Adverse Caregiving Environments and Biobehavioral Markers of Health Risk: Associations Among Child Maltreatment, Sleep Variability, and Mother-Infant Regulation

Background and Purpose: Early adverse caregiving experiences are associated with health disparities across the lifespan. Studies show that infant self-regulation, a biobehavioral marker of health risk, is shaped by maternal-infant interactions and may be disrupted in caregiving environments characterized by high risk. Specifically, child maltreatment and sleep variability may reflect adverse caregiving environments, but it is unknown whether they confer vulnerability for poorer infant self-regulation or the ability for mother and infant to regulate one another’s physiology and behavior over time (i.e., mother-infant co-regulation). Regulatory processes can be measured by respiratory sinus arrhythmia (RSA), which is an index of the parasympathetic nervous system and responsible for regulating stressful contexts and healthy adaptation. A growing literature shows that greater distress, evidenced by lower RSA (self-regulation) and discordant coupling of mother-infant RSA (co-regulation), is associated with child maltreatment and poor sleep. Therefore, the aim of this study was to examine mother-infant self- and co-regulation of RSA in relation to child maltreatment severity and night-to-night sleep variability in a low-income and racially and ethnically diverse sample of mother-infant dyads.

Methods: English- and Spanish-speaking families involved with public welfare and departments of human services were recruited to participate in a larger longitudinal study involving families experiencing adversity. Both English- and Spanish-speaking families (21% Latinx), with an infant between the age of 6 to 14 months, were invited to participate in the study. Participants were 47 mother-infant dyads (infant M_age = 8.47 months, SD = 2.39; mother M_age = 29.82, SD = 6.33). Child maltreatment severity was measured using maternal reports from the Conflict Tactics Scale Parent-Child Version. Mother and infant sleep were measured with actigraphy and daily diaries for seven nights. Mother and infant RSA were measured using heart rate monitors during a semi-structured stress paradigm. Multilevel coupled autoregressive models were conducted to examine differences in mother and infant self- and co-regulation of RSA by maltreatment severity and by night-to-night sleep variability.

Results: Higher maltreatment severity was associated with weakened concordance in RSA co-regulation (b = .006, SE = .003), suggesting greater infant distress and lower maternal support during the stress paradigm. Higher infant sleep variability was associated with infants’ lower mean RSA (b = -.031, SE = .012) and concordance in RSA co-regulation (b = .008, SE = .004), suggesting greater distress in both mothers and infants during the stress paradigm.

Conclusions & Implications: Findings indicate that adverse caregiving environments, characterized by higher maltreatment severity and night-to-night sleep variability, may differentially impact regulatory patterns in mothers and infants. Given that infancy is a sensitive period of development whereby regulatory processes are more susceptible to adverse conditions and may lead to poor health outcomes over time, these findings may inform modifiable health-risk factors as targets for future social work intervention with vulnerable children and families. Specifically, interventions that aim to increase positive and consistent caregiving may help strengthen mother and infant interactions to promote healthy regulation and optimal health outcomes.