$3.5M grant continues child mental health investigation in DRC


To understand the long-term effects of early child development programs on child and maternal mental health outcomes, researchers from the Michigan State University College of Osteopathic Medicine have been awarded a $3.5M, 5-year R01 grant from the National Institute of Mental Health for their project, “Congolese mother and child mental health in response to early child development interventions.” Based in the Democratic Republic of the Congo (DRC), this study assesses the mental health benefits for mothers and children who participated in an earlier intervention study, in which mothers were trained weekly over the course of a year on practical strategies for enriching a child’s early learning environment in the home, as well as nutritional strategies for supporting optimal developmental and physical health.

“We’re now measuring mental health outcomes among mothers and children from our previous study,” said Itziar Familiar-Lopez, M.D., Ph.D., MPH, assistant professor in MSU’s Department of Psychiatry. “We know that early childhood development programs like the one we implemented in the DRC four years ago are well-established and offer a means to buffer social drivers and behavioral issues in the short-term and can help children reach developmental milestones and achieve their potential. But now, we want to evaluate the long-term mental health effects of these programs, which are currently unknown, and explore what mechanisms may explain the outcomes.

“We also want to examine how family, social, child growth, and maternal mental health factors affect child mental health. Behavior and mental health are multifactorial, and our program is not the only thing shaping the children, so we want to evaluate how these factors independently impact mental health in children ages 5-12.”

Dr. Familiar-Lopez, who specializes in maternal mental health and its association with child behavior and neurodevelopment, said she and her collaborators will measure reciprocal effects of maternal and child mental health outcomes, both how maternal mental health affects children and how a child’s mental health affects a mother’s mental health.

“These findings will inform prevention of mental health problems in low- and middle-income countries,” she said. “By identifying more mechanisms and mediators of mental health, we will be able to devise and tailor new programs and interventions that could make a significant impact in these contexts.”

In their previous work, Dr. Familiar-Lopez and Michael Boivin, Ph.D., University Distinguished Professor in the MSU Departments of Psychiatry and Neurology and Ophthalmology, and director of the Psychiatry Research Program, implemented an early child development program–Mediational Intervention for Sensitizing Caregivers (MISC), originally developed at Bar Ilan University in Israel–to enhance the development of children ages 2-to-3 in Uganda who are infected and affected by exposure to the human immunodeficiency virus (HIV), and in DRC to lower the risk of konzo, a neurological disease caused by exposure to high levels of cyanide found in improperly processed cassava. Cassava, a root vegetable, is the main source of food for families in DRC’s Kahemba Territory during times of extreme food and water insecurity.

Dr. Boivin is an expert on child neurodevelopment, and has vast experience studying training programs for caregivers and how the caregiver’s mental health affects how they engage with a child. Boivin, along with MSU medical students and Ugandan colleagues, previously pioneered the use of eye tracking technologies in measuring early childhood attention and memory in children of mothers living with HIV.  The team will now pioneer use of these state-of-the-art eye-tracking technologies to gauge the viewing focus of the children as they watch scripted videos of mother-child interactions produced within their own cultural context.  

“This is the first time such eye-tracking measures have been used to gauge emotional responsiveness of mother and child – years after the caregiver training interventions in early childhood – to foster greater emotional attachment,” Dr. Boivin said. “One goal of this project will be to train and equip our Congolese neuropsychiatric colleagues at the University of Kinshasa Medical School in the use of such measures in support of their own clinical and research work.”

Also supporting this project are Barbara Thompson, Ph.D., assistant professor in the MSU College of Human Medicine's Department of Pediatrics and Human Development, and Alla Sikorskii, Ph.D., professor in MSU’s Department of Psychiatry. Dr. Thompson is a trained behavioral neuroscientist who uses eye-tracking technology – usually employed for commercial and advertisement placement – to analyze dynamic mother-child relationships. Dr. Thompson has also used innovative measures of maternal-child emotional connectedness through the analysis of their facial expressions in evaluating video recordings of such interactions, which Dr. Boivin’s team will have available from this study. Dr. Sikorskii serves as the team’s clinical methodologist and biostatistician, and has been a lead investigator in the previous studies involving enhanced early childhood development through caregiver training in DRC.

Other investigators include Desire Tshala-Katumbay, M.D., Ph.D., MPH, a neurologist at the Oregon Health & Science University and the University of Kinshasa, as well as Mumba Dieudonne Ngoyi, M.D., Ph.D., a tropical medicine specialist who is acting director of the Institute National Biomédicale de Recherche (INRB) in Kinshasa – the national referral laboratory for DRC. Drs. Tshala-Katumbay and Ngoyi are the in-country principal investigators for the present study, and have collaborated with Dr. Boivin on the previous NIH-sponsored studies that provided the foundation for the present NIMH R01 initiative.


By E. LaClear