Maternal self-efficacy and hostile-reactive parenting from infancy to toddlerhood

The effectiveness of an internet-based support program on maternal self-efficacy, postpartum depression and social support for primiparous women during the COVID-19 pandemic: Randomized controlled trial

Background

Many primiparous women usually encounter various parenting and mental health issues after childbirth. The effects of intervention based on internet platform on parenting and mental health outcomes for Chinese first-time mothers remain unknown during the COVID-19 pandemic. Therefore, our research aimed to evaluate the effectiveness of an internet-based support program (ISP) on maternal self-efficacy (MSE), postpartum depression (PPD) and social support for primiparous women amid the pandemic.

Methods

A multicenter randomized controlled trial (RCT) was conducted. From May 2020 to March 2021, 242 primiparous women were recruited in the maternity wards of two hospitals in Shenzhen City, China and randomly assigned to the intervention group and the control group. Women in control group (n = 118) received the routine postpartum care, and women in intervention group (n = 118) accessed to the ISP intervention (expert education and peer support) and routine postpartum care. Intervention outcomes were measured at baseline before randomization (T0), post-intervention (T1), and three-month follow up (T2) through questionnaires. The chi-square (χ²), the independent sample t-test and the repeated measures multivariate analysis of covariance were performed, and the two-tailed p-value <0.05 was regarded as statistically significant.

Results

In comparison with women in the control group, women in the intervention group had a significantly higher score of MSE at T1 (mean: 73.53, standard deviation [SD]: 6.21) and at T2 (mean: 72.90, SD: 6.73); and a lower score of PPD at T1(mean: 6.03, SD: 2.50) and T2 (mean: 5.70, SD: 2.23); and a higher score of social support at T1 (mean: 45.70, SD: 3.73), but no significant difference at T2 (mean: 42.90, SD: 3.29).

Conclusions

The effect of ISP was evaluated to significantly increase the levels of MSE, social support, and to alleviate PPD symptoms for Chinese first-time mothers. As an effective and easily accessible intervention, ISP could become a significant source for health professionals to support primiparous women on parenting and mental health during the COVID-19 pandemic.

Trial registration

The trial is registered at the Chinese Clinical Trials Registry (ChiCTR2000033154).

Mothers' Emotion Regulation and Negative Affect in Infants: The Role of Self-Efficacy and Knowledge of Parenting Practices

Early in development, children rely heavily on caregivers for assistance with the regulation of negative emotion. As such, it is important to understand parent characteristics that influence caregiver ability to attenuate infant negative affect and mediating factors by which this process may unfold. This study examined the relationship between parental emotional regulation strategies (ERs) and infants' negative affect and tested the mediating effects of parenting self-efficacy and knowledge of this association. Results indicated that higher maternal reappraisal was related to higher maternal self-efficacy whereas higher maternal suppression was related to lower knowledge of parenting practices. Maternal suppression was negatively related to infant frustration; maternal self-efficacy was positively related to infant falling reactivity and negatively related to sadness. There was a significant indirect effect between maternal reappraisal and infant falling reactivity through maternal self-efficacy. The mediation result suggests that mothers with higher use of reappraisal show higher self-efficacy and have infants with higher falling reactivity. Maternal knowledge about parenting practices was related to lower infant fear. Maternal knowledge of parenting practices did not mediate any associations between maternal emotion regulation strategies and infant negative affect. These findings contribute to the understanding early protective parenting mechanisms for supporting the external regulation of negative affect in infants and also in designing and implementing preventive parenting programs focused on the emotional needs of parents and children.

Parental Self-Efficacy and Child Diet Quality between Ages 2 and 5: The STEPS Study

Parental self-efficacy (PSE), a measure of the subjective competence in the parental role, has been linked with child well-being and health. Research on the influence of PSE on child eating habits is scarce, and the few studies have concentrated on certain food groups, such as vegetables or fruits, and have mostly included only maternal PSE. Thus, the aim of this study was to explore the associations between PSE (separately for mothers and fathers and as a total family-level score) and child diet quality in a cross-sectional and longitudinal study setting. PSE was measured at child ages of 1.5 and 5 years, and diet quality was measured at ages 2 and 5. Participants are from the Steps to Healthy Development (STEPS) Study (n = 270-883). We found that maternal PSE and family level PSE score were associated with child diet quality. Paternal PSE was not, but the dimension Routines was associated with child diet quality. PSE was similarly associated with child diet quality at both age points. Our results suggest that PSE is an important construct in the development of healthy dietary habits in children, and supporting parenting programs aimed at higher PSE could promote healthy diet quality in children.

Cohort Profile: Quebec Longitudinal Study of Child Development (QLSCD)

PURPOSE

The Quebec Longitudinal Study of Child Development (QLSCD) was designed to examine the long-term associations of preschool physical, cognitive, social, and emotional development with biopsychosocial development across childhood, adolescence, and young adulthood.

METHODS

QLSCD is an ongoing prospective cohort including 2120 singletons born in 1997/1998 in the Canadian province of Quebec. So far, data have been collected annually or every 2 years from child ages 5 months to 21 years. The cohort currently includes 1245 participants. Data available include a range of environmental (e.g., family characteristics, child behaviour, educational attainment, mental health), biological (e.g., hair cortisol, genetic, epigenetic), and administrative data.

RESULTS

QLSCD has contributed to the understanding of children's psychosocial development, including the development of physical aggression and anxiety. QLSCD articles have advanced scientific knowledge on the influence of early childhood factors on childhood, adolescent, and young adult mental health, including the effect of participation in early childcare on cognitive and behavioural development, the developmental origins of adolescent and young adult mental health problems and suicide risk, and the development of interpersonal difficulties (e.g., peer victimisation) from preschool years to adolescence.

CONCLUSION

QLSCD has given major contributions to our understanding of the link between different aspects of child development and biopsychosocial development during the first two decades of life. Unique features include the presence of environmental, biological, and administrative data, long-term follow-up with frequent data collections, and use of data from multiple informants, including teachers, mothers, fathers, and the children themselves.

Effects of Internet-Based Support Program on Parenting Outcomes for Primiparous Women: A Pilot Study

(1) Background: Some primiparous women are usually confronted with many parenting problems after childbirth, which can negatively influence the wellbeing of some mothers and infants. Evidence identified that internet interventions can include more tailored information, reach a larger research group, and supply more anonymity than face-to-face traditional interventions. Therefore, the internet-based support program (ISP) was designed to improve the parenting outcomes for Chinese first-time mothers. (2) Methods: A multicenter, single-blinded, pilot randomized controlled trial was conducted. From May to October 2020, a total of 44 participants were recruited in the obstetrical wards of two tertiary hospitals in China. Eighteen women in the control group received routine postnatal care; while eighteen women in the intervention group accessed to the ISP and routine postnatal care. The duration of intervention was not less than three months. Intervention outcomes were assessed through questionnaires before randomization (T0), immediately after intervention (T1), and three months after intervention (T2). The Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS), and Postpartum Social Support Scale (PSSS) were included to measure MSE, postpartum depression (PPD), and social support, respectively. (3) Results: No significant difference between the two groups were found in terms of the baseline social-demographic characteristics; and the scores of SICS, EPDS and PSSS at T0 (p > 0.05). Repeated measures multivariate analysis of covariance found that women in the intervention group had a higher MSE score at T1 (6.63, p = 0.007), and T2 (5.75, p = 0.020); a lower EPDS score at T1 (3.11, p = 0.003), and T2 (2.50, p = 0.005); and a higher PSSS score at T1 (4.30, p = 0.001); and no significant difference at T2 (0.35, p = 0.743), compared with women in the control group. (4) Conclusion: The effect of ISP was evaluated to significantly increase primiparous women’s MSE, social support, and to alleviate their PPD symptoms. However, the small sample in pilot study restricted the research results. Therefore, the ISP should be further investigated with a larger, diverse sample to confirm whether it should be adopted as routine postnatal care to support primiparous women on parenting outcomes and mental wellbeing in the early stage of motherhood.

Prefrontal cortex and amygdala anatomy in youth with persistent levels of harsh parenting practices and subclinical anxiety symptoms over time during childhood

Childhood adversity and anxiety have been associated with increased risk for internalizing disorders later in life and with a range of brain structural abnormalities. However, few studies have examined the link between harsh parenting practices and brain anatomy, outside of severe maltreatment or psychopathology. Moreover, to our knowledge, there has been no research on parenting and subclinical anxiety symptoms which remain persistent over time during childhood (i.e., between 2.5 and 9 years old). Here, we examined data in 94 youth, divided into four cells based on their levels of coercive parenting (high / low) and of anxiety (high / low) between 2.5 and 9 years old. Anatomical images were analyzed using voxel-based morphometry (VBM) and FreeSurfer. Smaller gray matter volumes in the prefrontal cortex regions and in the amygdala were observed in youth with high versus low levels of harsh parenting over time. In addition, we observed significant interaction effects between parenting practices and subclinical anxiety symptoms in rostral anterior cingulate cortical thickness and in amygdala volume. These youth should be followed further in time to identify which youth will or will not go on to develop an anxiety disorder, and to understand factors associated with the development of sustained anxiety psychopathology.

Internet-based support program on parenting outcomes for Chinese primiparous women: Study protocol for a randomized controlled trial

Aim

To evaluate the effects of internet‐based support program for primiparous women in terms of improving the levels of maternal self‐efficacy, social support, and satisfaction; and reducing their postpartum depression symptoms.

Design

A single‐blinded, multicentre, randomized, controlled, parallel‐group pre‐test and repeated post‐test design.

Methods

Based on the self‐efficacy theory and the social exchange theory, the internet‐based support program has five modules: (a) learning forum of parenting knowledge and skills; (b) communication forum; (c) ask‐the‐expert forum; (d) baby home forum; and (e) reminder forum. Primiparous women will be recruited in the obstetric wards of two university‐affiliated hospitals in China. The participants (N = 258) will be randomly allocated to the intervention group that receive routine care and access to the internet‐based support program and the control group that receive routine care during the 3 months postpartum. Maternal self‐efficacy, social support, and postpartum depression symptoms will be measured at baseline, immediately after the intervention (post‐test 1) and 3 months after the intervention (post‐test 2). The study was funded in January 2018 and was ethically approved in May 2020.

Discussion

If the internet‐based support program has positive outcomes, it will contribute to the scientific and practical knowledge of nursing interventions to support primiparous women on parenting; and could become the routine health care for health professionals to enhance parenting ability and mental well‐being of new mothers.

Impact

As the first RCT study on parenting outcomes using a rigorous research design and a theoretical framework in China, this research will contribute to evidence on the effectiveness of using internet platform to support women after childbirth. The results could help to advance research about the use of internet‐based intervention methods to improve women's maternal self‐efficacy, social support, satisfaction, and to alleviate depression symptoms.

Chinese Clinical Trial Registry: ChiCTR2000033154

Chronic harsh parenting and anxiety associations with fear circuitry function in healthy adolescents: A preliminary study

Previous studies have reported altered fear circuitry function during fear conditioning in highly anxious individuals and in adults with a history of severe childhood adversity; less is known regarding younger populations and more common forms of adversity. We investigated fear circuitry functioning in healthy youths with histories of high (HH) or low (LH) chronic harsh parenting and high (HA) or low (LA) anxiety levels. 84 youths aged 13-16 performed an fMRI fear conditioning task. HH displayed decreased selective medial temporal lobe deactivations to CS+> CS- relative to LH. In addition, we found less amygdala-insula connectivity in HH vs LH. Interestingly, we observed distinct patterns of anxiety differences in amygdala-rostral ACC connectivity and subjective fear ratings depending on harsh parenting levels, suggesting a history of harsh parenting is linked with unique neural and behavioral anxious manifestations, which are different from anxiety manifestations in a context of low adversity.

Confident Parents for Easier Children: A Parental Self-Efficacy Program to Improve Young Children’s Behavior

This study presents the effects on children’s behavior of Confident Parents, a focused parenting program targeting parental self-efficacy. This parenting program aims to improve child behavior through the enhancement of parental self-efficacy. Confident Parents was experimentally tested on a total sample of 80 parents of three-to-six-year-old preschool aged children with moderate to clinical levels of externalizing behavior. Thirty-seven parents participated in the program, and were compared with a waitlist control group (n = 43). The intervention consisted of eight weekly group sessions. Effect sizes were evaluated through both observational and parent-report measures on the child’s behavior, as well as self-reported parental self-efficacy at pretest, post-test, and a four-month follow-up. Through a multi-level analysis, predictors of the change in the child’s behavior were identified. The moderating effect of socio-economic risk and externalizing behavior at baseline were also included in the analysis. Results show that Confident Parents improved the child’s behavior, both reported by parents and, to a lesser extent, when observed in interaction with the parent. Children with higher levels of behavior difficulty benefited more while those with socio-economic risk benefited less from this program. These results illustrate that focusing a parenting program on improving self-efficacy is effective to reduce externalizing behavior in children. This underdeveloped treatment target is worthy of investigation in parenting intervention research.

Delineating Among Parenting Confidence, Parenting Self-Efficacy, and Competence

This article examined the concepts of parenting self-efficacy, parenting confidence, and competence. Using Morse's method of concept delineation, a literature review of each concept was conducted to uncover commonalities, distinctions, and measurement overlaps between concepts and provide conceptual boundaries. Findings revealed that parenting confidence and parenting self-efficacy describe a parents' internal attribution or beliefs about their ability to engage in parenting behaviors. Both terms have similar antecedents, attributes, and consequences, whereas competence is a concept that should be used as an objective measure by someone other than the parent to assess parenting quality.

Changes in maternal self-efficacy, postnatal depression symptoms and social support among Chinese primiparous women during the initial postpartum period: A longitudinal study

BACKGROUND

There are many parenting problems during infancy for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research examining MSE during infancy are that most studies were conducted with a homogeneous sample and there were few studies with Chinese women. Secondly, the trajectory of change in MSE, postnatal depression symptoms and social support for Chinese primiparous women was not clear during the initial postpartum period in earlier studies.

OBJECTIVES

This study aimed to describe changes in MSE, postnatal depression symptoms and social support among Chinese primiparous women in the first three months postnatally.

DESIGN

A quantitative longitudinal study using questionnaires was conducted.

SETTING

Obstetric wards at three hospitals in Xiamen City, South-East China.

PARTICIPANTS

In total, 420 Chinese primiparous women were recruited.

METHODS

Initial baseline questionnaires to measure socio-demographic and clinical characteristics at three days postnatally were distributed to participants face-to-face by the researcher on the postnatal ward. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS.

RESULTS

The mean MSE score at six weeks postnatally was 74.92 (SD = 11.05), and increased to 77.78 (SD = 11.13) at 12 weeks postnatally. The mean social support scores at six and 12 weeks postnatally were 40.99 (SD = 9.31) and 43.00 (SD = 9.55). The mean EPDS scores decreased from 9.09 (SD = 4.33) at six weeks postnatally to 8.63 (SD = 4.40) at 12 weeks postnatally; the proportion of women with an EPDS score of ten or more and 13 or more at the two time points declined from 47.4% to 38.3%, and from 21.4% to 18.2%, respectively.

CONCLUSIONS

In this study, Chinese primiparous women had a moderate level of MSE and received a moderate level of social support at six and 12 weeks postnatally, and a higher proportion of Chinese women had postnatal depression symptoms than did women in Western countries. From six to 12 weeks postnatally, the mean MSE scores and social support scores had a statistically significant increase; the mean EPDS scores had a statistically significant decrease.

Aggression can be contagious: Longitudinal associations between proactive aggression and reactive aggression among young twins

The present study examined sibling influence over reactive and proactive aggression in a sample of 452 same-sex twins (113 male dyads, 113 female dyads). Between and within siblings influence processes were examined as a function of relative levels of parental coercion and hostility to test the hypothesis that aggression contagion between twins occurs only among dyads who experience parental coerciveness. Teacher reports of reactive and proactive aggression were collected for each twin in kindergarten (M = 6.04 years; SD = 0.27) and in first grade (M = 7.08 years; SD = 0.27). Families were divided into relatively low, average, and relatively high parental coercion-hostility groups on the basis of maternal reports collected when the children were 5 years old. In families with relatively high levels of parental coercion-hostility, there was evidence of between-sibling influence, such that one twin's reactive aggression at age 6 predicted increases in the other twin's reactive aggression from ages 6 to 7, and one twin's proactive aggression at age 6 predicted increases in the other twin's proactive aggression from ages 6 to 7. There was also evidence of within-sibling influence such that a child's level of reactive aggression at age 6 predicted increases in the same child's proactive aggression at age 7, regardless of parental coercion-hostility. The findings provide new information about the etiology of reactive and proactive aggression and individual differences in their developmental interplay.

Psychometric qualities of the Short Form of the Self-efficacy for Parenting Tasks Index-Toddler Scale

Parental self-efficacy (PSE; parental self-perceived competence in parenting) is known to have considerable impact on parenting quality. Although PSE is particularly under pressure during the turbulent period of toddlerhood, most studies so far have focused on PSE in parents of older children. The current study presents the psychometric qualities of the Short Form of the Self-Efficacy for Parenting Tasks Index-Toddler Scale (SEPTI-TS). Parents from a normal (n = 282) and clinical sample (n = 27) of children filled in the SEPTI-TS, and other questionnaires concerning PSE, general self-evaluation, and psychological problems. Factor analysis resulted in a 26-item instrument, representing four domains of PSE with a strong factor structure and high reliability: nurturance, discipline, play, and routine. For this new Short Form of the SEPTI-TS, good face, discriminative, concurrent, and divergent validity were found. Cut-offs for normal PSE were provided. The Short Form SEPTI-TS enables identifying problematic PSE in specific domains of parenting during toddlerhood.