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Symposium 1.F - Families Under Stress, Violence, and Trauma: Caregiving, Child Adaptation, and Intervention Across Highly Disadvantaged Contexts
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10:30am - 11:30am
Families Under Stress, Violence, and Trauma: Caregiving, Child Adaptation, and Intervention Across Highly Disadvantaged Contexts Many children worldwide are exposed to high levels of adversity, profoundly shaping early development. Parenting behaviors, such as parental sensitivity, are central mechanisms through which adversities may influence children’s development (Valentino & Edler, 2022). Yet, important gaps remain in understanding these associations, and whether parent-child interventions can effectively support families living in highly disadvantaged contexts. This symposium brings together four studies from Canada, France, the Netherlands, and Brazil to advance understanding of parental behavior, child adaptation, and intervention effectiveness in contexts of poverty, intimate partner violence, and parental stress and PTSD. The papers are based on robust and diverse methodologies (i.e., meta‑analyses, cross‑sectional design, randomized controlled trial, single‑case experimental design) and rely on multi‑informant and observational data from parents and children aged 0-6 years, in countries characterized with various levels of social inequality. Findings converge on the negative impact of parental stress and trauma on quality of parental behaviors. Paper 1 highlights cross‑parent associations, showing that fathers’ sensitivity and disrupted behaviors are associated with their own stress and maternal stress, underscoring the interdependence of parenting within economically strained families. Paper 2 presents meta‑analytic results showing that parental PTSD is moderately associated with reduced parental sensitivity, identifying trauma as a risk for caregiving quality. Paper 3 demonstrates that attachment‑based (NIKA) and trauma‑informed (EMDR) interventions for mother-child dyads exposed to intimate partner violence can improve parental sensitivity and reduce disrupted behaviors. Paper 4 shows that an attachment‑based intervention (AVI) with highly disadvantaged Brazilian families can reduce externalizing problems in children of mothers who report more severe childhood trauma. Together, these studies emphasize that parental behavior is both related to adversity and a critical target for intervention. They also highlight the promise of attachment‑based and trauma‑informed approaches for supporting families facing adversity, in contexts with varying social inequality. Presentations of the Symposium Parental Stress and Parenting Behaviors in Low Income Families: Contributions of Mothers and Fathers Positive (e.g., sensitivity, warmth) and negative (e.g., hostile, atypical) parenting behaviors are important predictors of children’s development, underscoring the need to identify factors associated with these behaviors for both mothers and fathers. The family stress model suggests that financial insecurity places a burden on parents that increases their stress levels, which in turn affects parenting (Conger et al., 2000). A study conducted with low-income families showed that mothers’ and fathers’ parental stress was associated with lower levels of responsiveness and sensitivity in mother-child and father-child interactions (Ward & Lee, 2020). However, this study did not examine whether parental stress is linked to negative parenting behaviors, nor whether the other parent’s stress is also associated with positive and negative parenting behaviors. The current study aims to address these gaps by examining these associations in a low-income sample of mothers and fathers of preschool-aged children. Eighty-one mothers and fathers completed a questionnaire assessing parental stress (PSI-SF; Abidin, 1995). Sensitive (Moss et al., 1998) and atypical (AMBIANCE Brief; Cooke et al., 2020) parenting behaviors were evaluated during videotaped parent–child interactions in the home when the child was 3-5 years old. Analyses were conducted controlling for family income and parental education. For mothers, maternal sensitivity was associated with mothers’ parental stress, whereas atypical behaviors were not. For fathers, both paternal sensitivity and atypical behaviors were associated with both mothers’ and fathers’ parental stress. These findings highlight the relevance of parental stress as a factor associated with parenting in contexts of socioeconomic risk. They also underscore the importance of both parents’ parental stress in shaping fathers’ parenting behaviors. Parental post-traumatic stress disorder, parental sensitivity, and child attachment: A meta-analytic investigation Post-traumatic stress disorder (PTSD) is a condition affecting approximately 24% of individuals following exposure to a potentially traumatic event (Schincariol et al., 2024). The lifetime prevalence of PTSD is estimated at 4% (Koenen et al., 2017), while approximately 3% of women experience PTSD during the perinatal period (Yildiz et al., 2017). Despite growing evidence that parental PTSD may negatively impact caregiving and parent-child relationships (Christie et al., 2019), systematic quantitative synthesis of this evidence remains absent. As part of a preregistered series of meta-analyses, the current study examines associations between parental PTSD and (1) parental sensitivity and (2) child attachment. Following PRISMA guidelines, systematic searches were conducted across Academic Search Complete, APA PsycInfo, ERIC, Psychology and Behavioral Sciences Collection, and Scopus. While study selection (on a search that yielded 14 938 abstracts) is ongoing, preliminary analyses were conducted on a subset nine studies included to date, which met eligibility criteria. Random effects meta-analytic approach using the metafor package version 4.6.0 (Viechtbauer, 2010) in R version 4.4.1 (R Core Team, 2024). Preliminary findings revealed a moderate negative overall correlation between parental PTSD and parental sensitivity (r = -0.35, 95% CI [-0.57, -0.08], p= .011, k=4, N=209, 100% mothers). The overall correlation with child attachment security (r = -0.17, 95% CI [-0.37, 0.04], p= .115, k=5, N=217, predominantly mothers) was non-significant. Two additional studies examining disorganized attachment await integration into the final analyses, pending identification of further eligible studies. The presentation will outline the final study selection, effect size computation, and moderator analyses. The current preliminary results suggest that PTSD is associated with significant and clinically meaningful reductions in maternal sensitivity, while evidence for an association with child attachment security remains inconclusive. They also highlight the need for further research on the potential effects of parental PTSD, especially of paternal PTSD. Integrated treatment for IPV-exposed parents and young children: Results from an RCT and a SCED Interparental violence (IPV) can have profound consequences for both victimized parents and their children. Their problems are often interconnected. The impact of violence on the parent may affect their parenting capacity, which can undermine the quality of the parent–child relationship. Moreover, children are at risk for emotional and developmental problems, underscoring the crucial need of a supportive parent-child relationship. However, integrated evidence-based treatments that address effects of IPV on the parent, the child, and their relationship remain scarce. This study examined the effects of an attachment-based intervention (NIKA) and parent trauma therapy (EMDR) in 52 IPV-exposed mothers and their 0-6-year-old children residing in women’s shelters, using a two-phased randomized controlled trial (RCT). In addition, we developed a guidance document to support therapists in determining the optimal order of treatment (parent-child relationship therapy, parent trauma therapy, child trauma therapy). Integrated treatment based on this guidance document was evaluated in a single‑case experimental design (SCED) with three mother–child dyads. Results from the RCT indicated that NIKA (vs waiting list) significantly improved parental sensitivity in both a play paradigm with toys (B=2.12; p<.01; β=.47) and without toys (B=1.30; p=.02, β=.30), and reduced disrupted parenting assessed with the AMBIANCE (B=-1.46; p<.01; β=-.39). NIKA did not significantly affect child Post-Traumatic Stress Symptoms (PTSS) and child emotional and behavioral problems. EMDR for the parents (vs waiting list) significantly reduced parental PTSS (B=-19.06; p<.001; β=-.47) but did not affect parental sensitivity and child outcomes. SCED-results indicated meaningful improvements in parental PTSS during the integrated treatment trajectory, while effects on sensitive parenting were mixed, and child outcomes showed no clear improvement. Qualitative interviews revealed that both parents and therapists valued the treatment guidance document. Together, these findings underscore the importance of integrated trauma and relationship‑focused treatment and offer concrete guidance for strengthening support to IPV‑exposed families. Reducing Externalizing Symptoms with the Attachment Video-feedback Intervention (AVI) in Highly Disadvantaged Brazilian Children Attachment‑based interventions have been studied predominantly in WEIRD (Western, Educated, Industrialized, Rich, and Democratic) countries. Using the Attachment Video‑feedback Intervention (AVI), the current study examined whether: 1) reductions in child behavior problems, previously observed in AVI studies (e.g., Cyr et al., 2015), would also be found among families living in highly disadvantaged neighborhoods in Fortaleza, Brazil; and 2) moderated by the severity of maternal childhood maltreatment, given that trauma history can moderate effects of attachment-based interventions (e.g., Van der Asdonk et al., 2020). A sample of 138 mothers and children (Mage=1.93 years, SD=.80) were randomized to AVI (n=66) or Treatment‑as‑Usual (n=72). Mothers were recruited at a social pediatric clinic in Fortaleza. They completed a sociodemographic questionnaire, the CTQ (Bernstein & Fink, 1998) and the CBCL (Achenbach & Rescorla, 2001). We observed high adversity: 89% of mothers were unemployed, 64% had fewer than 10 years of education, 64% reported a monthly family income below 1,000 reais (200 USD), and 36% were single parents. Moderate-to-severe childhood maltreatment was reported by 78% of mothers, and elevated proportions of children exhibited clinical levels of externalizing (36%) and internalizing (43%) symptoms. To address attrition (14%), multiple imputation was used as an intention‑to‑treat (ITT) method. ITT regressions revealed no main effects of AVI on externalizing or internalizing problems. However, a significant moderation emerged: among children of mothers with lower-to-moderate levels of traumatic experiences, AVI had no impact; in contrast, among children of mothers with higher levels of traumatic experiences, externalizing symptoms were significantly lower for those in the AVI group than in the control group. The discussion emphasizes the critical role of AVI in reducing externalizing problems in children of highly vulnerable Brazilian mothers. | ||