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This paper outlines the theoretical antecedents that contextualize parental insightfulness and examines this concept's value in assessing parental functioning and in monitoring treatment progress with parents and young children who experience mental health and relationship problems. As a concept, parental insightfulness provides a much-needed bridge linking important aspects of attachment theory with their psychoanalytic origins, including early contributions that conceptualize parenting as a developmental process that furthers the unfolding capacities of the adult self. The paper examines the compatibility between the dimensions of parental insightfulness and the criteria for a healthy adult sense of self. The empirical body of knowledge generated by the concept of parental insightfulness is briefly reviewed as the basis for using the concept as a valuable tool for the empirical exploration of intrapsychic, interpersonal, and clinical processes in parents and their children.

Infants and young children of parents in the military deserve special attention because the first years of life are pivotal in establishing trusting attachment relationships, which are based on the developmental expectation that parents will be reliably available and protective both physically and emotionally. For young children in military families, the stresses of extended absences of mothers and/or fathers as the result of deployment abroad, recurrent separations and reunions resulting from repeated deployments, or parents struggling with the emotional sequelae of their war experiences, and the traumatic impact of parental injury and death can strain and derail the normative expectation of parental availability and protectiveness. This article describes the key features of mental health in infancy and early childhood, the developmentally expectable early anxieties that all children experience in the first years of life across cultures and circumstances, and the ways in which these normative anxieties are exacerbated by the specific circumstances of military families. The article also describes interventions that may be helpful in supporting military families and their children with the specific challenges they face.

Including fathers is the next frontier for infant mental health. In this article, the authors describe the inclusion of fathers as equal partners in Child-Parent Psychotherapy (CPP), an evidence-based treatment for young children experiencing or at risk for mental health problems following exposure to violence and other adversities. The authors present two vignettes in which the father's participation in treatment was pivotal to successful outcomes for the child, and they illustrate some of the considerations, complexities, concerns, and rewards of engaging and working with fathers. They discuss the benefit of using a "triadic lens" (McHale, 2011) for formulation and treatment planning with all families involved with CPP.

Children's exposure to violence is a national crisis. The high prevalence of exposure to violence in infancy and early childhood has implications for lifelong health and development because early experiences are most influential in shaping the structure and functioning of the brain, the quality of attachments and other relationships, and the child's readiness to explore and learn. The authors highlight the urgency of creating effective approaches to identification and treatment as well as public policy initiatives that protect both children and society.

A system of care for abused and neglected infants and young children should adopt a comprehensive perspective, with mental health considerations systematically incorporated into policies and decisions affecting children and their families. Children age birth to 5 years have disproportionately high rates of maltreatment, with long-term consequences for their mental and physical health. Research on normal development and developmental psychopathology has shown that early development unfolds in an ecology of transactional influences among biological, interpersonal, and environmental domains. Psychologists should collaborate with other early intervention disciplines to create systems of care based on an ecological-transactional model of development that includes early mental health principles in order to serve the needs of these young children. Didactic courses, practicums, and internships in infant and early childhood mental health should become integral components of undergraduate and graduate curricula in psychology in order to build capacity to achieve this goal. Recommendations are offered for systemic change by integrating infant and early childhood mental health principles into existing systems of care for young children and their families.

Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the "trouble-children" in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs.

This article describes the impact on young children of sudden and extended separation from a primary attachment figure. It recommends clinical intervention when the child's development and family functioning are negatively affected by the severity of the child's symptoms, and it highlights key treatment modalities derived from Child--Parent Psychotherapy, including the importance of "speaking the unspeakable," defined as affirming reality by giving words to the separation and its sequelae and the importance of offering a safe space for the child's expression of sadness, anger, and fear in the supportive presence of the caregiver. Two clinical examples illustrate treatment while the separation is ongoing and after reunion takes place. [ABSTRACT FROM AUTHOR]

Child-Parent Psychotherapy (CPP), an evidence-based dyadic therapeutic intervention for very young children exposed to trauma, is becoming the go-to therapeutic intervention for infant mental health practitioners. Although CPP has been shown to be effective for rebuilding the parent-child relationship, reducing trauma symptoms, and reducing depression in mothers, there are some challenges to training and disseminating the model. The authors present two training methods that have been anecdotally effective in training clinicians in the model. [ABSTRACT FROM AUTHOR]

This article describes recent developments in theory and clinical practice with traumatized children in the birth to five age range. It revisits the treatment of an abused two-year-old girl and her mother from the perspective of the child's reappearance in the clinic twenty years later to ask about her past. The early treatment of the child and the mother is re-examined from the perspective of the advances in theory and practice about early childhood trauma in the intervening decades. These advances are contrasted with the persistent gap between the urgent needs of maltreated children and their families and the availability of services designed to support their mental health. [ABSTRACT FROM AUTHOR]

There is a great need to better understand the impact of traumatic events very early in life on the course of children's future development. This report focuses on the intriguing case of a girl who witnessed the murder of her mother by her father at the age of 19 months and seemed to have no recollection of this incident until the age of 11, when she began to exhibit severe symptoms of posttraumatic stress disorder (PTSD) in response to a traumatic reminder. The case presentation serves as the basis for a discussion regarding pertinent issues involved in early childhood trauma. This case and accompanying discussion were originally presented at the 19th Annual Meeting of the International Society for Traumatic Stress Studies and were transcribed and revised for use in this article. Specific topics include early childhood memory and trauma, learning and the appraisal of danger, and PTSD and traumatic grief in early childhood. Clinical and public health implications are also discussed. This case illustrates the dramatic impact that "preverbal" traumatic memories can have on children's later functioning and speaks to the importance of assisting very young children in the immediate aftermath of traumatic events. [ABSTRACT FROM AUTHOR]

40 3-year-olds participated in a short-term longitudinal study assessing the relationship between peer competence and 2 antecedent variables, the security: of the attachment relationship with the mother and the amount of experience with peers. Security- of attachment was assessed through a home visit, the laboratory-based "strange situation," and a standardized maternal-attitude scale. The mother's report was used to estimate amount of experience with peers. Peer competence was assessed from the subjects' behavior in a familiar laboratory playroom with an unfamiliar same-age, same-sex playmate. Security of attachment as assessed at home was highly positively correlated with peer experience. Partial correlations showed that security of attachment was correlated only with nonverbal measures of peer competence, whereas peer experience was correlated only with verbal measures. It was concluded that security of attachment and peer experience were related to different aspects of peer competence. A separate analysis showed that maternal attitudes toward the child's expression of aggression and freedom to explore were significantly correlated with the measures of peer competence. [ABSTRACT FROM AUTHOR]

Face-to-face interaction between 26 infants and (a) their mothers and (b) a relatively unfamiliar figure was observed longitudinally between 6 and 15 weeks of age in the home environment. Highlights of normative findings are that infants became more responsive over this time period, whereas maternal behavior did not change. In the sample as a whole, infants were more responsive to the mother than to the unfamiliar figure on only I measure, bouncing. Individual differences in maternal behavior were stable throughout, but individual differences in infant behavior were not. Individual differences in interaction were analyzed and summarized by means of a factor analysis. Factor I opposed positive infant responsiveness to minimal response and maternal playfulness to impassiveness. Factor II contrasted maternal contingent pacing, infant delight, and prolonged interaction with routine maternal manner, abruptness, negative infant response, and brief interaction. Individual differences in interaction were found to be related to later differences in infant-mother attachment, as assessed by a strange-situation procedure at 51 weeks of age. Infants later identified as securely attached were more responsive in early en face encounters than infants judged to be anxiously attached, and their mothers were more contingently responsive and encouraging of interaction. Infants later identified as anxiously attached were more unresponsive and negative in early en face interaction than securely attached infants, and their mothers were more likely to be impassive or abrupt. Securely attached infants were more positively responsive to the mother than to an unfamiliar figure in early face-to-face episodes, while anxiously attached infants were not. [ABSTRACT FROM AUTHOR]

This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women ( M = 29.10 years, SD = 6.56, range = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity. [ABSTRACT FROM AUTHOR]