Tiwari Ashwini, Self-Brown Shannon, Lai Betty S, McCarty Colleen, Carruth Laura
a School of Public Health , Georgia State University , Atlanta , Georgia , USA.
b Neuroscience Institute , Georgia State University , Atlanta , Georgia , USA.
Soc Work Health Care. 2018 Mar;57(3):137-163. doi: 10.1080/00981389.2017.1371096. Epub 2017 Sep 11.
Parental stress is an important risk factor for child maltreatment (CM) perpetration. Evidence-based, parent-training programs can decrease CM perpetration risk and reduce self-reported parental stress; however, little is known about how such programs impact physiological stress correlates. In this quasi-experimental pilot study, maternal biobehavioral responses were measured in response to SafeCare®, an evidence-based program targeting CM, often implemented by social workers in child welfare settings. Maternal participants (N = 18) were recruited to complete SafeCare and repeated within-subject assessments pre- and post-intervention. Analyses examined associations between self-reported parental stress and mental health symptomology with stress markers for cortisol, alpha-amylase, and dihydroepiandrosterone at baseline and follow-up. Baseline correlation analyses showed strong associations between parental stress, salivary cortisol levels, and alpha-amylase. At follow-up, significant correlations were found between parental stress and alpha-amylase for intervention completers (n = 7). Completers on average exhibited decreases across self-reported parental stress and global distress symptomology and improvements in salivary cortisol and alpha-amylase levels. Participants with impaired cortisol levels at baseline were within normal limits post-intervention. These pilot findings suggest that salivary cortisol and alpha-amylase are compelling physiological correlates of parental stress among high-risk parents. Results also support short-term, positive effects of SafeCare in potentially regulating physiological stress systems among at-risk mothers.
父母压力是儿童虐待行为的一个重要风险因素。基于证据的父母培训项目可以降低儿童虐待行为的风险，并减少自我报告的父母压力；然而，对于此类项目如何影响生理压力相关指标却知之甚少。在这项准实验性试点研究中，针对儿童福利机构中经常由社会工作者实施的一项旨在预防儿童虐待的循证项目SafeCare，测量了母亲的生物行为反应。招募了18名母亲参与完成SafeCare项目，并在干预前后进行了重复的受试者内评估。分析考察了自我报告的父母压力和心理健康症状与基线和随访时皮质醇、α-淀粉酶和脱氢表雄酮等压力指标之间的关联。基线相关性分析显示，父母压力、唾液皮质醇水平和α-淀粉酶之间存在强关联。在随访时，干预完成者（n = 7）的父母压力与α-淀粉酶之间存在显著相关性。完成者平均在自我报告的父母压力和总体困扰症状方面有所下降，唾液皮质醇和α-淀粉酶水平有所改善。基线时皮质醇水平受损的参与者在干预后处于正常范围内。这些初步研究结果表明，唾液皮质醇和α-淀粉酶是高危父母中父母压力的有力生理相关指标。研究结果还支持SafeCare在潜在调节高危母亲生理压力系统方面的短期积极作用。
