Browsing by Author "Rash, Joshua"

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    Maternal cortisol during pregnancy is related to infant cardiac vagal control
    (Psychoneuroendocrinology, 2015-04) Rash, Joshua; Campbell, Tavis; Letourneau, Nicole; Giesbrecht, Gerald
    Background: Prenatal exposure to maternal psychological distress and glucocorticoids result in neurobiological adaptations within the fetus that increase risk for developing exaggerated emotional, behavioral, and stress responses to novelty and challenges in childhood. The current study investigated the influence of maternal depressed mood and cortisol during pregnancy on infant cardiac vagal control (CVC) to standardized laboratory challenge tasks. Methods: The sample comprised 194 women and their infants. Maternal reports of depressed mood and salivary cortisol were assessed at 14 and 32 weeks gestational age. Linear regression was used to examine associations between maternal measures during early and late pregnancy, and infant CVC indexed via respiratory sinus arrhythmia (RSA) at rest and in response to laboratory tasks designed to elicit frustration when infants were 6 months of age. It was hypothesized that maternal depressed mood and cortisol would be associated with lower basal RSA and smaller decreases in RSA from baseline to challenge. Results: A significant decrease in infant RSA from baseline to frustration tasks indicated that laboratory tasks elicited a reliable decrease in RSA from baseline to frustration among infants which is characterized by reduction in vagal efferent activity on the heart in response to challenge. Higher maternal cortisol, but not depressed mood, was associated with lower basal RSA and greater decrease in RSA from baseline to frustration. Associations between maternal cortisol and infant basal RSA were observed for both early and late pregnancy whereas the associations between prenatal cortisol and decrease in RSA from baseline to frustration were observed for early, but not late, pregnancy. Conclusions: Maternal cortisol during pregnancy was associated with infant CVC at 6-months of age. Such influences may have enduring impacts on the child and important implications for the development of physical and mental health outcomes.
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    Towards the rapid assessment of pain expression: The Index of Facial Pain Expression (IFPE)
    (2017) Rash, Joshua; Campbell, Tavis; Carlson, Linda; Noel, Melanie; McDonough, Meghan; Pukall, Caroline
    Pain is the most common reason for seeking healthcare and one in five Canadians suffer from chronic pain. Despite high prevalence and severe consequences, pain is often poorly recognized and inadequately managed. Training observers to recognize facial expressions of pain may improve observer detection and estimation of pain. Pain is accompanied by distinct and reliable changes in four facial muscles (i.e., brow, orbital, levator, eye closure) that can be characterized as a "pain expression." The facial expression of pain communicates quantitative information that is associated with self-report of pain. Observers do not fully utilize evidence for pain conveyed by the face and rely on salient indicators at the expense of subtle signs. This dissertation described the development, reliability, and validity of the Index of Facial Pain Expression (IFPE) - an abbreviated system for quantifying facial pain expression. This work consisted of three steps. First, we developed the IFPE which is an online environment designed to quantify pain through the use of an abbreviated Facial Action Coding System (FACS). This training environment included a manual, three online learning modules, and a final test containing 25 video-clips. Second, four comparable Sensitivity To Expressions of Pain (STEP) tests were designed to evaluate observer sensitivity and response bias to evidence of clinical pain. Participants (n=101) completed questionnaires, watched four STEP tests, and evaluated patient pain. Results indicated that observer characteristics were associated with evaluation of pain. Third, a controlled investigation was performed to evaluate the impact of training in the IFPE on observer sensitivity and response bias to clinical pain. Participants attended two laboratory testing sessions separated by an intervention period where they were assigned to complete the IFPE (n = 34) or a no contact control (n = 20). Participants completed questionnaires during the first testing session and watched parallel versions of the STEP test during laboratory sessions. Training in the IFPE resulted in reliable coding of facial muscle movements associated with pain, and improvement in sensitivity to evidence of clinical pain. Collectively, this work provides initial support for the IFPE as a tool to improve observer detection of facial pain expression.