Featured Article by Elizabeth Skowron, A Tribute to Lorna Smith Benjamin
Dr. Elizabeth Skowron,
Associate Professor,
University of Oregon
Associate Professor,
University of Oregon
I was delighted to present our research at the recent Feschrift
for Dr. Lorna Smith Benjamin at this year’s SITAR meeting in Park City,
Utah. There I presented findings from
our NIMH-funded research that targets the intersection of biology and
experience in an effort to clarify why child maltreatment (CM) is particularly
resistant to intervention (Skowron & Reinneman, 2005). CM affects almost one million children each
year (NCCAN, 2000), and constitutes a serious public health problem in the U.S.
(Shonkoff & Phillips, 2000).
Although CM parents engage in specific acts that define child abuse and
neglect, we believe that the immediate interactive context of CM is of critical
importance to better understand, in order to guide development and
understanding of effective intervention.
Our goal in this work is to provide more precise descriptions of the
dysfunctional interchanges that unfold in the moment-to-moment interactions
between maltreating mothers and their young children, how they diverge from
non-CM dyads, and the ways in which
they map onto the continuum of CM severity and subtype, and shape children’s
developing self-regulation (emotion, attention, physiology, and behavior) in
the preschool years.
We use SASB technology—both the micro-analytic observational coding system and self-report Intrex ratings—in our work, as it provides a powerful lens through which to study moment-to-moment parenting processes in these high-risk families. Use of SASB enables us to code individual mother and child speech acts, their bidirectional influence, and make important, fine grain distinctions between forms of parental control (i.e., affiliative or hostile), and between “clean” child autonomy assertions (i.e., autonomy-in-connection or “Friendly differentiation”) from those that are tinged with hostility (i.e., “Walling-off”). Among its many strengths, I particularly like that the way in which Interdependence is mapped on the SASB circumplex using a continuum from low (Autonomy-granting/asserting) to high (Control/Submit), enabling us to study the role of parents’ support for age-appropriate autonomy in their child’s developing capacities for self-regulation. Use of the SASB Intrex in conjunction with observational coding has enabled us to investigate multigenerational continuities and discontinuities in quality of parenting across three generations of these families-at-risk (Woerhle et al., in preparation).
Most observational coding systems that have been used to study CM parenting do little to capture the bidirectional nature of mother-child interactions (i.e., the degree to which child “pulls” for negative or positive behavior from the mother, and vice versa). Grounded in interpersonal theory (Sullivan, 1953), the SASB is well-suited to capturing these bidirectional patterns (i.e., complementarity), and enables us to model the interpersonal processes through which early socialization with a CM parent may account for individual differences in child outcomes. The dearth of information about sequential interaction patterns that unfold in maltreating parent-child dyads is noteworthy, in light of meta-analysis indicating that most interventions have minimal impact on improving the quality of parent-child interactions in such families (Skowron & Reinneman, 2005). Further, there is wide heterogeneity in the outcomes of CM exposed children, and individual differences are not well understood (e.g., Belsky, 1993; Cicchetti et al., 1993; Sabourin Ward & Haskett, 2007). Progress in understanding risk for and the effects of CM has been limited by our focus on discrete acts of CM and other broad ‘social address’ factors, along with molar/global measures of parenting quality. In order for us to effectively address the problem of CM, more research is needed that focuses on elucidating mechanisms and processes in a theory-driven manner, incorporates a multidisciplinary focus on psychological, relational, and biological processes, and use more sophisticated observational measures of the environment such as SASB, to clarify the interplay between biology and experience (e.g., Rutter, 2003).
One of the most robust findings from research on CM parenting is that they rely more heavily on use of negative, hostile forms of control when interacting with their child (e.g., Wilson, Rack, Shi, & Norris, 2008). Harsh parental control is related to poorer inhibitory control (Moilanen et al., 2010), and less autonomous self-regulated behavior in children (Trickett & McBride-Chang, 1995). In contrast, parents who engage in warm parent of their children during the early years (i.e., SASB Protect) support their children's developing self-regulation development (Moilanen, Shaw, Dishion, Gardner, & Wilson, 2010). However, we know that the experience of parent support for autonomy is also important for children’s developing self-regulation. In fact, greater parent support for their children’s autonomy (i.e., Friendly differentiation) is theorized as essential for children’s developing differentiation of self (i.e., Bowen, 1978; Kerr & Bowen, 1988) and self-regulation of attention, emotion, and behavior (Kopp, 1982; Thompson, 1991). Parents’ warm support for children’s age-appropriate autonomous behavior (i.e., SASB Cluster 2—Affirming) is an essential aspect of caregiving that has been shown to support children’s developing self-regulation of attention and behavior (Grolnick & Farkas, 2002; Landry, Miller-Loncar, Smith, & Swank, 2002; Lengua, Honorado, & Bush, 2007). Yet in the case of maltreating parents, they often are less adept at support their child’s expressions of autonomy relative to their non-CM peers (e.g., Dolz, Cerezo, & Milner, 1997).
Our findings confirm that physically abusive, neglecting, and non-CM mothers diverge in the extent of autonomy support and harsh control they display during moderately challenging teaching tasks (Skowron et al., 2011). Physically abusive mothers react to their children’s positive bids for autonomy with more controlling responses, than either neglecting or non-CM mothers. Likewise, physically-abused children’s autonomous and submissive behaviors are each more likely to elicit a harsh controlling response from their mother, than do neglected or non-maltreated children and this was also associated with children’s autonomic physiology. Specifically, beyond the effects of CM exposure, children whose positive, autonomous behaviors were more often responded to with maternal criticism & control showed lower parasympathetic tone, even after partialling out base rates of maternal control. In sum, we found that physically abusive parents engage in more maladaptive parenting practices, yet regardless of risk status, our data indicate that children exposed to such practices showed a physiological sensitivity to those effects. In contrast, children who received unconditioned support for their positive autonomous behavior during laboratory challenge showed greater parasympathetic tone.
In another recently published study, we sought to clarify the role of autonomic physiology (i.e., vagal tone) in parenting-at-risk (Skowron, Essel, Benjamin, Pincus, & Van Ryzin, 2013). Although we observed no differences in abusive, neglectful, or non-CM mothers’ resting vagal tone, we found different patterns of concurrent and time-ordered associations between mother’s vagal tone and quality of parenting, based on CM group status. Specifically, higher resting vagal tone was associated with more positive parenting in neglectful and non-CM mothers, but more hostile control parenting in abusive mothers. Dispersion tests on maternal RSA scores across the joint mother-child challenge tasks revealed significantly greater over time variability in non-CM mothers’ vagal tone and less variability, or greater consistency, in the vagal tone of physically abusive and neglectful mothers. These findings support the notion that healthy adaptive physiology tends to be expressed in terms of high levels of variability, while pathological states are often characterized by low variability or predictability in cardiac vagal tone (Appel et al., 1989; Goldberger, 1992, 1996). Further, the pattern of CM effects on variability observed in maternal RSA and quality of parenting showed greater over-time consistency in non-CM mothers’ positive parenting but more flexibility in their parasympathetic responding. Further research is needed to understand whether the high degree of unpredictability in quality of parenting observed in abusive mothers is the result of efforts to maintain consistency over time in parasympathetic tone or a steady physiological state. In other words, when a mother is stressed, is she more concerned about how she feels or how she relates to her child?
We also found that among abusive mothers, decreases in person-level vagal tone were associated with simultaneous increases in positive parenting, but these led to subsequent increases in use of strict/harsh control. Because we observed no significant effects when we reversed the models so that parenting predicted vagal tone, this supported the time-ordered effect of mother vagal tone on her subsequent parenting behavior, and not the reverse. The concurrent link suggests that a physically abusive mother’s efforts to provide warm support to her child while he/she completes a challenging task may tax her limited resources for self-control, and that increased arousal and depleted self-control may lead her to then begin to control her child in strict and hostile ways. From a family systems perspective, although CM parents’ use of aversive control may be harmful to a developing child, it may serve a maladaptive stabilizing function in the system, in terms of reflecting a parent’s attempts to cope with emotion dysregulation.
This pattern of significant coupling in physiology and behavior observed among the abusive mothers while parenting provides support for both Porges’ (2011) polyvagal theory and Baumeister’s resource model of self-control (Muraven & Baumeister, 2000). Consistent with polyvagal theory, the concurrent effects suggest that abusive mothers’ impaired social engagement skills may derive from experiencing the parenting context as more threatening on an autonomic level than their lower-risk peers. Porges’ (2011) concept of ‘neuroception’ describes a process that operates outside of our awareness through which we evaluate risk in the environment, which in turn shapes our autonomic responding. These findings highlight the challenges that abusive mothers face in providing adequate caregiving, given the heightened arousal they experience in particular while engaged in positive parenting, and suggest that the parenting capacities of abusive mothers are uniquely challenged by deficits in physiological regulation. Further work is needed to determine whether abusive parents who display patterns of concurrent and lagged parasympathetic withdrawal and positive/aversive parenting, are also predisposed toward threat-biased attributions of their child and greater vigilance in the context of parenting (e.g., Bugental, 2009). Do abusive parents exert strict, hostile control of their child in an effort to manage their experience of the parenting context as threatening?
If it is more physiological taxing for abusive mothers to parent in positive ways, then according to self-control theory (e.g., Baumeister & Heatherington, 1996), the efforts of abusive parents to engage in positive parenting represent active efforts to self-control in the context of caregiving. Does engaging in positive parenting deplete an abusive parent’s self-control resources, and result in spikes in harsh parenting that follows? Given that CM parents are known to engage in more aversive, controlling parenting (Wilson et al., 2008; Rogosch et al., 1995), the data suggest that the emergence of aversive control may be physiologically-driven, and result from threat-biased perceptions, vigilance in the parenting context, and/or depletion in self-control resources following efforts to engage in positive parenting. These findings require replication, however they suggest that physiological function may reflect a direct liability for the perpetration of physical abuse, and may help to explain why abusive parenting is so resistant to many interventions.
In this same study, we found that vagal tone did not predict quality of subsequent parenting in neglectful mothers; whereas the reversed models in which parenting predicted subsequent changes in mothers’ physiology response were significant. Specifically, when neglectful mothers increased their positive parenting, this led to subsequent increases in vagal tone. Conversely, increases in harsh control in neglectful mothers led to subsequent decreases in vagal tone. Thus in sum, the pathways linking maternal physiology and quality of parenting were different for maltreating mothers who were abusive versus those who solely engaged in physical neglect of their child. Maternal physiological states were found to affect quality of parenting in abusive mothers, whereas in neglectful mothers the reverse was observed, whereby the quality of parenting led to changes in maternal physiology. Further work is needed to learn whether parenting interventions that teach, reinforce, and support greater use of positive parenting strategies to neglectful mothers’ not only strengthen their positive parenting skills, but also lead to secondary benefits in the form of improvements in physiological regulation.
Conclusion and Next Steps. Our central goal in this research is to map parenting processes and autonomic physiology that underlie preschoolers’ developing self and emotion regulation, across physically abusive, neglecting and non-CM families. SASB technology is enabling us to use high resolution measurement of proximal dyadic parenting interactions and assessment of mothers’ and children’s autonomic physiology to understand inter-individual variability in preschool children’s emerging self-regulation capacities. In light of Rutter’s (2003) call for use of more sophisticated observational measures of environment that are essential for clarifying the interplay between biology and experience, we focus SASB’s micro-level lens on the moment-to-moment parenting interactions that characterize abuse, neglect, and non-CM dyads. Our research design, which involves collecting time-synchronized observational and cardiac physiology data from mother and child, enables us to take an integrative approach to understanding how neurobiology and environment converge in the context of CM.
Historically few interventions for CM have been shown to be effective for reducing CM parenting (Skowron & Reinneman, 2005), though evidence is growing with respect to the efficacy of a handful of intensive interventions (e.g., Chaffin et al., 2004, 2011). We hope that our findings can facilitate prescriptive matching of early interventions to target specific disruptive interactions in maltreating mother-child dyads. For example, because CM children showed higher parasympathetic activity when their mothers parented in ways which affirmed their pro-social autonomous bids, these findings highlight the possibility that effective interventions that achieve significant increases in positive parenting, may also positively impact CM children’s autonomic physiology. Likewise, some effective interventions my function to build regulatory strength in parents that supports positive engagement between parent and child, and lasting behavior change. Yet findings from our program of research suggest that interventions that are effective in reducing CM parenting, may achieve positive outcomes through different mechanisms of change for abusive vs. neglectful mothers.
Finally, in closing I would like to thank Lorna Benjamin for her extraordinary vision and ground-breaking contributions to the science of psychology. On a more personal note Lorna, I am so grateful to you for the profound support you’ve shown of my efforts and your cheers as we attempt to bridge the chasm that lies between these disciplines we work across. A leading personality theorist and psychotherapy researcher, Dr. Benjamin ranks as one of the most supremely gifted scientist--practitioners of our generation.
“If we had a keen vision and feeling of all ordinary human life, it would be like hearing the grass grow and the squirrel's heart beat, and we should die of that roar which lies on the other side of silence.”
--George Eliot (Middlemarch)
We use SASB technology—both the micro-analytic observational coding system and self-report Intrex ratings—in our work, as it provides a powerful lens through which to study moment-to-moment parenting processes in these high-risk families. Use of SASB enables us to code individual mother and child speech acts, their bidirectional influence, and make important, fine grain distinctions between forms of parental control (i.e., affiliative or hostile), and between “clean” child autonomy assertions (i.e., autonomy-in-connection or “Friendly differentiation”) from those that are tinged with hostility (i.e., “Walling-off”). Among its many strengths, I particularly like that the way in which Interdependence is mapped on the SASB circumplex using a continuum from low (Autonomy-granting/asserting) to high (Control/Submit), enabling us to study the role of parents’ support for age-appropriate autonomy in their child’s developing capacities for self-regulation. Use of the SASB Intrex in conjunction with observational coding has enabled us to investigate multigenerational continuities and discontinuities in quality of parenting across three generations of these families-at-risk (Woerhle et al., in preparation).
Most observational coding systems that have been used to study CM parenting do little to capture the bidirectional nature of mother-child interactions (i.e., the degree to which child “pulls” for negative or positive behavior from the mother, and vice versa). Grounded in interpersonal theory (Sullivan, 1953), the SASB is well-suited to capturing these bidirectional patterns (i.e., complementarity), and enables us to model the interpersonal processes through which early socialization with a CM parent may account for individual differences in child outcomes. The dearth of information about sequential interaction patterns that unfold in maltreating parent-child dyads is noteworthy, in light of meta-analysis indicating that most interventions have minimal impact on improving the quality of parent-child interactions in such families (Skowron & Reinneman, 2005). Further, there is wide heterogeneity in the outcomes of CM exposed children, and individual differences are not well understood (e.g., Belsky, 1993; Cicchetti et al., 1993; Sabourin Ward & Haskett, 2007). Progress in understanding risk for and the effects of CM has been limited by our focus on discrete acts of CM and other broad ‘social address’ factors, along with molar/global measures of parenting quality. In order for us to effectively address the problem of CM, more research is needed that focuses on elucidating mechanisms and processes in a theory-driven manner, incorporates a multidisciplinary focus on psychological, relational, and biological processes, and use more sophisticated observational measures of the environment such as SASB, to clarify the interplay between biology and experience (e.g., Rutter, 2003).
One of the most robust findings from research on CM parenting is that they rely more heavily on use of negative, hostile forms of control when interacting with their child (e.g., Wilson, Rack, Shi, & Norris, 2008). Harsh parental control is related to poorer inhibitory control (Moilanen et al., 2010), and less autonomous self-regulated behavior in children (Trickett & McBride-Chang, 1995). In contrast, parents who engage in warm parent of their children during the early years (i.e., SASB Protect) support their children's developing self-regulation development (Moilanen, Shaw, Dishion, Gardner, & Wilson, 2010). However, we know that the experience of parent support for autonomy is also important for children’s developing self-regulation. In fact, greater parent support for their children’s autonomy (i.e., Friendly differentiation) is theorized as essential for children’s developing differentiation of self (i.e., Bowen, 1978; Kerr & Bowen, 1988) and self-regulation of attention, emotion, and behavior (Kopp, 1982; Thompson, 1991). Parents’ warm support for children’s age-appropriate autonomous behavior (i.e., SASB Cluster 2—Affirming) is an essential aspect of caregiving that has been shown to support children’s developing self-regulation of attention and behavior (Grolnick & Farkas, 2002; Landry, Miller-Loncar, Smith, & Swank, 2002; Lengua, Honorado, & Bush, 2007). Yet in the case of maltreating parents, they often are less adept at support their child’s expressions of autonomy relative to their non-CM peers (e.g., Dolz, Cerezo, & Milner, 1997).
Our findings confirm that physically abusive, neglecting, and non-CM mothers diverge in the extent of autonomy support and harsh control they display during moderately challenging teaching tasks (Skowron et al., 2011). Physically abusive mothers react to their children’s positive bids for autonomy with more controlling responses, than either neglecting or non-CM mothers. Likewise, physically-abused children’s autonomous and submissive behaviors are each more likely to elicit a harsh controlling response from their mother, than do neglected or non-maltreated children and this was also associated with children’s autonomic physiology. Specifically, beyond the effects of CM exposure, children whose positive, autonomous behaviors were more often responded to with maternal criticism & control showed lower parasympathetic tone, even after partialling out base rates of maternal control. In sum, we found that physically abusive parents engage in more maladaptive parenting practices, yet regardless of risk status, our data indicate that children exposed to such practices showed a physiological sensitivity to those effects. In contrast, children who received unconditioned support for their positive autonomous behavior during laboratory challenge showed greater parasympathetic tone.
In another recently published study, we sought to clarify the role of autonomic physiology (i.e., vagal tone) in parenting-at-risk (Skowron, Essel, Benjamin, Pincus, & Van Ryzin, 2013). Although we observed no differences in abusive, neglectful, or non-CM mothers’ resting vagal tone, we found different patterns of concurrent and time-ordered associations between mother’s vagal tone and quality of parenting, based on CM group status. Specifically, higher resting vagal tone was associated with more positive parenting in neglectful and non-CM mothers, but more hostile control parenting in abusive mothers. Dispersion tests on maternal RSA scores across the joint mother-child challenge tasks revealed significantly greater over time variability in non-CM mothers’ vagal tone and less variability, or greater consistency, in the vagal tone of physically abusive and neglectful mothers. These findings support the notion that healthy adaptive physiology tends to be expressed in terms of high levels of variability, while pathological states are often characterized by low variability or predictability in cardiac vagal tone (Appel et al., 1989; Goldberger, 1992, 1996). Further, the pattern of CM effects on variability observed in maternal RSA and quality of parenting showed greater over-time consistency in non-CM mothers’ positive parenting but more flexibility in their parasympathetic responding. Further research is needed to understand whether the high degree of unpredictability in quality of parenting observed in abusive mothers is the result of efforts to maintain consistency over time in parasympathetic tone or a steady physiological state. In other words, when a mother is stressed, is she more concerned about how she feels or how she relates to her child?
We also found that among abusive mothers, decreases in person-level vagal tone were associated with simultaneous increases in positive parenting, but these led to subsequent increases in use of strict/harsh control. Because we observed no significant effects when we reversed the models so that parenting predicted vagal tone, this supported the time-ordered effect of mother vagal tone on her subsequent parenting behavior, and not the reverse. The concurrent link suggests that a physically abusive mother’s efforts to provide warm support to her child while he/she completes a challenging task may tax her limited resources for self-control, and that increased arousal and depleted self-control may lead her to then begin to control her child in strict and hostile ways. From a family systems perspective, although CM parents’ use of aversive control may be harmful to a developing child, it may serve a maladaptive stabilizing function in the system, in terms of reflecting a parent’s attempts to cope with emotion dysregulation.
This pattern of significant coupling in physiology and behavior observed among the abusive mothers while parenting provides support for both Porges’ (2011) polyvagal theory and Baumeister’s resource model of self-control (Muraven & Baumeister, 2000). Consistent with polyvagal theory, the concurrent effects suggest that abusive mothers’ impaired social engagement skills may derive from experiencing the parenting context as more threatening on an autonomic level than their lower-risk peers. Porges’ (2011) concept of ‘neuroception’ describes a process that operates outside of our awareness through which we evaluate risk in the environment, which in turn shapes our autonomic responding. These findings highlight the challenges that abusive mothers face in providing adequate caregiving, given the heightened arousal they experience in particular while engaged in positive parenting, and suggest that the parenting capacities of abusive mothers are uniquely challenged by deficits in physiological regulation. Further work is needed to determine whether abusive parents who display patterns of concurrent and lagged parasympathetic withdrawal and positive/aversive parenting, are also predisposed toward threat-biased attributions of their child and greater vigilance in the context of parenting (e.g., Bugental, 2009). Do abusive parents exert strict, hostile control of their child in an effort to manage their experience of the parenting context as threatening?
If it is more physiological taxing for abusive mothers to parent in positive ways, then according to self-control theory (e.g., Baumeister & Heatherington, 1996), the efforts of abusive parents to engage in positive parenting represent active efforts to self-control in the context of caregiving. Does engaging in positive parenting deplete an abusive parent’s self-control resources, and result in spikes in harsh parenting that follows? Given that CM parents are known to engage in more aversive, controlling parenting (Wilson et al., 2008; Rogosch et al., 1995), the data suggest that the emergence of aversive control may be physiologically-driven, and result from threat-biased perceptions, vigilance in the parenting context, and/or depletion in self-control resources following efforts to engage in positive parenting. These findings require replication, however they suggest that physiological function may reflect a direct liability for the perpetration of physical abuse, and may help to explain why abusive parenting is so resistant to many interventions.
In this same study, we found that vagal tone did not predict quality of subsequent parenting in neglectful mothers; whereas the reversed models in which parenting predicted subsequent changes in mothers’ physiology response were significant. Specifically, when neglectful mothers increased their positive parenting, this led to subsequent increases in vagal tone. Conversely, increases in harsh control in neglectful mothers led to subsequent decreases in vagal tone. Thus in sum, the pathways linking maternal physiology and quality of parenting were different for maltreating mothers who were abusive versus those who solely engaged in physical neglect of their child. Maternal physiological states were found to affect quality of parenting in abusive mothers, whereas in neglectful mothers the reverse was observed, whereby the quality of parenting led to changes in maternal physiology. Further work is needed to learn whether parenting interventions that teach, reinforce, and support greater use of positive parenting strategies to neglectful mothers’ not only strengthen their positive parenting skills, but also lead to secondary benefits in the form of improvements in physiological regulation.
Conclusion and Next Steps. Our central goal in this research is to map parenting processes and autonomic physiology that underlie preschoolers’ developing self and emotion regulation, across physically abusive, neglecting and non-CM families. SASB technology is enabling us to use high resolution measurement of proximal dyadic parenting interactions and assessment of mothers’ and children’s autonomic physiology to understand inter-individual variability in preschool children’s emerging self-regulation capacities. In light of Rutter’s (2003) call for use of more sophisticated observational measures of environment that are essential for clarifying the interplay between biology and experience, we focus SASB’s micro-level lens on the moment-to-moment parenting interactions that characterize abuse, neglect, and non-CM dyads. Our research design, which involves collecting time-synchronized observational and cardiac physiology data from mother and child, enables us to take an integrative approach to understanding how neurobiology and environment converge in the context of CM.
Historically few interventions for CM have been shown to be effective for reducing CM parenting (Skowron & Reinneman, 2005), though evidence is growing with respect to the efficacy of a handful of intensive interventions (e.g., Chaffin et al., 2004, 2011). We hope that our findings can facilitate prescriptive matching of early interventions to target specific disruptive interactions in maltreating mother-child dyads. For example, because CM children showed higher parasympathetic activity when their mothers parented in ways which affirmed their pro-social autonomous bids, these findings highlight the possibility that effective interventions that achieve significant increases in positive parenting, may also positively impact CM children’s autonomic physiology. Likewise, some effective interventions my function to build regulatory strength in parents that supports positive engagement between parent and child, and lasting behavior change. Yet findings from our program of research suggest that interventions that are effective in reducing CM parenting, may achieve positive outcomes through different mechanisms of change for abusive vs. neglectful mothers.
Finally, in closing I would like to thank Lorna Benjamin for her extraordinary vision and ground-breaking contributions to the science of psychology. On a more personal note Lorna, I am so grateful to you for the profound support you’ve shown of my efforts and your cheers as we attempt to bridge the chasm that lies between these disciplines we work across. A leading personality theorist and psychotherapy researcher, Dr. Benjamin ranks as one of the most supremely gifted scientist--practitioners of our generation.
“If we had a keen vision and feeling of all ordinary human life, it would be like hearing the grass grow and the squirrel's heart beat, and we should die of that roar which lies on the other side of silence.”
--George Eliot (Middlemarch)