Mother's early perception of her infant's difficult temperament, parenting stress and early mother-infant interaction

Predicting internalizing and externalizing problems at five years by child and parental factors in infancy and toddlerhood

This study examined child and parental factors in infancy and toddlerhood predicting subclinical or clinical levels of internalizing and externalizing problems at 5 years of age. Ninety-six children and their families participated. They were assessed when the children were 4-10 weeks old (T1), 2 years (T2) and 5 years old (T3). Child risks (difficult temperament, health problems, early emotional and behavioral problems), parental risks (psychopathology, parenting stress and perception of the child) and family risks (socio-economic status, quality of marital relationship and family violence) were examined. At 5 years, internalizing problems were predicted by family violence during the child's infancy and parenting stress at age 2. Externalizing problems were predicted by psychiatric problems of the mother before pregnancy and child's externalizing problems at 2 years of age. When interventions aiming at preventing emotional and behavioral problems in children are considered, these issues should be recognized early and effective intervention initiated.

The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers

OBJECTIVES

The study examined the early interaction between mothers and their infants with cleft lip, assessing the role of maternal affective state and expressiveness and differences in infant temperament.

METHODS

Mother-infant interactions were assessed in 25 2-month-old infants with cleft lip and 25 age-matched healthy infants. Self-report and behavioral observations were used to assess maternal depressive symptoms and expressions. Mothers rated infant temperament.

RESULTS

Infants with cleft lip were less engaged and their mothers showed more difficulty in interaction than control group dyads. Mothers of infants with cleft lip displayed more negative affectivity, but did not report more self-rated depressive symptoms than control group mothers. No group differences were found in infant temperament.

CONCLUSIONS

In order to support the mother's experience and facilitate her ongoing parental role, findings highlight the importance of identifying maternal negative affectivity during early interactions, even when they seem have little awareness of their depressive symptoms.

Maternal parenting stress and mothers' reports of their infants' mastery motivation

Mastery motivation is a psychological force that stimulates an individual to attempt to master a task that is challenging to him or her. This prospective longitudinal study examined the relationship between maternal stress, using the Parenting Stress Index-Short Form, and infant mastery motivation, using the Dimensions of Mastery Questionnaire, for 150 mother-infant pairs assessed at both 6- and 18-months of age. Infants of mothers with elevated stress levels at 6 months tended to show lower mastery motivation at 18 months (standardized beta=-.46, p=.001). Conversely, infants with lower general competence (standardized beta=-.24, p=.021) and lower persistence during social interactions with other children (standardized beta=-.18, p=.037) at 6 months of age had mothers with elevated total stress at 18 months of age. Implications for programs which simultaneously intervene with child and mother are discussed.

The Ages & Stages Questionnaire: Social-Emotional: A validation study of a mother-report questionnaire on a clinical mother-infant sample

Mother-report questionnaires of infant socioemotional functioning are increasingly used to screen for clinical referral to infant mental health services. The validity of the Ages & Stages Questionnaire: Social Emotional (ASQ:SE; J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002) was investigated in a sample of help-seeking mothers with young infants. It was compared with independent observer-rated dyadic interactions, and the quality of dyadic relationships was rated by expert clinicians. The ASQ:SE ratings also were compared with questionnaires on maternal psychological stress and distress. The ASQ:SE did not correlate significantly with either external ratings of dyadic interaction or clinically assessed relationship qualities, though the latter two were strongly associated with each other. In contrast, ASQ:SE scores were associated with questionnaires relating to maternal psychological distress. This was especially true for mothers classified as depressed. Furthermore, reports on the ASQ:SE were strongly predicted by maternal stress. The study points to some problems with the concurrent validity of the ASQ:SE in clinical samples. It also demonstrates a close link between mothers' psychological distress and their ratings of infant social and emotional functioning. Further research should investigate the extent to which the ASQ:SE specifically measures infant functioning or maternal distress, and how it functions in clinical versus nonclinical samples.

Infant temperament and parental stress in 3-month-old infants after surgery for complex congenital heart disease

OBJECTIVE

This study aimed to identify and compare differences in temperament and maternal stress between infants with complex congenital heart disease and healthy controls at 3 months of age.

METHODS

Study sample was drawn from an existing longitudinal study examining growth in infants with congenital heart disease when compared with healthy controls. Infant temperament and parental stress were measured in 129 mother-infant dyads. Inclusion criteria for infants with congenital heart disease were > or = 36-week postmenstrual age, > or = 2500 g at birth, surgery in first 6 weeks of life, and no major congenital anomalies or genetic syndromes. The Early Infancy Temperament Questionnaire and Parent Stress Index were the assessment tools used.

RESULTS

Infants with single ventricular (SV) physiology were more negative in mood (F = 7.14, p < .001) and less distractible (F = 5.00, p < .008) than the biventricular physiology or Control (C) infant groups. The demands of care for infants with congenital heart disease were a source of stress when compared with Control infants (p < .05). Five of 6 subscales of the Child Domain were significant sources of stress in the SV group compared with biventricle and Control groups. Negative mood and difficulty to soothe were predictors for Child Domain and Total Life Stress in SV infants.

CONCLUSION

The demands of parenting an irritable infant with SV physiology put these mothers at risk for high levels of stress. Results suggest the need for predischarge anticipatory guidance for parents to better understand and respond to the behavioral style of their infants, in particular, infants with SV physiology.

Situations-Reaktions-Fragebogen zur Messung elterlicher Sensitivität (PS-SRQ)

Zusammenfassung. Die elterliche Sensitivität gegenüber Kleinkindern als zentrale Erziehungsfertigkeit wurde bisher vorwiegend durch Fremdbeobachtungsverfahren ermittelt. Für die Forschung und klinische Praxis werden jedoch zeitökonomische Paper-Pencil-Verfahren gefordert. Der Situations-Reaktions-Fragebogen zur Messung elterlicher Sensitivität (PS-SRQ) ist ein Selbstbeurteilungsinstrument mit drei Situationsvignetten und verhaltensorientiertem Antwortformat. Gemessen werden die vier Subskalen „Empathie”, „Promptheit”, „Zuwendung” und „Bestrafung” als Komponenten der Gesamtskala „Sensitivität”. Es werden drei Studien zur Konstruktion, Reliabilität und internen Validität präsentiert. Zusammenfassend verfügt der PS-SRQ über eine hohe interne Konsistenz und hat sich für Mütter als intern valide erwiesen. Für die Gruppe der Väter steht der Nachweis der Konstruktvalidität noch aus. Der PS-SRQ ist daher ein vielversprechendes Selbstbeurteilungsinstrument zur Erfassung der mütterlichen Sensitivität.

Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers

AIM

Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers.

BACKGROUND

To study whether anxiety, depression, or marital problems increase the parenting stress in parents of toddlers.

METHODS

At early pregnancy, 2 - 3 months, and 2 - 3 years after delivery, 214 low-risk couples filled in questionnaires on their marital relationship, social support, child's temperament, and self-evaluated competence in routine care-taking. In hierarchical regression analyses, they were used as predictors of parental stress.

RESULTS

Those mothers who in early pregnancy had adequate social support, adaptive social strategies, and high self-esteem, and who had given birth vaginally, enjoyed breastfeeding, and whose spouse supported breastfeeding reported less stress 2 - 3 years later. Pregnancy-related anxiety, depression, general anxiety, neuroticism, and vulnerability in early pregnancy, as well as child's temperament and low self-estimated competence in routine care-taking measured at both 2 - 3 months and 2 - 3 years after childbirth predicted parental stress. Depression and living alone in early pregnancy, and the child-related variables (temperament and care-taking, measured both at 2 - 3 months and 2 - 3 years after childbirth) predicted high parenting stress in fathers of toddlers.

CONCLUSIONS

Parental stress in toddlers' parents was predicted both by the temperament of the child, and by the parents' depression, self-esteem, and anxiety, as well as by lack of support and low self-evaluated competence in routine care-taking.

Permissive hypercapnia and risk for brain injury and developmental impairment

OBJECTIVE

Permissive hypercapnia is a respiratory-care strategy that is used to reduce the risk for lung injury. The goal of this study was to evaluate whether permissive hypercapnia is associated with higher risk for intraventricular hemorrhage and early childhood behavioral and functional problems than normocapnia among very low birth weight infants.

METHODS

Very low birth weight infants from a statewide cohort were eligible for this study when they were born at <32 weeks' gestational age and survived at least 24 hours. Infants were classified as receiving a permissive hypercapnia, normocapnia, or unclassifiable respiratory strategy during the first 24 hours after birth according to an algorithm based on Pco(2) values and respiratory-treatment decisions that were abstracted from medical charts. Intraventricular hemorrhage diagnosis was also abstracted from the medical chart. Behavioral and functional outcomes were assessed by parent interview at 2 to 3 years. Logistic regression was used to evaluate the relationship between intraventricular hemorrhage and respiratory strategy; ordinary linear regression was used to evaluate differences in behavior and function scores between children by respiratory strategy.

RESULTS

Infants who received a permissive hypercapnia strategy were not more likely to have intraventricular hemorrhage than those with normocapnia. There were no differences in any of the behavioral or functional scores among children according to respiratory strategy. There was a significant interaction between care strategy and 1-minute Apgar score, indicating that infants with lower Apgar scores may be at higher risk for intraventricular hemorrhage with permissive hypercapnia.

CONCLUSIONS

This study suggests that permissive hypercapnia does not increase risk for brain injury and impairment among very low birth weight children. The interaction between respiratory strategy and Apgar score is a potential worrisome exception to this conclusion. Future research should further evaluate the effect of elevated Pco(2) levels among those who are sickest at birth.