Behaviour problems in 18- to 36-month old children of alcoholic fathers: secure mother-infant attachment as a protective factor

Adverse childhood experiences and psychopathology in adolescents from northern Chile: the moderating role of the attachment style

BACKGROUND

Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life.

OBJECTIVE

The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships- Relationship Structures (ECR-RS), and Youth Self Report (YSR-18).

RESULTS

The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = -0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models.

CONCLUSION

In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.

Attachment-Based Parenting Interventions and Evidence of Changes in Toddler Attachment Patterns: An Overview

There is strong evidence to show links between attachment security in young children and a range of positive outcomes in social, emotional, and psychological domains. The aims of this review were to provide a narrative summary of (1) the attachment-based interventions currently available for caregivers of toddlers aged 12-24 months and for which research about the impact of the program on child attachment patterns has been reported, and (2) the empirical effectiveness of these interventions at improving attachment security. A number of interventions were shown to be associated with shifts to secure and/or organized attachment, with Child-Parent Psychotherapy and Attachment and Biobehavioral Catch-Up emerging as the interventions with the strongest evidence bases. For most interventions, evidence came from just a single research study, and in some cases from studies that were not randomized controlled trials. In order for clinicians to make informed decisions about the interventions they use with parents and toddlers, it is vital that further research be conducted to test the efficacy of all available attachment-based parenting programs using randomized controlled trial designs, in a range of settings and clinical and cultural groups, and with longitudinal follow-ups.

Child attachment in adjusting the species-general contingency between environmental adversities and fast life history strategies

Extrinsic mortality risks calibrating fast life history (LH) represent a species-general principle that applies to almost all animals including humans. However, empirical research also finds exceptions to the LH principle. The present study proposes a maternal socialization hypothesis, whereby we argue that the more human-relevant attachment system adds to the LH principle by up- and down-regulating environmental harshness and unpredictability and their calibration of LH strategies. Based on a longitudinal sample of 259 rural Chinese adolescents and their primary caregivers, the results support the statistical moderating effect of caregiver-child attachment on the relation between childhood environmental adversities (harshness and unpredictability) and LH strategies. Our theorizing and findings point to an additional mechanism likely involved in the organization and possibly the slowdown of human LH.

Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

Background

The present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.

Methods

Participants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).

Results

Maternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.

Conclusion

Results indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.

School Bullying-The Silent Epidemic: A Cross-Sectional Study of Factors Associated With Peer Victimization Among Lebanese Adolescents

The objective of this study was to evaluate bullying at school and identify the factors associated with it among a sample of Lebanese school adolescents. A cross-sectional study was carried out between April 2014 and June 2014, using a convenient sampling of Lebanese students in private schools from Beirut and Mount Lebanon. The results showed that 712 (18.1%) adolescents had been bullied in the past 2 months (95% CI [0.169, 0.192]). A backward logistic regression, taking "being bullied in the last 2 months" as a dependent variable, showed significantly lower odds of being bullied in the last 2 months in those who find it easy (adjusted odds ratios [aOR] = 0.434) and very easy (aOR = 0.391) to talk to their father, and having some close male or female friends compared with none. Furthermore, significantly higher odds of being bullied were found among males compared with females (aOR = 0.664), having a best friend who smokes sometimes compared with never (aOR = 1.389), and a father who drinks everyday compared with never (aOR = 1.621). This study was able to shed light on a problem that sometimes goes silent in schools and has a negative impact on the mental health of teenagers. Indeed, the results of our study showed that peer victimization was closely linked to clinically relevant mental health issues. In addition, factors such as parental and peer support could protect against the negative effects of bullying.

Associations between pre-adolescents' cognitive responses to alcohol-related cues, maternal drinking, and direct exposure to alcohol

The current study investigated pre-adolescent children's (N = 140, M_age = 10.11 years, SD = 1.48, 59.5% girls) implicit evaluations of and explicit expectancies about alcohol-related cues as a function of their mothers' drinking behaviors and their exposure to alcohol. Children's implicit evaluative responses were measured using the Affect Misattribution Procedure (AMP), which consisted of trials that depicted pictures of either alcoholic or non-alcoholic beverages, half of which were presented alone (inactive) and half of which were presented with a human interacting with the beverage (active). In addition, children's explicit expectancies, whether they had ever tasted alcohol, and their mothers' alcohol dependency and escape drinking motivations were measured. Results indicated that overall children's implicit evaluations were less positive for alcohol- than for non-alcohol-related cues, and those whose mothers reported higher alcohol dependency evaluated inactive alcohol-related cues more negatively. Moreover, those who had previously tasted alcohol endorsed positive expectancies more than negative expectancies. These findings contribute to our understanding of the processes through which implicit associations are learned in the context of addiction. Understanding cognitive as well as other potential biological and environmental factors that may predict drinking behaviors in youth will aid in the development of more effective evidence-based strategies for the prevention of alcoholism.

Early Childhood Risk and Protective Factors Predicting Resilience against Adolescent Substance Use

We examined associations between early childhood (first 3 years of life) risk and protective factors and resilience against adolescent substance use in a prospective sample of alcoholic and non-alcoholic families. We defined resilience as low or no substance use in the context of adversity (having a father with alcohol problems). The sample included 227 families recruited from birth records when children were 12 months old and followed longitudinally to 15-17 years of child ages (n = 182). Adolescents were grouped into 4 categories: Non-challenged (non-alcoholic parent, no adolescent substance use, n = 50), Troubled (non-alcoholic parent, adolescent substance use, n = 30), Resilient (alcoholic parent, no adolescent substance use, n = 36), and Vulnerable (alcoholic parent and adolescent substance use, n = 66). Multivariate analyses were used to examine group differences (resilient vs. vulnerable; non-challenged vs. troubled) in child and parent characteristics and family relationships domains. Children in the troubled group compared to non-challenged had lower effortful control and emotion-regulation, and those in the resilient group were more unadaptable or reactive to novelty compared to the vulnerable group. Parents of resilient compared to vulnerable children reported significantly lower alcohol symptoms and more partner aggression. Finally, fathers of resilient compared to vulnerable children were less aggravated with them in early childhood. Results highlight the importance of continuous measures of alcohol problems, early childhood functioning, and family characteristics for associations with adolescent risk and resilience.Passive gene-environment correlations may account for associations between parent alcohol problem severity and adolescent substance use.

Participation in the Fathering through Change intervention reduces substance use among divorced and separated fathers

Recent evaluations of parent training programs have demonstrated beneficial crossover effects in reducing parental substance use. Because divorce is associated with substance use risk and substance use interferes with effective parenting, parent training programs are critically important for divorced fathers but there are few evidence-based programs tailored to fathers. We tested whether an evidence-based parenting program would exhibit beneficial impact on fathers' substance use and whether these changes were mediated by changes in parenting efficacy. We tested hypotheses in a sample of 426 divorced and separated fathers randomly assigned to the online Fathering through Change (FTC) program or the wait-listed control condition. Models specified as 3-month pre-post analyses of self-reported substance use. The FTC was associated with reductions in total substance use (d = 0.14) and drinking (d = 0.26) but not with reductions in tobacco smoking and marijuana use. Data also supported a significant indirect effect for FTC through pre-post changes in parenting efficacy (d = 0.36). We discuss clinical implications for the integration of parent training within substance use treatment.

Maternal Prenatal Anxiety and Children’s Externalizing and Internalizing Behavioral Problems: The Moderating Roles of Maternal-Child Attachment Security and Child Sex

Background

Prenatal anxiety is associated with child behavioral problems. Prenatal anxiety is predictive of postnatal anxiety which can interfere with the security of maternal-child attachment and further raise the risk of child behavior problems. Secure maternal-child attachment is essential for optimal emotional health. Sex influences the type of behavior problem experienced. There is a gap in understanding whether attachment security and the sex of the child can moderate association between prenatal anxiety and children’s behavioral problems.

Purpose

To examine the association between prenatal anxiety and child behavioral problems and to test the moderating effects of attachment security and child sex on the association between prenatal anxiety and child behavioral problems.

Methods

Secondary analysis of data from 182 mothers and their children, enrolled in the Alberta Pregnancy Outcomes and Nutrition Study using Hayes' (2013) conditional process modeling.

Results

Prenatal anxiety was associated with both externalizing ( b = −0.53; standard error ( SE) = 0.20; p = 0.009) and internalizing ( b = −0.32; SE = 0.13; p = 0.01) behaviors only in children with an insecure style of attachment. Child sex did not moderate the association between prenatal anxiety and children's behavioral problems.

Conclusions

Attachment security moderated the association between prenatal anxiety and children’s externalizing and internalizing behavioral problems.

Exploring health visiting professionals' evaluations of early parent-infant interactions

Objective: To examine the accuracy of Health Visitors (HVs) evaluations of the quality of parent-infant interactions. Background: HVs have been identified as key professionals in the early identification of difficulties in parent-infant interactions. Method: A sample of 56 HVs, 4 Family Health Nurses (FHNs) and 14 Community Nursery Nurses (CNNs) recruited from two National Health Service (NHS) Trusts, viewed video footage of six early parent-infant interactions which had been categorised as 'sensitive', 'mixed', and 'problematic' using the CARE-Index. Participants evaluated the quality of the parent-infant interactions shown in these videos using the Parent-Infant Interaction Rating Questionnaire (PIIRQ). Results: On average, participants correctly rated the problematic videos as lowest in quality, the mixed as higher in quality than the problematic videos, and the sensitive videos as highest in quality. Interestingly, within the problematic category participants rated the 'unresponsive' pattern of interaction as significantly lower in quality than the 'controlling' interaction. Conclusions: Findings suggest participants were relatively accurate in their evaluations of parent-infant interactions. However, they indicate that participants were more likely to be concerned about unresponsive, as opposed to controlling, interactive behaviours. Recommendations for further research include exploration of potential differences in how health-visiting professionals evaluate particular patterns of parent-infant interactions.

Using Social Networking Sites in Research: An Emerging Approach to Engaging With Young People Who Have a Parent With a Mental Illness and/or Substance Abuse Disorder

The challenges involved in engaging young people who have a parent with a mental illness in research and in programs are well documented. Social networking sites provide a potentially useful medium to include at-risk youths and their families by removing some accessibility barriers that may prevent engagement and connection with individuals whose parents or family members have a mental illness. This paper examines how social networking sites can be used to recruit youths and/or their families and engage them in research. Applying a case study analysis, the implications of using social media as a tool for recruitment and data collection and the ethical considerations and limitations will be discussed. Results tentatively indicate that social networking sites may be an effective method to engage young people of parents with a mental illness. The study argues for more informed use of social platforms for the translation and dissemination of research and intervention prevention. Overall, this paper will contribute to public mental health practice through guidelines and policy about social media research with at-risk young people and their families.

Mental Health Literacy of Youth That Have a Family Member With a Mental Illness: Outcomes From a New Program and Scale

A program evaluation examined mental health literacy levels and coping outcomes for youth (ages 10-16), before and at the end of their participation in a manualized, school-based mental health literacy program called Youth Education and Support (YES). Most of the youth reportedly had a parent or other family member with a mental health disorder such as depression, anxiety, and/or substance abuse. The mental health literacy levels of program participants from pre to post were evaluated with the developing Knowledge of Mental Illness and Recovery (K-MIR) scale. This scale was validated using item-response theory, demonstrating good psychometric properties. Youth answered two coping questions about their use of positive coping during the program and coping skills compared from pre to post intervention. Findings revealed that youth levels of mental health literacy increased significantly from pre to post program participation. Over 90% of the youth reported an improved use of positive coping strategies from pre to post intervention. The program appeared to deliver enhanced levels of literacy and coping for this sample of youth. The scale appeared to be appropriate to measure youth mental health literacy. Recommendations for practice, policy, and research are offered.

Etiological Pathways to Rejection Sensitivity in a High-Risk Sample

Rejection sensitivity is associated with social-emotional maladjustment in both childhood and adulthood. However, less is known about the etiology of rejection sensitivity. The present study tests an etiological model for rejection sensitivity using a high-risk sample ( N = 227) with prospective data from infancy (i.e., 12 months) to adolescence (i.e., eighth grade). Evidence for social learning and attachment theories was demonstrated. In particular, family and parenting factors, such as family conflict and maternal harshness, were predictive of rejection sensitivity in adolescence. Implications for intervention and prevention efforts are discussed.

Adult mental health clinicians' perspectives of parents with a mental illness and their children: single and dual focus approaches

BACKGROUND

When clinicians in the adult mental health sector work with clients who are parents with dependent children, it is critical they are able to acknowledge and respond to the needs of the parents and their children. However, little is known about clinicians' personal perspectives and reactions towards these parents and children or if/how they balance the needs of both.

METHODS

Semi structured interviews were conducted with eleven clinicians from adult mental health services in Australia. Interviews focused on clinicians' experiences when working with parents who have mental illness. Transcripts were analysed within an Interpretative Phenomenological Analysis framework to examine participants' perspectives and personal reactions to parents and children.

RESULTS

There was considerable divergence in participants' reactions towards parents and children and the focus of their perspectives when working with parental mental illness. Feelings of sympathy and responsibility made it difficult for some participants to maintain a dual focus on parents and children and contributed to some adopting practices that focused on the needs of parents (n = 3) or children (n = 1) exclusively. Other participants (n = 7) described strategies and supports that allowed them to manage these feelings and sustain a dual focus that incorporated the experiences and needs of both parents and children.

CONCLUSIONS

It is difficult for some mental health clinicians to maintain a dual focus that incorporates the needs and experiences of parents and their children. However, findings suggest that the challenges of a dual focus may be mitigated through adequate workplace support and a strengths-based practice framework that emphasises parental empowerment.

"I Feel It In My Heart When My Parents Fight": Experiences of 7-9-Year-Old Children of Alcoholics

Children are vulnerable when exposed to parental alcohol abuse. Although much is known about children of alcoholics (COA), research examining the experiences of younger COA is scarce. To gain knowledge of the consequences for these children, it is important to ask the children themselves. This study explored the consequences for a child of having an alcoholic parent, from the point of view of 7-9-year-old COA. Eighteen children were interviewed, whose alcoholic parent was undergoing treatment, using a vignette. In the analysis, using qualitative content analysis, the findings show that the children of this young age had much experiences and took a great responsibility for their alcoholic parent, and the family. The most significant feeling of the children was a feeling of sadness. They tried to control the situation in different ways. They wished for a change in the future, but despite problems in the family they described things they did together with a loving parent. Implications include the importance of listening to and supporting all COA, also children as young as 7-9 years old. Further studies should address the support that can and should be offered to COA.

Parents' concordant and discordant alcohol use and subsequent child behavioral outcomes

Alcohol problems have variable outcomes for marital relationships depending on whether drinking patterns are concordant or discordant among the members of the dyad; however, it is unclear what impact these variations in drinking patterns have on children. The current study was designed to explore several gaps and limitations in the parent heavy drinking literature. In particular, the prospective associations over 3years between parent heavy drinking, parenting, and child externalizing behavior were investigated in an integrated model to examine the influence of concordant and discordant drinking within couples on subsequent outcomes for their children. The study consisted of 180 couples recruited by mailings with children primarily between the ages of 4 and 11years old (52% male children). Parent-report of marital conflict, parenting, alcohol use, and child externalizing behavior were measured in a longitudinal study. Actor-Partner Interdependence Model analyses were conducted. Higher levels of maladaptive parenting were associated with higher externalizing for children of concordant drinking couples as opposed to discordant drinking couples. Implications for research and practice are discussed, including investigating mediators and moderators of the current findings such as quality of the parent-child relationship.

Mental Health Literacy Content for Children of Parents with a Mental Illness: Thematic Analysis of a Literature Review

Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children's MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children.

Definitional Elasticity in the Measurement of Intergenerational Continuity in Substance Use

Increasingly, three generation studies have investigated intergenerational (IG) continuity and discontinuity in substance use and related problem behaviors. However, surprisingly little attention has been paid to the conceptual definition of continuity or to different types of discontinuity (resilience and escalation) or to measurement sensitivity, which affects not only the magnitudes of observed continuity but also factors that correlate with this linkage. This study uses longitudinal data on 427 parent-child dyads from the Rochester IG Study to study continuity and discontinuity in substance use over ages 14-18. Results suggest that the degree of IG continuity, resilience, and escalation in adolescent substance use, as well as correlates of each, depend heavily on how heterogeneity in the behavior is taken into account.

Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review

Children of parents with drug and alcohol use disorders often grow up under severe stress and are at greater risk of developing psychological and social problems. However, a substantial proportion of affected children adapt to their distressing life conditions and show positive development in terms of their mental health. These children are described as resilient. One difference between resilient and maladapted children is the presence of protective factors. The aim of this systematic review is to provide an overview of the current state of the research concerning protective mental health factors in children of parents with alcohol or drug use disorders (COPAD). For that purpose, the PsychInfo, PubMed, CINAHL and ISI Web of Science databases were searched through January 2017. All the identified publications were screened using previously developed inclusion criteria. The search yielded 3,402 articles. Eleven of these publications (2003-2013) met the criteria for inclusion in the present review. Information on the studies was extracted using an extraction form. A narrative analysis was performed, and the methodological quality was examined using a checklist based on the Mixed Methods Appraisal Tool. The research identified familial, parental, child-related and biological factors that influenced mental health outcomes in affected children (N = 1,376, age range = 1-20 years). Overall, protective mental health factors are understudied in this target group. Most of the included studies were conducted in the United States and employed a cross-sectional design. A comparison of the included cross-sectional and longitudinal studies indicated consistent results related to a secure parent-child attachment. Based on the current state of the research, no causal conclusions with regard to the effectiveness of protective factors can be drawn. To develop effective prevention programs, further longitudinal studies and studies assessing the interactions between risk and protective factors are needed.

Attachment in young children with incarcerated fathers

The present study examined young children's attachment behaviors during paternal incarceration and reported on initial validity of a new measure used to rate children's attachment-related behaviors and emotions during visits in a corrections setting. Seventy-seven children, age 2 to 6 years, and their jailed fathers and current caregivers participated in the home visit portion of the study, whereas 28 of these children participated in the jail visit. The results indicated that 27% of children witnessed the father's crime and 22% of children witnessed the father's arrest, with most children who witnessed these events exhibiting extreme distress; children who witnessed these events were more likely to have insecure attachments to their caregivers. Consistent with attachment theory and research, caregivers who exhibited more sensitivity and responsivity during interactions with children and those who provided more stimulating, responsive, learning-oriented home environments had children who were more likely to have secure attachments (measured with the Attachment Q-Sort). We also found preliminary evidence for the validity of our new measure, the Jail Prison Observation Checklist, in that children's attachment-related behaviors and emotions during the jail visit correlated with their attachment security observed in the home. Our observations indicate that, in certain contexts, noncontact visits with incarcerated parents can be stressful for children and that children's caregivers may play a significant role during these visits.

Maternal heavy alcohol use and toddler behavior problems: a fixed effects regression analysis

Using data from the longitudinal Norwegian Mother and Child Cohort Study, the aims of the current study were to examine associations between postnatal maternal heavy alcohol use and toddler behavior problems, taking both observed and unobserved confounding factors into account by employing fixed effects regression models. Postnatal maternal heavy alcohol use (defined as drinking alcohol 4 or more times a week, or drinking 7 units or more per alcohol use episode) and toddler internalizing and externalizing behavior problems were assessed when the toddlers were aged 18 and 36 months. Maternal psychopathology, civil status and negative life events last year were included as time-variant covariates. Maternal heavy alcohol use was associated with toddler internalizing and externalizing behavior problems (p < 0.001) in the population when examined with generalized estimating equation models. The associations disappeared when observed and unobserved sources of confounding were taken into account in the fixed effects models [(p = 0.909 for externalizing behaviors (b = 0.002, SE = 0.021), p = 0.928 for internalizing behaviors (b = 0.002, SE = 0.023)], with an even further reduction of the estimates with the inclusion of time-variant confounders. No causal effect was found between postnatal maternal heavy alcohol use and toddler behavior problems. Increased levels of behavior problems among toddlers of heavy drinking mothers should therefore be attributed to other adverse characteristics associated with these mothers, toddlers and families. This should be taken into account when interventions aimed at at-risk families identified by maternal heavy alcohol use are planned and conducted.

The relation of infant attachment to attachment and cognitive and behavioural outcomes in early childhood

BACKGROUND

In China, research on the relation of mother-infant attachment to children's development is scarce.

AIMS

This study sought to investigate the relation of mother-infant attachment to attachment, cognitive and behavioural development in young children.

STUDY DESIGN

This study used a longitudinal study design.

SUBJECTS

The subjects included healthy infants (n=160) aged 12 to 18 months.

OUTCOME MEASURES

Ainsworth's "Strange Situation Procedure" was used to evaluate mother-infant attachment types. The attachment Q-set (AQS) was used to evaluate the attachment between young children and their mothers. The Bayley scale of infant development-second edition (BSID-II) was used to evaluate cognitive developmental level in early childhood. Achenbach's child behaviour checklist (CBCL) for 2- to 3-year-olds was used to investigate behavioural problems.

RESULTS

In total, 118 young children (73.8%) completed the follow-up; 89.7% of infants with secure attachment and 85.0% of infants with insecure attachment still demonstrated this type of attachment in early childhood (κ=0.738, p<0.05). Infants with insecure attachment collectively exhibited a significantly lower mental development index (MDI) in early childhood than did infants with secure attachment, especially the resistant type. In addition, resistant infants were reported to have greater social withdrawal, sleep problems and aggressive behaviour in early childhood.

CONCLUSION

There is a high consistency in attachment development from infancy to early childhood. Secure mother-infant attachment predicts a better cognitive and behavioural outcome; whereas insecure attachment, especially the resistant attachment, may lead to a lower cognitive level and greater behavioural problems in early childhood.

Maternal pre-pregnancy risk drinking and toddler behavior problems: the Norwegian Mother and Child Cohort Study

Maternal risk drinking may be a risk factor for child behavior problems even if the mother has discontinued this behavior. Whether pre-pregnancy risk drinking is an independent predictor of child behavior problems, or whether a potential effect may be explained by maternal alcohol use during and after pregnancy or other adverse maternal characteristics, is not known. Employing data from the Norwegian Mother and Child Cohort Study (MoBa), longitudinal associations between maternal pre-pregnancy risk drinking and behavior problems in toddlers aged 18 and 36 months were examined. Included in the study was mothers answering MoBa questionnaires when the child was 18 (N = 56,682) and 36 months (N = 46,756), and who had responded to questions regarding pre-pregnancy risk drinking at gestation week 17/18, using the screening instrument T-ACE. Toddler behavior problems were measured with items from Child Behavior Checklist. Associations were analyzed with multivariate logistic regression, controlling for pre and postnatal alcohol use, as well as other relevant covariates. Pre-pregnancy risk drinking was associated with child behavior problems at 18 and 36 months, even after controlling for pre and postnatal alcohol use. Maternal ADHD and anxiety and depression were the only covariates that had any substantial impact on the associations. When all covariates were included in the model, the associations were weak for internalizing behavior problems and non-significant for externalizing behavior problems. Pre-pregnancy risk drinking may predict early development of behavior problems in the offspring. This increased risk may be due to other adverse maternal characteristics associated with risk drinking, in particular co-occurring maternal psychopathology.

Understanding the diverse needs of children whose parents abuse substances

In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children's negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present.

The significance of insecure and disorganized attachment for children's internalizing symptoms: a meta-analytic study

This meta-analytic review examines the association between attachment and internalizing symptomatology during childhood, and compares the strength of this association with that for externalizing symptomatology. Based on 42 independent samples (N = 4,614), the association between insecurity and internalizing symptoms was small, yet significant (d = 0.15, CI 0.06~0.25) and not moderated by assessment age of internalizing problems. Avoidance, but not resistance (d = 0.03, CI -0.11~0.17) or disorganization (d = 0.08, CI -0.06~0.22), was significantly associated with internalizing symptoms (d = 0.17, CI 0.03~0.31). Insecurity and disorganization were more strongly associated with externalizing than internalizing symptoms. Discussion focuses on the significance of attachment for the development of internalizing versus externalizing symptomatology.

Moderate alcohol consumption as a mediator of mother's behaviour towards her child

AIM

The purpose of this study is to examine the effect of moderate drinking on mother's behaviour towards her child.

METHOD

The European Longitudinal Study of Pregnancy and Childhood (ELSPAC) survey sample consisted of 3,569 Czech women, who were interviewed when their children were 18 months old. There were three areas related to mother child relationship investigated: hygiene, activities with the child, and the mother's emotional relationship with the child. Besides alcohol consumption, we also evaluated the mother's neuroticisms.

RESULTS

Our results suggest that the behaviour of moderate drinking mothers differs from the behaviour of abstaining mothers. The abstinents express more emotions for the child, they handle better the demands of maternity and pay more attention to needs for child's educative activities. Significant differences were not noticed in the frequency of physical activities with the child (cuddling, physical playing, walks).

CONCLUSION

Our data supports the assumption that moderate drinking of a mother is disadvantageous for the child as compared to abstinence. The abstinents display a higher level of concern about the child.

Familial influence of substance use disorder on emotional disorder across three generations

The concomitant influence of grandparental (Generation 1; G1) and parental (G2) substance use disorder (SUD) on grandchild (G3) emotional disorder (EmD) across three generations is unclear. The present study addressed this in a sample of 284 families participating in the Oregon Adolescent Depression Project. Structured clinical interviews were used to collect psychiatric history data on a community cohort of G2 individuals and their G1 parents. G2 parents rated EmD symptoms in their G3 children (M age=5 years, SD=2.4). Results indicated that G1 SUD was associated with increased risk of G3 EmD symptom elevations, above and beyond the influence of comorbid G1 EmD. G2 SUD was associated with a similar independent increase in risk for G3 EmD symptoms. Also, G1 SUD conferred risk for G2 SUD. Mediational tests indicated that the influence of G1 SUD on G3 EmD was transmitted via its influence on G2 SUD. G1 and G2 SUD did not interact in predicting G3 EmD; rather results suggested an additive influence. There was no evidence that the influence of G1 SUD on G3 EmD was transmitted via G2 EmD. These findings shed light on the multigenerational processes through which SUD influences EmD.

Parent alcohol problems and peer bullying and victimization: child gender and toddler attachment security as moderators

This study examined the association between parents' alcoholism and peer bullying and victimization in middle childhood in 162 community-recruited families (80 girls and 82 boys) with and without alcohol problems. Toddler-mother attachment was assessed at 18 months of child age, and child reports of peer bullying and victimization were obtained in 4th grade. There was a direct association between fathers' alcohol symptoms and bullying of peers, as well as indirect association via toddler-mother attachment security. Multiple group models indicated that the direct association between parents' alcohol symptoms and bullying was significant for boys but not girls. The association between maternal alcohol symptoms and bullying was significant for secure but not insecure boys or secure/insecure girls. The association between fathers' alcohol symptoms and bullying was significant for insecure boys but not secure boys or secure/insecure girls.

The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study

This study addresses the extent to which insecure and disorganized attachments increase risk for externalizing problems using meta-analysis. From 69 samples (N = 5,947), the association between insecurity and externalizing problems was significant, d = 0.31 (95% CI: 0.23, 0.40). Larger effects were found for boys (d = 0.35), clinical samples (d = 0.49), and from observation-based outcome assessments (d = 0.58). Larger effects were found for attachment assessments other than the Strange Situation. Overall, disorganized children appeared at elevated risk (d = 0.34, 95% CI: 0.18, 0.50), with weaker effects for avoidance (d = 0.12, 95% CI: 0.03, 0.21) and resistance (d = 0.11, 95% CI: -0.04, 0.26). The results are discussed in terms of the potential significance of attachment for mental health.

Promoting a secure attachment: A primary prevention practice model

It is increasingly recognized that early sensitive care-giving predicts a secure attachment in infancy and early childhood.This preliminary report details the development, implementation and evaluation of a clinical programme that used a targeted prevention approach following a universally-offered screening of parent-infant interactions. The CARE-Index was used to assign dyads to low, medium and high risk groups, and interventions - featuring reflective videotape-based feedback - were tailored to each risk group in order to increase maternal sensitivity and improve infant attachment status. Results showed improved maternal sensitivity in the intervention conditions compared to comparisons. In addition, infants in the intervention conditions were significantly more likely to be classified as secure, and significantly less likely to be classified as having DMM complex attachment strategies. Methodological shortcomings, however, mean that these findings should be regarded as tentative.

Marital and family processes in the context of alcohol use and alcohol disorders

Alcohol use is often part of the fabric of marriage and family life, and although it is associated with certain positive effects, excessive drinking and alcohol disorders can exert a negative effect on the marital development and on the development of children in the context of the family. This review considers evidence that alcohol influences and is influenced by marital/family processes, including transitions into marriage and parenthood, marital satisfaction, marital violence, parenting, and child development. The review discusses the importance of antisocial behavior and the need to examine women's drinking, and the joint impact of men's and women's drinking on marital/family processes. The review highlights the lack of studies in certain key areas, including the link between discordant drinking and violence and marital satisfaction, the role of alcohol in child neglect, and the potential role of marital conflict as a mediator or moderator of the relationship between alcohol and child functioning.