Building bridges and crossing them: translational research in developmental psychopathology.
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Chronic Disease↗
Biomedical subjects
Sheree L Toth
Publications and source records attributed to Sheree L Toth.
Fostering secure attachment in infants in maltreating families through preventive interventions.
The malleability of insecure and disorganized attachment among infants from maltreating families was investigated through a randomized preventive intervention trial. Findings from research on the effects of maltreatment on infant attachment were incorporated into the design and evaluation of the intervention. One-year-old infants from maltreating families (N = 137) and their mothers were randomly assigned to one of three intervention conditions: (a) infant-parent psychotherapy (IPP), (b) psychoeducational parenting intervention (PPI), and (c) community standard (CS) controls. A fourth group of infants from nonmaltreating families (N = 52) and their mothers served as an additional low-income normative comparison (NC) group. At baseline, mothers in the maltreatment group, relative to the nonmaltreatment group mothers, reported greater abuse and neglect in their own childhoods, more insecure relationships with their own mothers, more maladaptive parenting attitudes, more parenting stress, and lower family support, and they were observed to evince lower maternal sensitivity. Infants in the maltreatment groups had significantly higher rates of disorganized attachment than infants in the NC group. At postintervention follow-up at age 26 months, children in the IPP and PPI groups demonstrated substantial increases in secure attachment, whereas increases in secure attachment were not found for the CS and NC groups. Moreover, disorganized attachment continued to predominate in the CS group. These results were maintained when intent to treat analyses were conducted. The findings are discussed in terms of the utility of translating basic research into the design and evaluation of clinical trials, as well as the importance of preventive interventions for altering attachment organization and promoting an adaptive developmental course for infants in maltreating families.
Adolescent↗
Cognitive and emotional differences in young maltreated children: a translational application of dynamic skill theory.
Through a translational approach, dynamic skill theory enhances the understanding of the variation in the behavioral and cognitive presentations of a high-risk population-maltreated children. Two studies illustrate the application of normative developmental constructs from a dynamic skills perspective to samples of young maltreated and nonmaltreated children. Each study examines the emotional and cognitive development of maltreated children with attention to their developing world view or negativity bias and cognitive skills. Across both studies, maltreated children demonstrate negativity bias when compared to their nonmaltreated counterparts. Cognitive complexity demonstrated by the maltreated children is dependent upon a positive or negative context. Positive problem solving is more difficult for maltreated children when compared to their nonmaltreated counterparts. Differences by maltreatment type, severity, timing of the abuse, and identity of the perpetrator are also delineated, and variation in the resulting developmental trajectories in each case is explored. This translation of dynamic skill theory, as applied to maltreated children, enhances our basic understanding of their functioning, clarifies the nature of their developmental differences, and underscores the need for early intervention.
Adult↗
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.
Child↗
Mother-child play and emerging social behaviors among infants from maltreating families.
Mother-child play of 12-month-old infants (N=130) from maltreating (N=78) and non-maltreating (N=52) families was analyzed as a context that integrates infants' developing social and cognitive skills. Play was coded from semistructured and unstructured play paradigms. No group differences were found in infants' play maturity. Infants from abusing families demonstrated more imitative play than infants from non-maltreating families, and engaged in less independent play than infants from both neglecting and non-maltreating families, suggesting a delay in emerging social behaviors. Mothers from abusing and non-maltreating families differed in attention directing behaviors. Maternal behaviors predicted child play style variables, but did not mediate the effects of maltreatment. Findings discuss the influence of an early maltreating environment upon the development of the emergent self. Implications for early intervention are underscored.
Adult↗
The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: a randomized preventive trial.
The development of insecure attachment relationships in the offspring of mothers with major depressive disorder (MDD) may initiate a negative trajectory leading to future psychopathology. Therefore, the provision of theoretically guided interventions designed to promote secure attachment is of paramount importance. Mothers who had experienced MDD since their child's birth were recruited (n = 130) and randomized to toddler-parent psychotherapy (DI) or to a control group (DC). Nondepressed mothers with no current or history of major mental disorder and their toddlers also were recruited for a nondepressed comparison group (NC; n = 68). Children averaged 20.34 months of age at the initial assessment. Higher rates of insecure attachment were present in both the DI and the DC groups at baseline, relative to the NC group. At postintervention, at age 36 months, insecure attachment continued to predominate in the DC group. In contrast, the rate of secure attachment had increased substantially in the DI group and was higher than that for the DC and the NC groups. These results demonstrate the efficacy of toddler-parent psychotherapy in fostering secure attachment relationships in young children of depressed mothers.
Adult↗
Expressed emotion in multiple subsystems of the families of toddlers with depressed mothers.
Expressed emotion was examined in families of toddlers (N = 101) whose mothers had experienced major depressive disorder occurring since the child's birth, and contrasted with expressed emotion in demographically comparable families (N = 54) with no history of parental mental disorder to elucidate family systems processes as contributors to child functioning. Both mothers and fathers provided Five-Minute Speech Samples on their child, their spouse, and themselves, and completed measures of marital adjustment, trait affect, relationship quality with their own parents in childhood, and child behavior problems. Maternal-expressed emotion criticism regarding child, self, and spouse was higher in the families with depressed mothers; paternal criticism regarding self and spouse also was higher in the depressed families. Mothers and fathers in the depressed group also differed on relational/ affective features, exhibiting lower marital satisfaction, higher trait negative affect, and more negative childhood relationship representations, relative to the nondepressed group, and mothers reported more child behavior problems. Mediational models were evaluated separately for the different targets of maternal and paternal criticism and child behavior problems, and findings supported both individual parent and spouse contributions as mediators of the relation between depression group status and expressed criticism and child behavior problems. The findings are discussed in terms of the multiple levels of family system influence on negativity in the emotional environment of toddlers of depressed mothers, developmental risk, and the need for family-level interventions.
Adult↗
False belief understanding in maltreated children.
False belief understanding was investigated in maltreated (N = 203), low socioeconomic status (SES) nonmaltreated (N = 143), and middle SES nonmaltreated (N = 172) 3- to 8-year-old children. Contrasts among the three groups provided an opportunity to examine the impact of family contextual influences on theory of mind development. Specifically, child maltreatment served as an "experiment of nature" in order to elucidate theory of mind abilities. Two false belief tasks and language assessments were administered. Among children with a verbal mental age of 49 months or greater, maltreatment was related to delays in the development of theory of mind, beyond the influence of chronological age and SES. The occurrence of maltreatment during the toddler period, onset during the toddler years, and physical abuse were features of maltreatment associated with delay in the development of theory of mind. Findings are discussed in terms of the influence of harsh caregiving on the development of theory of mind. Implications for the understanding of normal developmental processes are highlighted.
Child↗
The relative efficacy of two interventions in altering maltreated preschool children's representational models: implications for attachment theory.
A narrative story-stem task was used to evaluate the efficacy of two competing, developmentally informed preventive interventions for maltreated preschoolers and their mothers designed to modify children's internal representations of self and of self in relation to other. One hundred and twenty-two mothers and their preschoolers (87 maltreated and 35 nonmaltreated) served as participants. Maltreating families were randomly assigned to either the preschooler-parent psychotherapy (PPP, n = 23), psychoeducational home visitation (PHV, n = 34), or community standard (CS, n = 30) intervention group at baseline. Thirty-five nonmaltreating (NC) families served as comparisons. Narratives were administered to children at baseline and at the postintervention evaluation. Children in the PPP intervention evidenced more of a decline in maladaptive maternal representations over time than PHV and CS children and displayed a greater decrease in negative self-representations than CS, PHV, and NC children. Also, the mother-child relationship expectations of PPP children became more positive over the course of the intervention, as compared to NC and PHV participants. These results suggest that an attachment-theory informed model of intervention (PPP) is more effective at improving representations of self and of caregivers than is a didactic model of intervention directed at parenting skills. Findings are discussed with respect to their implications for developmental theory, with a specific focus on attachment theory and internal working models of relationships.
Child Abuse↗
Relations among children's perceptions of maternal behavior, attributional styles, and behavioral symptomatology in maltreated children.
This investigation examined relations among perceptions of mothers, attributional style, and counselor-rated behavior problems in 187 school age children (88 maltreated, 99 nonmaltreated). Hypotheses regarding the presence of higher levels of internalizing and externalizing behavior problems in maltreated children were confirmed. Attributional style was found to function as a moderator of externalizing behavior problems, suggesting that attributional style exerts a protective role against the harmful effect of child maltreatment. Perceptions of mothers were found to operate as a mediator of both internalizing and externalizing symptomatology, with maltreated children with less positive perceptions of their mothers exhibiting greater internalizing and externalizing behavior problems. These findings advance knowledge of how cognitive processes contribute to behavior problems in maltreated children and possess implications for prevention and intervention efforts.
Adaptation, Psychological↗
True and false memories in maltreated children.
Differences in basic memory processes between maltreated and nonmaltreated children were examined in an experiment in which middle-socioeconomic-status (SES; N = 60), low-SES maltreated (N = 48), and low-SES nonmaltreated (N = 51) children (ages 5-7, 8-9, and 10-12 years) studied 12 Deese-Roediger-McDermott lists. Using recall and recognition measures, the results showed that both true and false memories increased with age and, contrary to some speculation, these trends did not differ as a function of maltreatment status. However, there were differences in overall memory performance as a function of SES. These results are discussed in the broader framework of children's memory development and the effects of the chronic stress associated with child maltreatment on basic memory processes.
Child↗