Caregiver-Child Communication Following Child Maltreatment: A Dynamic Systems Approach

项目摘要 虐待儿童(CM)是一个重大的公共卫生问题，每年影响100万儿童， 造成2万亿美元的社会成本，并增加了一系列不利健康后果的风险。困难重重 情绪调节(ER)是解释CM如何导致一系列持续不良反应的潜在途径之一 健康结果和确定影响ER的因素的经验努力，无论是积极的还是消极的，都具有重要的意义 有可能为遭受虐待的儿童提供干预策略。《照顾者-儿童》(C-C) 关系对ER能力的发展至关重要，但到目前为止还没有作为一种 CM群体中CM-ER关系的潜在介体。此外，没有任何CM研究使用过 观察方法论，以检查动态的、时刻到时刻的C-C通信过程 儿童和青少年。这种创新和方法的严谨性将阐明实时、双向 关键发展时期的进程，可突出具体的预防和治疗目标 与CM人口的关系。利用从大型、多波、预期的NIH- 资助的队列研究，儿童健康研究(P50HD089922)，本研究将检查C-C 在三次互动中的沟通动态，重点是加强C-C关系和解决问题 主题。CHS通过对官方案件文件进行编码，提供了丰富的CM特征 虐待分类系统，多信息者对照顾者和儿童健康和社会的评估 情感幸福感，以及既定的C-C互动范式。护理者验证并使其无效 C-C互动期间的行为将被编码，以及儿童的积极和消极影响。重要的是 照顾者的确认和无效行为尚未在更密集的时间尺度上进行研究(例如，30 第二个时代)与儿童在C-C对话中的积极和消极情绪没有直接关系，因此 本研究有可能对中医文献做出重大的、创新性的贡献。这 奖学金提案将检查照顾者验证和无效过程中的变化和个体内的可变性 行为(目标1a)和儿童在三个C-C互动过程中的积极和消极影响(目标1b)， 以及护理者确认和无效行为在纵向和双向上如何与 儿童积极和消极情绪(目标2a)。假设的照顾者和儿童特质特征也将是 被测试为这些二元沟通过程的调解人(目标1c和2b)。最后，C-C交互 动力学将被测试为CM和ER之间的纵向关系的中介(目标3)，阐明新的 CM人群预防和治疗的行为指标。最终，成功的预防和 治疗努力将减少个人和终身的公共卫生负担和可归因于CM的社会成本。

PROJECT ABSTRACT Child maltreatment (CM) is a significant public health concern that affects one million children annually, exerts a societal cost of $2 trillion, and increases the risk for a range of adverse health outcomes. Difficulties in emotion regulation (ER) is one potential pathway explaining how CM leads to a range of sustained adverse health outcomes and empirical efforts to identify factors effecting ER, positively or negatively, have significant potential to inform intervention strategies for children exposed to maltreatment. The Caregiver-Child (C-C) relationship is critical to the development of ER abilities, but so far has not been thoroughly examined as a potential mediator of the CM-ER relation in the CM population. Furthermore, no CM studies have used observational methodology to examine dynamic, moment-to-moment C-C communication processes with older children and adolescents. Such innovation and methodological rigor will elucidate real-time, bidirectional processes during key developmental periods that can highlight specific targets for prevention and treatment with the CM population. Leveraging observational data collected from a large, multi-wave, prospective NIH- funded cohort study, The Child Health Study (P50HD089922), the present study will examine C-C communication dynamics over three interactions focusing on C-C relationship enhancing and problem-solving topics. The CHS affords richness in characterizations of CM via coding of official case files via the Maltreatment Classification System, multi-informant assessment of caregiver and child health and socio- emotional well-being, and an established C-C interactional paradigm. Caregiver validating and invalidating behaviors during C-C interactions will be coded as well as child positive and negative affect. Importantly, caregiver validating and invalidating behaviors have yet to be studied at more intensive time-scales (e.g., 30 second epochs) nor in direct relation to child positive and negative affect during C-C conversation, and thus the present study has the potential to make a significant, innovative contribution to the CM literature. This fellowship proposal will examine change and intra-individual variability in caregiver validating and invalidating behaviors (Aim 1a) and child positive and negative affect over the course of three C-C interactions (Aim 1b), as well as how caregiver validating and invalidating behaviors are longitudinally and bidirectionally related to child positive and negative affect (Aim 2a). Hypothesized caregiver and child trait characteristics will also be tested as moderators of these dyadic communication process (Aims 1c and 2b). Finally, C-C interaction dynamics will be tested as mediators in the longitudinal relation between CM and ER (Aim 3), elucidating novel behavioral targets for prevention and treatment in the CM population. Ultimately, successful prevention and treatment efforts will reduce the personal and lifelong public health burden and societal cost attributable to CM.