Susan Dickstein

Levels of family assessment: II. Impact of maternal psychopathology on family functioning.

The association of maternal and contextual risk factors with whole-family, marital, and parent-child levels of family functioning was examined. Matemal mental illness and multiple contextual risk best predicted whole-family functioning, but each was related to marital and parent-child levels as well. Nonspecific indicators of maternal illness, rather than diagnostic category, were the better predictors of family functioning. The multiple contextual risk index was the variable most associated with all levels of family functioning, more so than any indicator of maternal illness. These results indicate (a) that maternal mental illness and family functioning are strongly associated and (b) that variation in the conceptualization and measurement strategy for risk and family functioning affects the conclusions of research. The importance of clear conceptualization of family levels and psychopathology risk in families of young children is discussed.

Showing and telling about emotions: Interrelations between facets of emotional competence and associations with classroom adjustment in Head Start preschoolers

In this study of low income preschoolers (N =  60), we examined relations between three facets of emotional competence: emotion knowledge, level of negative emotion expression, and emotion regulation; and their associations with indicators of classroom adjustment. Emotion knowledge was positively related to positive emotion regulation but was not related to negative emotion expression or negative dysregulation. Negative emotion expression related to emotion regulation variables in expected directions. Negative emotion expression was associated with aggression and social skills after covarying verbal ability, age, and emotion knowledge. Negative dysregulation was related in expected directions to aggression, anxiety, and social skills after covarying verbal ability, age, emotion knowledge, and negative emotion expression. Positive emotion regulation was related negatively to anxiety and positively to social skills after covarying all other variables in the model. Results are discussed with regard to using the emotional competence domain to understand how emotion processing relates to early childhood adjustment.

Social Referencing in Infancy: A Glance at Fathers and Marriage.

Social referencing refers to the tendency of a person to look to a significant other in an ambiguous situation in order to obtain clarifying information. The aims of the study were to assess the extent to which infants use fathers as referencing targets, and to assess the familial context that might mediate referencing to both parents. 40 11-month-old infants were observed once with their mothers and once with their fathers in a 15-min social referencing situation that involved entrance of a female stranger as the ambiguous stimulus. Infants used their fathers and mothers as referencing targets to an equal extent. Additionally, marital satisfaction was found to be a significant modifier of referencing. A hierarchical regression analysis indicated that paternal marital satisfaction predicted social referencing to fathers as well as to mothers; no effect was found for maternal marital satisfaction alone. This suggests that in order to better understand early socioemotional development, it is necessary to consider the interdependence among various relationships within the family.

Family functioning in young children with cystic fibrosis: observations of interactions at mealtime.

ABSTRACT. This study examined family functioning at mealtime, a context relevant to the management of cystic fibrosis (CF). Thirty-three families of children with CF and a control sample of 33 families of children without a chronic illness were assessed. Family functioning was rated during a videotaped dinner using the McMaster Mealtime Interaction Coding System (MICS), and mealtime behavioral problems were assessed using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Ratings for families of children with CF were lower than for control families on overall functioning and five of six MICS dimensions (Communication, Interpersonal Involvement, Behavior Control, Affect Management, Roles). In families of children with CF, better family functioning was related to less frequently occurring mealtime behavioral problems (BPFAS); however, family functioning was not related to the childs weight status or the childs caloric intake. Data support that nutritional intervention may be maximized if dietary adherence is promoted in the context of positive parent-child and family interactions.

Infant colic and maternal depression

The combined impact of infant colic and maternal depression on infant, parent, and family difficulties was examined. The sample included 93 consecutive patients seen at an outpatient Colic Clinic. Most mothers had private insurance and completed high school. Infants were approximately 2 months of age. Questionnaires completed by the mother prior to treatment onset were used to measure depressive symptoms in the mothers, infant cry, sleep and temperament, characteristics, parenting stress, maternal self-esteem, social support, and family function. Moderate to severe depressive symptoms were reported by 45.2% of the mothers. More severe depressive symptoms in the mothers were related to fussy/difficult infant temperament, more parenting stress, lower parental self-esteem, and more family-functioning problems. Pediatric health care providers need to be aware that the combined effects of colic and maternal depression can be problematic for the family. ©2005 Michigan Association for Infant Mental Health.

Recognizing young children in need of mental health assessment: Development and preliminary validity of the early childhood screening assessment

The Early Childhood Screening Assessment (ECSA) is a primary care screening measure developed to identify very young children (1½-5 years old) who need further emotional or behavioral assessment. The ECSA was developed specifically to meet the logistical constraints of primary care settings. This study assessed the preliminary psychometric properties of the ECSA by comparing it with extant validated measures of young childrens emotional and behavioral development, comparing it with a diagnostic interview, and measuring test-retest reliability. In the study, 309 mothers in two primary care clinics completed the ECSA and the Child Behavior Checklist (CBCL; T. Achenbach & L. Rescorla, 2000). A subset (n = 69) also completed the Diagnostic Interview for the Preschool Age (DIPA; M. Scheeringa & N. Haslett, 2010). ECSA score correlated significantly and strongly with the CBCL Total Problem T score (Spearmans rho = 0.86, p ⩽ .01). The ECSA was 86% sensitive and 83% specific in identifying DIPA diagnoses. Internal consistency of the ECSA was 0.91. Test-retest reliability at 10 days was excellent (Spearmans rho = 0.81, p ⩽ .01). The ECSA is an easy-to-use screening measure that demonstrates strong convergent validity, criterion validity, and test-retest reliability in the pediatric setting. It shows potential as a feasible and psychometrically strong tool for busy primary care providers to identify preschoolers who need further socioemotional assessment.

Family routines and rituals--the importance of family functioning: comment on the special section.

This diverse collection of papers highlights routines and rituals in family life. Just as individual family members bring unique styles and perspectives to the family table, to be incorporated into a family framework, so do each of these papers present rich and varied research questions, designs, and measurement strategies that enrich our understanding of family routine behavior patterns and ritual meanings. This series adds to our conceptualization of family routines and rituals within a systems perspective highlighting: 1) families are comprised of multiple levels that operate individually; interact with each other; and as a whole, reveal properties distinct from separate parts; 2) families tend toward stability in meaningful patterns of functioning; and 3) family functioning has meaning for individual outcomes.

Attachment patterns across multiple family relationships in adulthood: Associations with maternal depression

We explored attachment in a family context by applying family systems principles to the investigation of multiple attachment relationships within families. This study focused on maternal adult attachment with respect to family of origin experiences (assessed using the Adult Attachment Interview [AAI]) as well as maternal marital attachment (assessed using the Marital Attachment Interview [MAI]). We examined associations between maternal adult attachment (or marital attachment) and three levels of family functioning including individual maternal depression symptoms, dyadic marital satisfaction (reported by mothers), and family unit functioning. We also examined associations between combined attachment security (consistent secure, AAI secure/MAI insecure, AAI insecure/MAI secure, and consistent insecure) and family outcomes. Finally, we assessed the extent to which attachment representations operate differently in the context of family stress, namely maternal depression. We found that attachment security with respect to particular relationships was differentially associated with different levels of family functioning. Examination of the security of combined adult and marital attachment further supported the multilevel organization of the family system.

Child-Focused Versus School-Focused Sociometrics: A Challenge for the Applied Researcher

We explored the feasibility and usefulness of collecting peer sociometric data on a sample of children from across southeastern New England who were being followed in a community-based longitudinal study. Applying what has typically been a school-focused research methodology to this child-focused follow-up highlighted challenges faced by applied researchers wanting to make use of this powerful method for assessing social adjustment in their school-aged participants. It also allowed us to conduct a “real-world” test of the 1998 sociometric sampling study by Terry et al., who concluded that valid sociometric data can be obtained from a small pool of classroom peers. Through presentation of our efforts to obtain sociometric data on 57 target children and the results of these child-focused sociometrics, we illustrate and discuss the methodological and pragmatic issues surrounding the use of child-focused (in contrast to the more typical school-focused) approach to sociometrics. School consent for child-focused sociometrics was the most formidable challenge to successful data collection in this study. In our discussion we present new data from a child-focused sociometric assessment of psychiatrically hospitalized children that demonstrate how emphasizing the clinical relevance of these data can help clinicians and applied researchers better address this particular challenge.

Biobehavioral Indices of Emotion Regulation Relate to School Attitudes, Motivation, and Behavior Problems in a Low-Income Preschool Sample

Abstract:  Effective emotion regulation may promote resilience and preschool classroom adjustment by supporting adaptive peer interactions and engagement in learning activities. We investigated how hypothalamus‐pituitary‐adrenal axis (HPA) regulation, cardiac reactivity, and classroom emotion displays related to adjustment among low‐income preschoolers attending Head Start. A total of 62 four‐year‐olds completed a laboratory session including a baseline soothing video; emotion‐eliciting slides/video clips, and recovery. Salivary cortisol, heart rate, and vagal tone were measured throughout. Independent coders used handheld computers to observe classroom emotion expression/regulation. Teachers rated child motivation, persistence/attention, learning attitudes, and internalizing/externalizing symptoms. Results reveal associations between biobehavioral markers of regulatory capacity and early school adjustment.