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Biomedical subjects

S L Toth

Publications and source records attributed to S L Toth.

At least 19 recordsLinked to original sources
PubMed2001

Dissociation in maltreated versus nonmaltreated preschool-aged children.

OBJECTIVE: Dissociation is linked to the experience of child maltreatment for adults and for school-aged children. The goals of the current paper were: First, to extend existing research and examine the link between child maltreatment and preschool-aged children; and second, to examine which subgroups of maltreated preschoolers are most likely to evidence dissociation. METHOD: A well-validated measure of dissociation in children, The Child Dissociative Checklist (CDC; Putnam, Helmers, & Trickett, 1993), was utilized in a sample of low SES maltreated and nonmaltreated preschoolers (N = 198). A measure of internalizing and externalizing symptoms was also utilized. The maltreated children were assessed for sexual abuse, physical abuse, neglect, and also for severity, chronicity, and multiple subtypes of maltreatment. RESULTS: The sexually abused, physically abused, and neglected groups each demonstrated more dissociation than did the nonmaltreated group. Dissociation in the clinical (psychopathological) range was associated with physical abuse. Moreover, maltreatment severity, chronicity, multiple subtypes, and internalizing and externalizing symptomatology were each related to dissociation. CONCLUSIONS: Child maltreatment is a factor in dissociation in preschool-aged children as it is in older children and in adults. Sexual abuse, physical abuse, neglect, severity, and chronicity are all implicated. Developmentally sensitive interventions that look beyond comorbidity with behavioral symptoms for dissociative preschool-aged children are needed.

Analysis of Variance↗
PubMed2001

The development of dissociation in maltreated preschool-aged children.

Dissociation reflects disruptions in the integration of memories, perception, and identity into a coherent sense of self, and may develop following childhood maltreatment. The preschool years were identified as an important period for the development of dissociation. However, prior research has not examined the development of dissociation during this time. In order to address this gap, evidence of dissociation in 45 maltreated children, assessed for sexual abuse, physical abuse, and neglect, was compared with dissociation in 33 nonmaltreated children. Rather than depend on adult observer reports of behavior, the study sought to gain an understanding of dissociation from the child's own point of view. Because self-reports have limitations with such young children, a measure of dissociation evidenced in children's narrative story-stem completions was utilized. Maltreated children, especially physically abused children and sexually abused children, demonstrated more dissociation than did nonmaltreated children. Moreover, during the preschool period maltreated and nonmaltreated children followed different trajectories such that dissociation increased for maltreated children but did not do so for nonmaltreated children. Findings suggest that although the self is normatively integrated during the preschool period, it becomes increasingly fragmented for some maltreated children. Results are discussed in terms of cascading effects of maltreatment throughout development, and the importance of developmentally sensitive interventions.

Child Abuse↗
PubMed2000

The efficacy of toddler-parent psychotherapy for fostering cognitive development in offspring of depressed mothers.

The efficacy of Toddler-Parent Psychotherapy (TPP) as a preventive intervention for fostering cognitive development in the offspring of depressed mothers was evaluated. Mothers with major depressive disorder and their toddlers were randomly assigned to TPP (n = 43) or to a nonintervention group (n = 54) and compared to a control group (n = 61) of women with no current or past mental disorder. At baseline (age 20 months), the groups did not differ on the Bayley Mental Development Index. At post-intervention follow-up (age 3 years), a relative decline in IQ was found in the depressed nonintervention group, whereas the depressed intervention and the normal control groups continued to be equivalent, with higher WPPSI-R Full Scale and Verbal IQs. The worst outcome was found among nonintervention children whose mothers had subsequent depressive episodes. The results confirm the developmental risks faced by offspring of depressed mothers and support the efficacy of the preventive intervention in safeguarding successful cognitive development in at-risk youngsters.

Adult↗
PubMed2000

Affective, organizational, and relational characteristics of maltreating families: a systems perspective.

In-home structured interactions of 42 maltreating families (neglect: n = 12; physical abuse: n = 19; sexual abuse: n = 11) and 23 low-income comparison families with preschool-aged children were examined to determine whether maltreating and nonmaltreating families could be distinguished by system-level processes. Coding from videotapes of family interactions yielded ratings for affective, organizational, and relational features of each family unit. Results from family coding demonstrated that sexually abusive families had significantly more difficulties regulating anger, evidenced more chaos and less role clarity, and relied less on adaptive-flexible relationship strategies than nonmaltreating families. The importance of family climate and structure, above and beyond individual maltreatment acts, are high-lighted. Treatment and social policy implications and directions for future research in the family study of child maltreatment are discussed.

Affect↗
PubMed2000

Narrative representations of caregivers and self in maltreated pre-schoolers.

This study examined narrative representations of parents and of self, as well as child behavior during the assessment, in maltreated (N = 56) and demographically comparable non-maltreated (N = 37) pre-school-aged children in a one-year longitudinal study. Maltreated children evidenced more negative representations of parents and of self at Time 2, including the juxta-position of both a negative and a grandiose self. Over time there was a marginal interaction such that maltreated children portrayed fewer disciplining parent representations and nonmaltreated children portrayed more. Also over time, maltreated children portrayed marginally more grandiose self-representations and nonmaltreated children fewer. Furthermore, maltreated children demonstrated less responsivity to the examiner over time and nonmaltreated children demonstrated more. The deleterious effects of maltreatment on representations of self and of others, especially as development proceeds, are discussed, and the importance of providing attachment-informed intervention prior to the consolidation of these negative representations is highlighted.

Child Abuse↗
PubMed2000

Narrative representations of moral-affiliative and conflictual themes and behavioral problems in maltreated preschoolers.

Examined whether maltreated preschoolers are more likely than nonmaltreated preschoolers to have fewer moral-affiliative and more conflictual narrative representations and whether these representations mediate child behavior problems. A structured narrative story-telling task was administered to assess representations, and independent ratings of behavior problems were obtained from teachers. The narratives of maltreated children contained more conflictual and fewer moral-affiliative themes. Maltreated children also exhibited more internalizing and externalizing behavior problems. A partial mediation effect of conflictual representations on the relation between child maltreatment and externalizing behavior problems was found. The results demonstrate the relation between child maltreatment and children's organization of their life experiences and their behavioral symptomatology.

Child Abuse↗
PubMed1999

Maltreated and nonmaltreated preschoolers' conceptions of hypothetical and actual moral transgressions.

Maltreated and nonmaltreated preschoolers' (mean age = 4 years 6 months) judgments regarding hypothetical and actual moral transgressions were examined. Thirty-six maltreated children (17 physically abused and 19 neglected) and 19 comparison nonmaltreated children judged, justified, and evaluated affective responses to 6 hypothetical moral transgressions. Perpetrators and victims also judged and evaluated affective responses to actual classroom moral transgressions. All children evaluated moral transgressions as very serious, punishable, and wrong in the absence of rules. Moral judgments and justifications differed as a function of context (hypothetical vs. actual) and type of transgression but not maltreatment status. Affective responses differed as a function of maltreatment subtype and gender. Maltreated and nonmaltreated children may differ in the organization of their affective responses rather than in their moral evaluations.

Analysis of Variance↗
PubMed1999

Effect of maltreatment on preschoolers' narrative representations of responses to relieve distress and of role reversal.

A total of 80 low-socioeconomic status maltreated preschoolers were contrasted with 27 nonmaltreated preschoolers on their narrative representations. The children completed story stems, taken from the MacArthur Story-Stem Battery (MSSB; I. Bretherton, D. Oppenheim, H. Buchsbaum, R. N. Emde, & the MacArthur Narrative Group, 1990), that introduced stressful family situations. Using the MacArthur narrative coding manual (J. Robinson, L. Mantz-Simmons, J. Macfie, & the MacArthur Narrative Group, 1992), coders rated portrayals of parental and child character responses, as well as participant responses, to relieve children's distress. They also rated role reversal (children caretaking their parents) from the narrative emotion coding manual (S. L. Warren, L. Mantz-Simmons, & R. N. Emde, 1993). Maltreated preschoolers portrayed parents and children as responding less often--yet themselves as stepping into the story more often to relieve children's distress--than did nonmaltreated preschoolers. Abused children (sexually, physically, or both) portrayed the most participant responses, and neglected children (with no abuse) portrayed the fewest child responses. Role reversal was associated with physical abuse.

Child Abuse↗
PubMed1999

The efficacy of toddler-parent psychotherapy to increase attachment security in offspring of depressed mothers.

The efficacy of toddler-parent psychotherapy (TPP) as a preventive intervention for promoting secure attachment in the offspring of depressed mothers was evaluated, 63 mothers with major depressive disorder being randomly assigned to TPP (n = 27) or to a no treatment group (n = 36) and compared with a control group (n = 45) of women with no current or past mental disorder. At baseline, comparable and higher rates of attachment insecurity were found in the two depressed offspring groups as compared with the non-depressed control group. At the post-treatment follow-up, offspring in the intervention group attained rates of secure attachment that were comparable with those of youngsters in the non-depressed control group. In contrast, the children in the depressed control group continued to demonstrate a greater rate of attachment insecurity than children in the non-depressed control group. The findings support the efficacy of an attachment-theory based model of intervention for fostering developmental competence in the offspring of depressed mothers.

Adult↗
PubMed1998

Maternal depressive disorder and contextual risk: contributions to the development of attachment insecurity and behavior problems in toddlerhood.

Research has shown that offspring of depressed caregivers are at increased risk for maladaptive development and emotional difficulties. Specifically, infants and toddlers of depressed mothers have been shown to evidence higher percentages of insecure attachments and more behavioral difficulties than offspring of nondisordered mothers. However, even in studies that reveal significant differences between children of depressed and nondepressed caregivers, a substantial number of children with depressed caregivers do not evidence dysfunction. Such findings have resulted in increased attention to the broader social context in which children of depressed mothers develop. This investigation examined the direct influences of maternal depression on child development, as well as the role of contextual risks that may be particularly heightened in families with depressed parents. Toddlers with depressed mothers evidenced significantly more insecure attachments than did toddlers with nondisordered mothers, and this difference was not accounted for by contextual risk. In predicting child behavior problems, contextual risk was found to mediate the relation between maternal depression and child behavior problems. Father-report data on child behavior corroborated the mother report data. Results are discussed in terms of the diversity of functioning in offspring of depressed caregivers that can be attributed to varied levels of contextual risk accompanying depression.

Child Behavior Disorders↗
PubMed1998

Remembering, forgetting, and the effects of trauma on memory: a developmental psychopathology perspective.

A developmental psychopathology framework, with its emphasis on an interdisciplinary perspective, the interplay between work conducted with normal and atypical populations, and its focus on investigating functioning in multiple domains of development concurrently, possesses significant potential for advancing work on memory and trauma. A brief historical overview of memory and trauma is provided. Significant issues are highlighted that must be confronted in order to advance the understanding of the effects of trauma on memory and the utility of a developmental psychopathology perspective for informing research efforts is examined. The implications of a developmental psychopathology perspective for guiding research, clinical, and social policy initiatives of relevance to trauma and memory are discussed.

Child↗
PubMed1998

The development of depression in children and adolescents.

In recent decades, research on child and adolescent depression has proliferated. Currently, attention in the field is directed toward examining the epidemiology, causes, course, sequelae, and treatment response of children at risk for developing or presently experiencing depressive disorders. In this article, a developmental psychopathology approach is used to elucidate the development of depressive disorders, the diverse pathways that evolve, and the processes that contribute to varied outcomes. The developmental psychopathology perspective underscores the importance of moving beyond the identification of isolated aberrations in psychological and biological components of depressive presentations to the understanding of how those components have evolved and how they are integrated within and transact across biological, psychological, and social systems. Implications for prevention and intervention are addressed as is the importance of increasing the public awareness of depressive disorders and reducing the social stigma that interfere with the attainment of treatment for depressed persons.

Adolescent↗
PubMed1997

Affect, cognition, and the emergence of self-knowledge in the toddler offspring of depressed mothers.

Visual self-recognition was examined utilizing the mirror-rouge paradigm in a sample of 18- to 21-month-old toddlers of depressed (n = 91) and nondepressed (n = 43) mothers in regard to linkages with cognitive and affective development. Overall, attainment of self-recognition was not related to differences in level of cognitive development, pre-rouge affective expression, or maternal depression. However, children of depressed mothers who exhibited self-recognition were more likely than children of nondepressed mothers to display nonpositive affect and to shift affect from positive to nonpositive in the post-rouge condition. Within the group of children of depressed mothers, toddlers who did not evidence self-recognition and who shifted affect were lower in attachment security and had mothers with less positive affect characteristics. Also, self-recognition and affective instability were related to differences in cognitive developmental level among toddlers of depressed mothers. Findings are discussed in terms of implications for understanding the relations between affect and cognition and the influence of maternal depression on affective and cognitive development.

Adult↗
PubMed1997

Representations of self and other in the narratives of neglected, physically abused, and sexually abused preschoolers.

The MacArthur Story Stem Battery was used to examine maternal and self-representations in neglected, physically abused, sexually abused, and nonmaltreated comparison preschool children. The narratives of maltreated children contained more negative maternal representations and more negative self-representations than did the narratives of nonmaltreated children. Maltreated children also were more controlling with and less responsive to the examiner. In examining the differential impact of maltreatment subtype differences on maternal and self-representations, physically abused children evidenced the most negative maternal representations; they also had more negative self-representations than nonmaltreated children. Sexually abused children manifested more positive self-representations than neglected children. Despite these differences in the nature of maternal and self-representations, physically and sexually abused children both were more controlling and less responsive to the examiner. The investigation adds to the corpus of knowledge regarding disturbances in the self-system functioning of maltreated children and provides support for relations between representational models of self and other and the self-organizing function that these models exert on children's lives.

Child Abuse↗
PubMed1996

Patterns of relatedness, depressive symptomatology, and perceived competence in maltreated children.

An attachment theory framework is applied toward understanding the emergence of depressive symptomatology and lower perceived competence in maltreated and nonmaltreated children. Hypotheses that maltreated children with nonoptimal patterns of relatedness evidence elevated depressive symptomatology and lower competence, whereas nonmaltreated children with optimal or adequate patterns of relatedness exhibit the least depressive symptomatology and higher competence, were confirmed. Additionally, differentiations between maltreated children with and without optimal or adequate patterns of relatedness emerged, suggesting that relatedness may mitigate against the adverse effects of maltreatment. Moreover, sexually abused children with confused patterns of relatedness evidenced clinically significant depressive symptomatology. Results are discussed with regard to mechanisms that contribute to adaptation or maladaptation in children with negative caregiving histories.

Achievement↗
PubMed1995

A developmental psychopathology perspective on child abuse and neglect.

OBJECTIVE: The purpose of this review is to conceptualize child abuse and neglect within a developmental psychopathology perspective. Toward this end, issues of definition and epidemiology, etiology, and sequelae are addressed. METHOD: Research and theory on child abuse and neglect with relevance to a developmental perspective is reviewed. RESULTS: Considerable progress has been made in our understanding of the etiology and consequences of child abuse and neglect. Less progress has been made in utilizing this knowledge to inform treatment efforts. CONCLUSIONS: Incorporation of a developmental psychopathology perspective into efforts to understand and ameliorate the adverse effects of child abuse and neglect holds considerable promise for advancing research and intervention in the area of child maltreatment. The importance of providing comprehensive and coordinated services that incorporate knowledge of how maltreated youngsters negotiate stage-salient issues of development is stressed. The provision of child-focused treatment, parent-based models of intervention, and ecologically driven approaches to prevention all can benefit from an understanding of the adverse effects that maltreatment exerts on the process of development.

Adaptation, Psychological↗