Narrative representations of moral-affiliative and conflictual themes and behavioral problems in maltreated preschoolers

Latent classes in preschoolers' internal working models of attachment and emotional security: Roles of family risk

Children's relationships inform their internal working models (IWMs) of the world around them. Attachment and emotional security theory (EST) emphasize the importance of parent-child and interparental relationships, respectively, for IWM. The current study examined (a) data-driven classes in child attachment and emotional security IWM, (b) associations between IWM classes and demographic variables, maltreatment, intimate partner violence (IPV), and maternal depressive symptoms, and (c) consistency in attachment and emotional security IWM classes, including as a function of maltreatment, IPV, and maternal depressive symptoms. Participants were 234 preschool-aged children (n = 152 experienced maltreatment and n = 82 had not experienced maltreatment) and their mothers. Children participated in a narrative-based assessment of IWM. Mothers reported demographics, IPV, and maternal depressive symptoms. Latent class analyses revealed three attachment IWM classes and three emotional security IWM classes. Maltreatment was associated with lower likelihood of being in the secure attachment class and elevated likelihood of being in the insecure dysregulated attachment class. Inconsistencies in classification across attachment and emotional security IWM classes were related to maltreatment, IPV, and maternal depressive symptoms. The current study juxtaposes attachment and EST and provides insight into impacts of family adversity on children's IWM across different family relationships.

The Experience of Maltreatment in Young Children Whose Mothers Have Borderline Personality Disorder: Reflections in Their Narrative Representations

Child maltreatment is an etiological factor in borderline personality disorder (BPD), which may be transmitted to the children of mothers with BPD. We assessed maltreatment in 36 children aged 4-7 whose mothers have BPD and in 34 normative comparisons. Children whose mothers have BPD were more likely to have experienced sexual abuse, physical abuse, and neglect than were normative comparisons. Mothers' self-reported borderline features were significantly correlated with children's maltreatment. Neglect was associated with mothers' affective instability, identity disturbance, negative relationships, and self-harm; sexual abuse was associated with mothers' identity disturbance, and negative relationships; and physical abuse was associated with mothers' self-harm. Maltreatment mediated the relationship between all four of mothers' borderline features and children's narrative representations of the caregiver-child relationship, which included fear of abandonment, role reversal, and mother-child relationship expectations. The authors discuss results in the context of risk for developing BPD in early adulthood and early preventive interventions targeting children's representations.

Representations of attachment security, attachment avoidance, and gender in Ugandan children

Researchers returned to the home of Mary Ainsworth's original attachment study to explore the contributions of Ugandan children's representations of attachment interactions with their caregivers to their perceptions about gender. Researchers administered the Attachment Story-Completion Task (ASCT) and applied three attachment narrative coding systems and a gender stereotypes typology to the ASCT stories of 51 Ugandan children ages 5-7. Nine attachment narrative variables were applied to the children's responses to a series of five attachment story stems told using a family of dolls. The narratives emerging from the children's responses to these story stems were also coded independently for 14 masculine and 14 feminine gender stereotypes. Empathic relations among the dolls and narrative coherence were positively correlated with counterstereotypical gender representations only in girls. Attachment representations of a rejecting father were positively correlated with stereotypical gender representations only in boys. Representations of attachment avoidance were negatively correlated with counterstereotypical gender representations in both boys and girls. The findings suggested two different trajectories for the development of gender representation flexibility in boys and girls. This study contextualizes these findings against the backdrop of a country with rigid sex roles and a fast-growing child population.

Exploring Attachment and Internal Representations in Looked-After Children

BACKGROUND

This article explores the Story Stem Assessment Profile (SSAP), a narrative-based measure, for the assessment of internal representations in children between the ages of 4 and 11 years old.

METHODS

The findings draw upon two samples of children comprising of a sample of looked-after children at Five Rivers Child Care (FR) (n = 42) and a community-based population (n = 42). The FR group identified were suggested to have a higher level of need, as defined by scores obtained from the Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ).

RESULTS

Using the SSAP, the findings indicate the instrument's discriminant validity with strong differences being displayed between the two populations. Consistently children in the FR sample displayed more disorganized, avoidant and negative representations, whilst at the same time having significantly fewer representations characteristic of 'secure' attachment.

CONCLUSION

The SSAP is successful in differentiating between 'low' and 'high' cohorts of children aged 4-11 years. The study provides strong support for the measure as a way of capturing internal and attachment representations, with further research to explore possible changes in these representations at follow-up being promising and intriguing. Continued research efforts at FR will allow for improved clinical formulations, increased understanding and therefore positive outcomes relating to the children in their care.

Children's concealment of a minor transgression: The role of age, maltreatment, and executive functioning

This study examined the role of age, maltreatment status, and executive functioning on 752 4- to 9-year-old maltreated and nonmaltreated children's recall disclosure of a transgression in which the children appeared to have broken toys while playing with a stranger. Interviewers used narrative practice rapport building and then questioned children with free recall and cued recall questions. Younger and maltreated children were more likely to disclose during rapport building, whereas older and nonmaltreated children were more likely to disclose in response to recall questions. Working memory deficits appeared to mediate the relation between children's characteristics and disclosure during rapport but not during recall. The results demonstrate that how children are questioned affects the relations between deception and age, maltreatment, and executive functioning.

The effects of the putative confession and evidence presentation on maltreated and non-maltreated 9- to 12-year-olds' disclosures of a minor transgression

The current study examined the influence of the putative confession (in which children are told that the suspect told them "everything that happened" and "wants [the child] to tell the truth") and evidence presentation on 9- to 12-year-old maltreated and non-maltreated children's disclosure (N = 321). Half of the children played a forbidden game with an adult confederate that resulted in a laptop computer breaking (no transgression occurred for the other half of the children), followed by coaching to conceal the forbidden game and to falsely disclose the sanctioned game. Children were then interviewed about the interaction with the confederate. Among the 9- and 10-year-olds, the putative confession led to a higher rate of breakage disclosure (62%) than the control condition (13%) and to a higher rate of leakage of incriminating details during recall (47% vs. 9%). Older children were more likely to disclose than younger children and to be uninfluenced by the putative confession. Among all ages, evidence presentation elicited disclosures from 63% of children who had not previously disclosed without eliciting any false disclosures.

Early Neglect and the Development of Aggression in Toddlerhood: The Role of Working Memory

Previous research has provided evidence for the robust relation between maltreatment and the development of externalizing behavior, including aggression. However, less empirical attention has been given to the specific role of neglect. The current study aimed to examine the role of working memory in the association between early neglect and aggression in toddlerhood. Longitudinal data were collected from 89 infants and their biological mothers when the infant was approximately 12, 26, and 38 months old. History of neglect was assessed at 12 months using official Child Protective Service records. Working memory and mental development were assessed at 26 months. Aggression was measured using maternal report at 38 months. Data were analyzed using structural equation modeling, and mediation was tested using 95% asymmetric confidence intervals. Results indicated that infants who experienced neglect exhibited poorer working memory abilities, specifically spatial working memory, and higher rates of aggression in toddlerhood. In addition, spatial working memory mediated the relation between neglect and aggression, suggesting that this may be one promising target for intervention.

The effects of promising to tell the truth, the putative confession, and recall and recognition questions on maltreated and non-maltreated children's disclosure of a minor transgression

This study examined the utility of two interview instructions designed to overcome children's reluctance to disclose transgressions: eliciting a promise from children to tell the truth and the putative confession (telling children that a suspect "told me everything that happened and wants you to tell the truth"). The key questions were whether the instructions increased disclosure in response to recall questions and in response to recognition questions that were less or more explicit about transgressions and whether instructions were differentially effective with age. A total sample of 217 4- to 9-year-old maltreated and comparable non-maltreated children and a stranger played with a set of toys. For half of the children within each group, two of the toys appeared to break while they were playing. The stranger admonished secrecy. Shortly thereafter, children were questioned about what happened in one of three interview conditions. Some children were asked to promise to tell the truth. Others were given the putative confession, and still others received no interview instructions. When coupled with recall questions, the promise was effective at increasing disclosures only among older children, whereas the putative confession was effective regardless of age. Across interview instruction conditions, recognition questions that did not suggest wrongdoing elicited few additional transgression disclosures, whereas recognition questions that explicitly mentioned wrongdoing elicited some true reports but also some false alarms. No differences in disclosure emerged between maltreated and non-maltreated children. Results highlight the potential benefits and limitations of different interviewing approaches when questioning reluctant children.

The Student-Teacher Relationship Quality of Abused Children

Considering the association between children's quality of relationships with teachers and their academic adjustment, information pertaining to how abused children are functioning in their relationships with teachers could be useful in promoting their academic success- yet there has been limited research in this area. The purpose of this study was to use cluster analyses to explore within-group differences in relational schemas and quality of student-teacher relationships for 70 abused children. Two clusters of abused children emerged, and as hypothesized, there were significant differences in student-teacher relationships for the two clusters. The cluster with more positive relational schemas had less conflict and less dependency reported by their teachers compared to the cluster with negative relational schemas. However, there were no differences between the clusters in terms of closeness with teachers. Implications for practice in schools is discussed.

Language Problems Among Abused and Neglected Children: A Meta-Analytic Review

Research data show that exposure to abuse and neglect has detrimental effects on a child's language development. In this meta-analysis, we analyze studies (k = 23), to compare the language skills (receptive language, expressive language, pragmatics) of children who have experienced abuse and/or neglect with the language skills of children who have not experienced abuse and/or neglect and to examine whether age or type of maltreatment moderate the relationship between maltreatment and language skills. Results confirm that the language skills of children who have experienced abuse and/or neglect are delayed when compared to children who have not experienced abuse and/or neglect. Compared to older children, young children seem particularly vulnerable to abuse and neglect. No significant differences were demonstrated concerning the type of maltreatment suffered by the child. These findings support the necessity of early detection of language problems in abused and neglected children as well as early intervention in order to implement interventions that will positively stimulate their development.

A Relação entre as Representações acerca das Figuras Parentais e as Competências Sociais em Crianças Maltratadas e não Maltratadas

RESUMO Assumindo a centralidade das representações acerca das figuras parentais na trajetória desenvolvimental, este estudo teve como objetivo analisar a relação destas representações com as competências sociais de crianças maltratadas e não maltratadas. Participaram, nesta investigação, 62 crianças em idade escolar (22 maltratadas e 40 não maltratadas). As representações acerca das figuras parentais foram avaliadas com a Entrevista de Avaliação das Representações acerca das Figuras Parentais e as competências sociais com a adaptação portuguesa da Social Skills Rating System - Form for Teachers. Nas crianças maltratadas, não se verifica a associação entre as representações das figuras parentais e as competências sociais, observada em amostras normativas. Os resultados sugerem que os dois grupos atribuem significados distintos aos comportamentos parentais.

Foster children's attachment behavior and representation: Influence of children's pre-placement experiences and foster caregiver's sensitivity

Although the majority of foster children have been exposed to early adversity in their biological families and have experienced one or more disruptions of attachment relationships, most studies surprisingly found foster children to be as securely attached as children in low-risk samples. However, attention has been paid almost exclusively to attachment formation in young children up to two years of age, and the majority of studies solely investigated attachment behavior whereas few is known about foster children's representations about attachment relationships. To extend findings on attachment in foster children and its predictors, our study examined both attachment behavior and representations in foster children aged between 3 and 8 years. Diverse potential predictors including child variables, birth parents' variables, pre-placement experiences, and foster caregiver's behavior were included in the analyses. Results revealed that foster children showed both lower attachment security and higher disorganization scores than children in low-risk samples. Attachment behavior and representation were found to be widely independent from each other. Different factors contributed to attachment behavior and representation: whereas foster children's attachment behavior was mainly influenced by foster parents' behavior, pre-placement experiences did predict hyperactivation and disorganization on the representational level. The results indicate that, when intervening with foster families, it seems crucial to focus not exclusively on the promotion of secure attachment behavior but also to develop interventions enhancing secure and organized attachment representations.

Multigenerational links between mothers' experiences of autonomy in childhood and preschoolers' respiratory sinus arrhythmia: Variations by maltreatment status

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)-Generation 2 (G2) mothers' early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children's autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1-G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention.

Neuropsychological Profile of Children, Adolescents and Adults Experiencing Maltreatment: A Meta-analysis

OBJECTIVE

Few studies have attempted to describe the range of cognitive impairments affecting people who have experienced child maltreatment. The aim of this meta-analysis was to examine the neuropsychological profile of these people and to determine the cognitive impacts of maltreatment from childhood to adulthood.

METHOD

Fifty-two publications from 1970 to 2013 were included.

RESULTS

The affected cognitive domains were working memory (g = -.65), attention (g = -.63), intelligence (g = -.56) and speed of processing (g = -.49). The impact of maltreatment was greater in young children (g = -.71) and less pronounced in adults (g = -.26).

CONCLUSIONS

These results suggest that exposure to maltreatment has an impact on specific cognitive processes, regardless of age.

Analyzing pathways from childhood maltreatment to internalizing symptoms and disorders in children and adolescents (AMIS): a study protocol

BACKGROUND

Effective interventions for maltreated children are impeded by gaps in our knowledge of the etiopathogenic mechanisms leading from maltreatment to mental disorders. Although some studies have already identified individual risk factors, there is a lack of large-scale multilevel research on how psychosocial, neurobiological, and genetic factors act in concert to modulate risk of internalizing psychopathology in childhood following maltreatment. To help close this gap, we aim to delineate gender-specific pathways from maltreatment to psychological disorder/resilience. To this end, we examine the interplay of specific maltreatment characteristics and psychological, endocrine, metabolomic, and (epi-)genomic stress response patterns as well as cognitive-emotional/social processes as determinants of developmental outcome. Specifically, we will explore endocrine, metabolomic, and epigenetic mechanisms leading from maltreatment to a higher risk of depression and anxiety disorders.

METHODS/DESIGN

Four large samples amounting to a total of N = 920 children aged 4-16 years will be assessed: Two cohorts with prior internalizing psychopathology and controls will be checked for maltreatment and two cohorts with substantiated maltreatment will be checked for internalizing (and externalizing) psychopathology. We will apply a multi-source (interview, questionnaires, official records), multi-informant strategy (parents, children, teachers) to assess maltreatment characteristics (e.g., subtypes, developmental timing, chronicity) and psychopathological symptoms, supplemented with multiple measurements of risk and protective factors and cutting-edge laboratory analyses of endocrine, steroid metabolomic and epigenetic factors. As previous assessments in the two largest samples are already available, longitudinal data will be generated within the three year study period.

DISCUSSION

Our results will lay the empirical foundation for (a) detection of early biopsychosocial markers, (b) development of screening measures, and

Physically Abused Children's Adjustment at the Transition to School: Child, Parent, and Family Factors

Childhood physical abuse predicts emotional/behavioral, self-regulatory, and social problems. Yet factors from multiple ecological levels contribute to children's adjustment. The purpose of this study was to examine the degree to which the social-emotional adjustment of physically abused children in first grade would be predicted by a set of child-, parent-, and family-level predictors in kindergarten. Drawing on a short-term longitudinal study of 92 physically abused children and their primary caregivers, the current study used linear regression to examine early childhood child (i.e., gender, IQ, child perceptions of maternal acceptance), parent (i.e., parental mental health), and family relationship (i.e., sensitive parenting, hostile parenting, family conflict) factors as predictors of first grade internalizing and externalizing symptomatology, emotion dysregulation, and negative peer interactions. We used a multi-method, multi-informant approach to measuring predictors and children's adjustment. Internalizing symptomatology was significantly predicted by child IQ, parental mental health, and family conflict. Externalizing symptomatology and emotion dysregulation were predicted by child IQ. Although a large proportion of variance in measures of adjustment was accounted for by the set of predictors, few individual variables were unique predictors of child adjustment. Variability in the predictors of adjustment for physically abused children underscores the need for individualized treatment approaches.

Internal working models and adjustment of physically abused children: the mediating role of self-regulatory abilities

BACKGROUND

Abused children's internal working models (IWM) of relationships are known to relate to their socioemotional adjustment, but mechanisms through which negative representations increase vulnerability to maladjustment have not been explored. We sought to expand the understanding of individual differences in IWM of abused children and investigate the mediating role of self-regulation in links between IWM and adjustment.

METHODS

Cluster analysis was used to subgroup 74 physically abused children based on their IWM. Internal working models were identified by children's representations, as measured by a narrative story stem task. Self-regulation was assessed by teacher report and a behavioral task, and adjustment was measured by teacher report.

RESULTS

Cluster analyses indicated two subgroups of abused children with distinct patterns of IWMs. Cluster membership predicted internalizing and externalizing problems. Associations between cluster membership and adjustment were mediated by children's regulation, as measured by teacher reports of many aspects of regulation. There was no support for mediation when regulation was measured by a behavioral task that tapped more narrow facets of regulation.

CONCLUSIONS

Abused children exhibit clinically relevant individual differences in their IWMs; these models are linked to adjustment in the school setting, possibly through children's self-regulation.

Preventive interventions and sustained attachment security in maltreated children

Thirteen-month-old maltreated infants (n = 137) and their mothers were randomly assigned to one of three conditions: child-parent psychotherapy (CPP), psychoeducational parenting intervention (PPI), or community standard (CS). A fourth group of nonmaltreated infants (n = 52) and their mothers served as a nonmaltreated comparison (NC) group. A prior investigation found that the CPP and the PPI groups demonstrated substantial increases in secure attachment at postintervention, whereas this change was not found in the CS and the NC groups. The current investigation involved the analysis of data obtained at a follow-up assessment that occurred 12 months after the completion of treatment. At follow-up, children in the CPP group had higher rates of secure and lower rates of disorganized attachment than did children in the PPI or the CS group. Rates of disorganized attachment did not differ between the CPP and the NC groups. Intention to treat analyses also showed higher rates of secure attachment at follow-up in the CPP group relative to the PPI and the CS groups. However, groups did not differ on disorganized attachment. Both primary and intention to treat analyses demonstrated that maternal-reported child behavior problems did not differ among the four groups at the follow-up assessment. This is the first investigation to demonstrate sustained attachment security in maltreated children 12 months after the completion of an attachment theory informed intervention. The findings also suggest that, although effective in the short term, parenting interventions alone may not be effective in maintaining secure attachment in children over time.

Romanian Children’s Representations of Negative and Self-Conscious Emotions in a Narrative Story Stem Technique

This research uses children’s story-stem play narratives to investigate dimensions of negative emotional expression. Fifty-one Romanian children between 6 and 11-years old participated in the study. Children’s narratives were coded for three basic negative emotions and five self-conscious emotions. Parents completed a general questionnaire for demographic data and the amount of time they spent with their children. Differences were found for frequencies of negative emotional representations in relation to the specific story-stems in which they occurred. Girls were more likely than boys to enact in their narratives guilt feelings coupled with apology following some wrongdoing. Children who spent more time with parents enacted significantly less anger and fear. Simultaneous expressions of multiple negative emotions were observed in the narrative responses of these middle childhood-aged Romanian children. While findings should be viewed with caution, owing to the small and homogeneous sample, new directions for future research with this assessment method are indicated.

Disclosing adult wrongdoing: maltreated and non-maltreated children's expectations and preferences

Little is known about the process by which children disclose adult wrongdoing, a topic of considerable debate and controversy. In the current study, we investigated children's evaluations of disclosing adult wrongdoing by focusing on children's preferences for particular disclosure recipients and perceptions of the consequences of disclosure in hypothetical vignettes. We tested whether children thought that disclosure recipients would believe a story child as a truth teller and what actions the recipients would take against the "instigator" who committed the transgression. Maltreated and non-maltreated 4- to 9-year-olds (N=235) responded to questions about vignettes that described a parent's or stranger's transgression. Older children preferred caregiver recipients over police officer recipients when disclosing a parent's transgression but not a stranger's transgression. Maltreated children's preference for caregiver recipients over police officer recipients developed more gradually than that of non-maltreated children. Older children expected disclosure recipients to be more skeptical of the story child's account, and older children and maltreated children expected disclosure recipients to intervene formally less often when a parent, rather than a stranger, was the instigator. Results contribute to understanding vulnerable children's development and highlight the developmental, experiential, and socio-contextual factors underlying children's disclosure patterns.

Maternal distress influences young children's family representations through maternal view of child behavior and parent-child interactions

Distress of a parent is a key influence on the quality of the child's experience in the family. We hypothesized that maternal distress would spill over into more negative views of their children's behaviors and less emotional availability in their relationships. Further, we investigated whether these cumulative experiences contributed to children's emerging narratives about mothers and family life. In this longitudinal study, mothers of young twin children reported their distress on three occasions in relation to: self, the marital relationship, and the family climate. Mothers also reported on their children's externalizing behavior problems. Mother-child interaction was observed focusing on maternal sensitivity and child responsivity. Children responded to story stem beginnings about challenging situations in the family and their narratives were scored for family conflict and cohesion themes. Actor-partner interdependence model methods of dyadic data analysis accounted for the inclusion of both twins in the analysis. Results from structural equation models supported the hypothesized cumulative experience of maternal distress on children's family life representations for both family conflict and family cohesion. A family environment in which children are exposed to persistent maternal distress early in life may have cumulative effects, influencing how mothers interact with and view their children's behavior at later developmental stages. Moreover, exposure to repeated distress for longer periods of time may contribute to an intergenerational continuity of distress for the child that may become rooted in negative affective bias in their own view of family relationships.

Eliciting maltreated and nonmaltreated children's transgression disclosures: narrative practice rapport building and a putative confession

This study tested the effects of narrative practice rapport building (asking open-ended questions about a neutral event) and a putative confession (telling the child an adult "told me everything that happened and he wants you to tell the truth") on 4- to 9-year-old maltreated and nonmaltreated children's reports of an interaction with a stranger who asked them to keep toy breakage a secret (n = 264). Only one third of children who received no interview manipulations disclosed breakage; in response to a putative confession, one half disclosed. Narrative practice rapport building did not affect the likelihood of disclosure. Maltreated children and nonmaltreated children responded similarly to the manipulations. Neither narrative practice rapport building nor a putative confession increased false reports.

The effect of sexual abuse on children's attachment representations in Chile

Child sexual abuse is associated with problems in children's emotional development, particularly increased insecurity of attachment. However, few studies have examined its effect on the organization of attachment representations in preschoolers, and the findings of those that have been conducted have not been entirely consistent. Therefore, this study aims to analyze the effect of child sexual abuse on attachment representation quality in a sample of children 3 to 7 years old in Chile. The results indicate child sexual abuse does affect children's attachment representation quality. The attachment narratives of child sexual abuse victims scored significantly higher than nonvictims on the hyperactivity and disorganization dimensions of attachment. These results are discussed in terms of attachment theory, clinical findings on child sexual abuse, and clinical implications.

Can maltreated children inhibit true and false memories for emotional information?

The authors examined 284 maltreated and nonmaltreated children's (6- to 12-year-olds) ability to inhibit true and false memories for neutral and emotional information using the Deese/Roediger-McDermott (DRM) paradigm. Children studied either emotional or neutral DRM lists in a control condition or were given directed-remembering or directed-forgetting instructions. The findings indicated that children, regardless of age and maltreatment status, could inhibit the output of true and false emotional information, although they did so less effectively than when they were inhibiting the output of neutral material. Verbal IQ was related to memory, but dissociative symptoms were not related to children's recollective ability. These findings add to the growing literature that shows more similarities among, than differences between, maltreated and nonmaltreated children's basic memory processes.

Efficacy of a home-visiting intervention aimed at improving maternal sensitivity, child attachment, and behavioral outcomes for maltreated children: a randomized control trial

The efficacy of a short-term attachment-based intervention for changing risk outcomes for children of maltreating families was examined using a randomized control trial. Sixty-seven primary caregivers reported for maltreatment and their children (1-5 years) were randomly assigned to an intervention or control group. The intervention group received 8 weekly home visits directed at the caregiver-child dyad and focused on improving caregiver sensitivity. Intervention sessions included brief discussions of attachment-emotion regulation-related themes and video feedback of parent-child interaction. Comparison of pre- and posttest scores revealed significant improvements for the intervention group in parental sensitivity and child attachment security, and a reduction in child disorganization. Older children in the intervention group also showed lower levels of internalizing and externalizing problems following intervention. This is the first study to demonstrate the efficacy of short-term attachment-based intervention in enhancing parental sensitivity, improving child security, and reducing disorganization for children in the early childhood period.

Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?

The effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.

Children's reasoning about disclosing adult transgressions: effects of maltreatment, child age, and adult identity

A total of two hundred ninety-nine 4- to 9-year-old maltreated and nonmaltreated children of comparable socioeconomic status and ethnicity judged whether children should or would disclose unspecified transgressions of adults (instigators) to other adults (recipients) in scenarios varying the identity of the instigator (stranger or parent), the identity of the recipient (parent, police, or teacher), and the severity of the transgression ("something really bad" or "something just a little bad"). Children endorsed more disclosure against stranger than parent instigators and less disclosure to teacher than parent and police recipients. The youngest maltreated children endorsed less disclosure than nonmaltreated children, but the opposite was true among the oldest children. Older maltreated children distinguished less than nonmaltreated children between parents and other types of instigators and recipients.

Can maltreated children inhibit true and false memories for emotional information?

The authors examined 284 maltreated and nonmaltreated children's (6- to 12-year-olds) ability to inhibit true and false memories for neutral and emotional information using the Deese/Roediger-McDermott (DRM) paradigm. Children studied either emotional or neutral DRM lists in a control condition or were given directed-remembering or directed-forgetting instructions. The findings indicated that children, regardless of age and maltreatment status, could inhibit the output of true and false emotional information, although they did so less effectively than when they were inhibiting the output of neutral material. Verbal IQ was related to memory, but dissociative symptoms were not related to children's recollective ability. These findings add to the growing literature that shows more similarities among, than differences between, maltreated and nonmaltreated children's basic memory processes.

The effects of maltreatment and neuroendocrine regulation on memory performance

This investigation examined basic memory processes, cortisol, and dissociation in maltreated children. School-aged children (age range=6-13), 143 maltreated and 174 non-maltreated, were administered the California Verbal Learning Test-Children (D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 1994) in a week-long camp setting, daily morning cortisol levels were assessed throughout the duration of camp, and behavioral symptoms were evaluated. Maltreatment and cortisol regulation were not related to short- or long-delay recall or recognition memory. However, children experiencing neglect and/or emotional maltreatment and low cortisol evinced heightened false recognition memory. Dissociative symptoms were higher in maltreated children; however, high dissociation was related to recognition inaccuracy only among non-maltreated children. Results highlight the interplay between maltreatment and hypocortisolism in children's recognition memory errors.

Young Children's Competency to Take the Oath: Effects of Task, Maltreatment, and Age

This study examined maltreated and non-maltreated children's (N = 183) emerging understanding of "truth" and "lie," terms about which they are quizzed to qualify as competent to testify. Four- to six-year-old children were asked to accept or reject true and false (T/F) statements, label T/F statements as the "truth" or "a lie," label T/F statements as "good" or "bad," and label "truth" and "lie" as "good" or "bad." The youngest children were at ceiling in accepting/rejecting T/F statements. The labeling tasks revealed improvement with age and children performed similarly across the tasks. Most children were better able to evaluate "truth" than "lie." Maltreated children exhibited somewhat different response patterns, suggesting greater sensitivity to the immorality of lying.

The role of trauma symptoms in the development of behavioral problems in maltreated preschoolers

OBJECTIVE

This study assessed the mediating role of trauma symptoms in the relation between child maltreatment and behavioral problems. It is based on the postulate that child maltreatment is a severe form of chronic relational trauma that has damaging consequences on the development of children's behavioral regulation.

METHOD

Participants were 34 maltreated and 64 non-maltreated children (mean age=60 months; range: 46 to 72 months), all from economically disadvantaged families. Maltreated children were recruited from the Child Protection Agencies. Behavioral problems and trauma symptoms were evaluated by the preschool teacher with the Internalizing and the Externalizing scales of the Child Behavior Checklist-Teacher Report Form (CBCL-TRF) and the posttraumatic stress score of the Trauma Symptoms Checklist for Young Children respectively (TSCYC).

RESULTS

Baron and Kenny's mediational procedure was conducted using structural equation modeling. Mediational analyses revealed that trauma symptoms fully mediated the association between maltreatment and both internalizing and externalizing behaviors.

CONCLUSIONS

Results were consistent with the literature on developmental trauma research and provide empirical support to the idea that trauma-related symptoms resulting from early maltreatment may constitute a mechanism in the development of psychosocial problems in preschoolers.

PRACTICE IMPLICATIONS

These findings underline the importance of understanding psychosocial maladjustment of maltreated children not only from the perspective of problematic behavior, but also by taking into account the traumatic reactions that might develop in response to chronic and intense stress associated with abuse and neglect.

Preschoolers with asthma: narratives of family functioning predict behavior problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.

Development in Children and Adolescents Whose Mothers Have Borderline Personality Disorder

A mother's mental illness may have a profound effect on her child's development, including an increased risk of the child developing the same disorder. From a developmental psychopathology perspective, offspring provide an opportunity to examine pathways to disorder versus resilience. Borderline personality disorder (BPD) is a severe disorder diagnosed in early adulthood involving stormy relationships, an unstable sense of identity, and self-destructive behavior. Interestingly, the domains of dysfunction are conceptually similar to developmental tasks in early childhood reworked in adolescence: attachment, self development, and self-regulation. Early deviation may increase the risk for later disorder. There are five empirical studies of children whose mothers have BPD, two conducted from a developmental perspective. This article proposes a theoretical framework and an innovative methodology with which to extend this research, and suggests an intervention to bring development back on track if necessary.

Representations of the caregiver-child relationship and of the self, and emotion regulation in the narratives of young children whose mothers have borderline personality disorder

Borderline personality disorder (BPD) represents a severe distortion in the development of attachment, self, and emotion regulation. Study of children at high risk of developing BPD may inform precursors to BPD. In a low socioeconomic status sample of 30 children aged 4-7 whose mothers have BPD and 30 normative comparisons, representations of the caregiver-child relationship and of the self, and emotion regulation were assessed with a story-stem completion measure. In contrast to comparisons and controlling for major depressive disorder, children whose mothers have BPD told stories with the following: (a) more parent-child role reversal, more fear of abandonment, and more negative mother-child and father-child relationship expectations; (b) more incongruent and shameful representations of the self; and (c) poorer emotion regulation indicated by more confusion of boundaries between fantasy and reality and between self and fantasy, more fantasy proneness, less narrative coherence, and marginally more intrusion of traumatic themes. In the sample as a whole, (a) a maladaptive caregiver-child relationship composite was associated with maternal identity disturbance and self-harm; (b) a maladaptive self-composite was associated with maternal self-harm; and (c) a maladaptive emotion regulation composite was associated with maternal identity disturbance, negative relationships, and self-harm. Results are discussed in terms of putative precursors to BPD and preventive interventions.

Young children's representations of conflict and distress: a longitudinal study of boys and girls with disruptive behavior problems

We investigated narratives, symbolic play, and emotions in children who varied in severity of disruptive behavior problems. Children's representations of hypothetical situations of conflict and distress were assessed at 4-5 and 7 years. Behavior problems also were assessed then and again at 9 years. Children's aggressive and caring themes differentiated nonproblem children, children whose problems remained or worsened with age, and those whose problems improved over time. Differences in boys and girls whose problems continued sometimes reflected exaggerations of prototypic gender differences seen across the groups. Boys with problems showed more hostile themes (physical aggression and anger), whereas girls with problems showed more caring (prosocial) themes relative to the other groups. Modulated (verbal) aggression, more common in girls than boys, showed developmentally appropriate increases with age. However, this was true only for children without problems and those whose problems improved. We consider how these findings contribute to an understanding the inner worlds of boys and girls who differ in their early developmental trajectories for behavior problems.

Child maltreatment

Child maltreatment exemplifies a toxic relational environment that poses significant risks for maladaptation across biological and psychological domains of development. Research on child maltreatment can inform developmental theory, but more importantly, it can enhance the quality of clinical, legal, and policy-making decisions for maltreated children. This chapter addresses definitional, epidemiological, and etiological aspects of child maltreatment. A developmental psychopathology perspective is directed toward the discussion of the psychological and neurobiological sequelae of child maltreatment. Implications for prevention, intervention, and social policy are discussed, and recommendations for future research are proffered.

The implications of emotional security theory for understanding and treating childhood psychopathology

Understanding why interparental difficulties pose a risk to children in families experiencing domestic violence is an urgent task for ameliorating childhood psychopathology, particularly in light of the paucity of knowledge on the unfolding mediating mechanisms and the potentiating and protective conditions that underlie the multiplicity of pathways between domestic violence and child maladjustment. Toward addressing this significant gap, this paper examines how the emotional security theory (EST) may foster advances in our understanding of the genesis, course, and treatment of children's psychological problems in families experiencing domestic violence. Following an overview of the theoretical assumptions and significance of translating the emotional security theory to high-risk contexts, we address how children's difficulties in preserving security may emerge in the face of domestic violence and accompanying forms of severe family adversity, and illustrate the implications of emotional insecurity for childhood psychopathology in homes characterized by domestic violences. In the final section, we address how the EST may be useful in informing public policy and intervention initiatives designed to reduce the burden of mental illness.

Factors that contribute to child maltreatment severity: a multi-method and multidimensional investigation

OBJECTIVES

This study used data gathered during evaluations conducted by the Comprehensive Assessment and Training Services (CATS) Project to determine the relative contribution of four primary domains (demographic, adult characteristics, child characteristics, relational characteristics) to variation in the severity of child maltreatment, and to facilitate the development of empirically-based risk assessment tools.

METHODS

A multidimensional, multi-method approach to data collection was used to assess 208 maltreating parents. Hierarchical multiple regression analyses were performed by entering each domain of variables into the regression equation in four consecutive blocks.

RESULTS

The results of this study suggest that maltreatment severity varies as a function of the level of trauma recovery, substance misuse, a child's externalizing behavior, and qualitative features of the parent-child relationship, as well as the level of family stress. Relationship variables added to the amount of variance accounted for in the overall model, beyond demographic, adult, and child variables.

CONCLUSIONS

: The findings of this study call attention to the importance of developing a multidimensional assessment model of the factors leading to child maltreatment severity and to broadening the parameters of assessment models used in child maltreatment research. The role that each of the contributing factors plays in the interference of effective parenting is also discussed.