Charles H Zeanah
Datos Biográficos
| ID | 4415540 |
|---|---|
| NOMBRE | Charles H Zeanah |
| NOMBRES | Charles H |
| APELLIDO | Zeanah |
| FIRMA | ZEANAH C H |
| AFILIACIONES | Tulane University |
| ORCID | 0000-0002-7004-6819 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 74 |
| TOTAL DE CITAS | 75 |
| TOTAL COMO AUTOR | 74 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1982 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 4 |
Practitioner Review
BACKGROUND: A major research effort in the past two decades has begun to illuminate how experience 'gets under the skin' - that is - the cellular and molecular processes that are associated with adversity and resilience. METHODS: We selectively review three areas of this research: epigenetics, especially DNA methylation, telomere length, and inflammatory processes, and consider the implications of this work for better understanding the effects of…
Centering the Young Child
Due to an array of barriers, the contemporary child welfare system has not achieved its mission of enhancing the safety, permanency, and well-being of children, particularly those in the early childhood developmental period (i.e., birth to 5 years of age). Instead of advocating for the abolition of the child welfare system, we argue for the system’s reform, grounded in a developmentally sensitive approach. We present evidence from epidemiology an…
Physical and neurophysiological maturation associated with ADHD among previously institutionalized children
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental outcome among children with a history of early institutional care. Prior research on institutionalized children suggested that accelerated physical growth in childhood is a risk factor for ADHD outcomes. METHODS: The current study examined physical and neurophysiological growth trajectories among institutionalized children randomized to foster care treatmen…
Exploring background aperiodic electroencephalography (EEG) activity in the Bucharest Early Intervention Project
Aperiodic activity is a background arrhythmic component of electroencephalogram (EEG) that is present in the power spectrum and characterized by an aperiodic offset and an aperiodic exponent. These components have been proposed as a marker of brain maturation, reflecting alterations in excitatory-inhibitory (E:I) balance and exhibiting developmental changes over time. Currently, there is limited understanding regarding how aperiodic activity chan…
Adaptive functioning at age 18 years following severe early deprivation
In the present study, we examined adaptive functioning data from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care following exposure to severe psychosocial deprivation. Adaptive functioning refers to the skills individuals need to meet age-appropriate social and practical demands required for independent functioning. These abilities are essential for successful navigati…
The undertold story
There are considerable data documenting the importance of early experiences for healthy human development. Though widely accepted amongst mental health clinicians, developmental researchers and early childhood policymakers, this information is not well known by much of the public. We describe a specialized program designed for established and emerging leaders in Louisiana, United States of America, to help them become better informed to take acti…
Gift, Lift, and the Transatlantic Shift
Evidence about the impact of maltreatment during infancy and concerning outcomes for children in care indicates the need for infant mental health assessment and interventions that are integrated with robust permanency decision processes. The NSPCC developed infant mental health services in the United Kingdom, based on the New Orleans Intervention Model (NIM), aiming to improve outcomes and decision-making for children under 5 in foster/kinship ca…
Consensus statement on developmentally appropriate policy and practice for adolescents in foster care
Family-based care buffers the stress sensitizing effect of early deprivation on executive functioning difficulties in adolescence
We examined whether family care following early-life deprivation buffered the association between stressful life events (SLEs) and executive functioning (EF) in adolescence. In early childhood, 136 institutionally reared children were randomly assigned to foster care or care-as-usual; 72 never-institutionalized children served as a comparison group. At age 16 years, adolescents (n = 143; 54% female; 67.1% Romanian) self-reported recent SLEs, comp…
Introduction to special section doing the “right” thing
Introducción a la Sección Especial: Hacer lo ‘correcto:’ Asuntos éticos en la salud mental infantil y en la temprana niñez ética, salud mental infantil y en la temprana niñez, código de ética
The ethics of infant and early childhood mental health practice
Ethics is concerned with the basis for moral judgments of “right” and “wrong” and is central to the clinical endeavor. Many clinicians integrate ethical estimations into their work without much conscious awareness. However, explicit use of ethical principles and frameworks can help navigate clinical decision‐making when there is a sense of moral conflict or ambiguity about the “right” course of action. This article aims to highlight the key conce…
Ethical dilemmas in infant mental health
Infant mental health is explicitly relational and strengths based as a field. Ethical dilemmas in infant mental health have received insufficient attention at the level of infant mental health professionals (IMHP) and other professionals caring for infants who must grapple with questions of when caregivers and infants have conflicting interests. We present composite cases drawn from North American and Australian contexts, using three systems in w…
Current approaches and future directions for addressing ethics in infant and early childhood mental health
In this paper, we consider whether the field of infant and early childhood mental health (IECMH) needs its own code of ethics. We begin by describing unique features of infant and early childhood mental health (IECMH) and the diverse strategies that the field has developed to address complex clinical dilemmas, among them workforce development, clinical supports, policy statements, and statements of ethical values. Because of the field's interdisc…
Heightened sensitivity to the caregiving environment during adolescence
BACKGROUND: Adolescence has been proposed to be a period of heightened sensitivity to environmental influence. If true, adolescence may present a window of opportunity for recovery for children exposed to early-life adversity. Recent evidence supports adolescent recalibration of stress response systems following early-life adversity. However, it is unknown whether similar recovery occurs in other domains of functioning in adolescence. METHODS: We…
Long-Term Effects of Institutional Care and Enhanced Attachment Relationships on Close Adolescent Friendships
This study examined whether early institutional rearing and attachment security influence the quality and quantity of friendships at age 16 in 138 participants, including children abandoned to institutions in Bucharest, Romania, who were randomized to care as usual (n = 45, 26 female), or foster care (n = 47, 25 female), and a never-institutionalized group (n = 46, 18 female). Adolescents in the foster care group with secure attachment to their f…
Autonomic reactivity to social rejection, peer difficulties, and the buffering effects of adolescent friendships following early psychosocial deprivation
Autonomic nervous system reactivity has been posited to be a mechanism contributing to social and emotional problems among children exposed to early adversity. Leveraging data from the Bucharest Early Intervention Project, a longitudinal randomized controlled trial of foster care versus institutional care of abandoned children in Romania, we assessed whether altered sympathetic reactivity to peer rejection feedback in early adolescence mediated t…
Caregiver regulation
This framework may be useful for guiding the priority of treatments, as well as making clear the needed menu of options to support children following adversity, in addressing specific concerns related to ensuring effective caregiver regulation to promote resilience. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Adverse caregiving in early life
Knowledge and understanding about the impact of cumulative adverse experiences on the health and wellbeing of children, adolescents, and adults has rapidly expanded over the past 30 years. Despite the invaluable attention and support this proliferation has drawn to the importance of early childhood experiences, we believe that it is time to move beyond broad indices of risk and toward more specific and individualized understanding of how risk exp…
Institutionalisation and deinstitutionalisation of children 1
Increased Risk for Family Violence During the Covid-19 Pandemic
Although the public health benefits of social distancing, isolation, and quarantines are well-established and essential for reducing risk of transmitting the coronavirus disease (COVID-19), the disease caused by the novel coronavirus (severe acute respiratory syndrome coronavirus 2), there are also likely consequences for these practices when considering the impact of violence in the home. Reports of increased domestic violence after quarantine o…
Social communication deficits following early‐life deprivation and relation to psychopathology
BACKGROUND: Children reared in institutions experience profound deprivation that is linked to impairments in social communication (SC). However, little is known about the long-term consequences of institutional rearing on SC through adolescence, and how SC deficits relate to broad-spectrum psychopathology. It is also unclear whether early removal from deprivation and placement into socially enriched environments remediates these difficulties. MET…
The Impact of Caregiving Disruptions of Previously Institutionalized Children on Multiple Outcomes in Late Childhood
This study examined disruptions in caregiving, as well as the association of these disruptions, with cognitive, behavioral, and social outcomes at age 12 in a sample of 136 Romanian children who were abandoned to institutions as infants and who experienced a range of subsequent types of care. Children were found to experience significantly more caregiving disruptions (CGD) earlier in life than later in childhood. More frequent CGD predicted incre…
The Consequences of Foster Care Versus Institutional Care in Early Childhood on Adolescent Cardiometabolic and Immune Markers
OBJECTIVE: Children exposed to institutional rearing often exhibit problems across a broad array of developmental domains. We compared the consequences of long-term, high-quality foster care versus standard institution-based care, which began in early childhood on cardiometabolic and immune markers assessed at the time of adolescence. METHODS: The Bucharest Early Intervention Project is a longitudinal investigation of children institutionalized d…
Disorganized attachment in infancy
Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of path…
Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Dc
The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-5; ZERO TO THREE) is scheduled to be published in 2016. The articles in this section are selective reviews that have been undertaken as part of the process of refining and updating the nosology. They provide the rationales for new disorders, for disorders that had not been included previously in the Diagnostic Classific…
Traumatized mothers can change their minds about their toddlers
This study explored the use of a brief experimental intervention that integrates principles of infant-parent psychotherapy, videofeedback, controlled exposure to child distress in the context of parental posttraumatic stress disorder (PTSD), and stimulation of parental reflective functioning (RF). The Clinician Assisted Videofeedback Exposure Session (CAVES) was applied to 32 interpersonal violence-exposed mothers of very young children (8-50 mon…
Institutional Care for Young Children
Millions of infants and toddlers are in institutional care around the world, care that is poorly suited to meet young children's developmental needs. In this article, we briefly review the history of institutional care and surrogate care. We then discuss why institutional care is at odds with children's needs, and review the empirical evidence regarding the effects of institutional care on young children's development. Finally, we discuss alterna…
Predictors of permanent loss of custody for mothers of infants and toddlers in foster care
The maltreating mothers of abused and neglected infants and toddlers were evaluated as part of an intensive intervention program. The purpose of this study was to examine cumulative risk versus specific risk factors that led to permanent loss of custody by mothers, predicated upon decisions by the Juvenile Court with regard to permanency planning. The following risk factors were analyzed as potential predictors of placement outcomes: maternal edu…
Defining Relational Pathology in Early Childhood
Infant mental health is explicitly relational in its focus, and therefore a diagnostic classification system for early childhood disorders should include attention not only to within‐the‐child psychopathology but also between child and caregiver psychopathology. In this article, we begin by providing a review of previous efforts to introduce this approach that date back more than 30 years. Next, we introduce changes proposed in the Diagnostic Cla…
DNA methylation at stress‐related genes is associated with exposure to early life institutionalization
OBJECTIVES: Differences in DNA methylation have been associated with early life adversity, suggesting that alterations in methylation function as one pathway through which adverse early environments are biologically embedded. This study examined associations between exposure to institutional care, quantified as the proportion of time in institutional care at specified follow-up assessment ages, and DNA methylation status in two stress-related gen…
Attachment disorders in family and social context
Serious disturbances of attachment in young children have been increasingly studied in the past decade as they arise in atypical rearing environments. The purpose of this review is to provide an update on recent findings and to consider their implications. Research on children raised in institutions, children adopted out of institutions, and young children who have experienced neglect in families is considered. Reactive attachment disorder may be…
Ethical considerations in international research collaboration
The Bucharest Early Intervention Project (BEIP) is the first ever randomized controlled trial of foster care as an alternative to institutional care for young children. It involved a collaboration between American investigators and Romanian health and child protection professionals. We present a brief description of the Romanian context and the project itself before discussing a number of ethical issues raised by the project. Organized around a d…
Maternal Factors as Moderators or Mediators of PTSD Symptoms in Very Young Children
Exploring psychopathology in early childhood
Standard nosologies of psychiatric disorders have made preliminary efforts to accommodate developmental differences in symptom manifestation by young children. Significant gaps remain in the validation of disorders for this age group. The DC: 0–3 represents an alternative nosology for disorders of infancy that attempts to complement existing approaches and assist clinicians and researchers. In this commentary we review research on two disorders o…
The ethics of infant and early childhood mental health practice
Ethics is concerned with the basis for moral judgments of “right” and “wrong” and is central to the clinical endeavor. Many clinicians integrate ethical estimations into their work without much conscious awareness. However, explicit use of ethical principles and frameworks can help navigate clinical decision‐making when there is a sense of moral conflict or ambiguity about the “right” course of action. This article aims to highlight the key conce…
The Effects of Early Institutionalization and Foster Care Intervention on Children's Social Behaviors at the Age of Eight
The present study compared the social behaviors of 8-year-old previously institutionalized Romanian children from the Bucharest Early Intervention Project (BEIP) in two groups: 1) children randomized to foster care homes (FCG), and 2) children randomized to care as usual (remaining in institutions) (CAUG). Children were observed interacting with an age and gender-matched unfamiliar, non-institutionalized peer from the community (NIG) during six i…
Early adverse experiences and the neurobiology of facial emotion processing
To examine the neurobiological consequences of early institutionalization, the authors recorded event-related potentials (ERPs) from 3 groups of Romanian children--currently institutionalized, previously institutionalized but randomly assigned to foster care, and family-reared children--in response to pictures of happy, angry, fearful, and sad facial expressions of emotion. At 3 assessments (baseline, 30 months, and 42 months), institutionalized …
Adverse caregiving in early life
Knowledge and understanding about the impact of cumulative adverse experiences on the health and wellbeing of children, adolescents, and adults has rapidly expanded over the past 30 years. Despite the invaluable attention and support this proliferation has drawn to the importance of early childhood experiences, we believe that it is time to move beyond broad indices of risk and toward more specific and individualized understanding of how risk exp…
IQ at age 12 following a history of institutional care
Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12 years of age in the Bucharest Early Intervention Project, a randomized clinical trial of foster care fo…
Psychopathology in Young Children in Two Types of Foster Care Following Institutional Rearing
Institutional rearing of young children has been demonstrated to increase risk for a broad range of psychiatric disorders and other impairments. This has led many countries to consider or to invest in foster care. However, no study to date has explored potential differences in psychiatric symptoms in children placed in different types of foster care. We assessed internalizing disorders, externalizing disorders, and attention deficit hyperactivity…
Recognizing young children in need of mental health assessment
The Early Childhood Screening Assessment (ECSA) is a primary care screening measure developed to identify very young children (11⁄2–5 years old) who need further emotional or behavioral assessment. The ECSA was developed specifically to meet the logistical constraints of primary care settings. This study assessed the preliminary psychometric properties of the ECSA by comparing it with extant validated measures of young children's emotional and be…
A new Piagetian substage
Clinical approaches to traumatized parents
Subjectivity in parent-infant relationships
Bowlby (1969/1982, 1973, 1980) has proposed that internal working models of self and other are psychic structures that guide an individual's subjective experience of and responses to others in important relationships. They are termed “working” models because they are believed to be dynamic mental representations that are modifiable, although they are presumed to become more resistant to change after the early years. This paper reviews Bowlby's co…
Adolescent mothers' perceptions of their infants before and after birth
Adolescent mothers had stable perceptions of several aspects of their infants' temperaments prenatally and at four months postnatally. Infants who were less responsive during feedings were rated as unpredictable by their mothers before and after birth. Implications for parental perceptions of their infants' temperament and behavior are discussed
Maternal attachment disturbances in failure to thrive
Psychological characteristics pertaining to attachment relationships were measured in mothers of 25 hospitalized failure-to-thrive (FTT) infants and mothers of 25 hospitalized, normally growing infants. The groups were matched for race, socioeconomic status, maternal education, and infant's age and sex. Results showed that 96% of mothers of FTT infants were classified as insecure with respect to attachment, as assessed by the Adult Attachment Int…
Introduction
Infant mental health practitioners have continually striven to understand and to improve disordered parent-infant relationships. Recently, researchers have begun attempts to describe and study these relationships systematically. There is an increasing interest in the construction of internal representations as indices of how relationship patterns are carried internally and transmitted from parent to child. This special issue of the Infant Mental …
Parents' constructions of their infants' personalities before and after birth
Representing the internal world
Two major points raised by Seligman in his commentary are discussed. First, attachment research has developed empirical methods for studying internal representations. In our view, this adds to our understanding rather than overvalues attachment as a construct or as a methodological approach. Second, we suggest that nomothetic (the study of general laws which hold for groups of individuals) and idiographic (the study of specific laws which hold fo…
Factors affecting parents' perceptions of temperament in early infancy
Parents' perceptions of temperament in their three-month-old infants were examined in relation to prenatally measured parental characteristics and to objective indices of infant behavior at three months. Infant behavior and parental characteristics appear to make independent contributions to parents' perceptions in early infancy
A clinical interview for parents of high-risk infants
The birth and hospitalization of a preterm infant are stressful and emotionally demanding experiences for parents. The Clinical Interview for Parents of High-Risk Infants (CLIP) is a semistruc tured clinical interview that may be used as a one-time assessment or as a cornerstone for ongoing psychosocial work with parents. The interview assesses early parental adaptation and alerts the clinician to areas of concern as identified by the parents. Th…
Introduction to constructions of the infant's representational world
Initial adaptation in mothers and fathers following perinatal loss
Two months following perinatal loss, 82 mothers out of a total of 205 whose infants died at a tertiary referral obstetrical hospital and 47 of their partners were assessed with regard to their reactions to the deaths of their infants. Sample to population comparisons indicated that those who participated in the investigation were more likely to be socially advantaged. Intensity of mothers' grief exceeded fathers', but in roughly 25% of cases fath…
Perinatal loss and infant mental health
Why should infant mental health clinicians be interested in perinatal loss? As experts on the meaning of infants to their parents, infant mental health professionals are uniquely suited to appreciate the meaning of loss of an infant. Complexly interwoven factors related to the infant, the parent, and the larger social and historical context affect the meanings of loss for parents. In addition, perinatal losses are thought to have implications for…
Symptom expression and trauma variables in children under 48 months of age
The present study compared the severity of posttraumatic symptomatology and the differential expression of the PTSD symptom clusters with six child and trauma-related variables. The independent variables were gender, age at time of trauma, acute versus repeated traumas, injured versus not injured, witnessed versus experienced, and threat to caregiver versus no threat to caregiver. The dependent variables were presence of the diagnosis of PTSD, th…
Mothers' Representations of Their Infants Assessed Prenatally
The stability and predictive validity of Classifications of mothers' representations of their infants as determined by the Working Model of the Child Interview (WMCI) were examined. Concordance between mothers' representations of their infants assessed prenatally and again one year later and infant Strange Situation (SS) attachment classifications at 12 months was also examined. WMCI classifications were stable over 12 months in 80% of mothers, c…
Becoming attached
Working model of the child interview”
Parental perceptions and subjective experience of infants have long been considered important in clinical work with infants and families. Using three different samples of infants, we compare mothers' representations of their infants in clinically referred and nonreferred groups, using the Working Model of the Child Interview (WMCI). Twenty-four mothers of infants with failure to thrive (and 25 matched controls), 17 mothers of toddlers with sleep …
Relationship assessment in infant mental health
Infant-caregiver relationships are the crucial context for infant development and psychopathology. Considerable evidence suggests that infants may construct qualitatively different relationships with different caregivers. For these reasons, infant-caregiver relationships should be a centerpiece of assessment in infant mental health. We advocate assessing infant relationships with all important caregivers in both clinic based and naturalistic sett…
Becoming attached
Reactive attachment disorder in maltreated twins
This case report summarizes in detail the clinical course of twins referred for intervention after maltreatment at 19 months of age who were followed to 36 months of age. Data from comprehensive assessment of parent–child relationships in these cases are reviewed and this material is considered in light of numerous family and systems factors that impacted the twins' clinical course. Diagnostic considerations pertaining to Reactive Attachment Diso…
Disturbances and disorders of attachment in infancy
This article is an introduction to the Special Issue. Reactive Attachment Disorder (RAD) has been in the psychiatric nosology since 1980, when DSM-III was published. Since 1980, however, there has been little research on RAD as a diagnostic category. On the other hand, research on the development of patterns of attachment has informed clinical practice. In this article, selected diagnostic issues are reviewed and a model for conceptualizing the c…
Attachment disturbances in infants born subsequent to perinatal loss
Mothers who have lost a baby in the perinatal period may experience relationship disturbances with infants born subsequently. This study involved mothers who had delivered a child within 19 months of losing a baby in the perinatal period. Mothers were assessed 2 months after the loss with a clinical interview. When the child born subsequent to the loss was 12 months old, the mother–child attachment relationship was assessed, and 45% of the infant…
Disorganized attachment associated with partner violence
Seventy-two low-income mothers and their 15-month-old infants were evaluated at home and in the laboratory to determine whether mothers' reports of distress and partner violence were associated with infant–mother attachment and infant mastery motivation. As predicted, mothers who experienced more serious partner violence were more likely to have infants with disorganized attachments to them. There was no association between mothers' experiences o…
Mother-blaming, relationship psychopathology, and infant mental health
A relational perspective on PTSD in early childhood
This paper describes the clinical and research evidence for the importance of the relational context of posttraumatic stress disorder in young children. We review 17 studies that simultaneously assessed parental and child functioning following trauma. In many studies, despite limitations, an association between undesirable parental/family variables and maladaptive child outcomes has been consistently found. We present a model of the parental/fami…
Psychology (68 obras) · Developmental psychology (49 obras) · Psychiatry (47 obras) · Medicine (42 obras) · Child Abuse and Trauma (34 obras) · Child Welfare and Adoption (28 obras) · Child and Adolescent Psychosocial and Emotional Development (27 obras) · Mental health (21 obras) · Clinical Psychology (20 obras) · Attachment and Relationship Dynamics (17 obras)