Attachment and Biobehavioral Catch-up (ABC) demonstrates efficacy in improving parent and child outcomes, with preliminary evidence for effectiveness in community settings. The objective of this study was to assess the effectiveness of a community-based ABC implementation in improving parent outcomes as well as to examine potential mediators and moderators of intervention effectiveness. Two hundred parents and their 5- to 21-month-old infants recruited from an urban community were randomly assigned to receive ABC or be placed on a waitlist. The majority of participants had a minority racial or ethnic background. Before intervention, parents completed questionnaires about sociodemographic risk and adverse childhood experiences. At both baseline and follow-up, parents reported depression symptoms and were video-recorded interacting with their infant, which was coded for sensitivity. The ABC intervention predicted significant increases in parental sensitivity and, among parents who completed the intervention, significant decreases in depression symptoms. Changes in parental depression symptoms did not significantly mediate the intervention effects on sensitivity. Risk variables did not moderate the intervention effects. The results indicate that ABC shows promise for improving parent outcomes in community settings, supporting dissemination.
Children who experience early adversity often show alterations across multiple stress response systems, including the hypothalamic–pituitary–adrenal (HPA) axis and autonomic nervous system (ANS). Changes in the diurnal rhythm of salivary cortisol (a marker of HPA axis functioning) and alpha‐amylase (a marker of ANS functioning) may increase their probability of developing behavior problems. The goal of this study is to examine how these analytes may interact to predict externalizing behavior in infants exposed to early stress. Participants included 179 parents and their 6‐ to 20‐month old infants recruited from a low‐income neighborhood. Parents reported on their infants’ externalizing behaviors and collected saliva samples from their children at wake‐up and bedtime over three days. Diurnal cortisol and alpha‐amylase were modeled using latent difference scores. Four models were tested examining the effects of cortisol and alpha‐amylase morning values and slopes, as well as their interactions, on externalizing behavior. Results showed a significant interaction effect of cortisol and alpha‐amylase morning values, such that low morning cortisol was associated with decreased externalizing behavior when morning alpha‐amylase was high but not low. These findings highlight the importance of examining multiple systems when characterizing the physiological correlates of externalizing behavior among infants experiencing adversity.
Dysregulation of diurnal cortisol rhythms is often seen among children exposed to early adversity and has been associated with a variety of negative physical and mental health outcomes. The present study examined whether two indicators of deprivation, sociodemographic burden and observed parental insensitivity, were associated with child diurnal cortisol rhythms among a diverse community sample of 250 infants ages 5 to 22 months (M ϭ 12.68 months, 47.2% male). The sample was diverse in terms of socioeconomic status as assessed by household income (M ϭ $59,163, SD ϭ $57,775, range ϭ $0Ϫ230,000) and infant race/ethnicity (41.6% African American, 19.2% White, 17.2% multiracial, 14.0% Hispanic/Latin, 2.8% Caribbean, 2.8% other, 1.2% American Indian/Alaska Native, and 1.2% Asian). Sociodemographic burden indicators were assessed through questionnaires completed by the parent. Parental sensitivity was assessed through observations of parents' interactions with their infants during a play interaction task. Cortisol was assayed from infant saliva samples collected at waking and bedtime across 3 days. Structural equation modeling revealed that higher sociodemographic burden, but not parental insensitivity, was associated with blunted diurnal cortisol slopes. Neither sociodemographic burden nor parental insensitivity were associated with the cortisol awakening response. These findings suggest that sociodemographic burden may be an important early predictor of diurnal cortisol slope dysregulation, highlighting the importance of interventions providing support to individuals who experience sociodemographic burden and promoting reduction of these early stressors.
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