Executive Functioning Predicts Reflective Functioning in Mothers

Maternal alexithymia and caregiving behavior: the role of executive functioning - A FinnBrain Birth Cohort study

PURPOSE

The growing interest in parental cognition calls for research clarifying how cognition interacts with other parenting determinants to shape caregiving behavior. We studied the interplay between executive functioning (EF; cognitive processes that enable goal-directed thinking and behavior) and alexithymic traits (characterized by emotion processing/regulation difficulties) in relation to emotional availability (EA; the dyad's ability to share an emotionally healthy relationship). As EF has been reported to shape parents' ability to regulate thoughts and emotions during caregiving, we examined whether EF moderated the association between maternal alexithymic traits, and EA.

METHODS

Among 119 mothers with 2.5-year-olds drawn from the FinnBrain Birth Cohort, EF was measured with Cogstate tasks, alexithymic traits with the Toronto Alexithymia Scale (TAS-20), and caregiving with the Emotional Availability Scales (EAS).

RESULTS

More alexithymic traits on the TAS-20 subscale Externally Oriented Thinking (EOT) were associated with poorer caregiving in a hierarchical regression analysis (ΔR2 = 0.05, p = .01). A marginally significant moderation effect was found when adding the EOTxEF interaction term to the model (ΔR2 = 0.03, p = .06). These associations weakened slightly when controlling for education level. Estimation of simple slopes and a Johnson-Neyman figure indicated a significant association between higher EOT and lower EAS, that increased in strength as EF decreased from the group mean level.

CONCLUSIONS

The influence of cognitive alexithymic traits on EA could be especially pronounced among low EF parents, but further studies are needed to support and extend the findings. The potential role of parental reflective functioning in this context is discussed.

Maternal cognitive functioning and psychopathology predict quality of parent-child relationship in the context of substance use disorder: A 15-month longitudinal study

This longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects.We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment.A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement.These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.

Attention control in the peripartum period: a longitudinal study

PURPOSE

Given research inconsistency, this study aimed to assess whether attention control changes from pregnancy to postpartum, focusing on the moderating role of maternal objective and subjective sleep. Our second objective was to evaluate attention control's role in predicting psychological outcomes in peripartum women.

METHOD

A cohort of 224 pregnant women completed the Antisaccade task, a measure of attention control, during the third trimester and again four months post-delivery. Objective and subjective sleep were measured using actigraphy and sleep diaries. Participants also completed questionnaires assessing depression, anxiety, emotion regulation, and maternal perceptions of the mother-infant relationship.

RESULTS

Attention control improved significantly from late pregnancy to postpartum (β = 0.91, p < .001). While objective sleep was not linked to attention control, poorer between-person subjective sleep was associated with better postpartum attention control (β = - 0.84, p < .001). Better within-person subjective sleep was associated with higher attention control during pregnancy (β = 0.87, p < .001), but a negative interaction with time (β = -1.5, p = .001) suggests a reverse trend postpartum. Attention control did not predict postpartum psychological outcomes.

CONCLUSION

Cognitive recovery may occur by four months postpartum, although the observed improvement could reflect practice effect. The novel finding of a negative association between subjective sleep and postpartum attention control may indicate better adaptation to perceived poor sleep or heightened attunement to sleep fluctuations in women with higher attention control. Attention control did not predict psychological outcomes, suggesting other factors may be more critical for maternal coping postpartum.

Do pregnancy and motherhood have an impact on cognitive functions in women

Pregnancy and motherhood are some of the most physically and mentally challenging periods in a woman's life. The aim of current study was to examine aspects of cognitive functions in pregnancy and motherhood that are controversial in the literature. The study included 30 healthy pregnant women aged between 18-40 years in their second and third trimesters, 30 healthy controls (nulliparous and non-pregnant women) and 30 healthy mothers matched with the pregnant women for age, handedness and education level. Edinburgh Postpartum Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Trail Making, Stroop, Digit Span, Verbal Fluency and Rey Auditory and Verbal Learning Tests (RAVLT) were applied to all participants. The pregnant group showed significantly lower performance in trail making, digit span, verbal fluency as well as RAVLT compared to other two groups suggesting deficiencies in cognitive areas such as attention, set-shifting, planning, learning, language functions, semantic memory, working memory, encoding memory and retrieval. A trend toward increased function in response inhibition was observed in the mothers. Regression analyses revealed that pregnancy significantly decreased performance in verbal fluency, trail making, and RAVLT. Our findings from rigorously selected participants may help comprehend alterations in cognitive functioning during pregnancy and motherhood, as well as shed light on the contradictory literature.

The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders

BACKGROUND

The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression.

METHODS

A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires.

RESULTS

Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression.

CONCLUSIONS

These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.

A process model of parental executive functioning as a spillover mechanism linking interparental conflict and parenting difficulties across parenting domains

There is a well-documented interdependency between destructive interparental conflict (IPC) and parenting difficulties (i.e., spillover effect), yet little is known about the mechanisms that "carry" spillover between IPC and parenting. Guided by a cascade model framework, the current study used a longitudinal, multimethod, multi-informant design to examine a process model of spillover that tested whether parental executive functioning (working memory, cognitive flexibility, inhibitory control) served as a mediator of the prospective associations between IPC and subsequent changes in parenting over a 2-year period. Mothers and fathers were separated into differentiated models and multiple domains of parenting were examined (i.e., authoritarian discipline and scaffolding behavior). Participants included 231 families (both mothers and fathers of preschoolers). Race was reported as White (62%), Black (21%), Mixed (8%), Asian (3%), or Other (6%) and 14% considered their ethnicity to be Hispanic/Latino. Median household income was $65,000. Results indicated that for fathers, IPC indirectly predicted domain-general parenting difficulties (increased authoritarian parenting and decreased scaffolding) via deficits in paternal cognitive flexibility (but not inhibitory control or working memory). In mothers, IPC directly predicted domain-specific parenting difficulties (decreased scaffolding only) that did not operate via maternal executive functions. Notably, these effects occurred over and above the influence of parental socioeconomic status. This study constitutes a first step toward documenting parental executive functioning as a mechanism underlying the spillover of IPC to the parent-child relationship. Family interventions intended to interrupt IPC spillover should emphasize father involvement and consider targeting parental executive functions as change mechanisms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impulsivity and self-regulation: A dual-process model of risky driving in young drivers in Iran

The dual-process model of risky driving (Lazuras, Rowe, Poulter, Powell, & Ypsilanti, 2019) suggested that regulatory processes mediate the effect of impulsivity on risky driving. The current study aimed to examine the cross-cultural generalisability of this model to Iranian drivers, who are from a country with a markedly higher rate of traffic collisions. We sampled 458 Iranian drivers aged 18 to 25 using an online survey measuring impulsive processes including impulsivity, normlessness and sensation-seeking, and regulatory processes comprising emotion-regulation, trait self-regulation, driving self-regulation, executive functions, reflective functioning and attitudes toward driving. In addition, we used the Driver Behaviour Questionnaire to measure driving violations and errors. Executive functions and driving self-regulation mediated the effect of attention impulsivity on driving errors. Executive functions, reflective functioning, and driving self-regulation mediated the relationship between motor impulsivity and driving errors. Finally, attitudes toward driving safety significantly mediated the relationship of both normlessness and sensation-seeking with driving violations. These results support the mediatory role of cognitive and self-regulatory capacities in the connection between impulsive processes and driving errors and violations. Overall, the present study confirmed the validity of the dual-process model of risky driving in a sample of young drivers in Iran. Implications for educating drivers and implementing policies and interventions based on this model are discussed.

Matrescence: lifetime impact of motherhood on cognition and the brain

Profound environmental, hormonal, and neurobiological changes mark the transition to motherhood as a major biosocial life event. Despite the ubiquity of motherhood, the enduring impact of caregiving on cognition and the brain across the lifespan is not well characterized and represents a unique window of opportunity to investigate human neural and cognitive development. By integrating insights from the human and animal maternal brain literatures with theories of cognitive ageing, we outline a framework for understanding maternal neural and cognitive changes across the lifespan. We suggest that the increased cognitive load of motherhood provides an initial challenge during the peripartum period, requiring continuous adaptation; yet when these demands are sustained across the lifespan, they result in increased late-life cognitive reserve.

Parental mentalization goes to school: a brief online mentalization-based intervention to improve parental academic support

Parental support of children's learning contributes to children's motivation, efficacy, and academic success. Nonetheless, in the context of homework, many parents struggle to offer adequate academic support and intervene in a manner that can curtail children's academic progress. A mentalization-based online intervention was proposed for improving parental homework support. The intervention involves teaching parents to dedicate the first 5 minutes of homework preparation to observation of the child's and the parent's mental states. Thirty-seven Israeli parents of elementary school children randomly assigned to intervention or waitlist conditions participated in a pilot study assessing the feasibility and initial efficacy of the intervention. Participants completed self-report measures before and after the intervention or a 2-week waiting period and provided feedback on the intervention. Pilot findings suggest that this low-intensity online intervention can be effective in improving parenting practices in the homework supervision context. A randomized controlled trial is required to further establish the intervention's efficacy.

Impacts of the Attachment and Child Health (ATTACHTM) Parenting Program on Mothers and Their Children at Risk of Maltreatment: Phase 2 Results

Early adversity (e.g., family violence, parental depression, low income) places children at risk for maltreatment and negatively impacts developmental outcomes. Optimal parental reflective function (RF), defined as the parent's ability to think about and identify thoughts, feelings, and mental states in themselves and in their children, is linked to secure attachment and may protect against suboptimal outcomes. We present the results of Phase 2 randomized control trials (RCTs) and quasi-experimental studies (QES) of the Attachment and Child Health (ATTACHTM) parental RF intervention for families with children at risk for maltreatment. Phase 2 parents experiencing adversity, along with their children aged 0-5 years (n = 45), received the 10-12-week ATTACHTM intervention. Building on completed Phase 1 pilot data, Phase 2 examined outcomes of long-standing interest, including parental RF and child development, as well as new outcomes, including parental perceived social support and executive function, and children's behavior, sleep, and executive function. RCTs and QES revealed significant improvements in parents' RF, perception of social support, and executive function, children's development (i.e., communication, problem-solving, personal-social, and fine motor skills), and a decrease in children's sleep and behavioral problems (i.e., anxiety/depression, attention problems, aggressive behavior, and externalizing problems), post-intervention. ATTACH™ positively impacts parental RF to prevent negative impacts on children at risk of maltreatment.

Psychometric Evaluation of the Parental Reflective Functioning Questionnaire in Chinese Parents

Parental reflective functioning (PRF) is important for parenting and child development. To effectively assess PRF in Chinese parents, this study aimed to revise the Parental Reflective Functioning Questionnaire (PRFQ) for the Chinese context. The original Chinese version of the PRFQ (PRFQ-C) was revised by following psychometric validation procedures in a sample of Chinese parents (N = 2,021, 1,034 mothers and 987 fathers). A series of psychometric analyses, including confirmatory factor analysis (CFA), internal consistency reliability analysis, discriminant validity, and criterion-related validity analysis, and analysis for measurement invariance between mothers and fathers, were conducted. The CFA results indicated that the final 12-item, three-factor model had a good fit {χ2(49)  =  472.381; CFI = 0.929; TLI = 0.904; RMSEA = 0.065, 90%CI = [0.060, 0.071]}. The Chinese version of the PRFQ with 12 items (PRFQ-12C) showed satisfactory reliability (omega = 0.68–0.82), discriminant validity [heterotrait-monotrait (HTMT) values &lt; 0.85], and criterion-related validity. The PRFQ-12C also had measurement invariance across mothers and fathers. In conclusion, the PRFQ-12C is psychometrically sound and can be applied in China.

Specifying the Relations among PTSD Symptom Clusters and Parenting Stress in Mothers Engaged in Substance Use Treatment

INTRODUCTION

Parenting stress is often heightened in mothers receiving treatment for substance use. Experiences of trauma are commonly seen in this population, which may give rise to Posttraumatic Stress Disorder (PTSD) symptoms, including intrusion, avoidance, negative cognition and mood, and affective arousal. While past research has demonstrated a significant relation between PTSD symptoms and parenting stress, no studies have examined the relative contributions of these symptoms to parenting stress in mothers engaged in substance use treatment.

METHODS

Seventy-four mothers attending outpatient substance use treatment who were parenting children aged 0-3 years completed measures of parenting stress, PTSD, substance use, and depression symptoms.

RESULTS

A canonical correlation analysis indicated two canonical variates accounting for significant variance between PTSD symptom clusters and parenting stress measures. The first canonical variate, primarily reflecting depressive and PTSD cognition and mood symptoms, was predominantly related to the parental distress aspect of parenting stress (40%). The second canonical variate, primarily reflecting intrusion and avoidance PTSD symptoms, was associated with increased parental perceptions of their child as difficult (10%).

CONCLUSION

Future research directions and clinical implications of these results are discussed for designing parenting interventions with mothers attending substance use treatment who present with PTSD symptoms.

“A Window of Opportunity”: Parenting and Addiction in the Context of Pregnancy

Purpose of Review

Maternal prenatal substance use presents a multilevel risk to child development and parenting. Although parenting interventions are increasingly integrated into substance use treatment, prenatal parenting processes have not received equal attention within these interventions. This article aims to synthesize the evidence on the specific prenatal risk factors affecting the development of early parenting of substance-using mothers, as well as interventions focusing on those factors.

Recent Findings

Both neurobiological and psychosocial risk factors affect the prenatal development of parenting in the context of maternal substance use. Maternal–fetal attachment, mentalization, self-regulation, and psychosocial risks are important in treatment and highly intertwined with abstinence. Although parenting interventions seem to be highly beneficial, most studies have not differentiated between pre- and postnatal interventions or described pregnancy-specific intervention elements.

Summary

Due to the salience of pregnancy in treating substance-using parents, interventions should begin prenatally and include pregnancy-specific parenting focus. Further research on prenatal interventions is warranted.

Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology

Parental reflective functioning (PRF) refers to the parent’s capacity to envision mental states in the infant and in themselves as a parent, and to link such underlying mental process with behavior, which is important for parenting sensitivity and child socio-emotional development. Current findings have linked maternal postpartum depression to impaired reflective skills, imposing a risk on the developing mother–infant relationship, but findings are mixed, and studies have generally used extensive methods for investigating PRF. The present study examined the factor structure and measurement invariance of the Danish version of the 18-item self-report Parental Reflective Functioning Questionnaire (PRFQ) in a sample of mothers with and without diagnosed postpartum depression. Moreover, the association between PRF and maternal postpartum depression in mothers with and without comorbid symptoms of personality disorder and/or clinical levels of psychological distress was investigated. Participants included 423 mothers of infants aged 1–11 months. Confirmatory factor analysis supported a three-factor structure of the PRFQ; however, item loadings suggested that a 15-item version was a more accurate measure of PRF in mothers of infants. Multi-group factor analysis of the 15-item PRFQ infant version indicated measurement invariance among mothers with and without diagnosed postpartum depression. Multinomial logistic regression showed that impaired PRF was associated with maternal psychopathology, although only for mothers with postpartum depression combined with other symptoms of psychopathology. These results provide new evidence for the assessment of maternal self-reported reflective skills as measured by a modified infant version of the PRFQ, as well as a more nuanced understanding of how variance in symptomatology is associated with impaired PRF in mothers in the postpartum period in differing ways.

Parental Reflectiveness, Posttraumatic Symptoms and Alcohol Use Disorder among Israeli Combat-Veteran Fathers

Combat veterans are highly prone to develop Alcohol Use Disorder (AUD) following their release from duty, presumably due to high prevalence of prolonged aversive emotional symptoms such as Posttraumatic Stress Symptoms (PTSS). Parental Reflective Functions (PRF) and Parental Sense of Competence (PSOC) have been identified as key protective factors in predicting maternal functioning and well-being, yet little is known of its role among fathers, let alone combat veteran fathers. In this study we explored whether PRF and PSOC moderated the association between PTSS and AUD among 189 Israel Defense Forces (IDF) male combat veterans. Participants filled out validated measures assessing PTSS, PRF, PSOC and AUD. Results indicated that PTSS, as well as PRF's "interest and curiosity regarding the child's mental states" subscale, were positively correlated to AUD. In addition, PRF's "certainty about child mental states" subscale moderated the association between PTSS and AUD, so that PTSS and AUD were significantly correlated for participants who reported average or high levels of certainty about their child's mental states. This finding may imply that intrusive mentalizing ("hypermentalizing") by veteran fathers may facilitate the association between PTSS and AUD, presumably by constituting a maladaptive mechanism for coping with the stressful uncertainty embedded in the parent-child relationship.

Maternal Anxiety Symptoms and Self-Regulation Capacity Are Associated With the Unpredictability of Maternal Sensory Signals in Caregiving Behavior

The unpredictability of maternal sensory signals in caregiving behavior has been recently found to be linked with infant neurodevelopment. The research area is new, and very little is yet known, how maternal anxiety and depressive symptoms and specific parental characteristics relate to the unpredictable maternal care. The aims of the current study were to explore how pre- and postnatal maternal anxiety and depressive symptoms and self-regulation capacity associate with the unpredictability of maternal sensory signals. The study population consisted of 177 mother-infant dyads. The unpredictability of the maternal sensory signals was explored from the video-recorded mother-infant free play situation when the infant was 8 months of age. Pre- and postnatal anxiety and depressive symptoms were measured by questionnaires prenatally at gwks 14, 24, 34, and 3 and 6 months postpartum. Maternal self-regulation capacity, a trait considered to be stable in adulthood, was assessed using adult temperament questionnaire when the infant was 12 months of age. We found that elevated prenatal maternal anxiety symptoms associated with higher unpredictability in the maternal care while depressive symptoms were unrelated to the unpredictability of maternal care. Moreover, the association was moderated by maternal self-regulation capacity, as higher anxiety symptoms during pre-and postnatal period were associated more unpredictability among the mothers with low self-regulation capacity. The combination of higher amount of maternal anxiety symptoms and lower self-regulation capacity seems to constitute specific risk for the unpredictable maternal care.

Exposure to infant images enhances attention control in mothers

Viewing cute images has been reported to promote performance on tasks requiring carefulness, possibly related to an enhanced positive emotional state. However, it is unclear whether viewing infant images also enhances attention control in mothers. Therefore, this experimental study examined whether exposure to images of infants affected mothers' performance on a visual search task, studying associations with happy facial expressivity. Mothers (N = 101, M_age  = 30.88) were randomly assigned to one of two conditions in which they either viewed images of infants or images of adults. Before and after viewing images, mothers performed a visual search task. Mothers' happy facial expressions at baseline and when viewing images were analysed. Viewing images of infants, in contrast to viewing images of adults, improved task performance indexed by accurateness, but not the number of correct responses. Images of infants elicited happy facial expressivity, which was associated with the number of correct responses on the visual search task. This study showed that viewing images of infants evokes happy facial expressions in mothers and can improve mothers' performance on a perceptual-cognitive task requiring attention control. Mothers' responses to infant images may be explained as an attentional preparedness for caregiving.

What's going on in my baby's mind? Mothers' executive functions contribute to individual differences in maternal mentalization during mother-infant interactions

Maternal mentalization refers to a mother's capacity to understand mental-states of herself and her child and to regard her child as a psychological agent. In mother-infant interactions, this capacity is commonly conceptualized as maternal mind-mindedness, which can be divided into two dimensions: appropriate and nonattuned interpretations of the infants' mental-states. Appropriate mind-mindedness refers to interpretations that seem to be compatible with the infant's behaviors, whereas nonattuned mind-mindedness refers to noncompatible interpretations. The aim of this study was to investigate the cognitive mechanisms that contribute to mind-mindedness. Specifically, we investigated the role of executive functions in appropriate and nonattuned mind-mindedness, and the moderating roles of two infant-related factors, prematurity (as a stressful context) and child temperament (as a context of unpredictability and negative emotionality). To this end, mother-infant free play interactions were coded for mind-mindedness in a sample of 102 mothers and their 6-month-old infants (61 preterm, 41 full-term). When children were 66-months old, mothers completed cognitive tasks that assessed working memory updating, resistance to interference, response inhibition, and shifting. Appropriate mind-mindedness was positively associated with updating, and this link was stronger when infant temperament was rated as more difficult. Furthermore, among mothers of full-term infants, mothers' resistance to interference was negatively associated with nonattuned mind-mindedness. This link was not evident in the stressful context of premature birth. Mothers' response inhibition and shifting were not associated with either of the mind-mindedness dimensions. Implications on understanding variability in maternal mentalization during mother-infant interactions and the roles of executive functions in parenting are discussed.

A developmental model of addictions: integrating neurobiological and psychodynamic theories through the lens of attachment

Although substance use and abuse may impact brain and behavior, it is still unclear why some people become addicted while others do not. Neuroscientific theories explain addiction as a series of between- and within-system neuroadaptations that lead to an increasingly dysregulating cycle, affecting reward, motivation, and executive control systems. In contrast, psychoanalysis understands addiction through a relational perspective wherein there is an underlying failure in affect regulation, a capacity shaped early developmentally. Considering recent findings suggesting the neurobiological overlap of addiction and attachment, it may be possible to integrate both perspectives into a developmental model through the lens of attachment. The goal of the present review is to evaluate the value of neurobiological and psychodynamic perspectives to inform our understanding of addiction, particularly substance-use disorders.