Poster #55 - Improved Mental Health Mediates Change in Parental Sensitivity: Attachment and Biobehavioral Catch-up

• In Event: 3-106 - Poster Session 11
  In Poster Session: PS 11 Section - Developmental Psychopathology

Integrative Statement

High-risk mothers (e.g., poor, homeless, history of adverse childhood experiences) are at heightened risk for maternal depression (Sidor et al., 2011), which has been shown to interfere with sensitive parenting (Bernard, Nissim, Vaccaro, Harris, & Lindhiem, 2018). Intervention approaches studied thus far for depressed mothers have taken a number of approaches including home-based dyadic interaction training/coaching (e.g., Kersten-Alvarez et al., 2010), support groups (e.g., Fleming et al., 1992), and individual psychotherapy (e.g., Murray et al., 2003). A meta-analysis of 10 studies reporting on 13 interventions for depressed mothers demonstrated a small to medium effect size of interventions on improved maternal sensitivity (Kersten-Alvarez et al., 2011). However, few studies have reported on intervention effectiveness on reducing maternal depression or whether reductions in depressive symptoms mediate intervention effects on parental sensitivity. This mechanism-focused approach can inform intergenerational models of developmental psychopathology and advance our understanding of critical targets for attachment-based intervention.

Participants included 200 parents of infants (99% racial/ethnic minority, 92% poverty) participating in a randomized clinical trial of Attachment and Biobehavioral Catch-up (ABC; Dozier et al., 2013) in the context of community-based implementation. ABC is a 10-session home-based intervention that aims to increase parental sensitivity. Participants were randomly assigned to receive ABC or to a waitlist condition. At baseline and post-intervention, parents and children were video-recorded during a standardized play interaction, which was coded for parental sensitivity (NICHD ECCRN, 1999, 2003). At baseline and post-intervention, depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). Approximately 37% of parents reported clinically elevated depression at pre-intervention, as defined by a score of 16 or higher on the CES-D. A composite sociodemographic risk score was computed by summing six dichotomized risk factors (i.e., poverty, housing risk, low education, CPS involvement, single parenthood, young parent age), and used as a covariate in analyses.

Analyses were conducted in Mplus 7.11 (Muthen & Muthen, 2013) for 127 participants (the full dataset will be available for presentation at SRCD, 2019). Controlling for baseline sensitivity, there was a significant direct effect of ABC (versus waitlist) on post sensitivity, β = .24, p = .010, suggesting that parents who received ABC demonstrated higher sensitivity than parents in the control group. In mediation analyses, controlling for baseline depressive symptoms, ABC was associated with reduced depressive symptoms at post. Reduced depressive symptoms were, in turn, associated with higher post sensitivity, controlling for baseline sensitivity. The indirect effect of ABC on increased post sensitivity via reduced depressive symptoms was significant, β = .08, p = .015 (See Table 1, Figure 1).

These results suggest that targeted attachment-based interventions, like ABC, may influence parental sensitivity in part by supporting parents’ own mental health. Future research should aim to identify specific aspects of ABC that promote improvements in mental health (e.g., increased social support, strengths-based parent coaching, enhanced parenting efficacy) and examine whether changes in mothers’ depressive symptoms are sustained over time.

Authors

• Allison Dash, Power of Two
  Presenting Author

• Melanie Rodriguez, Stony Brook University
  Non-Presenting Author

• Steven Imrisek, Stony Brook University
  Non-Presenting Author

• Kristin Bernard, Stony Brook University
  Non-Presenting Author