Jamie M. Lawler

Disinhibited social engagement in postinstitutionalized children: differentiating normal from atypical behavior.

The most commonly reported socially aberrant behavior in postinstitutionalized (PI) children is disinhibited social engagement (DSE; also known as indiscriminate friendliness). There is no gold standard for measurement of this phenomenon nor agreement on how to differentiate it from normative behavior. We adopted a developmental psychopathology approach (Cicchetti, 1984) to study this phenomenon by comparing it to normative social development and by studying its patterns over time in 50 newly adopted PI children (16-36 months at adoption) compared with 41 children adopted early from foster care overseas and 47 nonadopted (NA) controls. Using coded behavioral observations of the childs interaction with an unfamiliar adult, atypical behaviors were differentiated from normative behaviors. Principal components analysis identified two dimensions of social disinhibition. The nonphysical social dimension (e.g., initiations, proximity) showed wide variation in NA children and is therefore considered a typical form of sociability. Displays of physical contact and intimacy were rare in NA children, suggesting that they represent an atypical pattern of behavior. Both adopted groups demonstrated more physical DSE behavior than NA children. There were no group differences on the nonphysical factor, and it increased over time in all groups. Implications for understanding the etiology of DSE and future directions are discussed.

Improving Maternal Representations in High-Risk Mothers: A Randomized, Controlled Trial of the Mom Power Parenting Intervention

A key mechanism of risk transmission between maternal risk and child outcomes are the mother’s representations. The current study examined the effects of an attachment-based, trauma-informed parenting intervention, the Mom Power (MP) program, in optimizing maternal representations of high-risk mothers utilizing a randomized, controlled trial design (NCT01554215). High-risk mothers were recruited from low-income community locations and randomized to either the MP Intervention (n = 42) or a control condition (n = 33) in a parallel design. Maternal representations were assessed before and after the intervention using the Working Model of the Child Interview. The proportion of women with balanced (secure) representations increased in the MP group but not in the control group. Parenting Reflectivity for mothers in the treatment group significantly increased, with no change in the control condition. Participation in the MP program was associated with improvements in a key indicator of the security of the parent–child relationship: mothers’ representations of their children.

Bidirectional effects of parenting and child behavior in internationally adopting families

Adoption marks a radical transition in caregiving for thousands of children adopted internationally from institutional care; however, very little is known about the quality of this parenting compared with other populations or the transactional effects of parent and child characteristics in postadoption families during the transition to family care. The current study examined parental sensitivity/responsiveness and structure/limit-setting in a group of 68 children adopted internationally from institutions (41 girls, 27 boys; M age = 26.13 months, SD = 4.99) and their parents over the first year after adoption and compared them to a sample of nonadoptive families (26 girls, 26 boys; M age = 27.65 months, SD = 5.71). Results indicated no mean-level differences in parenting quality on either dimension between adoptive and nonadoptive parents. For postinstitutionalized youth, higher quality parental structure and limit-setting soon after adoption predicted reduced child regulation difficulties 8 months later; however, initial child regulation did not predict later parenting. There were no cross-lagged relations for parental sensitivity/responsiveness. Higher quality preadoptive care for children was associated with higher scores on both sensitivity/responsiveness and structure and limit-setting among adoptive parents. Less growth stunting, indicative of less preadoptive adversity, was associated with parents’ use of more effective structure and limit-setting behaviors. Policies should promote better preadoptive care abroad, such as lower caregiver-child ratios, as well as early adoption. At least in families exhibiting generally high sensitivity/responsiveness, interventions should target parental structure and limit-setting to have the greatest effect on child behavioral regulation in the immediate years postadoption.

Wearable sensors detect childhood internalizing disorders during mood induction task

There is a significant need to develop objective measures for identifying children under the age of 8 who have anxiety and depression. If left untreated, early internalizing symptoms can lead to adolescent and adult internalizing disorders as well as comorbidity which can yield significant health problems later in life including increased risk for suicide. To this end, we propose the use of an instrumented fear induction task for identifying children with internalizing disorders, and demonstrate its efficacy in a sample of 63 children between the ages of 3 and 7. In so doing, we extract objective measures that capture the full six degree-of-freedom movement of a child using data from a belt-worn inertial measurement unit (IMU) and relate them to behavioral fear codes, parent-reported child symptoms and clinician-rated child internalizing diagnoses. We find that IMU motion data, but not behavioral codes, are associated with parent-reported child symptoms and clinician-reported child internalizing diagnosis in this sample. These results demonstrate that IMU motion data are sensitive to behaviors indicative of child psychopathology. Moreover, the proposed IMU-based approach has increased feasibility of collection and processing compared to behavioral codes, and therefore should be explored further in future studies.

Mom Power: A Parenting Group Intervention for Mothers with Trauma Histories

Unresolved trauma and mental health problems have significant effects on parenting quality and child outcomes, thus, there is a critical need for targeted, preventive interventions for mothers with experiences of trauma and psychopathology. This chapter describes the Mom Power program, a time-limited, attachment-based, parenting and self-care group intervention for mothers with histories of trauma. In this chapter, we discuss the theoretical underpinnings and conceptual framework for this intervention, describe the intervention itself and evidence for effectiveness, and conclude with a case vignette.

MIXED‐METHODS EVALUATION OF PARTICIPANT RECRUITMENT AND RETENTION IN THE MOM POWER PARENTING INTERVENTION PROGRAM

Parenting group success begins with attendance. Using archival pilot data from 99 mothers who enrolled in the Mom Power (MP) parenting intervention, this study sought to understand the factors that influenced participant engagement and retention. MP is a group-based, early intervention program grounded in attachment theory that utilizes motivational interviewing as a core component to enhance program engagement. Study aims were to qualitatively describe the reasons why mothers were interested in participating in the program, including what they hoped to gain from the experience, and to quantitatively examine the extent to which attendance was associated with demographic, experiential, and psychosocial factors. The qualitative analysis of intake interviews revealed that mothers expected the MP intervention to provide a warm environment for themselves and their children as well as to support and enhance their parenting, and 95% revealed their hopes that the intervention would help them grow and develop as women. Attendance rates were relatively high, with 62% of mothers missing less than one group session. Quantitative analyses using multiple regression to test associations of demographic, experiential, and psychosocial factors with attendance rates were not significant. Results suggest that motivational interviewing may be an important component in promoting participant engagement efforts in parenting interventions.

A Collaborative Process for Evaluating Infant Mental Health Home Visiting in Michigan

This column describes an innovative collaboration in Michigan that could serve as a model for meaningful community-university-state partnerships. Recent legislation in Michigan threatened the infant mental health home visiting program, a service for Medicaid-eligible infants, toddlers, and families affected by mental illness. The University of Michigan is overseeing two major studies in collaboration with the Michigan Department of Health and Human Services, the Michigan Association for Infant Mental Health, the Michigan Infant Toddler Research Exchange faculty network, and community health service providers to determine the evidence base for the program and ensure its future success.

Caregiver-Child Relationships in Early Childhood: Interventions to Promote Well-Being and Reduce Risk for Psychopathology

Purpose of ReviewEarly caregiver-child relationships are foundational to early development and central to efforts to promote well-being and prevent psychopathology. We discuss the role of caregiver-child relationships in early development and risk for psychopathology, and psychotherapeutic interventions targeting early caregiver-child relationships.Recent FindingsEarly risk for psychopathology is conferred through the dynamic interaction of biological and environmental factors, with sensitive caregiving playing a critical role. Recent research suggests that quality of caregiving moderates the effect of a child’s genetic risk for psychopathology. The protective role of sensitive caregiving is especially vital in the context of stress and trauma. Caregiver-child psychotherapeutic interventions are effective in increasing the rates of secure attachment and sensitive caregiving, and reducing early psychopathology. Emerging evidence suggests some interventions may be associated with changes to parents’ neural circuitry that underlies sensitive caregiving.SummaryRelationship-based psychotherapeutic interventions are promising in the promotion of well-being and prevention of psychopathology in at-risk families.

Maltreated Children and Their Families in Juvenile Dependency Court II: Maltreatment Recidivism

The most serious maltreatment cases are referred to Juvenile Dependency Court. Eighty-eight court records were coded for factors related to maltreatment recidivism, including prior involvement histories, differential response, and placement changes. Seventy-two percent of caregivers had previous involvement, which correlated with family size and number of presenting concerns. When caregivers were offered voluntary services previously, 15% were completed. Children of substance-abusing caregivers were more likely to have prior involvement with the system. On average, children experienced four placement changes. Almost half of children reunified with caregivers had to be removed by the court. Recommendations and future directions are discussed.