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The long and winding road: Pathways from basic research to implementation and evaluation. Dev Psychopathol 2024:1-11. [PMID: 38454781 DOI: 10.1017/s0954579424000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
In this article, we celebrate Dante Cicchetti's extensive contributions to the discipline of developmental psychopathology. In his seminal article, he articulated why developmental psychopathology was imperative to create research portfolios that could inform the causes, consequences, and trajectories for adults often initiated by early lived experiences (Cicchetti, 1984). In this three-part article, we share our transdisciplinary efforts to use developmental psychopathology as a foundational theory from which to develop, implement, and evaluate interventions for populations who experienced early adversity or who were at risk for child abuse and neglect. After describing interventions conducted at Mt. Hope Family Center that spanned over three decades, we highlight the criticality of disseminating results and address policy implications of this work. We conclude by discussing future directions to facilitate work in developmental psychopathology. Currently, one of three national National Institute of Child Health and Human Development-funded child abuse and neglect centers, we look forward to continuing to build upon Dante's efforts to disseminate this important work to improve society for our children, our nation's often most vulnerable and forgotten citizens.
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The relative effects of parental alcohol use disorder and maltreatment on offspring alcohol use: Unique pathways of risk. Dev Psychopathol 2023:1-12. [PMID: 37905543 DOI: 10.1017/s0954579423001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Childhood adversity represents a robust risk factor for the development of harmful substance use. Although a range of empirical studies have examined the consequences of multiple forms of adversity (i.e., childhood maltreatment, parental alcohol use disorder [AUD]), there is a dearth of information on the relative effects of each form of adversity when considered simultaneously. The current study utilizes structural equation modeling to investigate three unique and amplifying pathways from parental AUD and maltreatment exposure to offspring alcohol use as emerging adults: (1) childhood externalizing symptomatology, (2) internalizing symptomatology, and (3) affiliation with substance-using peers and siblings. Participants (N = 422) were drawn from a longitudinal follow-up study of emerging adults who participated in a research summer camp program as children. Wave 1 of the study included 674 school-aged children with and without maltreatment histories. Results indicated that chronic maltreatment, over and above the effect of parent AUD, was uniquely associated with greater childhood conduct problems and depressive symptomatology. Mother alcohol dependence was uniquely associated with greater affiliation with substance-using peers and siblings, which in turn predicted greater alcohol use as emerging adults. Results support peer and sibling affiliation as a key mechanism in the intergenerational transmission of substance use between mothers and offspring.
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Maternal childhood maltreatment trauma resolution: Development of a novel narrative coding measure and implications for intergenerational parenting processes. Dev Psychopathol 2023:1-16. [PMID: 37791540 DOI: 10.1017/s0954579423001256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Child maltreatment constitutes a significant environmental risk for children, with carryover effects into future generations. There is a need to characterize protective factors that may buffer against the intergenerational transmission of maltreatment. The current study addresses this gap through two primary aims: 1) the development and validation of a novel measure assessing resolution of maternal childhood maltreatment trauma using narrative coding methods and 2) the evaluation of maternal maltreatment trauma resolution as a buffering factor that may moderate associations between maternal neglect histories and sensitive parenting of offspring. Results of reliability analyses from this sample of 210 diverse, low-income mothers suggest the novel childhood maltreatment trauma resolution measure is highly reliable. Furthermore, results highlight the generalizability, criterion validity, and concurrent and predictive validity of the measure. Results from cross-sectional analyses show that trauma resolution moderates associations between maternal physical neglect histories and sensitive parenting, such that under high maternal trauma resolution, there is no longer a negative association between neglect histories and sensitive parenting. Results from longitudinal analyses also show a protective effect of maternal trauma resolution, such that trauma resolution has a protective-enhancing effect on maternal sensitivity. Implications for research and clinical practice with families are discussed.
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Correction to: The Role of Peer- and Self-Appraisals in the Association Between Maltreatment and Symptomatology. Res Child Adolesc Psychopathol 2023; 51:1549. [PMID: 37329402 DOI: 10.1007/s10802-023-01094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
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The Role of Peer- and Self-Appraisals in the Association Between Maltreatment and Symptomatology. Res Child Adolesc Psychopathol 2023; 51:1289-1301. [PMID: 37284898 PMCID: PMC10524635 DOI: 10.1007/s10802-023-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/08/2023]
Abstract
Recent research highlights the use of artificial boundaries between distinct types of adverse experiences, including forms of maltreatment. Commonly-utilized methods that isolate the impact of one maltreatment subtype over others and fail to consider the often co-occurring nature of maltreatment may not adequately capture the complex heterogeneous nature of maltreatment and may obscure understanding of developmental pathways. Moreover, childhood maltreatment is associated with the development of maladaptive peer relationships and psychopathology, with negative conceptions of relationships identified as a risk pathway. The current study utilizes structural equation modeling to examine the impact of an adapted threat versus deprivation framework for conceptualizing maltreatment via children's negative conceptions of relationships, which have not been previously tested as mechanisms in the context of this conceptual framework. Participants included 680 socioeconomically disadvantaged children who attended a week-long summer camp. Multi-informant methods were used to assess children's symptomatology and interpersonal functioning. Results did not support differences between threatening versus depriving maltreatment experiences, but indicated that all groups of children who experienced maltreatment, including those enduring both threatening and depriving experiences, showed more maladaptive functioning and more negative conceptions of relationships relative to non-maltreated peers. Results of the current study support the mediating role of children's appraisals of the self and peers in the effect of maltreatment on children's internalizing and externalizing symptomatology.
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A person-centered data analytic approach to dopaminergic polygenic moderation of child maltreatment exposure. Dev Psychobiol 2023; 65:e22403. [PMID: 37338249 PMCID: PMC10287038 DOI: 10.1002/dev.22403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 06/21/2023]
Abstract
The present study illustrates the utility of latent class analysis, a person-centered data analytic approach, as an innovative method for identifying naturally occurring patterns of polygenic risk, specifically within the dopaminergic system. Moreover, this study tests whether latent classes of polygenic variation moderate the effect of child maltreatment exposure on internalizing symptoms among African ancestry youth. African ancestry youth were selected for this study because youth of color are overrepresented in the child welfare system and because African ancestry individuals are significantly underrepresented in genomics research. Results identified three latent classes of dopaminergic gene variation. Class 1 was marked predominately by homozygous minor alleles, Class 2 was characterized by homozygous major and heterozygous presentations, and Class 3 was marked by heterozygous alleles on the DAT-1 single-nucleotide polymorphisms (SNPs) and a combination of homozygous major and minor alleles on the other SNPs. Results indicated that a greater number of maltreatment subtypes experienced were associated with higher internalizing symptoms only for children with the latent polygenic Class 2 pattern. This latent class was distinctly characterized by more homozygous major or heterozygous allelic presentations along all three DAT-1 SNPs. This significant latent polygenic class by environment interaction was replicated in an independent replication sample. Together, findings suggest that African ancestry children with a pattern of dopaminergic variation characterized by this specific combination of polygenic variation are more vulnerable to developing internalizing symptoms following maltreatment exposure, relative to their peers with other dopamine-related polygenic patterns.
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Childhood attachment security mediates the effect of childhood maltreatment chronicity on emotion regulation patterns in emerging adulthood. Attach Hum Dev 2023; 25:437-459. [PMID: 37470397 PMCID: PMC10529986 DOI: 10.1080/14616734.2023.2234891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Abstract
This study uses a 2-wave, longitudinal design to evaluate mother-child attachment security (child-reported) and emotion regulation capacities (wave 1, age 10-12) as mediators linking childhood maltreatment chronicity and emotion regulation (ER) patterns in emerging adulthood (wave 2; N = 399; 48.1% male; 77.2% Black/African-American, 11.3% White, 7.8% Hispanic, 3.8% other race). Children from families eligible for public assistance with and without maltreatment exposure participated in a summer research camp (wave 1) and were recontacted in emerging adulthood (wave 2). SEM results showed that greater maltreatment chronicity predicted lower childhood attachment security, which in turn predicted membership in ER profiles marked by emotion dysregulation and limited access to ER strategies. Greater attachment security predicted membership in adaptive ER profiles in emerging adulthood. Results suggest that insecure attachment is one process by which childhood maltreatment disrupts adaptive ER across development, whereas greater attachment security in childhood can promote multiple forms of adaptive emotion regulation.
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Patterns of Mother, Father, and Peer Attachment Quality as Moderators of Child Maltreatment Risk for Depression and PTSD Symptoms in Adolescent Females. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6888-6914. [PMID: 36695104 PMCID: PMC10050148 DOI: 10.1177/08862605221138654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Child maltreatment (CM) is a robust risk factor for adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Quality attachment relationships have been posited as a protective factor but findings are equivocal and studies have not adequately considered the complex network of interpersonal relationships that adolescents rely on. The current study applied a person-centered approach to (a) identify subgroups of adolescent females characterized by distinct patterns of attachment quality with peers, fathers, and mothers and (b) determine if the effect of maltreatment on depressive and PTSD symptoms varied as a function of distinct patterns of attachment quality. Data came from a prospective, longitudinal cohort study of 464 racially diverse and adolescent females designed to examine the developmental sequelae of substantiated CM (260 maltreated and 204 demographically matched, nonmaltreated comparisons). Latent profile analysis (LPA) revealed four profiles of attachment characterized by: (a) above-average attachment quality across all three relationships (N = 207, 44.6%); (b) below-average quality with father and friends and above-average quality with mothers (N = 128, 27.6%); (c) below-average quality across all three relationships (N = 106, 22.9%); and (d) very low-(-1 SD) quality with mothers and above-average quality with fathers and friends (N = 23, 5.0%). Moderation models revealed that cumulative maltreatment exposure resulted in greater adolescent depressive symptoms only for those with a profile of attachment consisting of very low-quality maternal attachment and high-quality father and friend attachments. Profiles did not significantly moderate the effect of maltreatment on PTSD symptoms. Results identify subgroups of maltreatment survivors most vulnerable to the development of depression in adolescence. Such groups should be targets for the provision of finite clinical resources with clinical interventions that seek to promote healthy maternal attachment relationships to mitigate the impact of maltreatment on depression.
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Intergenerational effects of maternal depression and co-occurring antisocial behaviors: The mediating role of parenting-related processes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2023; 37:408-419. [PMID: 35925718 PMCID: PMC9898466 DOI: 10.1037/fam0001021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Co-occurring maternal depression and antisocial personality disorder (ASPD) are associated with the development of psychopathology in children, yet little is known about risk mechanisms. In a sample of 122 racially diverse and economically disadvantaged families, we prospectively investigated (a) to what extent child socioemotional problems were related to maternal depression-only, ASPD-only, or the co-occurrence of both and (b) specificity in parenting-related mechanisms linking single-type or comorbid maternal psychopathology to child outcomes at age 3. Compared to mothers without either ASPD or depression, exposure to maternal depression-only and comorbid depression/ASPD predicted child problems as a function of greater parenting stress and lower maternal sensitivity. Mothers with comorbid depression/ASPD uniquely exhibited more negative parenting and had children with more socioemotional problems than mothers with depression-only. Compared to mothers with neither ASPD nor depression, mothers with depression-only uniquely impacted child difficulties via lower maternal efficacy. Study findings suggest areas of parenting intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Developmental pathways from child maltreatment to adolescent pregnancy: A multiple mediational model. Dev Psychopathol 2023; 35:142-156. [PMID: 35074030 PMCID: PMC9309193 DOI: 10.1017/s0954579421001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adolescent pregnancy (AP) is a significant public health issue. Child maltreatment (CM) represents an established risk factor, yet little is known about the explanatory mechanisms linking the phenomena. Informed by developmental theory, this study prospectively tested seven multi-level, indirect pathways that could plausibly explain the relationship between CM and AP: (1) substance use (polysubstance use and frequency); (2) sexual risk behavior; (3) depressive symptoms; (4) posttraumatic stress disorder symptoms; (5) cognitive dysregulation; (6) pregnancy desire and difficulty expectancies; and (7) age at menarche. Data came from a prospective, longitudinal cohort study of 469 ethnically diverse, nulliparous adolescent females, designed to examine the impact of substantiated CM on reproductive outcomes such as pregnancy and childbirth (265 maltreated and 204 demographically matched comparison adolescents). A multiple-mediator structural equation model was conducted to simultaneously test multiple indirect effects while accounting for confounding variables. Maltreatment had an indirect effect on pregnancy via substance use and higher pregnancy desire/lower perceived difficulty. Findings represent a step towards elucidating pathways linking CM with AP. Recommendations are offered to prevent pregnancy by addressing the pregnancy-specific mechanisms that are part of the maltreatment sequelae.
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The Association Between Patterns of Trauma Exposure, Family Dysfunction, and Psychopathology Among Adolescent Females With Depressive Symptoms From Low-Income Contexts. CHILD MALTREATMENT 2023; 28:130-140. [PMID: 34989275 PMCID: PMC9256854 DOI: 10.1177/10775595211050303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Distinguishing profiles of trauma exposure among low-income adolescent females with depressive symptoms is important for understanding comorbidity, family relationships, and treatment. Specifically, child maltreatment is essential to examine in comparison to other traumas. Participants included 170 adolescent females (65.3% Black; 21.2% White; 13.5% other race; 14.1% Latina/x) with depressive symptoms and their primary caregiver from low-income families. Latent class analysis (LCA) identified three trauma classes. Probabilities of endorsing different subtypes of maltreatment (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse), number of subtypes of maltreatment, and non-maltreatment traumas (accident, experiencing or witnessing physical assault, death or injury of loved one, medical trauma) varied among groups. Higher levels of family dysfunction and traumatic stress symptoms were reported in both classes with maltreatment exposure as compared to the class with only non-maltreatment trauma exposure. Findings have implications for family-focused interventions for maltreated adolescent females with depressive symptoms from low-income contexts.
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An integrated review of social information processing as a mechanism in the association between maltreatment and depression among youth of color. CHILD ABUSE & NEGLECT 2023; 135:105956. [PMID: 36459888 PMCID: PMC9839652 DOI: 10.1016/j.chiabu.2022.105956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/19/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Child maltreatment is a potent risk factor for depression across the life course, with maltreatment and depression demonstrated to disproportionately impact youth of color. Despite evidence for mechanisms (e.g., social information processing; SIP) accounting for the effects of maltreatment on youth broadly, pathways of risk for depression among maltreated youth of color specifically remain largely under-investigated. OBJECTIVE In an effort to address this gap in the literature, the present review synthesizes available research regarding SIP as a mechanism underlying the impact of maltreatment on the development of depression in general, and among youth of color specifically. PARTICIPANTS & SETTING A review of literature was conducted on English language articles published between 1989 and 2022 involving maltreatment, depression, social information processing, and/or youth of color. METHODS An electronic database search using terms "Maltreatment," "Depression," "Social Information Processing," "Social Cognition," and "Youth of Color" identified relevant literature. RESULTS Synthesis of literature supports SIP as a salient mechanism in the effect of maltreatment on depressive symptomatology for youth broadly, identifying the need for additional empirical work explicitly assessing this pathway among youth of color. CONCLUSION In addition to support for SIP as a risk pathway for youth broadly, this review highlights associated processes that can lend support to SIP as a meaningful mechanism of risk for youth of color. Additionally, this review addresses the deficit-based approach through which research and intervention tools evaluate youth of color experiencing maltreatment and depression, proposing alternative approaches towards prevention and intervention efforts with this marginalized population.
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Negative Perceptions of Peer Relationships as Mechanisms in the Association Between Maltreatment Timing and the Development of Psychopathology. MERRILL-PALMER QUARTERLY (WAYNE STATE UNIVERSITY. PRESS) 2023; 69:2. [PMID: 37822455 PMCID: PMC10564383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Despite findings that developmental timing of maltreatment is a critical factor in predicting subsequent outcomes, children's developmental stage is understudied in maltreatment research. Moreover, childhood maltreatment is associated with the development of maladaptive peer relationships and psychopathology, with social cognition identified as a process underlying this risk. The current study utilizes structural equation modeling to examine the impact of developmental timing of maltreatment (i.e., infancy through preschool versus elementary and middle school years) on psychopathology via negative perceptions of peer relationships. Multi-informant methods were used to assess 680 socioeconomically disadvantaged children. Results did not support differential effects of early versus later maltreatment on children's internalizing symptomatology or disruptive behavior, but indicated that chronic maltreatment, relative to episodic maltreatment, has more severe consequences for children's internalizing symptomatology. Results further support the mediating role of children's perceptions of relationships in the effect of maltreatment on negative developmental outcomes.
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Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls. Psychoneuroendocrinology 2022; 143:105826. [PMID: 35700563 PMCID: PMC9357119 DOI: 10.1016/j.psyneuen.2022.105826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls' morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls' cognitive reappraisal utilization moderated profile membership-depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Developmental pathways from maternal history of childhood maltreatment and maternal depression to toddler attachment and early childhood behavioral outcomes. Attach Hum Dev 2021; 23:328-349. [PMID: 32126891 PMCID: PMC7483191 DOI: 10.1080/14616734.2020.1734642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
The current study examined the development of toddler attachment and early childhood behavior among children of mothers with a history of childhood maltreatment and current major depressive disorder. Maternal depression, maternal sensitivity, and toddler attachment were assessed as mediators of the association between maternal history of childhood maltreatment and child internalizing and externalizing behavior. Participants were from a low-income, largely racial minority urban sample and included 123 mothers with (n = 69) and without (n = 54) major depressive disorder at baseline and their children assessed at 12, 26, and 36 months old. Findings suggest maternal depression and maternal sensitivity mediated the association between maternal history of childhood maltreatment and disorganized attachment. Maternal depression, but not disorganized attachment, mediated the association between maternal history of childhood maltreatment and child symptomatology. Results suggest that supporting mothers through depression and processing their adverse childhood experiences are critical in fostering positive child development.
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Attachment and Affect between Mothers with Depression and their Children: Longitudinal Outcomes of Child Parent Psychotherapy. Res Child Adolesc Psychopathol 2021; 49:563-577. [PMID: 33411233 PMCID: PMC8035282 DOI: 10.1007/s10802-020-00681-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their mothers with depression on: a) maternal affective expression, b) child affective expression, and c) mother-child cohesion. Mothers with depression (Mage = 31.7 years; 92.8% White, 3.5% Black, 2.1% Hispanic, 2.3% other) and their toddlers were randomized to receive CPP (DI; n = 66) or to a control group (DC; n = 64). Mothers without depression and their toddlers (NC; n = 68) were recruited as an additional comparison group. Dyads were assessed at baseline (T1; 20 months old), post-intervention (T2; 36 months old), and follow-up (T3; 9 years old). Data from a mother-child conflict task was coded as a measure of observed outcome variables. Change in post-intervention attachment security assessed via the Strange Situation was evaluated as a mediator between intervention condition and maternal and child affective expression and dyadic cohesion at T3. Change to secure attachment post-intervention significantly mediated the association between intervention condition and T3 maternal warmth and child anger/problem behavior. Toddlers of mothers with depression who received CPP showed higher rates of change to secure attachment compared to those in both the DC and NC groups. Dyads who changed to secure attachment at T2 displayed higher levels of maternal warmth at T3 and lower levels of child anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and the importance of attachment as a mediator of long-term outcomes are discussed.
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Abstract
The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.
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Child maltreatment, recent stressful life events, and suicide ideation: A test of the stress sensitivity hypothesis. CHILD ABUSE & NEGLECT 2021; 113:104926. [PMID: 33444849 PMCID: PMC7880899 DOI: 10.1016/j.chiabu.2020.104926] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Exposure to child maltreatment is a well-known risk factor for suicide ideation among adolescents. Recent stressful life events may also contribute to this risk. However, the association between these risk factors is unclear in the etiology of suicide ideation for adolescents from socio-economically disadvantaged backgrounds. OBJECTIVE The present study tested the stress generation and stress sensitivity hypotheses in relation to child maltreatment, recent stressful life events (in the past year), and suicide ideation (in the past two weeks). PARTICIPANTS AND SETTING We utilized a sample of diverse, socioeconomically disadvantaged, depressed adolescent girls (N = 175) who were part of a depression treatment intervention. RESULTS Child maltreatment was significantly associated with adolescent suicide ideation, β = .40, p < .001. Results supported the stress sensitivity hypothesis, in that exposure to interpersonal stressors in the past year exacerbated the association between child maltreatment and adolescents' suicide ideation, β = .18, p < .05. We found evidence for a protective factor, cognitive reappraisal, in the association between stressful life events and suicide ideation, β = -.15, p < .05. CONCLUSIONS These findings have several implications for clinical practice and suicide prevention with adolescent girls, and contribute to the extant literature on the role of chronic and acute stress in the etiology of adolescent suicide ideation.
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Patterns of dating violence moderate the effect of child maltreatment on suicide risk among disadvantaged minority female adolescents with depressive symptoms. JOURNAL OF FAMILY VIOLENCE 2021; 36:5-16. [PMID: 34219913 PMCID: PMC8248270 DOI: 10.1007/s10896-020-00153-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Childhood maltreatment is associated with increased suicide risk. However, not all maltreated children report self-injurious thoughts and behaviors, highlighting the presence of other risk factors. Notably, adolescent dating violence (ADV) and child maltreatment are highly comorbid, with ADV also linked to suicide risk among adolescents. Current research further suggests that distinct patterns of ADV involvement are differentially related to adolescent mental health. To date, it is unknown whether differences in ADV patterns moderate changes in suicide risk for adolescents with and without a maltreatment history. This study aims to advance the literature by identifying patterns of ADV in a unique sample of adolescents and by determining the differential association between maltreatment and suicidal ideation and non-suicidal self-harming behaviors based on ADV profiles. METHODS Participants were racially and ethnically diverse low-income non-treatment-seeking adolescent females with elevated depressive symptoms, ages 13-16 (N=198). RESULTS Using latent class analysis, we found support for a 3-class model of dating violence: adolescent females without ADV involvement, those in relationships with mutual verbal abuse, and those in romantic relationships with multiple and more severe forms of ADV, such as verbal abuse and physical violence. A series of latent class moderation models indicated that the effect of child maltreatment on suicidal ideation significantly differed based on ADV class membership. CONCLUSION Results highlight the importance of considering different ADV patterns and maltreatment as interactive risk factors for increased self-injurious thoughts and behaviors. Intervention and prevention approaches relevant to maltreated youths are discussed for families and practitioners.
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The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1351-1365. [PMID: 32696103 PMCID: PMC7484366 DOI: 10.1007/s10802-020-00682-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients' distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13-15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary.
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The Interactive Effects of Child Maltreatment and Adolescent Pregnancy on Late-Adolescent Depressive Symptoms. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1223-1237. [PMID: 32594294 PMCID: PMC7395875 DOI: 10.1007/s10802-020-00669-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Adolescent females are disproportionately at risk for depression, which is expected to represent the leading cause of disability in 2030 (National Institute of Mental Health [NIMH] 2019). Although prior research has suggested that both child maltreatment and adolescent pregnancy increase the risk for depressive symptoms, less is known about how these two interact to influence depression in late adolescence. The present study tested the unique and interactive effects of adolescent pregnancy and child maltreatment on late-adolescent depressive symptomatology (N = 186) with a prospective, longitudinal design that utilized documented records of maltreatment and included demographically comparable (i.e., economically disadvantaged), nonmaltreated and non-pregnant comparisons. Participants were assessed at ages 10-12 and 18-21. Structural equation modeling was used to test whether adolescent pregnancy amplified the effect of child maltreatment on late-adolescent depressive symptoms. In the context of economic disadvantage, results indicated that the effect of child maltreatment on late-adolescent depressive symptoms was significantly enhanced for those who experienced an adolescent pregnancy. This effect remained after controlling for prior depressive symptoms, peer and maternal relationship quality, and romantic relationship violence. The findings are translated to preliminary guidance for practitioners regarding precision depression screening and tailored preventive interventions..
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Offspring Personality Mediates the Association between Maternal Depression and Childhood Psychopathology. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:345-357. [PMID: 29959661 DOI: 10.1007/s10802-018-0453-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Offspring of mothers diagnosed with major depression are at increased risk for a wide range of psychological problems. Previous research has shown that individual differences in personality development can be informative for predicting risk and resilience to psychopathology, especially within at-risk populations. In the present study, we examined whether individual differences in offspring personality development during early to middle childhood could account for the association between maternal depression and offspring behavior problems later in childhood. Participants included 64 offspring of mothers diagnosed with major depression and 68 offspring of healthy comparison mothers. Personality was assessed via parent report at ages 3, 4, 5, and 9. Offspring internalizing and externalizing symptoms were assessed at age 9 via parent and teacher report. Results of latent growth curve models indicated that offspring Neuroticism, Conscientiousness, and Agreeableness mediated the link between early maternal depression and later childhood behavior problems, though results varied across maternal and teacher reports. Findings suggest that individual differences in youth personality and personality development are important predictors of emerging psychopathology among offspring of mothers diagnosed with depression.
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The effect of maternal depression on mental representations and child negative affect. J Affect Disord 2020; 261:9-20. [PMID: 31600590 PMCID: PMC6936600 DOI: 10.1016/j.jad.2019.09.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/13/2019] [Accepted: 09/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Maternal depression is a widely recognized public health concern with significant implications for child functioning, including the development of negative child affect and risk for later depression. Negative mental representations may partially account for the association between maternal depression and child negative affect. METHODS The effect of depression on low-income mothers' representations of their child, self, and mother was assessed via Expressed Emotion (EE) during Five-Minute Speech Samples. Direct and indirect pathways between maternal depression, EE, and child negative affect were examined. Mothers (M = 24 years old) who had experienced a major depressive episode (n = 144) since child's birth, non-depressed comparison mothers (n = 62), and their children participated. RESULTS Examination of between-group differences revealed that depressed mothers had higher levels of overall self EE. Trend results also suggest depressed mothers may have higher overall EE toward their children and their own mothers. Novel coding systems for EE toward self (Identity and Depressotypic Cognitions) and EE toward mother (Source of Concrete Support and Resolution of Past Adversity) were also developed and tested. A significant indirect relation was found between maternal baseline depression and child negative affect at 26 months via the mother's level of EE-Criticism of her mother. LIMITATIONS Certain EE subcodes may need to be adapted for young children and high-risk, low-income participants. CONCLUSIONS Findings highlights the importance of relational interventions that focus on maternal representations for women with depression and their children.
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Childhood Maltreatment Disrupts Brain-Mediated Pathways Between Adolescent Maternal Relationship Quality and Positive Adult Outcomes. CHILD MALTREATMENT 2019; 24:424-434. [PMID: 31084199 PMCID: PMC6813873 DOI: 10.1177/1077559519847770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The quality of early caregiving may partially shape brain structure and circuits involved in regulating emotions, including the frontal cortex, affecting vulnerability to the development of psychopathology and maladaptation. Given the profound impact of child maltreatment (CM) on psychological and neural development, we tested whether CM alters the pathways linking mother-adolescent relationship, frontal cortex, and adult outcomes. We used structural equation modeling to investigate whether CM history affected the association between mother-child relationship quality during early adolescence, frontal lobe volume in adulthood, and adult internalizing and externalizing symptomatology and competence. Participants from a longitudinal high-risk, low-income sample included 48 adults with a history of CM and 40 adults without such history (M = 30.0 years). Results showed that greater frontal lobe volume predicted higher levels of adult adaptive functioning and fewer adult internalizing symptoms but showed no relation to adult externalizing symptoms. Frontal lobe volume significantly mediated the effect of adolescent maternal relationship quality on both adult internalizing symptoms and adult adaptive functioning, but only for individuals with no maltreatment history. Given the observed relationship between frontal lobe volume and healthy adult functioning across the full sample, it will be important to identify protective factors in maltreated individuals that foster frontal lobe development.
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Mother-Daughter Interpersonal Processes Underlying the Association Between Child Maltreatment and Adolescent Suicide Ideation. Suicide Life Threat Behav 2019; 49:1232-1240. [PMID: 30328155 PMCID: PMC6470049 DOI: 10.1111/sltb.12522] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 07/16/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of the present study was to investigate whether mother-daughter relationship quality and mother-daughter conflict represent mechanisms underlying the association between child maltreatment and adolescent passive or active suicide ideation. METHOD The sample included 164 socioeconomically disadvantaged depressed adolescent girls and their mothers (adolescents: mean age = 14.00 years; 66.3% African-American, 21.3% white, 14.0% Latina). Structural equation modeling was used to test three simultaneous and distinct mediating pathways linking child maltreatment to adolescent suicide ideation: (1) mother-daughter relationship quality, (2) mother-daughter conflict, and 3) adolescent depressive symptoms. RESULTS Consistent with the interpersonal-psychological theory of suicide (Joiner, Why people die by suicide, 2005, Harvard University Press, Cambridge, MA), both mother-daughter relationship quality and mother-daughter conflict mediated the effect of child maltreatment on adolescent suicide ideation, over and above the significant depressive symptoms mediational pathway. CONCLUSIONS These findings advance our understanding of why individuals who experienced child maltreatment are at risk for suicide ideation and highlight the importance of relationship-based interventions for these vulnerable youths.
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Re-examining the "cycle of abuse": Parenting determinants among previously maltreated, low-income mothers. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:742-752. [PMID: 31033305 PMCID: PMC6706323 DOI: 10.1037/fam0000534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Multidomain approaches toward understanding the transmission of harsh caregiving across generations have been largely overlooked in the literature. To address this, the current study examined how maternal and child factors may operate as mediating mechanisms in the association between maternal history of child maltreatment and maternal caregiving behaviors. In particular, we tested the relative roles of maternal depression, maternal efficacy beliefs, and child behavioral difficulties as explanatory variables in these associations. Participants (N = 127) were drawn from a community sample of mother-child dyads from socioeconomically disadvantaged, ethnically diverse backgrounds. Mother-child dyads were assessed at baseline, when the children were approximately 12 months old, with follow-up visits occurring when children were 26 and 37 months of age. Findings did not support a significant direct effect of childhood maltreatment on mothers' subsequent harsh or responsive parenting behavior. However, analyses demonstrated a significant indirect effect of childhood maltreatment history on later responsive parenting behaviors via maternal depression. Results also supported a significant indirect effect of childhood maltreatment history on later harsh parenting behavior through child behavior problems. Although mothers' childhood maltreatment history significantly predicted lower levels of maternal efficacy, results did not support a mediating role of maternal efficacy beliefs in the association between maltreatment history and subsequent parenting behaviors. Identifying specific factors that potentially disrupt the intergenerational pattern of maladaptive parenting can serve to guide prevention and intervention efforts aimed at facilitating more positive, responsive parenting strategies within high-risk families. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Developmental Consequences of Child Abuse and Neglect: Implications for Intervention. CHILD DEVELOPMENT PERSPECTIVES 2018. [DOI: 10.1111/cdep.12317] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Effectiveness of interpersonal psychotherapy-trauma for depressed women with childhood abuse histories. J Consult Clin Psychol 2018; 86:868-878. [PMID: 30265045 DOI: 10.1037/ccp0000335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Women with depression and childhood sexual abuse histories constitute more than 20% of the female patient population in publicly funded community mental health centers (CMHCs). Interventions are needed that address depression and posttraumatic stress disorder (PTSD) symptoms and social health. METHOD We compared Interpersonal Psychotherapy-Trauma (IPT-T), an IPT adaptation for this population and setting, to Clinic Psychotherapy (CP). CP clinicians were free to implement the psychotherapy of choice. Women (n = 162; 54% White, 10.5% Hispanic; 52.2% Medicaid-insured) with a major depressive episode (MDE) and history of sexual abuse before 18 were randomly assigned to IPT-T or CP. Participants were offered 16 free sessions of IPT-T or CP. Outcomes were MDE remission, improved depression (Beck Depression Inventory, Hamilton Depression Rating Scale) and PTSD symptoms (Modified PTSD Symptom Scale), and improved social health (e.g., UCLA Loneliness Scale). Weighted generalized estimating equations were used to examine outcomes at 8 (primary) and 20 (secondary) months postrandomization. RESULTS IPT-T led to greater improvements in PTSD symptoms and many social health indicators, including loneliness and social support, at both 8- and 20-month follow-up. Effect sizes ranged from .18 to .39 at the primary endpoint (8 months). IPT-T and CP yielded comparable improvements in depression symptoms and MDE remission. CONCLUSION Evidence-based psychotherapies like IPT-T are needed in CMHCs, where some of the most vulnerable patients receive treatment. With comparable findings for depression, IPT's superior improvements in social health and PTSD symptoms are cause for optimism. IPT-T should be evaluated in dissemination trials. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Early Neglect and the Development of Aggression in Toddlerhood: The Role of Working Memory. CHILD MALTREATMENT 2018; 23:344-354. [PMID: 29874924 DOI: 10.1177/1077559518778814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
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.
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Separable Effects of Childhood Maltreatment and Adult Adaptive Functioning on Amygdala Connectivity During Emotion Processing. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [PMID: 29529406 DOI: 10.1016/j.bpsc.2017.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Individuals with a history of maltreatment show altered amygdala reactivity to emotional stimuli, atypical frontal regulatory control, and differences in frontolimbic connectivity compared with nonmaltreated controls. However, despite early trauma, many individuals who experience maltreatment show resilience or adaptive functioning in adulthood including positive social, educational, and occupational outcomes. METHODS The present study used a psychophysiological interaction model to examine the effect of adult adaptive functioning on group differences between maltreated and nonmaltreated adults in task-based amygdala functional connectivity. The task used was a facial emotion-matching paradigm. Functional magnetic resonance imaging scans were collected from 41 adults with a history of substantiated childhood maltreatment and 39 nonmaltreated adults who were well matched on demographic variables, all of whom had been studied since childhood. Adaptive functioning was measured with a composite score of success on stage-salient developmental tasks. RESULTS Consistent with previous research, we found differences in task-related amygdala functional connectivity between the maltreated and nonmaltreated groups. Effects were seen in the left hippocampus, right dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and right thalamus. However, when adult functioning was included in the model, maltreatment-related differences in amygdala connectivity were observed only in the hippocampus. Adult adaptive functioning independently predicted task-related amygdala connectivity in frontal and parietal regions across the entire sample. CONCLUSIONS These results suggest that frontolimbic functional connectivity is predicted by positive developmental adaptation in this high-risk population, regardless of maltreatment history, whereas intralimbic connectivity (amygdala and hippocampus) is more specifically associated with maltreatment history.
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An investigation of child maltreatment and epigenetic mechanisms of mental and physical health risk. Dev Psychopathol 2016; 28:1305-1317. [PMID: 27691979 PMCID: PMC5087600 DOI: 10.1017/s0954579416000869] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the present investigation, differential methylation analyses of the whole genome were conducted among a sample of 548 school-aged low-income children (47.8% female, 67.7% Black, M age = 9.40 years), 54.4% of whom had a history of child maltreatment. In the context of a summer research camp, DNA samples via saliva were obtained. Using GenomeStudio, Methylation Module, and the Illumina Custom Model, differential methylation analyses revealed a pattern of greater methylation at low methylation sites (n = 197 sites) and medium methylation sites (n = 730 sites) and less methylation at high methylation sites (n = 907 sites) among maltreated children. The mean difference in methylation between the maltreated and nonmaltreated children was 6.2%. The relative risk of maltreatment with known disease biomarkers was also investigated using GenoGo MetaCore Software. A large number of network objects previously associated with mental health, cancer, cardiovascular systems, and immune functioning were identified evidencing differential methylation among maltreated and nonmaltreated children. Site-specific analyses were also conducted for aldehyde dehydrogenase 2 (ALDH2), ankyrin repeat and kinase domain containing 1 (ANKK1), and nuclear receptor subfamily 3, group C, member 1 (NR3C1) genes, and the results highlight the importance of considering gender and the developmental timing of maltreatment. For ALDH2, the results indicated that maltreated girls evidenced significantly lower methylation compared to nonmaltreated girls, and maltreated boys evidenced significantly higher methylation compared to nonmaltreated boys. Moreover, early onset-not recently maltreated boys evidenced significantly higher methylation at ALDH2 compared to nonmaltreated boys. Similarly, children with early onset-nonrecent maltreatment evidenced significantly higher methylation compared to nonmaltreated children at ANKK1. The site-specific results were not altered by controlling for genotypic variation of respective genes. The findings demonstrate increased risk for adverse physical and mental health outcomes associated with differences in methylation in maltreated children and indicate differences among maltreated children related to developmental timing of maltreatment and gender in genes involved in mental health functioning.
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The benefits of child-parent psychotherapy to marital satisfaction. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2015; 33:372-382. [PMID: 26192249 PMCID: PMC4673020 DOI: 10.1037/fsh0000149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Given the interdependent nature of relationships within the family system, the purpose of this study was to examine the potential role of child-parent psychotherapy (CPP) to extend its positive influence beyond the mother-child relationship within families challenged by maternal depression. Accordingly, we analyzed longitudinal associations between depressive symptoms and marital satisfaction over 3 years in order to evaluate if the benefits of CPP to mother-child attachment security might generalize within the family and indirectly benefit marital relationships. METHOD We tested our hypotheses in a randomized control trial of CPP (N = 159 families) to examine the intervention's efficacy in families with mothers with histories of depression since the target child's birth (Mage = 20.4 months, SD = 2.5; 56% boys). RESULTS Using hierarchical linear modeling (HLM) with an actor-partner interdependence modeling (APIM) framework, the results supported our hypothesis as well as revealed significant associations between depressive symptoms and marital functioning. Specifically, shifts in mothers' depressive symptoms within specific waves of follow-up were associated with corresponding shifts in both their husbands' and their own relationship satisfaction in those same waves. After controlling for those effects, only mothers with a history of depression who received CPP demonstrated slight improvements in relationship satisfaction over the 3 years of the study, suggesting secondary benefits of CPP within the family system. DISCUSSION Results are discussed in terms of the importance of examining therapeutic processes within the larger family system. Concerning future research, we also suggest examining potential mechanisms through which CPP might influence marital satisfaction. (PsycINFO Database Record
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Self-Criticism as a Mechanism Linking Childhood Maltreatment and Maternal Efficacy Beliefs in Low-Income Mothers With and Without Depression. CHILD MALTREATMENT 2015; 20:291-300. [PMID: 26318693 PMCID: PMC4618708 DOI: 10.1177/1077559515602095] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The primary aim of the current study was to examine self-criticism as a potential mechanism mediating the relation between mothers' own childhood maltreatment history and changes in subsequent maternal efficacy beliefs in a diverse sample of low-income mothers with and without major depressive disorder. Longitudinal data were drawn from a larger randomized clinical trial evaluating the effectiveness of interpersonal psychotherapy for depression among low-income mothers and their 12-month-old infant. Results indicated that higher levels of maltreatment in childhood led mothers to hold more self-critical judgments in adulthood. Additionally, mothers who had experienced more extensive childhood maltreatment histories perceived themselves as less efficacious in their role as mother. Structural equation modeling indicated that self-criticism mediated the relationship between childhood maltreatment and mothers' decreased perceived competency in her maternal role from when her child was an infant to the more demanding toddler years. Finally, this relationship held over and above the influence of mothers' depressive diagnostic status. Directions for future research and the clinical implications of these findings are discussed.
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Interrelations of maternal expressed emotion, maltreatment, and separation/divorce and links to family conflict and children's externalizing behavior. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 43:217-28. [PMID: 25037461 DOI: 10.1007/s10802-014-9911-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Research has documented that maternal expressed emotion-criticism (EE-Crit) from the Five-Minute Speech Sample (FMSS) predicts family conflict and children's externalizing behavior in clinical and community samples. However, studies have not examined EE-Crit in maltreating or separated/divorced families, or whether these family risks exacerbate the links between EE-Crit and family conflict and externalizing behavior. The current study examined the associations between maternal EE-Crit, maltreatment, and separation/divorce, and whether maltreatment and separation/divorce moderated associations between EE-Crit and children's externalizing problems, and EE-Crit and family conflict. Participants included 123 children (M = 8.01 years, SD = 1.58; 64.2 % males) from maltreating (n = 83) or low-income, comparison (n = 40) families, and 123 mothers (n = 48 separated/divorced). Mothers completed the FMSS for EE-Crit and the Family Environment Scale for family conflict. Maltreatment was coded with the Maltreatment Classification System using information from official Child Protection Services (CPS) reports from the Department of Human Services (DHS). Trained summer camp counselors rated children's externalizing behavior. Maltreatment was directly associated with higher externalizing problems, and separation/divorce, but not maltreatment, moderated the association between EE-Crit and externalizing behavior. Analyses pertaining to family conflict were not significant. Findings indicate that maltreatment is a direct risk factor for children's externalizing behavior and separation/divorce is a vulnerability factor for externalizing behavior in family contexts with high maternal EE-Crit. Intervention, prevention, and policy efforts to promote resilience in high-risk families may be effective in targeting maltreating and critical parents, especially those with co-occurring separation/divorce. Key Words: expressed emotion, EE-Crit, Five-Minute Speech Sample; maltreatment, divorce, externalizing behavior.
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Abstract
A randomized clinical trial was conducted to evaluate the efficacy of interpersonal psychotherapy (IPT) for ethnically and racially diverse, economically disadvantaged women with major depressive disorder. Non-treatment-seeking urban women (N = 128; M age = 25.40, SD = 4.98) with infants were recruited from the community. Participants were at or below the poverty level: 59.4% were Black and 21.1% were Hispanic. Women were screened for depressive symptoms using the Center for Epidemiologic Studies Depression Scale; the Diagnostic Interview Schedule was used to confirm major depressive disorder diagnosis. Participants were randomized to individual IPT or enhanced community standard. Depressive symptoms were assessed before, after, and 8 months posttreatment with the Beck Depression Inventory-II and the Revised Hamilton Rating Scale for Depression. The Social Support Behaviors Scale, the Social Adjustment Scale-Self-Report, and the Perceived Stress Scale were administered to examine mediators of outcome at follow-up. Treatment effects were evaluated with a growth mixture model for randomized trials using complier-average causal effect estimation. Depressive symptoms trajectories from baseline through postintervention to follow-up showed significant decreases among the IPT group compared to the enhanced community standard group. Changes on the Perceived Stress Scale and the Social Support Behaviors Scale mediated sustained treatment outcome.
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Abstract
It is well established that child maltreatment has significant deleterious effects for the individual as well as for society. We briefly review research regarding the impact of child maltreatment on the attachment relationship, highlighting the need for relational interventions for maltreated children and their families to effectively thwart negative developmental cascades that are so often observed in the context of child maltreatment. Next, historical and contemporaneous perspectives on relational interventions for individuals with histories of child maltreatment are discussed, with attention to the empirical evidence for and the current evidence-based status of several relationally based interventions for child maltreatment. Differential sensitivity to the environment is then discussed as a theoretical framework with important implications for interventions for individuals who have been reared in maltreating environments. Current research on neurobiology and maltreatment is then reviewed, with an emphasis on the need for future investigations on genetic variants, epigenetics, and the efficacy of relational interventions for maltreated children. We conclude with a discussion of the tenets of developmental psychopathology, their implications for relational interventions for child maltreatment, and recommendations for advancing the development, provision, and evaluation of relational interventions for individuals with histories of child maltreatment.
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Abstract
BACKGROUND: Research has consistently demonstrated the deleterious consequences of child maltreatment, not only during childhood but also across the life course. In particular, maltreatment negatively affects child attachment, with high percentages of maltreated children developing insecure or disorganized attachments with their primary caregiver. Therefore, interventions informed by attachment theory are important to prevent enduring relational difficulties. SCOPE: One such intervention, child-parent psychotherapy, has been shown to be efficacious in a number of randomized controlled trials. This article provides an overview of the evidence base for this intervention and the translation of this research into practice, particularly in community settings. CONCLUSION: Increasingly, it is imperative that such evidence-based models of intervention be translated into community settings so that the most vulnerable children and families can benefit from them.
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The relations among maternal depressive disorder, maternal expressed emotion, and toddler behavior problems and attachment. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:803-13. [PMID: 22146899 DOI: 10.1007/s10802-011-9598-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior problems); the Strange Situation (child attachment). Direct relations were significant linking: 1) maternal depression with both EE and child functioning; 2) Child-Criticism with child internalizing and externalizing symptoms; 3) Self-Criticism with child attachment. Significant indirect relations were found linking maternal depression with: 1) child externalizing behaviors via Child-Criticism; 2) child internalizing behaviors via Self- and Child-Criticism; and 3) child attachment via Self-Criticism. Findings are consistent with a conceptual model in which maternal EE mediates relations between maternal depression and toddler socio-emotional functioning.
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Mother-child play and maltreatment: a longitudinal analysis of emerging social behavior from infancy to toddlerhood. Dev Psychol 2012; 47:1280-94. [PMID: 21744951 DOI: 10.1037/a0024459] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mother-child play of maltreating and nonmaltreating families was analyzed when infants were 12 months old (Time 1), and 2 years old (Time 2), as a context to examine children's developing cognitive and social skills. At Time 1, infants from abusing families demonstrated less independent and more imitative behavior during play than did infants from neglecting and nonmaltreating families, suggesting a delay in emerging social behaviors. In this longitudinal follow-up, mother-child play was reassessed 1 year later (N = 78), with a focus on children's engagement in nonplay and pretend play and on children's abilities to initiate social exchanges and respond to parental requests. Play and social behavior were coded from semistructured and unstructured play paradigms at both time points. Maternal attention-directing behavior and limit setting also was assessed. At Time 2, children from abusing, neglecting, and nonmaltreating families did not differ in cognitive play complexity. However, children from abusing families engaged in less child-initiated play than did children from neglecting and nonmaltreating families, demonstrating less socially competent behavior. Longitudinal analyses revealed child initiated play at Time 2 was negatively associated with abuse and with maternal physical attention directing behavior at Time 1. Child negative reactivity at Time 2 was positively associated with Time 1 maternal physical behavior and child imitation and with Time 2 maternal controlling behavior. Implications for early intervention efforts are emphasized.
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Bridging research and practice: challenges and successes in implementing evidence-based preventive intervention strategies for child maltreatment. CHILD ABUSE & NEGLECT 2011; 35:633-636. [PMID: 21855142 DOI: 10.1016/j.chiabu.2011.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 05/03/2011] [Accepted: 05/03/2011] [Indexed: 05/31/2023]
Abstract
Child maltreatment has been associated with a wide range of negative developmental outcomes for children and families as well as significant economic consequences. While efficacious intervention strategies have been demonstrated to reduce symptoms of trauma and to improve behavioral and emotional functioning, these models have not been widely adopted by clinicians. The challenges associated with exporting evidence-based interventions into community settings are discussed, along with an example of a preventive intervention program for young mothers, successfully implemented through a partnership of community agencies and funders.
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Illogical thinking and thought disorder in maltreated children. J Am Acad Child Adolesc Psychiatry 2011; 50:659-68. [PMID: 21703493 DOI: 10.1016/j.jaac.2011.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 02/23/2011] [Accepted: 03/03/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine illogical thinking in children from low-income families with and without histories of child maltreatment. METHOD Maltreated (n = 91) and nonmaltreated (n = 43) school-age children individually participated in a story game designed to elicit speech samples. Children were instructed to listen to two recorded stories and prompted to retell the story; they then were asked to create their own story from possible topics. Child behavior ratings on the Child Behavior Checklist were completed by research assistants following 35 hours of observation. RESULTS Maltreated children exhibited more illogical thinking than did nonmaltreated children, and the level of illogical thinking in maltreated children was in the clinically pathological range. The occurrence of multiple subtypes of maltreatment and the chronicity of the maltreatment also were associated with illogical thinking. Dissociation did not differ between groups, although it was related to illogical thinking. CONCLUSION The ability to formulate ideas and communicate them logically is compromised in children who have been maltreated. These results extend prior research on selective attentional processes and negativity biases in maltreated children.
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43
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Effects of maternal negativity and of early and recent recurrent depressive disorder on children's false belief understanding. Dev Psychol 2011; 47:170-81. [PMID: 21244156 DOI: 10.1037/a0021305] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research has shown that children of depressed mothers are at risk for problems in a variety of developmental domains; however, little is known about the effects of maternal depression on children's emerging understanding of false beliefs. In this study, 3 false belief tasks were administered to 5-year-old children whose mothers had either met criteria for major depressive disorder within the first 20 months of the child's life (n = 91) or had never been depressed (n = 50). Significant difficulties in performance were found among the children of depressed mothers, especially those whose mothers had experienced early and recent recurrent depressive disorder. Regardless of diagnostic status, children whose mothers exhibited negativity during problem-solving tasks administered at an earlier developmental period also were less likely to demonstrate false belief understanding. These effects remained even after child verbal ability was controlled.
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Abstract
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.
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45
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Child maltreatment, attachment security, and internal representations of mother and mother-child relationships. CHILD MALTREATMENT 2011; 16:137-45. [PMID: 21339198 DOI: 10.1177/1077559511398294] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Attachment security and internal representations of mothers, and of the mother-child relationship, were examined in an ethnically diverse and economically disadvantaged sample of maltreated (N = 92) and nonmaltreated (N = 31) preschool-aged children. Maltreated preschoolers had lower rates of secure attachment and higher rates of disorganized attachment than did nonmaltreated preschoolers. Maltreatment also was associated with less positive global representations of the mother-child relationship relative to the nonmaltreated comparison group. Analyses were conducted to determine whether maltreatment characteristics such as subtype, chronicity, severity, and frequency were associated with attachment organization and with internal representations. Implications of these results for developmental theory and intervention with maltreated children are discussed.
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46
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Abstract
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.
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47
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Abstract
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.
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The differential impacts of early physical and sexual abuse and internalizing problems on daytime cortisol rhythm in school-aged children. Child Dev 2010; 81:252-69. [PMID: 20331666 DOI: 10.1111/j.1467-8624.2009.01393.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The impact of early physical and sexual abuse (EPA/SA) occurring in the first 5 years of life was investigated in relation to depressive and internalizing symptomatology and diurnal cortisol regulation. In a summer camp context, school-aged maltreated (n = 265) and nonmaltreated (n = 288) children provided morning and late afternoon saliva samples on 5 consecutive days. Child self-report and adult observer reports of child internalizing and depressive symptoms were obtained. Children experiencing EPA/SA and high depressive or internalizing symptoms uniquely exhibited an attenuated diurnal decrease in cortisol, indicative of neuroendocrine dysregulation. These results were specific to EPA/SA rather than later onset physical or sexual abuse or early occurring neglect or emotional maltreatment.
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The historical origins and developmental pathways of the discipline of developmental psychopathology. THE ISRAEL JOURNAL OF PSYCHIATRY AND RELATED SCIENCES 2010; 47:95-104. [PMID: 20733251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The historical origins of the field of developmental psychopathology are discussed and the meaning of a developmental psychopathology perspective is described. The definitional principles and tenets of the discipline of developmental psychopathology are delineated and they are utilized to highlight diversity in process and outcome. The definitional principles that are discussed include: 1) the mutual interplay between the study of normality and psychopathology; 2) the importance of a multiple-levels of analysis and multidisciplinary approach; 3) the processes that contribute to resilient adaptation in the face of significant adversity; 4) translational research; and 5) implications for prevention and intervention. Examples derived from research and clinical contexts are provided to illustrate these principles. Advances in our knowledge base in developmental psychopathology not only have benefitted the scientific understanding of the relation between normal and abnormal development, but also have contributed to reducing the individual and societal burden of mental illness.
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The differential impacts of early physical and sexual abuse and internalizing problems on daytime cortisol rhythm in school-aged children. Child Dev 2010. [PMID: 20331666 DOI: 10.1111/j.1467-8624.2009.01393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
The impact of early physical and sexual abuse (EPA/SA) occurring in the first 5 years of life was investigated in relation to depressive and internalizing symptomatology and diurnal cortisol regulation. In a summer camp context, school-aged maltreated (n = 265) and nonmaltreated (n = 288) children provided morning and late afternoon saliva samples on 5 consecutive days. Child self-report and adult observer reports of child internalizing and depressive symptoms were obtained. Children experiencing EPA/SA and high depressive or internalizing symptoms uniquely exhibited an attenuated diurnal decrease in cortisol, indicative of neuroendocrine dysregulation. These results were specific to EPA/SA rather than later onset physical or sexual abuse or early occurring neglect or emotional maltreatment.
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