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All in the Family - Nurse Researchers Study How Family Dynamics Affect Kids and Preteens

Sybil CarrèreSybil CarrèreWe've all heard parents joke, "Oh, I'm sure my kid is going to need therapy some day." But to be serious, what if parents could learn how to prevent emotional and behavioral problems in their children's teen years-instead of merely worrying about what the future may bring?

Soon parents may be able to learn ways to help ensure their kids grow into well-adjusted teens and adults, thanks to research spearheaded by Sybil Carrère. Carrère, a research assistant professor in family and child nursing, is entering the final year of a five-year Family Health Project study of the dynamics between pre-adolescent children and their parents, with a focus on the ways in which families communicate about emotions and the implications of this for their children's health and emotional development as they transition to puberty.

Until now, little research existed on how parents can help their pre-adolescent children understand and manage their emotions under stressful situations. Carrère wanted to learn more about everyday interactions between family members-not just the times when kids are getting into hot water. How do parents' emotional reactions in regular situations affect their children, for good or for bad?

The study, sponsored by the National Institute of Mental Health (NIMH), currently has 135 families enrolled from throughout the Puget Sound region; most of the kids now range in age from 8 to 10 years. In order to learn more about kids' reactions to stressful emotional situations, the School of Nursing teamed up with Boeing Co., Talaris Research Institute and the Museum of Flight to create a laboratory with the ideal conditions for gathering data on kids-one that would keep them focused and physically still so researchers could collect heart rate data. That turned out to be a realistic replica of the space shuttle. Parents and their kids were brought onboard the "shuttle," and the moms and dads were given a challenging task to teach their kids. Throughout the process, the researchers took the kids' electrocardiograms to measure cardiovascular responses to the stresses imposed on them.

"We've found that the kids who report to us [in interviews] that their parents are very understanding when they go to talk to them about their anger, those are the kids who are calmer, who have lower heart rates," Carrère says. Carrère and her team discovered the finding on heart rates when they bravely ventured into these families' homes during dinnertime, an event she and her researchers found to be "chaotic" in many cases.

Chaos or not, says Carrère, "An emotionally healthy family is one where the children feel like they can go to their parents when they're emotionally upset, when they're feeling angry, but also when they're feeling sad." Research shows it's OK for kids to see their parents express anger and sadness as long as mom and dad also model effective ways of dealing with their feelings.

For example, says Carrère, "When parents say, 'I'm going out for a run to burn off some steam,' instead of getting aggressive or violent, they're modeling for their kids what to do when you're feeling anger." Kids may not learn these sorts of emotional-coping strategies in elementary and middle schools, says Carrère, so they need to learn them at home. "When somebody is picking on you or you're feeling very angry, children who are emotionally dysregulated don't know how to use their words to defuse the situation and they become aggressive. Kids who are emotionally regulated go, 'OK, I know I'm getting really angry. What am I supposed to do? I'm supposed to use my words and talk my way through it, or just walk away.'"

It's the families in which anger and sadness are covered up and not expressed, Carrère is finding, that are most dysfunctional. "There's a big difference between sending an angry kid to his room until he calms down, saying 'A young man being angry is not OK in this house,' and saying, 'Let's talk about what you can do to work through that anger. Do you want to go to your room for a while to have a little more peace and quiet and so you can think about how you would like to resolve this issue that made you angry?'" says Carrère, who is also affiliated with the school's Center on Infant Mental Health and Development.

As the children in this study edge toward adolescence, Carrère is keeping a sharp eye on the kids and their symptoms of depression. The Family Health Project research may help families avoid such depressive episodes by uncovering some of the early warning signs that predict depression during adolescence. One question she and her research team are pursuing is whether children, particularly girls, who have difficulty regulating their emotions end up experiencing depression during adolescence.

With one more year of research left for the Family Health Project, Carrère is excited that the results will help both parents and health care providers better understand the teachings necessary for kids to function in an emotionally healthy way. Her hope is to get further NIMH funding in order to track these families until the children turn 18-at which point, one can hope, the parents won't be joking about sending their kids to a mental health counselor, but will be well-versed in what it takes to raise emotionally healthy children.

CREDITS: Sybil Carrère, right, co-pilots her laboratory "space shuttle," complete with views of Earth from above and Mission Control on the monitor behind her. Carrère uses the shuttle setting to study child and parent interactions and the effects of emotional stress on kids' heart rates.