Toth Sheree L, Sturge-Apple Melissa L, Rogosch Fred A, Cicchetti Dante
University of Rochester Mt. Hope Family Center.
Dev Psychopathol. 2015 Nov;27(4 Pt 2):1661-74. doi: 10.1017/S0954579415001017.
The present study applies a multilevel approach to an examination of the effect of two randomized preventive interventions with mothers in neglectful families who are also contending with elevated levels of impoverishment and ecological risk. Specifically, we examined how participation in either child-parent psychotherapy (CPP) or psychoeducational parenting intervention (PPI) was associated with reductions in maternal psychological parenting stress and in turn physiological stress system functioning when compared to mothers involved in standard community services as well as a demographic comparison group of nonmaltreating mothers. The resulting group sizes in the current investigation were 44 for CPP, 34 for PPI, 27 for community services, and 52 for nonmaltreating mothers. Mothers and their 13-month-old infants were randomly assigned to intervention group at baseline. Mothers completed assessments on stress within the parenting role at baseline and postintervention. Basal cortisol was sampled at postintervention and 1-year follow-up. Latent difference score analyses examined change in these constructs over time. Results suggested that mothers within the CPP intervention experienced significant declines in child-related parenting stress, while mothers in the PPI intervention reported declines in parent-related parenting stress. In turn, significant decreases in stress within the CPP mothers were further associated with adaptive basal cortisol functioning at 1-year postintervention. The results highlight the value of delineating how participation in preventive interventions aimed at ameliorating child maltreatment in neglectful families within the context of poverty may operate through improvements in psychological and physiological stress functioning. Findings are discussed with respect to the importance of multilevel assessments of intervention process and outcome.
本研究采用多层次方法，考察了两种随机预防性干预措施对忽视型家庭中母亲的影响，这些家庭同时还面临着贫困加剧和生态风险。具体而言，我们研究了与参与标准社区服务的母亲以及非虐待母亲的人口统计学比较组相比，参与儿童-家长心理治疗（CPP）或心理教育育儿干预（PPI）如何与母亲心理育儿压力的降低相关，进而与生理压力系统功能的降低相关。在当前调查中，CPP组的样本量为44，PPI组为34，社区服务组为27，非虐待母亲组为52。母亲及其13个月大的婴儿在基线时被随机分配到干预组。母亲们在基线和干预后完成了关于育儿角色压力的评估。在干预后和1年随访时采集基础皮质醇样本。潜在差异分数分析考察了这些构念随时间的变化。结果表明，CPP干预组的母亲在与孩子相关的育儿压力方面显著下降，而PPI干预组的母亲报告在与家长相关的育儿压力方面有所下降。反过来，CPP组母亲压力的显著降低进一步与干预后1年时适应性基础皮质醇功能相关。结果强调了描绘在贫困背景下旨在改善忽视型家庭中儿童虐待情况的预防性干预措施的参与如何通过心理和生理压力功能的改善来发挥作用的价值。讨论了关于干预过程和结果的多层次评估的重要性的研究发现。
