Child Mental Health Outcomes and Maternal Risk in Abusing Families

描述(由申请人提供)：这项拟议的研究将考察母亲的危险状况(严重抑郁、物质依赖和亲密伴侣暴力(IPV)受害)如何影响3至10岁受虐待儿童的高危人群中的儿童精神病理学。将分析的数据来自全国儿童和青少年幸福感调查(NSCAW)，这是一项关于接受儿童虐待调查的儿童及其家庭的纵向全国性概率研究。NSCAW是第一项关于儿童福利人口的全国性研究，收集有关儿童和照顾者福祉的数据，并提供了一个独特的机会来检查这一弱势群体中母亲对儿童精神病的影响。这项拟议研究的具体指导目标是：(1)在36个月的研究窗口期内，测试3至10岁受虐待儿童的母亲风险状况与儿童心理健康结果(内化和外化问题)之间的直接和间接(或中介)途径；(2)根据母亲和儿童福利工作者的报告，检查儿童和母亲在虐待调查后接受的服务的组合(即成人和儿童精神健康、药物滥用、家庭暴力、育儿支助和经济援助)；以及(3)确定儿童和母亲接受的服务组合是否在12个月和18个月随访、18个月随访和36个月随访之间发生变化。将测试的间接影响是严厉的父母教育、疏忽的父母教育、情感虐待的父母教育和服务接触。要研究的NSCAW的子样本是1,300个案例，其中母亲被确定为永久照顾者，孩子在基线年龄在3岁至10岁之间，在虐待调查后仍留在家里(这是一个处于危险之中但未得到充分研究的儿童群体)。这项研究借鉴了发展精神病理学，通过将育儿实践作为一个非静态结构来扩展现有的知识基础，并将除了最常研究的风险(母亲抑郁)之外，还将考虑母亲的风险状况。这项研究的结果将确定对育儿和儿童精神病影响最有害的母亲风险状况，因此，在有限的资源下解决这些问题是最关键的。此外，了解产妇风险状况影响子女结局的途径将有助于制定服务模式，其中包括针对所有关键风险的行之有效的干预措施。

DESCRIPTION (provided by applicant): The proposed study will examine how maternal risk conditions (major depression, substance dependence and intimate partner violence (IPV) victimization) influence child psychopathology among the high risk population of maltreated children between the ages of 3 and 10. The data to be analyzed are from the National Survey of Child and Adolescent Well-being (NSCAW), a longitudinal national probability study of children investigated for child maltreatment and their families. The NSCAW is the first national study of the child welfare population to collect data on child and caregiver well-being and provides a unique opportunity to examine maternal influences on child psychopathology among this vulnerable population. The specific aims guiding this proposed research are (1) to test the direct and indirect (or mediating) pathways between maternal risk conditions and child mental health outcomes (internalizing and externalizing problems) for maltreated children between the ages of 3 and 10 at baseline over the course of the 36-month study window; (2) Examine the combination of services received by children and mothers following the maltreatment investigation (i.e., adult and child mental health, substance abuse, domestic violence, parenting support and economic assistance), as reported by mothers and child welfare workers; and (3) Determine if the combinations of services received by children and mothers changes between 12-month follow-up and 18- month follow-up, 18-month follow-up and 36-month follow-up. The indirect effects that will be tested are harsh parenting, neglectful parenting, emotionally abusive parenting, and service contact. The sub-sample of NSCAW to be studied are 1,300 cases in which the mother is identified as the permanent caregiver, and the child was between the ages of 3 and 10 at baseline and remained in-home following the maltreatment investigation (an at risk, but understudied population of children). Drawing on developmental psychopathology, this study will expand the current knowledge base by treating parenting practices as a non-static construct and will consider maternal risk conditions in addition to the most frequently studied risk (maternal depression). Findings from this study will identify maternal risk conditions that have the most harmful effects on parenting and child psychopathology, and are therefore, most critical to address given limited resources. Furthermore, knowledge about the paths through which maternal risk conditions influence child outcomes will inform the development of service models that include proven interventions targeting all of the critical risks.