Research

The BE SAFE Study and the DU Pregnancy Study

The BE SAFE Pregnancy Study (also called the DU Pregnancy Study) examines how pregnancy is a transformative developmental period during which pregnant individuals and non-gestational caregivers (e.g., biological fathers of the baby, caregivers in same-sex relationships) reflect upon and make sense of their childhood experiences, draw on current relationships and resources, and organize expectations about how to be effective caregivers themselves.

The first wave of the BE SAFE Study took place at the Zuckerberg San Francisco General (ZSFG) Hospital (BE SAFE San Francisco), where 101 low-income, ethnically diverse English- and Spanish-speaking women were recruited during pregnancy. Researchers followed up with the women when their infants were three to four months old. The primary research questions sought to address how early, cumulative, and ongoing experiences, both adverse and benevolent, shaped health and wellbeing during the prenatal and postnatal periods; how mental health, relationship support and conflict, cultural influences, and stress physiology served as mediators and moderators of earlier experiences and subsequent functioning and adaptation; and the extent to which perinatal individuals' service utilization and needs during pregnancy predict their prenatal and postnatal health and infant development (Narayan et al., 2017, Zero to Three Journal).

Students in the PROTECT Lab have a wide range of opportunities to explore questions from the BE SAFE San Francisco study related to the intergenerational transmission of risk and resilience; continuity and change in mental health, relationships, emotions and behavior from the prenatal to the postnatal periods; early experiences as developmental antecedents to parenting and infant development; multicultural influences on pregnancy and parenting outcomes; and many other trauma-informed topics related to developmental psychopathology.

The expansion of the BE SAFE Study to Denver is currently underway (Narayan et al., 2019, Zero to Three Journal). We have currently collected data on 252 families during pregnancy, including 240 pregnant individuals and 150 non-gestational caregivers. Our participants predominantly identify as individuals from minority racial and ethnic groups (approximately 60% of all adults in the study identify as non-White). We have followed these families to three- to four-months postpartum and 12- to 15-months postpartum, with more than two-thirds retention of all families, despite the fact that more than 50% of all adults reported a lifetime history of homelessness, and the majority of families had their babies during the COVID-19 pandemic.

The BE SAFE Denver study expands on many of the questions from the BE SAFE San Francisco study by also focusing on the intergenerational transmission of childhood adversity and psychopathology, and the role of protective factors in promoting parent and child resilience and secure attachment. As an important addition, however, the BE SAFE Denver study has captured the invaluable perspectives of fathers-to-be, including how their early life experiences affect their mental health, relationships and plans for fatherhood; the role of co-parenting and romantic relationship dynamics on prenatal and postnatal health and wellbeing; and the intergenerational transmission of adversity, relationship patterns, psychopathology and resilience on infant attachment and childhood stress in the next generation.

We are currently conducting fourth and fifth waves of this study, through preschool and kindergarten. We are thrilled to now have teachers reporting on children's emotional, behavioral, and relational adjustment in the classroom!

Protective Factors

The PROTECT Lab has a keen interest in using efficient yet effective methodologies for research and clinical purposes, with the goal to assess the richness of behaviors, relationships and representations in parents and children. We are particularly interested in instruments that can assess resilience processes in ethnically-diverse families.

One line of our work focuses on developing, validating, and expanding the Benevolent Childhood Experiences (BCEs) scale, a 10-item checklist of favorable childhood experiences, relationships and resources that was first created and published by Angela Narayan, PhD, and colleagues in an article titled "Positive Childhood Experiences Predict Less Psychopathology and Stress in Pregnant Women with Childhood Adversity: A Pilot Study of the Benevolent Childhood Experiences Scale" (Narayan et al., 2017, Child Abuse and Neglect). Please see our website's Instruments page for more information on new versions of the BCEs scale!

We are continuing to examine psychometric properties of the BCEs in diverse samples of adults and parents. As one example, the PROTECT Lab conducted a large survey-based study of 1,750 young adults that examined the effects of BCEs in conjunction with childhood adversity and other childhood relationship influences on health, emotions and behavior in young adulthood.

Another related line of research focuses on understanding how positive childhood memories, which we refer to as "angels in the nursery," can be empirically identified to serve as protective factors that buffer adults and parents with histories of adversity from the effects of lifespan and intergenerational transmission of psychopathology, trauma and parenting difficulties into the next generation of children and families.

The first empirically-documented protective effects of angels in the nursery revealed that positive childhood "angel memories" buffered the effects of childhood maltreatment on adulthood PTSD symptoms in a pilot sample of mothers reared in foster care as children (Narayan et al., 2017, Infant Mental Health Journal). Replication findings showed that angel memories also buffer effects of mothers' childhood maltreatment on their comorbid psychopathology and their children's exposure to traumatic life events in the next generation (Narayan et al., 2019, Development and Psychopathology).

Students involved in these projects are trained in a variety of rich and dynamic coding systems, such as the Angels in the Nursery coding system, expressed emotion coding systems from the Five-Minute Speech Sample, maternal sensitivity and infant attachment from parent-child interactions including the Strange Situation Procedure, and various other narrative and observational methodological approaches in the PROTECT Lab.

Psychometric Development

The PROTECT Lab emphasizes psychometric rigor and creativity in construction and validation of psychological instruments and quantitative measures that assess individual and relational development. We are particularly interested in accurately and objectively understanding the perspectives of parents and families who are experiencing traumatic stress, interpersonal conflict and complex psychopathology; and identifying the assets and resources that help them to cope and thrive.

We place dual importance on gaining parents’ first-hand reports of stressors, struggles, and supports while also capturing their open-ended yet targeted accounts of relationships, experiences and memories that are less susceptible to reporter-based, context-specific, or social desirability biases. For instance, we assess complicated constructs (e.g., childhood maltreatment, relational support, pregnancy wantedness, co-parenting and romantic relationship dynamics, perceptions of neighborhood safety) through independent but convergent measurements from self-report questionnaires, audio-recorded narratives, observational methods, and coder ratings that employ validated scoring systems.

A main goal of this work is to inform translational efforts for research tools to become useful in clinical settings, such as perinatal health services with pregnant women and fathers-to-be, and in low-income, underserved families.