Publications by authors named "David B Flora"

In the second year of life, the brain undergoes rapid maturation, allowing young children to progress from relying mainly on their caregiver for comfort during distress to acquiring cognitive, motor, and emotional skills necessary for self-regulation of distress. This longitudinal, naturalistic observational study examined developmental patterns in pain-related distress responding during routine immunizations across the second year of life via cardiac and behavioural measures of pain-related distress. Respiratory Sinus Arrhythmia (RSA) and Face, Legs, Activity, Crying, and Consolability (FLACC) scores were collected at 4 epochs (Baseline, Needle, 1 min post-needle, and 2 min post-needle) during toddlers' 12-, 18-, and 24-month vaccination visits (N = 223).

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Objectives: Toxic chemicals can harm children's brain development, but the public's understanding of these harmful impacts is largely unknown. People's knowledge of toxic chemicals and their awareness of how to reduce children's exposure was examined. This study also assessed whether a video was efficacious in increasing knowledge about toxic chemicals and brain development and encouraging behavioral change to reduce exposure to toxic chemicals.

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Across subfields of psychology, researchers frequently encounter count variables (i.e., non-negative integer values, which result from counted measurements).

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Objective: This study investigated biological, psychological, and behavioral aspects of caregivers' responses to toddlers' pain-related distress by measuring caregivers' high-frequency heart rate variability (HRV) responses during toddler vaccination pain and examining associations with caregivers' behavioral responses and psychological stress.

Methods: Participants included caregiver-toddler dyads (N = 194) from a longitudinal cohort-sequential study who were observed during toddlers' 12-, 18-, or 24-month routine vaccinations. Changes in caregiver HRV were analyzed using growth curve modeling.

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The early stages of the COVID-19 pandemic exposed large portions of the global populations to increased daily stressors. Research on risky choice in medical contexts suggests that affect-rich choice options promote less-advantageous decision strategies compared with affect-poor options, causing an "affect gap" in decision making. The current experiments (total  = 437, age range: 21-82) sought to test whether negative pandemic-related affect would lower expected-value (EV) maximisation within individuals.

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Coefficient omega indices are model-based composite reliability estimates that have become increasingly popular. A coefficient omega index estimates how reliably an observed composite score measures a target construct as represented by a factor in a factor-analysis model; as such, the accuracy of omega estimates is likely to depend on correct model specification. The current paper presents a simulation study to investigate the performance of omega-unidimensional (based on the parameters of a one-factor model) and omega-hierarchical (based on a bifactor model) under correct and incorrect model misspecification for high and low reliability composites and different scale lengths.

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Introduction: Toddlers rely on their caregivers for regulatory support when faced with pain-related distress. The caregiver's ability to support their toddler relies on their capacity to regulate their own distress and respond effectively to the child's need for support. The aim of the current study was to describe patterns of caregiver-toddler physiological co-regulatory patterns, also known as attunement, during routine vaccinations across the second year of life.

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Objective: This study examined associations between Sport Concussion Assessment Tool-5 (SCAT-5) symptom reporting and gold-standard measures of anxiety and depression, and explored the utility SCAT-5 symptom subscales to identify anxiety and depression symptomology.

Design: Prospective cross-sectional study.

Setting: York University in Toronto, Canada.

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Objective: The current study discusses the development and preliminary validation of an observational measure of caregivers' distress-promoting behavior (OUCHIE-RV) in the context of toddler routine vaccination.

Methods: Measure validation was based on a sample of caregiver-toddler dyads (N = 223) from a longitudinal cohort-sequential study who were observed during toddlers' 12-, 18-, or 24-month routine vaccinations. Validity was assessed using correlations and cross-lagged path analysis and associations were tested between OUCHIE-RV composite scores and toddlers' pain-related distress as well as caregivers' state anxiety, soothing behaviors, heart rate, and heart rate variability.

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This systematic review and narrative synthesis characterized parents' physiological stress responses to child distress and how parents' physiological and behavioural responses relate. The review was pre-registered with PROSPERO (#CRD42021252852). In total, 3607 unique records were identified through Medline, Embase, PsycINFO, and CINAHL.

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Objective: Previous research discerned 3 groups of caregiver-toddler dyads that differed in their physiological coregulatory patterns, also known as physiological attunement, during routine vaccinations in the second year of life. One group of dyads (80% of sample) displayed an attuned regulatory pattern, and 2 groups of dyads (20% of sample) showed maladaptive attunement patterns (ie, a lack of attunement or misattunement). The objective of the current study was to examine how well the pain-related distress of children and caregivers during vaccination predicted these patterns.

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The purpose of this study was to further our understanding of early childhood pain-related distress regulation. Concurrent and predictive relations between child-led emotion regulation (ER) behaviors and pain-related distress during vaccination were examined at 2 different ages using autoregressive cross-lagged path analyses. Toddlers were video-recorded at the 12- and 18-month routine vaccination appointments (12-month-old [N = 163]; 18-month-old [N = 149]).

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Purpose: The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is to further examine the psychometric properties of the SPTS-12 by evaluating its criterion validity and how scores change over time in a sample of postsurgical patients at the Toronto General Hospital Transitional Pain Service.

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Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally.

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The goal of the current study was to review and meta-analyze the literature on relationships between child distress expression behaviors (e.g., cry) and three clusters of child distress regulation behaviors (disengagement of attention, parent-focused behaviors, and self-soothing) in the first three years of life.

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The objective of the current study was to systematically review the literature on caregiver-child biological attunement within distress contexts during the first three years of life. A total of 9932 unique abstracts were identified through Medline, Embase, PsycINFO, CINAHL, and Scopus databases. Thirty-six studies provided data from caregivers and their infants or toddlers within a distress paradigm, used biological indicators of distress, and assessed the relations between caregiver and child biological indicators.

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Drinking water is a major source of dietary fluoride intake in communities with water fluoridation. We examined the association between urinary fluoride adjusted for specific gravity (UF) and tap water fluoride levels, by age and sex, among individuals living in Canada. Participants included 1629 individuals aged 3 to 79 years from Cycle 3 (2012-2013) of the Canadian Health Measures Survey.

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Background: Fluoride has been associated with IQ deficits during early brain development, but the period in which children are most sensitive is unknown.

Objective: We assessed effects of fluoride on IQ scores across prenatal and postnatal exposure windows.

Methods: We used repeated exposures from 596 mother-child pairs in the Maternal-Infant Research on Environmental Chemicals pregnancy and birth cohort.

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There is considerable variability regarding the convergence between behavioral and biological aspects of distress responses in toddlerhood, and little research has investigated the convergence of these measures in high distress. The aim of the current study was to describe patterns of distress responses to vaccinations as indexed by both pain-related behavioral distress and heart rate (HR) at 12 and 18 months. Caregiver-toddler dyads were part of an ongoing longitudinal cohort observed during 12- (N = 158) and 18-month (N = 122) well-baby vaccinations.

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The aim of this study was to examine the concurrent and predictive relations between healthy toddlers' pain behavior and cardiac indicators (ie, heart rate [HR] and respiratory sinus arrhythmia [RSA]) during routine vaccinations. Caregiver-infant dyads were part of a longitudinal cohort observed during their 12- and 18-month vaccinations. Behavioral and cardiac data were simultaneously collected for 1-minute preneedle and 3-minutes postneedle.

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Measurement Invariance (MI) is often concluded from a nonsignificant chi-square difference test. Researchers have also proposed using change in goodness-of-fit indices ([Formula: see text]GOFs) instead. Both of these commonly used methods for testing MI have important limitations.

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Objective: The objective of this study was to determine which variables predict parental postvaccination pain ratings. It was hypothesized that after child behavior, parental sensitivity, and parental reports of worry would be the strongest predictors.

Methods: Data for 215 parent-child dyads were analyzed from a longitudinal cohort at the preschool (4 to 5 y of age) vaccination.

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To examine whether males and females with ADHD differ in their preferences for delayed rewards, since there is some evidence that suggests a sex difference with typically developing (TD) samples. We used meta-analyses to examine sex differences on delay of gratification and temporal discounting tasks in both TD and ADHD samples. We identified 28 papers with 52 effect sizes for children and adults, and calculated the average effect size for sex comparisons within TD and ADHD samples.

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