TRANSFORM operates under the overarching theoretical and methodological perspective of developmental psychopathology. This perspective integrates Bronfenbrenner’s (1979) ecological approach to understanding environmental contexts, organizational perspectives on development (Cicchetti & Toth, 2015; Cicchetti & Valentino, 2006), Belsky’s (1980) nested, interactive systems of influence on parenting, and Cicchetti and Rizley’s (1981) model of transactions among risk and protective factors. Equifinality and multifinality in developmental processes are seen as central for understanding normative and atypical development. From its inception, the developmental psychopathology framework has proffered the mutually- informative transactions that can occur between basic and applied research, with the ultimate goal of informing the provision of prevention and intervention initiatives. Within this framework, preventive interventions can provide important information on developmental processes in order to examine those factors that are modifiable with treatment. Thus, basic, as well as applied research can shape our understanding of etiological factors, change mechanisms, and sequelae of child maltreatment.
A multi-level analytical approach incorporates multiple influences, including psychosocial as well as neurobiological processes that impact development. Increasingly, the role of the stress response system through the hypothalamic-pituitary-adrenal (HPA) axis, as well as genetic and epigenetic factors, are being examined in high-risk populations to better understand its developmental impact and the opportunity it provides to assess treatment effects. Dysregulations in HPA axis activity and gene by environment interactions have been documented in our corpus of publications on maltreated children appearing in multiple top-tier journals. Although advances in science and technology have permitted more detailed examination of processes impacting the development of maltreated children, they also have uncovered variability and transactional challenges for which simplistic solutions have proven inadequate.
TRANSFORM facilitates ongoing and concerted lifespan research to further elucidate these processes by allowing us to follow a large cohort of maltreated and nonmaltreated children into adulthood. We build on a unique and extensive database of psychosocial and physiological data from this cohort’s childhoods to provide an in-depth analysis of the long-term impacts of child abuse and neglect and of processes that affect physical health in adulthood. This unique data set will allow us to provide important knowledge for the nation in determining future directions for mental and health care and court reform, as well as redesigning court procedures to be more responsive to these vulnerable litigants’ needs. An additional study, PROMISE, examines intervention initiated prenatally for economically disadvantaged women as an opportunity for preventive intervention to reduce emergence of harsh parenting and promote healthier outcomes for families. We build upon prior work with economically disadvantaged women, including the provision of a multi-tiered preventive strategy (Building Healthy Children). In this randomized trial that has been conducted for a decade, at risk mothers were provided with a tiered service model that included outreach by community health workers, psychoeducation on parenting, treatment for depression, and Child-Parent Psychotherapy (CPP). Results have demonstrated that the intervention promotes positive outcomes for these mothers and their children. In addition, our RCT evaluations of Child-Parent Psychotherapy (CPP) to improve attachment security and reduce trauma symptoms for maltreated children support the efficacy of this model. We will determine the impact on physiological and psychological mechanisms of change and determine whether CPP is most efficacious when initiated during pregnancy or during the post-partum period at follow-up assessment. We also will examine whether home visitation by a Community Health Worker is sufficient in promoting positive parenting and will examine mediators and moderators that can inform how best to intervene.
The results of these investigations will be relevant to the community: multidisciplinary professionals and stakeholders across child welfare, mental and physical health, legal, and educational systems that serve maltreated children. In addition to advancing our research goals, TRANSFORM will address best practices for disseminating current research findings in child maltreatment to these audiences and also address translating research into language and communication systems that facilitate the greatest uptake among professionals in these audiences. Given our track record of mentoring students and early career scientists, we will continue to support and train the next generation of young investigators to advance the field of child maltreatment research. However, we can broaden our reach nationally. TRANSFORM is unique in that our mentoring staff is interdisciplinary, helping emerging professionals to understand how systems affect the lives of vulnerable children, and using law and social research as an agent of change and a catalyst to help improve health. Through well-established community and national partnerships, we will utilize various venues and approaches to develop new, and extend existing, partnerships through which we will share lessons learned with key stakeholders. Throughout all of the activities and goals across Cores and Research Projects, we will be mindful of cultural sensitivity and addressing the needs of diverse groups of families and children who are an integral part of all of the work that we do.
To accomplish these goals, we will build on the strengths of collaborators in two Universities, those at University of Rochester’s Mt. Hope Family Center and at University of Minnesota’s Institute for Translational Research. A dual-site center will continue the developmental psychopathology approach to building bridges, expanding the reach of TRANSFORM across state lines and geographical regions. Both MHFC and the ITR have extensive histories of conducting innovative research in child maltreatment. Such research cannot be conducted by siloed individuals, but only by teams working collaboratively to address multiple challenges. Our TRANSFORM team has a long history of successful collaboration, as well as inviting new collaborations.
The TRANSFORM research data collection will be conducted at MHFC in Rochester, New York, where the large longitudinal sample was originally recruited and enrolled in summer camp research studies. Dr. Sheree Toth provides leadership as the TRANSFORM Project Director, the Administrative Core Director, and Principal Investigator on Research Project 1. To ensure collaboration across Universities, she is joined by Dr. Dante Cicchetti, ITR, as TRANSFORM Project Director and Principal Investigator on the Adult Health Study. The University of Rochester and the University of Minnesota are committed to providing infrastructure support to ensure success of project Aims. The accomplished and outstanding team of other TRANSFORM investigators will ensure the national reach of the engagement activities in multidisciplinary translation to key stakeholders. The External Advisory Board brings together a knowledgeable and nationally well-connected multidisciplinary group of experts in child maltreatment who will ensure that TRANSFORM is abreast of recent developments nationally in research, intervention, and dissemination as well as provide connections with national organizations, such as the National Child Traumatic Stress Network and the American Academy of Pediatrics.