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Sensory-Processing Sensitivity predicts treatment response to a school-based depression prevention program: Evidence of Vantage Sensitivity

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Treatment effects of preventative mental health interventions for adolescents tend to be relatively small. One reason for the small effects may be individual differences in the response to psychological treatment as a function of inherent characteristics, a notion proposed in the concept of Vantage Sensitivity. The current study investigated whether the personality trait Sensory-Processing Sensitivity moderated the efficacy of a new school-based intervention aimed at the prevention of depression.
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Sensory-Processing Sensitivity predicts treatment response
to a school-based depression prevention program: Evidence
of Vantage Sensitivity
Michael Pluess
a,
, Ilona Boniwell
b
a
Queen Mary University of London, London, UK
b
Anglia Ruskin University, Cambridge, UK
article info
Article history:
Received 27 November 2014
Received in revised form 4 March 2015
Accepted 4 March 2015
Keywords:
Depression
Prevention
Sensory-Processing Sensitivity
High Sensitive Personality
Vantage Sensitivity
abstract
Objective: Treatment effects of preventative mental health interventions for adolescents tend to be
relatively small. One reason for the small effects may be individual differences in the response to psycho-
logical treatment as a function of inherent characteristics, a notion proposed in the concept of Vantage
Sensitivity. The current study investigated whether the personality trait Sensory-Processing Sensitivity
moderated the efficacy of a new school-based intervention aimed at the prevention of depression.
Method: Using a two-cohort treatment/control design with one cohort serving as the control group
(N= 197) and a subsequent cohort as the treatment group (N= 166) it was tested whether
Sensory-Processing Sensitivity predicted depression trajectories from pre-treatment up to a 12 months
follow-up assessment in 11-year-old girls from an at-risk population in England.
Results: Sensory-Processing Sensitivity emerged as a significant predictor of treatment response. The pre-
vention program successfully reduced depression scores in girls scoring high on Sensory-Processing
Sensitivity but was not effective at all in girls scoring low on the same measure.
Conclusions: This study provides first empirical evidence for Vantage Sensitivity as a function of the per-
sonality trait Sensory-Processing Sensitivity regarding treatment response to a school-based depression
prevention intervention.
Ó2015 Elsevier Ltd. All rights reserved.
1. Introduction
Rising rates of depressive disorders during childhood and ado-
lescence pose a major public health concern in most Western
societies (e.g., Collishaw, Maughan, Goodman, & Pickles, 2004).
Not only are depressive symptoms in adolescence often associated
with social, academic, and physical health difficulties, but they also
tend to predict subsequent major depression in adulthood (Aalto-
Setala, Marttunen, Tuulio-Henriksson, Poikolainen, & Lonnqvist,
2002). Children growing up in economically deprived neighbor-
hoods (Yoshikawa, Aber, & Beardslee, 2012) and girls (Hyde,
Mezulis, & Abramson, 2008) are at a particularly high risk for the
development of depressive disorders. According to a recent study
in England the percentage of youth reporting frequent feelings of
depression and anxiety doubled over the last two decades, with
girls being almost three times more likely to suffer from depres-
sion/anxiety than boys (Collishaw, Maughan, Natarajan, & Pickles,
2010).
Given the detrimental effects of depression and the recent
increase of depressive disorders in adolescent populations, sub-
stantial efforts have been directed towards the prevention of
depression in childhood—usually through school-based promotion
of adaptive coping skills and related competencies (Sutton, 2007).
According to several meta-analyses such preventative interven-
tions have generally been found effective regarding the reduction
of depression symptoms (Brunwasser, Gillham, & Kim, 2009;
Horowitz & Garber, 2006; Stice, Shaw, Bohon, Marti, & Rohde,
2009). However, the average treatment effects tend to be modest
at best (r= .11–.24) and treatment efficacy appears to vary as a
function of intervention delivery and sample demographics
(Brunwasser et al., 2009; Durlak, Weissberg, Dymnicki, Taylor, &
Schellinger, 2011; Horowitz & Garber, 2006; Stice et al., 2009).
What has been neglected in existing work, until very recently
(Eley et al., 2012), is the notion that intervention effects may differ
as a function of inherent child characteristics (e.g., personality
http://dx.doi.org/10.1016/j.paid.2015.03.011
0191-8869/Ó2015 Elsevier Ltd. All rights reserved.
Corresponding author at: Department of Biological and Experimental Psychol-
ogy, Queen Mary University of London, Mile End Road, London E1 4NS, UK. Tel.: +44
(0)207 882 8004.
E-mail address: m.pluess@qmul.ac.uk (M. Pluess).
Personality and Individual Differences 82 (2015) 40–45
Contents lists available at ScienceDirect
Personality and Individual Differences
journal homepage: www.elsevier.com/locate/paid
traits, genetics). It is widely accepted that some individuals are
more vulnerable to the negative effects of adversity as a function
of individual traits, be they of psychological (Kochanska & Kim,
2012), physiological (Cummings, El-Sheikh, Kouros, & Keller,
2007), or genetic (Caspi et al., 2002) nature. Extending this
Diathesis-Stress perspective (Zuckerman, 1999), the Differential
Susceptibility framework (Belsky & Pluess, 2009) suggests that such
inherent traits may not just increase vulnerability to adversity but
rather sensitivity to a variety of environmental influences, with
more susceptible individuals being more affected by both negative
as well as positive experiences (Pluess, in press). In other words, the
same characteristics that make children more vulnerable to
adverse experiences may also make them more responsive to ben-
eficial exposures (Belsky & Pluess, 2009). The proposition—derived
from Differential Susceptibility reasoning—that individuals may dif-
fer generally in their response to positive experiences as a function
of inherent characteristics has recently been articulated in more
detail in the concept of Vantage Sensitivity (Pluess & Belsky,
2013). According to this framework some people are more likely
to benefit from positive exposures while others appear to be less
responsive or even resistant to the positive effects of the same sup-
portive experience. The suggested reason for such differences in
response to positive experiences is that people differ fundamen-
tally in their environmental sensitivity with some being more
and some less sensitive (Pluess, in press). Although a fairly new
concept, a growing body of empirical evidence reports individual
differences in Vantage Sensitivity as a function of different psycho-
logical, physiological, and genetic characteristics in response to a
wide range of positive exposures—including psychological inter-
vention (for an overview, see Belsky & Pluess, 2013). For example,
in their pioneering experimental study evaluating genetic modera-
tion of a psychological intervention, Bakermans-Kranenburg, van
IJzendoorn, Pijlman, Mesman and Juffer (2008) investigated
whether a genetic polymorphism in the dopamine receptor D4
(DRD4) gene moderated the positive effects of a video-feedback
parenting intervention on children’s externalizing behaviour in a
randomised controlled trial. Providing evidence for Vantage
Sensitivity as a function of genetic differences of the child, the
intervention proved effective in decreasing externalizing
behaviour—but only for children carrying the DRD4 7-repeat gene
variant. Children without this gene variant did not benefit from the
intervention at all.
In the current study we sought to investigate Vantage
Sensitivity as a function of Sensory-Processing Sensitivity (SPS)—a
personality trait measured with the Highly Sensitive Person
(HSP) Scale (Aron & Aron, 1997)—in response to a new universal
school-based preventative depression intervention, the SPARK
Resilience program (Boniwell & Ryan, 2009). About 20% of the
general population is estimated to score particularly high on SPS,
characterized by increased awareness and deeper processing of
environmental subtleties as well as the tendency to be more easily
overwhelmed when in very stimulating situations. SPS has been
hypothesized to be the manifestation of a highly sensitive central
nervous system, on which environmental influences register more
easily and more deeply (2012). In a first experimental study 160
undergraduate students were randomly allocated to solve either
very easy or very difficult math problems (Aron, Aron, & Davies,
2005). Students scoring high on SPS reported the highest negative
affect when assigned to the ‘‘difficult’’ math problems condition
but also the lowest negative affect when allocated to the ‘‘easy’’
condition, compared to students low on SPS in either experimental
condition, providing the first empirical evidence that SPS may
increase sensitivity to both negative and positive experiences.
The current study involved a sample of 363 11-year-old girls at
a state school in one of the most deprived neighborhoods of
England, representing the population most at risk for depressive
disorders in the United Kingdom. Applying a nonrandomized
two-cohort treatment/control design, the intervention was con-
ducted in the treatment cohort only, which included all children
in the same year at the same school, while the complete year-
ahead cohort served as a control group. Based on the Vantage
Sensitivity framework (Pluess & Belsky, 2013), it was hypothesized
that girls scoring high on SPS would show a greater positive
response (i.e., steeper decline of depression symptoms over time)
to the preventative intervention than girls scoring low on SPS.
2. Method
2.1. Procedure
The SPARK Resilience program (Boniwell & Ryan, 2009) was
delivered to all children of the same cohort in Year 7 (i.e., 6th grade)
as part of the standard curriculum at a girls-only state school in East
London, England. Data was collected on laptop computers during
class at school, using an online questionnaire service, immediately
before and after delivery of the program, as well as 6 and 12 months
after the program was completed. The year-ahead cohort served as
control group but was assessed only once at the end of school Year
8, exactly one year before the 12-month follow-up assessment of
the treatment cohort was conducted. Consequently, the control
data corresponds to the 12-month follow-up data of the treatment
group, gathered when each of the cohorts were approaching the
end of Year 8 (see Fig. 1 for flow chart).
2.2. Participants
The original evaluation study included 230 girls in the treat-
ment and 208 in the control cohort (Pluess, Boniwell, Hefferon, &
Tunariu, submitted). The current analysis is based on a subsample
of 166 girls in the treatment cohort for whom data on SPS was
available, and 197 girls in the year-ahead control cohort with com-
pleted depression questionnaires, resulting in a total sample of 363
participants. Due to failure to complete all questionnaires in time,
and absences from school when data collection took place, sample
size of the treatment cohort varied across repeated assessments
with 141 girls at pre, 166 at post, 144 at 6-month, and 113 at
the 12-month assessment (the statistical approach of the primary
analysis allowed for inclusion of all 166 girls that provided data
at least at one of the assessments). At the initial assessment, girls
in the treatment cohort were on average 11.4 years old
(SD = .49 years). There was no significant difference in age at the
end of Year 8 between the treatment cohort at 12-months fol-
low-up (M= 12.9 years, SD = .36) and the control cohort
(M= 12.8 years, SD = .90). The sample was ethnically diverse, with
51.2% Asian, 18.1% Mixed, 19.3% African/Caribbean, 9.0% Caucasian,
and 2.4% Middle Eastern in the treatment and 44.7% Asian, 17.8%
Mixed, 29.4% African/Caribbean, 6.6% Caucasian, and 1.5% Middle
Eastern in the control cohort. Distributions of ethnicities in treat-
ment and control cohort were not significantly different
(
v
2
= 5.63, p= .23). There were no significant differences in family
size (both groups with M= 4.6 persons per household, SD = 1.81) or
child-reported paternal education between treatment and control
cohorts (both cohorts combined: 1.4% with less than secondary
school, 19.6% with only secondary school, 20.4% with a university
degree, 14.0% more than one university degree, and 44.6%
unknown by the child). All children attended the same school in
the borough of Newham, which was ranked the third most
deprived area in all of England in the 2010 Index of Deprivation
(Department for Communities and Local Government, 2011).
The study received ethical approval from the University of East
London research ethics committee.
M. Pluess, I. Boniwell / Personality and Individual Differences 82 (2015) 40–45 41
2.3. Intervention
The SPARK Resilience program is a new universal school-based
positive education program (Boniwell & Ryan, 2009) that builds
on cognitive-behavioral therapy and positive psychology concepts
(e.g., resilience, post-traumatic growth) with the explicit goal of
fostering emotional resilience and associated skills, as well as
preventing depression. The program is delivered in 12 one-hour
sessions across 3–4 months by local school teachers who have
been trained extensively by professional psychologists and
provided with all necessary teaching materials (i.e., teacher’s
guidebook with detailed curriculum for each session, DVDs with
videos and presentation slides, props, and workbooks for
participating children).
2.4. Measures
Children provided information regarding their gender, age in
years, ethnicity of mother and father, number of persons living in
their household, and education of their father at each assessment
point. Depression Symptoms were assessed with the Center for
Epidemiologic Studies Depression scale (CESD) (Radloff, 1977), a
widely used 20-item measure inquiring about the presence of dif-
ferent depression symptoms in the past seven days (e.g., ‘‘I felt sad’’
and ‘‘I thought my life had been a failure’’) on a four-point scale
ranging from ‘‘1 = rarely or none of the time’’ to ‘‘4 = all or most
of the time’’. Sensory-Processing Sensitivity was measured with a
12-item child self-report version (Pluess et al., in preparation)of
the Highly Sensitive Person scale (HSP) (Aron & Aron, 1997).
Children rated how they generally feel on a seven-point scale from
‘‘1 = not at all’’ to ‘‘7 = extremely’’ (see Table 1 for all included
items). Higher values reflect higher sensitivity. Internal consis-
tency of the measure in the current sample was satisfactory
(alpha = .74). For technical reasons associated with the logistics
of data collection, SPS was measured at the post-rather than the
pre-treatment assessment and only in the treatment cohort. For
the analyses, SPS scores were corrected for concurrent negative
affect, measured with the Positive And Negative Affect Scales
(PANAS) (Watson, 1988), following recommendations of the
authors of the original Highly Sensitive Person Scale (Aron &
Aron, 1997). In order to achieve this, SPS scores were residualised
in a regression model for the influence of negative affect.
Residualised SPS scores correlated highly with the original scores
(r= .99, p< .01).
2.5. Statistical analysis
The moderation of treatment efficacy as a function of SPS was
tested longitudinally with a hierarchical linear model (growth
curve analysis) across the four repeated measures within the treat-
ment cohort only, which allowed for estimation of growth curves
for all of the 166 children included in the treatment cohort regard-
less of missing data across the different assessments. In order to
illustrate and interpret the results of the hierarchical linear model,
Fig. 1. Flow chart of the applied nonrandomized two-cohort treatment/control design.
Table 1
The 12 items of the Highly Sensitive Person Scale – Child Short form.
1 I notice when small things have changed in my environment
2 Loud noises make me feel uncomfortable
3 I love nice smells
4 I get nervous when I have to do a lot in little time
5 Some music can make me really happy
6 I am annoyed when people try to get me to do too many things at once
7 I don’t like watching TV programs that have a lot of violence in them
8 I find it unpleasant to have a lot going on at once
9 I don’t like it when things change in my life
10 I love nice tastes
11 I don’t like loud noises
12 When someone observes me, I get nervous. This makes me perform
worse than normal
42 M. Pluess, I. Boniwell / Personality and Individual Differences 82 (2015) 40–45
extreme groups were created based on SPS scores (top and bottom
25%) and growth curves were plotted for these extreme groups on
the basis of model predicted depression scores. Change in depres-
sion between pre assessment and 12 months follow-up assessment
within each extreme group were tested with dependent t-tests.
Differences between high and low SPS groups of the treatment
cohort as well as between high/low SPS treatment groups and the
complete control cohort at the 12 months follow-up assessment
were investigated with independent sample t-tests (using growth
curve model predicted depression scores for the treatment group
in order to account for missing data). The level of significance
was set at
a
= .05. All statistical analyses were carried out using
SPSS version 19 for Windows.
3. Results
According to univariate analyses of variance (ANOVA), depres-
sion and SPS did not differ as a function of child ethnicity or pater-
nal education in either cohort. Similarly, bivariate correlations
yielded no significant association between family size and depres-
sion or SPS. Consequently, ethnicity, family size and paternal
education were not included as covariates in the analyses.
Descriptive statistics and bivariate correlations of depression and
SPS are reported in Table 1. Importantly, SPS was not associated
with depression scores at pre and post assessment, suggesting that
SPS measures assessed at post-treatment were not influenced by
treatment effects.
In a hierarchical linear model that included both linear and
quadratic slopes across the four depression assessments in the
treatment cohort, SPS significantly predicted the depression inter-
cept at the 12-months follow-up assessment (B=.18, p= .03) as
well as the linear change in depression scores over time (B=.08,
p< .01). However, there was no significant differences in depression
scores between the treatment and control cohort at the 12-month
follow-up assessment (t
(361)
=1.64, p= .10, d=.17), a finding
consistent with the original evaluation of the study (Pluess et al.,
submitted). In order to investigate the significant effects of SPS on
the intercept centered at 12 months and the slope of depression,
extreme groups (bottom and top 25% of the treatment cohort based
on the original SPS scores) were created and model-predicted
depression scores for both extreme groups plotted across the four
measuring points (see Fig. 2). The top SPS group (M= 67.90,
SD = 6.16) had significantly higher SPS scores (t
(80)
= 18.62,
p< .01) than the bottom SPS group (M= 40.80, SD = 6.99).
According to repeated t-tests within each extreme group between
the pre-assessment and the 12-months follow-up assessment, the
change within the low SPS group was not significant
(t
(40)
= 1.45, p= .16, d= .19) whereas it was highly significant in
the high SPS group (t
(40)
=2.95, p< .01, d=.40). According to t-
tests between the two groups, the high SPS group did not differ from
the low SPS group at pre and post assessment, but had significantly
lower depression at the 6-months (t
(80)
=2.04, p< .05) and the 12-
months assessment (t
(80)
=2.18, p= .03)
1
. Comparing the 12-
months assessment depression scores of both high and low SPS treat-
ment groups with the complete control cohort revealed that the low
SPS group did not differ from the control cohort (t
(236)
= .41, p= .68,
d= .07), whereas the high SPS group had significantly lower depres-
sion scores (t
(236)
=2.08, p= .04, d=.39). These findings are illus-
trated in Fig. 3.
4. Discussion
Consistent with the hypothesis, SPS significantly predicted
treatment response to a depression prevention program in a sam-
ple of girls from an economically deprived background. The inter-
vention had a substantial positive effect in girls scoring high on SPS
but was not effective at all in girls scoring low on the same mea-
sure. Although low and high SPS girls did not differ in their initial
depression scores at baseline, high SPS girls had significantly lower
depression scores at the 6- and 12-months follow-up assessments.
Note. SPS = Sensory-Processing Sensitivity;* p< .05. ** p< .01.
Fig. 2. Growth curve model-predicted depression scores of the treatment cohort for Sensory-Processing Sensitivity extreme groups (top and bottom 25%, n= 41 for each)
across the four measuring points in order to illustrate growth curve model findings that emerged using the whole treatment cohort (N= 166).
1
According to these follow-up analyses SPS extreme groups differ significantly at 6
and 12 months based on model predicted depression scores. However, bivariate
correlations in Table 2 suggest that there was no significant association between SPS
and depression at 6 and 12 months. The reason for this contradiction is that bivariate
correlations were based on complete data only (n= 144 for 6 months, n= 113 for
12 months) whereas the growth curve model and follow-up analyses are based on all
cases using model predicted depression scores (n= 166 for growth curves, n= 82 for
extreme groups).
M. Pluess, I. Boniwell / Personality and Individual Differences 82 (2015) 40–45 43
Furthermore, when comparing the high and low SPS groups to the
control cohort at the 12-months follow-up assessment, the high
SPS group had significantly lower depression scores than the
control cohort, whereas the low SPS group did not differ from
the control cohort at all.
Importantly, whereas the treatment effect across the whole sam-
ple (derived from comparison between treatment and control
cohort) was not significant at the 12-month follow-up assessment,
a subgroup of children, those scoring high on SPS, appeared, in fact,
to have significantly lower depression scores at 12-month
follow-up compared to the control cohort, suggesting that the
intervention was indeed effective but only for a subsample of the
girls. Interestingly, the positive treatment effects in the high SPS
group emerged only in the follow-up assessments, suggesting that
depression scores of the high SPS group declined progressively
over time. Given that SPS is characterized not only by high sensitiv-
ity to environmental influences but also deeper processing of such
influences (Aron & Aron, 1997) one possible reason why girls
scoring high on SPS benefitted more from the intervention over
time—and continued to do so even many months after the
intervention ended—is that they processed the content of the
intervention more deeply which may have led to better internal-
ization and, consequently, continued application of the acquired
cognitive-behavioral coping strategies.
The primary assumption why individuals scoring high on SPS
tend to be more responsive to environmental influences, including
psychological intervention, is that they may be characterized by a
more sensitive central nervous system which enables them to pro-
cess environmental stimuli more deeply (Aron & Aron, 1997; Aron,
Aron, & Jagiellowicz, 2012). A recent imaging study provides
empirical evidence for this claim, reporting a significant associa-
tion between SPS and greater activity in brain regions involved in
visual processing (Jagiellowicz et al., 2011). Another study points
towards a potential genetic basis of SPS involving a number of
genes in the dopaminergic and serotonergic systems (Chen et al.,
2011). Hence, the greater treatment response of girls scoring high
on SPS may be due to genetic characteristics that contribute to
brain activities related to deeper processing of environmental
influences, greater ability to direct attention heightened, and
reward sensitivity (Pluess & Belsky, 2013). At this point, however,
these assumptions remain speculative at best and more work is
required to elucidate the exact mechanisms underlying the height-
ened environmental sensitivity associated with SPS.
Nevertheless, the current study provides the first empirical evi-
dence that SPS predicts treatment response consistent with the
Vantage Sensitivity framework (Pluess & Belsky, 2013). Future stud-
ies may want to test other potential Vantage Sensitivity factors (e.g.,
other personality traits, but also physiological and genetic factors)
Table 2
Descriptive statistics and unadjusted associations for outcome variables of the control (N= 197) and treatment cohort (N= 113–166).
Variables Mean value Standard deviation Sample size 1 2 3 4
Depression 12M (CC) 18.40 9.27 197
1 Depression Pre (TC) 17.06 7.77 141
2 Depression Post (TC) 16.44 9.50 166 .53
⁄⁄
3 Depression 6M (TC) 15.49 9.46 144 .36
⁄⁄
.69
⁄⁄
4 Depression 12M (TC) 16.90 10.46 113 .24
.44
⁄⁄
.61
⁄⁄
5 Sensory-Processing Sensitivity (TC) 54.25 11.00 166 .13 .04 .12 .13
Note. CC = control cohort, TC = treatment cohort, statistically significant correlations are marked bold.
*
p< .05.
**
p< .01.
Note. SPS = Sensory-Processing Sensitivity;*p< .05. **p< .01.
Fig. 3. Depression mean scores of the complete control cohort (N= 197) and growth curve model-predicted depression scores for both Sensory-Processing Sensitivity
extreme groups (top and bottom 25%, n= 41 for each) at the 12-months follow-up assessment in order to illustrate growth curve model findings that emerged across the
whole sample (N= 363).
44 M. Pluess, I. Boniwell / Personality and Individual Differences 82 (2015) 40–45
as SPS may not necessarily be the only or the best measure to pre-
dict Vantage Sensitivity in the context of psychological interven-
tions. Furthermore, the findings of the current study will have to
be replicated across different samples and across a range of differ-
ent interventions before routine measurement of SPS in clinical
settings can be recommended as a means of predicting treatment
response.
The strengths of this study include the recruitment of a sample
most at risk for the development of depression (i.e., girls, deprived
neighborhood), a two-cohort treatment/control design which
ensured that there was no bias for inclusion to the treatment or
control group, and the comparison of control and treatment
cohorts at the 12-month follow-up assessment with a focus on
long-term rather than short-term effects. However, findings have
to be considered in light of several methodological limitations.
Firstly, children were not randomly allocated into treatment and
control groups which limits causal interpretation of the findings.
Secondly, all measures were based on child self-report. Thirdly,
children in the control cohort were assessed only once. Fourthly,
the evaluation did not control for important covariates (e.g.,
socio-economic status of family, parenting quality, psychopathol-
ogy of parents). And finally, SPS in the treatment cohort was
assessed at post treatment rather than at pretreatment. It has to
be emphasized in this regard, however, that according to bivariate
correlations SPS was not associated with depression scores at pre
and post assessment, suggesting that SPS scores were not influ-
enced by the intervention.
In conclusion, the current study provides first evidence for
Vantage Sensitivity as a function of SPS regarding treatment
response to a depression prevention intervention in a Western
youth population most at risk for mental health problems.
According to the current analysis positive treatment effects were
confined to a subsample of children characterized by high SPS.
Treatment effects in this subsample were much stronger than the
average effect across the whole sample, whereas girls in the low
SPS group did not benefit from the intervention at all. Prediction
of treatment response with a brief self-report personality measure
such as the one used in this study may be helpful for the selection
and specific indication of psychological intervention on an individ-
ual personalized level.
Acknowledgments
We would like to express our gratitude to the participating
school, specifically the teachers involved in the intervention as
well as all participating children and their parents. Further, we
would like to thank research assistants Katrin Furler, M.Sc., and
Nadia Copiery, M.Sc., for their valuable contribution to the evalua-
tion of the program.
This research was conducted with the support of a Grant from
the Swiss National Science Foundation awarded to Michael
Pluess (PBBSP1-130909).
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... Numerous studies conducted with highly sensitive adolescents have also shown a greater influence of both supportive and aversive aspects of the environment on this group of adolescents. For example, in two studies where the SPARK resilience programme (Boniwell & Ryan, 2009) was implemented, it has been shown that highly sensitive students benefited more from this programme compared to their non-highly sensitive peers Pluess & Boniwell, 2015). This resilience programme, symbolised by the acronym SPARK, which stands for Situation (S), Perception (P), Autopilot (A), Reaction (R), and Knowledge (K), was first developed in the United Kingdom and is based on the principles of cognitive-behavioural therapy and positive psychology. ...
... The main aim of this programme is to promote protective factors (e.g. self-esteem, self--regulation, etc.) in young people in order to develop their re- silience and prevent depression (Boniwell & Ryan, 2009;Kibe et al., 2020;Pluess & Boniwell, 2015). The positive effect of the SPARK resilience programme implemented in schools in Great Britain has been demonstrated in research with highly sensitive students of early adolescent age. ...
... The positive effect of the SPARK resilience programme implemented in schools in Great Britain has been demonstrated in research with highly sensitive students of early adolescent age. Highly sensitive girls had significantly lower depression scores after participating in this programme, while this difference was not found for non--highly sensitive girls (Pluess & Boniwell, 2015). In a study conducted on a sample of Japanese high school students, it was also shown that highly sensitive adolescents (aged 15 to 16) benefited more from this programme. ...
Article
The main aim of this review article is to describe the current state of scientific knowledge on the characteristics of the sensory processing sensitivity (SPS) trait in adolescence. The SPS trait stands for an increased sensitivity of the central nervous system and is associated with a tendency to process stimuli more deeply. People with this trait are highly sensitive people. Previous research has shown that there is a link between this trait and poorer quality of mental health. In addition, ado- lescence itself is a particularly challenging phase of life for most young people, as numerous changes take place during this developmental phase. For these reasons, highly sensitive adolescents represent a particularly vulnerable group for the development of various types of mental health problems. How- ever, previous research has shown that the development of various problems in adolescents with the SPS trait is largely de- pendent on environmental factors. This knowledge is essential for professionals (psychologists and psychiatrists) who need to be aware of the main characteristics of highly sensitive ado- lescents in order to help this group of young people.
... This includes not only the problematic features of processing information in a deeper and slower way -leading to frequent overstimulation (Aron, 1997), rumination , negative cognitive patterns (Jagiellowicz et al., 2011), and higher levels of internalizing symptoms, with anxiety at the forefront (see Liss et al., 2008). It also encompasses the broader consequences of high reactivity to environmental conditions (Pluess, 2015) and reports that highly sensitive students are more reactive to both stressful environments (Scrimin et al., 2018;Saglietti et al., 2024) and favourable conditions (Ceccon et al., 2023;de Villiers et al., 2018;Nocentini et al., 2018;Pluess & Boniwell, 2015). In sum, although some studies suggest that ES increases the risk of psychopathology in children, adolescents, and adults (e.g., Cadogan et al., 2022;Greven et al., 2019;Morellini et al., 2023), other studies found that highly sensitive students may be particularly susceptible to the influence of positive and negative environmental stimuli related to family and school settings Dragone et al., 2024;Iimura & Kibe, 2020;Kibe et al., 2020). ...
... This interpretation partially aligns with the "vantage sensitivity" hypothesis on inter-individual sensitivity (Pluess, 2015;Pluess & Belsky, 2013), as we showed how TSR can impact the risky condition of marginalization. In this respect, our results are consistent with recent school-based research that found that adolescents with high scores in ES react more positively to school-based programs that address depression, bullying, and discrimination (Pluess & Boniwell, 2015;Nocentini et al., 2018;Ceccon et al., 2023), as well as school transitions (Iimura, 2021;Iimura & Kibe, 2020). This reinforces the hypothesis that adolescents high in ES can disproportionately benefit from positive environmental conditions, counterbalancing the adverse risk conditions associated with ES (as in Fisher et al., 2022;Liu et al., 2023). ...
Article
The present study addressed an area of research not yet sufficiently investigated: the environmental sensitivity trait in relation to perceived marginalization in the classroom, dropout intentions, and the quality of teacher-student relationship. Adopting a psychosocial perspective and based on a single study survey with a group of Italian secondary school students, we applied a moderated mediation model. The aim was to determine whether environmental sensitivity was indirectly related to students’ dropout intentions via perceived classroom marginality. Specifically, we proposed that the quality of the teacher-student relationship could act as a protective factor for the well-being of highly sensitive students and, therefore, moderate the relationships between environmental sensitivity and both marginality and dropout intentions. Our research findings partially confirmed these initial hypotheses. An indirect relationship between environmental sensitivity and dropout intentions through marginality was only found when the quality of the teacher-student relationship was low. These findings suggest that positive teacher-student relationship can have a buffering effect, reducing the risk of marginalization for highly sensitive students and thus potentially reducing the risk of early school leaving. Conversely, teacher-student relationship did not moderate the relationship between environmental sensitivity and dropout intentions. Considering these findings, we discuss implications for emerging school-based research on environmental sensitivity and offer insights into potential interventions to enhance highly sensitive students’ well-being and academic trajectories.
... However, research has shown that these same individuals who carry a high sensitivity trait are not only vulnerable to adversities, but also are more sensitive to positive stimuli. Individuals with an increased environmental sensitivity have been reported to benefit more of positive rearing contexts and experiences, including nurturing and supportive parenting (e.g., Slagt et al., 2018), intervention and prevention programs (Nocentini et al., 2018;Pluess & Boniwell, 2015), and video-clip inducing positive emotions in laboratory contexts . Hence, individual sensitivity factors do not only amplify risk for maladaptation in the face of adversities, but also promote a flourishing development and an exceptionally positive adjustment when individuals experience high-quality environments (differential Susceptibility model; Belsky et al., 2007;Belsky & Pluess, 2009). ...
... However, it has been shown that within the classroom children's environmental sensitivity moderated the effects of anti-bulling interventions on victimization and internalizing symptoms, that is more sensitive children benefitted more to the intervention compared with the less sensitive ones. This findings within a classroom environment are consistent with the notion of vantage sensitivity, that suggests that more sensitive individuals are not only more at risk when exposed to negative environment but are also the ones that benefit the most from positive environments and possibly interventions (Nocentini et al., 2018;Pluess & Boniwell, 2015). ...
Article
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Student-teacher interactions capture bystanders’ attention causing an emotional arousal that takes away the focus of attention form the assigned task. To assess attentional and emotional response to socio-emotional interactions within the classroom, student’s eye movement and dilatation were registered while investigating children’s environmental sensitivity. Primary school children’s pupil response (n = 95) while watching different interaction scenes were registered. Children self-reported on environmental sensitivity. Two mixed-effects regression models for pupil fixation durations and dilatation showed that students’ attention was captured more by the teacher yet the focus on the student caused grater arousal. The association between emotional arousal and focus of attention was moderated by students’ environmental sensitivity with incongruent socio-emotional exchanges causing grater emotional arousal in highly sensitive children compared to low sensitive ones. Intervention should promote emotionally positive and in-tune teacher-student interactions to avoid students’ distraction and sympathetic arousal, especially in more environmentally sensitive students.
... This is consistent with the overarching literature, which highlights SPS as a predictor of an individual's state of health (Yano et al., 2019). Although many studies have stated that HSP could show adaptive health features in supportive environments, these individuals are more likely to present mental health problems and psychopathological symptoms when they are involved in hostile contexts (Jagiellowicz et al., 2016;Pluess & Boniwell, 2015). Specifically, these findings are coherent with those demonstrating a relationship between SPS and depression (Liss et al., 2008;Yano & Oishi, 2018). ...
Article
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Sensory processing sensitivity (SPS) is an innate personality trait that describes how individuals perceive and capture environmental information. The extensive literature suggests that people high in SPS may present health implications, such as depressive symptoms and prefrontal symptoms. Prefrontal symptoms are related to executive functioning, especially to emotional, social, behavior control problems such as decision making or planification/organization problems, impulsivity, working memory difficulties. We recruited eight hundred Spanish adults (M = 26.66 years old, SD = 12.24) and completed the self-administer questionnaires on SPS, depression, and prefrontal symptoms. This study performed correlation and mediational analyses. Our results indicated positive associations of the depression variable with emotional (r = 0.481, p < 0.001) and behavioral (r = 0.534, p < 0.001) control problems, and also with prefrontal symptoms as a general factor (r = 0.572, p < 0.001), and SPS (r = 0.201, p < 0.001). SPS was also positively correlated with emotional (r = 0.354, p < 0.001), behavioral (r = 0.276, p < 0.001) control problems, and prefrontal symptoms as a general factor (r = 0.303, p < 0.001). Depression also showed a partial mediation between SPS and both emotional (R² = 0.38, p < 0.001, 95% CI [0.078, 0.142]) and behavioral (R² = 0.339, p < 0.001, 95% CI [0.097, 0.168]) control problems. Depression seems to mediate the relationship between SPS and prefrontal symptoms, being highly sensitive individuals with a tendency to depressive symptoms and problems related to emotional, social, and behavioral control.
... In contrast, the AES subscale (reflecting the enjoyment of art, awareness of subtleties and deeper stimulus processing) (Aron and Aron, 1997;Aron et al., 2012) is shown to be correlated with a positive trait cluster, related to, but mostly distinct from, openness (Attary and Ghazizadeh, 2021). AES is associated with positive outcomes such as entrepreneurial intention, imagination, and enhanced intervention response (Bröhl et al., 2022;Harms et al., 2019;Pluess and Boniwell, 2015;Verheul et al., in press). AES has also been associated with adaptive coping strategies such as problem solving, cognitive restructuring, seeking social support and emotional expression and quality of life (Chacón et al., 2024). ...
Article
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Introduction Sensory Processing Sensitivity (SPS) describes individual differences in sensitivity to environments, but there is little research on potential positive correlates of SPS. Hereby we investigate whether SPS and its Aesthetic Sensitivity (AES) component are associated with different facets of creativity and empathy. Methods Questionnaires on SPS, creativity and empathy were administered to 296 participants and data were analyzed using hierarchical multiple regression. Results Higher SPS total and AES scores were associated with more creative ideas (SPS: β = 0.294, pfdr < 0.001; AES: β = 0.484, pfdr < 0.001). Only AES was associated with more creative activities (AES: β = 0.292, pfdr < 0.001). Furthermore, higher SPS total and AES scores were associated with more overall empathy (SPS: β = 0.428, pfdr < 0.001; AES: β = 0.373, pfdr < 0.001), affective empathy (SPS: β = 0.507, pfdr < 0.001; AES: β = 0.331, pfdr < 0.001), cognitive empathy (SPS: β = 0.2692, pfdr < 0.001; AES: β = 0.347, pfdr < 0.001), and less emotional disconnection (SPS: β = 0.234, pfdr β 0.001; AES: β = 0.210, pfdr β 0.001). Most associations remained significant after controlling for openness to experience, and the other SPS components of ease of excitation and low sensory threshold and gender, age, and education. Discussion We conclude that SPS and AES are associated with creativity and empathy. Strengthening these positive aspects might help highly sensitive people flourish.
... Zhang et al., 2023), but the investigation of sensitivity scores also showed that around 20 to 30% of individuals falls into a highly sensitive group (referred to as orchids), 40 to 50% into a medium sensitive group (referred to as tulips), and 20-30% into a low sensitive group (referred to as dandelions) that differ quantitatively from each other Pluess et al., 2018Pluess et al., , 2023. Individuals scoring in the high group are more influenced by the environment in a for-better and for-worse manner (Belsky et al., 2007), so that they benefit more from positive exposures (e.g., Slagt et al., 2018) as intervention programs (Nocentini et al., 2018;Pluess & Boniwell, 2015) and suffer more than others when exposed to negative environments (e.g., Slagt et al., 2018). Those scoring in the low group are more resilient, or less plastic and susceptible to environmental exposures, while the medium sensitive group show some sensitivity, though not so high as those scoring high on this trait. ...
Article
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This study investigated the psychometric properties of the Highly Sensitive Child-Rating System (HSC-RS), the existence of sensitivity groups, and the characterization of sensitivity at behavioral, genetic, and physiological levels in 541 preschoolers (M(SD) age = 3.56(0.27); 45%male; 87%Caucasian). Temperament, genetic, cortisol, and electroencephalography asymmetry data were collected in subsamples (n = 94-476). Results showed a reliable observational measure of sensitivity. Confirmatory factor and latent class analysis supported a one-factor solution and three sensitivity groups, that are a low (23.3%), medium (54.2%), and a high (22.5%) sensitivity group. Hierarchical regression analyses showed moderate associations between HSC-RS and observed temperament traits (i.e., behavioral level). In addition, a small negative association between HSC-RS and a genome-wide association study polygenic risk score (GWAS PGS) for Attention Deficit Hyperactivity Disorder was found. No relations with candidate genes, other GWAS PGS phenotypes, and physiological measures were found. Implications of our findings and possible explanations for a lack of these associations are discussed.
... Third, we did not account for participants' prior experiences with exercise, including their exposure to different exercise intensities, which could impact current exercise behaviors and preferences. For instance, both observational [40] and experimental [9,41] research have found that individuals who score high in SPS have stronger reactions to positive and negative experiences than their low SPS counterparts. Thus, collecting data on previous exercise experiences would help clarify their influence on current behavior and preferences. ...
Article
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Background/Objectives: Regular exercise is important for overall health, yet exercise participation in the United States remains low. Exercise promotion depends on identifying factors such as personality that might influence exercise participation. Sensory processing sensitivity (SPS), a personality trait described as the tendency to deeply process environmental stimuli, is a psychological factor that may influence exercise participation. The purpose of this cross-sectional study was to examine relationships among SPS, exercise behavior, and preferred exercise intensity. Methods: Participants (N = 320) were college students and employees who completed the 12-Item Highly Sensitive Person Scale, the Godin Leisure-Time Exercise Questionnaire, and a question related to preferred exercise intensity. Results: Participants’ ages ranged from 18 to 70 years (M = 39.36, SD = 15.15), and they were mostly female (69.6%). Most participants were physically active (77.5%). Mean SPS scores were not significantly different between active (M = 50.2, SD = 10.9) and insufficiently active (M = 51.4, SD = 9.97) participants; however, post hoc analysis revealed that the mean increase in SPS score from preference for vigorous intensity to light intensity (5.18, 95% CI [0.13, 10.2]) was statistically significant (p = 0.043). Conclusions: Exercise preferences are an important consideration for exercise adoption and adherence; thus, these findings have practical implications for exercise promotion, especially for individuals who score higher in SPS.
Article
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This study aimed to investigate the relationship between sensory processing sensitivity (SPS), emotional and social loneliness and social isolation. Data were collected from September 2022 to May 2023 on a sample of 3247 participants aged 18 to 80 (mean age = 31.9 years ± 13.2; 66.2% female). We measured SPS using the Sensory Processing Sensitivity Questionnaire (SPSQ), loneliness using the De Jong Gierveld Loneliness Scale (DJGLS), and social isolation, Neuroticism and Extraversion with the Big Five Inventory. Data analysis was performed using linear regression, binary logistic regression, the t-test, the Chi-square test and ANOVA. In our study, lower SPS was observed especially among men, pensioners and graduates of secondary vocational schools. SPS was associated with emotional loneliness (t = 4.276; b = 0.074; adjusted R2 = 0.181; p < 0.001), but no significant relationship was found between SPS and social loneliness. SPS is associated with higher emotional but not social loneliness or social isolation. Highly Sensitive Persons (HSPs) appear to have a higher need for intimacy and understanding in close relationships, which is essential to know for them, their friends, families and therapists.
Preprint
Around 30% of children are highly sensitive to their environment and process experiences particularly deeply. To facilitate research into highly sensitive children in primary school, we developed a new teacher-report measure. The scale was initially implemented and analysed in a multi-informant sample of two hundred twenty 6–9-year-old Swiss children and their parents and teachers, followed by a validation study in England encompassing teacher reports on two hundred seven 6–9-year-old British children. Analysis across both samples led to a scale well suited to capture sensitivity in the context of school. The new Highly Sensitive Child in School scale (HSC – School) includes a six-item core sensitivity scale aimed at identifying sensitive children and an additional 3-item overstimulation scale. Sensitivity measured with this scale is normally distributed, presents similarly in girls and boys, but only correlates with overstimulation in some (UK sample) but not other contexts (Swiss sample), highlighting that sensitive children’s adjustment differs across school environments. This scale will be valuable for research and the identification of children at risk during potentially stressful transitioning periods or when confronted with challenges or stressors at home or school.
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A fundamental trait found in most organisms is the ability to register, process, and respond to external factors. Although such environmental sensitivity is critical for adapting successfully to contextual conditions, individuals tend to differ in their sensitivity to the environment, with some more sensitive than others. Such differences in environmental sensitivity can be seen across many species, including humans. Although the notion of variability in environmental sensitivity is reflected indirectly in many traditional concepts of human psychology, several new frameworks address individual differences in environmental sensitivity more directly and from a perspective of developmental and evolutionary theory. In this article, I integrate these perspectives into a broad meta-framework before proposing ideas for research on individual differences in environmental sensitivity. I also emphasize that inter-individual variability in environmental sensitivity be considered in both theoretical and applied work.
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We provide a theoretical and empirical basis for the claim that individual differences exist in developmental plasticity and that phenotypic plasticity should be a subject of study in its own right. To advance this argument, we begin by highlighting challenges that evolutionary thinking poses for a science of development and psychopathology, including for the diathesis-stress framework that has (fruitfully) guided so much empirical inquiry on developmental risk, resilience, and dysregulation. With this foundation laid, we raise a series of issues that the differential-susceptibility hypothesis calls attention to, while highlighting findings that have emerged over just the past several years and are pertinent to some of the questions posed. Even though it is clear that this new perspective on Person × Environment interaction is stimulating research and influencing how hypotheses are framed and data interpreted, a great many topics remain that need empirical attention. Our intention is to encourage students of development and psychopathology to treat phenotypic plasticity as an individual-difference construct while exploring unknowns in the differential-susceptibility equation.
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The notion that some people are more vulnerable to adversity as a function of inherent risk characteristics is widely embraced in most fields of psychology. This is reflected in the popularity of the diathesis-stress framework, which has received a vast amount of empirical support over the years. Much less effort has been directed toward the investigation of endogenous factors associated with variability in response to positive influences. One reason for the failure to investigate individual differences in response to positive experiences as a function of endogenous factors may be the absence of adequate theoretical frameworks. According to the differential-susceptibility hypothesis, individuals generally vary in their developmental plasticity regardless of whether they are exposed to negative or positive influences-a notion derived from evolutionary reasoning. On the basis of this now well-supported proposition, we advance herein the new concept of vantage sensitivity, reflecting variation in response to exclusively positive experiences as a function of individual endogenous characteristics. After distinguishing vantage sensitivity from theoretically related concepts of differential-susceptibility and resilience, we review some recent empirical evidence for vantage sensitivity featuring behavioral, physiological, and genetic factors as moderators of a wide range of positive experiences ranging from family environment and psychotherapy to educational intervention. Thereafter, we discuss genetic and environmental factors contributing to individual differences in vantage sensitivity, potential mechanisms underlying vantage sensitivity, and practical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that affect who becomes poor as well as mechanisms through which poverty appears to influence child and youth mental health. Third, we use this conceptual framework to selectively review the growing literatures on the mechanisms through which family poverty influences the mental, emotional, and behavioral health of children. We illustrate how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty. Fourth, we describe strategies to directly reduce poverty and the implications of these strategies for prevention. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Muñoz, Beardslee, & Leykin, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.
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In a randomized controlled trial we tested the role of genetic differences in explaining variability in intervention effects on child externalizing behavior. One hundred fifty-seven families with 1- to 3-year-old children screened for their relatively high levels of externalizing behavior participated in a study implementing Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), with six 1.5-hr intervention sessions focusing on maternal sensitivity and discipline. A moderating role of the dopamine D4 receptor (DRD4) variable-number tandem repeat (VNTR) exon III polymorphism was found: VIPP-SD proved to be effective in decreasing externalizing behavior in children with the DRD4 7-repeat allele, a polymorphism that is associated with motivational and reward mechanisms and Attention Deficit Hyperactivity Disorder (ADHD) in children. VIPP-SD effects were largest in children with the DRD4 7-repeat allele whose parents showed the largest increase in the use of positive discipline. The findings of this first experimental test of (measured) gene by (observed) environment interaction in human development indicate that children may be differentially susceptible to intervention effects depending on genetic differences.
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This article reviews the literature on sensory processing sensitivity (SPS) in light of growing evidence from evolutionary biology that many personality differences in nonhuman species involve being more or less responsive, reactive, flexible, or sensitive to the environment. After briefly defining SPS, it first discusses how biologists studying animal personality have conceptualized this general environmental sensitivity. Second, it reviews relevant previous human personality/temperament work, focusing on crossover interactions (where a trait generates positive or negative outcomes depending on the environment), and traits relevant to specific hypothesized aspects of SPS: inhibition of behavior, sensitivity to stimuli, depth of processing, and emotional/physiological reactivity. Third, it reviews support for the overall SPS model, focusing on development of the Highly Sensitive Person (HSP) Scale as a measure of SPS then on neuroimaging and genetic studies using the scale, all of which bears on the extent to which SPS in humans corresponds to biological responsivity.
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The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
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This book proposes that psychopathology is best understood as the interaction between 3 factors: biology–genetics, personality, and stressful events. These, in combination with social and familial factors, create vulnerability in the individual. Using this framework, the author synthesizes for his readers the most current research available on each of the major disorders including anxiety, mood, antisocial personality, substance abuse, pathological gambling, and schizophrenic disorders. The author's intent is to provide teachers, graduates students, clinicians, researchers, and theorists with an up-to-date coursebook, a single source of information on the major psychological disorders. The volume covers their history, diagnosis, prevalence, prognosis, course, outcome,comorbidity, demographic characteristics, genetics, biochemistry, and neurophysiology. An important finding is that while anxiety, depression, and antisocial personality represent extremes of normal personality dimensions, schizotypic personality and schizophrenic disorder are a taxon, not continuous with normal dimensions of personality. This comprehensive and authoritative book will be a valuable new resource. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Background: Research has shown that interactions between young children’s temperament and the quality of care they receive predict the emergence of positive and negative socioemotional developmental outcomes. This multimethod study addresses such interactions, using observed and mother-rated measures of difficult temperament, children’s committed, self-regulated compliance and externalizing problems, and mothers’ responsiveness in a low-income sample. Methods: In 186 thirty-month-old children, difficult temperament was observed in the laboratory (as poor effortful control and high anger proneness), and rated by mothers. Mothers’ responsiveness was observed in lengthy naturalistic interactions at 30 and 33 months. At 40 months, children’s committed compliance and externalizing behavior problems were assessed using observations and several well-established maternal report instruments. Results: Parallel significant interactions between child difficult temperament and maternal responsiveness were found across both observed and mother-rated measures of temperament. For difficult children, responsiveness had a significant effect such that those children were more compliant and had fewer externalizing problems when they received responsive care, but were less compliant and had more behavior problems when they received unresponsive care. For children with easy temperaments, maternal responsiveness and developmental outcomes were unrelated. All significant interactions reflected the diathesis-stress model. There was no evidence of differential susceptibility, perhaps due to the pervasive stress present in the ecology of the studied families. Conclusions: Those findings add to the growing body of evidence that for temperamentally difficult children, unresponsive parenting exacerbates risks for behavior problems, but responsive parenting can effectively buffer risks conferred by temperament.