Parenting Stress, Mental Health, Dyadic Adjustment: A Structural Equation Model

Longitudinal Study of Dyadic Adjustment in a Sample of Spanish Fathers

The objectives of this study were to examine the evolution of fathers’ long-term dyadic adjustment after the birth of a child and to analyze their evolution considering related factors. A total of 113 Spanish fathers with a mean age of 35.72 years (SD = 3.84 years) participated. In general, there was a decline in the dyadic adjustment of the fathers until 6–12 months after childbirth, after which their level of adjustment remained stable until 13–24 months. We observed different patterns when analyzing the evolution by subgroups formed based on these different variables, previous experience of paternity, and anxiety. The intrinsic differences between fathers should also be considered because these differences can influence the way in which men face the parental process as well as the evolution of the quality of their relationship with their partner.

Early styles of interaction in mother-twin infant dyads and maternal mental health

Transition to parenthood is considered a critical process for mothers of twins. There are, however, few studies on the subject. This study aims to evaluate the differences between mother-twin infant dyads and mother-singleton infant dyads with regard to maternal depression, anxiety, parenting stress, and the quality of mother-infant interaction. Mothers of twin infants (N = 40) were compared to mothers of singletons (N = 72). At infant 3 months, maternal depression, anxiety, and parenting stress were assessed via a questionnaire and styles of interaction with the Care-Index. The results indicated that mothers of twins (vs mothers of singletons) had significantly higher state anxiety and higher scores on the Difficult Child Scale of the Parenting Stress Index at infant 3 months. No significant differences between the two groups were found with regard to maternal depression. Mothers of twins had significantly lower sensitivity and were more unresponsive than mothers of singletons. Twin infants had significantly more difficult and compliant behaviours than singleton infants. Assisted reproductive treatment (ART) and prematurity had no effect on any of the examined variables. State anxiety was shown to partially mediate the relationship between twin parenthood and maternal sensitivity and to completely mediate the relationship between twin parenthood and infant difficult style. Maternal unresponsiveness was shown to be exclusively linked to being the parent of twins. The study shows that twin parenthood has a significant effect on maternal mental health and on the quality of mother-infant interaction and highlights the importance of early prevention programmes for twin parents.

The Role of Maternal Parenting for Children's Behavior Regulation in Environments of Risk

This study investigates the role of maternal parenting and subjective theories for associations between environmental risk and children's behavior regulation combining a qualitative and quantitative approach. Mothers of 113 primary school children (M = 10.06, SD = 0.86) in Germany completed questionnaires on parenting, environmental risk, and their child's behavior regulation. To test for associations, we applied hierarchical regression models. Further, we conducted nine focus groups in settings of high and low environmental risk and used thematic analysis. Maternal warmth showed positive associations with children's behavior regulation. Restrictive maternal control and children's behavior regulation were related negatively. The negative association between environmental risk and children's behavior regulation was partly explained by restrictive maternal control. When maternal warmth was added into the model on environmental risk, restrictive maternal control, and children's behavior regulation, both maternal parenting practices lost its significant associations with children's behavior regulation. Qualitative findings gave insights into parents' subjective theories, suggesting adverse peer effects as possible explanation for the relation between environmental risk and children's behavior regulation. The results are discussed in terms of their contribution to theoretical considerations on behavior regulation development in different environmental risk settings.

First-Time Mothers' and Fathers' Developmental Changes in the Perception of Their Daughters' and Sons' Temperament: Its Association With Parents' Mental Health

OBJECTIVE

Most studies investigating the role of parenting behaviors on a child's development are directed to mothers. However, recent analyses show that mothers and fathers have a different influence on a child's functioning, specifically her/his temperament. The present study explored the developmental change of parents' perception of their daughters' and sons' temperament and its association with parental mental health problems.

METHODS

The sample included 188 parents (94 couples) and their at-term 94 babies (55.3% boys, 44.7% girls). Assessments by self-reports were conducted at 3 (Time 1) and 12 (Time 2) months after the children's birth; at Time 1, mothers and fathers independently answered: the State-Trait Anxiety Inventory (STAI), the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Behavior Questionnaire (IBQ-R). At Time 2, EPDS, STAI, and IBQ-R were again administered to mothers and fathers.

RESULTS

In general, mothers and fathers would give similar descriptions of their child's temperament throughout the first year of life; however, infant temperament showed developmental changes as well as gender differences. Mother and father anxiety and depression symptoms are associated with the infants' negative affectivity. Also, mothers with high anxiety and depression levels perceive their infants with a minor tendency to approach novelty, to seek environmental stimulation, and to express/experience positive emotions.

CONCLUSION

The results highlight the need to screen for infants' temperament vulnerabilities in the context of maternal and paternal depression in order to protect the child from behavioral, cognitive, and emotional difficulties and to create specific programs aimed at preventing dysfunctional parent-infant relationships.

Antecedents of fathers' perception of child behavior at child age 12 months

This study investigates whether fathers' adverse childhood experiences (ACE) and attachment style reported during pregnancy predict fathers' perception of child behavior assessed 12 months postpartum, expressed by the Parenting Stress Index (PSI), Child Domain. Prospective fathers (N = 835) were recruited to "The Little in Norway (LiN) study" (Moe & Smith) at nine well-baby clinics in Norway, with data collection composed of five time points during pregnancy and two time points postpartum (6 and 12 months). The main analyses included linear regression, path-analysis modeling, and intraclass correlation based on mixed effects modeling. First, linear regression analyses showed that neither fathers' ACE nor attachment style significantly predicted perceived child behavior postpartum directly. Furthermore, path analyses showed that ACE and less secure attachment style (especially avoidant attachment) measured early in pregnancy strongly predicted negatively perceived child behavior, mediated by fathers' mental health symptoms during pregnancy and partner disharmony postpartum. Second, intraclass correlation analyses showed that fathers' perceived child behavior showed substantial stability between 6 and 12 months postpartum. Family interventions beginning in pregnancy may be most beneficial given that fathers' early experiences and perceptions of attachment in pregnancy were associated with later partner disharmony and stress.

Maternal prenatal depression, PTSD, and problematic parenting: the mediating role of maternal perceptions of infant emotion

Background: Perinatal illness is alarmingly common and has negative effects on maternal and infant well-being. Depression and posttraumatic stress disorder (PTSD), specifically, are characterised by negative views of the self and others, which may impact a mother's perceptions of herself and her child. Objective: This study examined the relationship between depression and PTSD symptoms, maternal perceptions of infant emotions, and parenting behaviours. Methods: 120 pregnant, mostly low-income women and their infants (after birth) participated in a longitudinal study. Maternal depression and PTSD symptoms were assessed during pregnancy and 1 year postpartum; maternal perceptions of infant emotions and parenting quality were assessed at 1 year. Results: Correlation analyses revealed significant, negative associations between prenatal (but not postnatal) psychiatric symptoms and positive perceptions of infant emotions, as well as between positive perceptions of infant emotions and negative parenting. Results also revealed significant indirect effects of prenatal depressive and PTSD symptoms on negative parenting via perceptions of infant emotion (95% CIs:.0013 -.0200 and.0008 -.0083, respectively). Conclusion: Findings highlight that mothers should be routinely screened for psychiatric symptoms during the perinatal period, and perceptions of infant emotions may be an important target for parent-infant mental health interventions.

Psychological distress profiles in expectant mothers: What is the association with pregnancy-related and relational variables?

INTRODUCTION

Research has progressively focused on antenatal psychological disease of expectant mothers, showing that anxiety and depression as well as fear of childbirth occur frequently during pregnancy. Some studies have investigated the connection between anxiety, depression, and fear of childbirth with contrasting results. Several authors have analyzed the association between psychological disease of pregnant women and numerous medical-obstetric and relational variables, still reporting inconclusive findings. The present study had three aims: 1) to investigate the psychological well-being of pregnant women based on their levels of anxiety, depression, and fear of childbirth, by identifying psychological profiles; (2) to analyze the association between the emergent psychological profiles and some medical-obstetric variables related to pregnancy; and (3) to examine the association between these profiles and couple's adjustment and social support.

METHODS

410 Italian primiparous pregnant women in the 7th-8th month of pregnancy completed a questionnaire packet on site that included the following scales: Wijma Delivery Expectancy Questionnaire, Edinburgh Postnatal Depression Scale, State-Trait Anxiety Inventory, Dyadic Adjustment Scale, Multidimensional Scale of Perceived Social Support.

RESULTS

Findings revealed the presence of three different clusters: "psychologically healthy women" (34.9%), comprised of women characterized by low levels of symptoms on all the scales; "women experiencing pregnancy- and childbirth-related anxiety" (47.3%), which groups women with an average state anxiety over the clinical value; and "psychologically distressed women" (17.8%), comprised of women who reported high levels of symptoms on all the scales, some above the clinical cut-offs. These profiles were not related to the medical-obstetric variables. On the other hand, findings revealed a significant association between marital adjustment as well as social support and cluster membership.

DISCUSSION

These results support the importance of early and multilevel psychological screening in order to understand the experience of pregnant women and to develop targeted and increasingly personalized interventions.

Reciprocal Influence of Depressive Symptoms Between Mothers and Fathers During the First Postpartum Year: A Comparison Among Full-Term, Very Low, and Extremely Low Birth Weight Infants

Background: Perinatal depression (PND) in mothers and fathers of very low and extremely low birth weight (VLBW and ELBW) infants has not been studied extensively. In particular, no studies investigated the reciprocal influence of depressive symptoms during the first 12 months postpartum. This study aimed at exploring the impact of the severity of prematurity on maternal and paternal PND during the first postpartum year; specifically, we used an Actor-Partner Interdependence Model (APIM) to test the interdependence of both partners on depressive symptoms. Methods: A total of 177 mothers and 177 fathers were recruited, divided into 38 couples with ELBW infants, 56 with VLBW, and 83 of full-term (FT) infants. PND was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at 3, 9, and 12 months postpartum (corrected age for preterm infants). Results: Maternal depressive symptoms at 3 months were positively related to those at 9 and 12 months in the 3 groups. Conversely, paternal depressive symptoms assessed at 3 months were positively related to those measured at 9 months for the ELBW group, 12 months for the VLBW group, 9 and 12 months for FT condition. Furthermore, a significantly positive partner effect was observed regarding the influence of 3 month maternal depressive symptoms on paternal depressive symptoms at 9 months, but only in the case of the VLBW group. Conclusion: Prematurity represents a very specific scenario in the transition to parenthood, leading to specific reactions in mothers and fathers, especially in high-risk conditions. Results should be deepened given the relevance of their clinical implications.

Antenatal and postnatal depressive symptoms: Association with quality of mother-infant interaction

Antenatal and postnatal depression are independently associated with an increased risk of adverse infant development. A key linking mechanism is the quality of mother-infant interaction.

OBJECTIVES

This study assesses the association between postnatal depressive symptoms (PDS) and their severity, with the quality of mother-infant interaction and compare the quality of mother-infant interaction and severity of the symptoms depending on the presence or absence of antenatal depressive symptoms (ADS).

METHODS

observational study in 177 psychosocial risk mother-infant dyads from Chile (infant aged 2-12 months).

RESULTS

Mothers with PDS had lower maternal sensitivity and a more intrusive/controlling style than mothers without PDS, although the severity of the symptoms was not associated with lower maternal sensitivity. Maternal sensitivity did not differ in the postnatal depressed mothers depending on the presence of ADS, although the mothers differed in interaction style and the severity of symptoms. Mothers with ADS and PDS presented with a predominant intrusive/controlling interaction style and more severe depressive symptoms, whereas those with only PDS presented with a predominant nonresponsive/passive interaction style and reduced severity of symptoms.

CONCLUSIONS

The results corroborate the need to offer treatment and dyadic interventions to antenatal and postnatal depressive mothers and postulate that the presence of antenatal depressive symptoms may influence the subsequent mother-infant interaction style and greater severity of symptoms.

The association between childbirth experience and mother's parenting stress: The mediating role of anxiety and depressive symptoms

Childbirth is one of the most significant experiences in women's lives. A bad experience could lead to psychological distress, including severe disease. This experience has a significant impact not only on the mother's well-being, but also on her first interactions with the baby. The present study thus had two aims: 1) investigate the association between the childbirth experience and parenting stress; and 2) analyze if this relation can be mediated by the woman's psychological well-being (anxiety and depressive symptoms). One hundred fifty-eight Italian primiparous women, with a single pregnancy, recruited between January 2016 and December 2016, completed three months after delivery the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale and Parenting Stress Index (Short Form). Data were analyzed through path analyses. Results revealed that the birth experience was not directly associated with parenting stress. The final model confirmed that the childbirth experience was related to parenting stress through the full mediation of anxiety and depressive symptoms. These findings highlight the importance of making mothers' childbirth experience as positive as possible, considering the crucial impact of this experience not only on their global functioning but also on their first relationships with the baby.

Relationship between parenting stress and children's behavioral characteristics in Japan

BACKGROUND

The evaluation of a child tends to differ between the mother and father regardless of whether the child has a disability or not, although parents have key information about the behavioral characteristics of the child. The number of reports in Japan, however, is limited. We, therefore, investigated the relationship between the parenting stress experienced by parents of non-clinical preschool children and the children's behavioral characteristics.

METHOD

The subjects were 83 pairs of mothers and fathers with non-clinical children in kindergarten and nursery school (average age, 59.1 ± 13.0 months; 36 boys, 47 girls). The study was conducted using the Parenting Stress Index-Short Form (PSI-SF) and the Strengths and Difficulties Questionnaire (SDQ).

RESULTS

There was no difference in the PSI-SF scores between mothers and fathers, but hyperactivity/inattention, peer relationship problems, and the total score of the SDQ were significantly higher in fathers. On multiple regression analysis, parenting stress experienced by fathers was significantly related to hyperactivity/inattention, while parenting stress experienced by mothers was significantly related to peer relationship problems and emotional symptoms.

CONCLUSION

Children's behavioral characteristics related to parenting stress differ between mothers and fathers.

Work-Family Conflict and Mindful Parenting: The Mediating Role of Parental Psychopathology Symptoms and Parenting Stress in a Sample of Portuguese Employed Parents

Aims: The aims of the current study are to examine whether parents' work-family conflict, emotional distress (anxiety/depressive symptoms and parenting stress) and mindful parenting vary according to the type of employment (full-time, part-time, and occasional), the type of work schedule (fixed, flexible, and shift), and the number of working hours per week and to explore whether parental emotional distress mediates the association between work-family conflict and mindful parenting dimensions. Methods: A sample of 335 employed parents (86.3% mothers) of children and adolescents between the ages of 1 and 19 years old completed a sociodemographic form and measures of work-family conflict, anxiety/depression symptoms, parenting stress, and mindful parenting. The differences in study variables among types of employment, work schedules and number of weekly working hours were analyzed. A path model was tested through structural equation modeling in AMOS to explore the indirect effect of work-family conflict on mindful parenting dimensions through anxiety, depression and parenting stress. The invariance of the path model across children's age groups (toddlers, preschool and grade school children, and adolescents) and parents' gender was also examined. Results: Parents with a shift work schedule, working full-time and 40 h or more per week, presented significantly higher levels of work-family conflict than those with a fixed or flexible schedule, working part-time and less than 40 h per week, respectively. Parents with a flexible work schedule presented significantly higher levels of self-regulation in parenting and of non-judgmental acceptance of parental functioning than parents with a shift work schedule. Higher levels of work-family conflict were associated with lower levels of mindful parenting dimensions through higher levels of anxiety/depression symptoms and parenting stress. The model was invariant across children's age groups and parents' gender. Discussion: Work-family conflict is associated with poorer parental mental health and with less mindful parenting. Workplaces should implement family-friendly policies (e.g., flexible work arrangements) that help parents successfully balance the competing responsibilities and demands of their work and family roles. These policies could have a critical impact on the mental health of parents and, consequently, on their parental practices.

Results From an RCT on Brief Parent Training: Long Term Effects on Parental Quality of Life

Background: Previous research has shown that quality of life for adults decreases when they become parents, remains at a lower level than of non-parents and declines further with each child they have. Consistent with this, parents report that having children leads to more daily struggles and concerns than their work outside the home. In this study, we have investigated how participating in a brief parent training intervention influences parents’ quality of life. The aim of the study was to evaluate whether a brief, six-session version of an evidence-based parent training program (The Incredible Years), delivered in a non-clinical community sample, changed parent quality of life up to four years after the initial intervention.

Methods: Data were collected from mothers and fathers in a randomized controlled community trial (N = 117). Children’s mean age was 3.95 years at baseline, and 7.5 years at 4-year follow-up.

Results: There were no significant differences in the trajectory of change over the four time points between the intervention and control groups for mothers or fathers. However, results from analysing the linear change from pre to each of the other measurement points, revealed statistically significantly different change on life satisfaction after completing the intervention compared to the control group; immediately following the intervention, t(357) = 2.76, p = 0.006; and the difference between the groups was maintained three years after the intervention, t(360) = 3.14, p = 0.002.

Conclusion: The results of this study suggest that offering a parenting program focused on building a positive parent-child relation, has the potential to improve mothers’ quality of life. Implications of this are discussed.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02850510. Retrospectively registered 29 July 2016.

Mothers' Depression, Anxiety, and Mental Representations After Preterm Birth: A Study During the Infant's Hospitalization in a Neonatal Intensive Care Unit

Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU).

Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy.

Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers.

Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005).

Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child—independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.

The Multiple Determinants of Maternal Parenting Stress 12 Months After Birth: The Contribution of Antenatal Attachment Style, Adverse Childhood Experiences, and Infant Temperament

Parenting stress can influence caregiving behavior negatively, which in turn may harm children's development. Identifying precursors of parenting stress, preferably beginning during pregnancy and throughout the first year of life, is therefore important. The present study aims to provide novel knowledge on this issue through a detailed examination of the association between maternal attachment style and later parenting stress. Moreover, we examine the role of several additional risk factors, specificially the mothers' own adverse childhood experiences (ACE), as well as infants' temperamental characteristics. Data from a community based longitudinal study of 1,036 Norwegian mothers, collected during pregnancy and 12 months after childbirth, were used. Results showed that attachment style in pregnancy predicted parenting stress 1 year after birth. In addition, it was demonstrated that the mothers' own ACEs predicted postnatal parenting stress, and that attachment style operated as a mediator of this association. A significant association between perceived infant temperament and parenting stress was also found. The study illustrates the importance of understanding the multifactorial antecedents of parenting stress. The results may inform early intervention efforts aimed at supporting mothers and their partners in the potentially difficult transition period around childbirth.

DOES FATHERS' PRENATAL MENTAL HEALTH BEAR A RELATIONSHIP TO PARENTING STRESS AT 6 MONTHS?

This study aimed to explore fathers' mental health and retrospectively reported adverse childhood experiences during pregnancy, as well as various pathways predicting self-reported stress at 6 months' postpartum as assessed by the Parenting Stress Index (PSI; R.R. Abidin, ). A total of 835 fathers contributed data to the study. Data collection comprised five time points during pregnancy and one at 6 months' postpartum. The main analyses were performed using linear regression and path analyses. First, linear regression analyses showed that paternal anxiety symptoms during pregnancy predicted stress scores in the PSI child domain at 6 months (coefficient = 0.36). Second, path analyses showed that depressive symptoms during pregnancy predicted parenting stress in the child domain, mediated by spousal disharmony at 6 months' postpartum (coefficient = 0.77). Third, adverse childhood experiences scores predicted parenting stress in the child domain by two different pathways: one mediated by anxiety symptoms in pregnancy (coefficient = 0.29) and the other by depressive symptoms in pregnancy and experienced spousal disharmony at 6 months' postpartum (coefficient = 0.77). The findings suggest that fathers' symptoms of anxiety and depression during pregnancy as well as adverse childhood experiences predict paternal stress and a negative perception of their children's behavior at 6 months' postpartum.