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Annual Research Review: Studying interpersonal interactions in developmental psychopathology.

Wass, S., Greenwood, E., Esposito, G., Smith, C., Necef, I., & Phillips, E. 2023. Institute of Psychology Psychiatry and Neuroscience

During development we transition from co-regulation (where regulatory processes are shared
between child and caregiver) to self-regulation. Most early co-regulatory interactions aim to
manage fluctuations in the infant’s arousal and alertness; but over time, co-regulatory
processes become progressively elaborated to encompass other functions such as sociocommunicative development, attention and executive control. The fundamental aim of coregulation is to help maintain an optimal ‘critical state’ between hypo- and hyper-activity.
Early co-regulatory processes involve both passive entrainment, through which a child’s state
entrains to the caregiver’s, and active contingent responsiveness, through which the caregiver
changes their behaviour in response to behaviours from the child. Contingent responsiveness
operates via negative feedback, through which the behavioural changes from the caregiver
compensate for increases and decreases in the child, to help maintain an intermediate critical
state. Similar principles, of interactive but asymmetric contingency, drive joint attention and
the maintenance of epistemic states as well as arousal/alertness, emotion regulation, and
socio-communicative development. Here, we review work that directly observed child-adult
co-regulatory interactions in the context of psychopathology. Early co-regulatory processes
are thought to play a role in the development of attachment and can develop atypically in a
range of ways, across conditions including premature birth, Autism, Attention Deficit
Hyperactivity Disorder, anxiety and depression. The most well-known of these is insufficient
contingent responsiveness, leading to reduced synchrony, which has been shown across a
range of modalities in different disorders, and which is the target of most current interventions.
We also present evidence that excessive contingent responsiveness/synchrony can develop in
some circumstances. And we show that positive feedback interactions can develop, which are
contingent but mutually amplificatory child-caregiver interactions that drive the child further
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from their critical state. We discuss implications of these findings for future intervention
research, and directions for future work.