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Firk C, Großheinrich N. Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying. Infant Ment Health J 2024; 45:263-275. [PMID: 38288564 DOI: 10.1002/imhj.22106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/27/2024]
Abstract
Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N = 389) of infant carrying (six times a week or daily) and parents reporting low levels (N = 128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.
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Affiliation(s)
- Christine Firk
- Department of Social Sciences, Catholic University of Applied Sciences of North Rhine-Eestphalia, Aachen, Germany
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences of North Rhine-Westphalia, Aachen, Germany
| | - Nicola Großheinrich
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences of North Rhine-Westphalia, Aachen, Germany
- Department of Social Sciences, Catholic University of Applied Sciences of North Rhine-Eestphalia, Cologne, Germany
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Wendelboe KI, Stuart AC, Smith-Nielsen J, Linkhorst TB, Væver MS. Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness. Infant Ment Health J 2024; 45:301-317. [PMID: 38446014 DOI: 10.1002/imhj.22109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/10/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024]
Abstract
Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N = 142), with symptoms of postpartum depression, and their 1-11-month-old infants. Offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire-Infant Version (PRFQ-I) and online mentalizing was assessed with interactional mind-mindedness. Ordinal logistic regressions showed that a higher score on the PRFQ-I prementalizing subscale was negatively related to number of overall mind-related comments and appropriate mind-related comments produced by mothers during interaction with their infant. Our results indicate partial overlaps between self-reported parental reflective functioning and mind-mindedness, that is, that particularly offline maladaptive mentalizing is associated with lower levels of mentalizing during interaction in mothers with symptoms of depression. Post-hoc examination of the interaction effect of postpartum depression showed that this association was only evident in mothers with medium to high levels of depression. Findings and implications are discussed.
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Affiliation(s)
- Katrine I Wendelboe
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Anne C Stuart
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Johanne Smith-Nielsen
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Thea B Linkhorst
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Mette Skovgaard Væver
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
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Smith-Nielsen J, Stuart AC, Wendelboe KI, Egmose I, Roos CO, Væver MS. The significance of parental mentalizing for four-year-old children's solitary pretend play. PLoS One 2024; 19:e0297671. [PMID: 38295066 PMCID: PMC10830029 DOI: 10.1371/journal.pone.0297671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play). Based on the assumption that child solitary pretend play reflects the child's 'baseline' pretend play ability, in this study, we investigated children's pretend play at its peak, i.e., during the preschool age, without the facilitation of another player. The overall objective was to investigate if parental mentalizing increases pretend play complexity in children. METHODS The sample consisted 99 Danish mothers and their 4-year-old children. Employing a cross-sectional design, we hypothesized that parental mental state language, as an indicator of 'online' mentalizing during interaction with the child, is a mechanism through which 'offline' mentalizing, measured as parental reflective functioning, is associated with child solitary pretend play. Child pretend play complexity was observed and coded with an adapted version of the 12-Step Play Scale. Maternal offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire, and maternal online mentalizing was assessed by coding the mothers' mental state language during interaction with the child using a modified version of the mind-mindedness coding scheme. RESULTS While there was no direct effect of maternal offline reflective functioning on child pretend play, online mental state language mediated the link between offline maternal reflective functioning and child pretend play. CONCLUSIONS These results provide support for the theoretically assumed link between parental mentalizing and children's capacity for pretend play. Furthermore, our study contributes to the literature on parental mentalization, suggesting that parental mentalizing facilitates child development only if the parent can translate this ability into 'mentalizing in action'.
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Affiliation(s)
| | | | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Zhou T, Zhang C, Yi C. Caregivers and interventionists: Developing a Dual Role Behaviors Scale for parents of children with autism spectrum disorders. FAMILY PROCESS 2023; 62:1740-1756. [PMID: 36347126 DOI: 10.1111/famp.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The integration of the roles of caregivers and interventionists is important in parenting a child with autism spectrum disorder (ASD). However, an instrument to measure dual-role behaviors is unavailable. This study developed and validated the Dual Role Behaviors Scale for parents of autistic children (DRBS-A). Initial items were generated using the interview transcripts of a previous qualitative study. The initial scale was administered to 422 parents. Data were randomly halved to generate Samples 1 and 2. Exploratory factor analysis conducted using Sample 1 (autism spectrum disorder = 216) screened items based on factor loadings and explored the scale's structure. Confirmatory factor analysis (CFA) conducted with Sample 2 (N = 206) examined structural validity. Among the participants, 121 (Sample 3) derived from the two samples were followed up after 1 month to examine the test-retest reliability. Convergent validity was examined with another sample of 105 parents (Sample 4). The formal version of the DRBS-A comprised 20 items across four dimensions: parental acceptance, parental disengagement, persistence in interventions, and punishment in interventions. The four-factor structure with two higher order factors was supported by the CFA results (χ2 = 290.90, df = 165, CFI = 0.94, TLI = 0.93, RMSEA = 0.061, SRMR = 0.063). The subscales' test-retest reliabilities ranged from 0.61 to 0.78. The internal consistencies were satisfactory (Cronbach's αs: 0.67-0.93). Convergent validity was supported by correlations of the DRBS-A dimensions with parental involvement and positive parenting practice. Other factors related to dual-role behaviors were also explored. The DRBS-A has good validity and reliability and can be used to explore the effects of role integration.
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Affiliation(s)
- Ting Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Chang Zhang
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Chunli Yi
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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Osborne J, Mattiske J, Winter A, Sved Williams A. Reflective functioning and mother-infant relationships among mothers with Borderline Personality Disorder post-therapy. Infant Ment Health J 2023; 44:679-690. [PMID: 37322386 DOI: 10.1002/imhj.22071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
The stressful nature of parenting infants exacerbates the characteristics of Borderline Personality Disorder (BPD). Consequently, mothers with BPD tend to be emotionally dysregulated, respond impulsively to their infants, and have poorer mother-infant relationships. Few parenting interventions target the specific skill deficits observed in mothers with BPD. This study explored the differences in parental reflective functioning (PRF) and mother-infant relationship quality at baseline and following a 24-week, group parenting intervention for mothers with BPD. PRF and mother-infant relationship quality were assessed from quantitative (N = 23) and qualitative (N = 32) perspectives. Quantitative data (Parental Reflective Functioning Questionnaire) showed a significant improvement in one of the three subscales, Interest and Curiosity, between baseline and post-intervention, and a significant moderate positive association between the subscale Certainty of Mental States and maternal-infant interaction quality post-intervention. Improvements in mother-infant relationship quality were not evident from the observational measure, Nursing Child Assessment Satellite Teaching scale. In contrast, semi-structured interview qualitative data found maternal improvements in parental reflection, coping strategies implemented post-intervention, and quality of mother-infant relationships. Overwhelmingly positive intervention feedback suggested perceived maternal benefits of group format and skills taught. Future studies with larger sample sizes would allow further clarification of such parenting interventions for mothers with BPD.
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Affiliation(s)
- Jo Osborne
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Julie Mattiske
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Amelia Winter
- Helen Mayo House, Women's and Children's Health Network, Adelaide, South Australia, Australia
- Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne Sved Williams
- Helen Mayo House, Women's and Children's Health Network, Adelaide, South Australia, Australia
- Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
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Cooke S, Cooke DC, Hauck Y. Relationship focused mother-infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning. Infant Ment Health J 2023; 44:705-719. [PMID: 37528631 DOI: 10.1002/imhj.22080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 07/02/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023]
Abstract
We report on two preliminary evaluations of a group intervention, targeting vulnerable infants and their mothers within the first 6-months postpartum. The Mother-Baby Nurture® program aims to strengthen the developing infant-mother attachment relationship by increasing maternal mentalizing. These studies were undertaken with pre-post evaluations with the mothers of infants under 10-months of age. The mother-infant dyads participated in ten 2-h group sessions. Study one (N = 69 dyads) included self-reported maternal depression, anxiety, and parenting confidence. In study two (N = 27 dyads), parenting stress and reflective functioning were measured by self-report, and reflective functioning coded on the 5 min speech sample (completed by N = 22). Results from study one confirmed a decrease in depression (p < .001, d = .79) and anxiety (p < .001, d = .72) symptoms, and an increase in mothers' scores for parenting confidence (p < .001, d = -.98). Results from Study Two demonstrated a significant decrease in parenting stress (p < .001, d = .94) and significant improvement in measures of self-report reflective functioning (p = .007, .024; d = .56, .61). These findings are preliminary yet promising indications that this program could be effective in alleviating parenting stress, depression, and anxiety, and improving mother's reflective functioning and parenting confidence. Further research is needed, with a control group and long-term follow-up assessments.
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Affiliation(s)
- Sharon Cooke
- Playgroup WA, Perth, Western Australia, Australia
| | | | - Yvonne Hauck
- School of Nursing, Curtin University, Perth, Australia
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Midgley N, Mortimer R, Carter M, Casey P, Coffman L, Edbrooke-Childs J, Edridge C, Fonagy P, Gomes M, Kapoor A, Marks S, Martin P, Moltrecht B, Morris E, Pokorna N, McFarquhar T. Emotion regulation in children (ERiC): A protocol for a randomised clinical trial to evaluate the clinical and cost effectiveness of Mentalization Based Treatment (MBT) vs Treatment as Usual for school-age children with mixed emotional and behavioural difficulties. PLoS One 2023; 18:e0289503. [PMID: 37590277 PMCID: PMC10434917 DOI: 10.1371/journal.pone.0289503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The majority of children referred to Child and Adolescent Mental Health Services (CAMHS) in the UK will present with mixed emotional and behavioural difficulties, but most mental health treatments are developed for single disorders. There is a need for research on treatments that are helpful for these mixed difficulties, especially for school-age children. Emotion Regulation (ER) difficulties present across a wide range of mental health disorders and mentalizing may help with regulation. The ability to mentalize one's own experiences and those of others plays a key role in coping with stress, regulation of emotions, and the formation of stable relationships. Mentalization Based Therapy (MBT) is a well-evidenced therapy that aims to promote mentalization, which in turn increases ER capacities, leading to decreased emotional and behavioural difficulties. The aim of this study is to test the clinical- and cost-effectiveness of MBT compared to treatment as usual for school age children with emotional and behavioural difficulties. If effective, we hope this approach can become available to the growing number of children presenting to mental health services with a mix of emotional and behavioural difficulties. MATERIALS AND METHODS Children referred to CAMHS aged 6-12 with mixed mental health problems (emotional and behavioural) as primary problem can take part with their parent/carers. Children will be randomly allocated to receive either MBT or treatment as usual (TAU) within the CAMHS clinic they have been referred to. MBT will be 6-8 sessions offered fortnightly and can flexibly include different family members. TAU is likely to include CBT, parenting groups, and/or children's social skills groups. Parent/carers and children will be asked to complete outcome assessments (questionnaires and tasks) online at the start of treatment, mid treatment (8 weeks), end of treatment (16 weeks) and at follow up (40 weeks). TRIAL REGISTRATION Clinical trial registration: ISRCTN 11620914.
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Affiliation(s)
- Nick Midgley
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Rose Mortimer
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Mark Carter
- Barnet, Enfield and Haringey NHS Trust, United Kingdom
| | - Polly Casey
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | | | | | - Chloe Edridge
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Peter Fonagy
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | | | - Anoushka Kapoor
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | | | | | - Bettina Moltrecht
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Emma Morris
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Nikola Pokorna
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
| | - Tara McFarquhar
- The Anna Freud Centre, London, United Kingdom
- University College London, United Kingdom
- University of East Anglia, Norwich, United Kingdom
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Georg AK, Meyerhöfer S, Taubner S, Volkert J. Is parental depression related to parental mentalizing? A systematic review and three-level meta-analysis. Clin Psychol Rev 2023; 104:102322. [PMID: 37572565 DOI: 10.1016/j.cpr.2023.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 08/14/2023]
Abstract
This systematic review and meta-analysis is aimed to summarize the state of research on the relation between parental depression and parental mentalizing. To account for the multifaceted nature of parental mentalizing, several conceptualizations and measures were included and compared. The last database search was conducted on March 13, 2023. Using three-level meta-analytic modelling, we analyzed a total of 12,665 participants from 63 studies with 233 effect sizes. Taken together, higher depression was only weakly associated with lower mentalizing (r = -0.06). Specifically, parents with higher depression scored lower on questionnaire measures of parental reflective functioning (r = -0.11). No significant correlations were found for interview measures of parental reflective functioning, the observational and interview measure of mind-mindedness, or insightfulness. The data showed substantial heterogeneity. The mean effect size for self-reported pre-mentalizing (r = -0.23 for reverse-coded subscale scores) was significantly stronger compared to other self-report subscales. In studies including parents with diagnosis and controls, there was limited evidence suggesting a larger negative correlation between depression, mind-mindedness, and insightfulness. Therefore, more research is needed in clinical samples. Due to their correlational nature, our results do not allow causal inferences. Future studies should target moderators that explain variability (e.g., comorbid psychological problems, coparenting, child behavior).
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany.
| | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany
| | - Jana Volkert
- Department of Psychology, MSB Medical School Berlin, Germany
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Shao R, Liu S, Coplan RJ, Chen X, Liu J. Examining a Complex Model Linking Maternal Reflective Functioning, Maternal Meta-Emotion Philosophies, and Child Emotion Regulation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1161. [PMID: 37508658 PMCID: PMC10378255 DOI: 10.3390/children10071161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
Parental Reflective Functioning (PRF) refers to parents' ability to understand their children's behavior in light of underlying mental states such as thoughts, desires, and intentions. This study aimed to investigate whether maternal meta-emotion philosophies (i.e., emotion coaching, emotion dismissing) mediated the relation between maternal RF and child emotion regulation (ER). Additionally, children's genders and ages were examined as moderators of the associations between maternal RF and maternal meta-emotion philosophies. The sample comprises 667 Chinese mothers of children aged 4-6 years. Mothers completed questionnaires assessing their reflective functioning, emotion coaching and dismissing, and child emotion regulation. Results indicated both a direct link between maternal RF and child emotion regulation, as well as indirect pathways mediated by emotion coaching and dismissing. A child's gender and age also moderated the relations between maternal RF and meta-emotion philosophies. Specifically, the negative association between maternal pre-mentalizing modes and emotion coaching was stronger for mothers of girls than boys; whereas the negative association between maternal certainty of mental states and emotion dismissing, as well as the positive association between maternal interest and curiosity and emotion coaching were both stronger for mothers of younger children than older children. The findings suggest that emotion coaching and dismissing mediate the relation between maternal PRF and the emotion regulation of children.
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Affiliation(s)
- Rong Shao
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East of China Normal University, Shanghai 200050, China
| | - Sitong Liu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East of China Normal University, Shanghai 200050, China
| | - Robert J Coplan
- Department of Psychology, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Xi Chen
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East of China Normal University, Shanghai 200050, China
| | - Junsheng Liu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East of China Normal University, Shanghai 200050, China
- Shanghai Changning Mental Health Center, Shanghai 200335, China
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Gur A, Hindi TN, Mashiach S, Roth D, Keren M. Parental reflective functioning and coping among parents of toddlers with severe developmental disabilities: An early integrative bio-psycho-social rehabilitative intervention in daycare facilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104555. [PMID: 37348329 DOI: 10.1016/j.ridd.2023.104555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 05/19/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Parental reflective functioning has a positive effect on parents' wellbeing. It is associated with positive outcomes for their children. However, there is little research on it among parents of toddlers with severe developmental disabilities. AIMS We examined an early bio-psycho-social rehabilitative intervention with parents of toddlers with severe developmental disabilities in daycare programs and its contribution to their parental reflective functioning and coping. METHODS AND PROCEDURES Seventy parents of children (ages 3 months to two and half years) responded to measures before and after the intervention in their children's daycare programs. Structural equation modeling of the mediation model revealed that the therapeutic inputs were associated with more adaptive coping strategies by increasing parental reflective functioning. OUTCOMES AND RESULTS Parents who participated in an intervention of 13 sessions or more significantly increased their reflective functioning. The path analysis showed that parental reflective functioning after the intervention mediated the association between its prior level and the therapeutic inputs, and the parents' proactivity and search for support. CONCLUSIONS AND IMPLICATIONS Parental reflective functioning positively affects parents' adaptive coping styles. A bio-psycho-social intervention targeting parental reflective functioning benefits parents of toddlers with severe developmental disabilities.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Tali-Noy Hindi
- School of Political Sciences, University of Haifa, Haifa, Israel
| | | | - Dana Roth
- Beit Issie Shapiro, Ra'anana, Israel
| | - Miri Keren
- Medical school, Tel Aviv University, Israel
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Cen-Yagiz S, Aytac B. Assessing Maternal Attitudes: Development, Validation, and Psychometric Properties of the Mother-Child Reminiscing Scales. Psychol Rep 2023:332941231180140. [PMID: 37269232 DOI: 10.1177/00332941231180140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Mother-child participation in conversations about past events in early childhood has an invaluable influence on child development. While previous studies have focused on the investigation of maternal styles of talking about the past, the role of maternal attitudes towards reminiscing has been overlooked. This paper presents two studies on the development and validation of two separate scales that assess maternal attitudes in mother-child conversations: the Maternal Attitudes Towards Mother-Child Reminiscing Scale (MCRS) and MCRS-Context. DESIGN In Study 1, we have investigated the factor structure of the MCRS (N = 312) and MCRS-Context (N = 278) with a sample of mothers whose children aged between 3 and 7. In Study 2, we aimed to test the factor structure obtained by exploratory factor analysis (EFA) in Study 1 using confirmatory factor analysis (CFA) and we have investigated the psychometric properties of the scales with a different sample of 223 mothers. RESULTS EFA and CFA results have suggested four theoretically consistent factors of the MCRS (interest, competency, satisfaction and difficulty) and a one-factor structure for the MCRS-Context (general positive attitudes in comparison to other mothers). To test construct validity, the relationships with related independent scales were investigated, indicating generally significant and theoretically expected correlations. The test/re-test, Cronbach alpha and composite reliability scores indicated acceptable internal consistency for both scales. CONCLUSIONS The findings of both studies provided evidence for the validity and reliability of these scales in evaluating maternal attitudes towards mother-child conversations. It is thought that the studies presented here will provide useful insight for future studies for understanding the link between maternal cognitions and reminiscing practices in mother-child conversations and the effect of that link on child development.
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Affiliation(s)
- Suzan Cen-Yagiz
- Department of Psychology, Faculty of Letters, Hacettepe University, Turkey
| | - Berna Aytac
- Department of Psychology, Faculty of Letters, Hacettepe University, Turkey
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Jin J, Goud R, Al-Shamali H, Dzunic A, Lyons T, Reeson M, Pazderka H, Dennett L, Polzin W, Wei Y, Silverstone PH, Greenshaw AJ. Early Mental Health Foundations: A Scoping Review of Reflective Functioning in Caregiver-Child Dyads. PSYCHIAT CLIN PSYCH 2023; 33:58-69. [PMID: 38764527 PMCID: PMC11082638 DOI: 10.5152/pcp.2023.22549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/20/2023] [Indexed: 05/21/2024] Open
Abstract
International public health strategies indicate a need for equitable resources for wellness in younger children and their caregivers. Reflective functioning, a proxy for emotional regulation abilities, is a key area in this domain. As an emerging area, reflective functioning has not been mapped comprehensively and requires systematic investigation. This review examines "what qualitative and quantitative evidence is there for the value of reflective functioning assessment and intervention studies in caregiver-child dyads?" This scoping review focused on data published to September 2021, focusing on caregivers of children ≤36 months of age (including Medline, PsycINFO, CINAHL, ERIC, Scopus, Web of Science, and Embase). Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed. From 5162 initial articles, 608 papers were screened for full text yielding a final 181 papers. Only 69 studies included multiple ethnicities. Seven of the 69 studies included at least 1 Indigenous person. No studies were conducted in low- to middle-income countries, and no studies reported data on gender identity. This review comprises a novel and comprehensive mapping of the reflective functioning literature in terms of both assessment and intervention studies. The present mapping of the reflective functioning literature indicates the importance of health disparities in caregiver-child dyads (these include gaps and needs for future research). In relation to gaps, studies of adverse childhood experience, consideration of equity, diversity, and inclusion, and global mental health are underrepresented. Future research is needed to provide information on the relevance of gender identity and low- to middle-income countries in relation to the impact on reflective functioning in this context.
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Affiliation(s)
- Jonathan Jin
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Rachel Goud
- University of Toronto, Temerty Faculty of Medicine, Toronto, Canada
| | - Huda Al-Shamali
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Anja Dzunic
- University of Alberta, School of Public Health, Edmonton, Canada
| | - Tirzah Lyons
- University of Alberta, Faculty of Education, Edmonton, Canada
| | - Matthew Reeson
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, Canada
- Little Warriors Be Brave Ranch, Edmonton Alberta, Canada
| | - Liz Dennett
- JW Scott Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Wanda Polzin
- Little Warriors Be Brave Ranch, Edmonton Alberta, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, Canada
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13
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Carlone C, Milan S, Decoste C, Borelli JL, McMahon TJ, Suchman NE. Self-report measure of parental reflective functioning: A study of reliability and validity across three samples of varying clinical risk. Infant Ment Health J 2023; 44:240-254. [PMID: 36857469 DOI: 10.1002/imhj.22046] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023]
Abstract
The Parental Reflective Functioning Questionnaire (PRFQ) provides an efficient way to measure a parent's capacity to recognize their child's mental states and to understand the relationship between underlying mental states and behavior. To date, limited work evaluates its psychometric properties beyond initial validation studies. Here we examined the reliability and validity of the PRFQ in three samples of varying clinical risk (e.g., community sample, previous mental health diagnosis, substance use disorder diagnosis). Across samples, the majority (e.g., 75%-78%) of mothers identified as White; all mothers were from the USA. We compared the PRFQ to task-based measures of mentalization, the Parent Development Interview (PDI), and measures of the parent-child relationship. The PRFQ was a reliable measure across samples, and it was associated in theoretically consistent ways with task-based measures of mentalization. Parental RF across the PDI and PRFQ were not highly correlated in a sample of mothers with substance use disorders. Existing RF measures may be tapping into a different component of the broader construct of parental reflective functioning (PRF). The PRFQ was further validated by demonstrating relationships with parent-report measures of the parent-child relationship. Taken together, these findings provide additional support for the reliability and validity of the PRFQ.
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Affiliation(s)
- Christina Carlone
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Stephanie Milan
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Cindy Decoste
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Thomas J McMahon
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy E Suchman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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14
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Gershy N, Cohen R, Poria NA. Parental mentalization goes to school: a brief online mentalization-based intervention to improve parental academic support. Attach Hum Dev 2023; 25:254-271. [PMID: 36847178 DOI: 10.1080/14616734.2023.2179578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
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.
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Affiliation(s)
- Naama Gershy
- The School of Education, the Hebrew University of Jerusalem, Jerusalem, Israel
| | - Racheli Cohen
- The School of Education, the Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Atzaba Poria
- The Department of Psychology, and DUET center, Ben Gurion University of the Negev, Be'er Sheva, Israel
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15
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Borelli JL, Kazmierski KFM, Gaskin GE, Kerr ML, Smiley PA, Rasmussen HF. Savoring interventions for mothers of young children: Mechanisms linking relational savoring and personal savoring to reflective functioning. Infant Ment Health J 2023; 44:200-217. [PMID: 36811971 DOI: 10.1002/imhj.22038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/19/2022] [Indexed: 02/24/2023]
Abstract
Parenting interventions can improve parenting outcomes, with widespread implications for children's developmental trajectories. Relational savoring (RS) is a brief attachment-based intervention with high potential for dissemination. Here we examine data from a recent intervention trial in order to isolate the mechanisms by which savoring predicts reflective functioning (RF) at treatment follow-up through an examination of the content of savoring sessions (specificity, positivity, connectedness, safe haven/secure base, self-focus, child-focus). Mothers (N = 147, Mage = 30.84 years, SDage = 5.13; Race: 67.3% White/Caucasian, 12.9% other or declined to state; 10.9% biracial/multiracial, 5.4% Asian, 1.4% Native American/Alaska Native, 2.0% Black/African American; Ethnicity: 41.5% Latina) of toddlers (Mage = 20.96 months, SDage = 2.50; 53.5% female) were randomized to four sessions of RS or personal savoring (PS). Both RS and PS predicted higher RF, but through different means. RS was indirectly associated with higher RF through greater connectedness and specificity of savoring content, while PS was indirectly associated with higher RF through greater self-focus in savoring content. We discuss the implications of these findings for treatment development and for our understanding of the emotional experience of mothers of toddlers.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Kelly F M Kazmierski
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Gerin E Gaskin
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Margaret L Kerr
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
| | - Patricia A Smiley
- Department of Psychology, Pomona College, Claremont, California, USA
| | - Hannah F Rasmussen
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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16
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Letourneau N, Anis L, Novick J, Pohl C, Ntanda H, Hart M. Impacts of the Attachment and Child Health (ATTACH TM) Parenting Program on Mothers and Their Children at Risk of Maltreatment: Phase 2 Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3078. [PMID: 36833770 PMCID: PMC9961631 DOI: 10.3390/ijerph20043078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Nicole Letourneau
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Faculty of Nursing, and Cumming School of Medicine, Departments of Pediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lubna Anis
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jason Novick
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Carrie Pohl
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Henry Ntanda
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Martha Hart
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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17
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Crouch JL, Bridgett DJ, Milner JS, Cote K, Lelakowska G, Davila A, McKay E, Savoree S. Prolonged Infant Crying: Caregiving Quality and Child Physical Abuse Risk. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3298-3320. [PMID: 35654573 DOI: 10.1177/08862605221106137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Research suggests that prolonged infant crying may increase risk for child physical abuse (CPA). However, few studies have examined behavioral responses to infant crying among parents at risk for CPA. The present study sought to fill this gap by using a simulated infant to examine how mothers and fathers with varying degrees of CPA risk respond to prolonged infant crying. Specifically, a sample of 184 general population caregivers (107 mothers and 77 fathers) participated in a task that involved attempting to soothe a simulated infant that cried continuously for 30 min. The simulated infant sessions were video-recorded, and quality of caregiving behavior was coded in 5-min segments. Participants rated their negative affect (feelings of upset, distress, irritability) at the outset of the data collection session, before beginning the simulated infant task, and after the simulated infant task concluded. It was predicted that high-risk caregivers, compared to low-risk caregivers, would display lower quality caregiving, higher levels of negative affect, and that CPA risk group differences would increase over time. Gender differences were explored in relation to the aforementioned hypotheses. Over the course of the 30-min simulated infant task, the quality of caregiving behavior diminished among both high- and low-risk caregivers. As expected, high-risk caregivers, compared to low-risk caregivers, exhibited lower quality caregiving behaviors and were more likely to discontinue the simulated infant task early. In addition, high-risk, compared to low-risk, caregivers reported higher levels of negative affect throughout the data collection session, with the highest level of negative affect reported by high-risk caregivers after completing the simulated infant task. Overall, the quality of caregiving exhibited by men and women did not significantly differ. The present findings highlight the importance of early intervention designed to support caregivers' abilities to respond effectively to prolonged infant crying.
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Affiliation(s)
- Julie L Crouch
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - David J Bridgett
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - Joel S Milner
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - Kreila Cote
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - Gabriela Lelakowska
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - America Davila
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - Erin McKay
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
| | - Shelby Savoree
- Center for the Study of Family Violence and Sexual Assault, 2848Northern Illinois University, DeKalb, IL, USA
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18
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Zerach G. Posttraumatic Stress Symptoms and Parenting Competence among Israeli Male Veterans: The Mediating Roles of Experiential Avoidance and Parental Reflective Functioning. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:301-313. [PMID: 35350596 PMCID: PMC8945870 DOI: 10.1007/s10826-022-02288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 05/17/2023]
Abstract
Although empirical studies have documented associations between posttraumatic stress symptoms (PTSS) and parenting among various high-risk populations, there is a relatively limited amount of research on paternal parenting among veterans. Moreover, the understanding of possible mechanisms which may account for this effect is severely lacking. This study examined associations between military related PTSS and parenting sense of competence (PSOC) among veteran fathers. Furthermore, we examined the mediating role of experiential avoidance (EA) and parental reflective functioning (PRF) in the association between PTSS and PSOC. Participants were 189 Israel Defense Forces (IDF) male combat veterans (mean age = 30.03) who completed a set of validated self-report questionnaires in a cross-sectional design study. Results showed negative associations between PTSS and PSOC-parental satisfaction but not parental efficacy. Furthermore, EA mediated the association between PTSS and parental satisfaction and efficacy; PRF- Pre mentalizing modes mediated the association between PTSS and parental satisfaction. Our findings imply that EA and PRF may serve as mechanisms of the association between PTSS and PSOC among veteran fathers. These findings are discussed in light of a psychological trauma perspective, and clinical implications to increase fathers' mentalization and psychological flexibility are suggested.
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Affiliation(s)
- Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
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19
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Lindblom J, Pajulo M, Nolvi S, Tervahartiala K, Karlsson H, Karlsson L, Korja R. Early pathways of maternal mentalization: Associations with child development in the FinnBrain birth cohort study. Front Psychol 2022; 13:855190. [PMID: 36582339 PMCID: PMC9792295 DOI: 10.3389/fpsyg.2022.855190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Parental mentalization refers to a parents' capacity and interest to consider the individual experience and mental state underlying the behaviors of the child. Higher mentalization is considered a key aspect for parental sensitivity in interaction, fostering child's socioemotional and self-regulatory development. Yet, previous studies have not examined the dynamic pathways through which the maternal mentalization may develop, nor their effects on child development. Thus, in the current person-oriented study, first, we identify distinct profiles and longitudinal trajectories of maternal mentalization from pregnancy to child's 2 years of age. Second, we test how the profiles and trajectories associate with children's internalizing and externalizing problems, social-emotional competence and effortful control at the age of 2 years. Third, we examine how the profiles and trajectories associate with contextual demographic and child related. The substudy was part of the FinnBrain Birth Cohort and included families from general population (n = 2,687). Mothers reported their parental reflective functioning (PRF) at late pregnancy, 6 months and 2 years of child's age. Both mothers (n = 1,437) and fathers (n = 715) reported the developmental child outcomes at the child's age of 2 years. Latent Profile Analysis and Latent Transition Analysis were used to identify PRF profiles and trajectories. The results showed decreasing heterogeneity in PRF from pregnancy to child's age of 6 months and 2 years (i.e., four, three and two latent classes, respectively). Most mothers progressed towards high PRF over time. Second, the profiles and trajectories depicting high PRF associated with child high social-emotional competence at the age of 2 years, yet no clear positive effects were found on child's problems and effortful control. The group of mixed PRF trajectories showed strongest association with child's internalizing and externalizing problems. Finally, there were theoretically meaningful associations between the PRF trajectories and both the contextual (e.g., parity) and child related (e.g., infant temperament) factors. This was the first study to explore the early unfolding of maternal mentalization. The results are discussed in relation with the potential mechanisms accounting for child development and with the nature and limitations of self-reported parental mentalization.
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Affiliation(s)
- J. Lindblom
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Faculty of Social Sciences, Tampere University, Tampere, Finland,*Correspondence: J. Lindblom,
| | - M. Pajulo
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - S. Nolvi
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Turku Institute for Advanced Studies, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
| | - K. Tervahartiala
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland
| | - H. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - L. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - R. Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
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20
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Wendelboe KI, Nielsen JS, Stuart AC, Væver MS. The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health. Infant Ment Health J 2022; 43:921-937. [PMID: 36228620 PMCID: PMC9828265 DOI: 10.1002/imhj.22023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 01/12/2023]
Abstract
The parents' capacity to reflect upon the psychological processes in their child, termed parental reflective functioning (PRF) can be impaired by parental mental health problems. The present study aimed to investigate the factor structure of an infant version of the Parental Reflective Functioning Questionnaire (PRFQ-I) in a low-risk sample of 259 Danish fathers of 1-11-month-old infants to investigate measurement invariance of the PRFQ-I between fathers and mothers; and to examine the association between PRF and paternal depressive symptoms, psychological distress, and parenting stress. Confirmatory factor analysis supported a three-factor model of the PRFQ-I. Multi-group factor analysis indicated partial measurement invariance. Multiple linear regressions showed that paternal depressive symptoms were not associated with PRF. There was an interaction effect of paternal depressive symptoms and general psychological distress on paternal interest and curiosity in their infant's mental state and certainty of infant mental state. Increased parenting stress was associated with impaired PRF on all three subscales of the PRFQ-I. These results provide further evidence for a multidimensional, brief assessment of paternal reflective skills and insight into how variability in paternal psychological functioning relates to impaired PRF in the postpartum period.
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Affiliation(s)
- Katrine Isabella Wendelboe
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Johanne Smith Nielsen
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Anne Christine Stuart
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Mette Skovgaard Væver
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
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21
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Cohen R, Yassin N, Gershy N. Parenting in Israel amid COVID-19: the Protective Role of Mentalization and Emotion Regulation. ADVERSITY AND RESILIENCE SCIENCE 2022; 3:283-296. [PMID: 36065320 PMCID: PMC9433528 DOI: 10.1007/s42844-022-00072-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 12/01/2022]
Abstract
The global COVID-19 pandemic changed the life of numerous parents. The medical worry, the financial hardship, and the need to take care of children 24/7 caused an enormous burden on parenting, resulting in an elevation in parenting stress and in harsh parenting. In the current study, we were interested in assessing the role of parental emotion regulation and parental mentalization as resilience-promoting factors, by mitigating the harmful relationship between parental distress and negative and positive parenting. Seventy Israeli parents of children (aged 6–14) participated in the study. We assessed parental mentalization and emotion dysregulation before the COVID-19 pandemic. During the national lockdown in Israel in May 2020, we assessed parental distress, COVID-related financial risk, and parental practices. Results indicated elevations in parental distress compared to the population mean, alongside high rates of financial risk. The results indicated that although parental distress was significantly related to parenting practices, parental mentalization, and emotion regulation moderated these relationships in differential ways. Improved capacity for emotion regulation reduced the prevalence of negative parenting practices and higher parental mentalization increased the prevalence of positive parenting, these are despite elevation in parental distress. The results suggested that when parents are able to regulate their own negative emotions and think about a child’s mind, they can remain available to support the child’s needs despite the elevation in parental distress. Supporting parental capacity for mentalization and emotion regulation during stressful times may prevent the harmful consequences of parental distress on parenting.
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Affiliation(s)
- Racheli Cohen
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nada Yassin
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Gershy
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
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22
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Condon EM, Tobon AL, Holland ML, Slade A, Mayes L, Sadler LS. Examining Mothers' Childhood Maltreatment History, Parental Reflective Functioning, and the Long-Term Effects of the Minding the Baby® Home Visiting Intervention. CHILD MALTREATMENT 2022; 27:378-388. [PMID: 33678048 DOI: 10.1177/1077559521999097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research is needed to better understand how childhood maltreatment history affects parental reflective capacities, and whether early childhood interventions help mitigate these effects. We examined associations between childhood maltreatment and current parenting (parental reflective functioning, parenting behaviors) among mothers who participated in a follow-up study (N = 97) of the Minding the Baby® (MTB) randomized control trial. MTB is a home visiting program that aims to help mothers understand their child's mental states (feelings, intentions, needs) by promoting parental reflective functioning. Mothers retrospectively reported childhood maltreatment using the Childhood Trauma Questionnaire. Endorsing a higher number of childhood maltreatment subtypes was associated with less supportive/engaged parenting and higher pre-mentalizing modes, or difficulty with appropriately reflecting on the child's mental states. These relationships were not moderated by participation in the MTB intervention. However, exploratory analyses of individual maltreatment subtypes revealed that participation in MTB may mitigate the harmful effects of childhood emotional abuse on pre-mentalizing modes, specifically. Further research is needed to understand the mechanisms through which early childhood interventions may prevent intergenerational cycles of maltreatment.
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Affiliation(s)
| | - Amalia Londono Tobon
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, 12321Brown University, Providence, RI, USA
| | | | | | - Linda Mayes
- 12228Yale Child Study Center, New Haven, CT, USA
| | - Lois S Sadler
- 16230Yale School of Nursing, Orange, CT, USA
- 12228Yale Child Study Center, New Haven, CT, USA
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23
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Parents' early representations of their children moderate socialization processes: Evidence from two studies. Dev Psychopathol 2022; 34:823-840. [PMID: 33342459 PMCID: PMC8215083 DOI: 10.1017/s0954579420001546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Difficult infants are commonly considered at risk for maladaptive developmental cascades, but evidence is mixed, prompting efforts to elucidate moderators of effects of difficulty. We examined features of parents' representations of their infants - adaptive (appropriate mind-mindedness, MM) and dysfunctional (low reflective functioning, RF, hostile attributions) - as potential moderators. In Family Study (N = 102), we tested parents' appropriate MM comments to their infants as moderating a path from infants' observed difficulty (negative affect, unresponsiveness) to parents' observed power assertion at ages 2-4.5 to children's observed and parent-rated (dis)regard for conduct rules at age 5.5. In father-child relationships, MM moderated that path: for fathers with low MM, the infants' increasing difficulty was associated with fathers' greater power assertion, which in turn was associated with children's more disregard for rules. The path was absent for fathers with average or high MM. In Children and Parents Study (N = 200), dysfunctional representations (low RF, hostile attributions) moderated the link between child objective difficulty, observed as anger in laboratory episodes, and difficulty as described by the parent. Reports of mothers with highly dysfunctional representations were unrelated to children's observed anger. Reports of mothers with average or low dysfunctional representations aligned with laboratory observations.
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24
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Ngoh G, Wu J, Potenza MN, Mayes LC, Rutherford HJV. Exploring resting frontal EEG and reflective functioning in maternal substance use. Infant Ment Health J 2022; 43:519-532. [PMID: 35699268 PMCID: PMC9827537 DOI: 10.1002/imhj.21991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/07/2022] [Indexed: 01/11/2023]
Abstract
Maternal substance use is associated with altered neural activity and poor offspring outcomes, which may be facilitated by suboptimal caregiving in the form of impaired parental reflective functioning (PRF). To investigate these associations, the resting-state frontal electroencephalography (EEG) power of 48 substance-using mothers and 37 non-substance-using mothers were examined, specifying seven frequency bands: delta, theta, alpha, alpha1, alpha2, beta, and gamma. Substance-using mothers exhibited enhanced beta and gamma spectral power compared to non-substance-using mothers, potentially reflecting higher arousal states in substance-using mothers. There were no between-group differences in any component of PRF (i.e., levels of pre-mentalizing, certainty, and interest and curiosity). Whole-sample analyses revealed significant positive correlations between pre-mentalizing and delta spectral power. Taken together, these findings suggest potential neural correlates of maternal substance use and PRF, providing an important next step into examining associations between maternal substance use and poor child outcomes.
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Affiliation(s)
- Gwendolyn Ngoh
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jia Wu
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Marc N Potenza
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut, USA
- The Connecticut Mental Health Center, New Haven, Connecticut, USA
- The Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
| | - Linda C Mayes
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
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25
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Stuhrmann LY, Göbel A, Bindt C, Mudra S. Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review. Front Psychol 2022; 13:765312. [PMID: 35310277 PMCID: PMC8927808 DOI: 10.3389/fpsyg.2022.765312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Background Parental reflective functioning (PRF) refers to parents’ mental capacity to understand their own and their children’s behaviors in terms of envisioned mental states. As part of a broader concept of parental mentalization, PRF has been identified as one of the central predictors for sensitive parenting. However, the unique contribution of PRF to the quality of various parenting behaviors has not yet been addressed systematically. Thus, the present article provides a systematic overview of current research on the associations between PRF or its sub-dimensions and observed parenting behaviors in infancy and early childhood, while considering the influence of contextual factors. Methods The review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Systematic searches were carried out in five electronic databases. The eligibility and methodological quality of the identified studies were assessed using pre-defined criteria and a standardized checklist. Results Sixteen studies with moderate to high quality on a total of 15 parenting behaviors were included, the majority of which examined positive parenting behaviors, while negative parenting behaviors were rarely investigated. Most of the associations indicated a positive effect of PRF on parenting behavior, with mostly small-sized effects. The strength and direction of the associations varied depending on the dimensionality of PRF, observation settings, sample types, socioeconomic factors, and cultural background. Moreover, five assessment instruments for PRF and 10 observation instruments for parenting behaviors were identified. Conclusion In summary, PRF has shown a positive association with parenting quality. However, its complex interaction with further contextual factors emphasizes the need for differentiation of PRF dimensions and the consideration of the observation settings, assessment time points, psychosocial risks, and sample types in observational as well as intervention studies. Further high-quality studies with multivariate analyses and diverse study settings are required.
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Affiliation(s)
- Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ye P, Ju J, Zheng K, Dang J, Bian Y. Psychometric Evaluation of the Parental Reflective Functioning Questionnaire in Chinese Parents. Front Psychol 2022; 13:745184. [PMID: 35153949 PMCID: PMC8837268 DOI: 10.3389/fpsyg.2022.745184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
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 < 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.
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Affiliation(s)
- Panqin Ye
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Jiawen Ju
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Kejun Zheng
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Junhua Dang
- Department of Surgical Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Yufang Bian
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
- Child and Family Education Research Center, Beijing Normal University, Beijing, China
- Institute of Mental Health and Education, Beijing Normal University, Beijing, China
- *Correspondence: Yufang Bian,
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Moreira H, Fonseca A. Measuring Parental Reflective Functioning: Further Validation of the Parental Reflective Functioning Questionnaire in Portuguese Mothers of Infants and Young Children. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01288-2. [PMID: 35064394 DOI: 10.1007/s10578-021-01288-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/03/2022]
Abstract
This study examines the factor structure and psychometric properties of the Portuguese Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ is a brief questionnaire of parental reflective functioning that comprises three subscales: pre-mentalizing modes of mental states, certainty about mental states, and interest and curiosity in mental states. Two independent samples were included in the study: a sample composed of 710 mothers of children aged 0 to 36 months (Study 1) and a sample composed of 120 mothers of children aged 1 to 5 years (Study 2). Each sample completed a different set of self-report questionnaires. The original correlated three-factor structure was confirmed through confirmatory factor analyses. The three PRFQ subscales exhibited adequate reliability and correlated in the expected directions with several outcomes (psychopathology symptoms, emotion dysregulation, parent attachment, and parenting styles). The Portuguese PRFQ is a psychometrically robust measure of parental reflective functioning appropriate for research use in Portugal.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal.
| | - Ana Fonseca
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal
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Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety. Child Psychiatry Hum Dev 2021; 52:1032-1043. [PMID: 33068211 DOI: 10.1007/s10578-020-01078-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
Theoretical models suggest parent anxiety leads to increased anxiogenic parenting, an important etiological factor for child anxiety disorders. Evidence suggests that parents engage in anxiogenic parenting to reduce distress in response to their child's anxiety; however, further study of this mechanism is needed. Cognitive risk factors, including distress intolerance, anxiety sensitivity, emotion-related impulsivity, and repetitive negative thinking are promising to examine as they impact emotion regulation. This study examined whether an indirect association between parent anxiety and anxiogenic parenting via these risk factors exists, and if child anxiety moderated this effect. Findings demonstrated evidence for an indirect association via distress intolerance in mothers at high levels of child anxiety, but not low levels. An unmoderated indirect effect via emotion-related impulsivity was found. Anxiety sensitivity and repetitive negative thinking did not demonstrate significant indirect effects. These findings suggest distress intolerance and emotional-related impulsivity may be targets for parent-focused child anxiety treatments.
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Midgley N, Irvine K, Rider B, Byford S, Cirasola A, Ganguli P, Katangwe-Chigamba T, Murdoch J, Pond M, Pursch B, Redfern S, Richards ZL, Shepstone L, Sims E, Smith C, Sprecher E, Swart AM, Wyatt S, Wellsted D. The Reflective Fostering Programme-improving the wellbeing of children in care through a group intervention for foster carers: a randomised controlled trial. Trials 2021; 22:841. [PMID: 34823552 PMCID: PMC8613455 DOI: 10.1186/s13063-021-05739-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background The needs of children in care are a government priority, yet the evidence base for effective interventions to support the emotional wellbeing of children in care is lacking. Research suggests that supporting the carer-child relationship, by promoting the carer’s reflective parenting, may be an effective approach to improving the wellbeing of these children. Methods The study comprises a definitive, superiority, two-armed, parallel, pragmatic, randomised controlled trial, with embedded process evaluation and economic evaluation, and an internal pilot, to evaluate the effectiveness, and cost-effectiveness, of the Reflective Fostering Programme. Randomisation is at the individual level using a 1:1 allocation ratio. The study is being conducted in local authority sites across England, and is targeted at foster carers (including kinship carers) looking after children aged 4 to 13. Consenting participants are randomly allocated to the Reflective Fostering Programme (intervention arm) in addition to usual support or usual support alone (control arm). The primary outcome is behavioural and emotional wellbeing of the child 12 months post-baseline, and secondary outcomes include the following: foster carer’s level of stress, quality of life, reflective capacity, compassion fatigue and burnout, placement stability, the quality of the child-carer relationship, child’s capacity for emotional regulation, and achievement of personalised goals set by the carer. Discussion A feasibility study has indicated effectiveness of the Programme in improving the child-carer relationship and emotional and behavioural wellbeing of children in care. This study will test the effectiveness and cost-effectiveness of implementing the Reflective Fostering Programme as an additional aid to the support already available to local authority foster carers. Trial registration ISRCTN 70832140.
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Affiliation(s)
- Nick Midgley
- Research Department of Clinical, Educational and Health Psychology, zUniversity College London, London, UK.
| | - Karen Irvine
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Beth Rider
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | | | | | | | | | - Jamie Murdoch
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Martin Pond
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Benita Pursch
- Anna Freud National Centre for Children and Families, London, UK
| | - Sheila Redfern
- Anna Freud National Centre for Children and Families, London, UK
| | - Zena Louise Richards
- Research Department of Clinical, Educational and Health Psychology, zUniversity College London, London, UK
| | - Lee Shepstone
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | | | - Eva Sprecher
- Anna Freud National Centre for Children and Families, London, UK
| | - Ann Marie Swart
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Solange Wyatt
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - David Wellsted
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
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Nobre-Trindade C, Caçador MI, Canavarro MC, Moreira H. Mothers' psychopathology symptoms and mindful parenting in the postpartum period: The role of parental reflective functioning. Infant Ment Health J 2021; 42:784-795. [PMID: 34741468 DOI: 10.1002/imhj.21947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 08/09/2021] [Indexed: 11/06/2022]
Abstract
Postpartum psychopathology has an adverse impact on parenting behaviors and, consequently, on the mother-infant relationship. This study aimed to explore whether the relationship between maternal anxiety and depression symptomatology in the postpartum period and the ability of mothers to adopt a mindful parenting approach is indirect and can be explained by parental reflective functioning. Two hundred ninety five Portuguese mothers of infants aged up to 12 months completed self-report measures assessing anxiety/depression symptoms, mindful parenting, and parental reflective functioning. Mothers who reported clinically significant anxious and/or depressive symptomatology levels (21%) showed lower levels of mindful parenting and of certainty about the mental states as well as higher levels of prementalizing modes of mental states than mothers with normal symptomatology levels. An indirect effect of depressive symptomatology on mindful parenting through the two dimensions of parental reflective functioning and a direct effect of anxious symptomatology on mindful parenting were found. The results suggest that parental reflective functioning is an important explanatory mechanism of the relationship between depressive symptomatology and mindful parenting, as well as that anxious symptomatology is directly associated with mindful parenting. This study suggests that reducing anxious and depressive symptoms in the postpartum period can promote reflective and mindful parenting skills.
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Affiliation(s)
- Cristiana Nobre-Trindade
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, Portugal
| | - Maria Inês Caçador
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, Portugal
| | - Helena Moreira
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, Portugal
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Schuetze P, Godleski S, Sassaman J. Prenatal exposure to opioids: Associations between the caregiving environment and externalizing behaviors. Neurotoxicol Teratol 2021; 87:107019. [PMID: 34403741 DOI: 10.1016/j.ntt.2021.107019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
Maternal opioid use during pregnancy is a rapidly growing public health crisis and is associated with a range of adverse developmental outcomes including externalizing behaviors among exposed children. Recent work has highlighted the role of indirect pathways from prenatal opioid exposure to behavioral outcomes through aspects of the caregiving environment, including parenting. This review highlights maternal sensitivity and related aspects of the caregiving environment that may impact the development of externalizing behaviors among children with a history of prenatal exposure to opioids. We conclude by providing suggestions for future directions in research examining development among children with prenatal opioid exposure.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, Buffalo State College, The State University of New York, USA; The Pennsylvania State University, USA.
| | | | - Jenna Sassaman
- Department of Psychology, College of Liberal Arts, The Pennsylvania State University, USA
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Wendelboe KI, Smith-Nielsen J, Stuart AC, Luyten P, Skovgaard Væver M. Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology. PLoS One 2021; 16:e0254792. [PMID: 34339422 PMCID: PMC8328297 DOI: 10.1371/journal.pone.0254792] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/04/2021] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Katrine I. Wendelboe
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Johanne Smith-Nielsen
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Anne C. Stuart
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Mette Skovgaard Væver
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
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Frolli A, Cavallaro A, Oduro S, Bosco A, Lombardi A, Di Carmine F, Ricci MC. DDAA and Maternal Reflective Functions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01818-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractIn this study, we propose to examine two types of Parent Training (PT) under DDAA —behavioral and reflective types of PT. The central idea of our work is that the development of parenting educational skills cannot ignore the development of reflective and regulatory functions, which promote pre-mentalization, social cognition, and empathic skills. Because of the lack of studies on the efficacy of behavioral PT addressed to the parents of subjects with DDAA, this work took place. This study included 90 families whose children were diagnosed with the disorder of dysregulated anger and aggression (DDAA) according to criteria of CD 0–5 (2016). The sample included pre-school children aged between 2 and 3 years old (age range 2–3 years), who were equally divided into two groups based on the type of PT administered to the parents or caregivers. Our results indicate that the PT intervention, which is focused on the improvement of parental reflexive functions, helps in obtaining greater results even in the reduction of the externalizing behavioral symptoms. Additionally, results show that the intervention of PT with a behavioral matrix does not improve parental reflexive functions even if it guarantees a slight reduction of children’s behavioral problems.
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Feingold D, Zerach G. Parental Reflectiveness, Posttraumatic Symptoms and Alcohol Use Disorder among Israeli Combat-Veteran Fathers. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:2155-2164. [PMID: 34230797 PMCID: PMC8249432 DOI: 10.1007/s10826-021-02024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
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.
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Affiliation(s)
| | - Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
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35
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Vanwoerden S, Penner F, Pearson C, Bick J, Yoshida H, Sharp C. Testing the Link Between Mothers' General Reflective Function Capacity and Adolescent Borderline Personality Features: Perceived Parenting Behaviors as a Potential Mechanism. J Pers Disord 2021; 35:56-73. [PMID: 33779277 PMCID: PMC8877123 DOI: 10.1521/pedi_2021_35_505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Impairments in mothers' reflective function (RF), the ability to imagine the mental states of the self and others, underlies maladaptive parenting strategies, which have been associated with borderline personality disorder (BPD). The current study evaluated the association between mother's RF and adolescents' BPD and the mediating role of a range of parenting behaviors. Five hundred and thirty-one inpatient adolescents and their mothers participated in the current study. A multimethod assessment of BPD was used alongside mothers' self-reported quality of RF. Children completed three questionnaires about maternal parenting behaviors. There was no direct relation between mother's RF capacity and adolescents' BPD. However, mothers' adaptive certainty about mental states related to less severe BPD in adolescents, specifically through decreases in inconsistent punishment. Mothers' RF capacity predicted various parenting behaviors, which was associated with adolescents' BPD severity. Implications of findings for early intervention and prevention are discussed.
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Affiliation(s)
- Salome Vanwoerden
- Department of Psychology, University of Houston, Houston, Texas,Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Johanna Bick
- Department of Psychology, University of Houston, Houston, Texas
| | - Hanako Yoshida
- Department of Psychology, University of Houston, Houston, Texas
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas
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Jacques DT, Sturge-Apple ML, Davies PT, Cicchetti D. Parsing alcohol-dependent mothers' insensitivity to child distress: Longitudinal links with children's affective and anxiety problems. Dev Psychol 2021; 57:900-912. [PMID: 34424008 PMCID: PMC8386000 DOI: 10.1037/dev0001190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prior work suggests that substance-dependent mothers insensitively respond to their child's emotional needs, which can increase children's risk for psychopathology. However, the mechanisms and processes underlying these associations remain unclarified. Mothers' insensitivity to children's distress is an especially unique predictor of child maladjustment, yet no study has examined whether or how different types of insensitivity to child distress uniquely affect the development of internalizing problems in children of alcohol-dependent mothers. To bridge these gaps, this study examined longitudinal mediational pathways between maternal alcohol dependence symptoms, 2 types of maternal insensitivity to child distress (disengagement and intrusiveness), and 2 types of child internalizing symptoms (affective and anxiety problems) in a majority Black and Latinx sample of young children (Mage = 2.14 years) and their mothers. Results revealed that maternal disengagement mediated associations between maternal alcohol dependence symptoms and child internalizing problems such that alcohol dependence predicted increased disengagement to children's distress, which subsequently predicted increases in children's affective problems. Maternal alcohol dependence symptoms were not associated with intrusiveness to child distress; however, increased intrusiveness predicted later increases in child anxiety problems. Findings support a differentiated approach to studying maternal insensitivity to child distress, specifically indicating that mothers with alcohol dependence symptoms may be more or less likely to display certain types of insensitivity to child distress which may differentially influence children's risk for internalizing problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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37
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Psychometric properties of the prenatal-parental reflective functioning questionnaire in Iranian mothers and fathers. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01909-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Stephanie K, Brigitte R. Various mentalizing concepts in mothers with postpartum depression, comorbid anxiety, and personality disorders. Infant Ment Health J 2021; 42:488-501. [PMID: 33759190 DOI: 10.1002/imhj.21914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mentalization is defined as the human capacity to reflect upon one's own or others' behaviors in terms of underlying mental states and intentions. Several concepts of mentalizing exist, which differ in content, assessment, and clinical prediction. AIMS The present study examines the relationship between the three main concepts of mentalizing, namely, reflective functioning (RF), parental reflective functioning (PRF), and Mind-Mindedness (MM), in mothers with postpartum depression. It was hypothesized that mentalizing concepts differ in their convergent and divergent variance, as well as their clinical validity regarding comorbid anxiety and personality disorders (PDs). METHOD Fifty clinically referred mothers with postpartum depression and infants aged 3-10 months were examined by means of the Reflective Functioning Scale, Parental Reflective Functioning Questionnaire, and Mind-Mindedness Coding-System. RESULTS No significant associations were found between RF and PRF, or between PRF and MM; higher RF was associated with more MM-nonattuned mind-related comments. Increased depression and anxiety were linked to lower PRF in terms of higher PRF-prementalizing. Lower RF, but not PRF, was associated with comorbid PDs. Specifically, obsessive-compulsive PD was associated to considerably fewer MM-nonattuned mind-related comments. CONCLUSION Distinct concepts of mentalizing represent divergent competencies, differentially linked to maternal postpartum psychopathology.
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Affiliation(s)
- Krink Stephanie
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Psychology, University of Münster, Muenster, Germany
| | - Ramsauer Brigitte
- Faculty of medicine, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Hamburg, Germany
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Øie MG, Aarnes IE, Eilertsen LH, Söderström K, Ystrom E, Håkansson U. High levels of the openness trait are associated with better parental reflective functioning in mothers with substance use disorders. Addict Behav Rep 2020; 12:100318. [PMID: 33364326 PMCID: PMC7752705 DOI: 10.1016/j.abrep.2020.100318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
Mothers with high levels of Openness had better parental reflective functioning. Mothers with low Openness need training in interpreting mental states in their children. It is important to assess the mothers personality before selecting form of treatment.
Aims Mothers with substance use disorders (SUD) often show impairments in parental reflective functioning (PRF), which may have adverse effects on their capacity for sensitive caregiving. Parenting personality is also associated with caregiving. However, no studies have investigated how these individual factors may contribute to variance in PRF in mothers with SUD. In this study PRF and personality were assessed in 43 mothers with SUD. Methods PRF was assessed by the Parent Development Interview. Personality traits were assessed by the Revised Neuroticism-Extraversion-Openness Personality Inventory. Results The results indicate that higher levels of the Openness trait are associated with better PRF. Conclusion Mothers low in Openness may need more specific and situational training in interpreting mental states in their children. Highly open mothers with SUD will likely need more help distinguishing the child’s mental states from their own, and might need help to maintain mutuality and regulating the intensity of their responses to the child’s behavior.
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Affiliation(s)
- Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | | | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.,Pharmacoepidemiology & Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Ulrika Håkansson
- Inland Norway University of Applied Sciences, Lillehammer, Norway
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40
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Borelli JL, Lai J, Smiley PA, Kerr ML, Buttitta K, Hecht HK, Rasmussen HF. Higher maternal reflective functioning is associated with toddlers' adaptive emotion regulation. Infant Ment Health J 2020; 42:473-487. [PMID: 33377209 DOI: 10.1002/imhj.21904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Parental reflective functioning (RF), the ability to consider the child's behavior as a function of mental states (cognitions, emotions), is theorized to promote emotion regulation in children via its positive impact on parenting sensitivity. Using a sample of mothers and toddlers (N = 151 dyads; 41% Latinx; 54% girls; MAge = 21 months; SDAge = 2.5 months), we measured mothers' self-reported RF (high RF = low certainty/high interest-curiosity/low prementalizing), toddlers' distress during a standardized challenging behavioral task (toy removal), and three methods of children's coping with distress. Then, we tested whether RF moderated the association between children's observed distress and coping during the task (mother-directed adaptive coping, task-directed adaptive coping, maladaptive aggression) as an index of emotion regulation. Although RF was not associated with toddlers' distress, indices of RF moderated the associations between distress and coping. As maternal RF increased, the positive association between toddler distress and mother-oriented behavior increased, whereas the association between toddler distress and child aggression decreased. Findings were present only for certainty of mental states, whereas no effects were present for prementalizing or interest/curiosity. We discuss these findings in terms of their contributions to theory regarding parent-child relationships, maternal RF, and child emotion regulation.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, Irvine, California
| | - Jocelyn Lai
- Department of Psychological Science, University of California, Irvine, Irvine, California
| | | | - Margaret L Kerr
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin
| | - Katherine Buttitta
- Brazelton Touchpoints Center, Boston Children's Hospital, Boston, Massachusetts
| | - Hannah K Hecht
- Department of Psychological Science, University of California, Irvine, Irvine, California
| | - Hannah F Rasmussen
- Department of Psychology, University of Southern California, Los Angeles, California
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41
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Abstract
Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.
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42
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Wan MW, Fitch-Bunce C, Heron K, Lester E. Infant screen media usage and social-emotional functioning. Infant Behav Dev 2020; 62:101509. [PMID: 33249357 DOI: 10.1016/j.infbeh.2020.101509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/08/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022]
Abstract
There has been little research on whether and how screen media usage affects social-emotional (SE) function prior to two years of age, even though early SE development is understood to be nurtured through interpersonal experience, mainly withthe primary caregiver. This study sought to characterise infant screen media usage and understand how it may link with concurrent SE function by testing associated effects on reducing parent-infant interaction and of parent psychological factors. Questionnaire responses from 327 UK-based parents of infants aged 6-24 months showed diverse usage in the amount of time spent on screen media ('screen time') and amount of parental involvement (co-sharing and co-referencing). Infants with possible SE delay experienced more screen time than those at low risk. The study tested three mediation models and found support for the displacement and not distancing hypothesis based on this community sample. While screen time predicted both SE competence and SE problems, reduced parent-infant play partially mediated the effect on SE competence. Parent depressed mood was positively linked with infant SE problems, but there was little evidence that increased screen time mediated this effect. Also, parent reflective function and attitudes toward parent-infant play were unrelated to screen time. Though longitudinal study is warranted, the findings implicate screen media usage as potentially directly and indirectly relevant when addressing infant mental health.
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Affiliation(s)
- Ming Wai Wan
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.
| | - Clem Fitch-Bunce
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Kate Heron
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Ellie Lester
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
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43
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Maternal working memory, emotion regulation, and responsivity to infant distress. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1016/j.appdev.2020.101202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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44
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Carlone C, Milan S. Does your child need therapy? Maternal reflective functioning and perceived need for and use of child mental health treatment. Attach Hum Dev 2020; 23:310-327. [PMID: 32167022 DOI: 10.1080/14616734.2020.1734641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Interventions to improve reflective functioning (RF) are being delivered to parents of children with mental health needs, yet whether this population differs in RF is unknown. We examine if mothers with varying levels of child mental health (CMH) treatment need and use differ in RF in a community sample of 212 mothers. Participants completed measures of general RF, parental RF, children's symptoms, perceived treatment need, treatment utilization, and perceptions of treatment efficacy at baseline and one year later. Low maternal RF was associated with elevated child symptoms, and a greater perceived need for treatment. Among mothers who believed their child needed services, those with low general RF were less likely to be utilizing services at baseline and in the next year. Mothers with lower parental RF also believed that CMH treatment was less effective. Findings support the use of RF-based interventions with parents identified because of their child's mental health.
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Affiliation(s)
- Christina Carlone
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Stephanie Milan
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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45
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Zayde A, Prout TA, Kilbride A, Kufferath-Lin T. The Connecting and Reflecting Experience (CARE): theoretical foundation and development of mentalizing-focused parenting groups. Attach Hum Dev 2020; 23:293-309. [PMID: 32072881 DOI: 10.1080/14616734.2020.1729213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
In underserved communities with limited resources and disproportionately high morbidity and mortality rates, attachment-based, short-term, group interventions that are effective yet simple to disseminate can have a profound public health impact. This paper describes the implementation of a mentalizing-focused group parenting intervention. The Connecting and Reflecting Experience (CARE) serves primary caregivers of children from birth to 18 years within a diverse and impoverished community setting. Families living in communities facing health disparities are at heightened risk for intergenerational cycles of trauma which give rise to myriad public health crises at high societal cost. CARE's mission is to facilitate the intergenerational transmission of secure attachment which can profoundly reduce rates of psychiatric illness for future generations. The theoretical and empirical bases for the intervention and the evidence base for existing mentalizing-focused parenting interventions are reviewed. The program's structure and treatment goals are presented in the context of clinical case material.
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Affiliation(s)
- Amanda Zayde
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, The Bronx, NY, USA.,Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Tracy A Prout
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Anna Kilbride
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, The Bronx, NY, USA
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46
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Lo AYH, Grotevant HD. Adoptive Parenting Cognitions: Acknowledgement of Differences as a Predictor of Adolescents' Attachment to Parents. PARENTING, SCIENCE AND PRACTICE 2020; 20:83-107. [PMID: 33716578 PMCID: PMC7954044 DOI: 10.1080/15295192.2019.1694826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Adoptive parents' acknowledgement of differences is defined as the propensity to think that adoptive and nonadoptive families are different in important ways. Few studies have examined the implications of such cognitions for the parent-child bond. DESIGN Structural equation modeling was utilized to examine the relation between adoptive parents' acknowledgement of differences and adolescents' later attachment to their parents in a sample of within-race domestic infant adoptions. Data from 189 adoptive families were drawn from two waves (middle childhood, adolescence) of the Minnesota/Texas Adoption Research Project, a longitudinal study of openness in adoption. RESULTS Levels of acknowledgement of differences displayed by the adoptive mother and adoptive father during middle childhood positively predicted adopted adolescents' feelings of attachment towards the respective parent 8 years later. This relation depended on adopted adolescents' attitude toward adoption-related communication during middle childhood as well as the adoptive family's level of openness during middle childhood. CONCLUSIONS Acknowledgement of differences in adoptive families has positive implications for the parent-child bond.
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Affiliation(s)
- Albert Y H Lo
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst; Tobin Hall, 135 Hicks Way, Amherst, MA 01003
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47
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Batra A, Beattie RM. Recognising malnutrition in children with neurodisability. Clin Nutr 2020; 39:327-330. [PMID: 31472988 DOI: 10.1016/j.clnu.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/23/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
Affiliation(s)
- A Batra
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - R M Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, United Kingdom.
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48
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Rutherford HJV, Mayes LC. Parenting stress: A novel mechanism of addiction vulnerability. Neurobiol Stress 2019; 11:100172. [PMID: 31193862 PMCID: PMC6543178 DOI: 10.1016/j.ynstr.2019.100172] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/10/2019] [Accepted: 05/15/2019] [Indexed: 02/03/2023] Open
Abstract
Addiction remains a significant public health concern. Despite numerous public health initiatives, many parents continue to use substances during the prenatal and postpartum period. While stress has been implicated in the maintenance of substance use disorders more generally, we propose that parenting stress specifically increases vulnerability to substance use in adults caring for young children. To explore this notion, we first consider the neurobiology of the adult transition to parenthood and the value of adopting a parenting-specific approach to understanding addictive processes. Next, we consider the neurobiology of addiction and parenting before directly addressing parenting stress in the context of addiction. Finally, we describe current interventions with parents that incorporate the management of negative affect to enhance caregiving quality and decrease substance use. Taken together, this article proposes that the unique demands of caring for a developing child may be more stressful above and beyond other forms of stress. As a consequence, intervention approaches that target stress in the parenting role hold promise for decreasing parental substance abuse.
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49
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Håkansson U, Watten RG, Söderström K, Øie MG. The association between executive functioning and parental stress and psychological distress is mediated by parental reflective functioning in mothers with substance use disorder. Stress Health 2019; 35:407-420. [PMID: 30977584 PMCID: PMC9328653 DOI: 10.1002/smi.2868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/02/2019] [Accepted: 04/07/2019] [Indexed: 12/05/2022]
Abstract
Mothers with a substance use disorder (SUD) have been found to exhibit heightened experience of stress and deficits in executive functioning (EF) and in parental reflective functioning (PRF). Although experiences of stress, EF and PRF are important for caregiving capacities; no studies have explored associations between the phenomena in mothers with SUD. This study aimed to examine the association between EF (working memory, inhibition, and cognitive flexibility) and different forms of stress (parental stress, general life stress, and psychological distress) in 43 mothers with SUD with infants. We further aimed to investigate whether PRF had a mediating function between EF and the experience of stress. The mothers completed self-report questionnaires regarding experiences of different types of stress, and we also used neuropsychological tests to assess EF and a semistructured interview to assess PRF. Results identified problems in EF were associated with higher parental stress and psychological distress but not with general life stress. Cognitive flexibility contributed uniquely to variance in parental stress, whereas working memory was a unique contributor to variance in psychological distress. PRF had a mediating function between EF and parental stress and between EF and psychological distress. Findings highlight the importance of considering individual differences in PRF when targeting EF in interventions trying to reduce the experience of parental stress and psychological distress in mothers with SUD.
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Affiliation(s)
- Ulrika Håkansson
- Department of PsychologyInnland Norway University of Applied SciencesLillehammerNorway
| | - Reidulf G. Watten
- Department of PsychologyInnland Norway University of Applied SciencesLillehammerNorway
| | - Kerstin Söderström
- Department of PsychologyInnland Norway University of Applied SciencesLillehammerNorway,Division of Mental Health CareInnlandet Hospital TrustLillehammerNorway
| | - Merete Glenne Øie
- Department of PsychologyUniversity of OsloOsloNorway,Research DivisionInnlandet Hospital TrustLillehammerNorway
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50
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Mazzeschi C, Buratta L, Germani A, Cavallina C, Ghignoni R, Margheriti M, Pazzagli C. Parental Reflective Functioning in Mothers and Fathers of Children With ADHD: Issues Regarding Assessment and Implications for Intervention. Front Public Health 2019; 7:263. [PMID: 31572704 PMCID: PMC6753962 DOI: 10.3389/fpubh.2019.00263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
Parental factors contribute to ADHD, partly in an etiological way and partly as moderators and mediators of child outcomes and treatment effects. An important aspect of parenting seems to be parental reflective functioning (PRF), defined as the parent's capacity to reflect upon his own and his child's internal mental experience. The studies on parenting factors linked to ADHD have not extensively investigated the role of PRF. Recent findings on interventions have begun to consider mentalization to promote empathy and emotion regulation in parents, but empirical studies assessing PRF are still scarce. The aim of this cross-sectional study was to compare specific familial and parental functioning characteristic between parents of children with attention deficit/hyperactivity disorder (ADHD) and parents of controls without ADHD. A clinical sample of 41 children with ADHD aged 8–11 years and their parents was compared with a matched, non-clinical sample of 40 children. Three aspects of parental functioning were investigated: parental symptomatology, parental alliances and PRF; children's differences in strength and difficulty profiles were also assessed. The results showed that families of children with ADHD had lower socioeconomic status, and both mothers and fathers of the same families reported higher scores for depression and lower PRF than did the control group; only mothers showed lower parental alliance. Logistic regression highlighted the fact that several of these familial and parental factors contributed to the increased risk of belonging to the clinical group, specifically both mothers' and fathers' depressive symptoms and lower PRF. These data represent new findings with potentially meaningful clinical implications for both assessment and intervention.
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Affiliation(s)
- Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Alessandro Germani
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Clarissa Cavallina
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Roberta Ghignoni
- Istituto Agazzi "Futurabile"-Outpatient Center of the Developmental Age, Arezzo, Italy
| | - Michele Margheriti
- Center for Clinical Neuropsychology of Developmental Age "Giorgio Sabbadini", Perugia, Italy
| | - Chiara Pazzagli
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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