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Jester JM, Riggs JL, Menke RA, Alfafara E, Issa M, Muzik M, Rosenblum KL. Randomized pilot trial of the "Mom Power" trauma- and attachment-informed multi-family group intervention in treating and preventing postpartum symptoms of depression among a health disparity sample. Front Psychiatry 2023; 14:1048511. [PMID: 37732075 PMCID: PMC10507705 DOI: 10.3389/fpsyt.2023.1048511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Perinatal depression, a common complication related to childbearing, impacts mothers, children, and families. Efficacious interventions reduce perinatal depression symptoms; effort is needed to prevent the onset of perinatal depression. To determine feasibility and preliminary efficacy in reducing perinatal depression, we conducted a community-based, randomized parallel open pilot trial of Mom Power, a group-based intervention to improve mental health and parenting in mothers with young children. Methods Mom Power consists of 10 group sessions, focused on parenting, child development and self-care and three individual sessions, to build rapport and provide personalized referrals. Control group participants received psychoeducational mailings. Computer-based urn randomization assigned mothers with experiences of interpersonal violence, depression, or other traumatic experiences to Mom Power (68) or control (54). Results At 3-months post-treatment, the 31 retained women assigned to Mom Power were half as likely to meet criteria for probable depression (26%) as the 22 women retained in the control group (55%), with treatment predicting lower incidence of probable depression (OR = 0.13, p = 0.015). Moreover, among the 23 women who did not meet criteria for depression diagnosis at baseline, no women in the treatment group developed depression (n = 0, 0%) compared to control group women (n = 3, 30%). Logistic regression controlling for selective attrition confirmed the treatment effect on preventing new onset of depression (OR = 0.029, p = 0.012). Conclusion These findings support the use of Mom Power for both treatment and prevention of perinatal depression. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT01554215, NCT01554215.
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McCaffery H, Zaituna J, Busch S, Kaciroti N, Miller AL, Lumeng JC, Rosenblum KL, Gearhardt A, Pesch MH. Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy. Appetite 2023; 188:106978. [PMID: 37495177 PMCID: PMC10844930 DOI: 10.1016/j.appet.2023.106978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.
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Affiliation(s)
- Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Julie Zaituna
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sophie Busch
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Ashley Gearhardt
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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3
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Brophy-Herb HE, Lawler JM, Stacks AM, Freeman SE, Pitzen J, Riggs J, Dalimonte-Merckling D, Wong K, Ribaudo J, Huth-Bocks A, Muzik M, Rosenblum KL. Longitudinal associations between parental reflective functioning and maternal mind-mindedness. J Fam Psychol 2023; 37:830-840. [PMID: 37166902 DOI: 10.1037/fam0001106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Little work has examined longitudinal associations between parental reflective functioning (PRF) and mind-mindedness (MM), limiting the understanding of separate or bidirectional trajectories of these related but distinct forms of mentalization. We examined cross-lagged associations between PRF, assessed via interview, and MM, coded from play interactions, over 12 months among 90 parents (86% female; 57% White, 43% Black) of infants (Mage = 10.56 months, SD = 8.20) who were participating in The Michigan Model of Infant Mental Health Home Visiting. Data were collected at study enrollment Time 1 (T1) and at 6-month Time 2 (T2) and 12-month Time 3 (T3) postenrollment. Mind-minded comments were coded as appropriate, reflecting accurate interpretation of mental states or nonattuned, characterizing inaccurate interpretations. PRF and appropriate MM each remained stable over time. PRF at the T1 positively predicted appropriate MM at T2. No other cross-lagged associations between PRF and appropriate MM were significant. Concurrent correlations between appropriate MM and PRF were significant only at T3. Nonattuned MM showed stability from T1 to T2 but nonattuned MM at the T2 did not predict nonattuned MM at T3. Greater PRF at T1 predicted less nonattuned MM at T2. No other cross-lagged associations between PRF and nonattuned MM were significant. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University
| | | | - Ann M Stacks
- Merrill Palmer Skillman Institute, Wayne State University
| | | | | | | | | | - Kristyn Wong
- Department of Psychiatry, University of Michigan
| | | | | | - Maria Muzik
- Department of Psychiatry, University of Michigan
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4
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Weiss SJ, Goodman SH, Kidd SA, Owen MT, Simeonova DI, Kim CY, Cooper B, Rosenblum KL, Muzik M. Unique Characteristics of Women and Infants Moderate the Association between Depression and Mother-Infant Interaction. J Clin Med 2023; 12:5503. [PMID: 37685568 PMCID: PMC10487744 DOI: 10.3390/jcm12175503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Research has shown mixed results regarding the association between women's postpartum depression and mother-infant interactions, suggesting that a woman's unique experience and context may moderate how depression shapes these interactions. We examined the extent to which a woman's comorbid anxiety, her exposure to adversity, and infant characteristics moderate the relationship between depressive symptoms of women and interactions with their infants at 6 (n = 647) and 12 months (n = 346) postpartum. The methods included standardized coding of mother-infant interactions and structural regression modeling. The results at 6 months of infant age indicated that infant male sex and infant negative affectivity were risk factors for mothers' depression being associated with less optimal interactions. At 12 months of infant age, two moderators appeared to buffer the influence of depression: a woman's history of trauma and infant preterm birth (≤37 weeks gestation). The results reinforce the salience of infant characteristics in the relationship between maternal depression and mother-infant interactions. The findings also suggest that experiences of trauma may offer opportunities for psychological growth that foster constructive management of depression's potential effect on mother-infant interactions. Further research is needed to clarify the underlying processes and mechanisms that explain the influence of these moderators. The ultimate goals are to reduce the risk of suboptimal interactions and reinforce healthy dyadic relations.
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Affiliation(s)
- Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, CA 94143, USA;
| | | | - Sharon A. Kidd
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA;
| | - Margaret Tresch Owen
- Department of Psychology, University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Christine Youngwon Kim
- Department of Human Development and Family Studies, Pennsylvania State University, Hershey, PA 17033, USA;
| | - Bruce Cooper
- Department of Community Health Systems, University of California, San Francisco, CA 94143, USA;
| | - Katherine L. Rosenblum
- Departments of Psychiatry and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; (K.L.R.); (M.M.)
| | - Maria Muzik
- Departments of Psychiatry and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; (K.L.R.); (M.M.)
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5
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Stein SF, Rios JM, Gearhardt AN, Nuttall AK, Riley HO, Kaciroti N, Rosenblum KL, Lumeng JC, Miller AL. Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression. Appetite 2023; 187:106589. [PMID: 37146651 PMCID: PMC11079996 DOI: 10.1016/j.appet.2023.106589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.
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Affiliation(s)
- Sara F Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI, 48109, USA.
| | - Julia M Rios
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, 552 West Circle Drive, East Lansing, MI, 48824, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, 4250 Plymouth Rd., Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Pediatrics, Michigan Medicine, 1522 Simpson Rd. East., Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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6
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Reynolds LAF, McCaffery H, Appugliese D, Kaciroti NA, Miller AL, Rosenblum KL, Gearhardt AN, Lumeng JC. Capacity for Regulation of Energy Intake in Infancy. JAMA Pediatr 2023; 177:590-598. [PMID: 37067796 PMCID: PMC10111233 DOI: 10.1001/jamapediatrics.2023.0688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/24/2023] [Indexed: 04/18/2023]
Abstract
Importance The capacity for regulation of energy intake (REI) to match energy needs is thought to contribute to differences in weight gain, and preventing excess infant weight gain is a priority. Objective To determine capacity for REI across infancy. Design, Setting, and Participants For this cohort study, a convenience sample of mother-infant dyads was recruited from the community in Michigan between 2015 and 2019. Inclusion criteria were healthy, full-term infants with weight appropriate for gestational age; biological mothers who were 18 years or older, English speaking, and a legal and custodial guardian; and infant having had consumed 2 oz or more in 1 feeding from an artificial nipple at least once per week. Infants were followed in the home setting with staff support for up to 12 months. Interventions Mother-infant dyads participated at infant age 1, 2.5, 5, 7, 10, and 12 months. In the intervention condition, mothers offered a feeding every hour for 6 hours. In the control condition, mothers fed infants as they typically would for 6 hours. Intake was recorded and kilocalories calculated. Main Outcomes and Measures Capacity for REI was indexed as the difference in intake in kilocalories per kilogram of body weight (intervention minus control condition); a value of 0 indicated perfect REI. Maternal and infant characteristics were obtained by questionnaire, and anthropometry was measured. Using multiple imputation, the intercept and slope for difference in kilocalories per kilogram across the 6 age points were estimated using mixed models accounting for repeated measures within participants. Statistical analyses were conducted between September 2021 and February 2023. Results The sample included 175 infants (87 [49.71%] female, 88 [50.29%] male; 494 pairs of intervention and control conditions and 4630 feedings). The mean (SD) 12-month weight-for-age z score was 0.1 (0.8). Mean (SD) gestational age as 39.55 (1.05) weeks, and mean (SD) birth weight was 3.43 (0.41) kg. Mean (SD) breastfeeding duration for those who reported stopping by 12 months was 17.83 (12.03) weeks. As designed, the intervention (compared with control) condition included more feedings at shorter intervals. After collapsing the data across age points in a mixed model accounting for repeated measures within participants, the REI estimate at 1 month differed from 0. On average, infants ate 5.21 kcal/kg (95% CI, 2.89-7.54 kcal/kg) more in the frequent feeding intervention condition than in the ad lib feeding control condition. This difference did not significantly change over 12 months of infancy (REI slope = -0.01 kcal/kg per month; 95% CI, -0.02 to 0.03 kcal/kg per month). Conclusions and Relevance The study's findings suggested that, on average, when offered more frequent feedings, healthy, full-term infants may overeat. The results provide support for responsive feeding as a strategy for preventing excess infant weight gain.
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Affiliation(s)
- Lyndsey A. F. Reynolds
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | | | - Niko A. Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | | | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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7
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Julian MM, Riggs J, Wong K, Lawler JM, Brophy-Herb HE, Ribaudo J, Stacks A, Jester JM, Pitzen J, Rosenblum KL, Muzik M. Relationships reduce risks for child maltreatment: Results of an experimental trial of Infant Mental Health Home Visiting. Front Psychiatry 2023; 14:979740. [PMID: 36926461 PMCID: PMC10012869 DOI: 10.3389/fpsyt.2023.979740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/06/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Research examining the effectiveness of home visiting programs that reduce child maltreatment or associated risks yield mixed findings; some find positive significant impacts on maltreatment, whereas others find small to no effects. The Michigan Model of Infant Mental Health Home Visiting (IMH-HV) is a manualized, needs-driven, relationship-focused, home-based intervention service that significantly impacts maternal and child outcomes; the effect of this intervention on child maltreatment has not been sufficiently evaluated. OBJECTIVE The current study examined associations between treatment and dosage of IMH-HV and child abuse potential in a longitudinal, randomized controlled trial (RCT). PARTICIPANTS AND SETTING Participants included 66 mother-infant dyads (Mother M age = 31.93 years at baseline; child M age = 11.22 months at baseline) who received up to 1 year of IMH-HV treatment (Mdn = 32 visits) or no IMH-HV treatment during the study period. METHODS Mothers completed a battery of assessments including the Brief Child Abuse Potential Inventory (BCAP) at baseline and at the 12-month follow-up assessment. RESULTS Regression analyses indicated that after controlling for baseline BCAP scores, those who received any IMH-HV treatment had lower 12-month BCAP scores compared to those who received no treatment. Additionally, participation in more visits was associated with lower child abuse potential at 12 months, and a reduced likelihood of scoring in the risk range. CONCLUSION Findings suggest that greater participation in IMH-HV is associated with decreased risk for child maltreatment 1 year after initiating treatment. IMH-HV promotes parent-clinician therapeutic alliance and provides infant-parent psychotherapy which differentiate it from traditional home visiting programs.
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Affiliation(s)
- Megan M Julian
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jessica Riggs
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Kristyn Wong
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jamie M Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, United States
| | - Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, MI, United States.,School of Social Work, Wayne State University, Detroit, MI, United States
| | - Ann Stacks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States
| | - Jennifer M Jester
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jerrica Pitzen
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
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Fisher JO, Hughes SO, Miller AL, Horodynski MA, Brophy-Herb HE, Contreras DA, Kaciroti N, Peterson KE, Rosenblum KL, Appugliese D, Lumeng JC. Correction: Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis. Int J Behav Nutr Phys Act 2022; 19:103. [PMID: 35941588 PMCID: PMC9358796 DOI: 10.1186/s12966-022-01341-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI, USA.,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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Fisher JO, Hughes SO, Miller AL, Horodynski MA, Brophy-Herb HE, Contreras DA, Kaciroti N, Peterson KE, Rosenblum KL, Appugliese D, Lumeng JC. Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis. Int J Behav Nutr Phys Act 2022; 19:91. [PMID: 35870976 PMCID: PMC9308918 DOI: 10.1186/s12966-022-01323-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. METHODS A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3-4 years and their parents with low-income backgrounds. Children's eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. RESULTS LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles. CONCLUSIONS Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children's fundamental dispositions towards eating.
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Affiliation(s)
- Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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Miller AL, Stein SF, Sokol R, Varisco R, Trout P, Julian MM, Ribaudo J, Kay J, Pilkauskas NV, Gardner-Neblett N, Herrenkohl TI, Zivin K, Muzik M, Rosenblum KL. From zero to thrive: A model of cross-system and cross-sector relational health to promote early childhood development across the child-serving ecosystem. Infant Ment Health J 2022; 43:624-637. [PMID: 35638583 DOI: 10.1002/imhj.21996] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 11/30/2021] [Indexed: 11/05/2022]
Abstract
Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a "child-serving ecosystem", that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the child-serving ecosystem may promote child health and well-being at a population level. Our model articulates what relational health looks like across levels of this ecosystem from primary caregiver-child relationships, to secondary relationships between caregivers and child-serving systems, to tertiary relationships among systems that shape child outcomes directly and indirectly. We posit that positive relational health across levels is critical for promoting child health and well-being broadly. We provide examples of evidence-based approaches that address primary, secondary, and tertiary relational health, and suggest ways to promote relational health through cross-sector training and psychoeducation in the science of early development. This model conceptualizes relational health across the child-serving ecosystem and can serve as a template for promoting child health and well-being in the context of adversity.
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Affiliation(s)
- Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sara F Stein
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebeccah Sokol
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Rachel Varisco
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Phoebe Trout
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan M Julian
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua Kay
- University of Michigan Law School, Ann Arbor, Michigan, USA
| | | | | | - Todd I Herrenkohl
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Kara Zivin
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Maria Muzik
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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11
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Rosenblum KL, Riggs J, Freeman S, Shah PE, Muzik M. In-the-moment ratings on the Early Relational Health Screen: A pilot study of application in home visiting and primary care. Infant Ment Health J 2022; 43:410-423. [PMID: 35579377 DOI: 10.1002/imhj.21978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/10/2021] [Indexed: 11/12/2022]
Abstract
Early infant-parent interaction sets a critical foundation for young children's well-being, and evidence regarding the protective role of secure early relationships has led to increased interest in effective screening and promotion of early relational health in pediatric primary care and home visiting settings. We report findings from two pilot studies conducted in the United States that describe the reliability and validity of a relational health screening tool, the Early Relational Health Screen (ERHS), implemented in two different contexts: an innovative model of relational health promotion in pediatric primary care (Study 1) and an Infant Mental Health Home Visiting (IMH-HV) model (Study 2). Across both studies, a trained clinician rated the ERHS following real-time observation of interaction (i.e., "in-the-moment" ratings). Reliability was assessed by comparing "in-the-moment" ERHS ratings to subsequent coding of the same interaction from video by an independent evaluator. In addition, Study 2 data permitted evaluation of the validity of "in-the-moment" ERHS ratings. Results from both studies indicated reliability of "in-the-moment" ERHS ratings. In addition, Study 2 clinician "in-the-moment" ratings were associated with maternal depression and ratings of child-parent interaction derived from a separate observational task coded by independent evaluators using a different well-validated research-based measure. Discussion highlights the potential of the ERHS as a screening, promotion, and prevention tool that may be feasibly administered by providers across pediatric primary care and home visiting settings.
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Affiliation(s)
- Katherine L Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica Riggs
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah Freeman
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Prachi E Shah
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA
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12
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Riggs JL, Rosenblum KL, Muzik M, Jester J, Freeman S, Huth-Bocks A, Waddell R, Alfafara E, Miller A, Lawler J, Erickson N, Weatherston D, Shah P, Brophy-Herb H. Infant Mental Health Home Visiting Mitigates Impact of Maternal Adverse Childhood Experiences on Toddler Language Competence: A Randomized Controlled Trial. J Dev Behav Pediatr 2022; 43:e227-e236. [PMID: 34698704 DOI: 10.1097/dbp.0000000000001020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The goal of this study was to test the impact of maternal adverse childhood experiences (ACEs) on subsequent child language competence; higher parental ACEs were expected to predict risk of toddler language delay. Participation in Infant Mental Health Home Visiting (IMH-HV) treatment, which aims to enhance responsive caregiving and improve child social-emotional development, was expected to mitigate this association. METHODS A randomized controlled trial (RCT) design was used. ACEs data were collected at baseline. Child language screening (using the Preschool Language Scales Screening Test) was conducted 12 months later by masters-level evaluators who were blind to treatment condition. Visits occurred in participants' homes. Participants were community-recruited and were randomized to treatment (psychotherapeutic IMH-HV) or control (treatment as usual). Data come from 62 families who participated in all waves of an RCT testing the efficacy of IMH-HV; mothers were eligible based on child age (<24 mo at enrollment) and endorsement of ≥2 sociodemographic eligibility criteria (economic disadvantage, depression, perceived parenting challenges, and/or high ACEs). RESULTS The age of mothers enrolled in this ranged from 19 to 44 years (M = 31.91; SD = 5.68); child age at baseline ranged from prenatal to 26 months (M = 12.06; SD = 6.62). The maternal ACE score predicted child language competence (t (5,55) = -3.27, p = 0.002). This effect was moderated by treatment (t (6,54) = 1.73, p = 0.04), indicating no association between maternal ACEs and child language for those randomized to IMH-HV. CONCLUSION The results highlight that the effects of parent ACEs on early childhood outcomes may be buffered by participation in psychotherapeutic home visiting (trial registration: NCT03175796).
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Affiliation(s)
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI
- Department of Obstetrics & Gynecology, Michigan Medicine, Ann Arbor, MI
| | - Maria Muzik
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI
- Department of Obstetrics & Gynecology, Michigan Medicine, Ann Arbor, MI
| | | | - Sarah Freeman
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI
| | - Alissa Huth-Bocks
- Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Rachel Waddell
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI
| | - Emily Alfafara
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI
| | - Alison Miller
- School of Public Health, University of Michigan, Ann Arbor, MI
| | - Jamie Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI
| | - Nora Erickson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Prachi Shah
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI
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13
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Stein SF, Riley HO, Kaciroti N, Rosenblum KL, Sturza JM, Gearhardt AN, Grogan-Kaylor AC, Lumeng JC, Miller AL. Infant Distress in a Food Delay Task Changes With Development and Predicts Amount Consumed. Front Nutr 2022; 9:786022. [PMID: 35464039 PMCID: PMC9021754 DOI: 10.3389/fnut.2022.786022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/08/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Eating behavior regulation emerges during early development and involves general self-regulation (emotional, behavioral), appetite regulation (homeostatic metabolic need) and appetite self-regulation (including both Bottom-Up Food Approach and Bottom-Up Food Avoidance and top-down purposeful self-control of eating). Limited research has investigated developmental trajectories of the regulation of eating behavior before the preschool years. The current study used a novel food delay task to assess infant distress as an early emerging marker of eating behavior regulation constructs across early infancy and examine associations with amount of milk consumed. Method Mother-infant dyads (n = 179) completed the Ability to Delay Gratification for Food in Infants Task (ATDG-FIT) at 2 weeks, 8 weeks, and 16 weeks of age. The ATDG-FIT required infants to wait before being fed while their bottle was present, but not accessible (3-min Pre-Feeding Delay). After this, the infant was fed for 1 min, then the feeding was paused for 30 s (Mid-Feeding Delay). Infant distress was coded during each feeding delay period and the amount of milk consumed was measured. Results The mean proportion of distress during the Pre-Feeding Delay period decreased from 8 to 16 weeks of age (F(2,230) = 15.02, p < 0.001), whereas the mean proportion of distress during the Mid-Feeding Delay increased from 2 to 8 weeks of age (F(2,230) = 27.04, p < 0.001). There was a positive interaction between distress during Mid-Feeding Delay and infant age predicting the amount consumed in the protocol (ß = 0.30, p = 0.022), suggesting that the association between distress during this part of the task and amount consumed strengthens as infants get older. Conclusion The ATDG-FIT may be an effective method to assess emerging eating behavior regulation constructs during early infancy.
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Affiliation(s)
- Sara F. Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Sara F. Stein,
| | - Hurley O. Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | | | - Julie M. Sturza
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | - Ashley N. Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science, and the Arts, Ann Arbor, MI, United States
| | | | - Julie C. Lumeng
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
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14
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Goodman SH, Muzik M, Simeonova DI, Kidd SA, Owen MT, Cooper B, Kim CY, Rosenblum KL, Weiss SJ. Maternal Interaction With Infants Among Women at Elevated Risk for Postpartum Depression. Front Psychol 2022; 13:737513. [PMID: 35310268 PMCID: PMC8929344 DOI: 10.3389/fpsyg.2022.737513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/27/2022] [Indexed: 12/03/2022] Open
Abstract
Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care.
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Affiliation(s)
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | | | - Sharon A. Kidd
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
| | - Margaret Tresch Owen
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
| | - Bruce Cooper
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
| | - Christine Y. Kim
- Department of Psychology, Emory University, Atlanta, GA, United States
- The Pennsylvania State University (PSU), University Park, PA, United States
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Sandra J. Weiss,
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15
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Torres C, Rosenblum KL, Jester JM, Julian MM, Niec LN, Muzik M. Clinician Racial Biases: Preliminary Investigation on Predictors of Poor Therapeutic Alliance and Retention in Home Visiting Intervention Program. Matern Child Health J 2022; 26:953-961. [PMID: 35107688 PMCID: PMC9018578 DOI: 10.1007/s10995-021-03369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Home visiting programs are effective in improving maternal-child health, and higher therapeutic alliance is associated with improved program retention and outcomes. Black, single, low-income mothers have a higher risk for poorer health outcomes in pregnancy and postpartum and for early termination of therapeutic services. OBJECTIVE To examine associations between clinician and client alliance and social, economic, and racial demographics. METHODS Mothers (N = 71) who were pregnant or had an infant (age < 24 m) receiving Infant Mental Health (IMH) services through community health service agencies and their clinicians (N = 50) completed the Scale to Assess Therapeutic Relationships (clinicians: STAR-C, clients: STAR-P) at 3-, 6-, 9-, and 12 months, and provided demographic information. RESULTS Survival analysis showed those with higher alliance ratings, both client and clinician ratings, at the 3-month time-point were more likely to remain in treatment longer (for clients est = -1.67, p = .0017; for clinician est = -.75, p = .031). Controlling for clinician experience and frequency of reflective supervision, Black clinicians had higher alliance ratings than white clinicians, (b = 3.1 (1.6), p = .049). Neither clinician-client racial match nor client marital status predicted alliance. Black clinicians' ratings of alliance did not vary by client race, but white clinicians reported weaker alliance with their Black, relative to white, clients (β = .40, p = .045). CONCLUSIONS Weaker alliance reported by white clinicians with Black clients, coupled with a lack of client-race related differences for Black clinicians, suggests white clinician racial bias may be important to consider in regards to program retention and health disparities.
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Affiliation(s)
- Chioma Torres
- Department of Pediatrics, University of Michigan Medical School, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA.
| | - Katherine L Rosenblum
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA.,Department of Obstetrics & Gynecology, University of Michigan Medical School, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA
| | - Jennifer M Jester
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Megan M Julian
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Larissa N Niec
- Center for Children, Families, and Communities, Central Michigan University, 2480 West Campus Drive, Suite B100, Mount Pleasant, MI, 48858, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA.,Department of Obstetrics & Gynecology, University of Michigan Medical School, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA
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16
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Ribaudo J, Lawler JM, Jester JM, Riggs J, Erickson NL, Stacks AM, Brophy-Herb H, Muzik M, Rosenblum KL. Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting. Front Psychol 2022; 12:792989. [PMID: 35111107 PMCID: PMC8802330 DOI: 10.3389/fpsyg.2021.792989] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/06/2021] [Indexed: 01/30/2023] Open
Abstract
BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.
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Affiliation(s)
- Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
- School of Social Work, Wayne State University, Detroit, MI, United States
- *Correspondence: Julie Ribaudo,
| | - Jamie M. Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | - Jennifer M. Jester
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jessica Riggs
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Nora L. Erickson
- Mother Baby Program, Department of Psychiatry, Hennepin Healthcare, Minneapolis, MN, United States
| | - Ann M. Stacks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States
| | - Holly Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, United States
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
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17
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Gray SAO, Moberg SA, Obus EA, Parker V, Rosenblum KL, Muzik M, Zeanah CH, Drury SS. Harnessing Virtual Mom Power: Process and Outcomes of a Pilot Telehealth Adaptation of a Multifamily, Attachment-Based Intervention. J Infant Child Adolesc Psychother 2022; 21:6-18. [PMID: 36686598 PMCID: PMC9853992 DOI: 10.1080/15289168.2022.2045464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective The COVID-19 pandemic and mitigation strategies amplified racial and income-based health disparities, profoundly shifted family life, and altered delivery systems for support services. We report pilot data from a telehealth adaptation of Mom Power, an evidence-based, attachment-informed multifamily preventive intervention (clinicaltrials.gov: de-identified). Method Virtual Mom Power (VMP), adapted for economically marginalized, predominantly Black mothers and their young children (n = 9) was implemented in New Orleans, an early COVID-19 hotspot with an entrenched history of structural racism and trauma. We outline our approach to adaptation of curriculum and service delivery, using a trauma-informed lens. Results Maternal reports of maternal and child functioning from pre to post were consistent with improvements in maternal depressive and posttraumatic stress symptoms and child competence, comparable to outcomes from in-person trials. Feasibility and acceptability data were strong. Discussion Preliminary results and reflections on process suggest that telehealth service delivery of a multifamily preventive intervention, with attention to decreasing barriers to online access and consideration of culture and context, facilitated engagement while maintaining fidelity and effects on intervention targets. Future research using larger samples, randomized controlled design, and multi-method assessment should continue to guide dissemination of reflective, group-based telehealth parenting programs.
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Affiliation(s)
- Sarah A O Gray
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA.,Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA.,The Brain Institute, Tulane University, New Orleans, LA, USA
| | - Stephanie A Moberg
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | - Elsia A Obus
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | - Victoria Parker
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | | | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Charles H Zeanah
- Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA
| | - Stacy S Drury
- Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA.,The Brain Institute, Tulane University, New Orleans, LA, USA
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18
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Horbatch F, Hruschak J, Hall M, Mannella KA, Synger A, Ip KI, Liu Y, Sadlier R, Gillett CB, Moser JS, Muzik M, Rosenblum KL, Fitzgerald KD. Conducting EEG research in clinically anxious preschoolers: A pilot study and preliminary recommendations. Dev Psychobiol 2021; 63:e22183. [PMID: 34674238 DOI: 10.1002/dev.22183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/28/2021] [Accepted: 07/23/2021] [Indexed: 11/08/2022]
Abstract
Electroencephalography (EEG) data collection can be challenging in preschoolers with anxiety who are often debilitated by fear of the unknown. Thus, we iteratively refined techniques for EEG collection in three cohorts of children with anxiety enrolled in our study of a novel intervention. Techniques involved directing child attention away from the EEG setup (Cohort 1, N = 18), open discussion of equipment and processes during setup (Cohort 2, N = 21), and a preparatory EEG-exposure session prior to data collection (Cohort 3, N = 6). Children (N = 45, 4-7 years) attempted a Time 1 EEG before intervention, and those who completed intervention (N = 28) were invited to a Time 2 EEG. The percentages who provided analyzable EEGs were assessed by cohort. Cohort 3 provided more Time 1 EEGs (83.3%) than Cohorts 1 or 2 (66.7% each), suggesting that the preparatory session supported first-time EEG collection. More children provided Time 2 EEG data across successive cohorts (Cohort 1: 66.7%, Cohort 2: 82%, Cohort 3: 100%), suggesting that more open communication facilitated repeat EEG collection. Ultimately, increased EEG exposure and child-friendly communication about procedures improved data acquisition in this sample of clinically anxious preschoolers. Detailed study procedures are shared to support future EEG research in young children with anxiety.
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Affiliation(s)
- Faith Horbatch
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Jessica Hruschak
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Melissa Hall
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Kristin A Mannella
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Ashley Synger
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Ka I Ip
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Raleigh Sadlier
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Carrie B Gillett
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Jason S Moser
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
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19
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McGinnis EW, Scism J, Hruschak J, Muzik M, Rosenblum KL, Fitzgerald K, Copeland W, McGinnis RS. Digital Phenotype for Childhood Internalizing Disorders: Less Positive Play and Promise for a Brief Assessment Battery. IEEE J Biomed Health Inform 2021; 25:3176-3184. [PMID: 33481724 PMCID: PMC8384142 DOI: 10.1109/jbhi.2021.3053846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Childhood internalizing disorders, like anxiety and depression, are common, impairing, and difficult to detect. Universal childhood mental health screening has been recommended, but new technologies are needed to provide objective detection. Instrumented mood induction tasks, designed to press children for specific behavioral responses, have emerged as means for detecting childhood internalizing psychopathology. In our previous work, we leveraged machine learning to identify digital phenotypes of childhood internalizing psychopathology from movement and voice data collected during negative valence tasks (pressing for anxiety and fear). In this work, we develop a digital phenotype for childhood internalizing disorders based on wearable inertial sensor data recorded from a Positive Valence task during which a child plays with bubbles. We find that a phenotype derived from features that capture reward responsiveness is able to accurately detect children with underlying internalizing psychopathology (AUC = 0.81). In so doing, we explore the impact of a variety of feature sets computed from wearable sensors deployed to two body locations on phenotype performance across two phases of the task. We further consider this novel digital phenotype in the context of our previous Negative Valence digital phenotypes and find that each task brings unique information to the problem of detecting childhood internalizing psychopathology, capturing different problems and disorder subtypes. Collectively, these results provide preliminary evidence for a mood induction task battery to develop a novel diagnostic for childhood internalizing disorders.
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Premo JE, Mannella KA, Duval ER, Liu Y, Morrison CL, Moser JS, Muzik M, Rosenblum KL, Fitzgerald KD. Startle to neutral, not negative stimuli: A neurophysiological correlate of behavioral inhibition in young children. Dev Psychobiol 2021; 63:1322-1329. [PMID: 33782955 DOI: 10.1002/dev.22120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/27/2021] [Accepted: 03/06/2021] [Indexed: 11/06/2022]
Abstract
A putative biomarker of anxiety risk, the startle response is typically enhanced by negative compared to neutral emotion modulation in adults, but remains understudied in children. To determine the extent to which neutral, negative, and positively valenced emotional conditions modulate startle response in early life, a child-friendly film paradigm was used to vary emotion across these conditions during startle induction in sixty-four 4- to 7-year-old children. Association of emotion-modulated startle with parent-reported anxiety symptom severity and child behavioral inhibition, a risk factor for anxiety problems, were assessed. Analyses revealed no difference in startle magnitude during negative compared to neutral film clips. By contrast, startle during both negative and neutral conditions was greater than startle during the positive condition. Larger startle magnitude during the neutral condition associated with higher levels of child behavioral inhibition (BI). These results are consistent with possible immaturity of startle response in young children, and suggest that startle amplitude in more emotionally ambiguous, neutral conditions could serve as an early biomarker for anxiety risk.
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Affiliation(s)
- Julie E Premo
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Claire L Morrison
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Jason S Moser
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Lawler JM, Hruschak J, Aho K, Liu Y, Ip KI, Lajiness‐O’Neill R, Rosenblum KL, Muzik M, Fitzgerald KD. The error-related negativity as a neuromarker of risk or resilience in young children. Brain Behav 2021; 11:e02008. [PMID: 33354942 PMCID: PMC7994696 DOI: 10.1002/brb3.2008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/09/2020] [Accepted: 11/29/2020] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION The error-related negativity (ERN) is a neural response that reflects error monitoring. Contradictorily, an enlarged (more negative) ERN has been cited as both a risk factor and a protective factor, which hinders its utility as a predictive indicator. The aim of the current study was to examine the associations between ERN measured in early childhood with the development of cognitive control (CC), emotion regulation, and internalizing/externalizing symptoms over 1-2 years. METHODS When children were ages 5-7, EEG was collected during a Go/No-Go task. A subset of the original participants (n = 30) were selected based on their baseline ERN in an extreme-case design: half with high-amplitude ERN, matched by age and sex with another group with low-amplitude ERN. RESULTS At follow-up, children in the High-Amplitude group showed better executive function, less self-reported anxiety and depression, less affect dysregulation, more parent-rated CC, less lability/negativity, and fewer parent-reported externalizing problems. Many results held even when accounting for baseline levels. Further, emotion dysregulation mediated the relationship between the ERN and both anxiety and externalizing problems, while CC mediated the ERN's relationship with externalizing problems only. CONCLUSIONS These results can inform identification and intervention efforts for children at risk for psychopathology.
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Affiliation(s)
| | | | | | - Yanni Liu
- University of MichiganAnn ArborMIUSA
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Stacks AM, Jester JM, Wong K, Huth-Bocks A, Brophy-Herb H, Lawler J, Riggs J, Ribaudo J, Muzik M, Rosenblum KL. Infant mental health home visiting: intervention dosage and therapist experience interact to support improvements in maternal reflective functioning. Attach Hum Dev 2021; 24:53-75. [PMID: 33427582 DOI: 10.1080/14616734.2020.1865606] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study examined changes in parental reflective functioning (PRF) among mothers enrolled in Infant Mental Health-Home Visiting (IMH-HV) and explored whether parental risk, treatment dosage or therapist experience predicted change in PRF. Participants included 75 mothers and their children who were enrolled in IMH-HV delivered by Community Mental Health therapists. Results indicated significant improvements in PRF from baseline to 12-months. Maternal demographic and psychosocial risk, therapist experience and treatment dosage were not directly associated with changes in PRF. However, Mothers who received more treatment sessions from therapists with six or more years of experience demonstrated the greatest improvements in PRF, while mothers who received more treatment sessions from therapists who had been practicing IMH for less than 15 months showed a decline in PRF. Therapists working with very high-risk families may need specific training and ongoing reflective supervision over a period of years to promote improvement in PRF.
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Affiliation(s)
- Ann M Stacks
- Merrill-Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
| | - Jennifer M Jester
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Kristyn Wong
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Alissa Huth-Bocks
- Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Holly Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Jamie Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Jessica Riggs
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Maria Muzik
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
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Sokol RL, Goldstick J, Zimmerman MA, Muzik M, Rosenblum KL, Miller AL. Transitions into and out of post-traumatic stress among children involved in the child welfare system. Child Youth Serv Rev 2020; 118:105384. [PMID: 32921859 PMCID: PMC7485932 DOI: 10.1016/j.childyouth.2020.105384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To describe the transition patterns into and out of post-traumatic stress (PTS) for youth and identify social supports preceding these transitions. METHODS We used inhomogeneous, continuous-time, 1Markov Chain models to model transitions in and out of PTS using data from Waves 1, 3, 4, and 5 of the National Survey of Child and Adolescent Wellbeing (NSCAW I)-a longitudinal study of children who first had contact with the child welfare system between 1999 and 2000. Our analytic sample contained 915 individuals aged 11-17 years. We analyzed data in 2020. RESULTS Youth with stronger peer relationships were less likely to transition into PTS (HR: 0.82; 95% CI [0.70-0.96]), and these individuals were also more likely to transition out of PTS (HR: 1.21; 95% CI [1.04, 1.42]). Youth with adult support were less likely to transition into PTS at any given time interval (HR: 0.37; 95% CI [0.17-0.78]), but adult support was not associated with the transition out of PTS. CONCLUSIONS Strengthening peer relationships may help at-risk children both avoid PTS altogether and recover from PTS after its onset. Promoting adult support, however, may only be most effective when attempting to prevent PTS-onset.
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Affiliation(s)
- Rebeccah L. Sokol
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202, USA
| | - Jason Goldstick
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alison L. Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
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Sokol RL, Zimmerman MA, Perron BE, Rosenblum KL, Muzik M, Miller AL. Developmental Differences in the Association of Peer Relationships with Traumatic Stress Symptoms. Prev Sci 2020; 21:841-849. [PMID: 32328960 DOI: 10.1007/s11121-020-01125-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although childhood trauma exposure has a high incidence, traumatic stress often goes untreated in children and youth. We investigated peer relationship quality as a prevention strategy for reducing traumatic stress across different developmental periods. We analyzed longitudinal data from the National Survey of Child and Adolescent Wellbeing (NSCAW I) using a time-varying effect model (TVEM) to investigate the association between peer relationship quality and traumatic stress symptoms across ages 8-17 years. We controlled for a robust set of confounders identified through a Directed Acyclic Graph (DAG). The unique association between peer relationship quality and traumatic stress symptoms was negative and significant from ages 8 to 8.5 years, and again from ages 9.4 to 10.9 years and at age 16.4 to 16.8 years, with maximum associations of - 1.45 T score points at age 8.5 years (95% CI = [- 2.87, - 0.40]), - 1.57 at age 9.4 years (95% CI = [- 3.13,- 0.01]), and - 1.89 at 16.7 years (95% CI = [- 3.70, - 0.09]). Peer relationship quality protected against traumatic stress during specific times during adolescent development. Our results suggest that helping youth establish and maintain positive peer relationships may be a useful prevention approach for helping them cope with trauma experiences.
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Affiliation(s)
- Rebeccah L Sokol
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Brian E Perron
- School of Social Work, University of Michigan, 1080 S University, Ann Arbor, MI, 48109, USA
| | | | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
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Huth‐Bocks AC, Jester JM, Stacks AM, Muzik M, Rosenblum KL. Infant mental health home visiting therapists’ fidelity to the Michigan IMH‐HV model in community practice settings. Infant Ment Health J 2020; 41:206-219. [DOI: 10.1002/imhj.21839] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Alissa C. Huth‐Bocks
- Department of Pediatrics, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, School of MedicineCase Western Reserve University Cleveland Ohio
| | | | - Ann M. Stacks
- Merrill Palmer InstituteWayne State University Detroit Michigan
| | - Maria Muzik
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
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Rosenblum KL, Muzik M, Jester JM, Huth‐Bocks A, Erickson N, Ludtke M, Weatherston D, Brophy‐Herb H, Tableman B, Alfafara E, Waddell R. Community‐delivered infant–parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting. Infant Ment Health J 2020; 41:178-190. [DOI: 10.1002/imhj.21840] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Maria Muzik
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | | | - Alissa Huth‐Bocks
- University Hospitals Cleveland Medical CenterCase Western Reserve University Cleveland Ohio
| | - Nora Erickson
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | - Mary Ludtke
- Michigan Department of Health and Human Services Lansing Michigan
| | | | - Holly Brophy‐Herb
- Department of Family and Child EcologyMichigan State University East Lansing Michigan
| | - Betty Tableman
- The Guidance CenterMichigan Association for Infant Mental Health Southgate Michigan
| | - Emily Alfafara
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | - Rachel Waddell
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
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Shea SE, Jester JM, Huth‐Bocks AC, Weatherston DJ, Muzik M, Rosenblum KL. Infant mental health home visiting therapists’ reflective supervision self‐efficacy in community practice settings. Infant Ment Health J 2020; 41:191-205. [DOI: 10.1002/imhj.21834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sarah E. Shea
- School of Social Work, Eastern Michigan University, Ypsilanti, Michigan
| | | | - Alissa C. Huth‐Bocks
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | | | - Maria Muzik
- University of Michigan/Michigan Medicine, Ann Arbor, Michigan
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Ho SS, Muzik M, Rosenblum KL, Morelen D, Nakamura Y, Swain JE. Potential Neural Mediators of Mom Power Parenting Intervention Effects on Maternal Intersubjectivity and Stress Resilience. Front Psychiatry 2020; 11:568824. [PMID: 33363481 PMCID: PMC7752922 DOI: 10.3389/fpsyt.2020.568824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022] Open
Abstract
Stress resilience in parenting depends on the parent's capacity to understand subjective experiences in self and child, namely intersubjectivity, which is intimately related to mimicking other's affective expressions (i. e., mirroring). Stress can worsen parenting by potentiating problems that can impair intersubjectivity, e.g., problems of "over-mentalizing" (misattribution of the child's behaviors) and "under-coupling" (inadequate child-oriented mirroring). Previously we have developed Mom Power (MP) parenting intervention to promote maternal intersubjectivity and reduce parenting stress. This study aimed to elucidate neural mechanisms underlying the effects of MP with a novel Child Face Mirroring Task (CFMT) in functional magnetic-resonance-imaging settings. In CFMT, the participants responded to own and other's child's facial pictures in three task conditions: (1) empathic mirroring (Join), (2) non-mirroring observing (Observe), and (3) voluntary responding (React). In each condition, each child's neutral, ambiguous, distressed, and joyful expressions were repeatedly displayed. We examined the CFMT-related neural responses in a sample of healthy mothers (n = 45) in Study 1, and MP effects on CFMT with a pre-intervention (T1) and post-intervention (T2) design in two groups, MP (n = 19) and Control (n = 17), in Study 2. We found that, from T1 to T2, MP (vs. Control) decreased parenting stress, decreased dorsomedial prefrontal cortex (dmPFC) during own-child-specific voluntary responding (React to Own vs. Other's Child), and increased activity in the frontoparietal cortices, midbrain, nucleus accumbens, and amygdala during own-child-specific empathic mirroring (Join vs. Observe of Own vs. Other's Child). We identified that MP effects on parenting stress were potentially mediated by T1-to-T2 changes in: (1) the left superior-temporal-gyrus differential responses in the contrast of Join vs. Observe of own (vs. other's) child, (2) the dmPFC-PAG (periaqueductal gray) differential functional connectivity in the same contrast, and (3) the left amygdala differential responses in the contrast of Join vs. Observe of own (vs. other's) child's joyful vs. distressed expressions. We discussed these results in support of the notion that MP reduces parenting stress via changing neural activities related to the problems of "over-mentalizing" and "under-coupling." Additionally, we discussed theoretical relationships between parenting stress and intersubjectivity in a novel dyadic active inference framework in a two-agent system to guide future research.
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Affiliation(s)
- S Shaun Ho
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Maria Muzik
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L Rosenblum
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Diana Morelen
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States
| | - Yoshio Nakamura
- Department of Anesthesiology, Pain Research Center, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
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Jordan AA, Appugliese DP, Miller AL, Lumeng JC, Rosenblum KL, Pesch MH. Maternal prompting types and child vegetable intake: Exploring the moderating role of picky eating. Appetite 2019; 146:104518. [PMID: 31734294 DOI: 10.1016/j.appet.2019.104518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/16/2019] [Accepted: 11/13/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND It is unknown if using different maternal prompting types is associated with vegetable intake in children perceived to be picky versus non-picky. OBJECTIVES 1) To test the correlation of counts of maternal prompting types with child vegetable intake, and picky eating, 2) to examine the interaction of prompting types and picky eating status on vegetable intake. DESIGN/METHODS Low-income mother-child dyads (N = 199, mean child age 6.0 years) participated in a videotaped laboratory eating protocol with green beans, a familiar vegetable. A coding scheme was developed and reliably applied to categorize mothers' prompting types. The prompting types were: Coercive Control (Sub-Categories: Reward and Pressure-to-Eat), Autonomy Promotion (Sub-Categories: Modeling, Reasoning, Praise, and Question), and Total Prompts (sum of all prompts). Mothers completed questionnaires. Bivariate analyses tested the association between counts of maternal prompting types with amount of green beans eaten, and picky eating. Regression analyses examined the interaction of picky eating status with counts of maternal prompting type on amount of green beans eaten. RESULTS Mothers used on average 1.66 prompts. Greater use of Coercive Control, Autonomy Promotion-Modeling, and Total Prompts were all inversely correlated with amount of green beans eaten. Greater use of Autonomy Promotion-Praise was directly correlated with amount of green beans eaten. In stratified models, greater use of Coercive Control prompts was negatively associated with amount of green beans eaten by the child in non-picky eaters, but not in picky eaters. There was no interaction between other prompting types and child picky eating status in predicting amount eaten. All p-values <0.05. CONCLUSIONS Mothers use different prompting types to encourage their children to eat vegetables depending on their picky eating status, most of which may be correlated with reduced intake.
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Affiliation(s)
- Ariel A Jordan
- Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA, 30310, USA.
| | | | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Center for Human Growth and Development, University of Michigan, Department of Nutritional Sciences, School of Public Health, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI, 48109-5406, USA.
| | - Katherine L Rosenblum
- Department of Psychiatry, Medical School, University of Michigan, Center for Human Growth and Development, University of Michigan. 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI, 48109, USA.
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1111 SE, Ann Arbor, MI, 48109-5456, USA.
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McGinnis EW, Anderau SP, Hruschak J, Gurchiek RD, Lopez-Duran NL, Fitzgerald K, Rosenblum KL, Muzik M, McGinnis RS. Giving Voice to Vulnerable Children: Machine Learning Analysis of Speech Detects Anxiety and Depression in Early Childhood. IEEE J Biomed Health Inform 2019; 23:2294-2301. [PMID: 31034426 PMCID: PMC7484854 DOI: 10.1109/jbhi.2019.2913590] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Childhood anxiety and depression often go undiagnosed. If left untreated these conditions, collectively known as internalizing disorders, are associated with long-term negative outcomes including substance abuse and increased risk for suicide. This paper presents a new approach for identifying young children with internalizing disorders using a 3-min speech task. We show that machine learning analysis of audio data from the task can be used to identify children with an internalizing disorder with 80% accuracy (54% sensitivity, 93% specificity). The speech features most discriminative of internalizing disorder are analyzed in detail, showing that affected children exhibit especially low-pitch voices, with repeatable speech inflections and content, and high-pitched response to surprising stimuli relative to controls. This new tool is shown to outperform clinical thresholds on parent-reported child symptoms, which identify children with an internalizing disorder with lower accuracy (67-77% versus 80%), and similar specificity (85-100% versus 93%), and sensitivity (0-58% versus 54%) in this sample. These results point toward the future use of this approach for screening children for internalizing disorders so that interventions can be deployed when they have the highest chance for long-term success.
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Julian MM, King AP, Bocknek EL, Mantha B, Beeghly M, Rosenblum KL, Muzik M. Associations between oxytocin receptor gene (OXTR) polymorphisms, childhood trauma, and parenting behavior. Dev Psychol 2019; 55:2135-2146. [PMID: 31282733 DOI: 10.1037/dev0000783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Maternal oxytocin is connected to aspects of parenting including sensitivity, warmth, positive affect, and affectionate touch. Oxytocin receptor gene (OXTR) polymorphisms are associated with circulating oxytocin levels, altered brain activity, and parenting behaviors. This study aimed to replicate prior work on OXTR single-nucleotide polymorphisms (SNPs) rs1042778 and rs53576 in relation to maternal sensitivity, explore associations with other aspects of parenting (i.e., negative parenting), evaluate observational and self-report measures of parenting in relation to OXTR SNPs, and examine whether childhood trauma exposure moderates the relation between OXTR SNPs and parenting. Mothers (N = 100) were observed during 2 teaching interaction tasks with their 7-month-old infant, completed questionnaire and interview measures related to parenting and trauma history, and provided saliva specimens to derive OXTR genotypes. Mothers with OXTR rs1042778 TT genotypes demonstrated lower behavioral sensitivity, lower engagement, higher intrusiveness, and more frequent frightened/frightening behavior than mothers with TG or GG genotypes. Genotype interacted with childhood trauma history such that mothers who had experienced childhood trauma were more likely to demonstrate frightened/frightening behavior if they had the TT genotype on rs1042778 relative to the TG or GG genotype; however, small cell sizes for this interaction suggest replication is warranted. Contrary to expectations, mothers with the TT genotype on rs1042778 self-reported that they had less impaired bonding than mothers with TG or GG genotypes. Results are discussed with respect to prior work with oxytocin in lower versus higher risk samples, and the potential role of mothers' self-awareness in explaining discrepancies between results from observational versus self-report measures of parenting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Brody Mantha
- Department of Psychiatry, University of Michigan
| | | | | | - Maria Muzik
- Department of Psychiatry, University of Michigan
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Julian MM, Leung CYY, Rosenblum KL, LeBourgeois MK, Lumeng JC, Kaciroti N, Miller AL. Parenting and toddler self-regulation in low-income families: What does sleep have to do with it? Infant Ment Health J 2019; 40:479-495. [PMID: 31066463 DOI: 10.1002/imhj.21783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Toddlerhood is a sensitive period in the development of self-regulation, a set of adaptive skills that are fundamental to mental health and partly shaped by parenting. Healthy sleep is known to be critical for self-regulation; yet, the degree to which child sleep alters interactive child-parent processes remains understudied. This study examines associations between observed parenting and toddler self-regulation, with toddler sleep as a moderator of this association. Toddlers in low-income families (N = 171) and their mothers were videotaped during free play and a self-regulation challenge task; videos were coded for mothers' behavior and affect (free play) and toddlers' self-regulation (challenge task). Mothers reported their child's nighttime sleep duration via questionnaire. Results revealed significant Sleep × Maternal Negative Affect and Sleep × Maternal Negative Control interactions. Children who did not experience negative parenting had good self-regulation regardless of their nighttime sleep duration. For children who did experience negative parenting, self-regulation was intact among those who obtained more nighttime sleep, but significantly poorer among children who were getting less nighttime sleep. Thus, among children who were reported to obtain less nighttime sleep, there were more robust associations between negative parenting and poorer self-regulation than among toddlers who were reported to obtain more sleep.
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Affiliation(s)
- Megan M Julian
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, Michigan.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | - Christy Y Y Leung
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Surgery, Division of Otolaryngology, University of Chicago Medicine, Chicago, Illinois
| | - Katherine L Rosenblum
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, Michigan.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Pediatrics and Communicable Diseases, Medical School, University of Michigan, Ann Arbor, Michigan.,Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Lawler JM, Bocknek EL, McGinnis EW, Martinez-Torteya C, Rosenblum KL, Muzik M. Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity. Infancy 2019; 24:249-274. [PMID: 32677203 DOI: 10.1111/infa.12271] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 09/10/2018] [Accepted: 09/15/2018] [Indexed: 01/01/2023]
Abstract
The current study examined the role of hypothalamic-pituitary-adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at-risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers' depression was measured five times during the infants' first 18 months. Infant cortisol was collected during a social stressor (the still-face paradigm) when infants were 6 months old, and mothers reported on toddlers' internalizing and externalizing symptoms at 18 months. Among this sample of high-risk mother-infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.
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Affiliation(s)
| | | | | | | | | | - Maria Muzik
- Department of Psychiatry, University of Michigan
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Pesch MH, Viechnicki GB, Appugliese DP, Kaciroti N, Rosenblum KL, Miller AL, Lumeng JC. A mixed methods analysis of maternal response to children's consumption of a palatable food: differences by child weight status. Pediatr Obes 2019; 14:e12474. [PMID: 30350348 PMCID: PMC6495602 DOI: 10.1111/ijpo.12474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 08/21/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about how mothers respond to their child eating palatable foods. OBJECTIVES The objectives of the study are to examine maternal behaviours when children are presented with a large portion of energy-dense palatable food in an experimental setting and to examine differences by child weight status. METHODS Mother-child dyads (N = 37) (mean child age 70.8 months) participated in a videotaped eating protocol with cupcakes. Anthropometrics were measured. Videos were analysed using discourse analysis and were reliably coded for the presence or absence of the most salient theme. Analysis of variance examined theme presence by child and mother weight status. RESULTS Mothers disavowed responsibility for their child's eating. Mothers were observed to roll their eyes at the child, throw their hands up in exasperation and distance themselves both physically and emotionally when the child ate the cupcakes voraciously or with high enjoyment. Mothers of children with obesity (vs recommended weight) engaged in more counts of disavowal (p = 0.01). CONCLUSIONS Mothers of children with obesity distanced themselves from their child, seeming to disavow responsibility for the child's eating of 'junk food'. Mothers may respond to their child's seemingly gluttonous eating by disavowing responsibility due to the stigma of being a parent of a child with obesity.
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Affiliation(s)
- Megan H. Pesch
- Department of Pediatrics and Communicable Diseases, Division of Developmental and Behavioral Pediatrics, University of Michigan.,Center for Human Growth and Development, University of Michigan
| | | | | | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan
| | - Katherine L. Rosenblum
- Center for Human Growth and Development, University of Michigan.,Department of Psychiatry, University of Michigan
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Julie C. Lumeng
- Department of Pediatrics and Communicable Diseases, Division of Developmental and Behavioral Pediatrics, University of Michigan.,Center for Human Growth and Development, University of Michigan.,Department of Nutrition Sciences, School of Public Health, University of Michigan
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McGinnis RS, McGinnis EW, Hruschak J, Lopez-Duran NL, Fitzgerald K, Rosenblum KL, Muzik M. Rapid detection of internalizing diagnosis in young children enabled by wearable sensors and machine learning. PLoS One 2019; 14:e0210267. [PMID: 30650109 PMCID: PMC6334916 DOI: 10.1371/journal.pone.0210267] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 12/18/2018] [Indexed: 01/21/2023] Open
Abstract
There is a critical need for fast, inexpensive, objective, and accurate screening tools for childhood psychopathology. Perhaps most compelling is in the case of internalizing disorders, like anxiety and depression, where unobservable symptoms cause children to go unassessed-suffering in silence because they never exhibiting the disruptive behaviors that would lead to a referral for diagnostic assessment. If left untreated these disorders are associated with long-term negative outcomes including substance abuse and increased risk for suicide. This paper presents a new approach for identifying children with internalizing disorders using an instrumented 90-second mood induction task. Participant motion during the task is monitored using a commercially available wearable sensor. We show that machine learning can be used to differentiate children with an internalizing diagnosis from controls with 81% accuracy (67% sensitivity, 88% specificity). We provide a detailed description of the modeling methodology used to arrive at these results and explore further the predictive ability of each temporal phase of the mood induction task. Kinematical measures most discriminative of internalizing diagnosis are analyzed in detail, showing affected children exhibit significantly more avoidance of ambiguous threat. Performance of the proposed approach is compared to clinical thresholds on parent-reported child symptoms which differentiate children with an internalizing diagnosis from controls with slightly lower accuracy (.68-.75 vs. .81), slightly higher specificity (.88-1.00 vs. .88), and lower sensitivity (.00-.42 vs. .67) than the proposed, instrumented method. These results point toward the future use of this approach for screening children for internalizing disorders so that interventions can be deployed when they have the highest chance for long-term success.
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Affiliation(s)
- Ryan S. McGinnis
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, United States of America
| | - Ellen W. McGinnis
- Department of Psychiatry, University of Vermont, Burlington, VT, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
| | - Jessica Hruschak
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Nestor L. Lopez-Duran
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
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Miller AL, Miller SE, LeBourgeois MK, Sturza J, Rosenblum KL, Lumeng JC. Sleep duration and quality are associated with eating behavior in low-income toddlers. Appetite 2019; 135:100-107. [PMID: 30634008 DOI: 10.1016/j.appet.2019.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The present study examined whether different sleep health parameters (duration, timing, and quality) are associated with obesity-related eating behaviors including emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness, and eating in the absence of hunger (EAH), during toddlerhood. DESIGN Among 134 low-income 33-month-old children, parents reported on child sleep parameters, including sleep quality (Children's Sleep Wake Scale; CSWS) and usual bedtimes and wake times on weekdays and weekends (weeknight sleep duration, weekday-to-weekend bedtime delay). Child eating behaviors were assessed using both observed and parent-report measures. Child Emotional Overeating, Food Responsiveness, Enjoyment of Food, and Satiety Responsiveness were measured by parent report using the Child Eating Behavior Questionnaire-Toddler. Observed child EAH was evaluated by measuring kilocalories of palatable foods consumed following a meal. Multivariable linear regression was used to examine the associations between sleep parameters and eating behaviors. RESULTS Poorer child sleep quality was associated with greater Emotional Overeating (standardized β = -0.20 (SE 0.09), p < .05) and greater Food Responsiveness (β = -0.18 (SE 0.09), p < .05). Shorter child nighttime sleep duration was associated with greater EAH kcal consumed (standardized β = -0.22 (SE 0.09), p < .05). Child bedtime delay was not associated with any of the eating behaviors, and no child sleep variables were associated with either Enjoyment of Food or Satiety Responsiveness. CONCLUSIONS Shorter nocturnal sleep duration and poorer sleep quality during toddlerhood were associated with some, but not all, of the obesity-related eating behaviors. Poor sleep health may promote childhood obesity risk through different eating behavior pathways. As children growing up in poverty may experience greater sleep decrements, sleep duration and sleep quality may be important targets for intervention among low-income families with young children.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States; Center for Human Growth and Development, University of Michigan, United States.
| | - Sara E Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States
| | | | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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Pesch MH, Appugliese DP, Miller AL, Rosenblum KL, Lumeng JC, Bauer KW. Approaches to restrictive feeding: Associations with child weight and eating behavior. Eat Behav 2018; 31:74-79. [PMID: 30153545 PMCID: PMC6226350 DOI: 10.1016/j.eatbeh.2018.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/09/2018] [Accepted: 08/22/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identifying differences in how mothers communicate restriction of their children's eating may be important to understanding the effects of restriction on children's intake and weight status. OBJECTIVES To characterize mothers' restrictive statements by affect and directness, and examine cross-sectional associations between restrictive statement types and children's body mass index and eating behaviors. METHODS Mother-child dyads (N = 223, mean child age 5.9 years) participated in a structured eating task. A coding scheme reliably characterized mothers' restrictive statements. Mothers completed measures of child enjoyment of food, food responsiveness, and satiety responsiveness, and child anthropometrics were measured. Poisson regression was used to test associations between type of restrictive statements and child BMI z-score (BMIz) and eating behaviors, adjusting for covariates. RESULTS Higher child BMIz was associated with mothers' more frequent use of negative direct restrictive statements, but not other types of statements. This association was stronger among girls (RR (95% CI) = 2.28 (1.45-3.59)) than boys (RR (95% CI) = 1.49 (1.05-2.10)). Among girls, but not boys, higher enjoyment of food and lower satiety responsiveness were associated with more frequent positive direct restrictive statements (RR (95% CI) = 1.63 (1.20-2.21) and RR (95% CI) = 1.94 (1.29-2.92), respectively). For both sexes, mothers' use of positive indirect restrictive statements was more frequent among children with higher enjoyment of food (RR (95% CI) = 1.38 (1.11-1.72). CONCLUSIONS The statements mothers use to restrict their children's eating vary in affect and directness. Child characteristics, such as sex, BMI, and the presence of specific eating behaviors, are associated with differing approaches to restriction by mothers.
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Affiliation(s)
- Megan H. Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, and the Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI 48109-5456, USA.
| | | | - Alison L. Miller
- Center for Human Growth and Development and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 3718 SPH Building I, Ann Arbor, MI 48109-2029, USA.
| | - Katherine L. Rosenblum
- Department of Psychiatry, Medical School and Center for Human Growth and Development, University of Michigan, 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
| | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases; the Center for Human Growth and Development, and the Department of Nutritional Sciences, School of Public Health at the University of Michigan, 300 N. Ingalls Street, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | - Katherine W. Bauer
- Department of Nutritional Sciences, School of Public Health, University of Michigan, and Center for Human Growth and Development, 3845 SPH 1, 1415 Washington Heights, Ann Arbor MI, 48109-2029, USA.
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Julian MM, Muzik M, Kees M, Valenstein M, Dexter C, Rosenblum KL. Intervention effects on reflectivity explain change in positive parenting in military families with young children. J Fam Psychol 2018; 32:804-815. [PMID: 29878806 PMCID: PMC6126948 DOI: 10.1037/fam0000431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Military families with young children often experience stress related to the unique circumstances of military families (e.g., deployment), and there is a need for interventions that are specifically tailored to military families with young children. The Strong Military Families (SMF) intervention responds to this need, and consists of two versions: A Multifamily Group (N = 34), and a Homebased psychoeducational written material program (N = 42; treated as the comparison group in this report). The Multifamily Group utilized an attachment-based parenting education curriculum and in vivo support of separations and reunions, encouraged peer support among parents, and connected families to additional services. In the present nonrandomized trial, we examine intervention effects on observed parenting behavior and affect, and test whether changes in parenting reflectivity account for intervention-related changes in observed parenting. Observed parenting behavior and affect were coded from the Caregiver-Child Structured Interaction Procedure (Crowell & Fleischmann, 1993), and parenting reflectivity was coded from the Working Model of the Child Interview (Zeanah & Benoit, 1995). Results suggest that relative to Homebased participants, Multifamily Group participants showed pre- and post- improvements in aspects of positive parenting (Emotional Responsivity, Positive Affect), but no decreases in negative parenting. The efficacy of the SMF Multifamily Group intervention does not appear to depend on parent risk level or preintervention parent behavior and affect. Further, a mediation model demonstrated that the intervention effects on parents' observed positive affect in an interaction task with their child were partially accounted for by intervention-related changes in their parenting reflectivity. (PsycINFO Database Record
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Affiliation(s)
- Megan M. Julian
- University of Michigan Center for Human Growth & Development
| | - Maria Muzik
- University of Michigan Center for Human Growth & Development
- University of Michigan Department of Psychiatry
| | | | | | - Casey Dexter
- Berry College, School of Education and Human Sciences
| | - Katherine L. Rosenblum
- University of Michigan Center for Human Growth & Development
- University of Michigan Department of Psychiatry
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Pesch MH, Berlin KS, Cesaro RJ, Rybak TM, Miller AL, Rosenblum KL, Lumeng JC. Maternal discouragement and child intake of a palatable dessert: A multilevel sequential analysis. Appetite 2018; 129:171-177. [PMID: 30009930 DOI: 10.1016/j.appet.2018.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/04/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Family mealtimes are often marked by parent-child conflict, which may arise when children's eating behaviors do not match parental expectations. Little is known about how children respond to parents' comments to discourage eating. OBJECTIVE The objective of this study was to examine the likelihood of a child taking a bite following a maternal statement to discourage child intake. METHODS 50 mother-child dyads (mean child age 71.8 months) participated in a laboratory eating task with cupcakes. Video recordings were reliably coded for maternal statements to discourage child intake (varying by domains of affective valence and directness) and child bites. Multilevel sequential analysis was performed to determine differences in pairs' antecedent statement to discourage child intake and a child's discouraged bite. RESULTS Children were significantly more likely to be non-compliant by taking a bite following negative (vs. positive), indirect (vs. direct) and negative direct (vs. positive direct) statements to discourage child intake (that is, a "discouraged bite"). There were no differences in children taking discouraged bites following a negative indirect vs. positive indirect statement to discourage child intake. CONCLUSIONS Children may be more apt to comply with their mother's mealtime commands if they are delivered with a direct approach and a positive affective valence. Future work should examine the longitudinal effects of using positive direct mealtime commands on children's food intake, weight gain and emotional health.
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Affiliation(s)
- Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI, 48109-5456, USA.
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis, and Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap, Rm 461R, Memphis, TN 38103, USA.
| | - Robert J Cesaro
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI, 48109-5624, USA.
| | - Tiffany M Rybak
- Department of Psychology, The University of Memphis, 400 Innovation Dr #202, Memphis, TN 38152, USA.
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, and Center for Human Growth and Development, University of Michigan. 3718 SPH Building I, Ann Arbor, MI, 48109-2029, USA.
| | - Katherine L Rosenblum
- Department of Psychiatry, Medical School, University of Michigan, and Center for Human Growth and Development, University of Michigan. 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI, 48109, USA.
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Center for Human Growth and Development, University of Michigan, and Department of Nutritional Sciences, School of Public Health, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI, 48109-5406, USA.
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McGinnis RS, McGinnis EW, Hruschak J, Lopez-Duran NL, Fitzgerald K, Rosenblum KL, Muzik M. Rapid Anxiety and Depression Diagnosis in Young Children Enabled by Wearable Sensors and Machine Learning. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2018:3983-3986. [PMID: 30441231 DOI: 10.1109/embc.2018.8513327] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper presents a new approach for diagnosing anxiety and depression in young children. Currently, diagnosis requires hours of structured clinical interviews and standardized questionnaires spread over days or weeks. We propose the use of a 90-second fear induction task during which time participant motion is monitoring using a commercially available wearable sensor. Machine learning and data extracted from the most clinically feasible 20-second phase of the task are used to predict diagnosis in a sample of children with and without an internalizing diagnosis. We examine the performance of a variety of feature sets and modeling approaches to identify the best performing logistic regression that provides a diagnostic accuracy of 80%. This accuracy is comparable to existing diagnostic techniques, but at a small fraction of the time and cost currently required. These results point toward the future use of this approach in a clinical setting for diagnosing children with internalizing disorders.
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Song JH, Miller AL, Leung CYY, Lumeng JC, Rosenblum KL. Positive Parenting Moderates the Association between Temperament and Self-Regulation in Low-Income Toddlers. J Child Fam Stud 2018; 27:2354-2364. [PMID: 30275671 PMCID: PMC6162054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Self-regulation develops rapidly during the toddler years and underlies many important developmental outcomes, including social-emotional competence and academic achievement. It is important to understand factors that contribute to early self-regulation skills among children at risk for adjustment difficulties in these domains, such as children growing up in poverty. The current study examined mother-reported child temperament (negative affect, effortful control) and observed maternal parenting (during a mother-child free play) as contributing factors to toddlers' observed self-regulation during delay of gratification tasks at 27 months (snack delay) and 33 months (gift delay). Participants were 198 toddlers (M age = 27 months; 53% boys; 48% non-Hispanic white) and their mothers from low-income families. Mothers' negative parenting characterized by negative affect, hostility, and negative control was associated with poorer self-regulation contemporaneously. Toddlers' lower negative affect and higher effortful control predicted better self-regulation at 33 months, but positive parenting characterized by positive affect and sensitivity moderated these associations at both time points. Specifically, we found a buffering effect of high positive parenting among toddlers with a temperamental risk and a deleterious effect of low positive parenting despite toddlers' temperamental strength. Results highlight the importance of positive parenting for fostering the development of self-regulation among toddlers growing up with poverty-related and child-level risks.
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Affiliation(s)
- Ju-Hyun Song
- Department of Psychology, University of Toronto, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Alison L Miller
- Center for Human Growth and Development, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Christy Y Y Leung
- TMW Center for Early Learning + Public Health, University of Chicago, Chicago, IL
| | - Julie C Lumeng
- Center for Human Growth and Development, Department of Pediatrics, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Katherine L Rosenblum
- Center for Human Growth and Development, Department of Psychiatry, University of Michigan, Ann Arbor, MI
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Julian MM, Rosenblum KL, Doom JR, Leung CYY, Lumeng JC, Cruz MG, Vazquez DM, Miller AL. Oxytocin and parenting behavior among impoverished mothers with low vs. high early life stress. Arch Womens Ment Health 2018; 21:375-382. [PMID: 29168023 PMCID: PMC5943180 DOI: 10.1007/s00737-017-0798-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/13/2017] [Indexed: 01/25/2023]
Abstract
Recent work suggests that key aspects of sensitive parenting (e.g., warmth, emotional attunement) may be shaped in part by biology, specifically the neuropeptide oxytocin. However, some studies have found that oxytocin may not act in expected ways in higher-risk populations (e.g., those with postnatal depression or borderline personality disorder). This study examined the relation between oxytocin and parenting among mothers with varying levels of early life stress. Forty low-income mothers and their 34- to 48-month-old child participated in this study. Mother-child dyads were observed in an interaction task in their home, and videos of these interactions were later coded for parenting behaviors. Mothers' oxytocin production before and after the interaction task was assessed through saliva. Mothers' early stress was assessed via the Adverse Childhood Experiences Scale (ACES; Felitti et al. Am J Prev Med 14:245-258, 1998). For mothers with low ACEs, higher oxytocin secretion was associated with more positive parenting. For mothers with high ACEs, higher oxytocin secretion was associated with lower levels of positive parenting. Oxytocin may be operating differently for mothers who experienced harsh early social environments, supporting more defensive behaviors and harsh parenting than anxiolytic and prosocial behaviors.
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Affiliation(s)
- Megan M. Julian
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Katherine L. Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Jenalee R. Doom
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Christy Y. Y. Leung
- Department of Surgery, Division of Otolaryngology, University of Chicago Medicine, Chicago, IL
| | - Julie C. Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI,Department of Nutrition Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | | | - Delia M. Vazquez
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Psychiatry, University of Michigan, Ann Arbor, MI,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
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Martinez-Torteya C, Rosenblum KL, Beeghly M, Oppenheim D, Koren-Karie N, Muzik M. Maternal insightfulness protects against the detrimental effects of postpartum stress on positive parenting among at-risk mother-infant dyads. Attach Hum Dev 2018; 20:272-286. [PMID: 29536802 PMCID: PMC6287079 DOI: 10.1080/14616734.2018.1446735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The current study evaluated whether maternal insightfulness can buffer the negative influence of postpartum stressful life events on maternal parenting behaviors. Participants were 125 mother-infant dyads (55% boys) who present a subsample of a larger longitudinal study on maternal maltreatment during childhood and its impact on peripartum maternal adjustment. Women were primarily white and middle class. At 4 months postpartum, mothers reported on the stressful life events experienced after the child's birth and current depressive symptoms. At 6 months postpartum, maternal parenting quality was assessed using videotaped mother-infant interactions and maternal insightfulness was evaluated using the Insightfulness Assessment. Insightfulness significantly moderated the effect of postpartum stressful events on maternal parenting behaviors. Mothers who were insightful displayed high levels of positive parenting during interactions with their infant regardless of the amount of stressful life events experienced. In contrast, mothers classified as non-insightful showed less positive parenting as they experienced more stressful life events. Findings highlight the protective role of maternal insightfulness in the face of postpartum stress, and suggest that efforts to enhance insightfulness during the early postpartum period may be particularly relevant for women in high-risk contexts.
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Affiliation(s)
| | - Katherine L Rosenblum
- b Women and Infants Mental Health Program, Department of Psychiatry and Center for Human Growth & Development , University of Michigan , Michigan , USA
| | - Marjorie Beeghly
- c Department of Psychology , Wayne State University , Detroit , USA
| | - David Oppenheim
- d Department of Psychology , University of Haifa , Haifa , Israel
| | | | - Maria Muzik
- b Women and Infants Mental Health Program, Department of Psychiatry and Center for Human Growth & Development , University of Michigan , Michigan , USA
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DeJesus JM, Gelman SA, Viechnicki GB, Appugliese DP, Miller AL, Rosenblum KL, Lumeng JC. An investigation of maternal food intake and maternal food talk as predictors of child food intake. Appetite 2018; 127:356-363. [PMID: 29758271 DOI: 10.1016/j.appet.2018.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 01/13/2023]
Abstract
Though parental modeling is thought to play a critical role in promoting children's healthy eating, little research has examined maternal food intake and maternal food talk as independent predictors of children's food intake. The present study examines maternal food talk during a structured eating protocol, in which mothers and their children had the opportunity to eat a series of familiar and unfamiliar vegetables and desserts. Several aspects of maternal talk during the protocol were coded, including overall food talk, directives, pronoun use, and questions. This study analyzed the predictors of maternal food talk and whether maternal food talk and maternal food intake predicted children's food intake during the protocol. Higher maternal body mass index (BMI) predicted lower amounts of food talk, pronoun use, and questions. Higher child BMI z-scores predicted more first person pronouns and more wh-questions within maternal food talk. Mothers of older children used fewer directives, fewer second person pronouns, and fewer yes/no questions. However, maternal food talk (overall and specific types of food talk) did not predict children's food intake. Instead, the most robust predictor of children's food intake during this protocol was the amount of food that mothers ate while sitting with their children. These findings emphasize the importance of modeling healthy eating through action and have implications for designing interventions to provide parents with more effective tools to promote their children's healthy eating.
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Affiliation(s)
- Jasmine M DeJesus
- Department of Psychology, University of Michigan, United States; Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, United States.
| | - Susan A Gelman
- Department of Psychology, University of Michigan, United States
| | | | | | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, United States
| | | | - Julie C Lumeng
- Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, United States; Department of Nutritional Sciences, School of Public Health, University of Michigan, United States
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Fernandez C, DeJesus JM, Miller AL, Appugliese DP, Rosenblum KL, Lumeng JC, Pesch MH. Selective eating behaviors in children: An observational validation of parental report measures. Appetite 2018; 127:163-170. [PMID: 29729326 DOI: 10.1016/j.appet.2018.04.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 01/13/2023]
Abstract
Selective eating in children is commonly measured by parental report questionnaires, yet it is unknown if parents accurately estimate their child's selective eating behavior. The objectives of this study were to test the validity and stability of two measures of selective eating using observed child behavior. Low-income mother-child dyads participated in a videotaped laboratory eating protocol at two time points (baseline: mean child age = 5.9 years; follow-up: mean child age = 8.6 years), during which they were presented with a familiar and an unfamiliar vegetable. Videos were reliably coded for child selective eating behaviors: amount consumed, child hedonic rating of vegetables, child compliance with maternal prompts to eat, latency to first bite, number of bites, and negative utterances. Mothers completed the Child Eating Behavior Questionnaire Food Fussiness (CEBQ FF) scale and the Food Neophobia Scale (FNS) at both time points. Questionnaire validity, stability of measured behaviors, and discriminant validity of questionnaires were examined in the full sample. CEBQ FF scores and FNS scores were both inversely correlated with the quantity consumed, child hedonic rating, and compliance with prompts to eat for both familiar and unfamiliar vegetables at baseline and at follow up. CEBQ FF and FNS scores were inversely correlated with number of bites (for both foods), positively correlated with latency to first bite (for both foods), and inversely correlated with child negative utterances (for the familiar food only). Notably, FNS scores correlated with observed behavior for both familiar and unfamiliar foods, rather than demonstrating a specific association with unfamiliar foods only. This study supports the validity of the CEBQ FF and FNS in low-income early school-aged children.
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Affiliation(s)
- Carmen Fernandez
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI 48109-5624, USA.
| | - Jasmine M DeJesus
- Center for Human Growth and Development, University of Michigan, Department of Pediatrics and Communicable Diseases, University of Michigan, and the Department of Psychology, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, and the Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | | | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, and Department of Psychiatry, Medical School, University of Michigan, 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Department of Nutritional Sciences, School of Public Health, University of Michigan, and Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI 48109, USA.
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, and Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI 48109-5456, USA.
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Abstract
OBJECTIVE Qualities of the parent-child relationship have not been explored as predictors of parent mobile device use during parent-child activities. METHODS In 195 mother-child dyads enrolled in an ongoing cohort study, maternal mental representations of their child (ability to reflect on their child's characteristics, emotional state, and their parenting role) were evaluated through the Working Model of the Child Interview (WMCI), a validated semistructured interview. WMCI scale scores were examined as predictors of active maternal mobile device use during parent-child eating encounters (videotaped home mealtimes and a structured laboratory-based protocol) in multivariate logistic regression models. RESULTS Children were aged 5.9 years (SD: 0.7), mothers were aged 31.5 years (SD: 7.4), and 73.3% of mothers were of white non-Hispanic race/ethnicity. During the family mealtime, 47 (24.1%) mothers actively used a mobile device at least once, whereas during the structured eating protocol, 44 (22.6%) mothers used a device. Controlling for maternal race/ethnicity, education level, and child's sex, WMCI subscales were associated with device use during home mealtimes (higher Child Difficulty) and the eating protocol (higher Child Difficulty and lower Richness of Perceptions and Caregiving Sensitivity). CONCLUSION Maternal mental representations of their child were significantly associated with using mobile devices during eating encounters. More research studies are needed to understand directionality and longer-term associations between mobile device use and parent-child relationship characteristics.
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Affiliation(s)
- Jenny Radesky
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Christy Leung
- Center for Human Growth and Development, University of Michigan, Ann Arbor MI
| | | | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor MI
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Julie C Lumeng
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI
- Center for Human Growth and Development, University of Michigan, Ann Arbor MI
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor MI
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
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McGinnis EW, McGinnis RS, Hruschak J, Bilek E, Ip K, Morlen D, Lawler J, Lopez-Duran NL, Fitzgerald K, Rosenblum KL, Muzik M. Wearable sensors detect childhood internalizing disorders during mood induction task. PLoS One 2018; 13:e0195598. [PMID: 29694369 PMCID: PMC5918795 DOI: 10.1371/journal.pone.0195598] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 03/26/2018] [Indexed: 12/18/2022] Open
Abstract
There is a significant need to develop objective measures for identifying children under the age of 8 who have anxiety and depression. If left untreated, early internalizing symptoms can lead to adolescent and adult internalizing disorders as well as comorbidity which can yield significant health problems later in life including increased risk for suicide. To this end, we propose the use of an instrumented fear induction task for identifying children with internalizing disorders, and demonstrate its efficacy in a sample of 63 children between the ages of 3 and 7. In so doing, we extract objective measures that capture the full six degree-of-freedom movement of a child using data from a belt-worn inertial measurement unit (IMU) and relate them to behavioral fear codes, parent-reported child symptoms and clinician-rated child internalizing diagnoses. We find that IMU motion data, but not behavioral codes, are associated with parent-reported child symptoms and clinician-reported child internalizing diagnosis in this sample. These results demonstrate that IMU motion data are sensitive to behaviors indicative of child psychopathology. Moreover, the proposed IMU-based approach has increased feasibility of collection and processing compared to behavioral codes, and therefore should be explored further in future studies.
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Affiliation(s)
- Ellen W. McGinnis
- Department of Psychiatry, University of Vermont, Burlington, VT, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
| | - Ryan S. McGinnis
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, United States of America
| | - Jessica Hruschak
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Emily Bilek
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Ka Ip
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Diana Morlen
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States of America
| | - Jamie Lawler
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Nestor L. Lopez-Duran
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
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Pesch MH, Miller AL, Appugliese DP, Rosenblum KL, Lumeng JC. Mothers of Obese Children Use More Direct Imperatives to Restrict Eating. J Nutr Educ Behav 2018; 50:403-407.e1. [PMID: 29242139 PMCID: PMC5893350 DOI: 10.1016/j.jneb.2017.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine the association of mother and child characteristics with use of direct imperatives to restrict eating. METHODS A total of 237 mother-child dyads (mean child age, 70.9 months) participated in a video-recorded, laboratory-standardized eating protocol with 2 large portions of cupcakes. Videos were reliably coded for counts of maternal direct imperatives to restrict children's eating. Anthropometrics were measured. Regression models tested the association of participant characteristics with counts of direct imperatives. RESULTS Child obese weight status and maternal white non-Hispanic race/ethnicity were associated with greater levels of direct imperatives to restrict eating (p = .0001 and .0004, respectively). CONCLUSIONS AND IMPLICATIONS Mothers of obese children may be using more direct imperatives to restrict eating so as to achieve behavioral compliance to decrease their child's food intake. Future work should consider the effects direct imperatives have on children's short- and long-term eating behaviors and weight gain trajectories.
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Affiliation(s)
- Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI.
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | | | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Medical School, University of Michigan
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
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49
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Menke RA, Morelen D, Simon VA, Rosenblum KL, Muzik M. Longitudinal Relations Between Childhood Maltreatment, Maltreatment-Specific Shame, and Postpartum Psychopathology. Child Maltreat 2018; 23:44-53. [PMID: 28705086 PMCID: PMC5593779 DOI: 10.1177/1077559517720070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The persistence of shame-based reactions to child maltreatment (CM) has been associated with poor posttraumatic adjustment. Despite evidence that the postpartum period is a vulnerable time for women with CM histories, little is known about the consequences of maltreatment-specific (MS) shame for postpartum functioning. The current study examined individual differences in MS shame among a sample of women during the postpartum period ( n = 100) as well as prospective relations from MS shame to postpartum psychopathology at 6-, 12-, 15-, and 18-month postpartum. Linear growth curve (LGC) analyses showed that MS shame predicted higher levels of depression symptoms but not post-traumatic stress disorder (PTSD) symptoms at all time points whereas path analyses showed that shame mediated the relations from multi-maltreatment to both depression and PTSD symptoms at all time points. Results point to the long-term consequences of MS shame during postpartum and the importance of attending to shame in clinical care of maltreatment survivors who present with postpartum psychopathology.
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Affiliation(s)
- Rena A. Menke
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Diana Morelen
- Eastern Tennessee State University, Johnson City, TN, USA
| | - Valerie A. Simon
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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50
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Briones NF, Cesaro RJ, Appugliese DP, Miller AL, Rosenblum KL, Pesch MH. Do children with obesity have worse table manners? Associations between child table manners, weight status and weight gain. Appetite 2018; 125:57-62. [PMID: 29409887 DOI: 10.1016/j.appet.2018.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/09/2018] [Accepted: 01/21/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Children with obesity experience stigma stemming from stereotypes, one such stereotype is that people with obesity are "sloppy" or have poor manners. Teaching children "proper table manners" has been proposed as an obesity prevention strategy. Little is known about the association between children's weight status and table manners. OBJECTIVES To examine correlates of child table manners and to examine the association of child table manners with child obese weight status and prospective change in child body mass index z-score (BMIz). METHODS Mother-child dyads (N = 228) participated in a videotaped laboratory eating task with cupcakes. Coding schemes to capture child table manners (making crumbs, chewing with mouth open, getting food on face, shoving food in mouth, slouching, and getting out of seat), and maternal attentiveness to child table manners, were reliably applied. Anthropometrics were measured at baseline and at follow-up two years later. Regression analyses examined the association of participant characteristics with child table manners, as well as the associations of child table manners with child obese weight status, and prospective change in BMIz/year. RESULTS Predictors of poorer child table manners were younger child age, greater cupcake consumption, and greater maternal attentiveness to child table manners. Poorer child table manners were not associated with child obese (vs. not) weight status, but were associated with a prospective decrease in BMIz/year in children with overweight/obesity. CONCLUSIONS Obesity interventions to improve table manners may be perpetuating unfavorable stereotypes and stigma. Future work investigating these associations is warranted to inform childhood obesity guidelines around table manners.
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Affiliation(s)
- Naomi F Briones
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI 48109-5624, USA.
| | - Robert J Cesaro
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI 48109-5624, USA.
| | | | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, and the Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, Department of Psychiatry, Medical School, University of Michigan, 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, and the Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI 48109-5456, USA.
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