Background and aims: There is substantial variation in recovery after pediatric traumatic brain injury (pTBI). Understanding the genetic and environmental factors influencing this variation, would allow optimization of treatments to reduce the profound negative societal and economic impact of pTBI. This study will examine the associations between genetic and environmental factors on global functioning and neurocognitive and behavioural functioning following severe pTBI.
Method: We will collect salivary DNA samples and measures of parenting and home environment from approximately 85 children in the U.K. who have participated in the international Approaches and Decisions in Acute Pediatric TBI Trial (ADAPT). The primary outcome will be global functioning assessed by the pediatric Glasgow Outcome Scale-Extended (GOSE) at 3-, 6-, and 12-months post-injury. Secondary outcomes will include an assessment of cognitive and behavioral functioning 12-months post-injury.
Results: an analytic approach that seeks to identify genes and variants associated with recovery that are over-represented (gene-enrichment) across response to injury and neurocognitive and behavioral reserve biologic processes will be used. Mixed model analyses will evaluate the association of genotypes with recovery after severe pTBI and to elucidate the association of environmental factors with recovery. How genetic and environmental factors and genetic and early clinical factors interact to influence recovery after severe pTBI will also be evaluated.
Conclusions: the study findings will help us to better understand what determines variation in recovery following pTBI, supporting the ability to provide accurate prognosis and develop novel precision treatments.

© the Author(s) 2019. Self-compassion and its cultivation in psychological interventions are associated with improved mental health and well-being. However, the underlying processes for this are not well understood. We randomly assigned 135 participants to study the effect of two short-term self-compassion exercises on self-reported-state mood and psychophysiological responses compared to three control conditions of negative (rumination), neutral, and positive (excitement) valence. Increased self-reported-state self-compassion, affiliative affect, and decreased self-criticism were found after both self-compassion exercises and the positive-excitement condition. However, a psychophysiological response pattern of reduced arousal (reduced heart rate and skin conductance) and increased parasympathetic activation (increased heart rate variability) were unique to the self-compassion conditions. This pattern is associated with effective emotion regulation in times of adversity. As predicted, rumination triggered the opposite pattern across self-report and physiological responses. Furthermore, we found partial evidence that physiological arousal reduction and parasympathetic activation precede the experience of feeling safe and connected.

Inhibitory processes have been implicated in depressive rumination. Inhibitory deficits may cause difficulties in disengaging from ruminative content (e.g. Joormann, 2005), or rumination may constitute a working memory load, causing deficits in inhibitory control (e.g. Hertel, 2004). These hypotheses have different implications for the treatment of depression. We conducted a systematic review of existing evidence, and conclude that most studies do not unambiguously measure inhibition. The majority of published evidence is correlational, and thus supports neither causal direction. No published experimental studies have investigated the inhibitory deficit -? rumination causal direction, and only six have investigated the rumination -? inhibitory deficit hypothesis. In two of these studies the dependent variable has low construct validity. One study reported no effect of rumination on interference, and three did not control for mood effects. There is need for carefully designed experimental research that has the potential to investigate these proposed causal mechanisms.

BACKGROUND AND OBJECTIVES: Control theory predicts that the detection of goal discrepancies initiates ruminative self-focus (Martin & Tesser, 1996). Despite the breadth of applications and interest in control theory, there is a lack of experimental evidence evaluating this prediction. The present study provided the first experimental test of this prediction. METHODS: We examined uninstructed state rumination in response to the cueing of resolved and unresolved goals in a non-clinical population using a novel measure of online rumination. RESULTS: Consistent with control theory, cueing an unresolved goal resulted in significantly greater recurrent intrusive ruminative thoughts than cueing a resolved goal. Individual differences in trait rumination moderated the impact of the goal cueing task on the extent of state rumination: individuals who had a stronger tendency to habitually ruminate were more susceptible to the effects of cueing goal discrepancies. LIMITATIONS: the findings await replication in a clinically depressed sample where there is greater variability and higher levels of trait rumination. CONCLUSIONS: These results indicate that control theories of goal pursuit provide a valuable framework for understanding the circumstances that trigger state rumination. Additionally, our measure of uninstructed online state rumination was found to be a valid and sensitive index of the extent and temporal course of state rumination, indicating its value for further investigating the proximal causes of state rumination.