Pivots and Partnerships: Successes, Challenges, and Lessons Learned From Conducting Research During a Global Pandemic.

While the importance of including vulnerable populations in research is widely acknowledged, the differential effects of COVID-19 on vulnerable populations necessitated thoughtful participant recruitment. This research note describes one team's attempt at conducting a longitudinal, mixed-methods study during the COVID-19 pandemic with women in the perinatal period who had experienced intimate partner violence. Initial recruitment strategies are provided, as well as the ways in which those initial efforts necessitated revision and redesign. Lessons learned are offered, including ways these strategies may be adapted for other similarly vulnerable populations in the context of a community-level trauma.

Factors Related to Providers Screening Children for Behavioral Health Risks in Primary Care Settings.

PURPOSE: To provide information from a large sample of pediatric and family medicine primary care providers on practices in screening children for behavioral health risks. DESIGN AND METHODS: Participants were a sample of physicians (n=319) and nurse practitioners (n=292) from across the U.S. who completed a confidential online survey about screening practices through a computer-assisted self-interview. RESULTS: Almost all respondents (89%) reported screening children for depression/anxiety and behavior problems. Child substance use (82%), family social support (74%), significant household changes (73%), bullying (72%), child abuse (62%) and domestic violence (52%) were also asked about regularly, although with high rates of informal screening methods. Caregiver mental health (49%), caregiver substance use (35%), family financial strain (33%) and transportation difficulties (27%) were screened less frequently. Screening was associated with higher rates of referral for risk-related problems, and was more likely when providers reported greater confidence providing support to clients, perceived community resource availability as higher, and worked in systems with integrated primary care and behavioral health. CONCLUSIONS: Findings suggest a great amount of diversity in how providers screen for behavioral health risks. There is reluctance to screen when options for addressing the problems are seen as limited. Research is needed to better guide healthcare providers in determining the right context and methods for screening social risks. PRACTICE IMPLICATIONS: Protocols for screening adverse childhood events (ACES) and other social risk factors should be accompanied by adequate training and efforts to improve community resource and support networks.

Preschoolers' secure base script representations predict teachers' ratings of social competence in two independent samples.

Associations between attachment security, assessed as a secure base script (SBS), and teachers' social competence ratings were examined in two samples (one from the Midwest region and the other from the Southern region of the United States). Consistent with previous reports, significant associations between domains were obtained in both samples and after combining the two samples, r = .33, p < .001. The associations remained significant when child sex, age, and verbal intelligence were controlled. Findings are discussed with reference to relations between SBS scores and the covariates. Regarding sex differences, an existing literature suggests that girls, compared with boys, may be advantaged with respect to skills that could support higher scores on the task used to assess secure base scripts. In both samples, teachers rated girls as somewhat higher on scales of social competence and controlling for sex reduced the magnitude of associations between SBS and social competence, but the results remained significant in all tests.

III. THE ORGANIZATION OF ATTACHMENT BEHAVIOR IN EARLY CHILDHOOD: LINKS WITH MATERNAL SENSITIVITY AND CHILD ATTACHMENT REPRESENTATIONS.

This article investigated two central questions about mother-child attachment relationships during early childhood: (1) the association between maternal sensitivity and child attachment behavior (Study 1) and (2) the link between child attachment behavior and representations (Study 2). In Study 1, maternal sensitivity and child security were assessed in naturalistic contexts among 74 middle-class dyads, when children were about 3.5 and again 5.5 years of age, using the Maternal Behavior with Preschoolers Q-set (MBPQS) and the Attachment Q-set (AQS), respectively. Sensitivity and security were significantly related at each point in time and stable from 3.5 to 5.5 years of age. Furthermore, changes in sensitivity predicted changes in child security. In Study 2, the relationship between the organization of preschoolers' attachment behavior and the structure of attachment representations (secure base script knowledge) was assessed. Participants were 158 preschoolers between 3 and 5.5 years. Children's secure base behavior was described with the AQS, whereas their attachment script knowledge was assessed with the MacArthur Attachment Story Completion Task. The organization of children's secure base behavior was significantly, if modestly, associated with their knowledge of the secure base script.

V. MATERNAL SENSITIVITY AND CO-CONSTRUCTION SKILLS: CONCURRENT AND LONGITUDINAL ASSOCIATIONS WITH PRESCHOOLERS' SECURE BASE BEHAVIOR.

This study investigated the associations among maternal sensitivity, maternal secure base script co-construction skills, and children's secure base behavior during early childhood. Maternal sensitivity and children's secure base behavior were assessed in naturalistic settings among 81 mother-child dyads when the children were approximately 3.5 years old. Maternal co-construction skills were also assessed at that age via a joint mother-child storytelling task. Maternal sensitivity and secure base behavior were assessed again when children (N = 74) were about 5.5 years old. Results indicated that mother sensitivity assessed at the early age was significantly related to maternal co-construction skills. Maternal co-constructive skills in turn were also significantly associated with children's secure base behavior both concurrently and longitudinally. Finally, regression analyses indicated both maternal sensitivity, concurrently at each point in time, and co-construction skills contributed unique and significant information to the prediction of child secure base behavior.

Ecologically salient stressors and supports and the coordination of cortisol and salivary alpha-amylase in mothers and infants.

This study examines the integration of the two main branches of the stress response system: the autonomic nervous system (via salivary alpha-amylase, sAA) and the hypothalamic-pituitary-adrenal axis (via cortisol). Mothers (n = 117) were randomized to have either a positive (n = 57) or conflictual (n = 60) discussion with their marital partner, after which mothers and infants (Mage = 5.9 months) engaged in free-play, followed by an infant-focused challenge task. Saliva samples were collected from the mother to assess physiological reactivity and recovery to the marital discussion, and from the infant to assess physiological reactivity and recovery to the challenge task. For both mothers and infants, sAA - cortisol coordination varied across the respective tasks. Further, findings suggest the sAA - cortisol connection is under social control, with stress response system coordination occurring only in supportive social relationships (i.e., mothers experiencing cohesive marital discussions, and in infants with sensitive and responsive mothers). Interestingly, however, it appears social support might function differently in mothers vs infants. Findings advance our understanding of the complex integration of stress physiology in the context of social relationships.

The impact of marital withdrawal and secure base script knowledge on mothers' and fathers' parenting.

The current study examines associations between marital conflict and negative parenting behaviors among fathers and mothers, and the extent to which internal working models (IWMs) of attachment relationships may serve as sources of risk or resilience during family interactions. The sample consisted of 115 families (mothers, fathers, and their 6-month-old infants) who participated in a controlled experiment. Couples were randomly assigned to engage in either a conflict or positive marital discussion, followed by parent-infant freeplay sessions and assessment of parental IWMs of attachment (i.e., secure base script knowledge). While no differences in parenting behaviors emerged between the conflict and positive groups, findings revealed that couple withdrawal during the marital discussion was related to more intrusive and emotionally disengaged parenting for mothers and fathers. Interestingly, secure base script knowledge was inversely related to intrusion and emotional disengagement for fathers, but not for mothers. Furthermore, only among fathers did secure base script knowledge serve to significantly buffer the impact of marital disengagement on negative parenting (emotional disengagement). Findings are discussed using a family systems framework and expand our understanding of families, and family members, at risk. (PsycINFO Database Record

Work/non-workday differences in mother, child, and mother-child morning cortisol in a sample of working mothers and their children.

BACKGROUND: Mothers have been shown to have higher morning cortisol on days they go to work compared to non-workdays; however, it is unknown how maternal workday associates with child morning cortisol or the attunement of mother-child morning cortisol. AIMS: This study examined the presence and stability of morning cortisol levels and slopes (i.e., cortisol awakening response or CAR) in a sample of 2-4year old children in out-of-home child care with working mothers. In addition, we examined the differential contributions of maternal workday on mother-child attunement in morning cortisol. METHOD: Mother and child morning cortisol was sampled twice a day (awakening and 30min later) across four consecutive days (2 non-workdays; 2 workdays) among 47 working mothers and their young children. Mothers also reported on compliance with sampling procedures and provided demographic information. RESULTS: While children exhibited stability in cortisol levels, children's CARs were variable, with children's non-work CARs not predictive of work CARs. Similarly, a significant morning rise in cortisol was only found on workdays, not non-workdays. Overall, mothers had higher cortisol levels and steeper CARs than their children. Further, maternal workday moderated the attunement of mother-child morning cortisol, such that mothers and children had concordant cortisol levels on non-workdays, but discordant cortisol levels on workdays. CONCLUSIONS: Morning cortisol may be more variable in pre-school aged children than adults but may be similarly responsive to the social environment. Further, workday mornings may be a time of reduced mother-child cortisol attunement.

Parenting stressors and morning cortisol in a sample of working mothers.

The cortisol awakening response (CAR) is a normative rise in cortisol levels across the 30 minutes post awakening. Both the levels and the degree of change in cortisol across this time period are sensitive to the perceived challenges of the day and are thought to prepare the individual to meet these tasks. However, working parents of young children may be under unique strains at this time as they attempt to simultaneously care for their children while also preparing themselves for the workday ahead. In these analyses we examined the contributions of both work and parenting stress on maternal cortisol levels and awakening responses, and how these relationships differed on workdays compared with nonworkdays. To do this, saliva samples were collected from 56 working mothers (25% single) with a child between the ages of 2 and 4 years old (mode = 2 children), at awakening and 30 min postawakening. Samples were collected on 4 consecutive days-2 nonworkdays followed by 2 workdays. Analyses revealed mothers reporting higher levels of parenting stress had higher average a.m. cortisol on workdays compared with nonworkdays. Further, mothers reporting a combination of high job strain and high parenting stress had significantly higher cortisol levels and steeper CAR increases on workdays compared with nonworkdays. Findings are discussed by integrating knowledge from the fields of parenting stress, work-family, and stress physiology.