MPHAMC: Mom Power With High-Adversity Mothers and Children
Study Details
Study Description
Brief Summary
This study will evaluate whether the intervention, Mom Power, improves the self-regulation of mothers with a history of trauma and their children. The central hypothesis is that the intervention will shift behavioral and physiological self-regulation in mothers, children, and dyads to mitigate psychopathology risk.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Adverse childhood experiences (ACEs) are significant risk factors for psychopathology across the lifespan - risks that extend to the next generation, likely transmitted through both biological and behavioral pathways. Biobehavioral self-regulation and parenting are key candidates for transmission and potential points of intervention. However, nearly all intervention research takes a one-generation approach, measuring outcomes in the individual adult or child in treatment. Additionally, very little research has examined biomarkers of self-regulation in parents or children following treatment, and no known research has examined these processes in parents and young children simultaneously across treatment to explore bidirectional effects. There is a critical need to specify targets of two-generation interventions among high-adversity families to decrease intergenerational transmission of mental illness. The objective of this RCT is to determine whether Mom Power, an evidence-based two generation intervention for mothers with histories of trauma, enhances physiological and behavioral self-regulation in mothers and young children, testing mechanisms and examining bidirectional effects. The central hypothesis is that the intervention will shift behavioral and physiological (Respiratory Sinus Arrhythmia) self-regulation in mothers, children, and dyads to mitigate psychopathology risk. Three specific aims are proposed: 1) Examine intervention effects on children's biobehavioral self-regulation and psychopathology; 2) Examine intervention effects on mothers' biobehavioral self-regulation, psychopathology, and parenting behavior; and 3) Examine intergenerational change processes, including shifts in dyadic physiological and behavioral synchrony as well as bidirectional influences between mother and child self-regulation.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Treatment The treatment group receives the 10-week, group-based Mom Power intervention; intervention is provided to both mothers and children by trained providers. Treatment delivery will be consistent with the Mom Power manual. |
Behavioral: Mom Power Intervention
Mom Power is a 10-week therapeutic intervention for at-risk families that incorporates elements of several evidence based practices. It combines didactic material with mindbody self-care skills and in vivo practice to improve the quality of attachment between parent and child, and to reduce the psychopathology of at-risk parents. The child team component provides each child with one-on-one care focusing on meeting the child's social-emotional needs and providing attachment-related experiences within a developmental framework.
|
| No Intervention: Waitlist control Participants randomized to waitlist control will not receive treatment during the experimental period; they will be offered treatment following completion of post- assessments. |
Outcome Measures
Primary Outcome Measures
- Child RSA [Within 6 weeks of treatment group completion; approximately 4 months]
Child self-regulation will be assessed physiologically with RSA baseline and RSA change during a parent-child dyadic task (Skowron et al., 2013); derived from electrocardiogram (ECG) collected using Mindware Technologies ambulatory mobile recorders during 1) 2-minute resting baseline; 2) a dyadic interaction task. ECG signals will be synchronized at acquisition with video and processed offline using Mindware software; research assistants will visually inspect for missing or erroneously identified R-peaks. Using spectral analysis of interbeat intervals, high-frequency heart rate variability will be extracted to quantify RSA within frequency bandwidths associated with respiration (.15-.40 for mothers; .24-1.04 for children), processed in 1-minute epochs averaged across tasks, and log-transformed.
- Parent RSA [Within 6 weeks of treatment group completion; approximately 4 months]
Parent self-regulation will be assessed physiologically with RSA baseline and RSA change during a parent-child dyadic task (Skowron et al., 2013); derived from electrocardiogram (ECG) collected using Mindware Technologies ambulatory mobile recorders during 1) 2-minute resting baseline; 2) a dyadic interaction task. ECG signals will be synchronized at acquisition with video and processed offline using Mindware software; research assistants will visually inspect for missing or erroneously identified R-peaks. Using spectral analysis of interbeat intervals, high-frequency heart rate variability will be extracted to quantify RSA within frequency bandwidths associated with respiration (.15-.40 for mothers; .24-1.04 for children), processed in 1-minute epochs averaged across tasks, and log-transformed.
Secondary Outcome Measures
- Child Behavior - parent report [Within 6 weeks of treatment group completion; approximately 4 months]
Child Behavior problems will be assessed via Total Score on parent report with the Child Behavior Checklist; higher scores indicate higher behavior problems (T score is a standardized score with a mean of 50).
- Child Behavior - teacher report [Within 6 weeks of treatment group completion; approximately 4 months]
Child Behavior problems will be assessed via teacher report with the Teacher Report Form; Achenbach & Rescorla, 2000. Higher scores indicate higher behavior problems (T score is a standardized score with a mean of 50).
- Dyadic synchrony - physiological [Within 6 weeks of treatment group completion; approximately 4 months]
Dyadic synchrony will be assessed using EKG (derived from maternal and child RSA, as described above)
- Dyadic synchrony - observational [Within 6 weeks of treatment group completion; approximately 4 months]
Dyadic synchrony will be assessed observationally with the Coding Interactive Behavior (CIB) measure.
- Parent psychopathology [Within 6 weeks of treatment group completion; approximately 4 months]
Parents will report on their own depression symptoms (Patient Health Questionnaire-9 and Posttraumatic Checklist - 5); individual scales will be z-scored and summed, with higher values reflecting higher levels of psychopathology
- Parent emotion regulation [Within 6 weeks of treatment group completion; approximately 4 months]
Parents will report on their own emotion regulation using the difficulties in emotion regulation (DERS; range: 36-180); higher scores reflect more difficulties with emotion regulation.
- Sensitive parenting behavior [Within 6 weeks of treatment group completion; approximately 4 months]
Observational data derived from parent-child interactions will be examined, coding using the Coding Interactive Behavior measure (CIB). Higher scores reflect more sensitivity.
- Parent self-efficacy [Within 6 weeks of treatment group completion; approximately 4 months]
Parents will report on their own parenting efficacy using the Parent Sense of Competence scale; range: 17-102, higher scores reflect more self-efficacy
- Parenting behavior [Within 6 weeks of treatment group completion; approximately 4 months]
Parents will report on their own parenting behavior using the Conflict Tactic Scales - Parent Child (CTS-PC); range: 0-240, higher values reflect harsher parenting
- Parent mental representation [Within 6 weeks of treatment group completion; approximately 4 months]
Parents will complete an abbreviated version of the Working Model of the Child Interview; interviews will be coded into 3 categories, and it is hypothesized that proportion of "balanced" representations will be higher post-treatment.
- Child Behavioral Self-Regulation, observational [Within 6 weeks of treatment group completion; approximately 4 months]
Child self-regulation will be assessed behaviorally using observation (Preschool Self-Regulation Assessment); children's behavior will be observed during 6 tasks, and codes z-scored and summed; higher scores reflect higher effortful control/executive function
- Child Behavioral Self-Regulation, parent report [Within 6 weeks of treatment group completion; approximately 4 months]
Child self-regulation will also be assessed by parent-report (Social Competence Scale - Emotion Regulation); range: 0-48; higher scores reflect higher self-regulation
Other Outcome Measures
- Maternal social support [Within 6 weeks of treatment group completion; approximately 4 months]
Mothers will report on social support (Multidimensional Scale of Perceived Social Support); range: 12-84; higher scores reflect higher perceived support.
- Perceived stress [Within 6 weeks of treatment group completion; approximately 4 months]
Mothers will report on perceived stress (Perceived Stress Scale-4); range: 0-16; higher scores reflect higher stress
Eligibility Criteria
Criteria
Participants in this study must include a mother-child dyad. There is inclusion and exclusion criteria for both mother and child.
Inclusion Criteria:
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For moms: Mothers must be female, the biological mother, have an ACE score of 3 or more, speak English, and be 18 years or older.
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For children: Children must be between the ages of 2 and 5.
Exclusion Criteria:
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For mothers: No pacemaker or self-reported heart condition; no active maternal substance abuse or psychosis on screeners (Brown & Rounds, 1995; Degenhardt, Hall, Korten, & Jablensky, 2005).
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For children: No parent report of diagnosis of autism or global development delay, no parent report of pacemaker or heart condition
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Educare New Orleans | New Orleans | Louisiana | United States | 70122 |
| 2 | Kingsley House Early Head Start Preschool | New Orleans | Louisiana | United States | 70130 |
Sponsors and Collaborators
- Tulane University
- National Institutes of Health (NIH)
- National Institute of Mental Health (NIMH)
Investigators
- Principal Investigator: Sarah A Gray, PhD, Tulane University
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
- 2018-2012
- 1K23MH119047-01