Elizabeth M. Demeusy’s research while affiliated with University of Rochester and other places

The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.

Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients’ distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13–15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary.

Trauma exposure in children and adolescents is a pervasive and detrimental public health concern. It can have many immediate and long‐term deleterious effects on a child's physical and mental health. Children who experience trauma may go on to develop psychopathology, often in the form of trauma and stress‐related disorders. This entry summarizes the subtypes of trauma and their prevalence, as well as the potential psychosocial correlates (e.g., mental illnesses) of such events. Well‐established, efficacious interventions for trauma and stress‐related disorders are highlighted. Finally, the entry discusses recent research findings relevant to the topic and future directions for research, practice, and policy.

Background When the primary disabilities associated with fetal alcohol spectrum disorders (FASD) are not well supported, individuals are at higher risk for mental health problems and other secondary conditions. The Families on Track (FOT) intervention was designed to prevent secondary conditions and improve family functioning in children with FASD. Promising results from a pilot study demonstrated positive effects on child and caregiver outcomes immediately following the intervention. The objective of this study was to examine the sustainability of these effects 6 months postintervention. Methods Thirty children (ages 4 to 8) with prenatal alcohol exposure and their caregivers were enrolled in the original study. Families were randomized to the FOT intervention or an active comparison group that provided comprehensive assessment and individualized feedback. The intervention integrated a positive parenting curriculum and a child skills group. Families were assessed at baseline, postintervention, and 6‐month follow‐up visits. Follow‐up data were available for 24 families on child and caregiver outcomes. Data were analyzed using effect size calculations and analysis‐of‐variance techniques. Results Relative to the comparison group, intervention families showed continued gains in parenting efficacy and maintained prior improvements in FASD knowledge over the follow‐up period. Although intervention families reported a decrease in their needs being met over the follow‐up period, they continued to report their needs being met to greater extent than those in the comparison group. Consistent with postintervention outcomes, children in both groups exhibited similar decreases in child disruptive behavior 6 months following the intervention. Unfortunately, positive gains seen at postintervention for child self‐esteem and emotion regulation were attenuated at follow‐up. Conclusions This pilot study yielded promising effects on important areas of caregiver functioning. However, the intervention's impact on child functioning waned over time, suggesting the need for sustained or alternate child intervention.

Previous research has provided evidence for the robust relation between maltreatment and the development of externalizing behavior, including aggression. However, less empirical attention has been given to the specific role of neglect. The current study aimed to examine the role of working memory in the association between early neglect and aggression in toddlerhood. Longitudinal data were collected from 89 infants and their biological mothers when the infant was approximately 12, 26, and 38 months old. History of neglect was assessed at 12 months using official Child Protective Service records. Working memory and mental development were assessed at 26 months. Aggression was measured using maternal report at 38 months. Data were analyzed using structural equation modeling, and mediation was tested using 95% asymmetric confidence intervals. Results indicated that infants who experienced neglect exhibited poorer working memory abilities, specifically spatial working memory, and higher rates of aggression in toddlerhood. In addition, spatial working memory mediated the relation between neglect and aggression, suggesting that this may be one promising target for intervention.