Optional video: Interview with Dante Cicchetti

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.

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.

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