I'm especially delighted today that we have a guest who's one of the preeminent scientists in the world, who studies not only resilience, but many other fields of science, and that is Dante Cicchetti. He's a McKnight Presidential Professor in child development at the University of Minnesota. And I've known him for many years and learned a great deal from him over that time. So thank you for being with us today. >> Thanks, Anne. I'm really glad to be here. >> Okay, well, you've been urging resilient scientists all over the world for decades to consider multiple levels of analysis in their work. All right, do you see progress? >> Well in the early years, most of the research, as you well know, on the determinants of resilience was psychosocial. And you and Norman Garmezy and others played a major role in that research and went on to also do longitudinal research in that vein. I have seen some progress being made, but I think a big problem is the communication between disciplines that's out there. In that to do multiple levels of analysis, there are few people who can master even a couple of levels, let alone everything you could think of. So you could think about genetics and immunology, and endocrinology, and neurobiology, and so on. There are very few people that are going to know more than one or two of those. And so, they often bring their perspective into the study of resilience and sometimes that results, in despite it being multiple levels, there is sort of more of an emphasis on one of the levels. So I think that there's been progress in that it's happening, people are moving beyond well, if they study a biological contributor to resilience, that that must mean that you're either going to do well or not based on the biology. They know that isn't the case. So there's some improvements, but I think a lot has to happen, including the statistical models one has to come up with to how you do analysis. One there's things at different levels or one level might develop faster than another level or whatever. So there's progress and a lot more I believe will come in the future. >> It seems like in work like you and your colleagues do as well as others, there is a bit more traction now in trying to measure the neurobiology processes and how they're interacting with the social processes. >> Mm-hm. >> Do you agree that there's some traction? And if so, what's made that possible? >> Well, I agree that there has been traction in that regard. And I think, obviously one of the things that's made it possible has been the advances we've seen in our understanding of molecular genetics, our knowledge of how to measure what's going on inside the brain and the like. But there is a danger. And the danger can be if people doing that sort of work believe that they don't need to be thinking about theory or thinking about developmental process. Or things like that, so it's almost like the technology gets reified and then they apply that, let's say, to resilience, or to pathology, if you look at one other end possible. And I think that that's something that really needs to improve greatly. A lot of that, I feel, is based on the need for, if possible, to have more interdisciplinary training in graduate school and in medical school, or other disciplines that also play a role in studying the development of resilience. That way minimally, even if they're on a team studying multiple levels, they'll be able to not only to contribute their perspective, but be able to listen to what the other perspectives are. And even challenge them in some ways to point out hey, you're missing this by focusing only on that. So, I think that's going to happen. And that, of course, is challenging, because it almost requires differences in how faculty are recruited and all that other stuff. But I think that there will be more attention paid to this in future curricula. >> It sounds like you think we haven't done as much as we need to do to train people in collaboration. It's not that easy, is it? >> No, it isn't. I mean if you trace back even the past three, four decades, this is becoming more of a recent phenomenon, to value collaboration. To within a department to say, hey, it's okay for faculty to collaborate, and not just show what they can do. The way things are looking due to the complexity of resilience process is, you have to be studying more than one thing, or at least coming together with a team that's capable of integrating that. And so we definitely have not encouraged it. It's been more like a silo. You do your thing. You do your thing. You do your thing. And then a discussion or in a chapter and we might be able to have someone integrate them all. But I think now it's changing within departments as not only research but frankly federal funding agencies are urging for more of this inner disciplinary collaboration, multiple levels. And if for no other reason then that, people who need funding to get their labs moving have been paying more attention to the need to do this. And of course, most of them will actually do it. >> You and your collaborators have done ground breaking work, collaborative ground breaking work, on risk and resilience in maltreatment. Could you just tell us a little bit about that and what you think is really exciting in that area of work? >> Well, [COUGH] at first my work was on studying resilience in kids who have been abused, neglected or maltreated. Was all behavioral research, all psychosocial research. Some of it looked at them in one point in time, like in the cross sectional study. Some were longer term studies. It's hard to do real long-term studies with maltreated kids, because they have so many risks and so many things that they're dealing with, and the families and so on, that it's hard to keep track of them over time. But you can. So I then started to realize that in a lot of my behavioral work, I would sort of neurologize about the behavioral findings, or neurobiologize, whatever. And so I started thinking like well, I'm talking the talk, but I'm not walking the walk. And I thought that was not a really good thing to do. And so I started studying more, and realized that we needed to, in my opinion, start integrating biological and genetic domains into the study of the psychosocial ones in resilience. And I think that has shown that both of them actually are important, either in studies where they interact or studies where each of them has a main effect on some of the outcomes. And so some of the things I've seen with maltreated kids is, one of the determinants of resilience from a behavioral level appears to be those who have strong self-determination. And who are also reserved, interestingly, in context where potential maltreatment or violence could occur. So they're in a home, and they've been in a maltreating home. They will be much more reserved in their interactions or than they would be if they were in another context. I've learned that context plays a big role because they're not going to behave the same way in every situation, which is one reason why you have to get a big, broad picture of resilience. Are they resilience at home, or in a laboratory, or in school, or where, and how do those come together? I think an interesting finding I've had recently was I begun doing gene environment interaction in outcomes of maltreated kids, be they resilient outcomes or non-resilient. And one of the things I found is, interestingly, I've looked at five different genes that seem to be good candidates to investigate when you're studying maltreatment based on a variety of data from animal work, human work, psychiatric work, and the like. And what we found was, interestingly, is if you look at, if you have a particular variant of each of those five genes, either in taking them one at a time or bringing them all five together, and you're non-maltreated, they had a greater likelihood of being resilient. Now I'm not saying all of them, but statistically speaking, that played a role in the development of their resilience. It wasn't the only thing, but it played a role. If you looked at it in maltreated kids, the genes I've studied have played no role in the development of resilience. Most of these kids have had multiple types of maltreatment such as sexual abuse, physical abuse, neglect, emotional maltreatment. And it's almost as if the maltreatment overpowers any genetic effect that's there. But maltreatment overpowers it. So I thought that was very interesting. We've also taken work where we've utilized interventions that were informed by basic research we did on maltreated children's attachment development and worked with attachment informed interventions that were developed by people in the field. And we've found that we could increase security of attachment in maltreated kids through intervention. And what we did was at baseline pre-intervention 97% of maltreated kids were in a insecure attachment classification. At the end of one year, whenever the intervention was completed, it was a weekly intervention focusing on parent-child relationship quality. 61% of the maltreated kids in the intervention developed a secure attachment. Whereas about 5% of those maltreated kids not in intervention, in the so-called treatment in the community, whatever the community gave us. They were getting a treatment but it was whatever the community gave them. Treatment as usual, they went from 3% at baseline to 5%, in essence nothing. Then we studied them another year, and the stability of attachment was still there one year later. We've also been able to improve the regulation of their hypothalamic pituitary adrenal access, the stress axis, by our intervention. We compared them to non-maltreated kids and maltreated kids getting treatment via as usual. And there was no differences after intervention and for another year later which is as long as we studied them, between maltreated kids in intervention and the non-maltreated kids. So psychology is changing, physiology, and vice versa, pointing out the need to look at the relation between the two. And that's also as a developmental psychopathologist something I'm very interested in in the field is namely looking at the relation between different domains as you say, multiple levels of analysis. Or looking at how does normal development inform abnormal and vise versa. Of course, this attachment was informed by early work with typical children and families. So, I think that was exciting to me that we were improving these kids and that'll help them more in the future, as they go to school and the like. >> Do you think of these intervention studies as trying to in effect promote resilience by targeting a key protective system, in this case the attachment system? >> Absolutely, absolutely. That's the goal. And I have a little hesitation, although I completely feel the same way, but I have a little bug in my ear which is saying, remember resilience is resilience where you measure it and what the context is and where you go. I'm not saying they're inoculated for the rest of their lives. >> For everything. >> Exactly, for everything. But yes, I view these as resilience promoting. And if I think of something that's going to have to come more in the future, it's doing preventive interventions or interventions that would help, and that would be ideally multi-level. That would be helpful to these kids and families, or other types of kids and families, not just maltreated kids. >> But always keeping context in mind. >> Always keeping the context in mind, yes. >> because I would imagine there are cultural issues and context issues where we think we have good intentions and we intervene thinking we're promoting resilience. But we may not provide the kind of protective skills that are good in a dangerous environment. >> Absolutely. >> Maybe great at school. >> Yes, I absolutely do think it's critical and I was saying that I directed a center in Rochester, New York. Mount Hope Family Center, in which we provided preventive interventions and treatment to maltreating parents and their children. We always did our best to speak with the parents. To try understand the culture, to understand any differences that would be there among, for example, African American, Caucasian, and Latino families. We also knew that they were experiencing varying degrees of other kinds of challenges in their lives, such as extreme poverty and the like. So we always paid attention to that and I think that's crucial and it's something that also requires developing a trust as you know so well between scientist and the community. Because especially since there are more maltreated kids that come from poverty backgrounds, there may be some mistrust, etc., in researchers in university settings. And so we always want to show them that we truly care, and we're not just in it to collect data and publish papers. It's, you're there, and that's really important. If I may tell an anecdote, in my early career, I was trying to start work on the effects of daycare on child abuse. And I went to a meeting expecting to find four people. Instead, there were 200 irate citizens at this meeting who were expressing great displeasure for having me there and for what I wanted to do. And when I tried to assure them that my intentions were purely good, over one or two meetings, they leaked to me what had happened in this community. And that was a famous professor at Harvard had built a daycare center there against their will. They came to really rely on that daycare center and after the grant ended the person shut down the center. And so, it made me realize you've gotta give and not just take. And for me that was pretty easy. That's the type of human being I am, but I see more and more of this going in the field. Your work as I said exemplifies a very similar approach. And I think that's really critical. >> Stay the course. >> Yeah stay the course. Mt Hope Family Center that you've founded has stayed the course for a long time, in Rochester. >> Yes, yes. >> Well, I just have one final question. And that is kind of looking way down the road, thinking about the long run future, are there any things on the distant horizon, that you're really excited about, that have to do with promoting resilience in children at risk? In maltreatment or in any other area of risk. >> Well, given that the Fourth Wave as you I believe called it, in a publication, the multi-level, so-and-so has wave has been really relatively recent. Maybe less than a decade, right? It's hard for me to really be certain about what I'll think about in ten years, but I think interventions are going to become more and more important. And you're going to see professors who may have never thought of doing intervention and have only done basic research realizing that they have the opportunity to take what they have done and translate it into preventive interventions or interventions. They can help children and also inform developmental theory in ways that it would not be informed if it didn't study a sort of atypical processes. So, that's gotta be one. I'm hoping that interdisciplinary work gets more common so that the multiple levels approach, Is actually capable of being used in truth and not just in words. I think we can't give up theory and theory should evolve over time. It's not just letting the, as I said earlier, the technology guide us and forget what we're doing. Even the term developmental psychopathology, despite it being around for quite a while now. Many people who use the term are still talking simply about problems in children. They're not really talking about development. And I'm hoping that the process of development plays a bigger role in future research on resilience and maybe also in gene environment interaction research, not just genes and environment, but also development. So genes by environment, by development or development by genes by environment. Whatever. And lastly, which has been exciting me, but I don't know the degree to which it's going to be possible for lots of people to do unless there's lots of collaborations, are the way that epigenetic research, wherein things like poverty, mental illness and the like can change the structure of DNA, but not the sequence. And some genes wind up being methylated and that can interfere with the expression of genes, if that will catch on or not. In my work, I've been really excited by it now, and I'm actually looking at intervention, but don't know the answers to what will happen. But I think that more and more of this stuff has gotta be if you're doing epigenetics, you gotta be thinking development. You gotta be thinking, not just that there's more methylation. You're hypermethylated, your genes are hypermethylated or hypomethylated. Which will effect gene expression, as I said. Sometimes you have hypermethylation and, that could mean the genes that shouldn't be expressing are expressing. It's very complicated. All that stuff, but not forgetting what are the mechanisms that happens, you know. How does it relate to behavior. How does it relate to resilience? Can you get, can you have methylation as a dependent variable in research, and have it be an outcome? And can you see methylation changes in intervention, or gene expression changes, as you're doing? >> That sounds like putting what we eventually learn and know about multiple levels to actually work, to promote the odds of resilience in development of children. >> Absolutely. And it's so funny. One thing, a pet peeve I have, is so often you'll see in the literature, people talking about basic research and applied research. And they would consider what you do and what I do. Some of those folks who are a lot of people in academia as applied researchers. And I don't think it is applied research. I think basic and applied are going hand in hand. The schisms that exist between them should be broken down. And when I'm talking with very prominent people in the field and I hear them interested in intervention, and assuming that it's genuine and they're really going to do it, I think that's exciting. Because you bring minds to a topic that aren't part of the club, and I think that can really help the club grow, you know? So to speak. >> Well, thank you for being here and thank you for everything you do and understanding and promoting resilience. >> Thanks Anna, it was my pleasure to be here. >> Thank you. [SOUND]
