Youth Post-traumatic Stress during COVID-19: Evidence for High Respiratory Sinus Arrhythmia as a Susceptibility Factor

• In Event: Impact of COVID-19 on Children and Youth

Abstract

Many youths experienced post-traumatic stress symptoms (PTSS) during the early stages of the COVID-19 pandemic (Field, 2022). Despite universal disruptions to normal activities, COVID-19 stressors were more consequential for some youth than for others (Miller et al., 2021). Caregiving quality influences youths’ responses to environmental stressors (Morris et al., 2014), but individual differences in psychophysiology (e.g., resting respiratory sinus arrhythmia; RSA) may qualify caregiving effects (Van der Graaff et al., 2016). The differential susceptibility hypothesis (DS; Belsky, 2005) suggests that some youth may be particularly sensitive to caregiving influences for better and for worse. RSA may be an important indicator of individual susceptibility to PTSS in adverse environments (Beauchaine, 2001). This investigation leveraged psychophysiological and parenting data obtained prior to COVID-19 to evaluate youths’ PTSS responses to COVID-19 as influenced by both supportive and adverse caregiving environments (i.e., secure attachment and caregiver psychopathology) and resting RSA.

Participants were 225 caregiver-youth dyads (50% female; 88% non-white). At age 12 (Mage=12.25 years, SD=.35), youth reported on attachment security using the Behavioral Systems Questionnaire (Furman & Wehner, 1999; alpha=.84), and caregivers self-reported internalizing psychopathology (i.e., depression, anxiety, somatization; alpha=.80) on the Brief Symptom Inventory (Derogatis & Spencer, 1993). We assessed PTSS using the Youth Self-Report (Achenbach & Rescorla, 2001; alpha=.84) pre-pandemic (Mage=14.24 years, SD=.50) and during the first weeks of COVID-19 restrictions in spring 2020 (Mage=15.2 years, SD=.57). Given evidence that resting RSA stabilizes during early childhood (El-Sheikh, 2005), we tested the moderating influence of youth resting RSA at age 6 (Mage=6.11 years, SD=.21). Analyses controlled for child gender, ethnicity-race, poverty status, and prior PTSS. A proportion affected (PA) index tested whether interaction effects were consistent with DS, with scores of .16 or higher reflecting evidence of DS (i.e., >16% of cases fall below the interaction crossover point; Roisman et al., 2012).

Youth PTSS scores increased in response to the pandemic (Mpre=53.21, SD=5.17; Mpost=55.58, SD=7.41; t(134) = 2.66, p = .009). Resting RSA interacted with secure attachment and caregiver internalizing psychopathology to predict youth PTSS during COVID-19. Youth with relatively high resting RSA evidenced the lowest PTSS scores when they reported high attachment security, but the highest PTSS scores when they reported lower attachment security (Figure 1; PA Index=.35). Similarly, youths with relatively high resting RSA had the highest PTSS scores when their caregivers reported greater internalizing, but the lowest PTSS scores when their caregivers reported low or no internalizing (Figure 2; PA index=.65). In contrast, the PTSS levels of youths with relatively low or average resting RSA did not differ depending on attachment security or caregiver internalizing.

This investigation identified specific caregiving and regulatory processes that shaped youths’ PTSS in response to the COVID-19 pandemic. Results showed that relatively high resting RSA may be a marker of youth sensitivity to caregiving environments in line with a DS hypothesis. These findings have theoretical and clinical implications that may enhance our understanding of the physiological basis of resilience during the COVID-19 pandemic.

Authors

• Linnea Linde-Krieger, University of Arizona
  Presenting Author

• Kristen L. Rudd, University of California - San Francisco

• Alexandra Sara Aringer, University of California - Riverside

• Tuppett M. Yates, University of California - Riverside