Papers by Katherine Rosenblum
Independent Replication of DRD4 x Maternal State Interaction on Child Behavior Problems (CBCL), a... more Independent Replication of DRD4 x Maternal State Interaction on Child Behavior Problems (CBCL), and Mediation by 7 mo Infant Temperament: Analyses in a Pilot Longitudinal Cohort of Mother-Infant Dyads
Anthony P. King1, Erika Bocknek2, Lindsay Hamilton1, Katherine Rosenblum1, Julia Seng3, Jacek Debiec1, Maria Muzik1
1Psychiatry, University of Michigan, Ann Arbor, MI,2Education, Wayne State University, Detroit, MI,3Nursing School, University of Michigan, Ann Arbor, MI
70th Annual Scientific Meeting of the Society-of-Biological-Psychiatry, Volume: 77
Background: The DRD4 VNTR has been associated with child behavior problems in gene x maternal insensitivity interactions in European and American cohorts of preschoolers; with 7-repeat allele associated with greater problems. We attempted to replicate and expand these findings by examining trajectories from early mother-infant dyadic interactions (7 mos) in a longitudinal cohort.
Methods: We are collecting a longitudinal cohort of mother-infant dyads (268 families recruited to date) with psychological and/or behavioral assessments at 6wks, 4mo, 7mo, 12mo, 15mo, 18mo, and 36mo. A latent variable “Negative Infant Temperament” was constructed from maternal report (IBQ) and behavioral coding (Distress, Negative Affect in Still Face paradigm at 7 mo), Achenbach CBCL was assessed at 18 mo. Maternal and infant genotype on DRD4 was obtained using PCR. A 65 family sample with complete DRD4 genotype, Infant Temperament, and 18 mo CBCL was used.
Results: Infants carrying 7- or 2-repeat DRD4 allele who had mothers meeting criteria for postpartum depression had greater behavior problems (CBCL) at 18 mo, but not non-carriers (interaction F=4.4,p<.05; beta=.305,p=.013). DRD4xMaternal depression was also associated with Infant Negative Temperament (beta=.365,p<.005), which mediated the effect on 18 mo CBCL (Sobel=3.31, p<.001)
Conclusions: These initial analyses replicate DRD4 x maternal state interaction in an independent cohort. The interaction effect on CBCL was seen at 18 mos, and was mediated by infant (7 mo) measure of negative temperament. Data collection is ongoing in this longitudinal cohort.
Mothers' representations of their infants may influence early development of emotional self-regul... more Mothers' representations of their infants may influence early development of emotional self-regulation. This study examined the associations between characteristics of mothers' ( N ϭ 100) narratives about their 7-monthold infants, maternal depression, and their infants' affect regulation during the Still Face procedure. Findings showed that (1) mothers' representations were linked with individual differences in their infants' behavior across the Still Face procedure, (2) the association between mothers' representations and their infants' behavior was mediated by parenting behavior, and (3) mothers' representations explained unique variance in their infants' affect regulation beyond the contribution of maternal depression. Although infants' displays of positive affect diminished while mothers held a still face, only infants of mothers in the balanced representation category returned to high levels of positive affect upon resuming interaction. These findings highlight the role of maternal representations in the process by which dyads repair temporary disruptions in interaction, as well as individual differences in infants' and mothers' responses to the Still Face.
Journal of Nutrition Education and Behavior, 2013
Objective: To determine how low-income, US women understand the meanings of the terms ''overweigh... more Objective: To determine how low-income, US women understand the meanings of the terms ''overweight'' and ''obese.'' Methods: Low-income women (n ¼ 145; 72% white, 12% black, and 8% Hispanic; 59% obese and 21% overweight) each participated in an individual semi-structured interview during which they were asked to explain what the terms ''overweight'' and ''obese'' mean to them. Responses were transcribed and the constant comparative method was used to identify themes. Results: Three themes emerged: (1) The terms are offensive and describe people who are unmotivated and depressed and do not care about themselves; (2) obese is an extreme weight (eg, 500 lb and being immobile); (3) being overweight is a matter of opinion; if a woman is ''comfortable in her own skin'' and ''feels healthy,'' she is not overweight. Conclusions and Implications: Health education focused on obesity should consider that vulnerable populations might consider the terms ''overweight'' and ''obese'' offensive and stigmatizing.
Academic Pediatrics
To examine associations of maternal mobile device use with the frequency of mother–child interact... more To examine associations of maternal mobile device use with the frequency of mother–child interactions during a structured laboratory task.Methods Participants included 225 low-income mother–child pairs. When children were ∼6 years old, dyads were videotaped during a standardized protocol in order to characterize how mothers and children interacted when asked to try familiar and unfamiliar foods. From videotapes, we dichotomized mothers on the basis of whether or not they spontaneously used a mobile device, and we counted maternal verbal and nonverbal prompts toward the child. We used multivariate Poisson regression to study associations of device use with eating prompt frequency for different foods.ResultsMothers were an average of 31.3 (SD 7.1) years old, and 28.0% were of Hispanic/nonwhite race/ethnicity. During the protocol, 23.1% of mothers spontaneously used a mobile device. Device use was not associated with any maternal characteristics, including age, race/ethnicity, educatio...
Appetite, 2015
Identifying maternal characteristics in relation to child feeding is important for addressing the... more Identifying maternal characteristics in relation to child feeding is important for addressing the current childhood obesity epidemic. The present study examines whether maternal representations of their children are associated with feeding beliefs and practices. Maternal representations refer to mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; affective and cognitive perspectives regarding their children and their subjective experiences of their relationships with their children. This key maternal characteristic has not been examined in association with maternal feeding. Thus the purpose of the current study was to examine whether maternal representations of their children, reflected by Working Model of the Child Interview typologies (Balanced, Disengaged, or Distorted), were associated with maternal feeding beliefs (Authority, Confidence, and Investment) and practices (Pressure to Eat, Restriction, and Monitoring) among low-income mothers of young children, with maternal education examined as a covariate. Results showed that Balanced mothers were most likely to demonstrate high authority, Distorted mothers were least likely to demonstrate confidence, and Disengaged mothers were least likely to demonstrate investment in child feeding. Moreover, Balanced mothers were least likely to pressure their children to eat. Findings are discussed with regard to implications for the study of childhood obesity and for applied preventions.
Purpose: The steep rise in rates of child abuse, divorce, and suicide in the families of military... more Purpose: The steep rise in rates of child abuse, divorce, and suicide in the families of military personnel during and following deployment speaks clearly to the need for increases in the support we provide to these families. In particular, separation from the deployed parent (often the father), coupled with heightened distress and psychiatric symptoms in the at-home parent, places young children at particular risk for problems in psychosocial functioning. Indeed, research indicates that deployment is linked to a range of deleterious child outcomes. Although often eagerly anticipated, reunification also poses challenges, including adjusting to the parent-soldier’s return, reestablishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological impacts (e.g., brain injuries, psychological trauma symptoms). The current study is embedded in a larger project to test the STRoNG Families parenting intervention which is aimed at enhancing po...
Journal of Affective Disorders
Recently postpartum women participated to investigate main and moderating influences of resilienc... more Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met P...
Complementary therapies in clinical practice
Prenatal psychopathology may have an adverse impact on mother and baby, but few women receive tre... more Prenatal psychopathology may have an adverse impact on mother and baby, but few women receive treatment. We offered a 10-week mindfulness yoga (M-Yoga) intervention to psychiatrically high-risk pregnant women as an alternative to pharmacological treatment. Participants (N = 18) were primiparous, 12-26 weeks pregnant, and had elevated scores (>9) on the Edinburgh Postnatal Depression Screen at baseline. In addition to a baseline diagnostic assessment, women completed self-ratings on depression, mindfulness, and maternal-fetal attachment before and after M-Yoga. Findings suggest that M-Yoga was feasible, accepted and effective. Symptoms of depression were significantly reduced (p = 0.025), while mindfulness (p = 0.007) and maternal-fetal attachment (p = 0.000) significantly increased. Overall, this pilot study is the first to demonstrate that M-Yoga may be an effective treatment alternative or augmentation to pharmacotherapy for pregnant women at high risk for psychopathology.
Health & social work
Although often eagerly anticipated, reunification after deployment poses challenges for families,... more Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They describe...
Infant Mental Health Journal
Military fathers of young children often endure repeated separations from their children, and the... more Military fathers of young children often endure repeated separations from their children, and these may disrupt the early parent-child relationship. Postdeployment reunification also poses challenges; disruptions that have occurred must often be repaired in the context of heightened emotions on the part of each family member at a time when fathers are themselves readjusting to the routines and responsibilities of family life. The current study employed qualitative research with the central aim of informing a richer understanding of these experiences. Interviews were conducted with 14 military fathers of young children who had experienced separation from their families during deployment. Narratives were coded using principles of grounded theory, and common parenting themes were extracted. Fathers shared their hopes that their young children would develop qualities of strength, confidence, and self-sufficiency. They also discussed difficulty in supporting the development of these qual...
Objective: Recently postpartum women participated to investigate main and moderating influences o... more Objective: Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. Method: At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Results: Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. Conclusions: Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk. Dr. Lev-Wiesel is a specialist in perinatal mental health following childhood trauma. Please find our submitted manuscript, "The Roles of Resilience and Childhood Trauma History: Main and Moderating Effects on Postpartum Maternal Mental Health and Functioning" by Minden Sexton et al. We appreciate your consideration for publication in the Journal of Affective Disorders.
Psychiatric services (Washington, D.C.)
Child abuse & neglect
Women who experienced abuse or neglect as children are more likely to have health problems during... more Women who experienced abuse or neglect as children are more likely to have health problems during pregnancy and postpartum, but can be reluctant to seek help due to a lack of trauma-informed services. As part of a larger mixed method study, this component aimed to obtain qualitative data from trauma-exposed new mothers about their health care preferences during the perinatal period with the ultimate goal to design personalized, supportive interventions. Fifty-two trauma-exposed mothers completed a semi-structured interview at seven months postpartum about health care preferences including ideas for programs that promote wellness, thoughts about the influences of being a new mother and possible names for a program serving trauma-exposed mothers. Interviews were transcribed and coded using N-Vivo. Participants described ambivalence about seeking help but also a sincere desire for healing, coupled with hope for the future. This tension was apparent in the discussions highlighting the i...
Breastfeeding Medicine
Abstract The goals of this article are to provide a review of key interventions and strategies th... more Abstract The goals of this article are to provide a review of key interventions and strategies that impact initiation and duration of breastfeeding with particular focus on low-income African American mothers' maternal psychological vulnerabilities during the early postpartum period using a social ecological perspective as a guiding framework. Although modest gains have been achieved in breastfeeding initiation rates in the United States, a projected gap remains between infant feeding practices and national Healthy People breastfeeding goals set for 2020, particularly among African Americans. These disparities raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes because of poorer mental health and increased vulnerability to chronic health conditions. Breastfeeding can be a protective factor, strengthening the relationship between mother and baby and increasing infant health and resilience. Evidence suggests that no si...
Psychiatry Research
Social relationships and attachment are core developmental elements of human existence and surviv... more Social relationships and attachment are core developmental elements of human existence and survival that evolve over the lifetime of an individual. The internal and external factors that influence them include the presence of illness in the individual or in their immediate environment. The developmental aspects of attachment and social relationships have become increasingly of interest and relevance in light of early developmental epigenetic modification of gene expression patterns that may influence subsequent behavioral patterns and outcomes. This review examines extant literature on attachment and social relationships in bipolar cohorts. Despite many methodological challenges, the findings indicate that social relationships and capacity for attachment are significantly compromised in individuals with bipolar disorder compared to other mood disorders and normal controls. Though extant research is limited, research clearly points toward the importance of social relationships on the...
Background and Purpose: Forty-four percent of U.S. service members are parents, most of them fath... more Background and Purpose: Forty-four percent of U.S. service members are parents, most of them fathers (U.S. DoD, 2011). In recent years, long separations from their children and families due to repeated deployments have been common for these men. Parental qualities of patience and flexibility are key to sensitive parenting of young children (Stern, 1985), but shifting back into an active fathering role may be challenging for some men following deployment. Parenting support during this period may help fathers transition effectively back to family life, yet services designed to meet this need are scarce. Methods: Using qualitative methodology, the current study solicited military fathers’ (n = 15) experiences of parenting young children in the context of repeated deployments. Data are drawn from a larger investigation examining the efficacy of a post-deployment intervention for parents of young children (≤ 7 years; STRoNG Military Families). Drawing on principles of grounded theory (e....
Archives of Women s Mental Health
Maternal psychopathology and traumatic life experiences may adversely impact family functioning, ... more Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent–child relationship and the attachment bond, placing the child’s early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outc...
Appetite, 2015
Birth order has been associated with childhood obesity. The objective of this cross-sectional stu... more Birth order has been associated with childhood obesity. The objective of this cross-sectional study was to examine maternal feeding and child eating behaviors as underlying processes for increased weight status of only children and youngest siblings. Participants included 274 low-income 4-8 year old children and their mothers. The dyads completed a videotaped laboratory mealtime observation. Mothers completed the Caregiver&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Feeding Styles Questionnaire and the Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Eating Behavior Questionnaire. Child weight and height were measured using standardized procedures. Path analysis was used to examine associations of birth order, maternal feeding behaviors, child eating behavior, and child overweight/obese status. The association between only child status and greater likelihood of overweight/obesity was fully mediated by higher maternal Verbal Discouragement to eat and lower maternal Praise (all p values &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The association between youngest sibling status and greater likelihood of overweight/obesity was partially mediated by lower maternal Praise and lower child Food Fussiness (all p values &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Results provide support for our hypothesis that maternal control and support and child food acceptance are underlying pathways for the association between birth order and weight status. Future findings can help inform family-based programs by guiding family counseling and tailoring of recommendations for family mealtime interactions.
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Papers by Katherine Rosenblum
Anthony P. King1, Erika Bocknek2, Lindsay Hamilton1, Katherine Rosenblum1, Julia Seng3, Jacek Debiec1, Maria Muzik1
1Psychiatry, University of Michigan, Ann Arbor, MI,2Education, Wayne State University, Detroit, MI,3Nursing School, University of Michigan, Ann Arbor, MI
70th Annual Scientific Meeting of the Society-of-Biological-Psychiatry, Volume: 77
Background: The DRD4 VNTR has been associated with child behavior problems in gene x maternal insensitivity interactions in European and American cohorts of preschoolers; with 7-repeat allele associated with greater problems. We attempted to replicate and expand these findings by examining trajectories from early mother-infant dyadic interactions (7 mos) in a longitudinal cohort.
Methods: We are collecting a longitudinal cohort of mother-infant dyads (268 families recruited to date) with psychological and/or behavioral assessments at 6wks, 4mo, 7mo, 12mo, 15mo, 18mo, and 36mo. A latent variable “Negative Infant Temperament” was constructed from maternal report (IBQ) and behavioral coding (Distress, Negative Affect in Still Face paradigm at 7 mo), Achenbach CBCL was assessed at 18 mo. Maternal and infant genotype on DRD4 was obtained using PCR. A 65 family sample with complete DRD4 genotype, Infant Temperament, and 18 mo CBCL was used.
Results: Infants carrying 7- or 2-repeat DRD4 allele who had mothers meeting criteria for postpartum depression had greater behavior problems (CBCL) at 18 mo, but not non-carriers (interaction F=4.4,p<.05; beta=.305,p=.013). DRD4xMaternal depression was also associated with Infant Negative Temperament (beta=.365,p<.005), which mediated the effect on 18 mo CBCL (Sobel=3.31, p<.001)
Conclusions: These initial analyses replicate DRD4 x maternal state interaction in an independent cohort. The interaction effect on CBCL was seen at 18 mos, and was mediated by infant (7 mo) measure of negative temperament. Data collection is ongoing in this longitudinal cohort.
Anthony P. King1, Erika Bocknek2, Lindsay Hamilton1, Katherine Rosenblum1, Julia Seng3, Jacek Debiec1, Maria Muzik1
1Psychiatry, University of Michigan, Ann Arbor, MI,2Education, Wayne State University, Detroit, MI,3Nursing School, University of Michigan, Ann Arbor, MI
70th Annual Scientific Meeting of the Society-of-Biological-Psychiatry, Volume: 77
Background: The DRD4 VNTR has been associated with child behavior problems in gene x maternal insensitivity interactions in European and American cohorts of preschoolers; with 7-repeat allele associated with greater problems. We attempted to replicate and expand these findings by examining trajectories from early mother-infant dyadic interactions (7 mos) in a longitudinal cohort.
Methods: We are collecting a longitudinal cohort of mother-infant dyads (268 families recruited to date) with psychological and/or behavioral assessments at 6wks, 4mo, 7mo, 12mo, 15mo, 18mo, and 36mo. A latent variable “Negative Infant Temperament” was constructed from maternal report (IBQ) and behavioral coding (Distress, Negative Affect in Still Face paradigm at 7 mo), Achenbach CBCL was assessed at 18 mo. Maternal and infant genotype on DRD4 was obtained using PCR. A 65 family sample with complete DRD4 genotype, Infant Temperament, and 18 mo CBCL was used.
Results: Infants carrying 7- or 2-repeat DRD4 allele who had mothers meeting criteria for postpartum depression had greater behavior problems (CBCL) at 18 mo, but not non-carriers (interaction F=4.4,p<.05; beta=.305,p=.013). DRD4xMaternal depression was also associated with Infant Negative Temperament (beta=.365,p<.005), which mediated the effect on 18 mo CBCL (Sobel=3.31, p<.001)
Conclusions: These initial analyses replicate DRD4 x maternal state interaction in an independent cohort. The interaction effect on CBCL was seen at 18 mos, and was mediated by infant (7 mo) measure of negative temperament. Data collection is ongoing in this longitudinal cohort.