Emotion, Mental Health, and the Epigenetic Clock in High-Risk Caregivers

1. Specific aims and hypotheses. (1) To determine differences in negative emotion generation (i.e., emotional experience, behavior, physiology) during dyadic interaction between UHR youth-caregiver and healthy control dyads. Hypotheses: During negative youth-caregiver interactions, (1.1) UHR youth will show higher levels of negative emotion (i.e., higher levels of negative emotional experience and autonomic physiological activation, but lower levels of negative behavior) and (1.2) UHR caregivers will show higher levels of negative emotion (i.e., experience, behavior, autonomic physiological activation) compared to control caregivers. Rationale: Alterations in emotional functioning among UHR youth, include heightened negative emotional experience 1; 2 and blunted emotional expressions 3; 4. However, these alterations have rarely been examined in social contexts of key emotional significance, such as during interactions with their parental caregivers 5. Moreover, the emotional burden for caregivers who witness patients suffering from psychological distress are well documented 6-9, and so it is reasonable to predict that caregivers of UHR youth may show heightened negative emotion during negative interactions with youth. (2) To determine how negative emotion generation (i.e., emotional experience, behavior, physiology) during dyadic interaction predicts mental health (i.e., depressive symptoms, anxiety) in UHR and healthy control caregivers. Rationale. Hypotheses. (3) To determine how negative emotion generation (i.e., emotional experience, behavior, physiology) during dyadic interaction predicts accelerated epigenetic aging in UHR and healthy control caregivers. Rationale. Hypotheses. 2. Significance. Focus on mental and physical health in high-risk caregivers. Caring for a loved one who suffers from mental illness can provide meaning and purpose, but also poses unique risks to the mental and physical health of caregivers (REF). The proposed project focuses on caregivers (i.e., parents or legal guardians) of youth who are at ultra-high risk for psychosis (i.e., ultra-high risk [UHR] youth). UHR youth are adolescents and young adults who display subtle attenuated positive symptoms and a decline in socio-occupational functioning and who are at heightened risk for developing a psychotic disorder10; 11. UHR caregivers are at a significant risk for heightened mental and physical health problems because (a) many of them live with the UHR youth they care for12; (b) UHR youth show significant impairments in socioemotional functioning; (c) caregivers may experience heightened negative emotions (e.g., anger, embarrassment; fear) in interaction with UHR youth; and (d) negative emotions play a well-documented role in the development of mental and physical health problems (REF). Past research has often focused on the well-being and health of UHR youth while giving less attention to caregivers who themselves are at considerable risk for mental and physical health impairments (which in turn may impact clinical course in UHR youth). Focus on emotion. Whether UHR caregivers fare well or poorly depends on numerous external (e.g., financial and social support; health care) and internal factors (e.g., emotion; personality). This project zooms in on individual differences in caregivers’ emotional functioning as a key factor that protects against or amplifies mental and physical health problems. Understanding emotions (defined as “short-lived psychological-physiological phenomena”) is critical because of the important role that emotions play in enabling