Edward Z. Tronick - US grants

The primary hypothesis to be tested in this project is that by 6 months of age infants respond to an interpersonal stress with specific coping strategies and specific emotional reactions. However, because a multiplicity of factors modify the infant's strategies, the following secondary hypotheses will also be examined: 1) that these specific reactions are affected by the infant's previous interpersonal history; 2) that they are affected by the infant's temperament; and 3) that 6 month olds exhibit stable individual differences in these reactions. To test these hypotheses, forty male and forty female 6 month old infants and their mothers will be subjects. At two sessions, separated by a week, they will experience a normal interaction followed by a stressful interaction followed by another normal interaction. The stressful interaction will be the mother acting still faced and unresponsive. The sessions will be videotaped. The infant's behavior will be scored from the tapes for coping strategies using Gianino's Self-Regulatory Scoring System (Gianino, 1982) and for affective displays using Izard's AFFEX system (Izard & Dougherty, 1982). The mother's behavior will be scored from the tapes for sensitivity using Ricks' Maternal Sensitivity and Responsivity Scales (Ricks, 1981). And infant tempeament will be assessed with Rothbart's Infant Behavior Questionnaire (Rothbart, 1981). Data will be analyzed using correlational techniques, analyses of variance, and lag sequential techniques to define differences between infant reactions to the normal and stressed interaction and to examine the relationship of those reactions to maternal sensitivity and temperament and to test their stability over time.

love /affection; parent offspring interaction; child care;

This is a preintervention study. Its specific aims are: (1) to provide and compare detailed descriptions of the caregiving behavior, affect and social interactions of mothers with high levels of depressive symptomatology and mothers with low levels of depressive symptomatology; (2) to describe and compare the impact f the caregiving of the two groups of mothers on their infants' behavior and affect during the first year of life; and (3) to evaluate the feasibility of intervention techniques aimed at primary prevention based on the findings from this project. The primary hypothesis to be evaluated is that the caregiving style of mothers with high levels of depressive symptomatology compromises their infants' affective and social development. To accomplish these aims, 50 mothers with high levels of depressive symptomatology will be compared to 50 mothers with low levels of symptomatology as assessed by a self-report measure. Aside from depressive symptomatology all the others will meet a set of low risk criteria. Repeated observations at 3, 6, and 2 months of infant age will be carried out on the interactions of the mothers and infants at home. Additionally, at 12 months the infants' security of attachment will be assessed in the Ainsworth Strange Situation and the infants' play interaction with a stranger will be evaluated. These home observations and the laboratory observations ill be videotaped. The results will then be used to develop primary prevention techniques.

The specific aims of this study are: (1) to provide and compare detailed descriptions of the affective behavior and face-to-face interactions of mothers with high levels of depressive symptomatology and mothers with low levels of depressive symptomatology; and (2) to describe and compare the influence of the behavior and effect of the two groups of mothers on their infants' behavior, affect, and developmental outcome during the first year of life. The primary hypothesis to be evaluated is that the behavioral and affective style of mothers with high levels of depressive symptomatology compromises their infants' affective and social development. Fifty mothers with high levels of depressive symptomatology and their infants will be compared to fifty mothers with low levels of depressive symptomatology and their infants. The mothers depressive symptomatology will be assessed by a self-report symptom scale. Aside from the proband mothers' depressive symptomatology, all mothers and their infants will meet a set of low-risk criteria. Face-to-face observations of normal play with the mother and a stranger and disruptive (still-face) interactions with the mother will be carried out in the laboratory at 3 and 6 months of infant age. Additionally, the infants' interactions with an unfamiliar adult and the infant's security of attachment will be assessed in the Ainsworth Strange Situation when the infants are 12 months old.

The goal of this grant is to evaluate the effects of intrauterine cocaine exposure on neuromotor development and functioning over the first year of life using kinematic analysis. Kinematic analysis, in this study a sophisticated system wedding infrared, video, and computer technology, is able to objectively and precisely quantify the parameters of movement that until recently could only by described in clinical terms. We expect that neuromotor dysfunction in the cocaine exposed infants compared to non-exposed infants will be evidenced by an increase in the number of component units making up a movement, aberrant patterns of velocities and accelerations, disruption and disorganization of the path of movement, and elongation of the natural pauses between movement phases. These effects are found to be associated with brain damage. The proposed study is a longitudinal prospective study of forty infants with documented intrauterine exposure to cocaine, and no other illicit substances, and a matched group of 40 infants with no history of exposure to illicit substances. All infants in the study will have had an uneventful neonatal course and will be above the 10th percentile for height, weight, and head circumference. In the neonatal period, their movement patterns will be assessed with kinematic analysis during the inanimate visual-auditory orientation item of the Neonatal Behavioral Assessment Scale (NBAS). At 7 and 15 months, infant movement patterns will be kinematically assessed during a reaching task. The infants will also be evaluated with the Movement Assessment of Infants at 7 months, and the Bayley Scales of Infant Development at 7 and 15 months.

The objective of this grant is to continue our longitudinal study of infants and mothers with either high, mid-range, or extremely low levels of depression on maternal and infant outcomes; b) longitudinal observations of naturally occurring maternal and infant interactive behavior are made in the home setting during the first year post partum; c) data on maternal and paternal depressive symptoms, psychiatric co-morbidities, and affective status are collected at each visit; and d) a separate group of mothers with extremely low levels of depressive symptoms is identified and followed. The primary hypotheses to be evaluated are that a) the behavioral and affective styles of mothers with either high or extremely low levels of depressive symptoms will differ from those of mothers with mid-range symptoms; b) patterns of infant behavior and affect will be related to maternal symptom levels; and c) the severity and chronicity of maternal symptoms will have negative effects on mother-infant interaction and infant outcomes. Our hypotheses are guided by the Mutual Regulation Model, which posits that infant development is dependent on the ongoing ability of the infant- caregiver dyad to regulate the infant~s affective states and to foster the infant~s ability to master the major developmental tasks of infancy. The naturally occurring behavior of mothers and infants is videotaped at home when infants are 3,6, and 12 months old. Additionally, infants and mothers are videotaped in the laboratory at 12 months during Ainsworth~s Strange Situation and infant-stranger play. Mothers~ diagnostic history is also obtained. At each age, mothers and fathers complete questionnaires regarding their current depressive symptoms, other psychiatric symptoms, and affective status. Infant and maternal behavior and affect are scored from the videotapes by masked, reliable coders using detailed coding systems. Multivariate techniques will be used to evaluate the hypotheses. Preliminary work and progress on this project has been substantial, and initial results support the hypotheses. This study will markedly increase our understanding of the effects of maternal depressive symptomatology and associated factors on mother-infant interaction and infant socio-emotional development during the first year.

There is no comprehensive standardized, normed assessment of neurobehavioral performance of normal Or high risk infants during the perinatal period. The specific aim of this project is to develop standardized norms for newborn neurobehavioral performance for gestational age (GA) groups and where appropriate, gender and/or race/ethnicity groups during the perinatal period using a uniquely comprehensive psychometrically sound scale, the Neonatal Intensive Care Research Network Neurobehavioral Scale (NNNS). Standardization of the NNNS will be a significant methodological advance for research in neonatology, pediatrics, pediatric neurology, and child development. It will provide norms to evaluate relations between neurobehavioral status and medical and social status variables, and to evaluate the effects of medical and developmental interventions (including changes in NICU ecology and early intervention) on neurobehavioral status during the perinatal period and at older ages. Furthermore, a standardized instrument will facilitate comparison of studies and the development of large data bases. Standardized norms will have a significant impact on clinical care because norms will identify neonates who are functionally abnormal or suspect and permit the evaluation of individual infants in comparison to the norms. We propose to carry out a prospective longitudinal study on a sample of 720 infants stratified by (1) GA: 1] 28-33 weeks; 2] 34-37 weeks; 3] 38-42 weeks; (2) 3 racial/ethnic groups (Black, Hispanic, White); and (3) gender. Within the boundaries of our exclusion criteria, the medical and social status of the infants will be free to vary. Infants in each GA group will be examined with the NNNS three times: 1] when medically stable +3 days or at Birth + 1 day, 2] Term (i.e., for the term group this is the same as Birth +1 day), and 3] at 44 weeks GA. Gestational age will be carefully defined using the converging measures.

Each day, infants confront a range of normal stressful social emotional events (e.g., waiting for their caregiver to respond to their needs). But do they remember these stressful events and for how long do they remember them? The goal of this project is to examine when young infants begin to remember events and for how long they can remember them. The event chosen for this experimental study is the a disruption of normal face to face social interaction between an infant and his/her mother called the still-face (SF) in which the mother looks her infant but does not respond to her infant's attempts to play with her. A wealth of studies has shown that the SF elicits a specific reaction in infants, characterized by a decrease in positive emotions of joy and interest and an increase in negative emotions of anger and sadness engagement, an increase in looking away from the mother and an increase in coping behaviors (e.g., thumb-sucking). Infants also evidence neurophysiologic signs of stress to the SF, such as an increase in heart rate and an increase in the stress hormone cortisol. But is this still face effect something that the infants remember?

In this study the PIs will observe the emotional, heart rate and cortisol reactions of 3, 4 and 5 month old infants to two exposures to normal face-to-face play and the still-face and compare their reactions at the second exposure to infants who had no prior experience with the still-face. The second exposure will occur at 1 day, 1 week or 1 month after the first exposure. Because contextual cues aid memory we will have the mothers wear a yellow smock when they are playing and doing the still-face with their infants. Our expectation is that infants in the experimental condition will exhibit evidence for memory for the SF by looking less at the mother, and by looking away sooner, and show more negative reactions and higher heart rates and hormonal reactivity than naive infants. These reactions will be stronger the short the interval between the first and second exposure and they will be stronger the older the infant.

Much of the stress infants experience in their daily lives is social in nature, and finding out how a social event affects memory, behavior, and physiology over the first months life will fill an important gap in our understanding of how normal infant cope with and remember a stressful events. The findings from this study will provide a useful framework for clinicians and others for understanding memory and reactivity in infants exposed to trauma, or parental abuse or neglect, with implications for the early development of psychopathology, intervention, and policy.

DESCRIPTION (provided by applicant): Since the introduction of event related potentials (ERPs) in developmental research, a great deal has been learned about the sensory and cognitive neurophysiologic processes of the non-verbal infant. The use of this non-invasive measure has informed us about early socio- emotional skills from infants'abilities to discriminate emotion expressions to their memory for faces and imitated acts. Although one can argue that seeing an angry or fearful face induces a certain amount of stress, the primary intention of this previous research has not been to evaluate infants'reactions to or memory of social stress. This gap in the literature exists even though there have been rapid advancements in our understanding of infant social capacities and their reactions to social stress. The proposed project aims to develop an ERP paradigm to examine infants'response to and memory of a socially stressful interaction, the Face-to-Face Still Face (FFSF) paradigm. This proposal will make a significant contribution to the field because it serves as a first step in addressing the gap in the literature by exploring the neurophysiologic indices of infants'memory of everyday social stress. Ultimately this paradigm and the data generated by this R21 will be used to propose a R01. One of the primary methodological issues to overcome in integrating these two experimental approaches is that ERPs studies require a large number of short, discrete trials in order to isolate important neural responses from artifacts in the EEG signal. The FFSF paradigm, however, is a live, continuous interaction between the mother and her infant. These differences make bringing both paradigms together challenging. In the initial paradigm, infants will be separated into an experimental or a control typical-play group. The experimental group will be exposed to the FFSF paradigm. The next day infants will participate in an ERP task. We will examine ERP components and we hypothesize that there will be differences between the two groups if infants in the experimental group remember the social stressor. The uniqueness of this project allows for exploratory questions to be asked of the ERP data. Specifically we will address what currently is unclear, the impact of the interactive social stressor as seen in the ERP waveform. Developing this measure will be of significance for understanding how stressful experiences are memorialized early in development and will provide a paradigm for evaluating the long- term impact of stressors on the developing social brain and on typical and atypical development, a significant goal of the NIH mission. PUBLIC HEALTH RELEVANCE: The proposed project is unique in developing a neurophysiologic measure of infant memory of a socially stressful interaction. Understanding infants'memory for social stressors may help us to better understand their role in the development of behavioral and physiological regulatory systems, differences among well and at-risk infants (e.g., infants with white matter disorder), and the consequences of typical and atypical parenting, including the effects of parental affective disorders and infant neglect. Such knowledge will help inform intervention strategies for infants'whose memories have the potential to distort and derail their development.

The quality of infants' social experiences over the course of development affects most aspects of their developing self. One of the biggest contributors to infant social experience is the mother. This is especially true in coping with stressful situations. Mothers' ability to regulate their own emotions and behaviors in stressful situations influences infants' ability to regulate their own stress reactions. This project aims to explore this relationship by introducing a moderate stressor experimentally to both mothers and their infants. Of interest is how maternal stress affects maternal self-regulation, infants' regulation, and the subsequent interaction between the two.
To address this question, 160 mother-infant dyads will be randomly assigned to one of two stress conditions, maternal stress or non-stress. To begin, all dyads will first participate in typical face-to-face play to assess individuals' and dyads' baseline behavior and physiology. Next, depending upon condition, mothers will hear either infant distress cries (maternal stressor) or positive vocalizations. Then, infants will be stressed using a standard approach called the Face-to-Face Still-Face paradigm in which the adult remains still and non-reactive while facing the infant. This project will assess whether the induced maternal stress predicts maternal, infant, and dyadic stress reactions during and following the infant stressor.
Raising a child in today's fast-paced and often chaotic society can prove daunting for most mothers. This project will introduce a reliable, innovative approach to manipulating maternal stress in an effort to better understand differences in maternal stress regulation. Results from this project will better inform intervention strategies by helping to identify mothers who are more vulnerable to stress and who, as a result, engage in less healthy stress regulation interactions with their infants thereby compromising the infant's capacity for healthy emotion regulation and social development.