Newborn pain cries and vagal tone: parallel changes in response to circumcision

Clinical studies have demonstrated that the cries of chronically stressed, medically compromised infants are characteristically higher and more variable in pitch than those of healthy infants. Other studies have indicated that the vagal tone of chronically stressed infants is significantly reduced in comparison to that of normal infants. A neural model of cry production has been proposed which suggests that decreased vagal tone among infants at risk may, in fact, be related to these increases in cry pitch. Using routine, unanesthetized circumcision as a model of stress, we were able to examine the relation between cry acoustics and vagal tone in normal, healthy newborns undergoing an acutely stressful event. Vocalizations, heart, and respiratory waveforms were continuously recorded from 49 (32 experimental; 17 control) 1-2-day-old, full-term infants during preoperative, surgical, and postoperative periods. Vagal tone, as measured by the amplitude of respiratory sinus arrhythmia extracted from heart period data, was significantly reduced during the severe stress of circumcision, and these reductions were paralleled by significant increases in the pitch of the infants' cries. In addition, individual differences in vagal tone measured prior to circumcision surgery were predictive of physiological and acoustic reactivity to subsequent stress. These results emphasize the potential role of vagal control of the autonomic nervous system during stress.     

Acoustic Characteristics of Naturally Occurring Cries of Infants with "Colic"

Although infantile colic has long been defined by a perceived excessive amount of crying, acoustic attributes of the cry sound may also contribute to perceptions that this early social behavior is excessive or problematic. From an original sample of 76 infants (38 infants referred to physicians for problematic crying, or "colic," and 38 pair-matched comparison infants), 48 infants who produced naturally occurring cry bouts both before and after an evening feeding were studied: 11 infants with Wessel's colic, 15 infants with non-Wessel's colic, and 22 comparison infants. Standard and vociferous cry segments were selected from up to 2 min of tape-recorded crying for spectrum analysis. Vociferous cry segments had a longer duration, a higher fundamental frequency, and a greater percentage of dysphonation than did standard segments. No differences between infant groups were found in cries before feeding. After feeding, infants who were problematic criers, independent of Wessel's criteria, showed a greater percentage of dysphonation in the vociferous cry segment than did comparison infants. This finding resulted from a decrease in dysphonation in the cries of comparison infants after feeding and an increase in those of infants with non-Wessel's colic. The dominant frequency also increased after feeding in the vociferous cries of infants with Wessel's colic, resulting in these infants having higher-pitched cries after feeding than infants in the other 2 groups. Results indicate that infants who are perceived to have problematic crying have objectively different acoustic features in their cry sounds that are particularly aversive, and that complaints about excessive crying cannot be accounted for simply on the basis of reporting bias in overly concerned or emotionally labile parents.     

Effects of marijuana use during pregnancy on newborn cry

The effects of maternal marijuana use on the newborn cry were studied in Jamaica, where it was possible to rule out confounding factors such as the use of other substances and demographic variables that have clouded previous studies and where higher dosages may make the effects more visible. The acoustic characteristics of the cries of 20 infants of marijuana users and 20 controls were analyzed. The cries of the infants of marijuana users were shorter, had a higher percentage of dysphonation, a higher and more variable fundamental frequency, and a lower first formant than controls. There was also a dose response relation between the first formant and marijuana use. We suggest that heavy marijuana use affects the neurophysiological integrity of the infant.     

Adult perceptions of pain and hunger cries: a synchrony of arousal

180 male and female nonparent adults rated tape-recordings of the initial, middle, and final 10-sec segments of pain and hunger cries on 4 7-point Likert-type scale items describing how urgent, arousing, aversive, and sick the cry segments sounded. Multivariate analyses of variance showed that the final segment of the pain cry was perceived as less urgent, arousing, and aversive than the initial and middle segments. The hunger cry was perceived as increasingly more urgent, arousing, and aversive from the initial to the middle to the final cry segments, with the final segment receiving higher ratings than the final segment of the pain cry. The middle segment of both cries was the most sick sounding. While females were more aroused than males as the hunger cry intensified, and females were less aroused than males as the pain cry subsided, the initial segments of the pain cry were particularly potent stimuli to both males and females. These results suggest that different segments of cries resulting from the same stimulus provide different messages that communicate the presumed level of infant arousal.     

Adults'' Tolerance of Cries: An Experimental Investigation of Acoustic Features

Variations in the aversiveness of a newborn's distress cry were examined using experimental manipulation of 3 acoustic features of the cry (fundamental frequency, intonation, spectral complexity) and of the information given to subjects about the infant's health status. The subjects (N = 164 medical students) were allowed to control the sound pressure level (range: 50 dB [A]-105 dB[A]) of the different cry versions by repeatedly pressing a button (operant titration). For the nonmanipulated (original) cry version, the accepted sound pressure level decreased as fundamental frequency increased at above 610 Hz. This effect was modified by experimental manipulation of spectral complexity as well as intonation. A preference of intonated cries over monotonous cries was most pronounced between 534 and 686 Hz. Significant interactions of the information variable with the intonation and the complexity variables suggest that the listener's reaction to certain physical cry characteristics can be altered substantially by inducing different cognitive sets.     

Neurobehavioral Syndromes in Cocaine-exposed Newborn Infants

The effects of fetal cocaine exposure on newborn cry characteristics were studied in 80 cocaine-exposed and 80 control infants. The groups were stratified to be similar on maternal demographic characteristics and maternal use of other illegal substances and alcohol during pregnancy. The hypothesis was that excitable cry characteristics were related to the direct effects of cocaine, while depressed cry characteristics were related to the indirect effects of cocaine secondary to low birthweight. Structural equation modeling (EQS) showed direct effects of cocaine on cries with a longer duration, higher fundamental frequency, and a higher and more variable first formant frequency. Indirect effects of cocaine secondary to low birthweight resulted in cries with a longer latency, fewer utterances, lower amplitude, and more dysphonation. Cocaine-exposed infants had a lower birthweight, shorter length, and smaller head circumference than the unexposed controls. Findings were consistent with the notion that 2 neurobehavioral syndromes, excitable and depressed, can be described in cocaine-exposed infants, and that these 2 syndromes are due, respectively, to direct neurotoxic effects and indirect effects secondary to intrauterine growth retardation.     

Verbal and Behavioral Responsiveness to the Cries of Atypical Infants

A total of 176 subjects (53 male students, 65 female students, and 58 mothers) were exposed to 1 of 6 types of infant cries coming from an adjacent room while their behavioral and affective responses were observed. The cries were the pain cries of 2 normal newborns, 1 infant with maladie du cri du chat, 1 with Down syndrome, 1 asphyxiated infant with brain damage, and one asphyxiated infant without brain damage. Subsequently the subjects rated the overhead cry on a series of affective, attributional, and perceptual dimensions. The results indicated that the 6 cries differentially affected the subjects' affective, self-reported, and behavioral responses, as well as their tendency to report not hearing the cry. In general, the findings suggested that the highest- pitched cries (those of the asphyxiated infants), in comparison to the lowest-pitched cries (those of the normal and Down infants), elicited less optimal responses from the listeners.     

Infant Crying and Adults'' Anticipated Caregiving Responses: Acoustic and Contextual Influences

These studies assessed adults' latencies to signal that they would respond to infant crying as functions of (1) the degree of infant distress they perceived in the cry, and (2) contextual information relevant to caregiving. In the first study (N = 34), listeners waited longer to respond to cries that they had earlier rated as sounding less distressed than when they heard cries of higher distress. Further, those who had been told that the infant needed sleep waited longer to respond than those without this information. This effect of context information, however, was limited to the latencies; in another study (N = 50), listeners' ratings of distress were not affected. Several acoustic features of the cries correlated with distress ratings and with latencies to signal a caregiving response. Taken together, the results suggest that adults' responses to crying are influenced both by acoustic gradations in the cry itself and by the caregiving context. Ratings of degree of distress manifest in the cry, in other words, may be highly predictive of caregiving behavior but not wholly so. Finally, although certain acoustic variations related to greater perceived distress and speed of response, differences were apparent between infants in the magnitude of these variations. The implication that the general process of cry perception may be calibrated, or fine tuned, to the range of acoustic variation provided by individual infants is discussed.     

Emerging Adults’ Perceptions of Male Circumcision in the United States: Facts,Fictions, and Future Plans

Abstract

Societal perspectives on male circumcision and its implications are not well understood. In this exploratory qualitative study, participants (N?=?34, 7 male, 27 female) enrolled in a human sexuality course were asked to share their perspectives on male circumcision through the development of a written response to open-ended questions. Written responses were analyzed using qualitative thematic analysis to determine the ways in which participants perceive male circumcision, as well as to explore the arguments, contradictions, and rationalizations emerging adults use to justify it. Participants were largely in support of circumcision and believe it to be beneficial in terms of hygiene, esthetics, social acceptability, and tradition. Participants acknowledged the risks of circumcision and rationalized them, indicating they were in favor of the procedure and would circumcise their own sons despite limited knowledge of the benefits and drawbacks. Findings indicate emerging adults do not often discuss male circumcision and do not carefully consider the procedure, perhaps due to the widespread belief that circumcision is a social norm that should not be questioned. Despite this lack of discussion or formal education on the topic, most of the emerging adults did express strong opinions in favor of circumcision based on their personal experiences and social interactions.     

On the importance of fundamental frequency and other acoustic features in cry perception and infant development

This study examined acoustic correlates of adults' ratings of infants' cries. Parents and nonparents rated 12 spontaneous cries from young infants on 8 items describing the cries' aversiveness and on 9 semantic differential items. The results indicated that the duration, the amount of dysphonation, and proportion of energy in various frequency bands were highly correlated with adults' ratings. Further, the pattern of correlations between each of the 17 rating scale items and the acoustic attributes was virtually the same, suggesting that the items represented a single underlying dimension of perceived aversiveness. Finally, no differences were found between the results for parents and nonparents. General issues in the study of cry perception are discussed.     

Adult Perception of Emotion Intensity in Human Infant Cries: Effects of Infant Age and Cry Acoustics

The relation between adult perception of emotion intensity in the cries of 1- and 6-month-old infants and the acoustic characteristics of the cries was examined. In the first study, adults who were inexperienced in child care rated 40 cries on 3 emotion intensity scales: anger, fear, and distress. The cries of 6-month-olds were rated as being significantly more intense. Different acoustic variables accounted for emotion intensity ratings for the 2 infant ages. Peak amplitude and noisiness of the cry predicted adult judgments of intensity ratings of 1-month-olds' cries; a measure of amplitude ratio (in 2 frequency bands) was the best predictor of intensity ratings of 6-month-olds' cries. In the second study, parents of infants rated the same cries on the same scales. They also rated the older infants' cries as being more intense. The 2 adult groups did not differ on their ratings, and a regression equation derived from one adult group predicted the other adult group's rating of the same infant age better than it predicted its own ratings for the other infant age. Infant age, and its associated acoustic features, seems to be a more important determinant of adults' perception of emotion intensity than are such adult characteristics as gender or infant-care experience.     

Children's emotions and behaviors in response to infants' cries

Infant crying can elicit in others both a range of emotions and contrasting behavioral reactions, such as altruistic caregiving versus aggression. Variations in reactions to young infants' cries were examined in 60 children ranging in age from late preschool to preadolescence. Each child over-heard either a preterm or a full-term tape-recorded cry from an adjacent room. Then a mother, carrying her infant, came looking for her (previously) "crying" infant's bottle. Later each child was interviewed after hearing a tape recording of a preterm and a full-term cry. Children's emotions and behaviors thus were assessed in response to simulated, real distresses and hypothetical representations of distress. Children's self-reports of empathy, their verbalized intentions to help, their actual helping responses, and observers' ratings of negative emotion were common responses to cries at all ages. In addition there were significant increases with age in prosocial, behavioral interventions. Expressions of negative emotion were inversely related to subsequent forms of prosocial behavior that required direct interaction with the infant. The emotions and behaviors of most children were not influenced by whether they heard preterm or full-term cries. They were, however, able to discriminate between such cries and some articulated "theories" about the impact of the cries on the listener.     

Coping with aversive stimulation in the neonatal period: quiet sleep and plasma cortisol levels during recovery from circumcision

Measures of behavioral state and plasma cortisol were obtained on 80 healthy, full-term, 2-3-day-old, male newborns who were scheduled to be circumcised. To establish baseline or precircumcision levels, the newborns were observed, and behavioral state was recorded for the half hour prior to circumcision. Blood was sampled via heelstick for plasma cortisol determination at the end of this observation period. The newborns were then circumcised and assigned randomly to one of 4 postcircumcision, blood-sampling time-point groups. The time points were 30, 90, 120, and 240 min following the beginning of circumcision. Behavioral state was observed during circumcision and for the half hour prior to taking the second blood sample. The results showed a return to baseline cortisol levels sometime prior to 240 min, with data from an additional group of 10 newborns indicating that the return occurred by 150 min. Behavioral distress during circumcision was associated with elevations in plasma cortisol at 30 and 90 min. Quiet sleep was correlated negatively with plasma cortisol prior to circumcision, and significant increases in quiet sleep followed circumcision, with the greatest increase corresponding to the period of most rapid reductions in cortisol.     

Metaphors as a reflection of middle school students' perceptions of school: A cross-cultural analysis

This study analyzes the perceptions of Turkish and American middle school students of school and schooling by examining the metaphors they produce. A total of 18 American and 24 Turkish students were interviewed as part of this study. The results show differences in the participants' perceptions of schooling by culture. Turkish participants perceived the school environment as family-like, care-giving, psychologically nurturing, educationally exemplary, and physically appealing. School was also seen as a fundamental prerequisite in the preparation for life and the possibility of employment, promising upward social mobility as an adult. Overall, while some American participants perceived school as a wild, crowded, chaotic, boring, painful, regulated environment in which students must learn to survive, others see it as a place of joy, caring, involvement, and learning. The study also indicates that metaphors are useful tools in understanding how students as real actors of school make sense of schooling and their experiences in school.     

The effects of within-group and between-group methodologies in the study of perceptions of infant crying

Recent studies have indicated that various infant cry patterns can be reliably distinguished when directly compared with other infant cry patterns. The purpose of this study was to compare the effects of this within-group method of cry presentation (in which listeners are exposed to 2 types of cry patterns) with the effects of a between-group methodology (in which listeners are exposed to only 1 type of infant cry pattern). 4 groups of adult listeners rated the tape-recorded cries of low- and high-risk infants on 4 Likert-type scale items during experimental phases. In phase 1, subjects were exposed to either the cries of low-risk or high-risk infants but not both. In phase 2, subjects were exposed to both low-risk and high-risk infant cries. In phase 3, subjects were exposed to the cries they heard in phase 1. Whereas all scale items differentiated the low- and high-risk infant cries during the within-group analyses of phase 2, all scale items did not differentiate low- and high-risk infant cries during the between-group phase of the experiment. The specific pattern of results indicate that within-group methods of cry presentation accentuate the perceptual distance among cry types and may actually create many reliable differences that would not be found in between-group comparisons.     

Cognitive Set and Coping Strategy Affect Mothers' Sensitivity to Infant Cries: A Signal Detection Approach

We used Signal Detection methodology to examine how cognitiveset affects mothers' response to an infant cry. We asked whether a cry from a "difficult" versus an "easy" infant would elicit a change in sensitivity or response bias in mother processing of these cries. Thirty-eight mothers of 4- to 6-month-old infants participated in a Signal Detection task in which they were asked whether they could detect differences between a standard cry and 1 to 4 cry variants. Cry variants differed from the standard cry in small, systematic changes in fundamental frequency. The task was conducted in 2 parts; each part constituted a condition wherein mother received a cognitive set manipulation that labeled the identical cry as coming from either a'difficult'or an "easy" infant. An increase in mothers' sensitivity was associated with the "difficult" infant cognitive set. We examined as well how a coping strategy(illusion of control) affected cry signal processing. Mothers who Exhibited high illusory control were least -sensitive in detecting differences between cries. Two information-prcessing, measures response time and heart rate, were also collected and showed that greater sensitivity was associated with more efficient processing of the cry signal.     

Psychophysiological and perceptual responses to infant cries varying in pitch: comparison of adults with low and high scores on the Child Abuse Potential Inventory.

Based on their scores on the Child Abuse Potential (CAP) Inventory, 30 nonparent adults were classified as either having high CAP scores (n = 15) or low CAP scores (n = 15). Subjects' heart rate and skin conductance were assessed as they listened to audio-taped presentations of four "normal" phonated infant cries and four high-pitched, hyperphonated infant cries. Subjects also rated the cries on several perceptual items. Results showed that both groups of subjects found hyperphonated cries more aversive, distressing, urgent, arousing, and sick than phonated cry sounds. Similarly, all listeners' showed higher skin conductance levels (SCL) in response to hyperphonated than phonated cries. SCL became attenuated over time in response to phonated, but not hyperphonated, cries. Adults in the high-CAP group, showed marginally higher heart rates than low-CAP adults following presentation of all infant cry sounds and responded to phonated cries with marginally higher skin conductance levels than low-CAP adults. The responses of high-CAP nonparent adults are similar to those of parents with histories of physically abusive interactions with their infants.     

Crying and infant abuse in rhesus monkeys

This study investigated the relation between crying and infant abuse in group-living rhesus monkeys (Macaca mulatta). The subjects were 10 abusive mothers with their infants and 10 control mother-infant pairs. Abused infants cried more frequently than controls in the first 12 weeks of life, even when cries immediately following abuse were excluded from the analysis. The coos of 5 abused infants differed from those of 5 controls in several acoustic parameters, whereas their screams and geckers were acoustically similar, when recorded in the same context. Abusive mothers were less likely than control mothers to respond positively to the cries of their infants. Although infant cries may increase the probability of abuse being repeated, infant crying per se does not appear to be a major determinant of abuse.     

Cross-cultural differences in maternal perceptions of cries of low- and high-risk infants

The tape-recorded cries of low- and high-risk newborn infants were rated by 150 inner-city Anglo-American, Black-American, and Cuban-American mothers during the hospital lying-in period following childbirth. Half of each cultural group was primiparous and half was multiparous. The mothers rated the cries along 4 perceptual and 6 caregiving response scale items. Reliable differences were found between low- and high-risk infant cries on all perceptual responses with the effects of culture and parental experience affecting the degree of differences. Generally, Anglo-American mothers found the cries more distressing, urgent, arousing, and sick sounding than Black-American mothers, while Cuban-American mothers showed similarities to both Black- and Anglo-American mothers depending on the scale items. The ratings on the caregiving response scale items paralleled cultural differences found on the perception scale items and previous reports of the mother-infant interaction patterns of other Anglo-, Black-, and Cuban-American samples. The results are discussed as being important in developing nonethnocentric views of the functional significance of the behaviors of the infant at risk, yet as providing evidence of the cross-cultural significance of the cry sound of the infant at risk.     

Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global assessments of job-satisfaction, psychological stress, and perceived pressures that may affect provision of care. There were also items dealing with the perceived benefit of prospective in-service training programs. Content analyses indicated interactions with residents as the most frequent source of stress and ethical challenges encountered by nursing staff. Further, results of correlational analyses suggested psychological stress to be associated with job satisfaction and pressure to take shortcuts in the provision of care. Continuing education via in-service training that addresses workplace stress and ethical challenges in nursing care is discussed.