Journal of Clinical Child & Adolescent Psychology

ISSN: 1537-4416 (Print) 1537-4424 (Online) Journal homepage: http://www.tandfonline.com/loi/hcap20

Moderating Effects of Coping on Associations between Autonomic Arousal and Adolescent Internalizing and Externalizing Problems Amy A. Paysnick & Keith B. Burt To cite this article: Amy A. Paysnick & Keith B. Burt (2015) Moderating Effects of Coping on Associations between Autonomic Arousal and Adolescent Internalizing and Externalizing Problems, Journal of Clinical Child & Adolescent Psychology, 44:5, 846-858, DOI: 10.1080/15374416.2014.891224 To link to this article: http://dx.doi.org/10.1080/15374416.2014.891224

Published online: 14 Apr 2014.

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Journal of Clinical Child & Adolescent Psychology, 44(5), 846–858, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1537-4416 print=1537-4424 online DOI: 10.1080/15374416.2014.891224

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Moderating Effects of Coping on Associations between Autonomic Arousal and Adolescent Internalizing and Externalizing Problems Downloaded by [Central Michigan University] at 20:25 05 November 2015

Amy A. Paysnick and Keith B. Burt Department of Psychology, University of Vermont

Few published studies have looked at the moderating role of coping styles on the association between stress reactivity and internalizing=externalizing problems despite theory suggesting that particular constellations of stress reactivity and coping may be uniquely problematic. The present study aimed to test the interactive effects of coping and psychophysiology on self- and parent-report broad-spectrum problems in a normative adolescent sample. Sixty-six late adolescents (ages 16–17; 60% female, 13% ethnic minority) completed questionnaires on coping, stressful life events, and behavioral= emotional problems, with parents also providing data on problems. In addition, skin conductance and heart rate data were obtained during a brief interview designed to elicit the feeling of reexperiencing a recent stressful experience. Path analytic results suggested evidence for several interaction effects between coping and skin conductance. Most commonly, the pattern of effects was consistent with a buffering effect for productive (or problem-focused) coping strategies against elevated internalizing and externalizing problems for individuals who demonstrated high physiological stress reactivity. Evidence for interaction effects related to respiratory sinus arrhythmia was less frequent and less consistent with a priori hypotheses. Although our cross-sectional results should be interpreted cautiously, the interactions reported here suggest that improving coping skills may be particularly beneficial for youth with high psychophysiological arousal.

Despite the well-documented link between stress and psychopathology, much remains unknown about individual differences in stress-related behavioral and emotional problems. To better understand these factors, there is a continued need for studies using a multilevel approach, including both biological and psychological constructs (Cicchetti & Curtis, 2007). Research has shown that the voluntary ways people cope with stress (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001) and the involuntary (e.g., physiological) ways people react to stress are related to psychopathology (e.g., Beauchaine, 2001; Lorber, 2004). However, few studies have examined the potential joint influence of Correspondence should be addressed to Amy A. Paysnick, Department of Psychology, University of Vermont, John Dewey Hall, 2 Colchester Avenue, Burlington, VT 05401. E-mail: amy.paysnick@ uvm.edu

coping and psychophysiology on adjustment, and none in adolescent samples. This research gap motivates the current project. AUTONOMIC ACTIVITY=REACTIVITY AND PSYCHOPATHOLOGY A burgeoning area of research related to the stresspsychopathology association is the study of psychophysiology, including the autonomic nervous system. Within the autonomic nervous system, the sympathetic nervous system (SNS) branch is activated under stress and triggers the ‘‘fight or flight’’ response. This includes increased heart rate, oxygen flow, and an increase in sweat gland production making skin conductance level (SCL), or electrodermal reactivity, a method for measuring SNS activity (Boucsin, 1992). The parasympathetic

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COPING AND AUTONOMIC AROUSAL

nervous system (PNS) branch, on the other hand, functions to reduce physiological arousal (e.g., slowing heart rate). One method for measuring PNS activity is respiratory sinus arrhythmia (RSA), an indicator of vagal tone. The vagus nerve regulates PNS input into the heart and can be thought of as a brake: high RSA (increase in PNS activity) slows heart rate, whereas low RSA increases heart rate (Beauchaine, 2001; Porges, 2007). In general, baseline SCL has been associated with behavioral and emotional problems. It has been theorized that individuals experiencing an uncomfortable physiological state of low arousal may engage in externalizing behaviors to increase arousal (Ortiz & Raine, 2004). Consistent with this theory, a meta-analysis showed that low SCL (baseline and during a laboratory task) is associated with higher externalizing problems (Lorber, 2004). Conversely, high baseline SCL, or high arousal during rest, is associated with internalizing problems, potentially due to shyness or higher levels of behavioral inhibition (e.g., Kagan, Reznick, & Snidman, 1987). In addition, there are theoretical reasons to expect associations between SCL reactivity (SCL-R; difference between task and baseline) and psychopathology. According to fearlessness theory, low physiological arousal in response to mild stressors is an indicator of low levels of fear, which may be associated with aggressive and=or antisocial behavior (Ortiz & Raine, 2004). Despite this theory, the literature examining associations between SCL-R and externalizing problems is mixed. According to results from a meta-analysis, SCL-R is positively associated with aggression and negatively associated with psychopathy in adults (Lorber, 2004). On the other hand, studies suggest that low SCL-R is associated with externalizing problems in children (e.g., Fung et al., 2005; Herpertz et al., 2005). Furthermore, high SCL-R has also been linked with internalizing problems among normative youth (e.g., El-Sheikh, 2005). In sum, findings provide consistent evidence for associations between high baseline SCL and SCL-R and internalizing problems and low baseline SCL and externalizing problems, but findings for SCL-R and externalizing problems are mixed. These variable results may be due to differences in sample demographics. Whereas most studies examining SCL have been conducted with predominately male participants who either exhibit clinical levels of psychopathology and=or have engaged in criminal activity, different patterns appear to be present for the fewer studies examining normative samples (El-Sheikh, Keller, & Erath, 2007). Additional work is needed to more consistently elucidate associations between SCL-R and psychopathology in female and normative youth. For RSA, high baseline and RSA withdrawal under stress are considered indicators of social and emotional regulation, whereas low baseline RSA and unreliable

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RSA modulation are indicative of difficulties with such regulation (Porges, 2007). A decrease in RSA under stress is thought to be adaptive in the sense that it signals a need for action (Calkins & Keane, 2004). At baseline, low RSA has consistently been associated with internalizing problems in youth (Beauchaine, 2001; Crowell et al., 2005; Dietrich et al., 2007). However, low baseline RSA has also been associated with externalizing problems, though this pattern has generally been found in clinical, rather than community, samples (Beauchaine, 2001; Beauchaine, Katkin, Strassberg, & Snarr, 2001). For reactivity, although early findings regarding the association between RSA withdrawal and adjustment were mixed (e.g., Beauchaine, 2001; Crowell et al., 2005), a recent meta-analysis (Graziano & Derefinko, 2013) examining RSA withdrawal in children and adolescents found that high RSA withdrawal is associated with fewer internalizing and externalizing problems. On the other hand, they also found that a failure to exhibit RSA withdrawal, involving either low withdrawal or even RSA augmentation (an increase in PNS activity) may serve as a risk factor for behavioral and emotional problems due to poor regulatory capabilities. Evidence suggests that this failure to demonstrate RSA withdrawal is associated with externalizing problems in adolescents (Beauchaine et al., 2001), particularly when combined with low baseline RSA (Hinnant & El-Sheikh, 2009). Overall, the literature suggests that high baseline RSA and high RSA withdrawal during stress are adaptive, whereas low baseline RSA and a failure to exhibit RSA withdrawal during stress are associated with adjustment problems. It is important to note that descriptors of ‘‘high’’ and ‘‘low’’ RSA are sample-specific: General cutoffs for these categories have yet to be identified and will likely vary by population and context. As with SCL, inconsistencies in findings related to RSA and externalizing problems may be due to differences by gender, age, and clinical versus community samples.

COPING WITH STRESS AND PSYCHOPATHOLOGY In addition to autonomic reactivity, the way that individuals cope with stress is also linked to psychopathology. Although coping has not been consistently measured across studies, it can be conceptualized broadly in terms of productive versus nonproductive coping (Frydenberg & Lewis, 1996). Productive coping refers to strategies aimed at solving the problem or increasing positive emotions whereas nonproductive coping refers to avoidance and self-blame. Evidence suggests that nonproductive coping is positively associated, whereas productive coping is negatively associated, with both internalizing

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and externalizing problems (Downey, Johnston, Hansen, Birney, & Stough, 2010).

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INTERACTIONS BETWEEN COPING AND PSYCHOPHYSIOLOGY Theoretically, coping may act as a risk-activated moderator of the association between psychophysiological reactivity and behavioral and emotional problems. According to Masten (2001), a risk-activated moderator is a variable that influences an outcome given a particular at-risk scenario, similar to an airbag in an automobile accident. In this case, physiological reactivity is conceptualized as an involuntary risk that signals a need for a volitional coping response. This idea connects with interventions for problems such as depression and anxiety. For example, in evidence-based treatments for psychopathology, individuals often first learn to recognize their physiological responses and then use productive coping strategies (e.g., relaxation, cognitive restructuring, problem solving) to alleviate associated symptoms (Weisz, Hawley, & Doss, 2004). Because these strategies are effective in reducing symptoms in clinical populations, it may be the case that individuals who have physiological profiles associated with adjustment difficulties but do not exhibit elevated symptoms of psychopathology are already employing some of these strategies. Therefore, it is plausible that higher use of productive coping may attenuate the association between psychophysiological arousal on psychopathology, whereas higher levels of nonproductive coping may amplify the same association. Here, we conceptualize coping as a potential moderator of the physiology–problem association (as opposed to the reverse) given its presumably greater malleability. Despite this theory, virtually no investigations have explicitly tested for moderation of psychophysiology– problem associations by coping style. Of particular relevance to the current study, in a preliminary investigation of interactions between coping and psychophysiology, Connor-Smith and Compas (2004) found that high levels of both productive and (contrary to their hypothesis) nonproductive forms of coping attenuated the positive association between higher heart rate reactivity and poor physical health in undergraduates. In addition, high levels of productive coping in the form of acceptance, distraction, or positive thinking attenuated the association between self-reported arousal and internalizing symptoms. CURRENT STUDY The aim of the current study was to test the moderating effect of coping on associations between autonomic

activity (SCL=RSA) and internalizing and externalizing symptoms in a normative sample of adolescents. It is important to extend research on interactions between physiological stress responses and coping from young adult (e.g., Connor-Smith & Compas, 2004) to adolescent samples for several reasons. First, as adolescents become more independent from their parents, navigating life challenges generates novel stressors, creating a need to study stress and coping broadly in this age group (Waaktaar, Borge, Fundingsrud, Christie, & Torgersen, 2004). Increases are also present in conflict with parents, mood disruptions, risk behavior, depressive and anxiety symptoms (particularly in female individuals), and conduct problems (particularly in male individuals; Arnett, 1999; Costello, Copeland, & Angold, 2011; Zahn-Waxler, Shirtcliff, & Marceau, 2008). Due to these reciprocal increases in stress and psychopathology (Grant, Compas, Thurm, McMahon, & Gipson, 2004), adolescence is an important period in which to study physiological reactivity and coping. Patterns of physiological responding to stress may be influenced by environmental contexts, particularly a history of stress, in order to best adapt to future stressful situations (Del Giudice, Hinnant, Ellis, & El-Sheikh, 2012). Psychophysiology has also been shown to interact with life stress in predicting psychopathology (e.g., El-Sheikh & Whitson, 2006; Obradovic´, Bush, & Boyce, 2011). Although testing three-way interactions between coping, life events, and psychophysiology was deemed too complex for our sample size and analytic methods, variations in life events were controlled for statistically in order to demonstrate that any observed interactions were not due to potential covariance of coping and recent stressful life events. In the current study, psychophysiological activity was assessed via continuous monitoring of heart rate and skin conductance level during the Social Competence Interview, a semistructured interview designed to elicit the physiological stress response. We hypothesized that (a) baseline SCL=SCL-R would be positively associated with internalizing problems, (b) baseline SCL would be negatively associated with externalizing problems, (c) baseline RSA would be negatively associated with internalizing and externalizing problems, and (d) RSA reactivity (RSA-R; in the form of withdrawal) would be negatively associated with internalizing and externalizing problems. Furthermore, we hypothesized that productive coping would attenuate, whereas nonproductive coping would amplify, these associations. No specific hypotheses were made regarding SCL-R and externalizing problems given the mixed findings in the literature.

COPING AND AUTONOMIC AROUSAL

METHOD

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Participants Participants for the present study were 66 adolescents (60% female) between the ages of 16 and 17 years old (M ¼ 16.6, SD ¼ 0.5). The ethnic background of the sample was primarily Caucasian (86%), with remaining responses divided among Asian (5%), Pacific Islander (3%), and other ethnicity (5%), reflective of the population in the local region from which the sample was drawn. One female participant declined to report her ethnic background. As a measure of socioeconomic status, parents’ occupations were coded using General Social Survey occupational prestige scores (Nakao & Treas, 1990). Fathers’ occupational prestige averaged 53.86 (SD ¼ 11.67) and mothers’ averaged 52.39 (SD ¼ 12.10), both of which most closely correspond to executive, administrative, and managerial occupations. Interrater reliability for coding parents’ occupations was 1.0 for father’s occupation and .99 for mother’s occupation. Participants were recruited from six area high schools via advertisements during lunch periods. Interested participants received follow-up phone calls with additional information and to obtain verbal parental consent. Of participants who expressed interest during recruitment, 27.5% obtained parental consent, provided assent, and completed the study. One or both parents of adolescent participants also completed questionnaires about their child. Questionnaires were completed by 55 biological mothers, 39 biological fathers, two adoptive=guardian mothers, two stepfathers, and one stepmother. Participants and parents received gift cards as compensation. All study procedures were approved by the sponsoring institution’s human subjects review board. Measures Psychophysiology. The Social Competence Interview (SCI; Ewart & Kolodner, 1991) is a 12- to 15-min semistructured interview used to elicit cardiovascular and skin conductance responses. Trained undergraduate research assistants administered the SCI to participants. During the interview, participants selected a recent stressful life experience to discuss with the interviewer and were asked to provide details on that experience to make them feel as though they were reliving it. Participants first chose a category (school, neighborhood, work, family, friends, and money) and were then asked to choose a specific recent stressful event within that category. The remainder of the interview asked participants to imagine their stressful experience happening to someone else and to reimagine the same situation with a different ending. For the current study, only psychophysiological responses collected during the

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reliving of the experience were used (an average of about 6 min across participants). The SCI has been shown to elicit greater physiological responses than cognitive tasks such as mirror tracing and mental arithmetic (Ewart & Kolodner, 1991). Prior to the SCI, participants were asked to sit and relax for a 4-min baseline period. All measures of autonomic arousal were recorded using a BioLog UFI 3991 portable bioamplifier (UFI Corporation, Moro Bay, CA). SCL was measured in microsiemens with two Ag=AgCL electrodes placed around the middle segment of the index and ring fingers on the nondominant hand. Isotonic citrate salt electrode gel was used to increase conduction. RSA was measured using an electrocardiogram. Participants placed three electrodes on their upper body; one electrode was placed on either side of the rib cage, and one was placed at the top of the sternum. The bioamplifier continuously recorded cardiac interbeat intervals (IBI), assessed as time in milliseconds between successive R waves of the electrocardiogram. For both SCL and RSA, scores for baseline and stressor= challenge periods were averaged across 30-s intervals. Coefficient alphas computed across 30-s interval scores were .94 for baseline RSA, .98 for challenge RSA, and .99 for both baseline and challenge SCL. Coping. The Adolescent Coping Scale—General Long Form (ACS; Frydenberg & Lewis, 1996) was used to assess participants’ general coping strategies. On this self-report inventory, participants were presented with 79 statements of possible coping strategies and were asked to respond on a 5-point Likert scale the degree to which they employ that strategy: 1 (doesn’t apply to me), 2 (used very little), 3 (used sometimes), 4 (used often), 5 (used a great deal). The Productive Coping and Nonproductive Coping scales of the ACS were used in the current study. The Productive Coping scale includes the narrow ACS scales of Focus on Solving the Problem, Seek Social Support, Physical Recreation, Seek Relaxing Diversions, Invest in Close Friends, Seek to Belong, Work Hard to Achieve, and Focus on the Positive. The Nonproductive scale includes the narrow ACS scales of Worry, Seek to Belong, Wishful Thinking, Not Coping, Ignore the Problem, Tension Reduction, Keep to Self, and Self-Blame. Coefficient alpha was .74 for Productive Coping and .76 for Nonproductive Coping. Based on the development of the ACS, the Seek to Belong subscale is included in both productive and nonproductive coping due to ambiguity of this strategy (Frydenberg & Lewis, 1996). Results presented next were unchanged in a set of follow-up analyses removing this particular subscale, with the exception that productive and nonproductive coping were negatively correlated (r ¼ .28, p < .05); thus, the shared subscale

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appeared to mask a modest negative association of these two coping strategies. Internalizing=Externalizing symptoms. The Youth Self-Report (YSR) and Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2001) were used to assess participants’ internalizing and externalizing symptoms. Both the YSR and the CBCL are rating scales that measure demographic information, behavioral and emotional problems, and adaptive functioning. Participants are asked to rate the degree to which statements describe themselves (or their child) on a scale from 0 (not true) to 2 (very true or often true). In cases where two parents completed the CBCL, their scores were averaged to create a composite score. T scores for the two broad scales of internalizing and externalizing symptoms were used for the present study. Coefficient alphas were .90 for YSR internalizing, .82 for YSR externalizing, .89 for CBCL internalizing, and .88 for CBCL externalizing. Stressful life events. An adapted version of the Life Experiences Survey (Sarason, Johnson, & Siegel, 1978) was used to measure stressful life events that occurred within the past year. This measure consists of 56 life events such as changes in family makeup, personal illness and injury, and illness or death of a loved one. Individuals were asked to indicate the valence and severity of the event on a 7-point Likert scale from 3 (extremely negative) to þ3 (extremely positive). Items endorsed with a negative valence were summed to create a measure of the number of stressful life events experienced within the past year. Two independent studies of the Life Experiences Survey have yielded test–retest reliability coefficients of .63 and .64 (Sarason et al., 1978). Coefficient alpha for the current study was .64. Body mass index (BMI). Participants’ height and weight were assessed at the time of physiological data collection to calculate BMI as weight in kilograms= (height in meters2). Psychophysiological Data Reduction To calculate RSA, IBI artifacts due to movement or digitizing error were manually edited using the CardioEdit software program (Brain-Body Center, 2007) and RSA estimates were calculated using procedures outlined by Porges (U.S. Patent No. 4,510,944, 1985). Briefly, we used time series methods and bandpass filtering to isolate heart rate variability due to respiration. RSA scores (reported in units of ln(ms)2) were computed from a natural log transformation of the variance for each 30-s epoch of IBI data. Estimates of

RSA were calculated separately for the 4-min baseline period and the reexperiencing section of the SCI using CardioBatch software, which provides the mean RSA score across 30-s epochs. Means across the baseline period for each participant were used for analyses including baseline SCL and baseline RSA. SCL-R and RSA-R were calculated as difference scores: mean RSA and SCL across the re-experiencing section of the SCI (stress condition) minus the baseline mean. Issues surrounding the choice of reactivity measure are complex: Although latent variable techniques are preferable in this domain (Burt & Obradovic´, 2013), our sample size precluded their use. As recommended by Burt and Obradovic´, we report associations and variability changes between baseline and challenge assessments. In addition, all analyses were reconducted using residual scores in place of difference scores with similar results (details available upon request). Analysis Plan Path analyses were conducted in Mplus version 6 (Muthe´n & Muthe´n, 2010) using full information maximum likelihood, using all available data under the assumption of data missing at random, which appeared plausible for our data (below). For all models, we employed fit criteria of comparative fit index (CFI) and Tucker–Lewis index (TLI) values greater than .95 and root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) values less than .05 for well-fitting models (Hu & Bentler, 1999; McDonald & Ho, 2002). We also report chi-square tests of model fit and associated p values. In total, eight path models were estimated: Each of four indices of psychophysiology (SCL=SCL-R and RSA=RSA-R) was crossed with each of two coping styles (productive and nonproductive). Internalizing and externalizing problems were analyzed together in all models, given expectation of differing patterns of results by class of problem. For each model, we estimated directional paths from psychophysiology, coping, and a psychophysiology  coping interaction term (created from mean-centered versions of each predictor) to adolescent- and parent-reported internalizing and externalizing problems. Residual covariances among the four dependent variables were included in each model. In addition, all analyses were conducted controlling for the number of self-reported stressful life events that occurred in the past year and BMI by estimating additional model paths from life stress and BMI to each dependent variable. For each significant interaction, simple slopes were calculated to test whether psychophysiological reactivity was differentially associated with internalizing or externalizing problems at different levels of productive or

COPING AND AUTONOMIC AROUSAL

p ¼ .79; baseline RSA, t(59) ¼ .77, p ¼ .45; RSA-R, t(57) ¼ 1.08, p ¼ .28. Similar results were found for participants only missing physiological data: data were missing at random based on Little’s MCAR test, and participants only missing psychophysiological data did not differ from participants with complete data on any variables of interest in the current study. RSA baseline and challenge scores were correlated at r ¼ .71, whereas SCL baseline and challenge scores were correlated at r ¼ .90. As discussed by Burt and Obradovic´ (2013), comparing lambda (lambda ¼ the ratio of baseline to challenge standard deviations) to the baseline-challenge correlation can be informative on the comparative reliability of difference scores and residual scores (given standard psychometric assumptions; R. H. Williams, Zimmerman, & Mazzagatti, 1987). Given the often-present high correlation between baseline and challenge, difference scores are more reliable when scores spread out more over time, such that variability increases during or after the stressor. In our sample, variability in RSA decreased from baseline to challenge (k ¼ 1.09), whereas variability in SCL increased from baseline to challenge (k ¼ 0.70). As these patterns did not unambiguously favor one operationalization of reactivity, we chose difference scores as our primary measure, although residual score analyses showed similar findings. Zero-order correlations, means, and standard deviations are presented in Table 1. Mean scores suggest a broad normative sample for internalizing and externalizing problems, albeit with considerable variability; mean coping scores were also consistent with prior normativesample studies of the ACS (e.g., Frydenberg & Lewis,

nonproductive coping. Simple slopes were calculated by reanalyzing each model with coping centered at 1 standard deviation above and 1 standard deviation below the mean value for coping (Aiken & West, 1991).

RESULTS Preliminary Analyses

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Initial data screening did not show significant problems with nonlinearity or skew. Data were missing for one participant for the ACS, two participants for the YSR, two participants for the CBCL, five participants for baseline RSA, seven participants for RSA-R, and two participants for baseline SCL and SCL-R. Missing data on questionnaires were due to skipped items or refusal to respond; missing data on psychophysiological assessments were due to experimenter error or equipment malfunction and were missing entirely (i.e., there were no missing epochs within participants). There was one extreme outlier for measures of SCL, likely due to an equipment malfunction; this value was treated as missing data. Little’s MCAR test suggests that the data were missing at random, v2(56) ¼ 48.232, p ¼ .760. In addition, no differences were found between participants with missing and complete data on any variables of interest in the current study: productive coping, t(63) ¼ .53, p ¼ .60; nonproductive coping, t(63) ¼ .01, p ¼ .10; YSR internalizing, t(62) ¼ 1.08, p ¼ .28; YSR externalizing, t(62) ¼ .60, p ¼ .55; CBCL internalizing, t(62) ¼ .96, p ¼ .34; CBCL externalizing, t(62) ¼ .22, p ¼ .83; baseline SCL, t(61) ¼ .83, p ¼ .41; SCL-R, t(61) ¼ .27,

TABLE 1 Zero-Order Correlations and Descriptive Statistics for Primary Study Variables

1. Baseline SCL 2. SCL Reactivity 3. Baseline RSA 4. RSA Reactivity 5. Productive Coping 6. Nonproductive Coping 7. YSR Internalizing 8. YSR Externalizing 9. CBCL Internalizing 10. CBCL Externalizing 11. Stress 12. Gender 13. BMI M SD

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

— .41 .09 .16 .18 .15 .21 .07 .15 .03 .06 .17 .10 5.23 2.40

— .23 .39 .01 .26 .12 .16 .09 .22 .10 .03 .09 2.47 1.67

— .49 .01 .16 .04 .03 .14 .17 .20 .01 .04 7.05 .95

— .09 .05 .20 .20 .05 .13 .11 .05 .10 .12 .70

— .08 .32 .01 .30 .03 .02 .02 .13 3.53 .48

— .63 .30 .20 .05 .38 .05 .11 2.66 .47

— .40 .40 .09 .51 .09 .01 51.89 10.56

— .14 .31 .16 .07 .12 50.69 9.00

— .60 .06 .04 .20 49.50 8.96

— .08 .03 .09 45.68 8.79

— .20 .23 2.74 2.60

— .13 .59 .50

— 22.40 2.56

Note: Means and standard deviations for YSR=CBCL subscales are reported as T scores (M ¼ 50, SD ¼ 10); all others are reported as raw scores. Gender was coded 0 for male and 1 for female. SCL ¼ skin conductance level; RSA ¼ respiratory sinus arrhythmia; YSR ¼ Youth Self Report; CBCL ¼ Child Behavior Checklist; BMI ¼ body mass index.  p < .05.  p < .01.

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2000). SCL-R was positively associated with RSA-R and nonproductive coping; in addition, baseline SCL and SCL-R were positively correlated, whereas baseline RSA and RSA-R were negatively correlated. No other correlations were found between psychophysiological variables and primary variables. Productive coping was negatively associated with YSR and CBCL internalizing problems, and nonproductive coping was positively associated with YSR internalizing and externalizing problems. Finally, correlations were found among outcome variables for both shared informant (e.g., CBCL internalizing and externalizing) and shared problem domain (e.g., CBCL and YSR externalizing). To determine whether the SCI elicited the expected stress responses, t tests were conducted separately for both SCL and RSA comparing the mean scores during baseline to the mean scores during the reliving portion of the SCI. Results showed a significant difference for SCL between baseline (M ¼ 5.23, SD ¼ 2.47) and challenge (M ¼ 7.74, SD ¼ 3.44), t(62) ¼ 11.74, p < .001, suggesting that the SCI successfully elicited SNS arousal; however, results showed no mean difference for RSA between baseline (M ¼ 7.05, SD ¼ .95) and challenge (M ¼ 7.17, SD ¼ .87), t(58) ¼ 1.37, p ¼ .18, suggesting that the SCI did not elicit a consistent PNS withdrawal response in this sample. Similar results have been found in other studies using the SCI, given individual differences in some participants demonstrating increases and some participants

demonstrating decreases in RSA (Murray-Close & Rellini, 2012; P. G. Williams, Rau, Cribbet, & Gunn, 2009). Of note, in the current sample 44% of participants demonstrated an overall increase in RSA values from baseline to challenge, whereas 56% of participants demonstrated the expected decrease in RSA. In interpreting results with RSA-R and SCL-R, positive scores indicate higher vagal augmentation and higher skin conductance during the stressor, whereas negative scores indicate vagal withdrawal and a decrease in skin conductance. Main Effects Figure 1 shows a path analytic model with standardized coefficients presented in Table 2 and model fit statistics presented in Table 3. Based on cutoff values for CFI, TLI, RMSEA, and SRMR, all models showed adequate to good fit to the data, with the exception of SCL-R and nonproductive coping, which showed a mixed pattern of fit indices. However, inspection of standardized residuals and model modification indices did not show any clear pattern of misfit for this model. In addition, as shown in Table 3, the RMSEA confidence interval ranged widely for some models, likely in part due to our small sample size relative to the number of estimated parameters. As shown in Table 3, all path models accounted for modest to large amounts of variance in the four dependent variables.

FIGURE 1 Illustrative path model for psychophysiology, coping, and the interaction between psychophysiology and coping predicting adolescentand parent-reported internalizing and externalizing problems. Note: Although not shown in the figure, all analyses were conducted controlling for the number of self-reported stressful life events in the past year as well as body mass index.

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.09 (.13) .04 (.12) .14 (.12) .11 (.15) .07 (.13) .03 (.14) .18 (.12) .15 (.13)

.08 (.10) .03 (.11)

.12 (.11) .02 (.10)

.15 (.11) .18 (.09)

b A-Ext

.11 (.10) .11 (.09)

a A-Int

.06 (.13) .09 (.13)

.14 (.13) .10 (.14)

.11 (.12) .07 (.15)

.04 (.12) .06 (.13)

c P-Int

.01 (.12) .27 (.13) .13 (.12) .25 (.13)

.28 (.10) .50 (.09) .22 (.10) .58 (.09)

.18 (.12) .16 (.13) .14 (.13) .12 (.13)

.03 (.13) .25 (.13)

.30 (.10) .52 (.09)

.19 (.11) .03 (.15)

f A-Ext

.01 (.13) .28 (.13)

e A-Int

.30 (.12) .22 (.14)

.27 (.11) .18 (.13)

.35 (.11) .19 (.13)

.30 (.11) .23 (.13)

g P-Int

Main Effect of Coping

.32 (.10) .50 (.09)

.06 (.13) .10 (.12)

d P-Ext

Main Effect of Psychophysiology

.06 (.13) .05 (.14)

.01 (.12) .08 (.14)

.10 (.12) .03 (.13)

.05 (.13) .12 (.13)

h P-Ext

.17 .18

.10 .05

.06 .01

(.11) (.10)

(.11) (.10)

(.11) (.12)

.28 (.10) .08 (.09)

i A-Int

(.13) (.13)

(.13) (.15)

(.13) (.12)

.44 (.12) .06 (.14)

.17 .03

.06 .02

.05 .07

j A-Ext

.11 .00

.00 .10

(.13) (.14)

(.13) (.13)

.33 (.11) .24 (.15)

.26 (.12) .20 (.12)

k P-Int

Psychophysiology  Coping

.18 .21

.26 .13

(.14) (.14)

(.12) (.13)

.37 (.12) .30 (.15)

.26 (.13) .44 (.11)

l P-Ext

Note: A-Int ¼ adolescent-reported internalizing problems; A-Ext ¼ adolescent-reported externalizing problems; P-Int ¼ parent-reported internalizing problems; P-Ext ¼ parent-reported externalizing problems; SCL ¼ skin conductance level; RSA ¼ respiratory sinus arrhythmia. Letters heading each column refer to paths in Figure 1.  p < .05.  p < .01.  p < .001.

Model Baseline SCL X Productive Coping Nonproductive Coping SCL Reactivity X Productive Coping Nonproductive Coping Baseline RSA X Productive Coping Nonproductive Coping RSA Reactivity X Productive Coping Nonproductive Coping

Path Coefficients

TABLE 2 Standardized Coefficients for All Path Analytic Models

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PAYSNICK AND BURT TABLE 3 Fit Statistics and Variance Explained for All Path Analytic Models

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R2

Model Baseline SCL X Productive Coping Nonproductive Coping SCL Reactivity X Productive Coping Nonproductive Coping Baseline RSA X Productive Coping Nonproductive Coping RSA Reactivity X Productive Coping Nonproductive Coping

df

v2

p

CFI

TLI

RMSEA

RMSEA [90% CI]

SRMR

A-Int

A-Ext

P-Int

P-Ext

3 3

2.93 1.56

.40 .67

1.0 1.0

1.0 1.11

.00 .00

[0, .206] [0, .161]

.03 .02

.44 .51

.05 .11

.18 .13

.08 .20

3 3

.10 4.98

.99 .17

1.0 .98

1.27 .83

.00 .10

[0, 0] [0, .250]

.01 .04

.35 .49

.06 .11

.23 .13

.19 .12

3 3

.06 1.34

1.0 .72

1.0 1.0

1.26 1.14

.00 .00

[0, 0] [0, .151]

.01 .02

.37 .49

.07 .10

.14 .10

.12 .08

3 3

1.33 .13

.72 .99

1.0 1.0

1.13 1.24

.00 .00

[0, .150] [0, 0]

.02 .01

.37 .54

.23 .13

.13 .09

.06 .08

Note: CFI ¼ comparative fit index; TLI ¼ Tucker–Lewis index; RMSEA ¼ root mean square error of approximation; SRMR ¼ standardized root mean square residual; A-Int ¼ adolescent internalizing; A-Ext ¼ adolescent externalizing; P-Int ¼ parent internalizing; P-Ext ¼ parent externalizing; SCL ¼ skin conductance level; RSA ¼ respiratory sinus arrhythmia.

Results suggested no main effects for any measures of SCL or RSA on either parent- or adolescent-reported internalizing or externalizing symptoms; however, results did suggest consistent positive main effects for nonproductive coping on adolescent-reported (but not parent-reported) internalizing (bs ranging from .50 to .58). Nonproductive coping was also positively associated with adolescent-reported externalizing problems in two models (bs ranging from .27 to .28). Negative main effects were consistently found for productive coping on internalizing problems across informants (bs ranging from .22 to .32 for adolescent report and .27 to .35 for parent report), suggesting that higher levels of productive coping were generally associated with lower levels of internalizing problems. There was a consistent lack of association between productive coping and externalizing problems across informants.

Interaction Effects Skin conductance. Our analyses resulted in a total of nine significant interactions between psychophysiology and coping, each of which is displayed graphically in Figure 2.1 Consistent with hypotheses for baseline SCL, high levels of productive coping attenuated the positive association between baseline SCL and adolescent-reported internalizing problems. There was a significant positive association between baseline SCL 1 Due to concerns about limited power for the full model, analyses were also conducted analyzing models with each outcome separately. In these analyses, four interaction models (Figure 2, Panels b, c, g, and h) were reduced to marginal significance with p values ranging from .053 to .072.

and internalizing problems for individuals reporting low levels of productive coping (b ¼ 1.65, p < .001) but not high levels of productive coping (b ¼ .75, p ¼ .28; Figure 2a). For parent report, the pattern was similar, though the positive association between baseline SCL and internalizing problems was marginal for individuals reporting low levels of productive coping (b ¼ 1.08, p ¼ .06), and nonsignificant for individuals reporting high levels of productive coping (b ¼ .82, p ¼ .25; Figure 2b). A significant interaction was also found for baseline SCL and productive coping with parentreported externalizing problems; however, simple slopes analyses tested at 1 SD of productive coping revealed no significant associations between SCL and externalizing problems for either high (b ¼ 1.16, p ¼ .12) or low productive coping (b ¼ .70, p ¼ .25; Figure 2c). In addition, there was a significant interaction for baseline SCL and nonproductive coping with parent-reported externalizing problems, such that there was a positive association between baseline SCL and externalizing problems for individuals reporting high levels of nonproductive coping (b ¼ 1.02, p ¼ .05) and a negative association between baseline SCL and externalizing problems for individuals reporting low levels of nonproductive coping (b ¼ 1.76, p ¼ .01; Figure 2d). For SCL-R, as hypothesized, there was a significant positive association between SCL-R and parent-reported internalizing problems for individuals reporting low levels of productive coping (b ¼ 2.68, p ¼ .01) but not high levels of productive coping (b ¼ 1.57, p ¼ .12; Figure 2e). Although no specific hypotheses were made regarding SCL-R and externalizing problems, a significant interaction was found, such that a positive association between SCL-R and parent-reported

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855

FIGURE 2 Significant interactions based on path model estimates. Note: For predictors, ‘‘high’’ ¼þ1 SD from the mean and ‘‘low’’ ¼ 1 SD from the mean. Dashed lines represent adaptive coping (i.e., high productive, low nonproductive) and solid lines represent maladaptive coping (i.e., low productive, high nonproductive). Y-axes represent the T-score metric. Grayed-out lines ¼ nonsignificant simple slope. SCL ¼ skin conductance level; RSA ¼ respiratory sinus arrhythmia. y p ¼ .06.

externalizing problems was observed for individuals reporting low levels of productive coping (b ¼ 3.34, p < .001) but not high levels of productive coping (b ¼ 1.34, p ¼ .17; Figure 2f). In addition, results showed a significant interaction between SCL-R and nonproductive coping, such that there was a significant positive association between SCL-R and parent-reported externalizing problems at high levels of nonproductive coping (b ¼ 1.59, p ¼ .03) but not low levels of nonproductive coping (b ¼ 1.33, p ¼ .33; Figure 2g). RSA. Two significant interactions were found with RSA. First, results showed a significant interaction between baseline RSA and productive coping, such that there was a significant negative association between baseline RSA and parent-reported externalizing problems for individuals reporting high levels (b ¼ 5.15, p ¼ .02), but not low levels, of productive coping (b ¼ 1.87, p ¼ .36; Figure 2h). Finally, contrary to our hypotheses there was a significant interaction between RSA-R and adolescent-reported externalizing problems such that RSA augmentation was associated with higher externalizing problems for individuals reporting high

levels of productive coping (b ¼ 10.17, p < .001), whereas RSA withdrawal was associated with higher externalizing problems for individuals reporting low levels of productive coping (b ¼ 5.43, p ¼ .04; Figure 2i).

DISCUSSION Results of the present study provide partial evidence for the interaction between psychophysiology—primarily SNS arousal—and broad adolescent- and parentreported internalizing and externalizing problems. Although no hypothesized main effects were found for psychophysiology and internalizing and externalizing problems, our main findings for SCL suggest that adolescents who engage in more productive coping strategies have a smaller association between higher baseline SCL=SCL-R and internalizing problems. Results also suggest a positive association between baseline SCL= SCL-R and externalizing problems for those who engage in more nonproductive coping strategies. Although the positive (rather than negative) simple slope between SCL and externalizing problems was unexpected, it is

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possible that the combination of a normative sample (60% female, with slightly below-average levels of externalizing) may have affected our results; our pattern of results tended to be more similar across internalizing and externalizing problems, particularly for parent report, consistent with some prior research on parents’ relative lack of discrimination of problem domains as compared to self-report (e.g., Burt & Masten, 2002). This finding, contrary to existing literature linking low SCL and externalizing problems, also highlights the need for additional studies with normative and female samples and should be interpreted cautiously pending replication. Despite mostly nonsignificant results for RSA, our two significant interactions were partially consistent with results from Graziano and Derefinko’s (2013) metaanalysis in that low baseline RSA and a failure to exhibit RSA withdrawal were associated with externalizing problems. However, it was unexpected that this association was only the case for individuals reporting high use of productive, but not nonproductive, coping strategies. It may be the case that adolescents with poor regulation are using externalizing behaviors, such as aggression, in an effort to engage with and problem-solve stressors. Although the general lack of findings for RSA was not expected, preliminary t tests indicated that there was no difference between mean RSA levels during baseline and during the challenge task, which may be due to the fact that some participants demonstrated increases in RSA, whereas others demonstrated decreases. It is possible that although our laboratory stressor did evoke SNS arousal, it was insufficient in producing consistent measurable PNS responses. In addition, the variability in RSA response decreased from baseline to challenge, resulting in a negative correlation between baseline and our reactivity measure. Although somewhat speculative, the combination of this correlation and our overall lack of mean RSA response may have influenced our conflicting findings regarding RSA (Figures 2h and 2i). Nonetheless, given evidence just described linking psychophysiology and psychopathology, results of the present study provide additional preliminary evidence that coping may influence the strength of this association. Prevention and intervention efforts aimed at teaching children and adolescents how to effectively cope with stress may be a beneficial strategy for those who are most susceptible to psychopathology due to their physiological responses. For example, youth who exhibit high baseline SCL and SCL reactivity may particularly benefit from early interventions identifying unhelpful coping strategies (e.g., ignoring the problem, self-blame) and substituting them for more effective strategies that target problem solving and healthy ways

to improve emotional responses to stress (e.g., seeking support, focusing on the positive). Limitations Limitations of the present study first include the crosssectional design, which restricts the interpretation of the results in terms of direction of effects and=or the possibility of additional confounding variables influencing these associations. In addition, coping was assessed only through adolescent self-report (not parent report) and was assessed based on how individuals generally cope with stress, rather than how they coped with the particular stressor in this study. Assessing coping in this general way is limited, as coping can vary based on the context of the stressor and the resources available (Compas et al., 2001). Furthermore, the stressor used in the current study (the Social Competence Interview) was a somewhat passive stressor that asked participants to describe a recent stressful event. Recalling an event that has already happened and may have already been resolved does not involve the same use of cognitive and emotional strategies that a more active laboratory stressor might use. Finally, our small sample size and homogeneous sample demographic limited this study in multiple ways. First, we were unable to subgroup our sample in order to examine differences across gender, age, or ethnic groups. Second, some of our model effects were reduced to marginal significance when broken down by informant. Third, the population estimates of our RMSEA model fit index varied widely in some models, suggesting less stability of estimation. Fourth, even though our theoretical basis for interaction effects relies partly on clinical intervention research, our sample was normative in terms of their levels of problems. Finally, our sample was self-selected, and thus potentially not representative of all U.S. adolescents. For all of these reasons, independent replication of these results is an important goal for future research. It is particularly important to assess interaction effects among coping and psychophysiology using larger sample sizes because both unreliability of measurement (Beauchaine, Neuhaus, Brenner, & Gatzke-Kopp, 2008) and properties of joint distributions of continuous variables (McClelland & Judd, 1993) can lead to difficulties in detecting interaction effects in field studies. Conclusion Despite these limitations, the present study helps to address a gap in the literature in testing whether interactions between psychophysiological reactivity and coping relate to emotional and behavioral problems. As research continues to enhance our understanding of

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COPING AND AUTONOMIC AROUSAL

the associations between autonomic arousal and health, identification of constructs that can positively moderate these associations becomes increasingly important in order to prevent or reduce problems. We provide preliminary evidence that productive coping may attenuate the association between high SNS arousal and behavioral and emotional problems. Ideally, future research will examine these constructs longitudinally in order to fully understand the direction of the effects. This work should examine effects of how adolescents cope with a specific stressor, rather than how adolescents cope more generally as assessed in the current study (Compas et al., 2001). Given evidence that psychophysiological responses may differ across age and different types of stressors (e.g., Stroud et al., 2009), additional work is needed with a wider age range and inclusion of stressors from multiple domains (e.g., social, cognitive), looking at both the way individuals cope and their autonomic arousal across these different types of stress. Finally, although the present study was conceptualized from a moderation standpoint, future studies should also investigate the potential mediating role of coping in the stress reactivity-psychopathology association, given evidence for associations between coping and physiology (Connor-Smith & Compas, 2004; Geisler, Kubiak, Siewert, & Weber, 2013). The evidence in support of productive coping is promising, and additional research is needed to determine how it may be used as a tool in the early prevention of psychopathology.

FUNDING This research was supported by Child and Adolescent Psychology Training and Research (CAPTR), Inc. We thank the principals at area high schools who allowed us to recruit participants for this study, as well as the undergraduate research assistants who worked on this project.

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