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Interpersonal Violence, Maternal Perception of Infant Emotion, and Child-Parent Psychotherapy

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Abstract

Caregivers’ ability to identify infant cues plays a crucial role in child development, enabling attuned and responsive caregiving that serves as the basis for secure attachment. At the same time, exposure to interpersonal violence (IPV) could alter mothers’ interpretations of social stimuli and interfere with normative parent-child interactional processes. The current study examined four interrelated hypotheses. The first two hypotheses test whether IPV-exposed mothers show bias toward fear or anger in interpreting infants’ facial expressions, and whether this bias is related to child symptoms. Our second set of hypotheses examines whether bias can be changed by Child-Parent Psychotherapy (CPP) and whether this change mediates treatment gains. 113 IPV-exposed mothers of 2 to 6 year old children completed the I FEEL picture task at baseline and again twelve months later. In the interim, 33 mothers were randomized into a treatment comparison group and the remainder received CPP. Analyses revealed that IPV-exposed mothers exhibit a perceptual bias toward fear, but not anger. Bias toward fear was linked to greater child internalizing symptoms while bias toward anger was linked to greater child externalizing symptoms. Participation in CPP resulted in decreased bias toward fearful faces. The treatment-related changes in mothers’ perceptions of children’s facial expression did not emerge as the mechanism by which CPP reduces children’s symptoms. These results suggest that exposure to IPV alters mothers’ ability to interpret infant facial expressions and that CPP is effective in reducing such biases.

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Notes

  1. Data from non-exposed comparison women came from a published community reference sample for the infant facial expression projective task used in the current study.

  2. As an additional check of this pooled treatment sample, we reanalyzed tests for this and all subsequent hypotheses (1–4) without pilot participants included. For all tests, we found that the exclusion of the pilot participants did not alter the general size, direction, or significance of the results. We also tried including randomized/not randomized as a control variable in our analyses, which similarly did not alter the results. Thus, we can be reasonably certain that the inclusion of the pilot data did not alter the results or conclusions drawn in the study.

  3. To rule out the possibility that non explicitly-trauma related symptoms were driving these null findings, we conducted this analysis again controlling for maternal anxiety and depression. We found that statistically adjusting for mothers’ anxious and depressive symptoms (as measured by the Symptom Checklist 90-R; Derogatis 1992) did not affect the results. Perceptual bias toward fear and anger was similarly unrelated to mothers’ anxious and depressive symptoms.

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Acknowledgements

This research was supported by the National Institute of Mental Health (grant R21 MH59,661) and by the Irving Harris Foundation. All research was approved by University of California, San Francisco’s Committee for the Protection of Human Subjects. We express our deepest gratitude to the mothers and children who participated in this study, the clinicians who cared for them, and the many research assistants who assisted on this project.

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  1. Department of Psychiatry, Child Trauma Research Program, University of California, Building 20, Suite 2100, 1001 Potrero Ave, San Francisco, CA, 94110, USA

    Rosemary E. Bernstein, Adela C. Timmons & Alicia F. Lieberman

  2. Department of Psychology, Florida International University, 11200 S.W. 8th Street, DM 256, Miami, FL, 33199, USA

    Adela C. Timmons

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  1. Rosemary E. Bernstein
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Bernstein, R.E., Timmons, A.C. & Lieberman, A.F. Interpersonal Violence, Maternal Perception of Infant Emotion, and Child-Parent Psychotherapy. J Fam Viol 34, 309–320 (2019). https://doi.org/10.1007/s10896-019-00041-7

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