Erika L. Bocknek

PTSD symptoms across pregnancy and early postpartum among women with lifetime PTSD diagnosis

Little is known about trajectories of PTSD symptoms across the peripartum period in women with trauma histories, specifically those who met lifetime PTSD diagnoses prior to pregnancy. The present study seeks to identify factors that influence PTSD symptom load across pregnancy and early postpartum, and study its impact on postpartum adaptation.

Longitudinal examination of infant baseline and reactivity cortisol from ages 7 to 16 months

This study characterized the longitudinal evolution of HPA axis functioning from 7 to 16 months of age and identified individual and environmental factors that shape changes in HPA axis functioning over time. Participants were 167 mother-infant dyads drawn from a larger longitudinal study, recruited based on maternal history of being maltreated during childhood. Salivary cortisol levels were assessed before and after age-appropriate psychosocial stressors when infants were 7 and 16 months old. Maternal observed parenting and maternal reports of infant and environmental characteristics were obtained at 7 months and evaluated as predictors of changes in infant baseline cortisol and reactivity from 7 to 16 months. Results revealed that infants did not show a cortisol response at 7 months, but reactivity to psychosocial stress emerged by 16 months. Individual differences in cortisol baseline and reactivity levels over time were related to infant sex and maternal overcontrolling behaviors, underscoring the malleable and socially informed nature of early HPA axis functioning. Findings can inform prevention and intervention efforts to promote healthy stress regulation during infancy.

Longitudinal Connections of Maternal Supportiveness and Early Emotion Regulation to Children’s School Readiness in Low-Income Families

Maternal supportiveness and children’s emotion regulation are considered crucial for the development of school readiness, and enhancing both is particularly important for children from low-income families who are at higher risk for reduced school readiness. This study uses latent growth curve analysis to examine longitudinal connections between maternal supportiveness and toddler emotion regulation as predictors of children’s cognitive school readiness at age 5 and as mediators of the relation between family demographic risk and cognitive school readiness. The sample includes 1,258 mother–child dyads enrolled in the Early Head Start Research Evaluation project. Results support the hypothesized connections between initial and subsequent growth in maternal supportiveness and children’s emotion regulation with later cognitive school readiness. Children’s initial emotion regulation and growth in emotion regulation partially mediate the relation between initial maternal supportiveness and school readiness. Maternal supportiveness, but not emotion regulation, partially mediates the effects of demographic risk on school readiness. Tests of gender moderation indicate that model effect sizes in the relation between maternal supportiveness and emotion regulation are more robust for girls. Findings imply that enhancing early maternal supportiveness and children’s emotion regulation benefits children’s early learning readiness. Limitations of the study and future directions are considered as well.

Psychopathology and parenting: An examination of perceived and observed parenting in mothers with depression and PTSD

BACKGROUND The postpartum period represents a major transition in the lives of many women, a time when women are at increased risk for the emergence of psychopathology including depression and PTSD. The current study aimed to better understand the unique contributions of clinically significant postpartum depression, PTSD, and comorbid PTSD/depression on mother-infant bonding and observed maternal parenting behaviors (i.e., behavioral sensitivity, negative affect, positive affect) at 6 months postpartum. METHODS Mothers (n=164; oversampled for history of childhood maltreatment given parent studys focus on perinatal mental health in women with trauma histories) and infants participated in 6-month home visit during which dyads engaged in interactional tasks varying in level of difficulties. Mothers also reported on their childhood abuse histories, current depression/PTSD symptoms, and bonding with the infant using standardized and validated instruments. RESULTS Mothers with clinically significant depression had the most parenting impairment (self-report and observed). Mothers with clinically significant PTSD alone (due to interpersonal trauma that occurred predominately in childhood) showed similar interactive behaviors to those who were healthy controls or trauma-exposed but resilient (i.e., no postpartum psychopathology). Childhood maltreatment in the absence of postpartum psychopathology did not infer parenting risk. LIMITATIONS Findings are limited by (1) small cell sizes per clinical group, limiting power, (2) sample size and sample demographics prohibited examination of third variables that might also impact parenting (e.g., income, education), (3) self-report of symptoms rather than use of psychiatric interviews. CONCLUSIONS Findings show that in the context of child abuse history and/or current PTSD, clinically significant maternal depression was the most salient factor during infancy that was associated with parenting impairment at this level of analysis.

Forward progress of scientific inquiry into the early father-child relationship: Introduction to the special issue on very young children and their fathers

Research on fathering and the father-child relationship has made substantial progress in the most recent 15 years since the last special issue of the Infant Mental Health Journal on fathers and young children. This special issue on fathers and young children contains a series of papers exemplifying this progress, including advances in methodology-more direct assessment and more observational measures-in addition to the increasing dynamic complexity of the conceptual models used to study fathers, the diversity of fathers studied, and the growth of programs to support early father involvement. In assessing the current state of the field, special attention is given to contributions made by the papers contained in this special issue, and two critical areas for continued progress are addressed: (1) methodological and measurement development that specifically address fathers and fathering relationships and (2) cross-cultural and ecologically valid research examining the diversity of models of fathering.

EXAMINING LONG‐TERM EFFECTS OF AN INFANT MENTAL HEALTH HOME‐BASED EARLY HEAD START PROGRAM ON FAMILY STRENGTHS AND RESILIENCE

Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home-based Early Head Start (IMH-HB EHS) program on family functioning. The sample includes 152 low-income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH-HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH-HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH-HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH-HB EHS services are maintained after services cease.

Qualitative inquiry and family therapist identity construction through community-based child welfare practice

The Marriage and Family Therapy (MFT) field has discussed how to emphasize broader sociological contexts in family therapy practices (Hardy, 2001; Johnson, 2001; Sluzki, 2001) and education (McDowell & Shelton, 2002). As a way to bridge perceived fragmentation between MFT education and intensive clinical practice within larger sociological contexts, this article describes our experiences as five MFT therapist-interns and one clinical faculty (practicing as both therapist and supervisor) facilitating the Families in Transition (FIT) program, a community-based family reunification program offered through an accredited MFT training clinic. Qualitative action research methods (Greenwood & Levin, 2005) synthesizing feminist autoethnography (Allen & Piercy, 2005; Holman-Jones, 2005; Richardson & St. Pierre, 2005) were used to present an illustration of our struggle of knowing how to act as MFTs in the real-world context of child welfare.

African American Fathers’ Mental Health & Child Well-Being: A Cultural Practices, Strengths-Based Perspective

Black fathers, and specifically fathers who identify as African American, represent a group of parents who are at once not well understood and pervasively stereotyped in negative ways. In this chapter, we describe the risks and resilience of Black fathers and their children, with a special focus on mental health and coping with stress. We emphasize a cultural practices approach that takes into account both the risks specific to Black fathers’ capacity to parent their children and a theoretical foundation for understanding the inherent strengths of Black men and their families. Finally, we address the need for early childhood educators to partner with Black fathers as a means to best support children and their families.

Child Fatalities in New York City: An Assessment of Child Protective Service Practice

This article describes the results of two exploratory studies conducted in New York City that used reports of child fatality investigations conducted by the New York State Office of Children and Family Services. It describes the characteristics of children who died as a result of maltreatment and the quality of the child fatality investigations, risk and safety assessments, and protective services responses. Three groups are the focus: children who died while living with families not previously referred to the public child welfare agency; children who died while living with families previously referred to the public child welfare agency; and all children in foster care. The studies found that safety and risk assessments often were not conducted appropriately when children were initially reported to child protective services and when the safety of surviving siblings was at issue; there often was insufficient attention to the elevation of risk as a result of the presence of multiple risk factors in families; and foster parents often did not receive adequate information about health conditions that posed significant risks for children in their care. This article advances practice and policy recommendations for strengthening responses to families who are at high risk and identifies future research directions.

Creating communities: a consortium model for early childhood leaders

Abstract The current paper describes an urban university-anchored but community-based consortium of early childhood centers and community partners in a large Midwestern US city. The goal of the Consortium is to provide professional development opportunities that include networking, coaching, and collaboration as part of a community of practice (CoP) intended to improve program quality. Our findings suggest that early childhood center directors who are part of the Consortium describe benefits consistent with a CoP, specifically in terms of connection, resources, and community. Our findings also show that sense of community is associated with deeper engagement with the Consortium and program quality rating of the member center. Implications of the findings for future practice, especially in urban settings, are discussed.