Skip to main content
Top
Gepubliceerd in: Journal of Child and Family Studies 8/2014

01-11-2014 | Original Paper

Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes

Auteurs: Fallon Cluxton-Keller, Lori Burrell, Sarah S. Crowne, Elizabeth McFarlane, S. Darius Tandon, Philip J. Leaf, Anne K. Duggan

Gepubliceerd in: Journal of Child and Family Studies | Uitgave 8/2014

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

The purpose of this study was to determine the extent to which maternal relationship insecurity and severe depressive symptoms moderate home visiting impacts on developmental and behavioral outcomes in 2-year old children. In an experimental trial of the Healthy Families Alaska home visiting program, families (N = 249) were randomly assigned to home visiting (n = 126) or community services as usual (n = 123). Maternal severe depressive symptoms (CES-D ≥ 24) and relationship insecurity were measured using the Center for Epidemiologic Studies Depression Scale and the Attachment Style Questionnaire at baseline. Child cognitive and psychomotor development and behavior problems were measured with the Bayley Scales of Infant Development and the Child Behavior Checklist at follow-up. The results revealed that home visiting significantly impacted three outcomes—child cognitive development, internalizing behavior, and externalizing behavior. Home visiting impacts were limited to subgroups defined by maternal depressive symptoms and relationship insecurity. Home visiting improved cognitive development (B = 6.02, p < .03), and decreased internalizing behavior (B = −3.83, p = .02) and externalizing behavior problems (B = −3.74, p = .03) in children of mothers with either severe depressive symptoms or high levels of discomfort with trust at baseline, but not both. Family engagement in home visiting seems to play a role in mediating these moderating effects. These findings reflect the importance of screening for maternal relationship insecurity and depressive symptoms to distinguish family subgroups likely to benefit from home visiting from those for whom an enhanced service model might be needed.
Literatuur
go back to reference Achenbach, T. M. (1991). Manual for the child behavior checklist and the 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry. Achenbach, T. M. (1991). Manual for the child behavior checklist and the 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
go back to reference Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families. Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.
go back to reference Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage. Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
go back to reference Ammerman, R. T., Peugh, J. L., Putnam, F. W., & Van Ginkel, J. B. (2012). Predictors of treatment response in depressed mothers receiving in-home cognitive behavioral therapy and concurrent home visiting. Behavior Modification, 36(4), 462–481.PubMedCrossRef Ammerman, R. T., Peugh, J. L., Putnam, F. W., & Van Ginkel, J. B. (2012). Predictors of treatment response in depressed mothers receiving in-home cognitive behavioral therapy and concurrent home visiting. Behavior Modification, 36(4), 462–481.PubMedCrossRef
go back to reference Ammerman, R. T., Putnam, F. W., Altaye, M., Stevens, J., Teeters, A. R., & Van Ginkel, J. B. (2013a). A clinical trial of in-home CBT for depressed mothers in home visitation. Behavior Therapy. doi:10.1016/j.beth.2013.01.002. Ammerman, R. T., Putnam, F. W., Altaye, M., Stevens, J., Teeters, A. R., & Van Ginkel, J. B. (2013a). A clinical trial of in-home CBT for depressed mothers in home visitation. Behavior Therapy. doi:10.​1016/​j.​beth.​2013.​01.​002.
go back to reference Ammerman, R. T., Putnam, F. W., Altaye, M., Teeters, A. R., Stevens, J., & Van Ginkel, J. B. (2013b). Treatment of depressed mothers in home visiting: Impact on psychological distress and social functioning. Child Abuse and Neglect. doi:10.1016/j.chiabu.2013.03.003. Ammerman, R. T., Putnam, F. W., Altaye, M., Teeters, A. R., Stevens, J., & Van Ginkel, J. B. (2013b). Treatment of depressed mothers in home visiting: Impact on psychological distress and social functioning. Child Abuse and Neglect. doi:10.​1016/​j.​chiabu.​2013.​03.​003.
go back to reference Ammerman, R. T., Putnam, F. W., Kopke, J. E., Gannon, T. A., Short, J. A., Van Ginkel, J. B., et al. (2007). Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky. Journal of Prevention and Intervention in the Community, 34, 89–107.PubMedCrossRef Ammerman, R. T., Putnam, F. W., Kopke, J. E., Gannon, T. A., Short, J. A., Van Ginkel, J. B., et al. (2007). Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky. Journal of Prevention and Intervention in the Community, 34, 89–107.PubMedCrossRef
go back to reference Ammerman, R. T., Putnam, F. W., Stevens, J., Holleb, L. J., Novak, A. L., & Van Ginkel, J. B. (2005). In-home cognitive behavior therapy for depression: An adapted treatment for first-time mothers in home visitation. Best Practices in Mental Health, 1, 1–14. Ammerman, R. T., Putnam, F. W., Stevens, J., Holleb, L. J., Novak, A. L., & Van Ginkel, J. B. (2005). In-home cognitive behavior therapy for depression: An adapted treatment for first-time mothers in home visitation. Best Practices in Mental Health, 1, 1–14.
go back to reference Bair-Merritt, M. H., Crowne, S. S., Burrell, L., Caldera, D., Cheng, T. L., & Duggan, A. K. (2008). Impact of intimate partner violence on children’s well-child care and medical home. Pediatrics, 121(3), 473–480.CrossRef Bair-Merritt, M. H., Crowne, S. S., Burrell, L., Caldera, D., Cheng, T. L., & Duggan, A. K. (2008). Impact of intimate partner violence on children’s well-child care and medical home. Pediatrics, 121(3), 473–480.CrossRef
go back to reference Bayley, N. (1993). Bayley Scales of infant development (2nd ed.). San Antonio, TX: The Psychological Corporation, Harcourt Brace & Company. Bayley, N. (1993). Bayley Scales of infant development (2nd ed.). San Antonio, TX: The Psychological Corporation, Harcourt Brace & Company.
go back to reference Bowlby, J. (1973). Attachment and loss, Vol. 2: Separation. New York, NY: Basic Books. Bowlby, J. (1973). Attachment and loss, Vol. 2: Separation. New York, NY: Basic Books.
go back to reference Bowlby, J. (1980). Attachment and loss, Vol. 3: Loss, sadness and depression. New York, NY: Basic Books. Bowlby, J. (1980). Attachment and loss, Vol. 3: Loss, sadness and depression. New York, NY: Basic Books.
go back to reference Bretherton, I., & Munholland, K. A. (2008). Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical application (2nd ed.). New York: Guilford. Bretherton, I., & Munholland, K. A. (2008). Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical application (2nd ed.). New York: Guilford.
go back to reference Caldera, D., Burrell, L., Rodriguez, K., Shea-Crowne, S., Rohde, C., & Duggan, A. (2007). Impact of statewide home visiting program on parenting and on child health and development. Child Abuse and Neglect, 31, 829–852.PubMedCrossRef Caldera, D., Burrell, L., Rodriguez, K., Shea-Crowne, S., Rohde, C., & Duggan, A. (2007). Impact of statewide home visiting program on parenting and on child health and development. Child Abuse and Neglect, 31, 829–852.PubMedCrossRef
go back to reference Chaffin, M. (2004). Is it time to rethink healthy start/healthy families? Child Abuse and Neglect, 28, 589–595.PubMedCrossRef Chaffin, M. (2004). Is it time to rethink healthy start/healthy families? Child Abuse and Neglect, 28, 589–595.PubMedCrossRef
go back to reference Daro, D. A., & Harding, K. A. (1999). Healthy Families America: Using research to enhance practice. The Future of Children, 9, 152–176.PubMedCrossRef Daro, D. A., & Harding, K. A. (1999). Healthy Families America: Using research to enhance practice. The Future of Children, 9, 152–176.PubMedCrossRef
go back to reference Diamond, G. S., & Stern, R. S. (2003). Attachment-based family therapy for depressed adolescents: Repairing attachment failures. In S. M. Johnson & V. E. Whiffen (Eds.), Attachment processes in couple and family therapy (pp. 191–212). New York: Gilford Press. Diamond, G. S., & Stern, R. S. (2003). Attachment-based family therapy for depressed adolescents: Repairing attachment failures. In S. M. Johnson & V. E. Whiffen (Eds.), Attachment processes in couple and family therapy (pp. 191–212). New York: Gilford Press.
go back to reference Dolan, R., Arnkoff, D., & Glass, C. (1993). Client attachment style and the psychotherapist’s interpersonal stance. Psychotherapy: Theory Research and Practice, 30, 408–412.CrossRef Dolan, R., Arnkoff, D., & Glass, C. (1993). Client attachment style and the psychotherapist’s interpersonal stance. Psychotherapy: Theory Research and Practice, 30, 408–412.CrossRef
go back to reference Duggan, A. K., Berlin, L. D., Cassidy, J., Burrell, L., & Tandon, S. D. (2009). Examining maternal depression and attachment insecurity as moderators of the impacts of home visiting for at-risk mothers and infants. Journal Consulting and Clinical Psychology, 77, 788–799.CrossRef Duggan, A. K., Berlin, L. D., Cassidy, J., Burrell, L., & Tandon, S. D. (2009). Examining maternal depression and attachment insecurity as moderators of the impacts of home visiting for at-risk mothers and infants. Journal Consulting and Clinical Psychology, 77, 788–799.CrossRef
go back to reference Duggan, A. K., Caldera, D., Rodriguez, K., Burrell, L., Rohde, C., & Crowne, S. S. (2007). Impact of a statewide home visiting program to prevent child abuse. Child Abuse and Neglect, 31, 829–852.PubMedCrossRef Duggan, A. K., Caldera, D., Rodriguez, K., Burrell, L., Rohde, C., & Crowne, S. S. (2007). Impact of a statewide home visiting program to prevent child abuse. Child Abuse and Neglect, 31, 829–852.PubMedCrossRef
go back to reference Duggan, A. K., McFarlane, E., Windham, A. M., Rohde, C. A., Salkever, D. S., Fuddy, L., et al. (1999). Evaluation of Hawaii’s healthy start program. The Future of Children, Home Visiting: Recent Program Evaluations, 9, 66–90.CrossRef Duggan, A. K., McFarlane, E., Windham, A. M., Rohde, C. A., Salkever, D. S., Fuddy, L., et al. (1999). Evaluation of Hawaii’s healthy start program. The Future of Children, Home Visiting: Recent Program Evaluations, 9, 66–90.CrossRef
go back to reference DuMont, K., Mitchell-Herzfeld, S., Greene, R., Lee, E., Lowenfels, A., & Rodriguez, M. (2006). Healthy Families New York (HFNY) randomized trial: Impacts on parenting after the first 2 years. Working Paper Series: Evaluating Healthy Families, OCFS Working Paper #1. DuMont, K., Mitchell-Herzfeld, S., Greene, R., Lee, E., Lowenfels, A., & Rodriguez, M. (2006). Healthy Families New York (HFNY) randomized trial: Impacts on parenting after the first 2 years. Working Paper Series: Evaluating Healthy Families, OCFS Working Paper #1.
go back to reference Feeney, J. A., Alexander, R., Noller, P., & Hohaus, L. (2003). Attachment insecurity, depression, and the transition to parenthood. Personal Relationships, 10, 475–493.CrossRef Feeney, J. A., Alexander, R., Noller, P., & Hohaus, L. (2003). Attachment insecurity, depression, and the transition to parenthood. Personal Relationships, 10, 475–493.CrossRef
go back to reference Feeney, J. A., Noller, P., & Hanrahan, M. (1994). Assessing adult attachment. In M. B. Sperling & W. H. Berman (Eds.), Attachment in adults: Clinical and developmental perspectives (pp. 128–152). New York: Guilford. Feeney, J. A., Noller, P., & Hanrahan, M. (1994). Assessing adult attachment. In M. B. Sperling & W. H. Berman (Eds.), Attachment in adults: Clinical and developmental perspectives (pp. 128–152). New York: Guilford.
go back to reference Gomby, D. S. (2007). The promise and limitations of home visiting: Implementing effective programs. Child Abuse and Neglect, 31, 793–799.PubMedCrossRef Gomby, D. S. (2007). The promise and limitations of home visiting: Implementing effective programs. Child Abuse and Neglect, 31, 793–799.PubMedCrossRef
go back to reference Guterman, N. B. (1999). Enrollment strategies in early home visitation to prevent physical child abuse and neglect and the “universal versus targeted” debate: A meta-analysis of population-based and screening-based programs. Child Abuse and Neglect, 23, 863–890.PubMedCrossRef Guterman, N. B. (1999). Enrollment strategies in early home visitation to prevent physical child abuse and neglect and the “universal versus targeted” debate: A meta-analysis of population-based and screening-based programs. Child Abuse and Neglect, 23, 863–890.PubMedCrossRef
go back to reference Halchuk, R., Makinen, J., & Johnson, S. M. (2010). Resolving attachment injuries in couples using emotionally focused therapy: A 3 years follow-up. Journal of Couple and Relationship Therapy, 9, 31–47.CrossRef Halchuk, R., Makinen, J., & Johnson, S. M. (2010). Resolving attachment injuries in couples using emotionally focused therapy: A 3 years follow-up. Journal of Couple and Relationship Therapy, 9, 31–47.CrossRef
go back to reference Healthy Families America. (2001). Healthy families America training participant’s manual-program manager, supervisor, family support worker and assessment worker. Chicago, IL: Prevent Child Abuse America. Healthy Families America. (2001). Healthy families America training participant’s manual-program manager, supervisor, family support worker and assessment worker. Chicago, IL: Prevent Child Abuse America.
go back to reference Holmes, J. (1997). Too early, too late: Endings in psychotherapy—An attachment perspective. British Journal of Psychotherapy, 14, 159–171.CrossRef Holmes, J. (1997). Too early, too late: Endings in psychotherapy—An attachment perspective. British Journal of Psychotherapy, 14, 159–171.CrossRef
go back to reference Kitzman, H., Olds, D. L., Henderson, C. R, Jr, Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: A randomized controlled trial. Journal of the American Medical Association, 278, 644–652.PubMedCrossRef Kitzman, H., Olds, D. L., Henderson, C. R, Jr, Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: A randomized controlled trial. Journal of the American Medical Association, 278, 644–652.PubMedCrossRef
go back to reference Liang, K. Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13–22.CrossRef Liang, K. Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13–22.CrossRef
go back to reference McDowell, I., & Newell, C. (1996). Depression. In I. McDowell & C. Newell (Eds.), Measuring health: A guide to rating scales and questionnaires (2nd ed., pp. 238–286). New York: Oxford University Press. McDowell, I., & Newell, C. (1996). Depression. In I. McDowell & C. Newell (Eds.), Measuring health: A guide to rating scales and questionnaires (2nd ed., pp. 238–286). New York: Oxford University Press.
go back to reference McFarlane, E., Burrell, L., Crowne, S., Cluxton-Keller, F., Fuddy, L., Leaf, P. J., et al. (2013). Maternal relationship security as a moderator of home visiting program impacts on maternal psychosocial functioning. Prevention Science, 14(1), 25–39.PubMedCrossRefPubMedCentral McFarlane, E., Burrell, L., Crowne, S., Cluxton-Keller, F., Fuddy, L., Leaf, P. J., et al. (2013). Maternal relationship security as a moderator of home visiting program impacts on maternal psychosocial functioning. Prevention Science, 14(1), 25–39.PubMedCrossRefPubMedCentral
go back to reference McFarlane, E., Burrell, L., Fuddy, L., Tandon, S. D., Derauf, D. C., Leaf, P., et al. (2010). Association of home visitors’ and mothers’ attachment style with family engagement. Journal of Community Psychology, 38, 541–556.CrossRef McFarlane, E., Burrell, L., Fuddy, L., Tandon, S. D., Derauf, D. C., Leaf, P., et al. (2010). Association of home visitors’ and mothers’ attachment style with family engagement. Journal of Community Psychology, 38, 541–556.CrossRef
go back to reference Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford. Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford.
go back to reference Olds, D. L., Henderson, C. R., Kitzman, H. J., Eckenrode, J. J., Cole, R. E., & Tatelbaum, R. C. (1999). Prenatal and infancy home visitation by nurses: Recent findings. The Future of Children, 9, 44–65.PubMedCrossRef Olds, D. L., Henderson, C. R., Kitzman, H. J., Eckenrode, J. J., Cole, R. E., & Tatelbaum, R. C. (1999). Prenatal and infancy home visitation by nurses: Recent findings. The Future of Children, 9, 44–65.PubMedCrossRef
go back to reference Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110, 486–496.PubMedCrossRef Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110, 486–496.PubMedCrossRef
go back to reference Piantadosi, S. (1997). Clinical trials: A methodologic perspective (Vol. 323). Hoboken, NJ: Wiley and Sons. Piantadosi, S. (1997). Clinical trials: A methodologic perspective (Vol. 323). Hoboken, NJ: Wiley and Sons.
go back to reference Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRef Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRef
go back to reference Roberts, J. E., Gotlib, I. H., & Kassel, J. D. (1996). Adult attachment styles and symptoms of depression: The mediating role of dysfunctional attitudes and low self-esteem. Journal of Personality and Social Psychology, 70, 310–320.PubMedCrossRef Roberts, J. E., Gotlib, I. H., & Kassel, J. D. (1996). Adult attachment styles and symptoms of depression: The mediating role of dysfunctional attitudes and low self-esteem. Journal of Personality and Social Psychology, 70, 310–320.PubMedCrossRef
go back to reference Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 58–66.PubMedCrossRef Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 58–66.PubMedCrossRef
go back to reference Robinson, J., & Emde, R. N. (2004). Mental health moderators of early head start on parenting and child development: Maternal depression and relationship attitudes. Parenting: Science and Practice, 4, 73–97.CrossRef Robinson, J., & Emde, R. N. (2004). Mental health moderators of early head start on parenting and child development: Maternal depression and relationship attitudes. Parenting: Science and Practice, 4, 73–97.CrossRef
go back to reference Slade, A. (1999). Attachment theory and research: Implications for the theory and practice of individual psychotherapy with adults. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 575–594). New York: Guilford Press. Slade, A. (1999). Attachment theory and research: Implications for the theory and practice of individual psychotherapy with adults. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 575–594). New York: Guilford Press.
go back to reference Spieker, S., Nelson, D., DeKlyen, M., & Staerkel, F. (2005). Enhancing early attachments in the context of early head start: Can programs emphasizing family support improve rates of secure infant–mother attachments in low-income families? In L. J. Berlin, Y. Ziv, L. Amaya-Jackson, & M. T. Greenberg (Eds.), Enhancing early attachments: Theory, research, intervention and policy (pp. 250–275). New York: Guilford. Spieker, S., Nelson, D., DeKlyen, M., & Staerkel, F. (2005). Enhancing early attachments in the context of early head start: Can programs emphasizing family support improve rates of secure infant–mother attachments in low-income families? In L. J. Berlin, Y. Ziv, L. Amaya-Jackson, & M. T. Greenberg (Eds.), Enhancing early attachments: Theory, research, intervention and policy (pp. 250–275). New York: Guilford.
go back to reference St. Pierre, R. G., & Layzer, J. I. (1999). Using home visits for multiple purposes: The comprehensive child development program. The Future of Children, 9, 134–151.PubMedCrossRef St. Pierre, R. G., & Layzer, J. I. (1999). Using home visits for multiple purposes: The comprehensive child development program. The Future of Children, 9, 134–151.PubMedCrossRef
go back to reference Strodl, E., & Noller, P. (2003). The relationship of adult attachment dimensions to depression and agoraphobia. Personal Relationships, 10, 171–185.CrossRef Strodl, E., & Noller, P. (2003). The relationship of adult attachment dimensions to depression and agoraphobia. Personal Relationships, 10, 171–185.CrossRef
go back to reference Wayment, H. A., & Vierthaler, J. (2002). Attachment style and bereavement reactions. Journal of Loss and Trauma, 7, 129–149.CrossRef Wayment, H. A., & Vierthaler, J. (2002). Attachment style and bereavement reactions. Journal of Loss and Trauma, 7, 129–149.CrossRef
go back to reference Zayas, V., Mischel, W., Shoda, Y., & Aber, J. L. (2010). Roots of adult attachment: Maternal caregiving at 18 months predicts adult peer and partner attachment. Social Psychological and Personality Science, 000, 1–9. Zayas, V., Mischel, W., Shoda, Y., & Aber, J. L. (2010). Roots of adult attachment: Maternal caregiving at 18 months predicts adult peer and partner attachment. Social Psychological and Personality Science, 000, 1–9.
Metagegevens
Titel
Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes
Auteurs
Fallon Cluxton-Keller
Lori Burrell
Sarah S. Crowne
Elizabeth McFarlane
S. Darius Tandon
Philip J. Leaf
Anne K. Duggan
Publicatiedatum
01-11-2014
Uitgeverij
Springer US
Gepubliceerd in
Journal of Child and Family Studies / Uitgave 8/2014
Print ISSN: 1062-1024
Elektronisch ISSN: 1573-2843
DOI
https://doi.org/10.1007/s10826-013-9799-x

Andere artikelen Uitgave 8/2014

Journal of Child and Family Studies 8/2014 Naar de uitgave