(PS10-B40) A Preliminary View of Child Maltreatment Risk Within a Randomized Controlled Trial of an Internet-based Virtual Cognitive Behavioral Intervention for Depression and Parenting Postpartum

Accessible interventions to improve maternal mood and optimize parenting practices are crucial for reducing child maltreatment risk among mothers who experience depression postpartum. In two prior randomized controlled trials (RCTs), the cognitive behavioral (CB) Mom Net Intervention resulted in significant reductions in depressive symptoms among depressed mothers with preschool aged children. In two separate RCTs, the CB Baby Net intervention program increased sensitive, responsive behavior of mothers interacting with their infants. Moreover, mothers at highest risk for child maltreatment in the Baby Net intervention sample, who received high intervention dosage, displayed the largest reduction in child maltreatment risk. However, none of the four RCT samples above provided opportunity to examine pre-intervention child maltreatment risk among depressed mothers with infants. In contrast a subsequent RCT study of the CB Mom and Baby Net program (CB-MBN) presented a unique opportunity to view pre-intervention child maltreatment risk among mothers with depression postpartum. The CB-MBN program is a virtual coaching intervention that integrates Mom Net content targeting maternal depression into the Baby Net program targeting sensitive parent responding. Mothers were primarily self-referred, from within a large urban southern city in the U.S., into the CB-MBN study. A sample of 184 mothers with depression during the first year postpartum were randomized to either CB-MBN or an alternative active (non-CB) intervention condition, Awareness of Depression and Developmental Awareness (DDAS), which served as a strong attention control for time spent in intervention and remote coaching contact. Mothers were administered the Brief Child Abuse Potential Inventory (BCAP) at pre-intervention assessment. A high percentage of the sample (81%) had either a clinically elevated Abuse subscale risk score (77%) or were below the clinical cut off with an elevated Lie Scale (4%), indicating defensive responding. At pre-assessment there were no significant between group differences in BCAP abuse risk. There were significant reductions from to pre- to post-assessment in BCAP abuse risk for both treatment conditions (p< .001; Hedge’s G= .815 and .661, respectively for CB-MBN and DDAS). The high percentage of the sample with elevated abuse risk at pre-intervention in this primarily self-referred community sample of depressed mothers postpartum was striking, especially given no recruitment from child welfare serving agencies. Mothers in both intervention groups demonstrated significant pre-post reductions in child abuse potential with larger effects for mothers in the CB-MBN condition. Implications for future studies targeting maternal depression and parent sensitivity postpartum will be discussed relative to intervention type, timing, and dosage.