of inquiry, but one that may provide critical, novel insight into the relations between stress and memory in childhood. We begin with a brief discussion of the rationale underlying the need to consider physiological stress responses when studying children’s memory for emotional, primarily stressful, experiences. We then provide an overview of existing research that has included general measures of physiological arousal (i.e., heart rate), followed by a review of the biological systems that respond to stressful events and how arousal as driven by each of these specific systems may affect children’s memory. We conclude with a discussion of the need to consider developmental factors concurrent with physiological stress responses when studying children’s memory for stressful events. Of importance, throughout our review, we focus primarily on the relations between acute stress and children’s memory. Chronic stress, as induced, for example, by repeated or continuous challenging life experiences (e.g., living in extreme poverty, exposure to maltreatment), can lead to profound effects on physiological systems (DeBellis, 2001; McEwen, 2004; Sapolsky, 2007; Watts-English, Fortson, Gibler, Hooper, & DeBellis, 2006), and such effects impact a broad range of socioemotional and cognitive processes, including memory functioning (Bremner, 1999; Perez & Widom, 1994). Acute stress, on the other hand, includes single, time-limited stressors that may or may not be anticipated. Exposure to these events leads to short-term physiological stress reactions, but not fundamental changes in individuals’ physiological systems’ general response proclivities. As such, acute stress may affect memory in a manner that is distinct from the effects of chronic stress (see Greenhoot, Johnson, Legerski, & McCloskey; Wiik & Gunnar, this volume, for more extensive discussions of chronic stress and children’s general memory processes). We are also primarily concerned with how physiological arousal during a to-be-remembered event that is itself stress-inducing affects children’s memory for that event. Numerous prior studies, particularly in adults, have focused on the effects of arousal on memory for general information or information unrelated to the cause of the stress (e.g., neutral word lists). Fewer studies have focused on the relations between physiological arousal and individuals’ memory for salient, personal experiences that are likely to be perceived as stressful. The relations between stress and memory vary considerably based on whether the 314

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to-be-remembered event is salient or central to the cause of the stress or unrelated and peripheral to the cause of the stress (Christianson, 1992; Quas, Goodman, Ghetti, & Redlich, 2000). Given our specific interest in children’s memory for stressful events, we mention, only when relevant, studies that have examined the effects of acute stress on individuals’ memory for information unrelated to the cause of the acute stress. Finally, given the paucity of studies that have specifically addressed the role of arousal as driven by specific physiological systems and memory in children, our chapter is not a straightforward review of a well-established body of research. Instead, our chapter discusses both research and theory that have implications for the study of physiological stress responses and memory. Our chapter is designed to provide a theoretical foundation for predictions concerning why physiological responses should relate to children’s memory, and we lay out several testable hypotheses concerning these relations. Overall, we hope that our chapter serves as a starting point for research to directly test the role that physiological stress responses play in memory across development.

Methodological Challenges in the Study of Children’s Memory for Stressful Events Despite the growing body of research investigating children’s memory for stressful events, findings remain mixed as to whether stress helps or hurts children’s memory. Several methodological differences across studies, however, may have contributed to the variable fi ndings. Differences most relevant to the present chapter include the type of to-be-remembered event studied and the manner in which stress was assessed. First, the to-be-remembered event has varied considerably across studies, leading to differences in a range of factors that may influence children’s subsequent memory. For instance, to-be-remembered events have varied in the level of distress associated with the event, the event’s controllability, the duration of the event, and the event’s complexity. Some studies, for example, have examined children’s memory for naturally occurring, highly distressing experiences to which the children were exposed regardless of the research itself (e.g., injuries, medical procedures) (Goodman, Quas, Batterman-Faunce, Riddlesberger, & Kuhn, 1997; Merritt et al., 1994; Peterson, 1996). Although investigating children’s memory for such events provides unique insight into how high levels of distress relate to memory, it is difficult to generalize across studies because the events themselves vary. Also, the time frames associated with the measurement of stress (e.g., an inoculation versus an Physiological Stress Responses and Children’s Event Memory

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entire dental check-up) and how stress is measured (e.g., observation, post-hoc parental report) vary. Finally, the events surrounding the stressors (e.g., parent behavior) are difficult to control and can affect children’s reactions and memory (e.g., Edelstein et al., 2004; Goodman, Quas, Batterman-Faunce, Riddlesberger, & Kuhn, 1994). Other researchers have investigated children’s memory for mildly stressful, controlled laboratory events (Bugental et al. 1992; Quas & Lench, 2007). This paradigm is similar to that employed in studies of adults’ memory of emotional information, in which memory is tested for emotionally evocative pictures or videos to which the adults were previously exposed (e.g., Canli, Zhao, Brewer, Gabrieli, & Cahill, 2000; Christianson & Loftus, 1987; Kern, Libkuman, Otani, & Holmes, 2005). The experimental control available with laboratory events is a clear, obvious advantage over naturally occurring stressors, although the level of arousal induced in laboratory studies is typically much lower. In fact, researchers have rarely adequately investigated whether the laboratorybased to-be-remembered events consistently and reliably induce stress responses in children. Insofar as clear insight into the relations between stress and memory is to be gleaned, the advantages of both types of research paradigms must be integrated: To-be-remembered events must be salient, personally significant, and reliably induce arousal in children, but at the same time be under experimental control so that clear inferences about the effects of stress on memory can be drawn. Second, researchers have relied on a variety of methods to assess children’s distress during a to-be-remembered event. The most common method has been to obtain ratings from an observer or a parent. For instance, in investigations of children’s reactions to and memory for medical procedures, research assistants or medical staff rated children’s distress during the events (e.g., Goodman et al., 1997). In a few investigations, parents have been asked to retrospectively report how distressed their child was during a prior accident or medical procedure (e.g., Peterson, Pardy, Tizzard-Drover, & Warren, 2005; Quas et al., 1999). Yet, children may mask their true feelings (Cole, 1986; Davis, 1995; Katz, Kellerman, & Siegel 1980), researchers or parents may interpret children’s behavior incorrectly, parents may not accurately remember their child’s reactions, and parents’ own responses to the stressor may influence their perception of the child’s stress reaction. To gain more direct insight into children’s distress, some researchers have asked children to rate their emotional reactions to particular events (e.g., Chen, Zeltzer, Craske, & Katz, 2000; Merritt et al., 1994). However, children’s responses may also be limited in the extent to which they reflect children’s true experiences, for instance, if children are unwilling to report their true feelings. Alternatively, children, especially those who are 316

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young, may not understand the questions. As an example, Chen and colleagues (2000) excluded 15 of 55 children (all between the ages of four and seven years) from a study of children’s memory for lumbar punctures because the children did not appear to understand the selfreport distress questions. Thus, even self-report measures have some limitations. Not surprisingly, given the above challenges across the different types of stress measures, the different indices are often uncorrelated statistically (Merritt et al., 1994; Walco, Conte, Labay, Engle, & Zeltzer, 2005). For instance, Merritt and colleagues (1994) found that parents’ and medical technicians’ reports of children’s distress during an invasive medical procedure involving urethral catheterization were marginally correlated with each other, but uncorrelated with children’s own reports. Similarly, the associations between stress and memory often vary across the different measures. In Merritt and colleagues’ study, medical technicians’ ratings of children’s distress were negatively related to children’s memory for the medical procedure shortly after it occurred, but parents’ and children’s own ratings were unrelated to their memory. The lack of correlations across measures makes it difficult to discern which measure most appropriately reflects children’s experienced distress during a particular event, and difficult to interpret the meaning of differences in the associations between stress and memory across measures. To overcome some of the measurement challenges reported above, a few researchers have included assessments of children’s physiological responses. Arguably, young children cannot volitionally control their physiological arousal to the same extent that they might control overt expression or self-report of emotion. As a result, the different types of stress measures are likely tapping into different aspects of children’s experiences and perceptions of stress. There are several theoretically important reasons why physiological stress responses may have unique effects on children’s memory. And, with some naturally occurring stressors and with laboratory-induced mild stressors, it has been possible to obtain comprehensive data concerning children’s physiological stress responses as an event is unfolding. Thus, these studies have the potential to provide new insight into how children remember stressful events, insight not possible when only observers’ or children’s own reports are considered. Next, we discuss, in greater detail, results of these studies, as well as why it is imperative to investigate the specific physiological systems driving children’s responses when attempting to understand the role that stress plays in their event memory. Of critical importance, we are not claiming other aspects of children’s experiences or expressions of distress are unimportant (e.g., in relation to children’s later conversations about or perceptions of former stressful events), however, we believe that Physiological Stress Responses and Children’s Event Memory

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it is also necessary to understand how biological acute distress responses relate to children’s event memory.

Physiological Stress Responses and Memory In children, a small but growing body of research has investigated the relations between physiological arousal and memory. A somewhat larger number of studies has investigated similar relations in adults. Across both populations, the most common measure of arousal has been heart rate, a peripheral measure of autonomic nervous system activity that can be easily and reliably collected via noninvasive means. Among memory studies that have included heart rate measures, findings in adults are fairly consistent: Increases in heart rate (e.g., while watching an emotionally evocative video) are generally associated with enhanced memory, both for emotionally arousing and nonarousing information (Christianson & Nilsson, 1984; Cohen & Waters, 1985; Lang, Newhagen, & Reeves, 1996; Vrana, Cuthbert, & Lang, 1989; but see Christianson, 1984). For instance, Buchanan and colleagues (2006) had adults listen to a series of words. Some words were taboo or mildly threatening words that elicited increases in autonomic arousal. The taboo words were better remembered than the less-emotional words. Moreover, among the taboo words, greater heart rate acceleration predicted better memory. A similar association between heart rate increases and improved memory was reported by Nielson, Yee, and Erickson (2005) who exposed adults to a list of common words followed by either a neutral or emotional video. Not only was heart rate higher among individuals who watched the emotional video, but memory for the word list was better. In developmental studies, results are much less consistent. A few studies have reported negative relations between heart rate and children’s memory (e.g., Bugental et al., 1992; Stein & Boyce, 1995). Bugental and colleagues (1992), for example, had five- to 10-year-olds watch a video during which their heart rate was monitored. In the video, a child protagonist visited the doctor and displayed either negative or neutral expressions. Children’s memory for the video was tested shortly afterward. Among the youngest children, greater heart rate during the video in which the protagonist displayed negative emotions was associated with poorer memory. No significant associations were observed between young children’s heart rate and memory for the video in which the protagonist displayed neutral expressions or among older children’s heart rate and memory regardless of the emotional displays in the video. Other studies, however, have reported different patterns of results: Chen and colleagues 318

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(2000) found that, with age controlled, children’s heart rate during lumbar punctures (relative to a baseline period) was unrelated to their memory for the procedure a week later. Quas and Lench (2007) found that increased heart rate while watching a fear-eliciting video was associated with fewer errors in five- and six-year-olds’ memory for the video two weeks later. Several reasons for the inconsistent results are possible. First, heart rate changes can be caused by a variety of internal and external factors unrelated to the induction of stress. For instance, heart rate rapidly increases in response to minimal physical activity, including changes in body posture or deep breathing (e.g., Faes, De Neeling, Kingman, TenVoorde, & Karemaker, 1995; Gellman et al., 1990). Age and gender can also affect heart rate (Steptoe, Fieldman, Evans, & Perry, 1996). Heart rate can increase as a result of exposure to positive stimuli and be indicative of arousal or novelty (e.g., Gomez & Danuser, 2004). Thus, changes in heart rate during a particular event may have little to do with experienced distress. Also, the to-be-remembered events (e.g., medical tests) in some studies involving children generally require more physical activity than those in studies involving adults, precluding direct comparisons across age because the magnitude of heart rate change may have been affected by physical activity in addition to level of distress experienced. Second, the to-be-remembered stressors in developmental studies varied considerably: Lumbar punctures are particularly painful; the duration of the procedure varies, and children are likely to experience a strong stress response, both in anticipation of and during the actual procedure. However, watching a video of a child experiencing an inoculation may be mildly arousing to children, but there is no personal threat to the children’s well-being. In other words, although some children experience increased heart rate during such an event, this increase may not reflect personal distress. Finally, other studies utilize staged stressful events (e.g., a surprise fire alarm in a laboratory). These events are startling and unanticipated. They may elicit perceptions of personal threat, but the duration is relatively short-lived and the resolution is quick. These variations in the events’ salience, duration, and personal relevance may affect the magnitude of children’s experienced arousal during the events and the specific physiological systems driving that arousal. Specifically, several physiological systems contribute to the experience of distress or arousal, and heart rate is one index of activity of these systems. Heart rate is under the control of two key physiological systems: the sympathetic and parasympathetic branches of the autonomic nervous system, and changes in heart rate may be driven by activation of one or both of these branches. A third system, the hypothalamic Physiological Stress Responses and Children’s Event Memory

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pituitary adrenal (HPA) axis, is also activated after exposure to some types of stressors (Tsigos & Chrousos, 2002). All three systems play an important allostatic role in the body, or rather, the systems help maintain stability. However, and of importance, the systems also, via their responses, prepare the body when it becomes necessary to respond to external challenges, demands, or stressors (McEwen & Wingfield, 2003). To understand more accurately how physiological stress responses relate to children’s memory, it is imperative to directly study the systems driving children’s responses, namely the sympathetic and parasympathetic branches of the autonomic nervous system and the HPA axis. As we turn to next, insight into the stress-responsive activity of these systems may provide much-needed new knowledge concerning the mechanisms that affect children’s ability to recount stressful experiences.

Autonomic Nervous System The autonomic (or visceral) nervous system (ANS) is part of the peripheral nervous system. Although most of its activities are involuntary, some functions (e.g., breathing) are amenable to partial voluntary control. The ANS is divided into the sympathetic and parasympathetic branches. Although not absolute, the role of the sympathetic branch is to rapidly prepare the body to respond to stress, whereas the parasympathetic branch is responsible for maintenance and repair. Yet, the activity of both systems is complementary. In response to threat or challenge, one or both systems may respond to varying degrees, and these responses may lead to differential attention during and possibly memory for the threatening event. Because the two branches can operate independently, the physiological changes associated with arousal as driven by each branch, along with an explanation of how these changes may affect children’s memory, are described separately.

Sympathetic Activation Stress-induced activation of the sympathetic system is most often associated with the classic “fight-or-flight” response, first described by the American physiologist Walter Cannon (Cannon, 1929/1953; 1939). Sympathetic activation originates in the central nervous system (CNS). Signals are sent via efferent, preganglionic sympathetic fibers that originate in the spinal cord to postganglionic sympathetic fibers that directly connect to target organs (e.g., the heart). Sympathetic activation leads to an increase in the production of catecholamines, specifically norepinephrine and epinephrine, from the adrenal medulla, and norepinephrine is also released from sympathetic nerve endings (Lovallo & Thomas, 2000). Because of direct innervation between the CNS and target organs 320

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and between the adrenal medulla and sympathetic fibers, catecholomine release occurs virtually instantaneously, and signals travel rapidly, resulting in physiological changes that can be observed almost immediately (Cannon, 1939; Goldstein, 2001; Tsigos & Chrousos, 2002). In general, sympathetic activation serves the critical function of preparing an individual for action that might be necessary as a result of sudden exposure to threat. That is, increased heart rate and contractility of atria and ventricles, vasoconstriction of arteries and veins, dilating of the pupils and protrusion of the eyes, activation of the sweat glands, release of epinephrine, among others, all mobilize resources that enable an individual to appropriately respond to the threat (to “fight or flight”), thereby enhancing likelihood of survival. Given this function of sympathetic activation, it makes intuitive sense that such activation, which results from exposure to stress, would enhance attention and hence memory. Specifically, it is advantageous for survival to attend to a threat, determine the cause of the threat, assess the immediacy and severity of the threat, and identify methods of escaping or reducing the threat. It is further advantageous to remember this information so that, should the threat arise again, an expedited appropriate response can be taken. This intuitive perspective is supported by physiological research: Increasing evidence, across studies including human and nonhuman animals, suggests that epinephrine selectively enhances memory for emotional and arousing information (e.g., Cahill & Alkarie, 2003; Cahill & McGaugh, 1996; Cahill, Prins, Weber, & McGaugh, 1994; Flint, Bunsey, & Riccio, 2007; Gold & van Buskirk, 1975; Introini-Collison & McGaugh, 1986; Sternberg, Martinez, Gold, & McGaugh, 1985). In adult humans, for instance, Cahill and Alkire (2003) had participants view a series of emotionally evocative images. Immediately afterwards, the researchers administered either a placebo or epinephrine to simulate sympathetic activation. Participants who received epinephrine exhibited better memory for the images one week later, suggesting that epinephrine is involved in the consolidation of emotional and arousing memory. In other studies, Cahill and colleagues examined the effects of propranolol, a beta-adrenergic receptor antagonist that inhibits sympathetic responses, on adults’ memory for emotionally evocative and neutral information (e.g., Cahill & McGaugh, 1996; Cahill, Prins, Weber, & McGaugh, 1994). Findings consistently reveal that propranolol inhibits memory specifically for emotional but not neutral information. For instance, in one study, adults viewed a brief slide show that depicted either a boy and his mother witnessing a minor accident and learning about surgery (nonarousing version) or a boy who experiences a major accident with his mother and is then rushed to a hospital for emergency surgery (arousing version) (Cahill et al., 1994). Immediately afterward, participants were Physiological Stress Responses and Children’s Event Memory

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administered either propranolol or a placebo. A surprise memory test took place a week later. Propranolol inhibited memory for the arousing story with the effects being greater for the most arousing parts of the story. In children, neither the exogenous administration of epinephrine nor beta blockers (e.g., propranolol) is an appropriate or ethical method of assessing effects of sympathetic arousal on memory. Researchers have instead relied on noninvasive methods of assessing children’s sympathetic activation, the most common of which is pre-ejection period (PEP), or the latency between ventricular contraction and opening of the aortic valve and onset of left ventricular depolarization, as measured via ECG. PEP is believed to reflect the effects of sympathetic activity on the cardiac cycle (Sherwood, 1993; Uchino, Cacioppo, Malarkey, & Glaser, 1995). A shorter PEP signifies that cardiac output is being produced at a more rapid pace and is thus indicative of increased sympathetic activity. Differences in children’s PEP resulting from exposure to stress or challenge relative to their PEP at baseline have been examined in relation to numerous socioemotional and health outcomes (e.g., attachment security, depression, physical health symptoms) (e.g., Boyce et al., 2002; Oosterman & Schuengel, 2007; Salomon, Matthews, & Allen, 2000). To date, only two published studies, however, have examined the associations between PEP and memory in children, the results of which are only partially consistent with those reported in adults. In one study, Quas and colleagues (2004) examined four- to sixyear-olds’ sympathetic arousal throughout a series of laboratory challenges (e.g., a cognitive task, a brief social interview) that concluded with a brief fire-alarm incident. Shortly afterward, children’s memory for the alarm incident was examined. No significant associations emerged between changes in children’s PEP scores between a baseline task and the laboratory challenges and their memory for the alarm. In a second study, Quas and colleagues (2006) examined memory for a fire alarm among a larger sample of children across a wider age range (four- to eight-year olds). Consistent with the adult literature, greater sympathetic activation, quantified according to a general index (which combined children’s average PEP during the tasks with their time to recover on individual tasks and their PEP variability) was associated with enhanced memory for the alarm. In summary, existing research suggests that sympathetic arousal in response to what could be considered moderate acute stress exposure is often associated with enhanced memory. In adults and nonhuman animals, experimental manipulations that affect sympathetic activation demonstrate reliable effects on memory specifically for emotional information. In children, hints at beneficial effects of sympathetic arousal on 322

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memory have emerged. As yet, developmental studies have not focused on whether sympathetic arousal enhances children’s memory for central information directly related to the cause of the stress. However, insofar as such arousal should direct attention toward the immediate threat and the means of responding to that threat, sympathetic arousal should be most strongly associated with enhanced memory for central information directly related to the cause of the stress.

Parasympathetic Withdrawal The parasympathetic branch of the autonomic nervous system regulates internal and external demands on the body by either increasing activation (often called vagal tone) or decreasing activation (often called vagal withdrawal) (e.g., Bernsten, Cacioppo, & Quigley, 1991; Porges, 1995; Salomon et al., 2000). When no external demands (e.g., stressors) are present, vagal tone is maintained to facilitate growth, repair, and protection of the body. For example, to promote digestive processes necessary for growth and repair, the salivary and digestive glands secrete enzymes, the muscles in the digestive tract increase in motility, and the pancreas secrets insulin. When an external demand presents itself, the parasympathetic system retains control of some such internal processes, but also withdraws its regulatory influence (e.g., on the cardiac cycle and other internal organs) to divert resources required to attend to the demand. The parasympathetic system’s direct innervation of key organs enables it to respond quickly, leading to near immediate increased vigilance, heart rate, and preparedness when necessary, and quick recovery and return to baseline after the stressor has ended. This preparedness often, but not always, coincides with sympathetic activation. In other words, although the two systems’ responses are related in some contexts, this is not always the case (Bernsten, Caciocippo, & Quigley, 1991; 1993). Although the precise biological mechanisms underlying associations between parasympathetically driven arousal and memory are not well articulated, there are more general theoretical reasons why such relations should exist. These reasons stem from evidence suggesting that the parasympathetic regulation (tone) and withdrawal play a key role in emotionality and emotion regulation (see Beauchaine, 2001; Butler, Wilhelm, & Gross, 2006; Frazier, Strauss, & Steinhauer, 2004; Wilhelm & Roth, 1998). By regulating physiological signals (e.g., heart rate, perspiration) associated with negative emotional (including stressful) experiences, parasympathetic tone serves to enhance physiological recovery following distress. However, when parasympathetic tone is not restored, parasympathetic withdrawal is extended, resulting in the continued directing of cognitive and emotional resources towards the stressor. This leaves Physiological Stress Responses and Children’s Event Memory

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fewer resources available to devote to processing of external information. Insofar as information is not well-attended to or processed, memory should be inhibited. Few studies have directly examined the associations between parasympathetic withdrawal and memory, and none has examined parasympathetic responses in adults. Two exceptions, both conducted with children, include Quas and colleagues’ (2004, 2006) studies of children’s memory for a fire-alarm incident. In the studies, respiratory sinus arrhythmia (RSA), an index of parasympathetic activation of the cardiac cycle, was measured via ECG as children listened to neutral stories (included to obtain baseline physiological data), completed the challenging tasks, and experienced the fire-alarm incident. In the study that included four- to six-year-olds, greater parasympathetic withdrawal during the challenges relative to baseline was associated with poorer memory for the alarm shortly after it occurred (Quas et al., 2004). In the study that included four- to eight-year-olds, greater parasympathetic withdrawal again predicted poorer memory, although only among the older (i.e., seven- to eight-year-old) children (Quas et al., 2006). Of note, in both studies, the magnitude of children’s parasympathetic responses to the laboratory challenges was minimal, thus precluding general conclusions to be drawn regarding the effects of moderate to high levels of parasympathetically induced arousal on children’s memory. However, given the functional role that parasympathetic tone and withdrawal seem to play in emotion regulation processes, continued investigations, particularly across development, are needed to clarify how parasympathetic withdrawal in response to salient, stressful experiences relates to children’s memory.

Hypothalamic Pituitary Adrenal Axis Another stress-responsive biological system is the HPA axis. Briefly, the hypothalamus releases corticotrophin-releasing hormone (CRH), which triggers the release of adrenocorticotropic hormone (ACTH) from the pituitary, which then stimulates the release of cortisol from the adrenal cortex (e.g., Tsigos & Chrousos, 2002). Cortisol affects virtually every organ and tissue in the body, and these effects orchestrate the body’s response to stress. Cortisol exerts its effects via mineralocorticoid receptors (MR) and glucocorticoid receptors (GR). MR have a significantly higher affinity for cortisol than GR. As such, GR are only fully activated when cortisol levels are high, for example under conditions of stress (de Kloet, Oitzl, & Joels, 1999; Reul & de Kloet, 1985). There are several theoretical reasons why HPA axis activity should be related to memory. One such reason stems from the high proportion of GR located in brain structures heavily implicated in both HPA axis 324

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feedback regulation and memory processes, specifically, the amygdala and the hippocampus (Roozendaal, 2003; Jacobson & Sapolsky, 1991; Smith & Vale, 2006). Activation of the amygdala, a limbic structure that directly responds to personally salient emotional events, including those that are threatening or stressful (Herman, Ostrander, Mueller, & Figueiredo, 2005), is associated with enhanced memory for emotional information, and also with HPA axis activity. In contrast, activation of the hippocampus, another limbic structure involved in memory processes, specifically spatial and general declarative memory, is associated with inhibiting HPA axis activity (i.e., down-regulation following stressor exposure). Given the central role of emotional arousal during exposure to stress and the amygdala’s activation in response to such arousal, HPA axis activity should enhance memory specifically for the emotionally arousing information. Several studies including both humans and nonhuman animals confirm that HPA axis activity is related to enhanced memory, although the precise nature of these relations depends on (a) the emotionality or personal significance of the to-be-remembered information and (b) the timing of the stressor in relation to the to-be-remembered information. Specifically, when the to-be-remembered event is either unrelated to the stressor or occurred prior to the induction of distress, an inverse association between cortisol and memory is typically found (e.g., Lupien & McEwen, 1997; Wolf, Schommer, Hellhammer, McEwen, & Kirschbaum, 2001; see Domes, Heinrichs, Reichwald, & Hautzinger, 2002 for an exception). From a functional standpoint, when attempting to cope with increased arousal that results from stress exposure, events unrelated to the stressor are not relevant and hence need not be attended to, evaluated, or remembered. This possibility is consistent with predictions concerning the associations between sympathetic activation and memory—remembering information unrelated to the cause of the stress would not enhance survival and thus memory for this information should not be enhanced via sympathetic or HPA axis activation. In contrast to the above studies suggesting negative associations between HPA axis activation and memory, studies in which the to-beremembered information takes place concurrent with or shortly after HPA axis stimulation, or in which the to-be-remembered event is the source of the HPA axis response, have more consistently reported positive associations between HPA axis activation and memory, at least in adults. For example, increases in both exogenous and endogenous cortisol facilitate adults’ memory for emotionally arousing pictures (e.g., Buchanan & Lovallo, 2001; Cahill et al., 2003), emotional stories (e.g. Rimmele, Domes, Mathiak, & Hautzinger, 2003), and faces depicting positive and negative emotions relative to neutral faces (e.g., Putman, Physiological Stress Responses and Children’s Event Memory

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van Honk, Kessels, Mulder, & Koppescharr, 2004). Thus, as hypothesized, HPA axis activation enhanced memory for central, salient information directly related to the cause of the stress. Few studies have examined whether similar patterns are evident in children, and existing studies have relied on methods substantially different from those employed in the adult literature. For instance, Chen and colleagues. (2000) and Merritt and colleagues (1994) examined children’s memory for invasive, highly distressing medical procedures—lumbar punctures (endured by children during leukemia treatment) and voiding cystoeurthrogram fluoroscopies (a procedure involving uretheral catheterization that helps identify potential kidney problems that involves urethral catheterization), respectively. In both studies, which included fairly small samples, children’s cortisol responses after the procedures were compared to their cortisol levels at the same time on another day. No significant associations emerged between cortisol and memory when children’s memory was assessed immediately after the procedure (Merritt et al., 1994) or when their memory was assessed several weeks later (Chen, 2000; Merritt et al., 1994). Conversely, in Quas and colleagues’ (2004) study of children’s memory for the fire-alarm incident described earlier, HPA axis reactivity (defined as the difference between children’s cortisol levels at the outset of the session and after they had completed the laboratory challenges) was positively associated with children’s memory for the alarm. Given the differences in the salience of the to-be-remembered events between invasive medical procedures and a brief alarm experienced in the laboratory, it is premature to draw any definitive conclusions from these studies. However, the mild stressor examined in Quas and colleagues. (2004) seems to be more similar to the type of stressors (e.g. arousing slides) included in investigations involving adults, which may be the reason why the results are more comparable to those reported in the adult literature than those reported by Merritt and colleagues and Chen and colleagues Of note, in Quas and colleagues’ study, although some children exhibited HPA axis responses to the laboratory challenges, many children did not, thus again raising mild concerns about whether the tobe-remembered event was adequate to induce a consistent, reliable stress response, particularly as driven by the HPA axis. In order to test more directly the effects of HPA axis activation on children’s memory, procedures that are well-controlled and that reliably elicit stress responses in children need to be studied, and the content of the to-be-remembered information must be systematically varied. Such a test would reveal whether and when HPA axis activation affects children’s memory. In summary, studies involving adults suggest that elevated HPA axis responses are associated with better memory of emotional and personally 326

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significant information, particularly when the to-be-remembered information is the source of HPA axis stimulation or the information occurs concurrent with or shortly after HPA axis stimulation. One study with children has reported similar trends, but other studies have yielded different results. Controlled studies in children are a necessary next step to determine precisely how stress-induced HPA axis activation affects children’s memory for stressful, personal experiences.

Interactions among Systems For heuristic purposes, in the aforementioned sections, we treated stress responses driven by the sympathetic, parasympathetic, and HPA systems as functionally separate. However, the systems do not act independently. Stress responses as driven by one system are often dependent on those of another, and the systems are well-coordinated. For example, typically, the CNS, upon identification of a stressor, concurrently activates the sympathetic system and the HPA axis, while withdrawing parasympathetic activation. At this initial stage, hormones are released from both the sympathetic system (i.e., catecholamines) and the HPA axis (i.e., CRH and ACTH). After initial activation, the systems continue to operate in a coordinated manner, such that activation in one system can activate or inhibit another system. The withdrawal of the vagal brake, for instance, permits increased cardiac activity, and the subsequent secretion of cortisol allows for continued and enhanced cardiac activity. Also, norepinephrine enhances the secretion of CRH, leading to activation of the HPA axis. Coordinated stress responses across systems are clearly advantageous in that they support efforts to effectively cope with threat and stress. Yet, it is sometimes the case that the systems are not coordinated in a simple, characteristic pattern. As an example, the sympathetic and parasympathetic systems may be concurrently activated, concurrently inhibited, or the systems may be uncoupled (Alkon et al., 2003; Bernsten, Cacioppio, & Quigley, 1991; Salomon et al., 2000). Unfortunately, the conditions under which these different patterns of responses occur (coactivation versus coinhibition versus uncoupling) are not yet well understood. However, the potential for these patterns highlights the importance of measuring multiple systems simultaneously to determine how each relates, independently and jointly, children’s memory for stressful, personal experiences.

Developmental Considerations In the aforementioned section, we reviewed theory and research relevant to how stress responses—as driven by the sympathetic, parasympathetic, Physiological Stress Responses and Children’s Event Memory

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and HPA systems—may affect children’s memory. We did not discuss the underlying reasons for the particular systems’ responses; nor did we outline what might cause individual children’s physiological systems to respond in distinct or specific ways. Knowledge concerning sources of variability in children’s physiological responses will provide additional, valuable insight into how stress affects children’s memory. Numerous factors, both within children and in their social environment, may affect their interpretations and coping with threatening events and hence their subsequent physiological and behavioral responses to those events. These factors may also affect children’s memory. Some of the more well-studied factors include children’s temperament (Buss & Kiel, 2004; Fox, Henderson Marshall, Nichols, & Ghera, 2005; Kagan & Baird, 2004), genetics (Healy, 1992; Lupien, Ouellet-Mourin et al., 2006; Propper & Moore, 2006), attachment relationships (Gunnar, Broedersen, Krueger, & Rigatuso, 1996; Spangler & Grossman, 1993), family stress (e.g., Boyce & Ellis, 2005), and perceived social support (Gerin, Milner, Chawla, & Pickering, 1995). Space precludes an extended discussion of how each of these factors may affect children’s stress responses, and the implications of these effects for children’s memory. However, we will discuss one critical individual-difference factor, namely development, because of the broad nature of its influence and its centrality to understanding specifically how children remember stressful events. With age, children’s expressions of distress and strategies employed to cope with stressors change, as do the magnitude and duration of their stress responses and their ability to provide coherent and detailed narratives. Each of these changes has implications for how children remember (and recount) prior stressful experiences. As such, it is not possible to interpret children’s stress responses, memory performance, or the links between them without taking into account developmental considerations. First, with age, children rely more on active coping strategies rather than on others to help regulate emotional responses to potential stressors (e.g. Compas & Boyer, 2001; Compas et al., 2001). In fact, the ability to cope effectively with stress continues to develop through adolescence and early adulthood (Blanchard-Fields & Irion, 1988; Compas, Malcarne, & Fondacaro, 1988). For instance, with age, children use a greater range of coping strategies (e.g., resignation, distraction, cognitive restructuring, withdrawal, positive self-talk) when faced with environmental challenges commonly experienced in their lives, such as in relationships with parents, at school or in other potentially threatening situations (e.g., a visit to the dentist) (e.g., Brown, O’Keeffe, Sanders, & Baker, 1986; Donaldson, Prinstein, Danovsky, & Spirito, 2000). In particular, older children report using more than one strategy concurrently and relying more on cognitive strategies, especially in controllable situations, 328

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than do younger children (Brown et al., 1986). Age differences in how children cope with challenge may affect the intensity of children’s stress responses as well as the amount of time required to recover following these responses. Further, even when younger and older children are comparably distressed, given older children’s greater range of coping capabilities, they may attend to different features of an event relative to younger children. For instance, older children may focus on the consequences of an event in an effort to find meaning in the event or to identify potential topics of positive self-talk about the event. In contrast, younger children may focus on the location and availability of a caregiver to assist in coping. Such age-related differential attention would affect what is considered “central,” or most important, and possibly subsequent memory (Quas et al., 2000). Finally, given young children’s more limited repertoire of coping strategies and cognitive resources (Case, 1991), young children may need to direct their efforts toward self-regulation, leading to fewer resources to attend to an ongoing event. Second, children’s physiological stress responses also undergo developmental change. In fact, children’s general predisposition to respond physiologically to stress (e.g., via parasympathetic withdrawal) may not be stable and hence consistently predictive of behavior and emotion regulation until mid to late preschool years (e.g., Porges, DoussardRoosevelt, Portales, & Suess, 1994). Thus, with young children, physiological responses may vary for developmental reasons rather than stress exposure per se. Also, the same events also do not necessarily trigger similar physiological reactions across age. For example, Alkon and colleagues (2003) examined age-related changes in three- to eight-year-olds’ parasympathetic and sympathetic responses during a baseline activity and in response to a series of laboratory challenges (see also Boyce et al., 2001). With age, children exhibited greater overall parasympathetic tone and lower overall sympathetic withdrawal, across both the baseline and laboratory tasks. No age differences emerged in children’s difference scores (task mean minus baseline) within each system separately, although when coordination across systems was examined, the proportion of children who exhibited high levels of arousal across systems (i.e., children who responded to the tasks with high sympathetic activation and high parasympathetic withdrawal) decreased with age. The proportion of children who exhibited low responses across system (i.e., children who exhibited low sympathetic activation and concurrently high parasympathetic tone) and the proportion of children whose responses appeared well-coordinated (i.e., children who exhibited low sympathetic activation and high parasympathetic withdrawal) increased with age. As another example, the Trier Social Stress Test (TSST; Kirschbaum, Pirke, & Hellhammer, 1993) is a laboratory procedure that involves individuals Physiological Stress Responses and Children’s Event Memory

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giving a brief speech and completing a math task while being observed. The TSST reliably induces HPA axis responses in children ages nine years through adults (Kirschbaum et al., 1993; Buske-Kirschbaum et al., 1997; Kudielka, Buske-Kirschbaum, Hellhammer, & Kirschbaum, 2004). As yet, however, studies have not consistently demonstrated that similar HPA responses are evident in younger children (Wewerka, Frenn, & Gunnar, 2007). Third, a few studies have directly examined whether age interacts with children’s physiological stress responses to affect their memory. Bugental and colleagues (1992), for example, monitored five- to 10-yearolds’ heart rate while they observed a video of a child visiting a doctor. The youngest (five- and six-year-olds) but not older children evidenced an increase in heart rate when the child in the video displayed negative affect. Also among only the youngest children, increased heart rate was related to increased memory errors. In the study of four- to eight-yearolds’ memory for a fire-alarm incident shortly after it occurred (Quas et al., 2006), as mentioned, parasympathetic withdrawal during the laboratory challenges predicted poorer memory for the alarm among older children, but not among younger children. Given the different events (witnessed video versus personal experience) and age ranges included (five to 10 versus four to eight) across the two studies, it is not possible to determine why the results appeared to vary. However, the findings point to the potential importance of ensuring that developmental changes in initial responses, coping, recovery, and memory are central to any investigation of the relations between physiological arousal and memory in childhood. Together, studies suggest that the effects of arousal on memory may vary with age because of age-related changes in the use and effectiveness of coping strategies, in the magnitude or duration of children’s physiological stress responses, or in children’s ability to attend to emotionally evocative information. Overall, children’s coping, physiological stress responses, and memory are not static across development. It is imperative, in future studies, that children across a wide age range be included to determine how development moderates the associations between physiological stress responses and memory in childhood.

Conclusions In the present chapter, we reviewed existing theory and research concerning physiological stress responses in childhood, and the implications of such responses for children’s attention during, and later memory for, salient personal experiences. Admittedly, the hypotheses we laid out in 330

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the chapter are largely speculative, not because of a lack of theoretical basis or supporting extant research in adults, but because the hypotheses have yet to be systematically investigated using rigorous, experimental procedures designed specifically for use with children. Thus, we conclude with a few brief recommendations for key features that future investigations must include to begin to address fundamentally important questions about when and how physiological stress responses—as driven by multiple and potentially interacting systems—affect children’s memory. First, investigations concerning the relations between physiological arousal and memory must obtain multiple measures of distress as a to-be-remembered event is unfolding. It is not adequate to only monitor children’s behavior, ask them about their experiences, or assess their heart rate. Measures of children’s sympathetic, parasympathetic, and HPA axis responses must be collected, ideally in addition to rather than instead of other indices. These measures should be obtained before, during, and after the event so that clearer assessments of how children respond initially and how they regulate their responses over time can be gained. The inclusion of multiple, concurrent measures will also be critical in pursuing broader, more complex questions concerning how interactions among and coordinated responses between physiological systems relate to memory. Second and related, the to-be-remembered event must be salient and reliably induce stress responses, in at least one physiological system but ideally across multiple systems. At the same time, it must be sufficiently controllable (or at least observable) so that the accuracy of children’s later memory can be assessed. The to-be-remembered event must be directly related to the cause of the stress to test the specific predictions we put forth (see Christianson, 1992; Quas et al., 2000; Wolf, 2003). Fortunately, researchers are testing new laboratory procedures that are effective at inducing physiological responses across relatively wide age ranges. As mentioned, Kudielka and colleagues. (2004a, b) assessed nineto 76-year-olds’ HPA axis responses to the TSST and found no significant differences in the magnitude of cortisol or heart rate responses between children and young adults during the TSST. In younger children, results have been variable, although adaptations to the TSST are continually being tested to identify procedures that similarly induce HPA axis responses in younger and older children, as well as adults. Third, in any investigation, children across a wide age range must be included to determine whether age directly or indirectly affects the relations between stress and memory, and if so, why. For instance, it may be that age affects children’s stress responses. Alternatively, age may affect how children regulate responses that do occur. Given the many developmental changes that occur in children’s coping, attention, self-regulation, Physiological Stress Responses and Children’s Event Memory

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and cognitive and memory capabilities generally, age must play a central role in future studies. In closing, as the chapters in this volume attest, much insight has been gleaned during the past few decades concerning the relations between stress and memory in children. At the same time, many new questions have arisen, questions whose answers are needed to continue to advance this important domain of inquiry. In this chapter, we reviewed literature relevant to physiological stress responses and memory, and we outlined testable hypotheses concerning their relations. As empirical studies move toward testing these hypotheses, answers to questions about the effects of physiological stress responses on children’s memory can be obtained, thus further contributing to our knowledge of when and how children remember salient, personally significant experiences.

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Integration and New Directions

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13 Co-constructing Memories and Meaning over Time Robyn Fivush

I

n this volume, researchers have struggled to understand how children make sense of highly emotional and traumatic events. In examining the processes underlying brain development, hormonal development, physiological regulation, cognitive development and socioemotional relationships that influence remembering, all the contributors share a focus on how memories are shaped at multiple levels. Whether considering the developing individual or the developing memory of a specific event, the contributors to this volume highlight that remembering is a biological, cognitive, and social process that occurs over time. Here, I consider how time is conceptualized as a developmental process that occurs both within individuals and within socioemotional contexts that both shape and are shaped by what we remember. I first discuss aspects of individual development, focusing on the tension between change and continuity, and how developmental level and individual differences are complexly intertwined across time. I then turn to how individual development is modulated within socioemotional contexts that provide the framework for the development and expression of memory and emotion. Stemming from Vygotsky’s (1978) sociocultural theory of development, I argue that the concept of “scaffolding,” how adults guide and structure social interaction, helps to integrate the ways in which attachment and reminiscing interact with individual development in shaping memories of emotional events. Finally, I return to the question of meaning-making. In the end, what may matter the most about our memories of highly emotional and stressful events is how we are able to create meaning in such a way that our memories do not

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overwhelm us, and this is a process that may only be possible within a social context in which meaning is co-constructed.

Individual Change and Continuity Obviously, memory changes with development. Chapters in this volume explicate changes in the brain structures underlying memory, in the physiological and hormonal regulatory systems, and in cognitive skills, language skills, and emotional regulatory skills. Some of these changes occur early in development and reach adult-like levels by the end of infancy, whereas others continue to develop throughout childhood and even into adulthood. Basic developmental changes underlie changes in the ability to attend to and encode specific kinds and amount of information, to consolidate and store information, and to retrieve information and express it in action and language (see Bauer, 1996, for an overview). Critically, however, development does not always involve change; there is also consistency across development. Individual differences apparent in infancy may still be apparent in later childhood and adulthood. There are often consistencies across development in temperament, becoming individual differences in personality variables with growth (Rothbart & Bates, 2006), that may include consistent differences in physiological reactivity and negativity that will certainly play a role in how a given individual experiences and recalls a stressful event, as discussed in the chapters by Wiik and Gunnar (Chapter 10) and by Wallin, Quas, and Yim (Chapter 12). The role of temperament more generally in memory seems more tenuous, with some research finding effects of temperament on memory and some not, as discussed in the chapters by Baker-Ward, Ornstein, and Starnes (Chapter 2) and by Peterson and Warren (Chapter 3). The important point is that how any given individual experiences and remembers stress will be a function of both developmental level and individual differences (as expressed and maintained within social contexts as discussed below), and a more nuanced understanding of how these interact as needed. Many of the chapters in this volume provide beginning evidence of how individual differences interact with developmental change to produce different memorial effects. The chapters by Baker-Ward et al.; by Compas, Campbell, Robinson, and Rodriguex (Chapter 5); by Wiik and Gunnar, and by Wallin et al. all discuss findings where individual differences in physiological reactivity, stress reactivity, and temperament may interact and be expressed differently at different ages. Further, even when development involves change, change may not be linear. Qualitative shifts in children’s abilities to understand and 344

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remember events may occur rapidly when certain levels of cognitive and linguistic sophistication are achieved. For example, rapid changes in working memory and executive function towards the end of the preschool years may yield rapid shifts in encoding and organization, as well as the ability to regulate arousal, as discussed in the chapters by Alexander and O’Hara (Chapter 9) and by Compas et al. Moreover, it is not just the effects of development on the construction of new memories that must be considered, but also on the reconstruction of older memories. Whereas some memories may change retrospectively with the acquisition of particular developmental skills, others might not. Peterson and Warren discuss that children experiencing a stressful event before the age of two do not become able to recall this event in language even as language skills develop (see also Bauer & Wewerka, 1997; and Simcock & Hayne, 2002). Yet, once children achieve a certain level of language skill that allows them to verbally recall an event at occurrence, they actually recall more information verbally as more time passes, even though forgetting also occurs (see also van Abbama & Bauer, 2005; Fivush, Sales, Goldberg, Bahrick & Parker, 2004). This pattern suggests that memories encoded before children develop some threshold level of linguistic skill will remain difficult if not impossible to recall verbally, but once that threshold is achieved, children are able to express more information in their verbal recall as their language skills increase. One issue that findings such as these raise is whether children are actually recalling more about what they personally experienced at the time of the event, or are they incorporating information they have been told by others or learned more generally about the world. This highlights the complex relations among memory, development, and recall. All memory, of course, is reconstructed, an amalgam of information encoded at the time as well as information integrated during subsequent recalls. Baker-Ward et al. explicate the notion of “extended encoding,” where subsequent developmental and experiential events allow children to interpret events retrospectively in new ways, such that children reconstruct their memory in the context of their current knowledge of the world. This is clearly a Piagetian notion of accommodation and reconstruction in memory with development (Piaget & Inhelder, 1973), and suggests that changes in processing schemas influence how information is reconstructed at the time of retrieval. Memories reconstructed from more sophisticated cognitive understanding of the world may link events causally in new ways and/or qualitatively change children’s evaluation of what occurred (see Hudson & Fivush, 1991; and Principe, Ornstein, Baker-Ward & Gordon, 2000, for some examples of this). Importantly, the argument here is that this kind of change is truly developmental, in Co-constructing Memories and Meaning over Time

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that new cognitive skills fundamentally change the way in which previous events are understood and therefore represented. It is assumed to be a permanent change in representations, not a fluctuating change based on current conditions. Yet there is sparse research examining memory over development, tracking how and what is remembered across periods of substantial cognitive change. Moreover, in terms of the focus of this volume on memories for highly emotional events, how memories are reconstructed across development may be particularly important, as these events are highly likely to be thought about and talked about over time. Further, with highly emotional and stressful events, an additional complexity is the memory for the emotion itself over time (Fivush, Bohanek, Marin, & Sales, in press). There is a general decrease in recall of negative affect over time (Walker, Skowronski, & Thompson, 2003), but, even more so, as emotional memories are shared in reminiscing, interpretations, intensity, and even the valence of the memory can change. For example, Baker-Ward et al. present evidence that both the process of sharing memories with others and the coherence and content of the memory changes as a function of whether the very same event becomes coded as a positive versus a negative experience. Moreover, this is a process that may continue over time, well after the actual event is over and is no longer a topic of conversation. Greenhoot presents evidence that adolescents’ adaptation to their current environment colors the way they recall the emotional aspects of past abusive experiences. However, unlike developmental changes in cognitive understanding, which do seem to fundamentally change how the event is understood and therefore represented, relations between emotional understanding and memory over time are less clear. That is, is this a simple “mood and memory” effect, in which current emotional state influences access to certain memories or parts of memories at a particular point of time (Ellis & Moore, 1999), or are there actual changes in the underlying representations as a function of increasing emotional understanding and regulation skills? In other words, is this actually extended encoding over time that continues to modulate the memory representations or is it simply differential access to different memories or parts of memories at different times as a function of current state? As children develop more sophisticated emotional understanding and regulation skills, are memories retroactively reconstructed in truly developmental fashion? These questions beg for additional research. In the adult literature, the claim is made that changes in the emotional understanding of a stressful experience lead to a more coherent memory representation, which, in turn, are related to better physical and psychological health (Foa, Molnar & Cashman, 1995; Pennebaker, 1997). Are children’s changing emotional 346

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understandings of stressful events operating in similar ways, and how might this depend on developing emotional skills? Nonlinear changes in development further suggest that there may be sensitive periods, or that links between emotion and memory may be different at different developmental stages. For example, Wiik and Gunnar discuss nonlinear changes in physiological reactivity across the first year of life. And Wallin et al. and Baker-Ward et al. discuss how stress affects memory differently for younger than for older children. As discussed by Compas et al. and by Wallin et al., the way in which more cognitively controlled response systems will interact and influence more automatic systems changes with development, producing different relations between stress and memory at different ages. Thus, there may be particular points in development where qualitative shifts in memory may occur. Moreover, the developmental patterns described throughout the chapters in this volume suggest a need to be more sensitive to understanding that development occurs not only within domains but across domains, and that developments in one area, whether biological, cognitive or emotional, simultaneously affect developments in other areas, as well as the organization of the system as a whole. This idea is discussed most elegantly in Chapter 10 by Alexander and O’Hara, who describ a dynamic systems approach to stress and memory. Thus the developmental patterns emerging from the research discussed throughout this volume point to the complex interactions between multiple developing systems, yielding both developmental change and developmental consistency. Children with different physiological reactivity, different temperaments, and different developmental rates may show different developmental patterns. These may be differences in the age at which specific skills are acquired, or differences in the patterning and interactions of skills. Development is not just an increase in specific skill sets over time; development is also about how multiple skills develop in relation to each other, often leading to fundamentally new abilities (Thelen & Smith, 1997; see Nelson & Fivush, 2004, for how this argument relates to the development of autobiographical memory). And as if this were not complex enough, the individual child is obviously developing within complex social worlds as well.

The Socioemotional Context: Attachment, Reminiscing, and Scaffolding Even before birth, infants are embedded in a social world in which parental and societal goals, values, and conventions provide a structure for the understanding of people and events (Fogel, 1993; Gauvain, 2001). Co-constructing Memories and Meaning over Time

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Events are experienced and remembered within social contexts in which people interact, interpret, and evaluate their experience, and infants develop within this social world. The chapters in this book highlight at least two ways in which the socioemotional context modulates infant and child memory: the attachment relationship and reminiscing style. Here, I agree with arguments presented by Sales, and argue that both can be conceptualized as forms of maternal scaffolding, with mothers who are able to provide more sensitive, more contingent and more validating responses, in both the emotional give-and-take of daily interactions and in mother guided reminiscing, provide a sense of coherence, predictability and validation for their children, which underlies both secure attachment and coherent memory representations (see Fivush & Sales, 2005, and Meins, 1997, for related arguments). Multiple chapters in this book describe attachment theory and lay out specific predictions between the quality of the mother-child attachment bond and mother-child reminiscing. Briefly, mothers who are themselves securely attached (due in part to their own childhood experiences) are able to provide sensitive and responsive caregiving to their infants, and these infants in turn develop expectations that their needs will be met and they are safe and secure. These early nonconscious expectations develop into internal working models of relationships, such that securely attached infants view themselves as cared for and loved, others as trustworthy and loving, and the world as predictable and safe. In contrast, insecurely attached mothers who are not able to respond as sensitively to their infants’ needs will create insecure attachment representations in their infants, such that their infants will develop internal working models of themselves as uncared for and unloved, others as untrustworthy and unloving and the world as unpredictable and unsafe (see Cassidy & Shaver, 1999, for an overview). As the various chapters in this book demonstrate, there are multiple ways in which attachment is related to memory, especially for emotional events. Beginning in the earliest days of life, parental interactions modulate children’s general physiological reactivity and hormonal responses to stress, as outlined by Wiik and Gunnar. Because more securely attached mothers are able to provide more regulated and more emotionally attuned interactions with their infants, these infants are better able to self-regulate as they develop. The relations between attachment status and emotional regulation continue to develop, and the chapters by Chae, Ogle and Goodman (Chapter 1), by Alexander and O’Hara (Chapter 9), by Laible and Panfile (Chapter 7), and by Oppenheim and Koren-Karie (Chapter 6) all demonstrate how the developing attachment relationship between infant and mother forms a context within which events are interpreted and recalled. Multiple arguments are presented throughout 348

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these chapters on why the attachment system matters, including securely attached dyads’ ability to express and discuss difficult emotions together, to engage in more coherent reminiscing about stressful events, and to be more emotionally attuned. Here, I focus on two interrelated reasons: why secure attachment is related to maternal reminiscing style and why both are related to more coherent memories of stressful events. First, a secure attachment system provides the infant with a sense of predictability. Caregivers will be available when needed and will provide appropriate responsive care; therefore cognitive and emotional resources can be used to explore the environment. In contrast, insecurely attached infants, for whom care is less predictable and responsive, must devote more of their cognitive and emotional resources to monitoring their own needs (Bretherton, 1990). In addition, predictability provides a structure for children’s understanding of events. Early memories are based on routine and predictable events that are represented as scripts or generalized event representations (Nelson, 1986). A more coherent and predictable environment allows the infant to construct more coherent and predictable event representations of how the world works. These early generalized event representations are the building blocks of memory (Nelson & Gruendel, 1979). Young children have particular difficulty representing more unpredictable and more variable events (Hudson, Fivush, & Kuebli, 1992). Thus, early caregiving routines that provide the basis for secure attachment also provide the basis for more coherent event representations that lay the basis for later event memory (Fivush, 2006). Simply put, sensitive and responsive caregiving early in development helps create a predictable world that allows infants to represent their experiences in more coherent ways. Second, these early nonconscious representations that develop in the give-and-take of everyday interaction provide the basis for early verbal reminiscing. Just as mothers differ in sensitive and responsive caregiving, they also differ in sensitive and responsive reminiscing. The chapters by Chae et al., by Alexander and O’Hara, by Oppenheim and Koren-Karie, and by Sales (Chapter 1, 9, 6, and 8, respectively) demonstrate connections between maternal attachment style and maternal reminiscing style. A more elaborative and evaluative reminiscing style reflects underlying maternal goals of connection, care and validation. Moreover, a more elaborative maternal reminiscing style helps the mother and child to create a shared history in which they are emotionally bonded through time, and thus helps to maintain and extend a more secure attachment bond. The reciprocal effects of maternal attachment status and maternal reminiscing style have implications for both memory development in general and for memories of emotional events in particular. In terms of memory development, mothers who are highly elaborative when reminiscing with their preschool children have children who Co-constructing Memories and Meaning over Time

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come to have more detailed and coherent memories of their experiences (see Fivush, Haden & Reese, 2006, for a review). Moreover, elaborated maternal reminiscing predicts later recall, both verbal and nonverbal recall, of an event more than how the event is talked about while it is occurring (McGuiguan & Salmon, 2004). And Peterson and Warren present evidence that maternal elaborative reminiscing style predicts recall of highly stressful injury and hospital events even years later. Importantly, it may not just be memory of a specific event that is talked about or not talked about that is influenced by maternal reminiscing style. Rather, highly elaborative mothers are providing a model of remembering for their children. Just as maternal caregiving behaviors provide a model of the world as predictable or not, maternal reminiscing provides a model of the past as elaborated and coherent or not. Children of highly elaborative mothers come to recall their personal past in general in more detailed and coherent ways (Fivush et al., 2006), and, most likely, come to represent their past in more detailed and coherent ways as well. Thus, just as attachment leads to internal working models of self and other in interaction, maternal reminiscing leads to internal working models of self and other in the past, and provides a sense of continuity of self and other through time (Fivush & Nelson, 2006). More specific to emotional events, as demonstrated in multiple chapters in this volume, a secure attachment relationship allows for more open and emotionally expressive communication between mother and child. More talk about emotion, and especially more explanatory and regulated talk about emotion, helps children learn emotional regulation skills (Laible, 2004; Sales & Fivush, 2005). Open and regulated emotional communication will facilitate children’s recall of the specific emotional event under discussion, as well as help children learn emotional regulation skills for understanding and recalling future emotional events. Given that emotional distress may disrupt memory for certain aspects of experiences, the ability to self-regulate will aid in the ability to process certain aspects of events as they are occurring, as well as to recall certain aspects of events in retrospect. Thus, secure attachment is related to more accurate and more coherent memories, as described in the chapters by Chae et al., and by Alexander and O’Hara. There are also relations between attachment status and the developing relations between automatic and controlled coping strategies, as discussed by Compas et al. by Wallin et al., and by Sales, as children learn to consciously modulate their emotional responses. However, again, there may not be a linear relation; as emotional stress rises, attention and focus increases and the ability to attend, encode, and recall information for the emotional event itself also increases, but if emotion becomes too intense, and physiological reactions begin to cascade, memory seems to be disrupted 350

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(Brewin, 2003). Thus, secure attachment, which allows for higher levels of emotional self-regulation, also allows for higher levels of attention and focus when experiencing and recalling stressful events, but even this may break down at extreme levels of stress, as described by Sales. Insecure attachment, whether anxious or avoidant, will, in contrast, lead to either emotional disruption or distancing and thus less coherent memories of stressful events. Oppenheim and Koren-Karie discusses how insecurely attached dyads may not be emotionally tuned to each other, leading to distorted conversations about emotional experiences, and perhaps to distorted memories as well. Greenhoot, Johnson, Legerski, and McCloskey (Chapter 4) presents evidence that children who witnessed domestic violence during childhood subsequently recalled less emotion about these experiences. Although no measures of attachment were available, we can speculate that abusive environments lead to avoidant attachments (Barnett, Ganiban, & Cicchetti, 1999), which would be displayed in emotional numbing and avoidance in later childhood and adulthood (Shaver & Mikulnicer, 2002). In adults, attachment status affects the actual perception and encoding of emotional information (Fraley, Niedenthal, Marks, Brumbaugh, & Vicary, 2006); avoidantly attached individuals simply “see” different emotions in their environment. Might attachment status affect the very way in which children will process and encode experiences in the world, as well as how they may recall them retrospectively, and, as Chae et al. propose, is this restricted to attachment-related experiences, or does it represent a more overarching cognitive style of remembering? These are important questions for future research.

Meaning Making as a Social Process Across the chapters in this volume, the consensus is that how children come to remember the stressful events of their lives is a complex interaction among individual differences in temperament and physiological reactivity; in developing language, memory, and cognitive skills; as well as developing emotional understanding and regulation. Moreover, these developments are embedded in social contexts in which mother-child interactions may or may not be supportive and validating and therefore may or may not help create predictability and coherence. Individual and developmental differences will be modulated within social contexts that either do or do not support the development of specific skills in specific ways, and these skills will be displayed in social interactions in which they will be further refined and modulated. Although the ability to encode, consolidate and retrieve information can be described at the individual level, ultimately, meaning can only Co-constructing Memories and Meaning over Time

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exist within a social context. It is not just what happened that is critical, but what this event means for the self. How any given event is evaluated will be a function of the cultural expectations about the shape of a life (Bernsten & Rubin, 2004) and how this event fits into an evolving life story that places the individual within a complex tapestry of family, relationships, communities, and culture, and places any single event in relation to other events, other people, and other times (Fivush, in press; Fivush & Marin, 2007; Reese & Fivush, in press). Especially when events are stressful, individuals look outward to others and to the world, to engage in meaning-making processes that create an evaluative framework for understanding this single event in a larger life context. Young children are particularly reliant on others, usually their caregivers, to provide the appropriate social interpretative frameworks. Although memories may be thought of as existing within individuals, remembering and meaning-making is clearly situated in the social world. The chapters in this volume provide complex yet elegant theoretical models and begin to provide the empirical data needed to elucidate these important processes. The path for future research is clear.

References Barnett, D., Ganiban, J., & Cicchetti, D. (1999). Maltreatment, negative expressivity, and the development of Type D attachments from 12 to 24 months of age. Monographs of the Society for Research in Child Development, 64, 97–118. Bauer, P. (1996). Recalling past events: From infancy to early childhood. Annals of Child Development, 11, 25–71. Bauer, P., & Wewerka, S. (1997). Saying is revealing: Verbal expression of event memory in the transition from infancy to early childhood. In P. van den Broek, P. J. Bauer, & T. Bourg (Eds.), Developmental spans in event comprehension and representation: Bridging fictional and actual events (pp. 139–168). Mahwah, NJ: Erlbaum. Bernsten, D. & Rubin, D. C. (2004). Cultural life scripts structure recall from autobiographical memory. Memory and Cognition, 32, 427–442. Bretherton, I. (1990). Open communication and internal working models: Their role in the development of attachment relationships. In R. A. Thompson (Ed.), Nebraska Symposium on Motivation: Vol. 36. Socioemotional development (pp. 59–113). Lincoln, NB: University of Nebraska Press. Brewin, C. (2003). Posttraumatic stress disorder: Malady or myth? New Haven, CT: Yale University Press. Cassidy, J., & Shaver, P. R. (1999). Handbook of attachment: Theory, research and clinical applications. New York, NY: Guilford. Ellis, H. C. & Moore, B. A. (1999). Mood and Memory. In T. Dalgleish & M. J. Power (Eds.), Handbook of cognition and emotion. (pp. 193–210). New York, NY: John Wiley & Sons Ltd. 352

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Fivush, R., (2006). Scripting attachment: Generalized event representations and internal working models. Attachment and Human Behavior, 8, 283–289. Fivush, R. (in press). Remembering and reminiscing: How individual lives are constructed in family narratives. Memory Studies. Fivush, R., Bohanek, J. G., Marin, K. A., & Sales, J. M. (in press). Emotional memory and memory of emotion. In O. Luminet, A. Curci and M. Conway (Eds.), Flashbulb memories: New issues and new perspectives. New York, NY: Psychology Press Fivush, R., Haden, C., & Reese, E. (2006). Elaborating on elaborations: The role of maternal reminiscing style in cognitive and socioemotional development. Child Development, 77, 1568–1588. Fivush, R., & Marin, K. (2007). Place and power: A feminist perspective on self-event relations. Human Development, 50, 111–118. Fivush, R., & Nelson, K. (2006). Parent-child reminiscing locates the self in the past. British Journal of Developmental Psychology, 24, 235–251. Fivush, R., & Sales, J. M. (2006). Coping, attachment, and mother-child reminiscing about stressful events. Merrill-Palmer Quarterly, 52, 125–150. Fivush, R., Sales, J. M., Goldberg, A., Bahrick, L., & Parker, J. F (2004). Weathering the storm: Children’s long-term recall of Hurricane Andrew. Memory, 12(1), 104–118 Foa, E. B., Molnar, C., & Cashman, L. (1995). Change in rape narratives during exposure therapy for posttraumatic stress disorder. Journal of Traumatic Stress, 8, 675–690. Fogel, A. (1993). Developing through relationships. Chicago, IL: University of Chicago Press. Fraley, R. C., Niedenthal, P. M., Marks, M., Brumbaugh, C., & Vicary, A. (2006) Adult attachment and the perception of emotional expressions: Probing the hyperactivating strategies underlying anxious attachment. Journal of Personality, 74, 1163–1190. Gauvain, M. (2001). The social context of cognitive development. New York, NY: Guilford Press. Haden, C. A., Ornstein, P. A., Eckerman C. O., & Didow, S. M. (2001). Mother-child conversational interactions as events unfold: Linkages to subsequent remembering. Child Development, 72, 1016–1031. Hudson, J. A., & Fivush, R. (1991). As time goes by: Sixth graders remember a kindergarten event. Applied Cognitive Psychology, 5, 346–360. Hudson, J. A., Fivush, R., & Kuebli, J. (1992). Scripts and episodes: The development of event memory. Applied Cognitive Psychology, 6, 483–505. Laible, D. (2004). Mother-child discourse in two contexts: Links with child temperament, attachment security, and socioemotional competence. Developmental Psychology, 40, 979–992. McGuigan, F., & Salmon, K. (2004). The time to talk: The influence of the timing of adult-child talk on children’s event memory. Child Development, 75, 669–686. Meins, E. (1997). Security of attachment and the social development of cognition. Hove, England: Psychology Press/Erlbaum (UK) Taylor & Francis. Nelson, K. (1986). Event knowledge: Structures and function in development. Hillsdale, NJ: Erlbaum.

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Nelson, K., & Fivush, R. (2004). The Emergence of Autobiographical Memory: A Social Cultural Developmental Theory. Psychological Review, 111, 486–511. Nelson, K., & Greundel, J. (1979). Generalized event representations: Basic building blocks of cognitive development. In A. L. Brown & M. E. Lamb (Eds.), Advances in developmental psychology, Vol. 1 (pp. 131–158). Hillsdale, NJ: Erlbaum. Pennebaker, J. W. (1997). Opening up. New York, NY: Guilford Press. Piaget, J., & Inhelder, B. (1973). Memory and intelligence. New York, NY: Basic Books. Principe, G. F., Ornstein, P. A., Baker-Ward, L., Gordon, B. N. (2000). The effects of intervening experiences on children’s memory for a physical examination. Applied Cognitive Psychology, 14, 59–80. Reese, E., & Fivush, R. (in press). Collective memory: A developmental sociocultural perspective. Memory. Rothbart, M. K. & Bates, J. E. (2006). Temperament. In N. Eisenberg, W. Damon, & R. M. Lerner (Eds.), Handbook of child psychology: Vol. 3, Social, emotional, and personality development (6th ed., pp. 99–166). Hoboken, NJ, US: John Wiley & Sons Inc. Sales, J. M. & Fivush, R. (2005). Social and emotional functions of motherchild reminiscing about emotional events. Social Cognition, 23, 66–88. Shaver, P. R., & Mikulincer, M. (2002). Attachment-related psychodynamics. Attachment & Human Development, 4, 133–161. Simcock, G., & Hayne, H. (2002). Breaking the barrier? Children fail to translate their preverbal memories into language. Psychological Science, 13, 225–231. Thelen, E., & Smith, L. B. (1997). Dynamic systems theories. In R. M. Lerner (Series Ed.) & W. Damon (Vol. Ed.), Handbook of child psychology: Vol 1. Theoretical models of human development (5th ed., pp. 563–634). New York, NY: Wiley Van Abbema, D. L., & Bauer, P. J. (2005). Autobiographical memory in middle childhood: recollections of the recent and distant past. Memory, 13, 829–845. Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press. Walker, W. R., Skowronski, J. J., & Thompson, C. P. (2003). Life is pleasant—and memory helps keep it that way! Review of General Psychology, 7, 203–210.

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14 Relationships, Stress, and Memory Ross A. Thompson

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emory is typically viewed as a cognitive activity that occurs in the minds of individuals. The contributions to this volume show that memory is also a social process. How could it be otherwise? As Baker-Ward and her colleagues (Chapter 2) note, social influences are incorporated into the initial and extended encoding of events, and social influences affect the storage of memories and the reconstructive retrieval of past experiences. The social construction of memory is especially apparent in conditions of stress. As the research profiled in this volume indicates, memory for difficult or traumatic experiences is influenced by social support when the experience occurs, the sensitivity of caregivers when the experience is recounted, and the social interactions that guide representations of experience in general. Relationships envelop the most important social influences on children’s experience of stress and their memory for difficult experiences. The connections between relationships, stress, and memory are thus the focus of this commentary chapter. Attachment theory provides a provocative framework for understanding these connections, and because attachment ideas are at the core of several programs of research described in this volume, the next section discusses the influence of attachment relationships on children’s memory for stressful events. Parent-child conversation is also a recurrent theme of these chapters that touches on the connections between relationships, stress, and memory, so the next section highlights how discourse influences memory, especially for stressful events, and future research directions in this area. Finally, emotion regulation also connects relationships, memory, and stress, and the expanding research literature in this field is considered in the last section. 355

I conclude with some ideas for the future directions of this field and its practical applications.

Attachment Theory The prominence of attachment theory in this volume is unsurprising in light of how uniquely this theory addresses the associations between relationships, stress, and memory. Although Bowlby and Ainsworth had relatively little to say about attachment and cognitive functions (including memory), they recognized that stressful and traumatic events activate the attachment system. The security of attachment is important for how children are helped to cope with difficult experiences, their experience of stress as manageable or overwhelming, their confidence in the accessibility of caregivers when problems occur, and thus how they process and remember threatening events. The chapters by Chae, Ogle, and Goodman (Chapter 1); Laible and Panfile (Chapter 7); Oppenheim and Koren-Karie (Chapter 6); and Alexander and O’Hara (Chapter 9), among others, attest to the vitality of attachment ideas to studies of memory, stress, and relationships.

Attachment Security and Children’s Memory for Stressful Events Attachment theory offers several explanations for the influence of attachment security on memory for stressful events (see also Alexander, Quas, & Goodman, 2002). First, owing to the sensitivity of parental care, infants and young children in secure relationships are more capable of emotion regulation based on their confidence in the parent’s support (Thompson, 2008) and this is likely to strengthen memory for difficult experiences. This is one way that attachment security might affect the encoding of events through attention allocation, the immediate and extended encoding of experience, and in other ways. Several studies relevant to this formulation have found, using behavioral and parent-report measures, that securely attached children are stronger in emotion regulation in infancy (NICHD Early Child Care Research Network, 2004), early childhood (Gilliom, Shaw, Beck, Shonberg, & Lukon, 2002), and middle childhood (Contreras, Kerns, Weimer, Gentzler, & Tomich, 2000). In a study assessing the cortisol reactivity of 18-month-olds to moderate stressors, Nachmias, Gunnar, Mangelsdorf, Parritz, and Buss (1996) reported that postsession cortisol elevations were found only for temperamentally inhibited toddlers who were in insecure relationships with their mothers. For inhibited toddlers in secure relationships, the mother’s presence helped to buffer the physiological effects of challenging events (see also 356

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Wiik and Gunnar, Chapter 10, this volume, for other research on relational buffers of stress reactivity). There are several avenues by which a secure attachment might contribute to enhanced emotion regulation in young children, including how parents intervene to manage the emotions of infants before they become overwhelming, the parent’s greater acceptance and constructive response to children’s distress, the parent as a model of competent emotion self-regulation, and the broader family emotional climate (Thompson & Meyer, 2007). No research has linked enhanced emotion regulation in secure children to memory for stressful events, however, which is why the research conducted by Goodman and Alexander and their students is important and has the potential of informing attachment theory as well as the literature on stress and memory. To the extent that researchers find an association between enhanced emotion coping during difficult experiences and improved memory for those experiences in securely attached children, it suggests one way that the emotional consequences of attachment security can have implications for cognitive functioning. A second way that attachment can influence memory for stressful events is through parent-child conversation about these events. This is relevant to constructive influences involved in the storage and retrieval of memories for difficult experiences. Attachment theorists have long believed that parent-child communication is an important avenue by which security is conveyed and maintained, with Bretherton (1993), for example, arguing that parents and children in secure relationships engage in more candid “open, fluid communication” that enables greater personal disclosure by children of troubling feelings or thoughts (see also Thompson, 2000a, 2006). In this context, memories of stressful events can be reconstructed through the reassurance provided by the parent and the content of the adult’s supportive co-construction of the experience with the child. Several of the contributors to this volume focus on the influence of parental conversational style on children’s memory for stressful events, and the Laible and Panfile chapter especially highlights an expanding research literature documenting the associations between secure mother-child attachment, maternal sensitive and elaborative discussion of feelings, and children’s enhanced emotion understanding and representations of relationships (see also Thompson, Laible, & Ontai, 2003). This literature has not yet established an association between the quality of mother-child conversation in secure relationships and children’s memory for stressful experiences, however, which is an important next step to elucidating the benefits of “open, fluid communication” for securely attached children’s stress reactivity. Oppenheim and Koren-Karie have built on these formulations in their discussion of how mother-child dialogues can promote a sense of Relationships, Stress, and Memory

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security in children. In a manner analogous to how attachment figures are a physical source of security that fosters infant exploration, they argue, the same adults become a psychological secure base for the young child’s exploration of the internal world, particularly when the child’s inner world is troubled. Their approach provides a useful framework for understanding how attachment security can influence memory for stressful events and, perhaps more importantly, how attachment-related mental representations grow and are refined in childhood. Their longitudinal findings suggest that mother-child dialogues build on the legacy of earlier attachment relationships and, through the parent’s dialogic sensitivity, help to maintain the child’s security and elaborate the child’s representations of relationships, emotions, and self (see also Thompson, 2006a, in press). This leads to Bowlby’s concept of “internal working models,” which is a third way that attachment can influence memory for stressful events. As noted by other contributors, Bowlby believed that attachment relationships inspire the development of mental models of relationships, close partners, and the self that emerge in infancy and grow in sophistication and scope in the years that follow. These mental working models enable the child to forecast the behavior of attachment figures, provide informal rules for interacting with others, color self-perceptions, and constitute interpretive filters on new experiences and relationships to conform them to past experiences and expectations (see Bretherton & Munholland, 1999). As described by Chae and colleagues and by Alexander and O’Hara, internal working models are likely to influence memory for attachment-relevant experiences (including stressful or traumatic events) by affecting the kind of information that children attend to, process, and remember. Children who are insecure-avoidant, for example, are more likely to defensively exclude threatening information in order to reduce exposure to the negative, disturbing emotions with which it is associated, and the chapter by Greenhoot, Johnson, Legerski, and McCloskey (Chapter 4) adds empirical support to this view. Bowlby’s concept of mental working models is a brilliant proposal for understanding the nature of integrated, affectively colored relational representations. But it is important to recognize that “internal working model” is a conceptual metaphor, not a systematically defined theoretical construct, and critics from within and outside attachment theory have worried about increasingly expansive interpretations of this concept to “explain” the association between attachment security and a broadening range of external correlates (Belsky & Cassidy, 1994; Thompson & Raikes, 2003). Because the defining qualities and developmental course of internal working models are not well conceptualized within attachment theory, the concept can be (perhaps too) broadly and flexibly 358

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applied to diverse research domains. Clarifying the nature and development of internal working models, especially in relation to the advances of current developmental science, is thus an important task for attachment theorists. In attachment theory and research there are, for example, two different ways of understanding the influence of internal working models on memory. In one view, attention and memory are oriented toward information that is consistent with prior expectations and mental schemas. This was the approach of Belsky, Spritz, and Crnic (1996), who assessed three-year-old boys’ delayed recognition memory for positive and negative events during a previously viewed puppet show. Children who were securely attached (assessed in infancy) remembered the positive events more accurately than the negative events, while the reverse was true for those earlier deemed insecurely attached, even though there were no group differences in initial attention to the positive or negative events in the puppet show. This view is consistent with other literatures on the heightened sensitivity of children in maritally conflicted homes to cues of adult disagreement (Cummings & Davies, 1994) and the hypervigilance of anxious children to cues associated with threatening or frightening stimuli (Thompson, 2000b). In an alternative view, attention and memory is oriented away from schema-consistent information, especially if it is painful or disturbing, and thus accounts for theoretical expectations of the defensive exclusion of insecurely attached children. Based on this view, Kirsh and Cassidy (1997) studied the relevance of infant attachment security for 3 ½-yearolds’ memory for stories depicting maternal responsiveness, rejection, and exaggerated distress-related responding. Like Belsky and colleagues, they found that securely attached preschoolers remembered the stories describing responsive mothers better than insecure children, but contrary to expectations, they also remembered rejecting and exaggerated stories better than insecurely attached children. The latter (especially insecureambivalent children) remembered stories of maternal rejection more poorly, rather than better than, securely attached children. Both approaches to the influence of internal working models on memory seem sensible in the context of attachment theory, but these dissonant predictions indicate that greater clarity of Bowlby’s concept of the development and functioning of mental working models is needed. These and other diverse findings related to attachment and memory may be reconciled with respect to whether the remembered information is relevant to attachment concerns (as suggested by Chae and colleagues), although it is likely that other influences are also important, including the interpersonal context of the original experience, the child’s emotional arousal, the relevance to the self of the remembered event, and the Relationships, Stress, and Memory

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nature of the memories that result (e.g., for peripheral or central events). Thus the research programs profiled in these chapters have the potential of informing attachment theory concerning the nature of the association between security and memory and thus of clarifying certain elements of Bowlby’s internal working models construct.

Parent Attachment Finally, there has been considerable attention to parental attachment style in the studies on attachment and memory discussed in this volume. The focus here is how adults’ representations of attachment influence their support to children in stressful or traumatic circumstances. Although several studies have found a significant association between parental attachment style and the memory of offspring for stressful events, investigations of mediators of this association have yielded mixed results. This suggests that greater theoretical consideration of how parental attachment style might influence the memory representations of children is required to guide future research efforts, as well as potential moderators of this influence. Parent attachment representations might be influential not only for the immediate emotional support provided under stressful circumstances or their recounting, but also for its broader influence on children’s understanding of themselves and of stressful experiences. In these studies, parents’ attachment representations have been assessed as representations of romantic relationships. In two studies in which adults’ representations of their childhood attachment relationships have been assessed, there have been convergent findings to those reported in this volume and promising leads. Reese (in press) assessed maternal attachment representations using the Adult Attachment Interview and found a significant association between maternal coherence in these representations and maternal elaborative reminiscing about past events with the child as well as children’s self-concept. Bost and her colleagues (2006) assessed maternal attachment representations using newly validated script methodology and found that maternal secure base scripts were associated with emotional references during reminiscing with the child about shared experiences as well as the child’s engagement in the memory task. Maternal secure base scripts and reminiscing narrative style were also significant predictors of children’s security of attachment. Although neither study examined child memory, these findings suggest some of the indirect ways that parental attachment representations might influence children’s construction of stressful experiences in ways relevant to memory. In particular, the coherence of maternal attachment representations of childhood experience might contribute to maternal coherence 360

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and elaborativeness during parent-child conversations about stressful experiences. These findings also suggest that in addition to researchers’ current interest in parental attachment style as a significant determinant of support to children in stressful circumstances, other variables might also be influential. Research in our lab has focused on the emotional development of preschoolers from low-income, at-risk families served by the Early Head Start program who are often exposed to stressful experiences in the home (Raikes & Thompson, 2006, in press). For these children, emotion understanding was supported by secure attachments to their mothers but was undermined by maternal depression, assessed a year earlier, that seems to have colored the emotional climate in which these children developed an understanding of feelings. The emotional risks in the mother’s life (such as domestic violence or alcohol abuse in the family) and economic stresses influenced the quality of her reminiscing with children about recent experiences involving emotion, which in turn was also related to children’s emotion understanding. Although emotion understanding, not memory, was the focus of this investigation, the findings suggest that children’s coping with stress is likely shaped by relational influences that extend significantly beyond the immediate context of the experience or its recollection to incorporate features of the family emotional climate in which children learn about themselves and the emotional events of their lives. This is one of the reasons why Laible and Panfile’s interest in the broader affective quality of parentchild conversation is so important as a marker of the broader emotional climate of the parent-child relationship that shapes children’s stress reactivity. Parent attachment representations are one influence on these relational influences, but there are clearly many others. Taken together, it is apparent why attachment theory is a generative approach for understanding the connections between relationships, stress, and memory. The contributions to this volume may also help to extend attachment formulations by clarifying how secure relationships contribute to enhanced memory functioning, especially in conditions of stress.

Parent-Child Conversation Attachment theorists have not been the only ones to consider how the content and quality of parent-child conversation influences young children’s representations of experience. A significant theme of this volume that connects relationships, stress, and memory is the quality and content of parent-child reminiscing about difficult or traumatic events. The chapters by Peterson and Warren (Chapter 3), and by Sales (Chapter 8), Relationships, Stress, and Memory

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Laible and Panfile, and others in this collection draw on a significant research literature documenting the influence of a parent’s rich, elaborative narrative style on the depth of young children’s autobiographical memory (see Fivush & Nelson, 2006, and Nelson & Fivush, 2004, for reviews). The application of this research to the association between stress and memory is clear: parent-child reminiscing—especially when it is focused on internal states—can co-construct a young child’s representation of a traumatic event in a manner that facilitates better memory and enhanced coping. The research programs profiled in this volume contribute empirical support to this view. These chapters also extend this view in interesting and important ways. The contributors to this volume have studied parent-child discourse not only in the context of reminiscing about shared past events, but also in the context of conflict (Laible and Panfile), anticipatory or preparatory event discussions (Baker-Ward, Ornstein, and Starnes), and joint storytelling associated with semiprojective narrative prompts (Oppenheim and Koren-Karie). They have focused on the elaborativeness of parental narrative in a manner consistent with the research on parent-child reminiscing, but they have also focused on other elements of parent discourse (e.g., emotion language, acceptance, collaboration with the child) and nonverbal features of parent-child conversation (e.g., affective quality). These contributors have been interested in conversation not only as an influence on children’s memory but also on emotion understanding and coping, emotional security, and other influences on the association between stress and memory. These chapters thus present an opportunity to consider the influence of parental elaboration in the context of other features of parent-child reminiscing, and the influence of reminiscing within the broader context of the social construction of children’s experience.

Parent-Child Conversation and Developing Understanding This is important because of growing scientific attention to the influence of parent-child conversation on young children’s understanding (Thompson, 2006b). In research on developing theory of mind, event representation, analogical reasoning, emotion understanding, self-concept, and conscience as well as autobiographical memory, developmental scientists are recognizing that parent-child discourse in the context of cooperative social interaction is an essential constituent of young children’s understanding of themselves and the world (see Carpendale & Lewis, 2004, for an illustration). Consistent with this view, Harris (2007; Harris & Koenig, 2006) has argued that children accept the word of adults 362

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on a wide range of issues of importance to them, from comprehending the shape of the earth and other natural phenomena, to the association between mind and brain and other psychological phenomena, to the nature of God, the afterlife, and other metaphysical phenomena. Young children accept the truthfulness of what they are told but cannot independently confirm, and this knowledge is readily integrated into knowledge systems based on personal experience. Young children are thus intuitive theorists but not isolated ones, and they build their understanding of the world based partly on what they have learned from parent-child conversation. With respect to understanding the internal world of emotions and coping, it is well that they should. The consuming interest of infants and young children in the mental and emotional experiences of people is matched by the complexity of this conceptual challenge for them. The intentions, goals, feelings, thoughts, and traits that underlie human conduct are invisible, multifaceted, and multidetermined, and they are only indirectly revealed in observable behavior. These characteristics of the internal world are thus likely to undermine young children’s efforts to infer mental and emotional states in others on the basis of naive observation alone. Parent-child conversation provides conceptual bootstraps for young children because of the clarity of the adult’s representations of psychological experience. In conversation, adults explicitly identify internal states in the child or others by using semantic referents for psychological experiences that might otherwise be inchoate or unclear in the child’s prelinguistic mental representations. It is natural that adults should do so because they inhabit a world that is informed by psychological experience, so they readily impart such understanding in conversations with young children about everyday events in which they explicitly identify the intentions, goals, feelings, thoughts, and other internal states of the people who are being discussed. In doing so, parents embed these mental and emotional referents in current or recent experience that aids children’s comprehension of them. A study by Ontai and Thompson (2002) illustrates these conversational contributions to emotion understanding. In analyses of the conversations of three-year-olds with their mothers about emotional issues (i.e., storybook pictures about emotions and recent events in which the child had experienced sadness, anger, or distress), several features of the mother’s conversational discourse were prominent and were highly interrelated. Mothers who made more frequent references to emotion with the child also talked more about the causes and the outcomes of emotional arousal, defined emotion in conversation (e.g., “furious is when you’re really, really mad”), requested information from the child about feelings expressed in the situation or story, and linked events in the child’s Relationships, Stress, and Memory

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experience to the material to help the child better understand the emotion (e.g., “that’s how you felt when Abby knocked down your blocks”). Importantly, each of these discourse elements was significantly associated with global ratings of the mother’s elaborative narrative style which, in turn, interacted with the security of attachment in predicting children’s later emotion understanding. Maternal elaboration in parent-child conversation is not only associated with young children’s memory but also, in this and other studies, with enhanced understanding of emotion (see Thompson, 2006a, for a review). Elaborative speech is, in this sense, the conduit for narrative elements that can foster psychological understanding in young children. These conversational bootstraps are apparent not only when parents and children are reminiscing about shared experiences, but also when they are anticipating events to come and during the course of immediate experience. As noted by Baker-Ward and colleagues, and by Chae and colleagues, for example, how children respond to stressful events is affected by the anticipatory event representations by which parents prepare their children for expected challenges, such as a medical exam. Young children can better cope with difficult events when these events are explained to them beforehand, and this may help explain their enhanced memory for the procedures. Likewise, conversation during the event itself also orients the child’s attentional focus and understanding and, in so doing, can either aid or undermine emotion management in ways that are also relevant to memory (Miller & Green, 1985; Ornstein, Haden, & Hedrick, 2004). Although parent-child reminiscing has deservedly received more research attention in studies of stress and memory than have the influences of parent-child conversations in anticipation of or during the course of shared experience, these alternative conversational contexts are likely to be important influences on children’s understanding, coping, and memory for these events.

Discordant Representations of Shared Experiences To be sure, parental conversation can be a source of misinformation as well as adaptive understanding. In an evocative study, Levine, Stein, and Liwag (1999) found that parents and young children commonly disagreed about the child’s experiences and feelings when recalling shared events, often because adults made assumptions about the child’s goals that were incorrect, particularly when children were perceived as unhappy. The approach of a friendly dog was recounted by one child, for example, as a happy experience but was represented by the parent (who was also present) as annoying or frightening to her child. In our laboratory (in collaboration with Sara Meyer and Rebecca Goodvin), we have studied 364

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anticipatory event representations by asking mothers to talk with their preschool children about a novel event that would occur during the next week, and subsequently asking the child to describe that experience to a familiarized experimenter. Our findings have revealed, at times, discordance in the expectations of mothers and their children that influenced, in turn, the latter’s anticipatory event representations. In one of these parent-child conversations, the long-awaited first day of kindergarten was the conversational focus: Mother: . . . are you scared at all or are you just excited about going [to kindergarten]? Child: I’m excited! Mother: Are you scared at all? Child: No! Mother: I didn’t think so. ‘Cause you know some people are scared to go to kindergarten.

Later, when the child was talking with the experimenter, the influence of the earlier conversation was apparent: Experimenter: How do you think you’ll feel when you go to kindergarten? Child: Scared. ‘Cause maybe . . . um . . . I don’t know what I am going to play with.

When parental expectations and perceptions are discordant with the child’s experience, anticipatory event representations and shared reminiscence can become for the child a conflict between primary and secondary representations of an event. For children of any age, this can be perceived as invalidating the child’s direct experience and potentially contributes to the child’s view of the adult as insensitive or unaware of her experiences. Older children can respond to the parent’s misinterpretation by disagreeing and correcting the adult. When children are young, as in our research example, this conflict may instead be resolved through the young child’s adoption of the adult’s construction of the experience. Little research has been devoted to these experiences of discordant parental and child representations of shared experience in nonclinical samples, nor is there much examination of developmental changes in how children resolve such conflicts. More research of this kind would be valuable, especially in studies of stress and memory when the potential for discordant representations of shared experiences is likely to be high because of the unique perspectives of child and parent on an emotionally evocative event. Such research may help to clarify the unexpected finding of McDermott Sales described in this volume that parental elaborative speech was associated with parental anxiety rather than security in her study and, in such situations, may not be associated with adaptive child understanding and coping. In Relationships, Stress, and Memory

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instances like these, elaborative discourse may be an expression of maternal unease that is manifested in self-absorbed discourse and/or efforts to impose a specific construction of experience on the child. More generally, as conversation increasingly constitutes a forum for developing psychological understanding, young children are likely to incorporate into their representations of experience not only the parent’s understanding of events and emotions but also attributional biases, moral evaluations, self-referent beliefs, judgments of responsibility, empathic perspectives, and other beliefs and values that derive from the parent’s orientation to the social world and cultural modes of thought. These are conveyed in what is said and also in how it is said through vocal tone, facial expression, and other pragmatics of conversational quality. In the social construction of experience, parent-child conversation is a potent influence on the intergenerational transmission of representations of the psychological world, including oneself and one’s relationships with others. Viewed in this light, the focus of stress and memory research on parent-child reminiscing is an excellent orientation to a variety of conversational influences by which children’s coping with and memory for difficult and traumatic experiences is guided. The contributors to this volume show that for many families, reminiscence follows from preparatory conversations in which stressful events have been anticipated as well as discourse during the experience itself. These chapters suggest that children’s memory for traumatic events is affected by coping capacities that are forged, in part, from prior conversational influences on emotion understanding, self-awareness, and (as we saw in other sections) self-regulatory strategies. How parents conversationally orient children’s attention when difficult events arise and when they are subsequently discussed is influential on memory in the context of parents’ validations, evaluations, and occasional misinterpretations of the child’s experience. Broadening our inquiry into the nature and influence of these conversational processes will help to contextualize current understanding as well as contributing to a deeper understanding of relational influences on memory for stressful events.

Emotion Regulation Another topic of contemporary research interest that unites many of the themes of this volume is emotion regulation (Eisenberg & Morris, 2002; Gross, 2007; Thompson, 1994). Emotion regulation is a broader concept than coping, which is focused on managing stress, and it is relevant to the association between stress and memory because of the diverse emotions associated with the experience of difficult events. In 366

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the circumstances studied by the researchers who contributed to this volume, for example, children were required to manage feelings of fear, anxiety, and distress but also anger, disappointment, and perhaps also guilt or shame. In addition, research on emotion regulation focuses on a range of developmental, relational, and representational foundations to the management of emotion that can inform research on emotion and memory in development. Understanding developmental processes in emotion regulation is especially important for thinking about how children’s capacities to cope with stress change throughout childhood, along with the changing role of caregivers and the development of emotion regulatory skills (see Thompson, Lewis, & Calkins, in press, and Thompson, Meyer, & Jochem, 2008 for reviews). Because the neurobiological foundations of self-regulation are slow to mature, infants and toddlers rely on the support and responsiveness of caregivers to regulate their emotions even as they are early capable of rudimentary forms of stress management, such as through self-soothing and attentional redirection. Even so, the core developmental story of emotion regulation is children’s growing competence at managing their feelings—including their responses to stress— with increasing independence, flexibility, sophistication, and reliance on mental strategies (e.g., mental redirection of attention, changing goals, cognitively reframing the situation). This process occurs as other developing abilities are recruited into emotion regulatory skills and knowledge, such as the growth of attentional control, language, executive function, theory of mind, emotion understanding, self-efficacy, and knowledge of sociocultural display rules. Equally important is the emergence throughout infancy and childhood of individual differences in emotion regulatory styles that derive from temperamental differences in emotional reactivity and self-regulation, parental influences, and importantly, early experiences of stress. Concerning the latter, several chapters in this volume (by Wiik and Gunnar; by Wallin, Quas, and Yim [Chapter 12]; and by Carver and Cluver [Chapter 11]) note the vulnerability of the developing brain to the harmful effects of prolonged exposure to stress hormones in ways that can alter the functioning of psychobiological stress systems and the brain structures associated with explicit memory. For this reason, the relational supports for emotion management are important. Besides their direct intervention to manage stressful experiences for offspring and their proactive efforts to regulate the emotional demands on children, parents are important in other ways (Eisenberg, Cumberland, & Spinrad, 1998; Thompson & Meyer, 2007). How parents sympathetically respond to the emotional behavior of children or with critical, dismissive, or punitive reactions contributes to children’s appraisals of their own feelings and their efforts to manage them. Parent-child Relationships, Stress, and Memory

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conversations about emotion influence children’s developing representations of emotion, emotion regulatory processes, and expectations for emotion management (see Gottman, Katz, & Hooven, 1997), as well as providing a forum for co-constructing representations of prior experiences of distress in ways that can facilitate constructive coping and memory, as earlier noted. The broader emotional climate of the family is important for exposing children to constructive or maladaptive models for emotion coping, as well as for the everyday emotional demands and emotion coaching from other family members. And as the attachment literature indicates, the security or insecurity of the parent-child relationship is an important influence on developing emotion regulatory skills because of these influences and their effects on children’s broader representations of themselves and relationships. Research in our lab by Sara Meyer has shown that many of these parental socialization influences on emotion regulation are guided by the adult’s personal views of emotion and its management (Meyer, 2008). Mothers who reported that they were attentive to their own emotions, believed that emotions were important to them, and used constructive strategies to manage their feelings were more likely to encourage children to express their own feelings and to engage in problem-solving solutions for emotion coping. These socialization approaches were, in turn, associated with children’s constructive emotion regulation strategies. By contrast, parents who were more doubtful about the importance of emotion and tended to suppress their own feelings did not encourage emotional expression in their children and provided less constructive responses. There are several implications of the emotion regulation literature for understanding the associations between stress and memory in development as they have been elucidated by the chapters of this volume. First, developmental changes in emotion regulation are multifaceted and complex: children not only become strategically more competent at managing their feelings but do so with skills that change qualitatively with increasing age. Emotional coping in stressful circumstances is affected, for example, by an infant’s capacity to find sources of relational support; by a preschooler’s capacity to manage attentional and perceptual exposure to stress-provoking events and to use language to understand them; and by a grade-schooler’s abilities to cognitively reframe the situation in ways that are emotionally helpful and to cope with their implications for the self. These qualitative differences in developmentally graded skills in emotion management have important implications, of course, for how children of different ages can be assisted in coping as well as for how they are affected by the broader social environment in which stressful events occur. Second, individual differences in emotional coping arise not only from the influence of stressful experiences and (sometimes 368

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unsupportive) relationships but also from differences in intrinsic vulnerability to stress. More importantly, these temperamental differences are likely to interact with experience and relational support to further shape children’s vulnerability to stress and trauma; what temperamentally vulnerable children require from caregiving relationships may be different from what temperamentally resilient children need. Third, it is likely that children in situations of chronic or overwhelming stress are undermined by multiple deficiencies in the social context of emotion regulation. In troubled families, children are likely to experience difficult and unexpected emotional demands, obtain little support in their management of arousal (owing, sometimes, to adults who are themselves emotionally overwhelmed), and experience parental dismissive or punitive reactions to their feelings, in the context of insecure attachment relationships. Understanding the conditions of children in chronic stress in terms of constellations of challenges to effective emotion regulation is important not only to better understanding their self-regulatory difficulties but also, at times, to appreciate that how they regulate emotion may be the best that is possible in emotionally impossible circumstances (Thompson et al., in press). Finally, it is important to recognize that many characteristics of caregivers influence children’s emotion coping, including how adults represent and respond to their own experiences of emotion and stress that may derive from the parent’s background and current experiences of stress and, for some, depressive symptomatology. Indeed, these emotion-related representations may be associated with the differences in parent attachment styles that have been more frequently the focus of investigation in this literature. As the chapters by Greenhoot et al. and by Compas, Campbell, Robinson and Rodriguez (Chapter 5) note, avoidant approaches to coping and emotion regulation are emotionally maladaptive and impair memory specificity. The emotion regulation literature offers a number of hypotheses about the developmental origins and correlates of avoidance that are relevant to better understanding the association between avoidant coping and memory. In particular, the finding by Greenhoot and her group that adolescents with childhood abuse histories produce fewer negative emotion terms (but not fewer positive or neutral terms) in their autobiographical recollections compels attention—as they recognize—to the potential developmental influences of childhood attachment history, current attachment style, parent-child reminiscing, emotional socialization influences in the family and responses to family conflict, and the adolescent’s own representations of emotion and of emotion management as potential explanations for this finding. Future research on emotion and memory in development will benefit from such a wide conceptual net.

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Conclusion There are at least two conclusions warranted by this remarkable volume. First, the research field of stress, emotion, and memory in development is exciting and expanding as the contributors to this volume profile both the state of the science and its emerging future directions. It is remarkable to find a collection of chapters on a focused topic with the breadth of scope of this one that encompasses attachment, stress physiology, memory functioning, parent-child conversation, the neurobiology of memory, trauma, and coping. Nevertheless, the call of this commentary is for greater breadth in research perspective without losing the integrative strengths of this field. Continued study of the influence of parent-child reminiscence should be complemented by greater attention to parent-child conversation prior to stressful events and during their course. Individual differences in coping arise both from social support during difficult experiences and from a network of broader developmental influences on emotion regulation. Attachment-oriented studies should confirm the theoretical connections between attachment security, emotion regulation, parent-child conversation, and memory for stressful events and, in doing so, may help to clarify important questions and theoretical uncertainties within attachment theory. Discordance between parental and child representations of shared events, especially traumatic experiences, may be an important influence on children’s coping with and memory for those experiences. Parent romantic attachment style may be an important influence on children’s coping, but so also might be the parents’ coherent constructions of childhood attachment, their representations of their own emotions, the effects of stresses with which they are coping, and even affective psychopathology. Parent-child conversation and elaborative narrative style are important for children’s memory and also for their emotion understanding, conceptions of self, knowledge of emotion regulatory capacities, and other influences on the experience of stress and coping. There is, in short, no shortage of interesting and important questions to guide future study. Second, the science is young, so practical applications of this research are limited. Nevertheless, the contributors to this volume offer a convincing case that this research is important because of these implications for clinical practice, legal procedures, or developmentally appropriate guidance. New approaches to forensic interviews should take into account knowledge from these contributions about developmental influences on children’s memory, communicative capacities, social understanding, and relational needs (see, e.g., Lamb, Orbach, Hershkowitz, Esplin, & Horowitz, 2007). Children should be prepared for anticipated experiences 370

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that may be stressful with information that is relevant to their developmental understanding and needs. Because of the significance of the relationships on which children rely, parents should be assisted to function as children’s support agents, especially when their own background, history, or current functioning may make it difficult for them to do so. This can include helping them to learn how to converse with their children about difficult events in a manner that facilitates coping as well as memory (Wareham & Salmon, 2006). Taken together, these contributions provide an encouraging perspective on the state of science concerning stress and memory in development and a challenging prospectus for much-needed future inquiry.

References Alexander, K. W., Quas, J. A., & Goodman, G. S. (2002). Theoretical advances in understanding children’s memory for distressing events: The role of attachment. Developmental Review, 22, 490–519. Belsky, J., & Cassidy, J. (1994). Attachment: Theory and evidence. In M. Rutter & D. Hay (Eds.), Development through life (pp. 373–402). Oxford, UK: Blackwell Publishing. Belsky, J., Spritz, B., & Crnic, K. (1996). Infant attachment security and affective-cognitive information processing at age 3. Psychological Science, 7, 111–114. Bost, K. K., Shin, N., McBride, B. A., Brown, G. L., Vaughn, B. E., Coppola, G., Verissimo, M., Monteiro, L., & Korth, B. (2006). Maternal secure base scripts, children’s attachment security, and mother-child narrative styles. Attachment & Human Development, 8, 241–260. Bretherton, I. (1993). From dialogue to internal working models: The coconstruction of self in relationships. In C. A. Nelson (Ed.), Memory and affect in development. Minnesota Symposia on Child Psychology, Vol 26 (pp. 237–263). Hillsdale, NJ: Erlbaum. Bretherton, I., & Munholland, K. (1999). Internal working models in attachment relationships: A construct revisited. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 89–111). New York, NY: Guilford Press. Carpendale, J. I. M., & Lewis, C. (2004). Constructing an understanding of mind: The development of children’s social understanding within social interaction. Behavioral and Brain Sciences, 27, 79–96. Contreras, J. M., Kerns, K. A., Weimer, B. L., Gentzler, A. L., & Tomich, P. L. (2000). Emotion regulation as a mediator of associations between mother-child attachment and peer relationships in middle childhood. Journal of Family Psychology, 14, 111–124. Cummings, E., & Davies, P. (1994). Children and marital conflict. New York: Guilford. Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental socialization of emotion. Psychological Inquiry, 9, 241–273. Eisenberg, N. & Morris, A. S. (2002). Children’s emotion-related regulation. In R. Kail (Ed.), Advances in child development and behavior, Vol 30 (pp. 190–229). San Diego, CA: Academic. Relationships, Stress, and Memory

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Fivush, R., & Nelson, K. (2006). Parent-child reminiscing locates the self in the past. British Journal of Developmental Psychology, 24, 235–251. Gilliom, M., Shaw, D. S., Beck, J. E., Schonberg, M. A., & Lukon, J. L. (2002). Anger regulation in disadvantaged preschool boys: Strategies, antecedents, and the development of self-control. Developmental Psychology, 38, 222–235. Gottman, J. M., Katz, L. F., & Hooven, C. (1997). Meta-emotion: How families communicate emotionally. Mahwah, NJ: Erlbaum. Gross, J. (Ed.) (2007). Handbook of emotion regulation. New York, NY: Guilford Press. Harris, P. L. (2007). Trust. Developmental Science, 10, 135–138. Harris, P. L., & Koenig, M. (2006). Trust in testimony: How children learn about science and religion. Child Development, 77, 505–524. Kirsh, S. J., & Cassidy, J. (1997). Preschoolers’ attention to and memory for attachment-relevant information. Child Development, 68, 1143–1153. Lamb, M. E., Orbach, Y., Hershkowitz, I., Esplin, P. W., & Horowitz, D. (2007). A structured forensic interview protocol improves the quality and informativeness of investigative interviews with children: A review of research using the NICHD Investigative Interview Protocol. Child Abuse & Neglect, 31, 1201–1231. Levine, L., Stein, N., & Liwag, M. (1999). Remembering children’s emotions: Sources of concordant and discordant accounts between parents and children. Developmental Psychology, 35, 790–801. Meyer, S. (2008). The socialization of young children’s emotion regulation strategies: Parental emotion representations, expressivity, and communication style. Unpublished doctoral dissertation, University of California, Davis. Miller, S. M., & Green, M. L. (1985). Coping with stress and frustration: Origins, nature, and development. In M. Lewis & C. Saarni (Eds.), The socialization of emotions (pp. 263–314). New York, NY: Plenum. Nachmias, M., Gunnar, M., Mangelsdorf, S., Parritz, R. H., & Buss, K. (1996). Behavioral inhibition and stress reactivity: The moderating role of attachment security. Child Development, 67, 508–522. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social-cultural developmental theory. Psychological Review, 111, 486–511. NICHD Early Child Care Research Network (2004). Affect dysregulation in the mother-child relationship in the toddler years: Antecedents and consequences. Development and Psychopathology, 16, 43–68. Ontai, L, & Thompson, R. A. (2002). Patterns of attachment and maternal discourse effects on children’s emotion understanding from 3- to 5-years of age. Social Development, 11, 433–450. Ornstein, P. A., Haden, C. A., & Hedrick, A. M. (2004). Learning to remember: Social-communicative exchanges and the development of children’s memory skills. Developmental Review, 24, 374–395. Raikes, H. A., & Thompson, R. A. (2006). Family emotional climate, attachment security, and young children’s emotion knowledge in a high risk sample. British Journal of Developmental Psychology, 24, 89–104. Raikes, H. A., & Thompson, R. A. (2008). Conversations about emotion in high-risk dyads. Attachment & Human Development, 345–365.

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Reese, E. (in press). Maternal coherence in the Adult Attachment Interview is linked to maternal reminiscing and to children’s self concept. Attachment & Human Development. Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. In N. A. Fox (Ed.), The development of emotion regulation and dysregulation: Biological and behavioral aspects. Monographs of the Society for Research in Child Development, 59 (2–3), 25–52 (Serial no. 240). Thompson, R. A. (2000a). The legacy of early attachments. Child Development, 71(1), 145–152. Thompson, R. A. (2000b). Childhood anxiety disorders from the perspective of emotion regulation and attachment. In M. W. Vasey & M. R. Dadds (Eds.), The developmental psychopathology of anxiety (pp. 160–182). Oxford, UK: Oxford University Press. Thompson, R. A. (2006a). The development of the person: Social understanding, relationships, self, conscience. In W. Damon & R. M. Lerner (Eds.), Handbook of child psychology (6th ed.), Vol 3. Social, emotional, and personality development (N. Eisenberg, Vol Ed.) (pp. 24–98). New York, NY: Wiley. Thompson, R. A. (2006b). Conversation and developing understanding: Introduction to the special issue. Merrill-Palmer Quarterly, 52, 1–16. Thompson, R. A. (in press). Early attachment and later development: Familiar questions, new answers. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment (2nd ed.). New York, NY: Guilford Press. Thompson, R. A., Laible, D., & Ontai, L. (2003). Early understanding of emotion, morality, and the self: Developing a working model. In R. Kail (Ed.), Advances in child development and behavior, Vol 31 (pp. 137–171). San Diego, CA: Academic. Thompson, R. A., Lewis, M., & Calkins, S. D. (in press). Reassessing emotion regulation. Child Development Perspectives, in press. Thompson, R. A. & Meyer, S. (2007). The socialization of emotion regulation in the family. In J. Gross (Ed.), Handbook of emotion regulation (pp. 249–268). New York, NY: Guilford Press. Thompson, R. A., Meyer, S. C., & Jochem, R. (2008). Emotion regulation. In M. M. Haith & J. B. Benson (Eds.), Encyclopedia of infant and early childhood development (pp. 431–441). Oxford, UK: Elsevier. Thompson, R. A., & Raikes, H. A. (2003). Toward the next quarter-century: Conceptual and methodological challenges for attachment theory. Development and Psychopathology, 15, 691–718. Wareham, P., & Salmon, K. (2006). Mother-child reminiscing about everyday experiences: Implications for psychological interventions in the preschool years. Clinical Psychology Review, 26, 535–554.

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15 Complications Abound, and Why That’s a Good Thing Patricia J. Bauer

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start this discussion with hearty “Thank You”s and “Congratulations” to all of the contributors, and to Robyn Fivush and Jodi Quas, for bringing them together. The collection that appears between the covers of this volume is impressive indeed. The views and concerns are diverse and multifaceted, yet all coherently and clearly relate to the topic at hand. One is struck by the multiple levels at which riveting questions are addressed, both within and across the chapters. Each chapter makes a unique contribution, yet in myriad ways they complement and extend one another. The authors have done marvelous jobs providing perspective on their research programs, each of which supplies an essential piece of one of the most challenging puzzles in the field of developmental science. I was delighted to serve as a discussant at the Emory Cognition Project symposium itself. I am honored to have the opportunity to comment on the advances described in this volume. I hope that in some small way, my observations further the development of our understanding already so well facilitated by the contributors to this superb collection. The question that served as the centerpiece for the Emory Cognition Project symposium that gave rise to this volume, and which concerns all of the chapters in this collection, is familiar indeed. How stress and memory relate to one another has been the subject of empirical attention for well over a century, and the object of speculation long prior to that. In one way or another, virtually every chapter in this collection makes clear why the question endures. Put simply—“it’s complicated.” Yet given our aesthetic attraction to clear, concise answers to questions, and the limits on information-processing capacity from which we suffer, 374

we have treated a single answer to this question as the Holy Grail, doggedly pursuing the one true formula that would reveal the relation for all to appreciate. For those who at the beginning of this volume still held out that hope, I am sorry that you were disappointed! I trust that you were because the one simple truth revealed in the pages of the chapters of this book is that there is no formula or single answer to the question of how stress and memory are related to one another. On the other hand, for those who relish a challenge, this volume is immensely satisfying in that it maps out for us in clear and compelling ways the ground that we must cover as we seek an understanding of how stress and memory combine. Why does a simple answer to the question of how stress relates to memory elude us, and why am I pessimistic that we can ever hope to generate a “10 words or less” answer to the question? I am optimistic that the challenge will endure for three simple reasons. First, memory is complicated. Second, the “events” that are the subject of our memories—and the many factors that affect our understanding of them— are complicated. Third, our reactions to those events—including stress reactivity—is, you guessed it, complicated. Curiously, although the subject of the Emory Cognition Project symposium was “stress and memory,” none of the speakers took as her or his primary object the subject of memory, per se. Since convincing the reader that memory is “complicated” is central to my thesis, I say a few words about memory itself, before moving on to discussions of the complications created by events and by stress. After utterly and thoroughly convincing you of the hopelessness of a simple answer to a challenging question, I end my remarks with some prescriptions for future foci of study (yes, yet more complications).

Memory Is Complicated I am convinced that one of the reasons that I am interested in memory in general and in the development of memory in particular is because it is such a challenging domain. Memory is not a unitary trait; it is not pudding. Pudding is a homogeneous entity. When you put a spoon into a bowl of pudding, you draw out pudding. Each spoonful looks like the last spoonful. Comments, characterizations, and truths that you declare about one spoonful are equally true of the next, and the next, and the next. Michael Maratsos—from whom I borrowed this metaphor—used it to make a point about language, namely, that there are many different aspects of language, including phonology, morphology, semantics, syntax, and pragmatics. In other words, language is not pudding. Laws that apply in the domain of phonology do not necessarily hold true, or even Complications Abound, and Why That’s a Good Thing

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have relevance, in the domain of syntax, for example. Thus, one cannot sample “language” and make broad characterizations (see Maratsos, 1998, for discussion of the conceptual pitfalls of considering heterogeneous domains such as language to be essentially homogeneous, or qualitatively the same throughout). As I discussed in Bauer (2007), this point is equally valid about memory. There are many different types of memory and many ways that it can be divided. One common division is along a temporal dimension—some memories are short term: they last only seconds. Others are long term and may even last a lifetime. Other divisions of the thing we call “memory” range from the type of content of the memory (e.g., whether it is of facts and figures or personally relevant events), to the brain structures that we think are responsible for it. If memory were pudding, then we could select any given memory phenomenon and use it to describe and characterize all of memory. Memory is not pudding, though, and that makes it critical that we be explicit about the type of memory we have in mind when we talk about relations between memory and stress. Though few of the authors of the chapters in this volume are explicit about it (Compas, Campbell, Robinson, & Rodriguez [Chapter 5] being an exception), virtually all are concerned with declarative memory. That is, they are concerned with memories that are consciously and thus potentially verbally accessible, as opposed to skills, habits, or procedures that may influence our behavior, but which are inaccessible to consciousness. Moreover, virtually all of the authors are concerned with a particular type of declarative memory, namely, episodic as opposed to semantic memory. As the name implies, episodic memories are of specific events or episodes, as opposed to the timeless, placeless memories that make up our stores of world knowledge. What is more, virtually all of the authors are concerned with a particular subtype of episodic memory, namely, autobiographical or personal memory. Autobiographical memories are episodic memories that are self-relevant and even selfdefining. It is this feature that puts the auto in autobiographical. As my own “friendly amendment” adaptation of a figure from Nelson and Fivush (2004) illustrates (see Figure 15–1), autobiographical memory depends on a large number of domains, components, and processes. Each of the entities has its own developmental trajectory. As each develops, more and more memories take on the special status of “autobiographical” (see Bauer, 2007, for discussion). The relation of two of the components to autobiographical memory is transparent, namely, “Conversations about the past and future” and “Narrative structure and content.” The role of conversation in autobiographical memory is easy to appreciate. It is, after all, in conversations with others that we share our past experiences. Talk about the past freely intermixes with talk about 376

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Self Representation Theory of Mind

Cognitive Self Beginning Language Core Self Basic Memory (implicit/explicit) Social Interaction/Communication/ Intentionality

Complex Language Representational

Semantic Memory

Conversations about the Past & Future

AUTOBIOGRAPHICAL

Episodic Memory

MEMORY

Mental Concepts

Temporal Concepts

Narrative structure and content

with Developmental Time…

OGRAPHICAL

AUTOBI

Figure 15–1. Adaptation of Figure 1 from Nelson and Fivush (2004), reflecting the numerous domains that lend an autobiographical flavor to episodic memories, each with its own developmental course, such that over time, memories take on an increasingly autobiographical persona (see Bauer, 2007, for elaboration of the argument).

upcoming, anticipated, or future events. The role that narrative structure and content play in autobiographical memory is also easy to appreciate. We use narratives to tell the tales of our lives; the narratives have both form and content. Inspection of Figure 15–1 makes clear that the status of a memory as autobiographical rests on more than conversation and narrative, however. Memories that are truly autobiographical also depend on developments in self concept (continuity over space and time), in temporal concepts (enabling location of events on a personal timeline), and in appreciation of the representational nature of mind (that mental contents can reflect an event from the past; that others might perceive an event differently than I do). It is as all of these “moving parts” develop that episodic memories become more recognizable as personally relevant or autobiographical (see Bauer, 2007, for elaboration of this argument). This brief tour should make clear that to understand how stress and memory are related, we are going to have to consider the developmental status of the memory system itself. Carver and Cluver (Chapter 11) make this point when they talk about the impact of stress on the neural substrate implicated in episodic (and thus, autobiographical) memory (discussed below). It is implicit any time “age at the time of experience of the event” is considered. Yet of course, age is only a proxy for the developmental status of one or more of the components in Figure 15–1.

Events, and Our Understanding of Them, Are Complicated When we think about relations between stress and memory, we take as a given that memory is of or for something. That is, something, typically a specific event, is represented in the mnemonic trace that is being affected (or not) by stress. This is so obvious as to be trivial, yet it is potentially anything but. In their chapter (Chapter 3), Peterson and Warren specifically entertain the possibility that the nature of the to-beremembered event might influence relations between stress and memory (see also Wallin, Quas, & Yim [Chapter 12]). They speculate that the variability in findings across the literature might relate to the nature of the distressing event. However, on the basis of a large data base from a very productive research program, Peterson and Warren conclude that at least within the domain of personal injury necessitating visits to the emergency room (for treatment of bone fractures, lacerations requiring sutures, and so forth), there is no effect of the nature of the event on children’s immediate or later (sometimes years later) recall. 378

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To some extent, Peterson and Warren’s conclusion flies in the face of what we know about memory. We all know that highly stressful events are processed differently than events that are not highly stressful. Yet barely a moment’s reflection reveals the flaw in this argument: What, exactly, makes an event stressful? We can all agree that certain categories of events are good candidates for classification as “stressful.” The personal injuries studied by Peterson and Warren certainly fall into this category. The bloody-murder screams that some of the subjects in their research produce are consistent with this classification. Yet other children are cool, calm, and collected, and both they and their parents rate them as experiencing a relatively low level of distress. If a broken arm produces no overt signs of distress, is it still stressful? What if in addition to no overt signs of distress, covert or physiological signs also are lacking? In the absence of changes in heart rate, respiration, pupil dilation, galvanic skin response, and so forth, is an event “stressful”? The question of whether an event can be considered “stressful,” even if the experiencer shows no overt or physiological signs of distress, goes to the age-old distinction between the nominal and the functional stimulus. Nominally, a broken arm, or experience of a hurricane (Bahrick, Parker, Merritt, & Fivush, 1998; Fivush, Sales, Goldberg, Bahrick, & Parker, 2004), tornado (e.g., Ackil, Van Abbema, & Bauer, 2003), or physical abuse (see Greenhoot, Johnson, Legerski, & McCloskey, Chapter 4), is stressful. These events are potentially life threatening. At the very least they produce physical changes in the body that are detrimental to well-being (e.g., tissue damage, blood loss). Yet what several of the chapters in this volume make clear is that these events are not necessarily interpreted as stressful and thus, functionally, they may not be stressful. And even if they are, as discussed by Alexander and O’Hara (Chapter 9), they need not necessarily set into motion the chains of events that constitute the mechanisms by which “stress” influences “memory” (discussed in Carver & Cluver, and Wiik & Gunnar [Chapter 10], in particular). Conversely, events that for most of us would not be considered stressful or only mildly so (e.g., presenting a lecture in a class), may for others present insurmountable odds and occasion a doozey of a stress response. A variety of factors determine whether an event is perceived or experienced as “stressful.” Critically, as discussed at length by Baker-Ward, Ornstein, and Starnes (Chapter 2), events also can change their status over time and with development (more on this later). For an event to be considered stressful, the experiencer must appreciate the threat to physical or psychological health (to self or others) that it poses. If I lack the requisite knowledge of potential harm, there is no basis for interpretation of the event or experience as stressful. In many domains, children may well Complications Abound, and Why That’s a Good Thing

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lack the requisite knowledge and remain blissfully unaware of the potential harm. Alternatively, either through their own interpretation or with the aid of a parent or other more learned soul, children may interpret an otherwise threatening situation as “safe,” and thus more a matter of curiosity than reason for fear. The fact that my bone is sticking out of my arm at the point of a compound fracture is “way cool” if I am studying anatomy in school and/or my doctor makes it a point of pride that my fracture is the “worst one” she has seen today. The point is that events are not inherently stressful or not stressful. It is our knowledge of the potential consequences of the event and our interpretation of the opportunities they afford that confers upon events the status of “stressful.” Thus, any answer to the question of how stress relates to memory for an event must consider whether the event was in fact stressful, and just how stressful it was. To further complicate matters, the status of events as stressful or not can change over the course of time and development. Baker-Ward and colleagues talk about the concept of “extended encoding” to capture the dynamic feature of the status of events as stressful. They point out that understanding is a process that is extended through time. We construe and reconstrue events and as we do so, our memories of them may change. In this conceptualization, the “stressful” nature of events may be recognized at the time the event is experienced and initially encoded, or only later, as new knowledge about the world accrues. The emphasis is on the significance of the event for the individual, as opposed to the nominal qualities of the experience. The personal significance of the event, as well as the emotional assessment of it, can even alter or influence the likelihood that the event will be reexamined and updated as to its current significance. For example, the pride you feel at the extent of your compound fracture may encourage you to talk freely about the experience, opening yourself up for alternative interpretations of the event (e.g., compound fractures are not “awesome,” but scary and stressful). Alternatively, the shame that we might feel at breaking the prohibition that led to the fracture in the first place might cause us to avoid conversation about it. Finally, several of the chapters make the critical point that children are not alone in their interpretations and reinterpretations of events as “stressful.” The contributions of Greenhoot et al., Johnson, Legerski and McCloskey (Chapter 4), and Sales (Chapter 8), in particular, highlight the critical role that conversations with parents about stressful events play in influencing children’s understanding and appreciation of the significance of events for their lives and thus their memories for the events. It is now well documented that the way parents and children talk together about past events has profound impacts on memory for the specific events discussed as well as autobiographical memory reporting generally. When conversation is with a partner who elaborates on the child’s 380

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contributions to the discussion, the child tends to be more engaged in production of the narrative and to report more about the event. Over time, these children produce longer and more detailed narratives about past experiences both with elaborative conversational partners and in independent production. Their narratives not only include more information about the event in general, but about the relevance of the event for the child. These and other findings highlighted in the chapters in this volume make clear that how parents and their children talk about past events is critical to the meaning that children make of the stressful experiences in their lives. Conversational partners play a major role in the way children come to represent and share the stressful (and other) events of their lives. Several of the chapters in the volume argue that the impact of these conversations extends beyond event memory to influence self and emotion regulation, coping, and well-being. For example, Laible and Panfile (Chapter 7) make the argument that through conversations in general, children learn about relationships and about emotion. Conversations about events that have passed are especially important because they provide opportunity to examine emotional reactions after the emotion has dissipated, freeing cognitive resources that can be devoted to reflection on the parent’s message. When conversations about negative emotion take place in the context of the sensitive and caring relationships that characterize secure attachments of children and caregivers, children learn important skills for regulating their emotions and coping with stressful events and life circumstances. Oppenheim and Koren-Karie (Chapter 6) equate sensitive maternal guidance and structure of conversations about past events to a “psychological secure base” from which children can explore the emotional significance of events. Sensitive guidance contributes to children’s openness and cooperation in conversations about the past, thus affording opportunities for examination of the significance of life events. Compas, Campbell, Robinson, and Rodriguez argue that the implications of such conversations extend well beyond memory for past events, to influence skills for adaptation to stress and coping more broadly. The chapters by Chae, Ogle, and Goodman (Chapter 1) and Alexander and O’Hara help to close the circle (or more accurately, the spiral) by articulating critical links between the characteristics of relationships in which children discuss past events, the characteristics of the child, and the basic memory processes involved in encoding, consolidation, storage, and retrieval of events. Chae and colleagues argue that, because stressful events threaten safety and security, they inevitably trigger the attachment system. As a result, the internal working models that children have formed about relationship are brought “into play” as children attend to and encode the events and we may presume, as encoding Complications Abound, and Why That’s a Good Thing

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extends through time (Baker-Ward, Ornstein, & Starnes). This influences the aspects or features of the events to which children attend and thus, in critical ways, what they remember. Alexander and O’Hara point out that these processes are further impacted by the temperament and reactivity of the child, which in turn relate to the physiological systems underlying emotional memory. These influences operate not only on the memory trace itself, but may even impact children’s responses when queried about the events later on, thus affecting the quality of eyewitness testimony and susceptibility to suggestive questioning.

Our Reactions to Stress Are Complicated “Your Brain on Stress,” is the catchy title of John Spiro’s review of The End of Stress as We Know It (McEwen & Lasley, 2002). Our reactions to stress—neural and otherwise—are yet another source of complication in our endeavor to understand relations between stress and memory. If our reactions were main effects, then assuming we had resolved all the complications of “memory,” and all of the complications of “events,” we would be able to understand how our reactions to stressful events influenced memory. Yet as the chapters by Alexander and O’Hara; Carver and Cluver; Wallin, Quas, and Yim; and Wiik and Gunnar make clear, we cannot characterize “our brains on stress” in main effect, or even higher-order interaction, terms. Rather, as these authors skillfully illustrate, our neural and physiological reactions to stress are dynamic “events” affected by myriad factors, as diverse as the time of day the event occurs (the ability of the system to adaptively respond to release of glucocorticoids, a.k.a, stress hormones, varies over the course of the day), the time the response is measured relative to the timing of the stressor (it takes time for the body to mount a stress response; there are both slow- and fast-acting glucocorticoids), the age of the experiencer (effects of prenatal and postnatal stress are not the same; the Hypothalamic Pituitary Adrenal, or HPA, axis implicated in the stress response itself develops), the history of exposure to stress (mildly stressful experiences early in life can actually have a positive effect, at least if you are a rat), interpretation of the event (the amygdala moderates memory for emotional events), and the history of sensitive caregiving (secure attachment seemingly “buffers” children from exhibiting significant HPA activation in threatening situations). This brief—and woefully incomplete—list illustrates the challenge that we face as we attempt to understand biological reactions to stressful events. Our understanding of reactions to stress is further complicated by the fact that we cannot directly observe them. Of course, this is 382

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true of most of the phenomena in which psychologists are interested. Somehow it seems worse in the case of our reactions to stress, however: They seem almost perverse in their lack of transparency. One complicating issue is that there are multiple different ways of measuring stress. That alone is not a problem. It could in fact be seen as a virtue. But in the case of stress responses, it seems not a blessing but a curse because the different assessments of “the same thing” often are not correlated with one another! Different observational measures—such as ratings by a parent and a medical care provider—may be correlated. Self-report and other report (again, by parent or other care provider) sometimes are correlated and other times not (Wallin, Quas, & Yim), though at least on occasion, they tell the same story (Peterson & Warren). Measurement problems really become apparent when stress is measured at different levels of analysis, such as via overt behavior and physiological responses. As Wallin, Quas, and Yim make abundantly clear, in the case of ratings of behavior and measurements of physiological function, it seems that the numbers sometimes do lie. Acute stress is associated with a number of physiological responses, including changes in cortisol and in sympathetic arousal and parasympathetic withdrawal. Cortisol can be measured in plasma (e.g., Gunnar, Connors, & Isensee, 1989) and in saliva (discussed in Wiik & Gunnar). Changes in sympathetic arousal can be measured via EKG, and parasympathetic withdrawal is indexed in respiratory sinus arrhythmia (RSA; Wallin, Quas, & Yim). Many have tried—and failed—to fi nd relations between these (and no doubt other) physiological measures and behavioral ratings of stress. Some scholars, including Wallin and colleagues, use the absence of correlations between measures to argue that one measure or another be used as the “true” index of stress. They favor physiological indices, noting that children might be able to control their emotional expressions or self-reports but they cannot volitionally control their physiological responses, rendering them more “truthful.” My own inclination is to suggest that no means of assessment be banned or elevated to the status of “truth.” In all likelihood the most appropriate measure will depend on the question of interest. For example, if we want to know how parents help children cope or regulate their emotions, we likely should examine parents’ sensitivity to children’s overt behavioral responses. If on the other hand we want to know whether children are likely to attend to some specific feature of an event, we may want to know how physiologically aroused they were at the time it occurred. In other words, what is needed is a more nuanced approach, one acknowledging that the “right” answer might be “both/and” rather than “either/or.” Complications Abound, and Why That’s a Good Thing

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How Could Relations between Stress and Memory Be Anything but Complicated? In light of the seemingly endless “complications” of memory, events, and our reactions to them, we now must ask how we could expect relations between stress and memory for events to be anything but immensely complicated. The chapters in this volume aptly demonstrate that to advance in our understanding of the dynamic interplay between stress and memory, we are going to need to adopt a “molecules-to-mind” approach, analyzing the problem not only in terms of its many components (Figure 15–1), but also in terms of multiple levels of analysis. Our task is not to identify the deterministic relation between stress and memory, but to determine what factors matter at each level, in a principled way. It was not always the case that we understood that multiple, rather than single, factors influence memory, or that the influences are in terms of “interactions all the way down.” In the not-too-distant past, we operated under the assumption that the relation between stress and memory was direct, such as depicted in Figure 15–2. In such a model, stress produces either enhanced or impaired memory performance. If we were feeling really nuanced, we recognized that the relation might actually be U-shaped, such that too much or too little stress produced poor memory, whereas an amount of stress that was “just right” produced optimal memory (Easterbrook, 1959). This model inevitably gave way to one suggested by some of the early experiments described in several of the chapters in this volume. The newer conceptualization was that depicted in Figure 15–3. This model explicitly recognizes that stressful events are associated with both physiological reactions and distress behaviors, and that these “intermediaries,” rather than the stressful event itself, stand to be related to memory. This view seemingly guides work in which we look for direct relations (a) between a stressful event and a variety of physiological reactions, including sympathetic activations, parasympathetic withdrawal, and/or HPA axis activation; and (b) between one or more of these reactions and memory performance. Similarly, the view is apparent when we look

Stressful Event

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Figure 15–2. Schematic representation of a direct relation between a stressful event and subsequent memory for it. 384

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Physiological Reaction Stressful Event

Memory Performance Distress Behaviors

Figure 15–3. Schematic representation of relations between a stressful event, physiological reactions and distress behaviors associated with it, and subsequent memory for the event.

Physiological Reaction Stressful Event

Moderators

Memory Performance

Distress Behaviors

Figure 15–4. Schematic representation of relations between a stressful event, physiological reactions and distress behaviors associated with it, moderators of those reactions, and subsequent memory for the event.

for relations (a) between a stressful event and various distress behaviors, including crying, reports of distress, and ratings of pain; and (b) between one or more of these behaviors and memory performance. These investigations are a vast improvement over the more “straightforward” approach depicted in Figure 15–2. Yet perhaps their greatest contribution has been to make clear that we need at least one more box in our model. The missing box—added in Figure 15–4—contains the numerous moderating variables that fold, spindle, and mutilate relations between stress and memory performance. Within the volume are entire chapters (or portions thereof) detailing the important variance in memory accounted for by the child’s typical reactions to everyday and unique events (a.k.a. temperament); the conditions under which memory reports are elicited (e.g., the interviewer’s “style”: the interviewer’s emotional tone or openness); the style of the child’s more typical conversational partner, namely, the parents; and even the attachment status of the Complications Abound, and Why That’s a Good Thing

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parent-child dyad (though it seems possible that attachment status may matter for negative events only), to name a few. Clearly, we have come a long way from the straight line depicted in Figure 15–2. Another insight that flavors the pages of this volume is that when we ask how “stress” relates to “memory,” we must be careful to specify whether we are talking about acute or chronic stress, and whether we are talking about memory for a particular stressful experience or memory capacity, more broadly. Studies of children’s memories for emergency medical procedures (Peterson & Warren), fire alarms (Wallin, Quas, & Yim), and the events surrounding tornadoes (Ackil et al., 2003) and hurricanes (Bahrick et al., 1998), are of acute, one time only experiences. In these cases we typically are interested only in children’s memories for the target event. If other events are queried, it is in the service of a comparison or control (e.g., Ackil et al., 2003). The other “prototype” is the study of memory capacity—as opposed to memories of a specific event—in individuals who have experienced chronic stress either pre- or postnatally. Many of the animal model studies reviewed in the chapter by Carver and Cluver (for example) are of this ilk. The third cell of the 2 × 2 matrix would contain studies of relations between acute stress and general memory capacity. This relation is not often the subject of inquiry and is not represented in the present volume. The final cell of the 2 × 2 matrix contains studies of chronic stress on children’s memories for specific events. In the current volume, this cell is filled by Greenhoot, Johnson, Legerski, and McCloskey, and their examination of the impact of the chronic stress associated with exposure to and/or experience of family violence. Their interesting findings indicate that the atypical memory patterns observed in this sample (e.g., overgeneral memories of early childhood) are not explained by the chronic stressor itself, but may be attributed to broader emotion management or regulation tendencies and socialization histories. Perhaps more than any other, this cell reminds us of the need to examine multiple determinants at different levels.

We Still Have a Long Way to Go Even as we celebrate how far along the path to enlightenment we have moved, we recognize that we still have a very long way to go before we can be said to have “arrived” at an adequate understanding of relations between stress and memory, be it acute or chronic, and be it specific or general. My inventory of the content of the talks delivered at the Emory Cognition Project symposium itself, and of the excellent chapters in this volume, identified five “themes” in particular that require further 386

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development. I devote the balance of this chapter to these themes, in the hopes that the next generation of studies might feature them more prominently.

More on Cognition One of the “truths” about our understanding of relations between stress and memory is that it is going to be informed by our understanding of memory and its development. Yet by and large, the chapters in this volume paid relatively little attention to the basic processes of memory. There are any number of questions that are relevant to our understanding of stress/memory relations. First, there is little in the literature to date that informs regarding what was encoded about the event (stressful or otherwise) to begin with. This is a critical missing piece since what was encoded initially is an important determinant of what will be available to be retrieved later on. In the absence of information about what the child encoded at the time of the event, we cannot truly understand how moderators operate to inform the outcome of memory. The second, and related, question is how various moderators relate to encoding. How does the attachment status of a child, for example, influence what is encoded about a stressful event? How does the child’s temperament relate to encoding? And so forth. This is not to say that the power of these factors is ignored: Chae, Ogle, and Goodman, and Alexander and O’Hara, in particular, highlight moderators of the focus of attention. These and similar questions are critically important and with this comment I mean to encourage further development of them. Third, at present, we know very little about postevent appraisal and reappraisal. The experience of the event—encoding of it—is only the first step on a long road of memory processing. Postencoding, but prior to retrieval, memory traces undergo consolidation, a process by which initially labile traces are stabilized and integrated with existing stored memory representations. Subsequent references to the event, intentional or otherwise, cause the event to be reinstated in memory. With every reinstatement comes an opportunity for reencoding and reconsolidation (see Bauer, in press, for discussion). Baker-Ward, Ornstein, and Starnes refer to these processes as “extended encoding.” Recognition that encoding of any event is “extended” is important; in the case of stressful or traumatic events it may be critical to progress in understanding memory for them. We need to know more about the time course of consolidation of memory traces generally, and whether the processes or the time frame for stressful events is any different. Fourth, the current literature is virtually mute on the question of how new knowledge “feeds back” on existing memory representations. We Complications Abound, and Why That’s a Good Thing

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have long known that knowledge and memory interact (e.g., Bjorklund, 1987; Chi, 1978). We also have suggestions that children’s knowledge at the time of an event influences what they remember about it. For example, in Pillemer, Picariello, and Pruett (1994), children who were older at the time of an unexpected fire alarm in their school had more accurate memories for the event two weeks and six years later, a fact that Pillemer and colleagues attributed to their greater knowledge base at the time of the experience. No one would deny that knowledge increases over the course of development, yet how new knowledge informs existing memories is not known. The question must be asked. Finally, although the state of the art with regard to our knowledge about memory and its development is healthier than ever before, we still have large tracts of ignorance. On any question for which we do not have an answer, we also do not have an answer for how the issue is affected by the stressful or traumatic nature of the event. In this case ignorance is not bliss. What we do not know can harm us. These questions about cognition and basic memory processes are critically important not only to understand how any given stressful or traumatic event might be remembered, but also because memories of old events inform interpretation of new events. That is, memory for Event 1 influences our perception of Event n + 1, and all subsequent events. Memory also influences our physiological reactions and our distress behaviors. No doubt, it also influences moderating variables. Thus, we are not talking just about how stress and memory for any given event relate, but how stress and memory at T1 relate to T2 perception and management of stress, as well as others’ thoughts, reflections, and reactions to the experiencer’s thoughts, reflections, and reactions. It is not a circle, but a spiral: early events influence later events. As such, memory for early events is critically important to understanding of how memory for later events will play out.

More on the Reactions of Others to Events When we talk about relations between stress and memory, we talk about the stress experienced by the target child or person, and the target child’s or person’s subsequent memory for the event. Some events—such as child sexual abuse—are private (or are kept private for a time) and it may be only the voice of the perpetrator that sounds in the child’s head as she or he thinks back on the event. Other events—such as a tornado that rips through a small rural town—affect entire communities. The private versus public nature of an event no doubt impacts memory, yet we know virtually nothing about how the appraisal of others relates to children’s memory. Of course, several of the chapters in this volume 388

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consider the influence of parents and other caregivers in helping children to gain perspective on events, to regulate their emotions, and to cope with the unfortunate circumstances of life. Others focus on relations between the way mothers and their children talk about past events and children’s subsequent narratives of these and other events. Yet there are few studies of what others have to say about an event, and how others’ appraisals affect later memory and narrative production. One such examination was of the internal states language (e.g., emotion words) that mothers and their children used as they talked about the event of a tornado that devastated their town (Bauer, Stark, Lukowski, Rademacher, Van Abbema, & Ackil, 2005). Mothers who used negative emotion language to talk about the tornado had children who six months later themselves used more negative language. In this example, that appraisal of another at Time 1 was directly related to how children appraised the event (or at least, how they talked about it) at Time 2. Effects such as these are potentially pervasive and, as such, deserve our attention. Another aspect of the reactions of others to which we have not paid adequate attention is the negative or positive coping behaviors in which others engage. When a child is rushed to the hospital for treatment of accidental injuries (Peterson & Warren) or an asthma attack (Fivush & Sales, 2006; Sales & Fivush, 2005), in all likelihood, the rushers (children’s parents) are themselves experiencing some stress. How they cope with the situation, both outwardly and inwardly, likely affects the child’s own interpretation and assessment of the situation and thus, her or his subsequent memory for it. This subject is not far from the minds of many authors in this volume when they think about and examine how mothers and their children work together to make sense of past events. Yet to date, there has been little focus on the adult actors in these interactions, as opposed to the dyad itself. What I am suggesting is that we attend to the overt coping behaviors of parents and other adults surrounding the child during and after a stressful event, as possible determinants of children’s subsequent memory.

More on How Events Become Integrated into the World View The reactions of parents and others close to the child are critical to informing the child’s evaluation of events and experiences. Also critical are the views of the larger society. When something bad happens, it matters whether your social group or culture responds that “bad things happen to good people,” or with the sentiment that individuals earn their misfortunes and thus bring punishments upon themselves. How children make sense of the experiences of their lives thus is critically informed Complications Abound, and Why That’s a Good Thing

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by how their social group and culture make sense of similar events. Because most of the research on relations between stress and memory has taken place within Western societies with overlapping cultural values, we know little about cultural influences on perceptions of stressful and traumatic events and how those perceptions shape children’s interpretations and subsequent memories. Also of importance as we think about how stressful and traumatic events become integrated into the world view are cultural and societal prohibitions or regulations on the expression of emotion and other responses to such events. It is reasonable to speculate that in cultures and subcultures with prohibitions on expression of distress and negative emotion, we will not see strong relations between overt distress behaviors (crying, reports of distress, ratings of pain) and subsequent memory (see Figure 15–3). We may even expect to find changing patterns of relation between physiological reactions (sympathetic and HPA activation, parasympathetic withdrawal) and subsequent memory as children become socialized regarding overt behavior, which can be expected to feed back on physiological reactions. In short, it is not sufficient to stop at the family door when examining the responses of those around the child to the events of their lives. We must look to the larger social milieu for possible sources of influence on children’s evaluation of their experiences and thus their memories for them.

More on What We Mean by “Stress” and How (and Whether) It Differs from Emotion Most of the chapters in this volume focus on stress and trauma, and how they might relate to memory. Yet a minority of chapters declare themselves interested in “emotion” (Alexander & O’Hara; Laible & Panfile; Oppenheim & Koren-Karie). I wonder whether the difference is more than semantic, and I encourage us to find out. Surely in the case of positive emotion, emotion and stress are not the same at all. On the other hand, many “happy” events—such as marriage (or remarriage) and the birth of a child, for example—are quite stressful. These positive events add to our life stress factor, yet I dare say that we would be hard pressed to convince an NIH study section or council that we need to study how such experiences influence memory. Conversely, not all negative emotion produces stress. Is disappointment, such as over a broken toy or missed opportunity, “stressful”? Surely there is negative emotion associated with disappointment, but is it “stress”? The point of asking whether “emotion” and “stress” are the same thing is not to split hairs but to encourage deeper reflection on whether models of “emotional memory” (Alexander & O’Hara) and of how stress 390

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affects the brain system underlying explicit memory (Carver & Cluver), for example, are models of the same thing at all. Do emotions, even negative ones, induce the type of stress response described by Wiik and Gunnar or Carver and Cluver? Do they necessarily influence the physiological responses that are the subject of inquiry in Wallin, Quas, and Yim? Do positive experiences that are nonetheless stressful produce the same type of reactions? Is stress produced by strong negative emotion and, if so, does strong positive emotion do the same thing? If stress and emotion are not the same, then we have a whole new task before us, which is to understand how emotion differs from stress in terms of relations with memory. Even as I say this, I recognize the danger of finding ourselves in the measurement morass described earlier. Yet it is important to keep this question in mind, because, just like language and memory, “stress” and “emotion” are not pudding.

More on Development The real elephant that was not especially salient in the room during the Emory Cognition Project symposium and which is not especially wellrepresented in the chapters in the volume is development. Although several contributors talk about age differences in memory and memory behavior, most have little to say about possible sources of age-related change. There is no lack of candidate sources of change in memory and in relations between stress and memory, including basic memory processes (encoding, consolidation, storage, retrieval), attentional control, world knowledge, coping strategies, self-concept and integration of events therein, physiological processes, distress behaviors, and more. Just as each of the domains that “feeds into” autobiographical memory (Figure 15–1) has its own developmental course, so too does each of these arenas have its own developmental course. We need to consider not only age-related differences and changes, but also the mechanisms of developmental change. What is more, we must consider the mechanisms of change and how they relate to factors such as perception of the event, physiological and behavioral reactions, moderators (both the “popular” candidates and those of less focus), and expressions or manifestations of memory. This is a tall order, but one that must be filled if we are to understand relations between stress and memory in development.

Closing Thoughts As a student of autobiographical memory, the question of why some events and episodes are remembered and others are forgotten is a Complications Abound, and Why That’s a Good Thing

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source of constant curiosity. One of the major candidate determinants of whether an event will be remembered, how much will be remembered, and how accurately it will be remembered, is the level of stress induced by the event. The expectation of systematic relations between stress and memory is a part of our formal theories of mnemonic processes as well as our folk theories of how memory works. Yet one thing that is patently obvious from the chapters in this volume is that the relations may be systematic, but they are not direct, simple, or straightforward. And I would say that at this moment in time, we are struggling to uncover whatever systematicity may exist. Although “struggle” often has a negative connotation, in this circumstance, I do not mean it that way. That is, I do not remark on our “struggle” out of a sense of defeat. On the contrary, we have made substantial and significant progress in addressing the critical question of how stress and memory relate to one another. An index of the success of our endeavors is the sheer number of determinants and moderators of stress-memory relations that we have identified. They include those that are obvious, such as the nature of the event itself, the amount of time that has passed since the event, and the age or developmental status of the experiencer, as well as several that are less obvious, such as the experiencer’s evaluation of the significance of the event, the actions and reactions of relevant others privy to it, and the broader context in which the event takes place. These and many other determinants help to illustrate the two major “lessons” I learned at the Xth Emory Cognition Project Symposia in Cognition, namely, that memory is complicated, and that relations between stress and memory are even more complicated than that. The good news is that these challenging questions have attracted the attention of some of the “best and brightest” in the field. Their efforts—summarized on the pages of this volume—are allowing us significant progress not only in appreciation of the complexity of the problem, but in the natural elegance of the solutions.

References Ackil, J. K., Van Abbema, D. L., & Bauer, P. J. (2003). After the storm: Enduring differences in mother-child recollections of traumatic and nontraumatic events. Journal of Experimental Child Psychology, 84, 286–309. Bahrick, L. Parker, J., Merritt, K., & Fivush, R. (1998). Children’s memory for Hurricane Andrew. Journal of Experimental Psychology: Applied, 4, 308–331. Bauer, P. J. (2007). Remembering the times of our lives. Memory in infancy and beyond. Mahwah, NJ: Lawrence Erlbaum Associates.

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Bauer, P. J. (in press). Learning and memory: Like a horse and carriage. To appear in A. Woodward and A. Needham (Eds.), Learning and the infant mind. New York, NY: Oxford University Press. Bauer, P. J., Stark, E. N., Lukowski, A. F., Rademacher, J., Van Abbema, D. L., & Ackil, J. K. (2005). Working together to make sense of the past: Mothers’ and children’s use of internal states language in conversations about traumatic and non-traumatic events. Journal of Cognition and Development, 6, 463–488. Bjorklund, D. F. (1987). How age changes in knowledge base contribute to the development of children’s memory: An interpretive review. Developmental Review, 7, 93–130. Chi, M. T. H. (1978). Knowledge structures and memory development. In R. S. Siegler (Ed.), Children’s thinking: What develops? (pp. 73–96). Hillsdale, NJ: Lawrence Erlbaum Associates. Easterbrook, J. A. (1959). The effect of emotion on cue utilization and the organization of behavior. Psychological Review, 66, 183–201. Fivush, R., & Sales, J. M. (2006). Coping, attachment, and mother-child narratives of stressful event. Merrill-Palmer Quarterly, 52(1), 125–151. Fivush, R., Sales, J. M., Goldberg, A., Bahrick, L., & Parker, J. F. (2004). Weathering the storm: Children’s long-term recall of Hurricane Andrew. Memory, 12, 104–118. Gunnar, M. R., Connors, J., & Isensee, J. (1989). Lack of stability in neonatal adrenocortical reactivity because of rapid habituation of the adrenocortical response. Developmental Psychobiology, 22, 221–233. Maratsos, M. (1998). The acquisition of grammar. In D. Kuhn & R. S. Siegler (Volume Eds.) Cognition, perception, and language, Vol 2; W. Damon (Editor-in-Chief), Handbook of child psychology, Fifth Edition (pp. 421–466). New York: John Wiley and Sons. McEwen, B., & Lasley, E. N. (2002). The end of stress as we know it. Washington, DC: Joseph Henry Press. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social cultural developmental theory. Psychological Review, 111, 486–511. Pillemer, D. B., Picariello, M. L., & Pruett, J. C. (1994). Very long-term memories of a salient preschool event. Applied Cognitive Psychology, 8, 95–106. Sales, J. M., & Fivush, R. (2005). Social and emotional functions of motherchild reminiscing about stressful events. Social Cognition, 23, 70–90. Spiro, J. E. (2003). Your brain on stress. Review of McEwen, B., & Lasley, E. N. (2002), The End of Stress as We Know It. Nature Neuroscience, 6, 13.

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16 Emotion and Memory in Development Clinical and Forensic Implications Karen Salmon Rowena Conroy

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hen a maltreated child undergoes evaluation in a clinical context or is involved in a forensic investigation, an understanding of the complex relations between emotion and memory is essential if we are to respond effectively to the child’s needs. The clinician and forensic investigator alike must take into account how emotionally charged experiences are represented in memory and how they can be retrieved and reported for the specific purposes of the evaluation or interview. The clinician is additionally charged with the planning of an effective approach to treatment; this, in turn, entails an appreciation of how memories influence children’s psychological adjustment and their impact on children’s ability to function in everyday contexts. The chapters in this volume, which provide several different “windows” on the association between emotion and memory, therefore have potentially far-reaching implications, translating into significant benefits for the most vulnerable of children. Collectively, the contributions to the volume converge on a compelling account of how children’s emotional memories—and in particular, their autobiographical emotional memories—are shaped across childhood and adolescence. The story that unfolds here is important, from our perspective for two reasons, first, because it emphasizes the We are grateful for the comments of Professors Mel Pipe and Tony Ward and Associate Professor Tammy Marche on earlier versions of this chapter.

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interrelatedness of all aspects of memory (social, cognitive, biological) and, second, because of the implications for understanding the development of psychopathology. Interrelatedness. The chapters in the current volume extend earlier attempts to understand the association between emotion and memory, research that tended to focus on “fragments of the organism” (Ayoub & Fischer, 2006; in Alexander, & O’Hara [Chapter 9]) and to ask relatively straightforward questions regarding whether emotion in general, and stress in particular, enhanced or impaired children’s recall (see also Wallin, Quas, & Yim, Chapter 12 of this volume). The answer to such broad questions is, almost inevitably, “it depends,” and a major contribution of the current volume is that the theory and research attempt to delineate factors upon which the answer depends. In so doing, collectively, they address Horowitz’s (2000) exhortation that “ . . . developmental scientists . . . convey with care the complexity of development . . . ” (p. 1). At the heart of the current story is the interrelatedness of the cognitive, socioemotional, neurobiological domains, strands of the “developmental web” (Ayoub & Fischer, 2006, in Alexander & O’Hara). Thus, Alexander, and O’Hara bring a dynamic systems framework to the understanding of memory and emotion; within a developmental trajectory, the individual’s appraisal and memory of an emotionally laden event are influenced by “innermost” factors (genes, temperament, age), interacting with parentchild relationships and psychobiological factors, within the broader social and cultural context. The conclusion is underscored that, to understand the emotion-memory association, “(t)he emotional cannot be divorced from the cognitive nor the individual from the social” (Brown, Brandsford, & Ferrara, 1983, p. 150); nor can the physiological and neurobiological. Development of psychopathology. This is also a story about the ways in which memory may shape psychological adjustment, across childhood and into adolescence. The picture that emerges suggests that troubled parent-child relationships, characterized, for example, by insecure attachment or impoverished parent-child reminiscing conversations, are strongly associated with children’s poorer memory skills and with their compromised emotion regulation and coping. There is also a suggestion that these interrelations unfold across childhood and into adolescence; for example, that insecure parent-child relationships and the associated difficulties in the domains of emotion understanding, emotion regulation, and autobiographical memory lead to a propensity to engage in a variety of problematic coping strategies, in turn associated with internalizing and externalizing behaviors. The current chapters therefore forge a link with an emerging body of research investigating the development of psychopathology, where uncertain family relations, a dearth of particular kinds of conversational exchanges, negative appraisals of one’s experiences, and Emotion and Memory in Development

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avoidant coping are all acknowledged risk factors (e.g., Hayes & Wilson, 2003; Rutter, 2005). The association between memory and psychopathology has only recently begun to receive direct attention within child clinical psychology, despite a longer history in theory and research on adult psychopathology. For both children and adults, memories of previous experiences play a critical role in everyday functioning. One’s accrued autobiographical recall provides a store of memories that facilitates the management of current situations and guides future expectations (Nelson & Fivush, 2004): As noted by Pillemer (2003), “memories are linked to future well-being through their persistent reminders of what is worth pursuing and what is to be avoided” (p. 197). At times, however, this autobiographical store is less than helpful, such as when the child’s personal memories lead to the repetition of maladaptive patterns of behavior and emotion, or when intense fear induced by memories of a traumatic experience interfere with the child’s ability to manage his/her present circumstances (Conway, 2003). It is clear, therefore, that focusing on memory potentially expands our understanding of key mechanisms in the child’s pathway to psychopathology or to adaptive functioning—the how of developmental processes in addition to the what (Rutter & Sroufe, 2000). In the remainder of this commentary, we consider the implications of the contributing chapters for understanding the association between emotion and memory in relation to psychopathology and its treatment.

Emotion, Memory, and Understanding Psychopathology Relevant to understanding how memory may influence the development of psychopathology, three tightly interrelated themes emerge from the current collection of chapters: the influence of language and conversation; the role of “cognitive processing” factors such as understanding, knowledge, and appraisal; and avoidance and coping. We consider each theme in turn.

Language and Conversation Foundational skills for remembering and managing emotional experiences develop within the inherently emotional parent-child relationship (see Carpendale & Lewis, 2004; Dunn, Brown, & Beardsall, 1991; Nelson & Fivush, 2004). Engagement in discussion of past experiences may play a particularly salient role in the development of these foundational skills. Discussion of the past provides a “reflective distance” from which parents and children can consider the emotional experience when no longer 396

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aroused (see Laible & Panfile, Chapter 7, Fivush, Brotman, Buckner, & Goodman, 2000). Moreover, information discussed after an event tends to be better recalled, contributing to a more robust store of personal experiences in memory (McGuigan & Salmon, 2004). The chapters in the current volume extend extant research by showing that, via language-based exchanges with their parents, children potentially develop a powerful means of self-expression and self-control, essential for positive psychological adjustment. Emotion-rich and elaborative reminiscing conversations teach children how to remember their experiences and to label their internal states. These skills, in turn, equip children to retrieve and communicate their experiences and emotions to others (see Laible & Panfile; Sales [Chapter 8]; Ensor & Hughes, 2007; O’Kearney & Dadds, 2005). Children are able to establish a complex body of knowledge about their own and others’ emotions (Laible & Panfile, Sales, this volume), which, in turn, is associated with later social and academic competence (Ackerman & Izard, 2004; Brown & Dunn, 1996). Self-regulatory skills can be learned as children are helped to make sense of their negative experiences and to integrate these into the individual’s autobiographical memory (“meaning-making”), and as they engage in sensitive, emotionally matched dialogues in which their feelings are contained and they develop confidence in their parents’ support (Laible & Panfile; Oppenheim & Koren-Karie [Chapter 6]; Sales). Over time, children have the opportunity to learn both how to reflect on their experiences and emotions and also the value of so doing (Chae, Ogle, & Goodman [Chapter 1]; Oppenheim & Koren-Karie). As noted by Stegge and Terwogt (2007), “conscious reflection on emotional experience profits from an introspective attitude on the one hand and the availability of explicit emotion knowledge on the other” (p. 272) (see also Greenberg, 2007). There are many instances where the development of these critical skills and knowledge is compromised, however. Where the child or parent has an insecure (avoidant, anxious) attachment relationship, reminiscing is less frequent, less elaborative, and does not ultimately help the child understand how to effectively manage negative emotions, potentially laying the foundations for the child’s adoption of problematic coping strategies such as avoidance (Chae et al.; Laible & Panfile; Oppenheim & Koren-Karie; Sales). Discussions about emotional experiences between children and parents at high socioemotional risk may be underregulated (flat, lacking in content) or overregulated (excessive, disorganized, and flooded with emotional themes) (Oppenheim & Koren-Karie). Given findings that deficits in emotion awareness and regulation and in introspective activity are associated with a range of childhood disorders, the findings reported in this volume represent an Emotion and Memory in Development

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important step in extending the investigation of these critical conversational exchanges to clinical populations (Lineham, Bohus, & Lynch, 2007; Suveg, Southam-Gerow, Goodman, & Kendall, 2007). To illustrate the potential importance of adopting a clinical focus, we take two examples from the albeit small body of relevant research that complements the current chapters. Shipman and colleagues observed maltreating mothers in discussions of past emotional events with their children and found that, compared to a matched control group, maltreating mothers were less likely to include the causes and consequences of emotion and became more aroused in response to their children’s negative emotion. In contrast to mothers in the control group, maltreating mothers also engaged in invalidating behaviors, including minimization, blame, and criticism of the child’s contribution to the discussion, and these behaviors, in turn, mediated the association between maltreatment and negative child outcomes, such as poorer emotion skill and higher levels of symptomatology (Shipman, Schneider, & Sims, 2005; Shipman & Zeman, 1999; Shipman et al., 2007). Focusing on the socialization of anxiety, Suveg, Zeman, FlannerySchroeder, and Cassano (2005) investigated the discussion of past negative emotional experiences between anxious children (aged eight to 12 years) and their mothers and nonanxious control mother-child dyads, and found that the mothers of anxious children spoke less, used fewer positive emotion words, and engaged in greater discouragement of their children’s reminiscing. Other research suggests that parents play an important role in socializing anxiety in their children, particularly where children have the risk factors of behavioral inhibition and insecure attachment (Shamir-Essakow, Ungerer, & Rapee, 2005). For example, parents of anxious children tend to engage in controlling behaviors in relation to their children, and to encourage avoidant coping in response to perceived threat (Barrett, Dadds, Rapee, & Ryan, 1996; Wood, McLeod, Sigman, Huang, & Chu, 2003). As little research has addressed how children become fearful and anxious, there is a need to investigate the underlying mechanisms; the findings outlined above suggest that a focus on conversational exchanges may contribute to this end. A focus on reminiscing may be fruitful in furthering our understanding of socialization processes in the development of other forms of psychopathology, although, again, there is very little research to date. For example, children with oppositional, noncompliant behavior problems appear to have limited ability to adopt a self-reflective stance and, in addition, manifest impoverished emotion knowledge and regulation (O’Kearney & Dadds, 2005; Stegge & Terwogt, 2007). It is wellestablished that the patterns of interaction in the families of children 398

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with such conduct problems include ineffective and irritable parenting practices (Reid, Patterson, & Snyder, 2002), and we might speculate that there would, therefore, be very limited opportunity for elaborative, emotionally rich reminiscing. Further investigation of the nature and consequences of invalidating behaviors during reminiscing is also warranted. It has been proposed, for example, that maternal invalidation induces high levels of arousal, which children generally have limited skills to manage effectively, promoting the development of dysfunctional “escape” or avoidant responses (see Chae et al.; see also Eisenberg, Cumberland, & Spinrad, 1999; Fruzetti, Shenk, & Hoffman, 2005). The research presented in this volume provides evidence that the frequency, style, content, and process of reminiscing conversations between parents and their children both reflect and contribute to adaptive and maladaptive psychological adjustment. In so doing, it provides an important springboard for future work investigating how family interactional patterns shape children’s developmental pathways. Understanding and appraisal. A second compelling theme in the current volume concerns the degree to which a child’s understanding and appraisal of an emotional experience influences how the experience is remembered and, ultimately, managed. The research presented suggests that, over time, there is a dynamic, unfolding interaction among the child’s emotional response to an experience, his/her appraisal of it, and subsequent recall and coping. According to Baker-Ward, Ornstein, and Starnes (Chapter 2), for example, a positive evaluation of an emotional experience elicits greater engagement, as reflected in the child’s deployment of attentional resources as the experience unfolds. Thereafter, the positive evaluation leads to more discussion and reflection, with each “revisiting” potentially strengthening the experience in memory and heightening positive affect. These processes are dynamic in that all elements are subject to change over time. For example, attempts to develop a meaningful account of a stressful experience (“efforts after meaning”), which provide a causal and explanatory framework and integrate the experience into the child’s autobiographical memory, are also likely to enhance memory and diminish negative affect (Baker-Ward et al., see also chapters by Laible & Panfile; Sales; Oppenheim & Koren-Karie; Peterson & Warren). BakerWard and colleagues reported that young soccer players who had thought that victory was possible until the game’s final minutes recalled more information about it compared to players who thought they would lose. Moreover, winning soccer players increased their rating of their own performance in the several weeks following the game, and reported that they had discussed the game more frequently. Similarly, Peterson and Warren (this volume) reported that children of parents who used a high Emotion and Memory in Development

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rather than low elaborative reminiscing style had more complete and accurate recall of a stressful experience both immediately after and over time, presumably because experiences were rehearsed more frequently and richly. Just as a positive appraisal may enhance memory via its association with the child’s allocation of attention, experiences negatively appraised are more likely to be associated with impoverished memory. This is illustrated in the current volume by Chae and colleagues, who, drawing on attachment theory, proposed that children whose “bids for care have been rejected or belittled” are unable to attend to and process threatening information, with implications for all aspects of information processing. They showed that parents with an avoidant attachment style were less responsive to their distressed child during and after a medical procedure, and the children manifested poorer memory, reflected in less-complete free recall, more errors, and greater vulnerability to suggestion. Of course, this parental behavior implicitly encouraged avoidant coping on the part of their children. Interestingly, Wallin and colleagues (Chapter 12) raise the possibility that the relatively poorer memory found in children of avoidantly attached parents may also be underpinned by physiological processes associated with impaired parasympathetic regulation, which facilitates physiological recovery following distress. Research within clinical contexts, while still limited, underscores the associations between the child’s appraisal and memory of a stressful or traumatic experience and their subsequent coping, consistent with the findings reported by Baker-Ward et al. and Chae. For example, in a study by Chen, Zeltzer, Craske, and Katz (2000), child cancer patients who were more distressed during an initial lumbar puncture provided negatively distorted ratings of their pain and distress one week later, compared with their original ratings, and this was, in turn, associated with higher distress during a subsequent lumbar puncture. Similarly, recent advances in the understanding of the development of psychopathology following exposure to a traumatic event implicate the individual’s appraisal of the remembered experience. Specifically, posttraumatic stress symptoms are more likely when both children and adults negatively appraise the traumatic event and its sequelae, fuelled, at times, by feelings of shame and guilt (Bryant, Salmon, & Davidson, 2007; Marshall, Bryant, Amsel, Suh, Cook, & Neria, 2007; Meiser-Stedman, Dalgleish, Smith, Yule, & Glucksman, 2007). The significant associations between a child’s understanding and appraisal of a past experience and their coping described in the chapters here extend the nascent body of clinical research by demonstrating these associations experimentally, and highlight the importance of further investigation. For example, theories of children’s social adjustment 400

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propose that memories of past social experiences, colored by negative appraisals and interpretational biases, in turn influence children’s aggressive responding (Crick & Dodge, 1994). Despite the core role of memory, few studies have focused directly on this, and thus, the association generally lacks empirical validation. Avoidance and coping. A third significant strand in this volume relates to the associations among memory, avoidance, and psychopathology. It has long been considered that reliance on avoidance as a means of regulating emotion is associated with psychopathology. Avoidance is a core feature of a range of psychological difficulties, including anxiety and mood disorders, posttraumatic stress disorder, and borderline personality disorder (Campbell-Sills & Barlow, 2007; Gratz, Rosenthal, Tull, Lejuez, & Gunderson, 2006). Experiential avoidance, of which a core feature is an “unwillingness to remain in contact with aversive private experiences” such as thoughts, feelings, and memories, is considered to be a stronger contributor to psychopathology than the intensity, frequency, or negative valence of these experiences (Chawla & Ostafin, 2007, p. 871; Hayes & Wilson, 2003). Understanding the development and consequences of the various manifestations of avoidance clearly has significant theoretical and practical implications. The current volume has much to contribute with respect to this understanding. As we have discussed already, several findings reported here indicate that a tendency to avoid emotional distress can have its origins within an insecure, avoidant parent-child attachment relationship, with significant implications for the child’s personal memories and socioemotional functioning (Chae et al.; Laible & Panfile; Sales, this volume). Greenhoot, Johnson, Legerski, and McCloskey (Chapter 4) focused on factors associated with one form of experiential avoidance, the avoidance of specific painful memories and the retrieval, instead, of “overgeneral” memories. Their findings showed that adolescents with a history of sexual abuse and exposure to parental violence (compared to violence alone) manifested a range of memory deficits, including shorter memories, fewer negatively valenced memories and more overgeneral memories in response to neutral cues, and greater reliance on interviewer prompting to elicit information. Moreover, adolescents with childhood abuse histories produced fewer emotion words in response to negative cues than those without abuse history. Greenhoot and colleagues suggested that, for some individuals, retrieval of overgeneral rather than specific memories of stressful emotional experiences may be part of a general “style” of avoidance of emotion arising from socialization experiences, with each avoidant instance negatively reinforced by reduction in negative affect. In drawing on data from a longitudinal sample of children and adolescents exposed to violence, these findings extend the current Emotion and Memory in Development

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literature on autobiographical memory specificity and emotional disorder, which has focused largely on adults and has tended to use a concurrent design (Williams et al., 2007). Compas, Campbell, Robinson, and Rodriguez (Chapter 5) draw attention to the fact that the associations between coping and memory are not restricted to autobiographical memory. Working memory, too, has a critical role to play in determining whether effective coping strategies, such as cognitive reappraisal, can be adopted. Their findings of individual differences in self and parent reports of coping strategies used by adolescents with leukemia support their position. Specifically, maladaptive coping (avoidance/disengagement) was negatively associated with working memory and positively associated with internalizing difficulties. In contrast, adaptive coping (in particular, reappraisal) was positively associated with executive functioning (including working memory) and fewer internalizing/externalizing behavior problems. These findings relating memory processes to avoidance and coping, together with those implicating an association between avoidance and poor psychological adjustment, highlight the need for further work directly examining the role of memory, both autobiographical and working, in the development of psychopathological responses. For example, avoidant strategies such as thought suppression, hiding emotions, and distancing oneself have been shown to have a variety of negative effects on memory and on psychological functioning, although much of this work has been conducted with adults and the precise linkages have not been clearly articulated (see Rassin, Merckelbach, & Muris, 2000; Richards & Gross, 2006). Moreover, the associations appear to be complex; for example, while greater working memory facilitates effective coping (Compas et al.), it also enables better suppression of intrusive thoughts, a less-effective coping strategy (Geraerts, Merckelbach, Jelicic, & Habets, 2007). The influence on memory of differing patterns of conversational avoidance between parents and their young children also warrants more detailed investigation (Chae et al.; Greenhoot et al.; Oppenheim & Koren-Karie). We have already discussed the potential role of parental invalidation of children’s conversational contributions in promoting the adoption of avoidant coping strategies, but other patterns are, of course, possible. For example, depending on the motivation of the parent, some negative events might not be discussed at all: parents may wish to minimize the child’s distress (Salmon & Bryant, 2002), or for socially prohibited activities such as sexual abuse, to maintain secrecy (Fivush, Pipe, Murachver, & Reese, 1997). Alternatively, parents may focus on some aspects of an experience at the expense of others. For example, parents may avoid discussing the negative elements of a past experience, or, in 402

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contrast, become particularly preoccupied with its negative aspects (see Chae et al.; Farrar, Fasig, & Welch-Ross, 1997; Scheeringa & Zeanah, 2001). Research on retrieval-induced forgetting in adults show that such selective review has significant implications for memory (Anderson, Bjork, & Bjork, 1994). Similarly, we (Conroy & Salmon, 2005, 2006) found, with young children, that repeatedly discussing some aspects of an event at the expense of others impaired their recall of the nondiscussed aspects. Highlighting the potential clinical and forensic relevance of selective review, Schooler (1997) described the case of an adult who, after years of apparent forgetting, had remembered sexual abuse disclosed as a child. Schooler suggested that exclusive focus on remembering her experience of physical abuse may have reduced the accessibility of the memory for sexual abuse.

What Are the Implications for Clinical Interventions? To this point, we have considered the implications of this volume for understanding the development of psychopathology an important “first step” from a clinical perspective. But ultimately, a critical task is to develop treatments that promote children’s adaptive functioning based on that understanding. It is to the potential treatment implications of the chapters reviewed here that we now turn. Training parents in elaborative reminiscing. The richness of the information conveyed via parent-child reminiscing conversations points to the potential for developing interventions based on training parents in elaborative and emotion-rich reminiscing about past experiences (see Wareham & Salmon, 2006, for review). There have been only a few training studies to date, and they have been conducted largely with community rather than clinical samples. They have, however, demonstrated that mothers can be trained to alter their reminiscing style, with benefits for their children’s autobiographical recall and language skill. Reese and Newcombe (2007), for example, found that, relative to an untrained group, mothers trained in elaborative reminiscing when their children were aged 18 and 30 months altered their reminiscing style in the direction of the training. At age three, their children provided longer and richer independent narratives (see also Peterson, Jesso, & McCabe, 1999). In our own research, mothers were given elaborative reminiscing training that also included a focus on emotion (Wareham, Salmon, Dadds, & Allen, 2007). We found that, compared to a control group who were trained in child-directed play but not in elaborative reminiscing, mothers in the intervention group had increased their elaborations and emotion references when assessed immediately after the intervention. Six months later, their four-year-old Emotion and Memory in Development

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children provided more detailed narratives with greater emotion content when talking with their parent and manifested more advanced understanding of emotion causes than those whose mothers did not receive reminiscing training. Nonetheless, if these findings are to be extended beyond community samples, it is likely to be necessary to also directly target the problematic parent-child patterns of behavior typically found in families with difficulties of clinical severity (Hawes & Dadds, 2005; Rapee, Kennedy, Ingram, Edwards, & Sweeney, 2005). In a recent pilot study, we incorporated emotion-rich reminiscing and child directed play as adjuncts to parent management training (Salmon, Dadds, Allen, & Hawes, 2007), the most effective intervention for targeting noncompliance in young children (Webster-Stratton & Hammond, 1997). Assessments conducted before and immediately after the treatment showed reductions in children’s disruptive behavior in both conditions and increases in elaborative, emotional talk for parents and children who engaged in reminiscing training. These findings demonstrate that parents of children with difficulties of clinical severity can adopt elaborative reminiscing without compromising the effectiveness of other aspects of treatment, but, of course, a longer follow-up is necessary. While these preliminary findings are encouraging, much remains to be learned before reminiscing training can be advocated as a clinical intervention. For example, in all but Reese and Newcombe’s (2007) study, the rate of dropping out of treatment has been high, highlighting the need to identify barriers to successful engagement in the intervention. Moreover, the effective elements of style and content of reminiscing have yet to be determined, in particular, in relation to specific populations. Training parents in emotion-rich reminiscing may be ineffective or even unhelpful when, for example, the parent fails to provide resolutions when discussing negative emotional experiences (see Oppenheim & Koren-Karie, Sales, this volume), where the child is “swamped” with negative emotion, potentially leading to avoidance (see Greenhoot et al.; Oppenheim & Koren-Karie, this volume), and where parents’ goal is to remediate their child’s social deficits rather than clarifying and teaching about emotion. As noted by Eisenberg et al (1999), “(t)he challenge, of course, is to reliably discern the function of parental communications about emotion” (p. 256), and, in the current context, to “harness” those communications that will have long-term benefit for children as part of a treatment program. Finally, findings reported by Wiik and Gunnar (Chapter 10) that secure mother-child attachment can buffer children from significant activation of the hypothalamic-pituitary-adrenal system in response to threatening stimuli suggest that understanding the impact of interventions on these critical neurobiological systems that underlie memory is also important. 404

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Targeting memories of stressful and traumatic events. The associations among a stressful experience, negatively appraised memory, the child’s coping response, and consequently, the development of psychopathology, also have important implications for clinical interventions. That memory is malleable and vulnerable to the influence of internally and externally provided information is advantageous in this context (BakerWard et al.). Indeed, effective psychosocial interventions for posttraumatic stress disorder (PTSD) share a directive focus on the memory of the traumatic event; reconstruction and reappraisal of what occurred (via exposure to the memory) is currently the most effective means of reducing PTSD for children and adults (Marshall et al., 2007). According to Cohen, Mannarino, and Deblinger (2006), exposure to the trauma memory and the construction of a trauma narrative reduce the child’s anxiety and avoidance while also enabling the child to integrate the traumatic experience “into the totality of his/her life. In this way, the trauma is only one part of the child’s life experience and self-concept, rather than being the defining aspect of both” (p. 120). Interestingly, preliminary findings suggest that facilitating mothers’ ability to jointly create a trauma narrative with their child is an effective intervention for traumatized preschoolers with behavior problems (Lieberman, Chandraghosh, & Vanhorn, 2006; see Oppenheim & Koren-Karie, this volume). These approaches to the treatment of children’s trauma have considerable overlap with the notion of “meaning-making,” whereby a traumatic event comes to be understood and integrated into the individual’s autobiographical memory (see Baker-Ward et al.; Sales; this volume; see also Ramírez-Espaza & Pennebaker, 2006). It is also noteworthy that adults treated for PTSD retrieve more specific and fewer overgeneral memories as their symptoms reduce (Sutherland & Bryant, 2007). Although the direction and underlying mechanism of this relation have yet to be determined, they nonetheless underscore the significant association between memory and psychological functioning. The effectiveness of directly targeting memory has been demonstrated in other contexts. For example, Chen et al. (1999) reduced children’s distress in response to a lumbar puncture by directly targeting their negatively distorted memories, by, in particular, highlighting the coping strategies used by the children (see also Pickrell et al., 2007). An alternative approach is to attempt to prevent negatively appraised and distorted memories via intervention during and before a stressful event, a strategy only possible where the experience is planned and predictable, such as a medical or dental procedure. For example, as Baker-Ward and colleagues noted in relation to our study (Salmon, McGuigan, & Pereira, 2006), one aim was to prevent negatively exaggerated memories for children (aged three to seven years) undergoing an invasive medical procedure (the Emotion and Memory in Development

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VCUG: voiding cystourethrogram). As the procedure unfolded, the children were provided with distraction either alone or accompanied by a procedural narration aiming to reduce fear and negative appraisals (e.g., “this is our big camera. It will come down over your tummy but it won’t touch you”). Relative to standard care, children in the combined distraction and narration condition manifested less distress during the procedure and provided more complete memory reports one week later. Attempts to target appraisals and memory in advance of a novel distressing procedure by providing preparatory information have been less effective for young children at least. The relatively small effects of preparatory information are likely to reflect a memory representation based on verbal information alone, without prior direct experience (Salmon, 2006). In summary, increasing our understanding of the role of memory in the development of psychopathology opens up important possibilities for intervention. We have discussed the potential usefulness of training parents in elaborative, emotion-rich reminiscing and directly targeting negatively appraised memories of emotional experiences, but this line of research is very much in its early stages, and there is clearly a need for studies more directly addressing the implications for treatment. Finally, in this context, we note that although training and other intervention studies have been considered from a practical standpoint, they also have the advantage of providing a strong test of the theoretical tenets outlined above and elsewhere in the literature, permitting us to address, for example, whether there is a causal relationship between the parent and child reminiscing style and content, and whether memory plays a causal role in the development of other forms of psychopathology.

What Are the Implications for Forensic Contexts? The children interviewed in forensic contexts are likely to experience complex difficulties that impair their ability to retrieve their experiences from memory and to report them during the interview. Maltreating families provide few of the experiences necessary for fostering competent adaptation (Cicchetti & Toth, 2005). Deprived of the opportunity for elaborative and emotion-rich conversations and exposed to parental invalidation, many maltreated children will be unskilled in retrieving a coherent narrative account of their experiences. They may experience high levels of negative affect, including shame, lack emotion knowledge and regulation skills, and may engage in avoidant coping. Maltreated children may also be troubled by intrusive memories associated with PTSD and may retrieve overgeneral rather than specific memories (Baker-Ward et al., Chae et al., Greenhoot et al., Oppenheim & Koren-Karie, this 406

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volume; Saywitz, Mannarino, Berliner, & Cohen, 2000). Some of these factors render the child vulnerable to suggestion, as demonstrated by Chae and colleagues, and they will also influence the child’s ability to be cooperative during the interview. As is clear from the foregoing section, a high level of skill is demanded of the forensic interviewer (see Lyon & Saywitz, 2006; Pipe & Salmon, 2009, for further discussion), and they point to some important practice implications. First, the forensic interviewer should have a comprehensive understanding of the child’s psychological functioning. Traditionally, the clinical and forensic literatures have been somewhat separate, yet understanding that the child is anxious, depressed, or experiences intrusive memories, potentially enables the interviewer to conduct a more sensitive and effective interview. Second, to facilitate the child’s ease in the interview and to reduce the risk of eliciting misinformation due to social compliance, care should be devoted to developing rapport. Although relatively little research has focused on the effective elements of rapport building (Lyon & Saywitz, 2006), some strategies have emerged from the experimental literature. For example, social support, including eye contact, warmth, and time spent developing rapport, has been shown to decrease children’s social compliance and to enhance their free recall reports, without adverse effects (Bottoms, Quas, & Davis, 2007), and normalizing feelings of fear and ambivalence has also been found to reduce errors (Saywitz, Esplin, & Romanoff, 2007). Moreover, explaining the “ground rules” of the interview to the child and practicing open-ended narrative responses in relation to neutral topics, before moving to the topic of interest, can also enhance children’s reports (Sternberg et al., 1997; see Lyon & Saywitz, 2006). For example, Sternberg and colleagues found that children with whom rapport had been established using open-ended questions provided over twice as much information in response to the first utterance as did children who had been given direct, closed-ended questions, and this pattern continued for the duration of the interview. Finally, adherence to evidence-based interview strategies can optimize children’s recall while taking into account some of the specific difficulties experienced by maltreated children, such as difficulty providing a free narrative account. Thus, experimental and field research suggests that using an interview protocol that emphasizes open-ended questioning while reducing interviewer input can elicit relatively detailed accounts from children without negative sequelae. For example, the interview protocol developed and evaluated by the National Institute of Child Health and Development (NICHD) entails seeking elaboration of information the child has already reported, has been found to elicit more detailed and accurate reports than are elicited by nonprotocol-based interviews, Emotion and Memory in Development

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and without compromising the rate of disclosure of sexual abuse (e.g., Lamb & Brown, 2006; Pipe et al., 2007). These kinds of approaches to forensic interviewing may help overcome the difficulties faced by the maltreated child by, for example, reducing the “demand” for a response, inherent in a closed question and by providing nonleading retrieval cues (the child’s own words) that can encourage and structure a more complete search of memory.

Concluding Comment This volume provides a springboard for ongoing exchange between researchers investigating emotion and memory and those investigating the development of psychopathology. How emotional memories are managed clearly has multiple significant implications for the child’s current and future psychological functioning. Not only may this exchange further our understanding of psychopathological processes, it ultimately guides effective intervention. There can be little doubt that the next decade will see considerable developments, both theoretical and applied, to these ends, the seeds of which were sown in the foregoing chapters. References Ackerman, B. P., & Izard, C. E. (2004). Emotion cognition in children and adolescents: Introduction to the special issue. Journal of Experimental Child Psychology. Special Issue: Emotional Cognition in Children, 89, 271–275. Anderson, M. C., Bjork, R. A., & Bjork, E. L. (1994). Remembering can cause forgetting: Retrieval dynamics in long-term memory. Journal of Experimental Psychology: Learning, Memory, & Cognition, 20, 1063–1087. Barrett, P. M., Rapee, R. M., Dadds, M. R., & Ryan, S. M. (1996). Family enhancement of cognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology, 24, 187–203. Bottoms, B., Quas, J. A., & Davis, S. (2007). The influence of interviewer-provided social support on children’s suggestibility, memory, and disclosures. In M-E Pipe, M. E. Lamb, Y. Orbach, A-C Cederborg (Eds.), Child sexual abuse: Disclosure, delay and denial (pp. 135–157). Mahwah, NJ: Lawrence Erlbaum Associates. Brown, A. L., Bransford, J. D., Ferrara, R. A., & Campione, J. C. (1983). Learning, remembering, and understanding. In P. H. Mussen. (Series Ed.), & J. H. Flavell & E. M. Markman (Vol. Eds.), Handbook of child psychology: Vol 3. Cognitive development (4th ed., pp. 77–166). New York, NY: John Wiley & Sons. Brown, J., & Dunn, J. (1992). Talk with your mother or your sibling? Developmental changes in early family conversations about feelings. Child Development, 63, 336–349.

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Bryant, R. A., Salmon, K., Sinclair, E., & Davidson, P. (2007). A prospective study of appraisals in childhood posttraumatic stress disorder. Behaviour Research and Therapy, 45, 2502–2507. Campbell-Sills, L., & Barlow, D. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In Gross, J. J. (Ed.) Handbook of emotion regulation (pp. 452–559). New York, NY: Guilford Press. Carpendale, J. I. M., & Lewis, C. (2004). Constructing an understanding of mind: The development of children’s social understanding within social interaction. Behavioral and Brain Sciences, 27, 79–151. Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. Journal of Clinical Psychology, 63, 871–890. Chen, E., Zeltzer, L. K., Craske, M. G., & Katz, E. R. (1999). Alteration of memory in the reduction of children’s distress during repeated aversive medical procedures. Journal of Consulting & Clinical Psychology, 67, 481–490. Chen, E., Zeltzer, L. K., Craske, M. G., & Katz, E. R. (2000). Children’s memories for painful cancer treatment procedures: Implications for distress. Child Development, 71, 931–945. Cicchetti, D., & Toth, S. L. (2005). Child maltreatment. Annual Review of Clinical Psychology, 1, 409–438. Cohen, J. A., Mannarino, A. P., & & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York, NY: Guilford Press. Conroy, R., & Salmon, K. (2005). Talking about parts of a past event: Selective post-event review and children’s memory for non-reviewed materials. Journal of Experimental Child Psychology, 90, 185–207. Conroy, R., & Salmon, K. (2006). Talking about parts of a past experience: The influence of elaborative discussion and event structure on children’s recall of nondiscussed information. Journal of Experimental Child Psychology, 95, 278–297. Conway, M. A. (2003). Commentary: Cognitive-affective mechanisms and processes in autobiographical memory. Memory, 11, 217–224. Crick, N. R., & Dodge, K. A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin, 115, 74–101. Dunn, J., Brown, J., Beardsall, L. (1991). Family talk about feeling states and children’s later understanding of others’ emotions. Developmental Psychology, 27, 448–455. Eisenberg, N., Cumberland, A., & Spinrad, T. (1999). Parental socialization of emotion. Psychological Inquiry, 9, 241–273. Ensor, R., & Hughes, C. (2008). Content or connectedness? Mother-child talk and early social understanding. Child Development. Farrar, M. J., Fasig, L. G., & Welch-Ross, M. K. (1997). Attachment and emotion in autobiographical memory development. Journal of Experimental Child Psychology, 67, 389–408. Fivush, R., Brotman, M., Buckner, J. P., & Goodman, S.H. (2000). Gender differences in parent-child emotion narratives. Sex Roles, 42, 233–253. Fivush, R., Pipe, M., Murachver, T., & Reese, E. (1997). Events spoken and unspoken: Implications of language and memory development for the

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recovered memory debate. In Conway, M.A. (Ed.), Recovered Memories and False Memories (pp. 34–62). Oxford, UK: Oxford University Press. Fruzetti, A. E., Shenk, C., & Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007–1030. Geraerts, E., Merckelbach, H., Jelicic, M., & Habets, P. (2007). Suppression of intrusive thoughts and working memory capacity in repressive coping. American Journal of Psychology, 120, 205–218. Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115, 850–855. Greenberg, M. T. (2007). Commentary on “The role of emotion theory and research in child therapy development.” Clinical Psychology: Science and Practice, 14, 372–376. Hawes, D., & Dadds, M. R. (2005). The treatment of conduct problems in children with callous-unemotional traits. Journal of Consulting and Clinical Psychology, 73, 737–741. Hayes, S. C., & Wilson, K. G. (2003). Mindfulness: Method and process. Clinical Psychology: Science and Practice, 10, 161–165. Horowitz, F. D. (2000). Child development and the PITS: Simple questions, complex answers, and developmental theory. Child Development, 71, 1–10. Lamb, M. E., & Brown, D. A. (2006). Conversational apprentices: Helping children become competent informants about their own experiences. British Journal of Developmental Psychology, 24, 215–234. Lieberman, A. F., Chandraghosh, I., & Vanhorn, P. (2006). Child-parent psychotherapy: 6-month follow up of a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 913–918. Lineham, M. M., Bohus, M., & Lynch, T. R. (2007). Dialectical behavior therapy for pervasive emotion dysregulation: Theoretical and practical underpinnings. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 581–605). New York, NY: Guildford Press. Lyon, T. D., & Saywitz, K. J. (2006). From post-mortem to preventive medicine: Next steps for research on child witnesses. Journal of Social Issues, 62, 833–861. Marshall, R. D., Bryant, R. A., Amsel, L., Suh, E. J., Cook, J. M., & Neria, Y. (2007). The psychology of ongoing threat: Relative risk appraisal, the September 11 attacks, and terrorism-related fears. American Psychologist, 62, 304–316. McGuigan, F., & Salmon, K. (2004). The time to talk: The influence of adultchild talk on children’s event memory. Child Development, 75, 669–78. Meiser-Stedman, R., Dalgleish, T., Smith, P., Yule, W., & Glucksman, E. (2007). Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents. Journal of Abnormal Psychology, 116, 65–79. Nelson, K., & Fivush, R. (2004). The emergence of autobiographical memory: A social cultural developmental theory. Psychological Review, 111, 486–511.

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AUTHOR INDEX

Abraham, A., 286 Abraham, H., 283 Abrous, D. N., 289 Aburada, M., 287 Achenbach, T. M, 20 Ackil, J. K., 185, 186, 188, 199, 201, 379, 386, 389 Adams Parrish, K., 213 Adams, S., 106 Addis, D. R., 283 Adolphs, R., 224, 226 Ahadi, S. A., 16 Ainsworth, M. D. S., 4, 143, 144, 153, 155, 178, 203 Aitken, D. H., 293 Akil, H., 260 Akirav, I., 285 Alexander, K. W., 6, 7, 8, 17, 19, 20, 206, 221, 222, 231, 233, 234, 235, 236, 237, 239, 240, 242, 313, 356 Alkire, M. T., 227, 321 Alkon, A., 234, 327, 329 Allard, L. M., 237 Allen, E. A., 5 Allen, J., 403, 404 Allen, J. J. B., 230 Allen, M. T., 322 Allhusen, V. D., 8 Almeida, O. F., 292 Alvarez, J. A., 230 Amaral, D. G., 227 Amini, F., 237 Amsel, L., 400 Anda, R. F., 87 Andersen, S. L., 89, 292

Andersen, S. M., 237 Anderson, M. C., 403 Anderson, N. D., 230 Anderson, V. A., 131 Andreano, J. M., 263 Andrew, C., 234 Andrews, B., 87 Arbib, M. A., 224 Archer, M. A., 291 Arcus, D., 236 Arend, R. A., 144 Armario, A., 233 Arntz, A., 88 Aron, A. R., 127 Ashman, S. B., 269 Auerbach, S., 169 Avishai-Eliner, S., 290 Ayers, T. S., 125, 196 Ayoub, C. C., 223 Babinsky, R., 227 Bahrick, L., 63, 65, 68, 71, 184, 345, 379, 386 Baig, R., 289 Bailey, C. H., 282 Bailey, J., 94 Baird, A., 328 Bajic, D., 266 Baker-Ward, L., 28, 29, 30, 31, 33, 34, 35, 37, 41, 46, 49, 50, 52, 53, 60, 72, 279, 313, 345 Bakker, A., 89, 263 Baldwin, M. W., 237 Bale, T. L., 297, 300 Bangston, S. K., 284 Banks, J. B., 35, 46 Baram, T., 290 Baran, S. E., 286

415

Barclay, J. R., 30 Bar-Heim, Y., 124 Barlow, D., 401 Barnett, A. M., 299 Barnett, D., 6, 21, 351 Barnhofer, T., 91, 234 Baron, R. M., 15 Barr, R., 280, 284 Barrett, L., 168, 237 Barrett, P. M., 398 Bartholomew, K., 14, 16, 17, 18, 19, 20 Bartlett, F. C., 28, 29, 224 Bates, J. E., 344 Batterman-Faunce, J. M., 6, 65, 238, 315, 316 Bauer, P. J., 98, 185, 186, 199, 280, 281, 282, 283, 284, 285, 344, 345, 374, 376, 377, 378, 379, 387, 389 Baum, A. S., 272 Beardsall, L., 102, 170, 396 Beauchaine, T. P., 323 Beazley, L. D., 291 Beck, J. E., 356 Becker, K., 286, 292 Beeghly, M., 170, 240 Bell, M., 42, 64, 67, 79, 313 Bell, S., 178 Belsky, J., 7, 238, 358, 359 Bennett, M. C., 228 Benoit, D., 8 Bensadoun, J., 5 Bentivegna, C., 170

Berlin, L. J., 101, 102, 110, 207 Berliner, L., 407 Bernsten, D., 352 Bernstson, G. G., 323, 327 Bertrand, F., 299 Beveridge, M., 291 Bialik, R. J., 100 Bidell, T. R., 222 Bidrose, S., 3 Binet, A., 29, 31 Biringen, Z., 16, 144 Birmaher, B., 272 Birmingham, M. K., 89 Birnbaum, G., 5 Bjork, E. L., 403 Bjork, R. A., 403 Bjorklund, D. F., 388 Blair, K., 169 Blaise, H. J., 293 Blakely, B. S., 5 Blanchard-Fields, F., 328 Blehar, M., 4, 143, 153 Bliss, T. V., 228 Bloom, J., 170 Blue, J., 313 Bohanek, J., 142, 346 Bohlin, G., 168 Bohus, M., 398 Boland, A. M., 60, 71, 72, 73, 80 Boman, E., 297 Bonne, O., 295 Boon Vermeeren, M., 88 Boone, C., 126 Boring, A. M., 89, 272 Born, J., 264 Bornstein, B .H., 13, 61 Bortfeld, H., 233 Bortolotti, S., 241 Bost, K. K., 360 Bottoms, B. L., 3, 407 Bowlby, J., 4, 6, 9, 11, 12, 144, 145, 176, 177, 178, 187, 203, 237 Bowman, P. J., 184 Boyce, W. T., 5, 234, 318, 322, 328, 329 Boyer, M. C., 101, 109, 124, 328 Boyle, P. A., 106 Brabham, T., 290 Brailey, K., 90 Brainerd, C. J., 32 Brammer, M. J., 234 Bransford, J. D., 32, 395 Braun, K., 286 Braunwald, K., 21 Bremner, J. D., 89, 90, 263, 285, 286, 294, 295, 314

416

AUTHOR INDEX

Brennan, K. A., 5, 103, 207 Brennan, K. H., 43 Bretherton, I., 4, 11, 145, 170, 176, 177, 178, 204, 212, 237, 240, 349, 357, 358 Brewer, J., 227, 316 Brewin, C. R., 87, 88, 90, 98, 197, 294, 296, 351 Bridges, L., 168 Britner, P. A., 144 Brittlebank, A. D., 87, 91, 110 Britton, W. B., 226 Brodersen, L., 328 Bronen, R. A., 89, 295 Bronfenbrenner, U., 222, 224, 225, 243 Brosschot, J. F., 235 Brotman, M., 397 Brown, A. L., 395 Brown, D. A., 408 Brown, J., 102, 169, 170, 240, 396, 397 Brown, S. M., 285 Brown, T., 98, 186 Bruce, M., 136 Bruck, M., 6, 31, 79 Brumbaugh, C., 351 Bruner, J. S., 29, 30 Brunson, K., 290, 293 Bryant, R. A., 400, 241, 402, 405 Buchanan T. W., 226, 265, 318, 325 Buckner, J. P., 397 Bugental, D. B., 313, 316, 318, 330 Buitelaar, J. K., 289 Bullmore, E., 129 Bunge, S. A., 122 Bunsey, M. D., 321 Burgwyn-Bailes, E., 35, 48, 49, 60, 67, 72, 313 Burnside, E., 88, 234 Bush, G., 231 Buske-Kirschbaum, A., 330 Buss, A. H., 187 Buss, C., 286 Buss, K. A., 328, 356 Butler, E. A., 323 Butler, S., 241 Butter, H. J., 100 Buttsworth, D. L., 131 Byatt, M., 88, 234 Cabeza, R., 230 Cacioppo, J. T., 322, 323, 327 Cahill, L., 226, 227, 263, 287, 296, 298, 316, 321, 325

Calabrese, P., 283 Calkins, S. D., 235, 367 Callender, G., 235 Calvete, E., 126 Cameron, J. L., 258 Campbell, B. A., 32 Campbell, L. K., 109, 121, 201 Campbell, L. L., 130, 131, 132 Campbell, S. B., 9 Campbell-Sills, L., 401 Campos, J. J., 32, 233 Campos, R. G., 32 Canli, T., 227, 233, 316 Cannistraci, C. J., 130 Cannon, W. B., 320, 321 Capatides, J., 170 Carlson, E., 186 Carlson, M., 272 Carlson, V., 21 Carpendale, J. I. M., 362, 396 Carrey, N. J., 100 Carrick, N., 234 Carrion, V. G., 272, 295, 296 Carver, C., 202, 207 Carver, L. J., 89, 278, 280, 281, 284, 285 Case, R., 329 Cashman, L., 346 Cassano, M., 398 Cassel, J.-C., 299 Cassidy, J., 5, 7, 10, 101, 161, 178, 203, 204, 207, 224, 238, 239, 348, 358, 359 Caviness, V. S., 296 Ceci, S. J., 31, 79 Chae, Y., 3, 20 Chan, S., 91 Chandraghosh, I., 405 Charmandari, E., 258 Charney, D. S., 89 Chastain, R. L., 110 Chattararji, S., 286 Chavez, B., 297 Chawla, N., 401 Chawla, S., 328 Chen, E., 316, 317, 318, 326, 400 405 Chen, S., 237 Chen, Y., 290 Chi, M. T. H., 36, 388 Chicz-Demet, A., 288 Chisholm, K., 272 Chow, U., 293 Christensen, A., 103 Christianson, S., 12, 13, 17, 230, 232, 315, 316, 318, 331

Christianson, S -V., 3 Chrousos, G. P., 258, 320, 321, 324 Chu, B. C., 398 Chua, C., 297 Chun, M. M., 89 Cicchetti, D., 6, 21, 90, 100, 168, 233, 238, 351, 406 Cladis, M., 240 Clark, C. L., 5, 103, 207 Clark, K. B., 228 Clarke-Stewart, K. A., 8 Clayborn, H., 228 Clubb, P. A., 31, 33, 34, 36, 53, 224 Cluver, A. 278 Coe, C. L., 289 Cohen, J. A., 405, 407 Cohen, N. J., 229 Cohen, R. A., 133, 318 Cole, P. M., 316 Collingridge, G. L., 228 Collins, N. L., 237 Collins, W. A., 107 Compas, B. E., 101, 109, 121, 122, 125, 126, 127, 128, 130, 133, 134, 135, 136, 137, 168, 328 Cone, R. P., 258 Connors, J., 383 Connor-Smith, J. K., 122, 126, 168 Conrad, C. D., 122, 286 Conroy, R., 73, 80, 394, 403 Constans, J. I., 90 Conte, P. M., 317 Contreras, J. M., 356 Conway, M. A., 92, 396 Cook, J. M., 400 Copeland, W. E., 128 Cortez, V., 313 Costa, P. T., 16 Couchaud, E. A., 102, 240 Couchoud, E., 169 Couperus, J. W., 231 Courage, M. L., 281 Cousens, P., 131 Crandell, L. E., 181 Crane, C., 91 Craske, M. G., 316, 400 Crawley, A. P., 283 Crick, N. R., 401 Crisp, V., 169 Crnic, K., 7, 238, 359 Cromer, C. C., 30, 45 Culver, C., 178 Cumberland, A., 168, 170, 367

Cummings, E. M., 100, 143, 169, 359 Cuthbert, B. N., 318 Dabholkar, A. S., 283 Dadds, M. R., 397, 398, 403, 404 Dalgleish, T., 88, 124, 233, 295 Daly, B. P., 281 Daly, J. R., 258 Dalziel, S., 289 Daniels, W. M. U., 293 Danuser, B., 319 Davalos, M., 240 Davidson, P., 400 Davidson, R. J., 123, 223, 230 Davies, D., 196 Davies, P., 359 Davis, E. P., 291 Davis, K. E., 5 Davis, S. L., 13, 407 Davis, T. L., 316 Davis O’Hara, K. M., 237 Dawson, G., 230, 240 Dawud Noursi, S., 88 Day, J. C., 294 De Bellis, M. D., 89, 272, 295, 296, 314 de Brabander, B., 126 de Decker, A., 88, 90, 91, 98, 109 de Jong-Meyer, R., 234 de Kloet, E. R., 259, 260, 291, 292, 324 De Neeling, N. N., 319 de Quervain, D. J. F., 89, 265 De Ruiter, C., 235 Dean, E., 285 Deane, K. E., 7, 20 Debiec, J., 266 Deblinger, E., 405 Declerck, C. H., 126 Deffenbacher, K. A., 13, 17, 61–62 63, 70, 71 DeForest, M., 224 Defranc, A., 91 Degirmenci, M., 264 Delaney, R. C., 90 D’Elia, P., 241 Dellu, F. O., 240 Denham, S. A., 102, 166, 169, 170, 240 Dennig, M. D., 126 Derryberry, D., 231, 235 Desmond, J. E., 233 DeWolff, M. S., 9 Diamond, A., 235 Diamond, D. M., 228 Dickinson, D. K., 76

Didow, S. M., 60 Dix, T., 169 Dobbing, J., 304 Dodd, D. H., 30, 45 Dodge, K. A., 401 Dolan, R. J., 33, 232 Domes, G., 325 Donzella, B., 267, 268, 271, 291 Doost, H. T. N., 295 Dorio, J., 294 Dorward, E. C., 293 Doussard-Roosevelt, J. A., 228, 329 Dow, G. A., 284 Dowden, A., 280 Dozier, M., 268, 271, 272 Drevets, W., 259 Dritschel, B. H., 91 Dropik, P. L., 281, 284 Drosopoulos, S., 264 Druin, D. P., 235 Drummey, A. B., 281 Dubrovsky, B., 89 Duggan, D. S., 91 Duke, M., 142 Dunkel-Schetter, C., 288 Dunlop, S. A., 291, 295 Dunn, J., 102, 169, 170, 240, 241, 396, 397 Dunsmore, J., 170 Durgerian, S., 133 Durkin, K., 73 Durwen, H. F., 283 Duvarci, S., 298 Eals, M., 297, 298 Earls, F., 272 Easterbrook, J. A., 33, 44, 384 Eaton, K., 35, 42, 46, 47, 169 Eccard, C. H., 272 Eckerman, C. O., 60 Edelbrock, C., 20 Edelstein, R. S., 5, 6, 7, 8, 10, 15, 17, 18, 234, 235, 238, 239, 316 Edwards, S., 404 Edwards, V. J., 87 Eelen, P., 88, 91 Egeland, B., 186 Ehlert, U., 264 Eich, E., 223, 223 Eichenbaum, H., 223 Eisen, M. L., 88 Eisenberg, A. R., 240, 241 Eisenberg, N., 168, 170, 240, 366, 367, 404 El-Sheikh, M., 100 Ellenbroek, B. A., 290

Author Index

417

Ellis, B. J., 328 Ellis, H. C., 346 Ellis, L. K., 235 Elmquist, J. K., 258 Elzinga, B. M., 89, 263 Emde, R. N., 16, 155 Emory, E., 230 Engelberg, E., 12 Engle, R., 317 Ensor, R., 397 Epping-Jordan, J. E., 135, 136 Erickson, K., 259 Erickson, K. I., 318 Erickson, M. F., 271 Esplin, P. W., 370, 407 Espy, K. A., 131 Etzion-Carasso, A., 144, 146, 147, 150, 151, 152, 154, 178, 203 Evans, J. I., 258 Evans, O., 319 Eye, J., 173, 187 Fabes, R. A., 168 Faes, T. J., 319 Fairclough, D., 131 Falduto, J., 297 Farrant, K., 11, 102, 240 Farrar, M. J., 12, 146, 172, 179, 180, 241, 403 Fasig, L. G., 12, 146, 172, 179, 180, 241, 403 Faure, J., 293 Favez, N., 12 Faw, B., 230 Fearnow, M. D., 101 Feeney, B. C., 224, 237 Felitti, V. J., 87 Fellous, J.-M., 224 Ferrara, R. A., 395 Ferrier, I. N., 87, 110 Field, T., 240 Fieldman, G., 319 Fiese, B. H., 198 Figueiredo, H., 325 Figueredo, A. J., 93 Filali, M., 227 Filipek, P. A., 296 Fillipini, D., 89 Fischer, K. W., 222, 223, 234 Fisher, P., 272 Fisher, R. P., 43 Fitzgerald, H. E., 181 Fivush, R., 9, 12, 29, 31, 33, 52, 63, 65, 67, 68, 72, 73, 74, 77, 84, 87, 98, 99, 101, 102, 106, 110, 142, 146, 147,

418

AUTHOR INDEX

160, 171, 172, 173, 179, 184, 185, 186, 197, 198, 199, 200, 202, 203, 204, 205, 206, 207, 212, 213, 224, 237, 240, 241, 244, 281, 313, 343, 345, 346, 347, 348, 349, 350, 352, 362, 376, 377, 379, 389, 396, 397, 402 Flannery-Schroeder, E., 398 Flavell, E. R., 240 Flavell, J. H., 240 Fleck, K., 313 Fleming, A. S., 292 Fleshner, M., 228 Flint, R. W., 321 Flugge, G., 89 Fluttert, M., 292 Foa, E. B., 346 Fogel, A., 347 Folkman, S., 124, 201 Follmer, A., 53 Fonagy, P., 27 Fondacaro, K. M., 328 Ford, D. H., 222 Ford, M. B., 237 Fortson, B. L., 314 Fox, N. A., 235, 236, 237, 240, 328 Frackowiak, R. S. J., 89 Fraley, R. C., 5, 10, 15, 239, 351 Francis, D. D., 294 Frankfurt, M., 297 Franks, J. J., 32 Frazier, T. W., 323 Frenn, K. A., 330 Frith, C. D., 89 Fritz, J., 240 Fromhoff, F., 72, 77, 172, 199, 207 Frösch, F., 292 Frustaci, K., 89 Fruzetti, A. E., 399 Fuchs, E., 89 Fujioka, T., 290 Fung, H., 172 Furtado, E., 30 Gabrieli, J. D. E., 122, 227, 230, 233, 316 Gado, M. H., 89 Galea, L. A. M., 286, 297, 298 Galef, B. G., Jr., 291 Ganiban, J., 6, 351 Ganor, G., 151, 152, 153 Garcia, A., 233 Garner, J. P., 10, 239

Gauvain, M., 347 Gebelt, J., 170 Gehlen, W., 283 Gellman, M., 319 Gentzler, A. L., 356 George, C., 244 Geraerts, E., 402 Gerin, W., 328 Getzler-Yosef, R., 158 Ghera, M. M., 328 Ghetti, S., 315 Ghosh Ippen, C., 161 Gibbons, J., 123 Gibler, N., 314 Gijsbers, K., 89 Gilbertson, M. W., 90, 296 Gilboa, A., 282, 283 Gillath, O., 5, 239 Gilliom, M., 356 Gini, M., 147, 151, 156, 207 Glaser, B., 272 Glaser, R., 322 Glisky, E., 91, 94, 95 Glover, G., 233 Glover, V., 291 Glynn, L. M., 288 Goeke-Morey, M., 169 Gold, P. E., 228, 321 Goldberg, A., 63, 345, 379 Goldberg, S., 181 Golden, A.-M., 233 Golding, J., 291 Goldsmith, D. F., 157 Goldsmith, H. H., 187 Goldstein, L., 234 Gomez, J. L., 286 Gomez, P., 319 Gonzalez, J., 240 Goodman, G. S., 3, 6, 7, 8, 14, 17, 19, 65, 67, 206, 222, 234, 235, 236, 238, 239, 313, 315, 316, 356 Goodman, K. L., 398 Goodman, S. H., 397 Goodyer, I. M., 87, 90 Gordon, B. N., 30, 31, 33, 34, 35, 40, 49, 52, 53, 60, 72, 313, 345 Gottlieb, G., 222, 225 Gottman, J. M., 170, 368 Gould, E., 89, 286, 291, 293, 297 Grady, C. L., 282 Gramzow, E., 34 Granhag, P., 3 Gratz, K. L., 401 Graves, E. I., 232 Graziano, W. G., 236

Green, F. L., 240 Green, M. L., 364 Greenberg, M. T., 187, 397 Greenberger, E., 186 Greenhoot, A. F., 30, 34, 46, 72, 86, 91, 94, 95, 98, 101, 106, 108, 301 Greenough, W. T., 297 Gregory, S., 88 Greundel, J., 349 Griffin, D., 16, 17, 20 Grolnick, W., 168 Gross, J. J., 86, 122, 225, 236, 323, 366, 402 Grossmann, K. E., 178, 328 Grunau, R. E., 288 Guichard, A. C., 237 Gunderson, J. G., 401 Gunnar, M. R., 89, 229, 235, 237, 256, 257, 258, 259, 260, 264, 267, 268, 269, 271, 272, 273, 291, 328, 330, 356, 383 Gurvits, T. V., 295 Guthrie, I. K., 168 Gutteling, B. M., 288, 290, 291 Habets, P., 402 Habib, R., 223, 226, 229 Haden, C. A., 60, 72, 77, 102, 142, 171, 172, 197, 199, 241, 281, 350, 364 Hafer, N., 233 Haft, W. L., 181 Haight, J. C., 98 Haimovich, Z., 203 Haine, R. A., 72 Haines, K. E., 293 Halberstadt, A., 169, 170 Haley, D., 262 Hall, J., 89 Hammond, M., 404 Han, J. J., 73 Han, J.-S., 286 Hanna, C., 89 Hansen, A. L., 228 Harada, Y., 299 Harbuz, M. S., 233 Hargreaves, I., 88 Harley, K., 72, 77, 281 Harmon-Jones, E., 230 Harris, P. L., 155, 169, 362 Hart, B., 77 Hasher, L., 92, 243 Hastings, N. B., 286 Hautzinger, M., 325

Haviland, J., 170 Hawes, D., 404 Hawkins, R. D., 282 Haydon, K. C., 107 Hayes, S. C., 67, 396, 401 Hayne, H., 72, 280, 345 Hazan, C., 5, 14 Hazzard, A., 98, 99, 103, 186 Healy, B. T., 328 Hedrick, A. M., 60, 364 Heim, C., 264, 273 Heinrichs, M., 325 Hellhammer, D. H., 286, 325, 329, 330 Hellhammer, D. K., 264 Helmeke, C., 286 Henderson, D., 88, 98 Henderson, H. A., 328 Hendriks, W., 290 Hennessy, K. D., 100 Henning, S., 285 Henri, V., 29 Hepps, D., 3, 313 Herman, J. L., 87 Herman J. P., 325 Hermans, D., 88, 91, 101 Heron, J., 291 Hershkowitz, I., 3, 370 Hertsgaard, L., 271, 281 Hess, T. M., 35, 313 Hesse, E., 156, 158 Hessl, D., 272 Het, S., 261, 262, 265, 273 Hevenor, S. J., 282 Hill, D., 240 Hill, D. E., 131 Hill, J., 88, 234 Hinde, R., 187 Hirschman, J. E., 3, 313 Hock, C., 265 Hoffman, P. D., 399 Hofmeister, C., 146 Holbrook, T. L., 296 Holmes, K., 316 Hoogstra, L., 172 Hooper, S. R., 314 Hooven, C., 170, 368 Hoover, C., 183 Horowitz, D., 370 Horowitz, F. D., 395 Horowitz, L. M., 14, 17, 18, 19, 20 Howe, M. L., 90, 281 Howe, N., 240 Howell, D. C., 135, 136 Howell, R., 88 Hoyt, D. B., 296 Hubbard, J., 170 Hudson, A. E., 40

Hudson, J., 12, 32, 170, 171, 172, 224, 284, 345, 349 Hudson, M. M., 131 Hughes, C., 170, 241, 397 Huizink, A. C., 290, 291 Humphreys, A. G., 297 Hunter, E. C. M., 87 Hurlemann, R., 232 Huttenlocher, J., 169 Huttenlocher, P. R., 283 Hwang W-C., 398 Ingram, M., 404 Inhelder, B., 224, 345 Introini-Collison, I. B., 321 Irion, J. C., 328 Irwin, W., 230 Isensee, J., 383 Ishige, A., 287 Jackson, K., 213 Jackson, M. F., 290 Jacobs, W. J., 226 Jacobson, L., 286, 290, 325 Jacobvitz, D., 153 Jager, G., 297 Janowsky, J. S., 297, 298 Jaynes, J., 32 Jelicic, M., 402 Jeltsch, H., 299 Jensen, R. A., 228 Jesso, B., 80, 403 Jewel, E., 228 Jochem, R., 367 Joëls, M., 324 John, O. P., 86, 236 John, R. S., 100 Johnsen, B. H., 228 Johnson, R. J., 86, 91, 95, 98, 100, 101, 103, 107 Jones, N. A., 240 Juraska, J. M., 297 Kagan, J., 123, 235, 328 Kail, R., 222 Kaleita, T. A., 131 Kampen, D. L., 298 Kandel, E. R., 282 Kang, H., 290 Kanitz, E., 285, 286, 289 Kaplan, K., 203, 204 Kaplan, N., 5, 161, 178 Kapoor, A., 288 Kapur, S., 223, 229 Karemaker, J. M., 319 Karst, H., 258, 260 Kasuga, S., 299 Katz, E. R., 316, 400

Author Index

419

Katz, L. F., 170, 368 Kavushansky, A., 287 Kazak, A. E., 136 Keedwell, P. A., 234 Kellerman, J., 316 Kendall, P. C., 398 Kennedy Jr., D. N., 296 Kennedy, S., 404 Kenny, D. A., 15 Kermoian, R., 32 Kern, R. P., 316 Kerns, K. A., 356 Kertes, D. A., 267, 272 Keshavan, M. S., 272, 296 Kessels, R. P. C., 297, 326 Kiel, E. J., 328 Kieras, J., 236 Killeen, P. R., 122 Kim, J. J., 286 Kindler, J., 286 King, L. A. Kingman, R., 319 Kirschbaum, C., 228, 325, 329, 330 Kirsh, S. J., 7, 10, 238, 239, 359 Kitayama, N., 89 Klann-Delius, G., 146 Kleen, J. K., 122, 123 Kliewer, W., 101, 102, 213 Klinger, L. G., 240 Klorman, R., 233 Knight, R. T., 223, 229, 230 Koehler, A. J., 290 Koeneker, A., 262 Koenig, M., 362 Kohlberg, L., 50 Koppeschaar, H. P. F., 297, 326 Koranda, J. L., 293 Koreishi, A., 73 Koren-Karie, N., 142, 146, 149, 151, 152, 153, 158, 159, 203 Körkel, J., 36 Kornack, D. R., 295 Koss, M. P., 93 Kosztolanyi, G. Y., 283 Koverola, C., 89, 295 Kraft, R. H., 231, 233, 239 Krag, D. N., 135 Krahl, S. E., 228 Krueger, K., 328 Kudielka, B. M., 330, 331 Kuebli, J., 106, 224, 241, 349 Kuehn, E.-M., 234

420

AUTHOR INDEX

Kuersten-Hogan, R., 241 Kuhlmann, S., 228, 265 Kuhn, J., 6, 65, 238, 315, 316 Kushner, S. A., 282 Kutner, M., 89 Kuyken, W., 87, 88, 90, 98, 233 LaBar, K. S., 231 Labay, L. E., 317 Ladd, C. O., 292 Lagattuta, K, 169, 170 Laible, D., 9, 12, 102, 146, 166, 169, 170, 171, 172, 173, 175, 179, 180, 186, 187, 203, 350, 357 Laird, A. R., 129 Lamarque, S., 289 Lamb, M. E., 3, 88, 370, 408 Lane, R. D., 103 Lanes, O., 3 Lang, A., 318 Lang, P. J., 318 Lanigan, L., 5 Lannon, R., 237 Larson, D. G., 110 Larson, M., 268 Larus, D., 31, 33, 34 Lasko, N. B., 90 Lasley, E. N., 382 Laumakis, M. A., 100 Lazarus, C., 299 Lazarus, R. S., 32, 124, 201, 224 Le Moal, M., 240, 289 Leander, L., 3 LeDoux, J. E., 227, 266 Lee, H. J., 286 Legerski, J. P., 86, 106 Leichtman, M. D., 12, 73, 80 Leidy, M. S., 240 Lejuez, C. W., 401 Lemaire, V., 289 Lench, H. C., 265, 316, 319 Lepage, M., 226 Lerner, R. M., 222 Levine, B., 223 Levine, L., 169, 364 Levine, S., 240, 268, 289, 293 Levitt, M., 63 Levy, F., 291, 294 Lewis, C., 362, 396 Lewis, M., 184, 367 Lewis, T., 237 Libkuman, T, M., 232, 316

Lickliter, R., 222 Lieberman, A. F., 158, 160, 161 Likhtik, E., 227 Lindauer, B. K., 28, 29, 30 Lineham, M. M., 398 Linke, R., 292 Liu, D., 294 Livesay, K. L., 130 Liwag, M. D., 48, 364 Locantore, J. K., 230 Loftus, E. F., 19–20, 31, 316 Long, J., 272 Lopez, J. F., 260 Losoya, S. H., 168 Louie, A., 237 Lovallo, W. R., 265, 325 Lovallo, W. T., 320 Low, J., 73 Low, M. J., 258 Lubach, G. R., 291 Luine, V., 285 Lukon, J. L., 356 Lukowski, A. F., 186, 389 Lukoyanov, N. V., 292 Lumley, M. A., 40 Luna, B., 127, 129 Lupien, S. J., 226, 325, 328 Luu, P., 231 Lynch, M., 238 Lynch, T. R., 398 Lyon, T. D., 407 Lyons-Ruth, K., 153 McAdams, D. P., 184 McAndrews, M. P., 283 Macaulay, D., 223, 223 McCabe, A., 72, 73, 76, 77, 80, 102, 403 McCall, R., 187 McCarthy, G., 231 McCarty, B., 295 McCarty, R., 228 McCauley, M. R., 43 McCloskey, L. A., 86, 91, 93, 94, 95, 98, 103 McCrae, R. R., 16 McDermott, K. B., 31 MacDonald, J. F., 290 McDonald, R. J., 229 McDowell, D. J., 240 McEwan, B. S 32 McEwen, B. S., 89, 228, 260, 285, 286, 291, 297, 314, 320, 325, 382 McGaugh, J. L., 89, 226, 227, 265, 266, 286, 287, 298, 321

McGorty, E. K., 13, 61 McGuigan, F., 53, 73, 80, 350, 397, 405 McHale, J. P., 241 McIntosh, A. R., 226, 283 McIntyre, C. K., 286 MacKay-Soroka, S., 181 MacKinnon, D., 196 Macklin, M. L., 90 McLaughlin, C., 186 McLaughlin, K. J., 286 McLeod B. D., 398 McMillan, K. M., 129 McNally, R. J., 90 Madeira, M. D., 292 Madsen, N. J., 272 Magarinos, A. M., 285 Maguire, E. A., 89 Main, M., 5, 6, 10, 146, 158, 161, 178, 203, 204 Malarkey, W., 322 Malatesta, C., 178 Malcarne, V. L., 328 Malloy, L. C., 8 Mandler, J. M., 224, 281 Mangelsdorf, S., 356 Manly, J. T., 21 Mannarino, A. P., 405, 407 Manteufel, G., 285 Maor, G. I., 286 Marais, L., 293 Maratsos, M., 376 Margolin, G., 100, 103 Marin, K. A., 346, 352 Markowitsch, H. J., 223, 227, 229, 283 Marks, M., 351 Marsh, E. L., 32, 47 Marshall, P. J., 235, 237, 328 Marshall, R. D., 400, 405 Marshall, T. R., 235 Marti, O., 233 Martin, J. N., 235, 236 Martinez, C., 285 Martinez, J. L., 321 Marvin, R. S., 144 Matas, L., 144 Mathiak, K., 325 Matlina, E., 286 Matthews, K. A., 322 Matthews, S. G., 288, 290 Matynia, A., 282 Mayford, M., 282 Mayo, W., 240 Mazure, C., 89 Meaney, M. J., 293, 294 Meck, W. H., 299 Meeren, M., 88

Meins, E., 204, 348 Melamed, B. G., 40 Melinder, A., 20 Melnyk, L., 6 Melo, A. I., 291 Melo, B., 283 Meltzoff, A. N., 280 Mennuti-Washburn, J., 101, 207 Merckelbach, H., 88, 402 Merritt, K. A., 30, 34, 35, 36, 40, 41, 65, 72, 313, 315, 316, 317, 326, 379 Mervis, C. B., 170, 240 Messier, C., 230 Meyer, S., 168, 357, 367, 368 Mikulincer, M., 5, 6, 204, 239, 351 Miller, J. B., 238 Miller, P., 101, 172, 198, 240 Miller, S. M., 364 Milner, D., 328 Mintun, M. A., 89 Mintz, J., 172 Mirescu, C., 293 Mitchell-Copeland, J., 169 Mitra, R., 286 Mizoguchi, K., 287, 288 Mody, T., 240 Moehler, E., 236 Molnar, C., 346 Montgomery, L. A., 228 Moore, B. A., 346 Moore, G. A., 328 Moradi, A. R., 295 Morison, S. J., 272 Moritz, G., 89 Morris, A. S., 366 Morris, P. A., 222, 224, 225, 243 Moscovitch, M., 282, 283 Moses, S. N., 229 Mravec, B., 228 Mueller, B. R., 297, 300 Mueller N. K., 325 Mulder, E. J. H., 289 Mulder, M., 326 Mulhern, R. K., 130, 131 Mulholland, K. A., 204, 212 Mumme, D. L., 32, 233 Munck, A. U., 258 Munholland, K. A., 4, 11, 237, 358 Murachver, T., 402 Murdoch, B. E., 131 Muris, P., 402 Murmu, M. S., 285 Murowchick, E., 5

Myers, R. E., 289 Myles-Worsley, M., 30, 45 Nachmias, M., 270, 271, 356 Nachmias, O., 5 Nadel, L., 226 Narayan, M., 89, 285 Narayanan, K., 230 Nawrocki, T., 240 Nelligan, J. S., 15 Nelson, C. A., 89, 231, 284 Nelson, K., 12, 73, 84, 102, 142, 171, 172, 198, 224, 281, 284, 347, 349, 350, 362, 376, 377, 396 Nemeroff, C. B., 273, 292 Neria, Y., 400 Ness, K. K., 131 Neubort, S., 285 Neufeld, H., 283 Newcombe, N. S., 281 Newcombe, R., 11, 241, 403, 404 Newhagen, J., 318 Newnham, J. P., 291 Niarhos, F., 130 Nichols, K. E., 328 Nida, R. E., 36 Niedenthal, P. M., 351 Nielson, K. A., 318 Nilsson, L., 318 Nir, A., 155 Nishio, H., 299 Nitsch, R., 265 Noirot, M., 238 Nolen-Hoeksema, S., 127 Nordenberg, D. F., 87 Oates, K., 67 Obegi, J. H., 239 Ochs, J., 131 Ochsner, K. N., 122, 130 O’Connor, T. G., 291, 300 Ogle, C. M., 3, 19 O’Hara, K. D., 50, 221, 231, 233, 239 O-Heeron, R., 183 Oitzl, M. S., 291, 292, 324 O’Kearney, R., 397, 398 O’Keeffe, G., 28 Okuda, S., 266 Olthof, T., 169 Ontai, L., 9, 169, 172, 357, 363 Oosterman, M., 322 Oppedisano, G., 135 Oppenheim, D., 12, 142, 144, 146, 147, 150, 151, 152, 153, 154,

Author Index

421

155, 156, 157, 158, 161, 162, 178, 197, 203, 207 Orbach, Y., 88, 370 Ornstein, P. A., 28, 30, 31, 32, 33, 34, 35, 36, 37, 40, 45, 49, 51, 52, 53, 60, 65, 72, 279, 313, 345, 364 Orwoll, E., 297 Ostafin, B., 401 Ostrander M. M., 325 Otani, H., 232, 316 Otten, W., 285 Ouellet-Morin, I., 328 Owen, A. M., 129 Owens, M. J., 292 Ozanne, A. E., 131 Packard, M. G., 286 Page, K. C., 289 Pals, J. L., 184 Panagiotides, H., 240 Panfile, T., 12, 166, 173, 187 Papini, S., 265 Papp, L., 169 Pardy, L., 80, 316 Pare, D., 227, 298 Paris, S. G., 28, 29, 30 Park, R. J., 87, 90 Parke, R. D., 240 Parker, J. F., 63, 184, 345, 379 Parker, K. C. H., 8 Parritz, R. H., 356 Parsons, B., 67 Patten, A. H., 184 Patterson, G. R., 399 Paula-Barbosa, M. M., 292 Pavlides, C., 228 Payne, J. D., 226 Peeters, F., 88 Pelletier, J. G., 227 Pelphrey, K. A., 34 Pennebaker, J. W., 52, 110, 183, 184, 199, 201, 202, 206, 346, 405 Penrod, S. D., 13, 61 Pereg, D., 239 Pereira, J. K., 53, 65, 236, 241, 405 Perez, C., 314 Perez-Edgar, K. F., 235 Perras, B., 264 Perrig, P., 223 Perrig, W. J., 223 Perry, L., 319 Persinger, M. A., 100 Peters, D. P., 61, 68

422

AUTHOR INDEX

Peters, J. D., 293 Peterson, C., 42, 60, 61, 64, 65, 67, 72, 73, 74, 76, 77, 79, 80, 81, 101, 102, 106, 200, 281, 313, 315, 316, 403 Peterson, E., 123 Pfaff, D. W., 297 Phelph, E. A., 89 Phillips, M. L., 234 Piaget, J., 224, 345 Picariello, M. L., 388 Pickens, J., 240 Pickering, T. G., 328 Pickrell, J. E., 19–20, 405 Pier-Vincenzo, P., 289 Pietromonaco, P. R., 237 Pillemer, D. B., 12, 73, 388, 396 Pipe, M-E., 402, 407, 408 Pirke, K., 329 Pitman, R. K., 90, 285 Pleydell-Pearce, C. W., 92 Plihal, W., 264 Pliska, V., 290 Plomin, R., 187 Pokorny, J., 290 Pollak, S., 233 Pollock, L. R., 91, 110 Porges, S. W., 228, 323, 329 Portales, L. A., 329 Posner, M. I., 124, 231, 235, 236 Postma, A., 297, 298 Potts, R., 172 Powell, M. B., 45 Power, A. E., 286 Prabhakaran, V., 230 Pratt, M. W., 198 Pressley, M., 77 Prevor, M. B., 235 Price, M., 65 Primeau, M., 133 Primo, K., 135 Principe, G. F., 28, 30, 31, 40, 41, 53, 345 Prins, B., 321 Propper, C., 328 Proudfit, H., 266 Pruett, J. C., 388 Putman, P., 325 Qin, J. J., 7, 19 Quas, J. A., 5, 6, 7, 15, 18, 19, 65, 67, 206, 222, 234, 236, 238, 244, 265, 313, 315, 316, 319, 322, 324, 326, 329, 330, 331, 356, 407

Quevedo, K., 257, 258 Quigley, K. S., 323, 327 Quinlan, D. M., 103 Quinlivan, J. A., 291 Rabideau, G. J., 100 Racagni, G., 290 Rademacher, J., 186, 296, 389 Radley, J. J., 287 Radloff, L. S., 96 Raes, F., 88, 90, 91, 106 Raikes, H. A., 358, 361 Rakic, P., 288, 291, 295 Ramírez-Esparza, N., 405 Ramlow, G., 261 Ramsden, S., 170 Ramsey, C., 184 Randall, P., 89, 295 Rao, S. M., 133 Rapee, R. M., 398, 404 Rassin, E., 402 Rauch, S. L., 285 Ray, R. D., 272 Redlich, A. D., 315 Reed, M. A., 235 Reed, R. S., 3 Rees, M., 74 Reese, E., 11, 72, 73, 77, 102, 142, 171, 172, 179, 197, 199, 240, 241, 281, 350, 352, 360, 402, 403, 404 Reeves, B., 318 Reichwald, U., 325 Reid, J., 399 Reid, M., 30 Reiser, M., 168 Reiss, A. L., 272, 295 Reul, J. M., 260, 324 Reynolds, J., 184 Reynolds, M., 90, 197 Reznick, J. S., 123, 236 Reznik, I., 237 Rholes, W. S., 5, 15 Riccio, D. C., 321 Richards, J. M., 236, 402 Richelme, C., 296 Richter-Levin, G., 285, 287 Riddlesberger, M. M., 6, 65, 238, 315, 316 Rideout, R., 67 Ridgeway, D., 240 Rigatuso, J., 328 Rimmele, U., 325 Risley, T. R., 77 Riva, M. A., 290 Roberts, C., 77 Roberts, D., 289 Roberts, K. P., 45 Robertson, R., 142

Robinson, J. L., 16 Robinson, K. E., 109, 121, 130, 132, 201 Robison, L. L., 131 Robles de Medina, P. G., 289 Roceri, M., 290, 293 Rochester, M., 181 Rodriguez, A., 313 Rodriguez, E. M., 109, 121, 201 Roediger, H. L. III, 31 Rogoff, B., 225 Rollinson, L., 88, 234 Romanoff, S., 407 Romero, M., 258 Roosa, M., 196 Roozendaal, B., 89, 226, 227, 228, 262, 265, 266, 273, 287, 298, 325 Rose, G. M., 228 Rose, S. P., 234 Rosen, H., 286 Rosenberg, L. T., 289 Rosenthal, M. Z., 401 Roskoden, T., 292 Ross, M., 30, 32, 33, 48 Roth, W. T., 323 Rothbart, M. K., 16, 124, 187, 235, 236, 344 Roughton, E. C., 290 Rubin, D. C., 352 Rudolph, K. D., 126 Rudy, L., 3, 313 Rutter, M., 396 Ryan, S. M., 398 Rydel, T. A., 286 Rydell, A-M., 168 Saarni, C., 168, 169, 233 Sagi-Schwartz, A., 156, 207 Saisa, J., 230 Sales, J. M., 9, 63, 74, 98, 101, 106, 160, 184, 185, 186, 196, 197, 200, 202, 203, 206, 207, 212, 213, 313, 345, 346, 348, 350, 379, 389 Salmon, K., 53, 65, 67, 70, 73, 80, 236, 241, 322, 323, 327, 350, 371, 394, 397, 400, 402, 403, 404, 405, 406, 407 Salovey, P., 168 Saltzman, H., 122, 168 Samish-Nemlich, T., 151, 152 Sandler, I. N., 196, 202

Sandman, C. A., 288 Sanghavi, M., 89 Sapolsky, R. M., 89, 90, 228, 258, 260, 286, 290, 314, 325 Sarfati, D., 98, 186 Sarrieau, A., 293 Saxton, M., 197 Saywitz, K. J., 407 Scaduto, M., 130 Schaaf, J. M., 7, 8, 19, 234, 235 Schaaf, M. J. M., 290 Schacter, D. L., 222 Schartau, P., 233 Schatzow, E., 87 Scheeringa, M. S., 403 Scheier, M., 202, 207 Scherf, K. S., 129 Schin, L. M., 285 Schmidt, L. A., 235, 236 Schmitz, C., 299 Schneider, M. L., 290, 291 Schneider, R., 398 Schneider, W., 36, 77 Schoener, J. A., 289 Schommer, N. C., 325 Schonberg, M. A., 356 Schooler, J. W., 403 Schroeder, C. S., 33 Schuder, M., 272 Schuengel, C., 322 Schulkin, J., 259 Schuman, E. M., 290 Schwartz, G. E., 103 Schwartz-Kenney, B. M., 3 Schwegler, H., 292 Scollon, C. K., 184 Scott, J., 87, 110 Scott, T. M., 90 Scullin, M. H., 265 Seagal, J., 183 Segal, Y., 151 Seibyl, J., 295 Seress, L., 283 Setiawan, E., 290, 297, 299 Shamir-Essakow, G., 398 Shankaranarayana Rao, B. S., 286 Sharma, S., 293 Shaver, P. R., 5, 10, 14, 15, 103, 204, 207, 234, 239, 348, 351 Shaw, D. S., 356 Sheffield, E. G., 32 Sheline, Y. I., 89 Shenk, C., 399 Shepard, B., 178 Shepard, S. A., 168

Sherwin, B. B., 298 Sherwood, A., 322 Shields, A., 168 Shin, L., 287 Shipman, K., 398 Shivy, V. A., 213 Shors, T. J., 121, 122, 297 Shrimpton, S., 67 Sieber, W. J., 296 Siegel, S. E., 316 Sigman M., 398 Silfvenius, H., 230 Silva, A. J., 282 Silverman, L., 297, 298 Simcock, G., 72, 345 Simpson, J. A., 5, 15, 107 Sims, C., 398 Sitomer, M. T., 122 Skinner, E. A., 121, 124, 125, 137, 168, 175 Skowronek, J. S., 12 Skowronski, J. J., 346 Slade, A., 181 Slomkowski, C., 240 Sloviter, R. S., 285 Smart, J. L., 304 Smeenk, J., 91 Smeets, T., 122, 232 Smiley, P., 169 Smith, D. C., 228 Smith, L. B., 222, 347 Smith, S. M., 325 Smyth, J. M., 110 Snidman, N., 123, 235 Snow, C. E., 76 Snyder, J., 399 Sollas, A. L., 285 Solomon, J., 5, 244 Song, J., 171, 173, 179, 180 Sousa, N., 292 Southam-Gerow, M. A., 398 Southwick, S. M., 90, 295 Spangler, G., 178, 328 Sperry, L. L., 240 Spicker, B., 35, 65, 313 Spieker, S., 5 Spinillo, A., 289, 290 Spinrad, T. L., 168, 170, 367 Spiro, J. E., 382 Spritz, B., 7, 238, 359 Squire, L. R., 89, 280, 282, 289 Sroufe, A., 186 Sroufe, L. A., 144, 396 Staib, L., 89 Stansbury, K., 89, 262 Stark, E. N., 186, 389

Author Index

423

Starnes, L., 28, 41 Startup, M., 88, 234 Stayton, D., 178 Steele, H., 27 Steele, M., 27 Stegge, H., 166, 397, 398 Stein, D. J., 293 Stein, M. B., 89, 90, 295, 296 Stein, N., 48, 169, 318, 364 Steinhauer, S. R., 323 Stennes, L., 98 Steptoe, A., 319 Sternberg, D. B., 321 Sternberg, K. J., 88, 407 Stevenson-Hinde, J., 235 Steward, M. S., 69 Stone, L. D., 52 Strage, A., 146 Strandberg, K., 169 Strange, B. A., 232 Straus, M. A., 94 Strauss, M. E., 323 Stroud, L., 269 Stuber, M. L., 136 Stuewig, J., 103 Suess, P. E., 329 Suh, E. J., 400 Sutanto, W., 260 Sutherland, K., 405 Sutherland, R. J., 229 Sutker, P. B., 90 Suveg, C., 398 Sweeney, J. A., 127, 129 Sweeney, L., 404 Sweet, L. H., 133 Switzer, H., 236, 238, 239, 241 Szuran, T. F., 290 Tabira, T., 287 Taghavi, M. R., 295 Talley, C. P., 228 Tanapat, P., 89, 286 Tata, P., 90 Taylor, K. W., 213 Teasdale, J. D., 87, 90 Teicher, M. H., 89, 292 Tein, J., 202 TenVoorde, B. J., 319 Terr, L., 67, 279 Terwogt, M. M., 166, 397, 398 Tesla, C., 240 Tesman, J., 178 Tessler, M., 73 Thatcher, R. W., 234 Thayer, J. F., 228 Theall-Honey, L. A., 235, 236 Thelen, E., 222, 347

424

AUTHOR INDEX

Thomas, R. C., 243 Thomas, T. L., 320 Thompson, C. P., 346 Thompson, R. A., 9, 11, 12, 102, 146, 168, 169, 170, 171, 172, 173, 177, 179, 180, 181, 186, 197, 203, 204, 212, 225, 355, 356, 357, 358, 359, 361, 362, 363, 364, 366, 367, 369 Thomsen, A. H., 122, 168 Thorell, L. B., 168 Tizzard-Drover, T., 80, 316 Tobin, D. L., 125 Tobin, R. E. M., 236 Toki, S., 294 Tomich, P. L., 356 Torchia, M. G., 89, 295 Tornoczky, T., 283 Toth, S. L., 90, 406 Tran, S., 107 Tsethlikai, M., 46 Tsigos, C., 258, 320, 321, 324 Tuchscherer, M., 285 Tucker, D. M., 231 Tuiten, A., 297 Tull, M. T., 401 Tulving, E., 223, 226, 229 Tupler, L. A., 295, 296 Tyler, C. S., 34 Uchino, B. N., 322 Uddo, M., 90 Underwood, B. J., 29 Ungerer, J. A., 398 Ushijama, M., 299 Uys, J. D. K., 293 Vaandermaas, M. O., 313 Vaccarino, V., 89 Vale, W. W., 325 Valentino, R. J., 266 Valiente, C., 168, 240 Vallee, M., 240, 288, 289 Van Abbema, D. L., 185, 186, 199, 345, 379, 389 Van Bockstaele, E. J., 266 van Buskirk, R., 321 van der Kolk, B., 279 Van der Zee, E. A., 266 van Honk, J., 297, 326 Van Horn, P. J., 158, 160, 161 Van IJzendoorn, M. H., 8, 9, 235 Van Minnen, A., 91

Van Slyke, D., 130 van Steegeren, A., 287, 296, 298 Vandermaas, M. O., 35 Vanhorn, P., 405 Vasterling, J. J., 90 Vasudeva, A., 12, 102, 146, 171, 172, 179, 205 Vazquez, D., 258, 259, 260, 264, 268, 269, 273 Velles, A., 233 Verhaak, C 91 Vermetten, E., 89 Vernberg, E. M., 106 Viau, V., 293 Vicary, A., 351 Villegas, M., 285 Visser, G. H. A., 289 Vrana, S., 318 Vyas, A., 286 Vygotsky, L. S., 197, 198, 204, 212, 225, 243, 343 Vythilingam, M., 89 Waddington, C. H., 224 Wadhwa, P. D., 288 Wadsworth, M. E., 122, 127, 168 Wagner, U., 264, 265, 273 Wahlsten, D., 222 Walco, G. A., 317 Walker, J. M., 213 Walker, L. S., 125 Walker, P. A., 103 Walker, W. R., 346 Wall, P. M., 230 Wall, S., 4, 143, 153 Wallin, A. R., 265, 313 Wang, Q., 32, 73 Wareham, P., 371, 403 Warren, K., 60, 80, 316 Warren, S. G., 155, 297, 298 Watamura, S. E., 267 Watanabe, Y., 228, 286 Waters, E., 4, 7, 20, 143, 153 Waters, H. A., 12 Waters, J. M., 284 Waters, W. E., 318 Watkins, E., 90 Watson, S. J., 260 Watts-English, T., 314 Weber, M., 321 Webster-Stratton, C., 404 Weems, C. F., 272, 295 Wegner, D. M., 91, 135 Weimer, B. L., 356

Weinberg, J., 293 Weinert, F. E., 36 Weinfield, N., 186 Weinstock, M., 286, 289, 297, 299, 300 Weintraub, J. K., 202, 207 Weiss, P., 89 Weisz, J. R., 126 Welch-Ross, M. K., 12, 146, 172, 179, 180, 241, 403 Wellman, C. L., 285 Wellman, H., 170 Welzl, H., 290 Wenner, J. A., 284 Wessel, I., 88, 90, 91, 107, 109 West, S., 202 Wewerka, S., 284, 330, 345 Whalen, N., 61, 65, 67 Wheeler, M. A., 226 Whipple, E. E., 181 Whissell, C. M., 241 Whitlock, J. A., 130 Widner, R. L., Jr., 232 Widom, C. S., 314

Wiebe, S. A., 284 Wiik, Gunnar, M., 292 Wiik, K. L., 256 Wilhelm, F. H., 323 Williams, C. L., 299 Williams, J. M. G., 87, 91, 92, 97, 109, 110, 402 Williams, R. M., 90 Williams, S. C. R., 234 Williams, T., 184 Wilson, K. G., 396, 401 Wingfield, J. C., 320 Winkel, J., 297 Winocur, G., 282 Witt, J., 286 Woddis, D., 5 Wolchik, S. A., 196 Wolf, D. P., 144 Wolf, O. T., 228, 261, 265, 286, 325, 331 Wood, J. J., 398 Woolley, C. S., 291, 297 Workel, J. O., 292 Wranik, T., 168 Yamasaki, H., 231 Ye, R., 16

Yee, D., 318 Yeh, T. F., 290 Yehuda, R., 267 Yeung, C. A., 233 Yim, I. S., 244, 313 Yule, W., 295 Zacks, R. T., 92 Zagron, G., 289 Zahn-Waxler, C., 240 Zanakos, S., 91 Zeanah, C. H., 403 Zeijlmans van Emmichoven, I. A., 235, 238 Zeitlin, S. B., 103 Zelter, L. K., 317 Zeltzer, L. K., 316, 317, 400 Zeman, J., 398 Zentner, M., 123 Zhao, Z., 227, 230, 233, 316 Zimmer-Gembeck, M. J., 121, 125, 137, 168, 175 Zola-Morgan, S., 289 Zoller, D., 102, 169, 240

Author Index

425

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SUBJECT INDEX

Acute lympocytic leukemia (ALL), 130–133 Adrenocorticotropic hormone (ACTH), 258–259, 268, 324 Adult Attachment Interview (AAI), 161, 162, 181, 203, 204, 360 AEED. See Autobiographical Emotional Event Dialogue Allostatic load, 133 Amygdala, 227, 266, 325 and emotion, 286–287 gender differences, in memory, 298 AMT. See Autobiographical Memory Test Anterior cingulate cortex (ACC), 231 Anxiety, 5, 18–19, 40, 53–54, 124, 204 socialization of, 398 Arginine vasopressin (AVP), 257, 258 Attachment theory, 6–7, 356 for child sexual abuse, 18–19 and coping, parental scaffolding content code, 206, 208, 210 quality code, 206, 208, 210–211 structure code, 206, 207–208, 209 and false memory, 19–20 on HPA axis functioning, 270–271 and links with open communication, 176–182 elaborative style, 180 internal working models, 176–178 securely and insecurely, relationship between, 178–179 with memory and suggestibility, relations children, 7–8 mechanisms encoding, 9–11 retrieval, 12–13 storage, 11–12

parental, 8–9 research on, 13 and mother-child dialogues, 145–147 parental, 360–361 scaffolding, 203–205 perspective, 3–6 security on children’s memory for stressful events, 356–360 socioemotional context, 348–350 transaction, with caregiving environment, 237–239 Autobiographical Emotional Event Dialogue (AEED), 147, 150 coding system, 148 low-risk samples, 150–151 mother-child dialogues, 153–159 and risk status, 152–153 stability over time of, 151–152 Autobiographical memory functioning, 280, 281 and abuse, 95–106 emotion-socialization experiences, 102–106 internal states language, 98–101 conversation role in, 376–378 and depression, 96–97 and family violence, research program on, 93–95 narrative structure and content role in, 378 parental scaffolding, 198–199 for positive and negative valenced events, 200–202 trauma history, children and adults with, 87–88 trauma-related, 88–93 affect regulation hypothesis, 91–92 cognitive resources, depletion of, 90–91

427

Autobiographical memory functioning (Contd.) hippocampal impairment, 89–90 retrieval conditions, 90 Autobiographical Memory Test (AMT), 87, 88, 91, 93, 94, 96–98, 104 Automatic responses, to stress, 123–124 Autonoetic awareness, 281 Autonomic nervous system (ANS), 123, 257, 320–324 parasympathetic withdrawal, 323–324 sympathetic activation, 320–323 Avoidance, 5, 103–104, 135–136, 204 and coping, 401–403 Basolateral nucleus of amygdala (BLA), 262, 286–287, 298 Behavioral inhibition, 123, 235, 270 Brain system development underlying explicit memory, 282–285 frontal cortex, 283 hippocampus, 282–283 relationship, 284–285 storage and retrieval of memories, 283 stress effects childhood and adolescence, exposure in, 294–296 early postnatal exposure, 291–294 emotion and amygdala, 286–287 gender differences, 296–299 gender-dependent effects, 299–300 hippocampal and limbic structures, 285–286 immature brain, 288 prefrontal cortex, 287–288 prenatal and glucocorticoid exposure, 288–291 Brain-derived neruotrophic factor (BDNF), 293 Catecholamine, 266, 320 Co-constructing memories individual development change and continuity, 344–347 and meaning making, as social process, 351–352 narratives of stressful events, 205, 207, 208, 209–210 socioemotional context attachment, 348–350 reminiscing, 348–350 scaffolding, 348 Cognitive ability transaction, with child characteristics, 234–235 Cognitive reappraisal, 130 Complications, 374 of events and our understanding of them, 378–382 of memory, 375–378 our reactions to stress, 382–383

428

SUBJECT INDEX

stress and memory, relations between, 384–386 on cognition, 387–388 on development, 391 emotion relates, 390–391 on how events become integrated into the world view, 389–390 on reactions of others to events, 388–389 Constructive processes impact of, 30 knowledge-based, 33 of memory, 29–30 over time, 30–32 Controlled responses to stress, 124–125 Coping, 121 and attachment status, parental scaffolding content code, 206, 208, 210 quality code, 206, 208, 210–211 structure code, 206, 207–208, 209 avoidance and, 401–403 disengagement, 125–126, 134–136 emotion-focused, 202 engagement, 125–126, 127 executive function, 127–128 intrusive memories, 134–137 with negative emotion during and after stressful experiences, 167–175 in parental scaffolding, 201–202, 202–203 primary control, 126 problem-focused, 201–202 and responses to stress, 122 automatic, 123–124 controlled, 124–125 integrating automatic and controlled processes, 125–127 secondary control, 126, 129–134 working memory, 128–129 Corticotrophin-releasing hormone (CRH), 257, 258, 292, 324 Defensive exclusion, 6, 9 Depression, 240, 361 and autobiographical memory, 90, 91, 96–97, 233 Developmental changes in HPA axis, during childhood basal rhythm, 267 hyporesponsive period, 267–268 responsivity, 268–269 Disengagement coping, 125–126, 134–136 Divergent emotions, 32 Dual-process model of responses to stress automatic, 123–124 controlled, 124–125 integrating automatic and controlled processes, 125–127 Dynamic systems theory, emotional memory, 222–226

Emergency-room injury/hospital treatment children’s recall, 62–65 age, 66–68 individual difference factors, 77–78 parental conversational style, 72–77 prototype components, 63–64 variation in language competence, 71–72 in stress, 68–71 in temperament, 72 well-remembered events, 65–66 implications, 78–82 Emory Cognition Project symposium, 374, 375, 386, 391 Emotion management, in abuse-related memory patterns, 102–106 Emotion regulation, 168, 234, 236, 237, 366–369 implications of, 368–369 neurobiology of, 126 relational supports for, 367–368 representation, 368–369 understanding developmental processes in, 367, 368 Emotional memory, in development, 394 interrelatedness, 395 psychopathology, 395–396 avoidance and coping, 401–403 clinical interventions, implications for stressful and traumatic events, targeting memories of, 405–406 training parents, in elaborative reminiscing, 403–404 forensic contexts, implications for, 406–408 language and conversation, 396–399 understanding and appraisal, 399–401 Emotional memory, integrated model of, 221 dynamic systems theory, 222–226 neurophysiological processes, 226–227 neurobiology, 231–232 physiological systems, 227–231 amygdala, 227 frontal cortex, 230–231 hippocampus, 228–229 stress hormones, 227 transaction caregiving environment, qualities of, 237–241 attachment, 237–239 parent-child interaction style, 239–241 child, qualities of, 234–236 cognitive ability, 234–235 temperament and reactivity, 235–236 event, qualities of, 232–234

Emotional reactions, 32, 43, 51 Emotionally matched (EM), 149, 157–159 in low-risk samples, 150–151 Emotion-focused coping, 202 Endogenous forces, 30–31 Engagement coping, 125–126, 127 Epinephrine, 227, 228, 321 Episodic memory, 280 Estrogen, 297, 298 Executive function processes, 127–128, 132 Executive-resource deficits, 92 Exogenous forces, 31 Experiences in Close Relationships Inventory (ECRI), 204 Explicit memory development, 279–281 brain system underlying frontal cortex, 283 hippocampus, 282–283 relationship, 284–285 storage and retrieval of memories, 283 stress effects childhood and adolescence, exposure in, 294–296 early postnatal exposure, 291–294 emotion and amygdala, 286–287 gender differences, 296–299 gender-dependent effects, 299–300 hippocampal and limbic structures, 285–286 immature brain, 288 prefrontal cortex, 287–288 prenatal and glucocorticoid exposure, 288–291 Extended encoding, 345, 380, 387 implications, 52–54 investigation of, 33–36 changing expectations and memory, for soccer match, 42–44 constructive activity among soccer players, on winning vs. losing teams, 46–47 dental examination preparation and recall, 37–40 injury reports one-year later, changes, 48–50 invasive radiological procedure, 40–41 pediatric examination expectations and long-term recall, 45–46 prior knowledge and memory for, 36–37 play evaluations and extended coding among young athletes, 47–48 of personal experiences constructive processes impact of, 30 knowledge-based, 33

Subject Index

429

Extended encoding, (Contd.) of memory, 29–30 over time, 30–32 emotion, 32–33 stress, 32–33 False memory, 19–20 Family violence, 96 and memory functioning, 93–95 Frontal cortex, 230–231, 283 Glucocorticoids, 134, 227, 228, 257, 258, 259–260, 266, 273, 285, 292, 324 applications of findings, 266–267 on learning, 261–262 memory consolidation, 262–264 memory retrieval, 265 nonemotional versus emotional events, 265–266 and norepinephrine, in emotional memory, 266 and prenatal stress effects, 289–291 sleep, 264 Hippocampus, 89, 134, 228–229, 282–283, 285–286, 289–290, 295, 299 Hypothalamic-pituitary-adrenal (HPA) axis, 229, 256 anatomy and physiology of, 257–260 glucocorticoids. See Glucocorticoids developmental changes, during childhood basal rhythm, 267 hyporesponsive period, 267–268 responsivity, 268–269 physiological stress responses in children’s memory, 324–327 social regulation, in children, 269–272 attachment relationship, 270–271 social buffering versus vulnerability, 271–272 traumatic childhood memories chronic stress, 273 relationships and buffering, 273 timing, importance of, 272–273 Hypothalamus, 257–258 Infantile amnesia, 281 Inoculations, 15–17 Internal states language in autobiographical memory functioning, 98–101 Internal working models (IWMs), 4, 6, 176–178, 181–182, 203, 205, 358–359, 381 Intrusive memory, 90, 134–137 Investigation, of extended encoding, 33–36 changing expectations and memory, for soccer match, 42–44

430

SUBJECT INDEX

constructive activity among soccer players, on winning vs. losing teams, 46–47 dental examination preparation and recall, 37–40 injury reports one-year later, changes, 48–50 invasive radiological procedure, 40–41 medical procedures, 34 pediatric examination expectations and long-term recall, 45–46 prior knowledge and memory for, 36–37 among young athletes and play evaluations, 47–48 IWMs. See Internal working models Joint Storytelling Task (JST), 155–156 Knowledge-based constructive processes, 33 Language of coping, 202, 212 Meaning-making, 197, 405 as social process, 351–352 Memory accuracy, 35 with attachment and suggestibility, relations children, 7–8 mechanisms encoding, 9–11 retrieval, 12–13 storage, 11–12 parental, 8–9 research on, 13 constructivist perspective of, 29–30 and coping. See Coping glucocorticoids applications of findings, 266–267 consolidation, 262–264 on learning, 261–262 nonemotional versus emotional events, 265–266 and norepinephrine, in emotional memory, 266 retrieval, 265 sleep, 264 for inoculations, 16–17 and stress, relationship between, 61–62 for VCUG, 14–15 Mental working models, 358, 359 Mineralocorticoid receptors (MR), 259–260, 266, 273, 292, 324 Neurophysiological processes underlying emotional memory, 226–227 neurobiology, 231–232

physiological systems, 227–231 amygdala, 227 frontal cortex, 230–231 hippocampus, 228–229 stress hormones, 227 Nonemotionally matched exercise, 149 flat, 150 inconsistent, 150 Norepinephrine (NE), 227 and glucocorticoids, in emotional memory, 266 Parental attachment, 360–361 in children’s memory and suggestibility, 8–9 and communication with children, 180–181 and coping content code, 206, 208, 210 quality code, 206, 208, 210–211 structure code, 206, 207–208, 209 for inoculations, 15–17 and reminiscing style, connection between, 349 for VCUG, 14–15 Parental responsiveness for inoculations, 15–16 for VCUG, 14–15 Parental scaffolding attachment status, 203–205 of autobiographical memory development, 198–199 for positive and negative valenced events, 200–202 of children’s narratives, 197–202 coping and attachment status relates content code, 206, 208, 210 quality code, 206, 208, 210–211 structure code, 206, 207–208, 209 coping theory, 201–202, 202–203 individual differences in, 202–206 socioemotional context, 348 Parent-child emotion dialogues, 142, 361–366 AEED low-risk samples, 150–151 and risk status, 152–153 stability over time of, 151–152 and attachment, 145–147 studies, 153–156 coding system, 147 emotionally matched (EM), 149 nonemotionally matched exercise, 149 flat, 150 inconsistent, 150 and developing understanding, 362–364 discordant representations of shared experiences, 364–366 risk status, 156–159

secure base, 143–145 transaction, with caregiving environment, 239–241 Parent-child reminiscing, 166, 199 attachment theory and links with open communication, 176–182 elaborative style, 180 internal working models, 176–178 securely and insecurely, relationship between, 178–180 for children’s understanding of stressful experiences and psychological well-being, 182–186 coping with negative emotion during and after stressful experiences, 167–175 emotional understanding, development of, 168–170 socioemotional context, 348–350 Physiological stress responses and children’s event memory, 313, 318–320 autonomic nervous system, 320–324 parasympathetic withdrawal, 323–324 sympathetic activation, 320–323 developmental considerations, 327–330 HPA axis, 319–320, 324–327 interactions among systems, 327 methodological challenges, 315–318 Physiological systems, underlying emotional memory, 227–231 amygdala, 227 frontal cortex, 230–231 hippocampus, 228–229 stress hormones, 227 Posttraumatic stress disorder (PTSD), 89–90, 135, 267, 287, 294–296, 405 Prefrontal cortex (PFC), 127–128, 133, 231, 287–288, 293 Primary control coping, 126, 128, 132 Problem-focused coping, 201–202 Procedural narrative, 41 Proximal development, zone of, 198 Psychopathology development, 395–396 avoidance and coping, 401–403 clinical interventions, implications for stressful and traumatic events, targeting memories of, 405–406 training parents, in elaborative reminiscing, 403–404 forensic contexts, implications for, 406–408 language and conversation, 396–399 understanding and appraisal, 399–401 PTSD. See Posttraumatic stress disorder Rapid eye movement (REM) sleep, 264, 267, 273 Relationships, stress, and memory attachment theory, 356

Subject Index

431

Relationships, stress, and memory (Contd.) parental, 360–361 security on children’s memory for stressful events, 356–360 emotion regulation, 366–369 implications of, 368–369 relational supports for, 367–368 representation, 368–369 understanding developmental processes in, 367, 368 parent-child conversation, 361–366 and developing understanding, 362–364 discordant representations of shared experiences, 364–366 Secondary control coping, 126, 128, 129–134 Secure base, 143–145, 153, 157, 381 Self-concept, 171, 173, 183, 186, 360 Semantic memory, 280, 376 Separation-Reunion Narrative Co-Construction (SRNCC), 155, 156 Sexual abuse, 97, 145, 158 attachment and memory for, 18–19 Slow-wave sleep (SWS), 264, 273 Social process, meaning making as, 351–352 Social regulation of HPA axis, in children, 269–272 attachment relationship, 270–271 social buffering versus vulnerability, 271–272 Socialization in abuse-related memory patterns, 102 of anxiety, 398 Strange Situation, 4, 7, 8, 14, 155, 270–271 Stress effects on brain system underlying explicit memory childhood and adolescence, exposure in, 294–296 early postnatal exposure, 291–294 emotion and amygdala, 286–287 frontal cortex, 283 gender differences, 296–299 gender-dependent effects, 299–300 hippocampus, 282–283 and limbic structures, 285–286 immature brain, 288 prefrontal cortex, 287–288 prenatal and glucocorticoid exposure, 288–291 relationship, 284–285 storage and retrieval of memories, 283 Stress hormones, 227 Stress hyporesponsive period (SHRP), 291–292 Stress reactivity, 123

432

SUBJECT INDEX

Stressful events, children’s recall about emergency-room injury/ hospital treatment age, 66–68 individual difference factors, 77–78 parental conversational style, 72–77 prototype components, 63–64 variation in language competence, 71–72 in stress, 68–71 in temperament, 72 well-remembered events, 65–66 Suggestibility and attachment-memory children, 7–8 mechanisms encoding, 9–11 retrieval, 12–13 storage, 11–12 parental, 8–9 research on, 13 for inoculations, 16–17 for VCUG, 14–15 Sympathetic-adrenomedullary (SAM) system, 257 Temperament, 344 individual differences in, 123 transaction, with child characteristics, 187, 235–236 variation in, 72 Testosterone, 297, 298, 299 Trauma-related autobiographical memory, 88–93 affect regulation hypothesis, 91–92 cognitive resources, depletion of, 90–91 hippocampal impairment, 89–90 retrieval conditions, 90 Traumatic childhood memories attachment-memory/suggestibility children, 7–8 mechanisms encoding, 9–11 retrieval, 12–13 storage, 11–12 parental, 8–9 research on, 13 chronic stress, 273 relationships and buffering, 273 timing, importance of, 272–273 Trier Social Stress Test (TSST), 329–330, 331 Voiding cystourethrogram (VCUG), 8, 14–15, 40–41, 42, 53, 70, 72 Vygotsky’s theory, 198, 212 Working memory, 128–129, 229, 235, 239, 299, 402 and secondary control coping, 129–134