Children's basic memory processes, stress and maltreatment

Building upon methods and research utilized with normative populations, we examine extant assumptions regarding the effects of child maltreatment on memory. The effects of stress on basic memory processes is examined, and potential neurobiological changes relevant to memory development are examined. The impact of maltreatment-related sequelae (including dissociation and depression) on basic memory processes as well as false memories and suggestibility are also outlined. Although there is a clear need for additional research, the investigations that do exist reveal that maltreated children's basic memory processes are not reliably different from that of other, nonmaltreated children

The efficacy of interpersonal psychotherapy for depression among economically disadvantaged mothers

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

Disorganized Attachment in Infancy: A Review of the Phenomenon and Its Implications for Clinicians and Policy-Makers

Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static trait of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions

A developmental psychopathology perspective on psychopathic traits in girls : the role of maltreatment, maternal responsiveness and emotional functioning.

Thesis (Ph. D.)--University of Rochester. Department of Clinical and Social Psychology, 2015.Psychopathic traits show well-documented associations with maltreatment (e.g., Lang, Klintegerg, & Alm, 2002; Weiler & Widom, 1996). However, the majority of research in this area has been based on adult male offenders, with less attention to female, youth or community samples. This dissertation sought to extend past work by examining the association between psychopathic traits and maltreatment among pre-adolescent girls from low-income, urban environments. This work aimed to determine whether the relationship between maltreatment and psychopathic traits would be moderated by maternal responsiveness, and whether emotional functioning could account for any observed associations. Finally, this study aimed to determine whether psychopathic traits would be related to externalizing or internalizing symptoms among this group. Seventy-three girls (M = 10.74, SD = 0.93) and their mothers completed a variety of self-report measures, interviews, and behavioral tasks. Maltreatment data was obtained from official records as well as interviews with mothers. Results provided limited support for the hypothesis that maltreatment and psychopathic traits would be related. Additionally, maternal responsiveness did not moderate the relationship between maltreatment and psychopathic traits. Importantly, different facets of psychopathic traits were related to different constructs. Affective/callous-unemotional traits were linked to lower empathy and lower anxiety. Higher interpersonal/narcissism traits were related to higher self-reported experience of negative affect, lower expression of anger, worry and sadness in a coded behavioral task after experiencing a disappointing event (when in the presence of another person), yet greater expression of anger when left by themselves. Finally, behavioral/impulsivity traits were associated with greater expression of worry/distress in the behavioral task, and higher levels of anxiety and depression. These preliminary findings require replication. Yet the results provide evidence that different facets of psychopathic traits are associated with distinct mental health correlates among pre-adolescent girls. Future studies should further investigate the developmental progression of these relationships to more clearly identify appropriate intervention points. These findings may help to inform clinical practice with young girls in high-risk communities

Preventive interventions and sustained attachment security in maltreated children : a 12-month follow-up of a randomized controlled trial

Thesis (Ph. D.)--University of Rochester. Dept. of Clinical and Social Sciences in Psychology, 2012.The stability of attachment security and behavior problems among maltreated children was investigated through a 12-month follow-up of a randomized preventive intervention trial. One-year-old maltreated infants (n = 137) and their mothers were randomly assigned to one of three intervention conditions (a) child-parent psychotherapy (CPP), (b) psychoeducational parenting intervention (PPI), and (c) community standard (CS). A fourth group of nonmaltreated infants (n =52) and their mothers served as a low-income normative comparison (NC) group. At baseline (Time 1), infants in the maltreatment groups had significantly higher rates of disorganized attachment than did infants in the NC group. Mothers in the maltreatment groups reported experiencing more traumatic events and were more likely to meet criteria for post-traumatic stress disorder (PTSD), mood disorders, and substance abuse and/or dependence than were mothers in the NC group. At post-intervention (Time 2), when the children were age 26 months, children in the CPP and PPI groups demonstrated substantial increases in secure attachment, whereas this change was not found in the CS and NC groups. At the 12-month follow-up assessment (Time 3), when the children were age 38 months, children in the CPP group had higher rates of secure attachment and lower rates of disorganized attachment than did children in the PPI or CS groups. Maternal history of childhood maltreatment predicted children’s disorganized attachment at Time 2 and Time 3 and maternal PTSD predicted insecure attachment at Time 2. Neither maternal trauma history nor maternal psychopathology influenced attachment when accounting for treatment effects at Time 2 or Time 3. Receipt of intervention had an indirect effect on maternal report of children’s behavior problems at Time 3 through the fostering of secure attachment at post-intervention

Affective expression and relationship cohesion between depressed mothers and their offspring: a longitudinal examination of the effects of child-parent psychotherapy

Thesis (Ph. D.)--University of Rochester. Department of Clinical and Social Sciences in Psychology, 2017.The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their depressed mothers on the following constructs: a) maternal affective expression, b) child affective expression, and c) the degree of cohesiveness within the mother-child dyad. Depressed mothers and their toddlers were randomized to receive CPP (DI; N = 66) or to a control group (DC; N = 64). Non-depressed mothers with no history of major mental illness and their toddlers (NC; N = 68) were recruited as an additional comparison group. Mother-child dyads were followed across three time points: Baseline (T1; 20 months), post-intervention (T2; 36 months), and follow-up (T3), when children were approximately 9 years of age. Data from a mother-child conflict task was coded as a measure of observed outcome variables. The roles of 1) post-intervention maternal self-efficacy and 2) post-intervention toddler attachment security were evaluated as mediators of the relationship between baseline group assignment on maternal and child affective expression and dyadic cohesion at T3. Post-intervention maternal self-efficacy did not mediate the association between baseline group assignment and maternal warmth or hostility at T3. However, T2 attachment security significantly mediated the association between baseline group assignment and T3 maternal warmth and child anger/problem behavior. As previously shown by Toth, Rogosch, Manly, and Cicchetti (2006), toddlers of depressed mothers who received CPP showed higher rates of secure attachment compared to those in both the DC and NC groups. In turn, mothers of children who were securely attached at T2 displayed higher levels of warmth during a mother-child conflict task at T3. Additionally, children who were securely attached to their mothers at T2 exhibited lower levels of anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and of the importance of attachment as a mediator of long-term outcomes are discussed