Early mental health problems frequently are associated with risk factors in the mother, the infant, and in their interactions. Among these are maternal depression, infant negative emotionality, and parenting stress. Although offspring of depressed women are at higher risk for later problems and have been targeted for selective interventions, we propose that a triple risk selection model would be more efficient in reducing later child mental health problems. Mothers who are depressed are less adaptive in their interactions. Infants with excessive crying have self-regulation problems and require greater adaptability from their caregivers. Parent's sense of stress is a pathway for many ecological risk factors to alter effective and sensitive interactive behavior with children. 60% of infants with these three risk factors have a mental health problem in their 3rd year of life. A brief 12-session Interaction Guidance program will be delivered as a Preventive intervention between 7 and 14 months to high risk families to increase the adaptive relation between mother and infants. 160 families with depressed mothers and 6-month-old infants will be recruited and randomly assigned into an Interaction Guidance intervention group or a Phone Contact contrast group. Prime features of the Interaction Guidance intervention include (1) coaching parents with feedback on videotaped play interactions with the child, (2) focus on identifying positive parenting behaviors, and (3) empowerment of family members through attending to problems and insights that they initiate. Assessments of the infant, parent and their interaction will occur at a 7-month Pretest, a 14-month Posttest, and a 30-month Follow-Up at home and in the laboratory using a multi-method approach of parent self-reports, clinician interviews and ratings, and observations of interactive behavior. Comparisons will be made at the Posttest and at Follow-Up to determine if more adaptive interactions and better mental health are occurring in the. Within the Interaction Guidance treatment group subsidiary analyses will determine the relative impact of the intervention on the effects of the three primary risk conditions.
|Bank, Anna M; Barr, Rachel; Calvert, Sandra L et al. (2012) Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis. J Child Fam Stud 21:208-216|