Elizabeth A. Skowron - US grants

[unreadable] DESCRIPTION (provided by applicant): While child maltreatment affects almost 1 million children each year, and constitutes a serious public health problem in the U.S., evidence from meta-analysis suggests that interventions for child maltreatment do little to strengthen the quality of interactions between maltreating parents and their children. We propose to study patterns of interactive synchrony, rupture, and repair in transactions between maltreating mothers and their preschool children in order to improve the identification of child risk for negative self-regulatory and behavioral outcomes, and facilitate prescriptive matching of early interventions to specific types of disruptive interactions in maltreating mother-child dyads. The sample consists of 250 mothers and their 3-5 year old children. One hundred-fifty (150) maltreating mother-child dyads will be drawn from Children & Youth Service agencies (i.e., mothers identified as perpetrators of physical abuse or neglect, and representing a range of maltreatment severity). One hundred (100) non-maltreating mother-child dyads matched on key socio-demographics will also participate. Mother-child interactions during a series of unstructured and compliance tasks will be assessed during a home visit and subsequent laboratory session, and coded via the Structural Analysis of Social Behavior (SASB) for extent of interactive coordination, and patterns of relationship rupture and repair. Physiological and behavior measures of regulation (i.e., emotion regulation, baseline cardiac vagal tone, vagal regulation, behavioral control), and problem behavior will be collected from children. Neurophysiological and survey-based indices of parent regulation (i.e., baseline cardiac vagal tone, vagal regulation, effortful control) will also be obtained. Analyses will be used to (1) empirically determine classes of dyadic interactive coordination, rupture, and repair in maltreating dyads that distinguish subtype and level of maltreatment severity; assess (2) relations between mother-child interactions and child emotion regulation and behavior; and (3) examine relations among parent regulation, dyadic interactions, maltreatment, and child outcomes. This innovative project addresses gaps in the maltreatment literature by: (a) examining patterns of parent-child interactive coordination associated with severity and subtype of maltreatment; (b) combining neurophysiological and behavioral assessment of emotion regulation in maltreating mothers and their preschool children; (c) using advanced micro-analytic coding technologies and state-of-the-art statistical methods to model patterns of interactive synchrony, rupture, and repair that unfold over time in the sequential interactions between maltreating mothers and their preschool children; and (d) examining the bi-directional influence of mother and child during these inter- changes. Following conclusion of this project, we plan to develop testable interventions to target specific patterns of interactive disruption in maltreating families. [unreadable] [unreadable] [unreadable]

7. Project Summary/Abstract Child maltreatment (CM) constitutes a serious public health problem in the United States1 and is known to compromise children's developing self-regulation skills and amplify risk for substance use and other regulatory disorders. Parents are implicated in more than 80% of CM cases involving physical abuse and neglect and thus represent critical targets of intervention. Research on the physiological response of CM parents during parenting suggests that parenting interventions may be less effective with this population2 because they fail to affect the neurobehavioral markers of dysregulation that drive harsh, aversive parenting. Parent?Child Interaction Therapy (PCIT), an intensive, 20-session parenting intervention, has been shown to improve the quality of CM parenting, improve positive parenting and child behavior, and produce declines in CM recidivism,3,4 though the mechanisms underlying its effects are little understood. On the basis of its live- coached, moment-by-moment scaffolding of positive parenting, we theorize that PCIT builds regulatory strength in parents, which then supports lasting behavior change. Use of bug-in-the-ear technology?unique to PCIT?provides parents with immediate access to therapist reinforcements for positive parenting that work to counter parents' heightened physiological arousal, inhibit (prepotent) aversive responding, and support greater use of (nondominant) positive parenting behavior. This study is designed to extend the collective work of our investigative team. It uses an experimental intervention design as a vehicle for testing a causal model of change in neurobehavioral indices of self-regulation. Specifically, we propose to conduct a randomized, controlled trial of PCIT for CM and test the effects of PCIT on self-regulation and behavior in CM parents and their elementary-school children. Two hundred-fifty (250) maltreating mothers and their children (age 5?8 years) will be drawn from Child Protective Services and randomized to the PCIT intervention or a control condition (services as usual). Key contextual risk factors will be assessed, including cumulative risk, parent mental health, and parent substance use. A multirater, multimethod approach to assessment will include neural (EEG/ERP), physiological (ECG), behavioral, and self-report measures of self-regulation in CM mothers and their children, as well as standard measures of parenting skills and children's behavior outcomes. Families will be followed at 6 months for self-regulation, parenting, and child behavioral outcomes, and to 1 year for CM recidivism. Findings from this proposed study are expected to have significant implications for optimizing CM parenting interventions by (a) determining the sensitivity of CM parent and child neurobehavioral self-regulation systems to intervention, and (b) identifying individual differences in self-regulation that mediate and moderate response to intervention and long-term maintenance of gains.

DESCRIPTION (provided by applicant): Child maltreatment (CM) constitutes a serious public health problem in the United States1 and is known to compromise children's developing self-regulation skills and amplify risk for substance use and other regulatory disorders. Parents are implicated in more than 80% of CM cases involving physical abuse and neglect and thus represent critical targets of intervention. Research on the physiological response of CM parents during parenting suggests that parenting interventions may be less effective with this population2 because they fail to affect the neurobehavioral markers of dysregulation that drive harsh, aversive parenting. Parent-Child Interaction Therapy (PCIT), an intensive, 20-session parenting intervention, has been shown to improve the quality of CM parenting, improve positive parenting and child behavior, and produce declines in CM recidivism,3,4 though the mechanisms underlying its effects are little understood. On the basis of its live- coached, moment-by-moment scaffolding of positive parenting, we theorize that PCIT builds regulatory strength in parents, which then supports lasting behavior change. Use of bug-in-the-ear technology-unique to PCIT-provides parents with immediate access to therapist reinforcements for positive parenting that work to counter parents' heightened physiological arousal, inhibit (prepotent) aversive responding, and support greater use of (nondominant) positive parenting behavior. This study is designed to extend the collective work of our investigative team. It uses an experimental intervention design as a vehicle for testing a causal model of change in neurobehavioral indices of self-regulation. Specifically, we propose to conduct a randomized, controlled trial of PCIT for CM and test the effects of PCIT on self-regulation and behavior in CM parents and their elementary-school children. Two hundred-fifty (250) maltreating mothers and their children (age 5-8 years) will be drawn from Child Protective Services and randomized to the PCIT intervention or a control condition (services as usual). Key contextual risk factors will be assessed, including cumulative risk, parent mental health, and parent substance use. A multirater, multimethod approach to assessment will include neural (EEG/ERP), physiological (ECG), behavioral, and self-report measures of self-regulation in CM mothers and their children, as well as standard measures of parenting skills and children's behavior outcomes. Families will be followed at 6 months for self-regulation, parenting, and child behavioral outcomes, and to 1 year for CM recidivism. Findings from this proposed study are expected to have significant implications for optimizing CM parenting interventions by (a) determining the sensitivity of CM parent and child neurobehavioral self-regulation systems to intervention, and (b) identifying individual differences in self-regulation that mediate and moderate response to intervention and long-term maintenance of gains.