Emotional relationships between mothers and infants: knowns, unknowns, and unknown unknowns

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

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

Unveiling complexities: Examining the role of traumatic loss in shaping the interplay between black maternal mental health and maternal bonding

Black women are more likely to experience traumatic birthing events, more likely to experience perinatal depression, and less likely to receive mental health treatment than women of other racial and ethnic backgrounds, and yet largely overlooked in perinatal mental health research. This pilot study seeks to understand how unacceptable racial disparities and adverse perinatal outcomes influence Black maternal depression and maternal bonding by exploring how prior traumatic loss moderates the relationship between depression and bonding during a subsequent pregnancy among a sample of Black mothers. We use survey data collected from 75 Black mothers as part of the Black Fathers, Equal Partners in Promoting Maternal and Infant Health study, a collaboration between the University of Wisconsin Madison and the African American Breastfeeding Network in Milwaukee, Wisconsin, USA. Study results suggest there is a correlation between maternal depression and bonding; when traumatic loss is included as an interaction variable, it produces a moderating effect, changing the direction of the relationship between bonding and depression. As maternal depression increases, bonding increases when moderated by the variable traumatic loss. This finding has important implications for infant mental health research and practice, disrupting the expectation that depression necessarily poses a risk to maternal-infant bonding.

Video-feedback intervention for promoting social engagement in children with neurodevelopmental disabilities

Introduction

Children with neurodevelopmental disabilities (NDs) display several developmental impairments across various domains that impact parent-child interactions, emphasizing the need for effective early interventions. This multi-centric study aimed to evaluate the impact of video-feedback intervention (VFI) on enhancing maternal behavior (i.e., sensitivity) and socio-emotional skills (i.e., engagement and emotionality) in children with NDs during normal or stressful interactions (i.e., the Face-to-Face Still-Face, [FFSF]) paradigm.

Methods

A single-cohort design with pre-(T0) and post-(T1) intervention assessment was used to evaluate 37 mother-child dyads from three units in Northern Italy. The children, aged between 6 and 24 months, had a diagnosis of ND, including psychomotor delay (n = 26) and cerebral palsy (n = 5). The VFI was administered over 6 weeks, with each session focusing on improving parents' developmental supporting behaviors and enhancing the quality of parent-child interactions. Using the Global Rating Scale coding system (GRS), child behaviors (engagement and emotionality) and maternal behavior (sensitivity) were assessed during the FFSF.

Results

Analyses of variance (ANOVA) indicated significant improvement post-intervention in child engagement in the Reunion episode, with an increase in mother-directed gaze communicative gestures and positive vocalization. A paired sample t-test revealed that the mother's sensitivity significantly improves between T0 and T1 during the Reunion phase. Moreover, a higher increase in sensitive maternal behavior during the Reunion phase was associated with greater child engagement at T1 during the Reunion episode. No significant changes post-intervention were observed in the emotionality of the child.

Conclusion

The VFI effectively enhanced socio-emotional skills and maternal sensitivity during parent-child interactions, particularly in recovering from interactive disruptions.

Effectiveness of expressive writing therapy for postpartum women with psychological distress: Meta-analysis and narrative review

BACKGROUND

The increasing prevalence of psychological distress among mothers is outpacing the effectiveness of conventional coping methods like cognitive behavioral therapy. The efficacy of alternatives such as writing therapy for maternal psychological well-being remains uncertain due to a lack of extensive research and inconsistent findings.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of expressive writing therapy in comparison to standard postpartum care for alleviating psychological distress, encompassing symptoms of depression, anxiety, or stress, in postpartum women.

SEARCH STRATEGY

For this purpose, seven bibliographic databases, including CINAHL, Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science, and gray literature were examined up to December 27, 2022 for randomized controlled trials, comparing expressive writing against standard care or controlled writing among postpartum women with psychological distress.

DATA COLLECTION AND ANALYSIS

Data was collected using a random effect model for meta-analysis.

RESULTS

A meta-analysis of five studies with 483 participants found that expressive writing therapy was more effective than standard care or controlled writing in reducing postpartum depression and stress among women with psychological distress. Expressive writing resulted in a significant reduction in initial depression with standard mean difference (SMD) = -0.65%, 95% confidence interval (CI) = -1.08 to -0.22, Z = 2.96, P = 0.003, in comparison to controlled writing as an intervention. Regarding expressive writing versus standard care, a narrative review was conducted due to an I2 above 75%. The results showed significant improvements compared to the baseline at the seventh day and third month post-intervention. In terms of stress scores, there was a significant difference favoring expressive writing over standard care at the first month (SMD = -0.80%, 95% CI = -1.35 to -0.24, Z = 2.81, P = 0.005) and third month (SMD = -0.53%, 95% CI = -0.86 to -0.20, Z = 3.13, P = 0.002) post-intervention. Stress scores are also greatly reduced for expressive writing versus controlled writing with SMD = -0.79%, 95% CI = -1.03 to -0.55, Z = 6.48, P < 0.00001. However, the effectiveness of expressive writing on postpartum anxiety should be interpreted cautiously due to low certainty.

CONCLUSION

Expressive writing serves as an effective alternative for non-pharmacological intervention for postpartum women with depression and stress, but more research is needed for postpartum anxiety. As substantial heterogeneity was detected, results must be interpreted cautiously. Postpartum women with psychological distress are encouraged to use expressive writing as an affordable way to promote maternal mental health for the benefit of both the mother and the child.

Developing the mother-child interaction inventory and uncovering mother-child interaction profiles in Türkiye

BACKGROUND

In this study, we aimed to design a mother-report inventory to comprehensively assess mother-child interaction in the 0-3 age range, focusing on maternal and child interaction behavior and mutual attunement.

METHODS

Our research involved three stages, with 1061 mothers and their 0-3-year-old children: 45 in the pilot study, 498 in exploratory factor analysis and latent profile analysis, and 518 in confirmatory factor analysis.

FINDINGS

The Mother-Child Interaction Inventory emerged as a valid and reliable measurement tool, comprising three distinct scales: 1) Maternal Interaction Behavior Questionnaire with sensitive structuring, hostility, and intrusiveness subscales; 2) Child Interaction Behavior Questionnaire with emotional-behavioral involvement and child characteristics; and 3) Mutual Attunement Questionnaire with reciprocity and problem-solving subscales. Latent profile analysis revealed four mother-child interaction profiles, indicating different characteristics in maternal and child interaction behavior and mutual attunement, categorized as "Excellent interaction quality," "Average interaction quality 1", "Average interaction quality 2," and "Poor interaction quality."

DISCUSSION

The study underscores the significance of maternal and child interaction behavior and mutual attunement in determining the quality of mother-child interaction. The mother-report The Mother-Child Interaction Inventory is a functional measurement tool to evaluate interaction separately and holistically, unveiling mother-child interaction profiles in the Turkish context.

PRACTICE IMPLICATIONS

The practical implications of this research are significant for health professionals, educators, and stakeholders working with children and families. The Mother-Child Interaction Inventory provides a valuable tool for assessing interaction dynamics, offering insights that can be directly applied to improve mother-child interaction.

How Still? Parent-Infant Interaction During the Still-Face and Later Infant Attachment

In the still-face episode of the Face-to-Face/Still-Face (FFSF), parents are asked to become unresponsive. However, infant-parent interaction may be irrepressible, and there is some evidence that interaction during the still-face is associated with attachment outcome. To explore these questions, we independently coded the continuous affective valence of parents and 6-month-old infants (negative to positive) during the FFSF (N=73) and assessed attachment at 15 months with the Strange Situation Procedure (n=66). There was a mean positive correlation between moment-to-moment parent and infant affective valence, indicating synchronous affective interaction during the still-face. Higher levels of affect interaction during the still-face episode were detected in infants later classified as disorganized compared to securely attached. Findings underscore the importance of testing for still-face interaction and suggest that this interaction may be an unappreciated predictor of infant attachment outcomes.

Venturing outside: Local journeying, belonging and new parenthood

The transition to parenthood is a transformative journey marked by numerous adjustments, presenting both physical and mental health challenges. Recognising the crucial role of a sense of belonging for parental health in this transition, this study delves into the experiences of new parents, exploring the act of "journeying" within their local geographies. Through analysis of an online survey among new parents in suburban Wellington, Aotearoa New Zealand, this study highlights the multifaceted role of journeying, not only as physical movement but as a slow-creeping transformative process that affects connections with local environments, people, and places, highlighting the importance of local geographies in new parents' journey towards belonging.

Psychometric properties of the Marschak Interaction Method of Psychometrics and the Assessment of Parent-Child Interaction within residential care and non-referred settings

Introduction

Assessment and identification of children with developmental needs and their interaction with primary caregivers are critical for emotional and social development. However, to the best of our knowledge, there is a scarcity of valid observation-based tools that guide the work with family communication, which is essential for the child's healthy development.

Method

The Marschak Interaction Method of Psychometrics (MIM-P) and Assessment of Parent-Child Interaction (APCI) are both interaction and observation-based assessment tool, and they were explored for their validity and reliability in assessing caregiver-child interaction. The study included 30 trained and certified professionals who recruited referred and non-referred caregiver-child dyads over 11 months. Assessment data was collected from 139 caregiver-child dyads for the MIM-P with 278 individuals (100 referred and 178 non-referred) and 129 caregiver-child dyads for the APCI with 257 individuals (95 referred and 162 non-referred).

Results

The psychometric analyses show that both the MIM-P and APCI presents relevant sources of reliability and validity for assessing caregiver-child interaction including interrater reliability, internal consistency, test re-test reliability as well as concurrent and construct validity.

Discussion and conclusion

The study highlights the need for observation-based assessment tools within social work and contributes to the understanding of the importance of relationships and interaction in children's emotional and social development. However, further research is needed to explore norms and further strengthen implementation and quality of the tools.

Do toys get in the way? The duration of shared emotional experiences is longer when mothers engage their infants without toys

During mother-infant interaction, shared emotional experiences, defined as reciprocal and synchronous emotional sharing between mother and infant, are an indicator of early relational health. Yet, it is unclear how mothers' efforts to engage with their infants relate to dyadic-level shared emotional experiences. Utilizing a sample of 80 randomly selected videos of the NICHD Study of Early Child Care and Youth Development, we examined how mothers' bids for interaction with their 6-month-old infants related to the duration of shared emotional experiences. An event sampling, sequential coding system was used to identify a maternal bid for interaction (i.e., with toy, without toy) and the subsequent presence or absence of a shared emotional experience, including duration of the shared emotional experience. Results indicated that shared emotional experiences were longer following mothers' efforts to engage their infants in play without toys. Findings suggest that methods matter; researchers and practitioners interested in studying and promoting shared emotional experiences between mothers and infants may wish to focus on dyadic interactions without toys.

The Mother-Child Dyad Adipokine Pattern: A Review of Current Knowledge

An important role in the network of interconnections between the mother and child is played by adipokines, which are adipose tissue hormones engaged in the regulation of metabolism. Alternations of maternal adipokines translate to the worsening of maternal insulin resistance as well as metabolic stress, altered placenta functions, and fetal development, which finally contribute to long-term metabolic unfavorable conditions. This paper is the first to summarize the current state of knowledge concerning the concentrations of individual adipokines in different biological fluids of maternal and cord plasma, newborn/infant plasma, milk, and the placenta, where it highlights the impact of adverse perinatal risk factors, including gestational diabetes mellitus, preeclampsia, intrauterine growth restriction, preterm delivery, and maternal obesity on the adipokine patterns in maternal-infant dyads. The importance of adipokine measurement and relationships in biological fluids during pregnancy and lactation is crucial for public health in the area of prevention of most diet-related metabolic diseases. The review highlights the huge knowledge gap in the field of hormones participating in the energy homeostasis and metabolic pathways during perinatal and postnatal periods in the mother-child dyad. An in-depth characterization is needed to confirm if the adverse outcomes of early developmental programming might be modulated via maternal lifestyle intervention.

Associations between Perinatal Sleepiness and Breastfeeding Intentions and Attitudes and Infant Feeding Behaviors and Beliefs

Breastfeeding rates fall short of public health goals, but barriers are poorly understood. We examined whether excessive sleepiness during pregnancy and the postpartum period was associated with breastfeeding intentions, attitudes, initiation, and continuation in a tobacco-exposed sample participating in a randomized controlled trial to reduce smoke exposure (n = 399). We used the Epworth Sleepiness Scale (ESS) to examine associations between excessive sleepiness in early (12-16 weeks gestation) and late (32 weeks gestation) pregnancy and at 6 months postpartum, with breastfeeding attitudes using the Mitra index, intentions, initiation, and continuation, as well as other infant feeding practices using the Infant Feeding Questionnaire. Logistic regression models adjusted for age, racial/ethnic identity, parity, marital status, and maternal education showed that excessive sleepiness in late pregnancy was associated with less favorable attitudes toward breastfeeding. In addition, in unadjusted models, excessive sleepiness at 6 months postpartum was associated with less of a tendency to use feeding to calm a fussy infant. Excessive sleepiness was not associated with intent, initiation, or continuation of breastfeeding. Assessing excessive sleepiness in late pregnancy may assist in identifying individuals with negative attitudes to breastfeeding and lead to novel approaches to promoting breastfeeding in populations with lower breastfeeding rates.

Postpartum Depression and Maternal Care: Exploring the Complex Effects on Mothers and Infants

Postpartum depression (PPD) is a common and debilitating mental health condition affecting many mothers worldwide. This review article aims to explore the complex effects of PPD on mothers and infants, focusing on maternal care. The transition to motherhood is a critical period characterized by numerous physical, psychological, and social changes, making women vulnerable to the onset of PPD. Consequently, PPD can significantly impact a mother's ability to provide optimal care for her infant, leading to potential adverse consequences for both parties. The article synthesizes existing research literature on the topic, encompassing studies from various disciplines, including psychology, psychiatry, obstetrics, and pediatrics. It begins by providing an overview of the prevalence and risk factors associated with PPD, emphasizing the importance of early detection and intervention. The impact of PPD on maternal caregiving behaviors, such as bonding, sensitivity, and responsiveness, is then examined, highlighting the potential disruptions in the mother-infant relationship. Furthermore, the article delves into the potential consequences of impaired maternal care on infant development, including emotional, cognitive, and social domains. Several factors contributing to the complex interplay between PPD and maternal care are discussed, including hormonal changes, psychosocial stressors, and the influence of social support networks. The review also addresses the bidirectional nature of the mother-infant relationship, whereby infant characteristics and behaviors can exacerbate or mitigate the effects of PPD on maternal care. Moreover, the article explores the role of healthcare providers and the importance of implementing effective screening, assessment, and treatment strategies for PPD to promote optimal maternal-infant outcomes. By consolidating current knowledge on the topic, this review article provides valuable insights into the multifaceted effects of PPD on both mothers and infants. Recognizing the significance of maternal care and understanding the mechanisms through which PPD disrupts it can inform the development of targeted interventions to promote early detection, effective treatment, and supportive interventions for mothers experiencing PPD. Ultimately, improving maternal mental health and enhancing maternal-infant relationships can yield long-term positive effects on mothers' and infants' well-being and development.

Parental stress and support perception in southern Italy's households with intellectual disabilities and/or autistic spectrum disorder before and during the COVID-19 pandemic

The stress experienced by parents of persons with Intellectual Disability (ID) and Autism Spectrum Disorder (ASD) is higher than that of parents of neurotypical children (TD). An important protective factor is the perception of the support received within the family and the social network. The emergency of the COVID-19 pandemic had a negative impact on the health of people with ASD/ID and their families. The aim of the study was to describe the levels of parental stress and anxiety before and during the lockdown in southern Italy's families with ASD/ID persons and analyze how the levels of support perceived by these families. 106 parents, the ages of 23 and 74 years (M = 45; SD = 9), from southern Italy responded to an online battery of questionnaires measuring parental stress, anxiety, perception of support and attendance at school activities and rehabilitation centers, before and during lockdown. In addition, descriptive, Chi-Square, MANOVA, ANOVAs, and correlational analyses were conducted. The results showed that during the lockdown, attendance at therapies and extra-moenia activities and participation in school activities drastically dropped. During lockdown, parents felt inadequate. The parental stress and anxiety were moderate, but the perception of support dropped significantly.

Emotional availability in the mother-child relationship for families of young children with autism spectrum disorder in Australia: A cross-sectional survey

BACKGROUND

In families of children with autism spectrum disorder (ASD) the mother-child relationship can be affected by many factors; however, the impacts of maternal broad autism phenotype (BAP) and attachment styles are unknown. This study investigated predictors of emotional availability in the mother-child relationship in families of children with ASD.

METHODS

Mothers (N = 231) of children with ASD living in Australia completed questionnaires assessing emotional availability in the parent-child relationship (mutual attunement, child involvement, affect quality) and mothers' BAP, mental health, adult attachment style and parenting experiences. Hierarchical multiple regressions and a mediation analysis were conducted.

RESULTS

Parent-reported positive parenting experiences was the greatest predictor of mutual attunement, child involvement and affect quality in the parent-child relationship. Maternal stress and anxiety predicted poorer mutual attunement, stress and depressive symptoms predicted less child involvement and anxiety predicted worse affect quality. Negative parenting experiences, maternal anxiety and stress mediated the relationship between BAP and mutual attunement.

CONCLUSION

Interventions combining mental health and parenting support for mothers of children with ASD to bolster emotional availability within the mother-child relationship may be warranted.

Cognitive and Mental Health of Young Mothers' Offspring: A Meta-analysis

BACKGROUND AND OBJECTIVES

The nature and magnitude of the cognitive and mental health risks among the offspring of young mothers is not fully understood. Our objective is to examine the risk of mental disorders in these offspring.

METHODS

Five databases (Medline, Embase, Web of Science, PsycINFO, and CINAHL) were searched from their inceptions until February 2022. Studies were eligible if they assessed offspring of young mothers (&lt;21 years), contained a control group, and assessed any cognitive and/or mental health outcomes. Random-effects meta-analysis was used to generate standardized mean differences (SMDs) in infants (0-3 years), children (4-9), adolescents (10-19), and adults (20+). Methodological bias was assessed using the Newcastle-Ottawa Scale.

RESULTS

51 outcomes were meta-analyzed. Levels of cognitive and learning problems were higher among the infants (SMD = 0.30 [95% confidence interval 0.0-0.55]) and adolescents (SMD = 0.43 [0.24 to 0.62]) of young mothers. Adolescents had more symptoms of delinquency (SMD = 0.24 [0.12 to 0.36]). As adults, they are more often convicted of violent crimes (SMD = 0.36 [0.22 to 0.50]). Internalizing symptoms were higher in these offspring in childhood (SMD = 0.29 [0.14 to 0.45]) and adulthood (SMD = 0.35 [0.34 to 0.36]). This review uses unadjusted data and is thus unequipped to infer causality. Studies have high attrition and rely heavily on self-report.

CONCLUSIONS

Young mothers' offspring have more cognitive, externalizing, and internalizing problems across the lifespan than individuals born to mothers ≥21 years of age. They may benefit from early detection and support.

A proportionate, universal parenting programme to enhance social-emotional well-being in infants and toddlers in England: the E-SEE Steps RCT

Background

Mental disorders have become a public health crisis. Early prevention is key. Parenting programmes are effective for children aged ≥ 3 years; however, there is a lack of evidence of their effectiveness for children aged ≤ 2 years.

Objectives

To establish if the model named Enhancing Social–Emotional Health and Well-being in the Early Years (E-SEE) Steps can (1) enhance child social emotional well-being and establish whether or not it is cost-effective at 20 months of age when compared with services as usual; and (2) be delivered as a proportionate universal model with fidelity.

Design

A pragmatic two-arm randomised controlled trial and economic appraisal, with an embedded process evaluation to examine the outcomes, implementation and cost-effectiveness of the intervention, and intervention uptake, compared with services as usual. The study had an external pilot phase (which was originally planned as an internal pilot).

Setting

The intervention was delivered in community settings by early years children’s services and/or public health staff in four sites.

Participants

A total of 341 parents of infants aged ≤ 8 weeks were randomised in a ratio of 5 : 1 (intervention, n = 285; control, n = 56). The target sample was 606 parents.

Intervention

Two Incredible Years® parenting programmes (i.e. infant and toddler) delivered in a proportionate universal model with three levels [one universal (book) and two targeted group-based parenting programmes].

Main outcome measures

Child social and emotional well-being (primary outcome) was assessed using the Ages and Stages Questionnaire: Social and Emotional, 2nd edition, at 2, 9 and 18 months after randomisation. Parent depression (secondary key outcome) was assessed using the Patient Health Questionnaire-9 items. Both questionnaires were eligibility screeners for targeted groups.

Results

The primary outcome analysis provided no evidence that the E-SEE Steps model was effective in enhancing child social and emotional well-being. The adjusted mean difference was 3.02 on the original Ages and Stages Questionnaire: Social and Emotional, 2nd edition, in favour of the control [95% confidence interval –0.03 to 6.08; p = 0.052; N = 321 (intervention, n = 268; control, n = 53)]. Analysis of the key secondary outcome (i.e. parent depression levels as assessed by the Patient Health Questionnaire-9 items) provided weak evidence on the Patient Health Questionnaire-9 items in favour of the intervention (adjusted mean difference –0.61, 95% confidence interval –1.34 to 0.12; p = 0.1). Other secondary outcomes did not differ between arms. The economic analysis showed that the E-SEE Steps model was associated with higher costs and was marginally more effective (0.031 quality-adjusted life-years gained from E-SEE Steps compared with SAU, 95% confidence interval –0.008 to 0.071) than services as usual, resulting in an incremental cost-effectiveness ratio of approximately £20,062 per quality-adjusted life-year compared with services as usual. Overall take-up of the targeted parenting programmes was low. Sites, although enthusiastic, identified barriers to delivering the intervention.

Limitations

The target sample size was not met and the study was not powered to explore the effectiveness of each level of intervention. Most parents in the sample were well educated and, therefore, the results are unlikely to be generalisable, particularly to those at greatest risk of poor social and emotional well-being.

Conclusions

The E-SEE Steps proportionate universal model did not enhance child social and emotional well-being, but generated non-significant improvements in parent health outcomes, resulting in considerable uncertainty around the cost-effectiveness of the intervention. The primary and key secondary outcome gave inconsistent signals. Although, with system changes, increased resources and adaptations to the intervention, the model could be implemented, evidence for positive outcomes from the E-SEE Steps model is poor.

Future work

The universal-level E-SEE Step data (i.e. the Incredible Years book) from the external pilot will be pooled with the main trial data for further exploration up to follow-up 1, which is the time point at which most change was seen.

Trial registration

This trial is registered as ISRCTN11079129.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 8. See the NIHR Journals Library website for further project information.

Fostering Emotional Availability in Mother-Child-Dyads With an Immigrant Background: A Randomized-Controlled-Trial on the Effects of the Early Prevention Program First Steps

Background

In many Western countries like Germany, the social integration of children with an immigrant background has become an urgent social tasks. The probability of them living in high-risk environments and being disadvantaged regarding health and education-related variables is still relatively higher. Yet, promoting language acquisition is not the only relevant factor for their social integration, but also the support of earlier developmental processes associated with adequate early parenting in their first months of life. The Emotional Availability Scales (EAS) measure the quality of caregiver-child-interactions as an indicator of the quality of their relationship and thus of such early parenting, focusing on mutual and emotional aspects of their interaction.

Method

This pilot study examined in a randomized controlled trial the effects of the prevention project First Steps regarding the hypothesis that the Emotional Availability (EA) improved to a greater extent in "difficult-to-reach" immigrant mother-child dyads in a psychoanalytically oriented early intervention (A, FIRST STEPS) compared to a usual care intervention (B) offered by paraprofessionals with an immigrant background. A sample of N = 118 immigrant women in Germany from 37 different countries and their children was compared with regard to the parental EA-dimensions sensitivity, structuring, non-intrusiveness and non-hostility and the child dimensions responsiveness to and involvement of the caregiver in the pre-post RCT design.

Results and Conclusion

Different from what was expected, repeated ANOVAs revealed no significant pre-post group differences for the parental dimensions. For the child dimensions the effect of time of measurement was highly significant, which can be interpreted as mostly natural developmental effects. Still, on the level of simple main effects for each intervention, only in the FIRST STEPS groups child responsiveness significantly improved. When controlled for confounding variables, a significant interaction effect for maternal sensitivity in favor of the FIRST STEPS intervention was found. The systematic group differences indicate that the more extensive and professional intervention, focusing on the individual needs of the participants, is more suitable to support the quality of the mother-child-relationship amongst immigrant mother-child dyads than usual care. The results are discussed taking into account the context of the maternal migration process and potential maternal traumatization.

Clinical Trial Registration

[https://clinicaltrials.gov], identifier [DRKS00004632].

The porridge-like framework: A multidimensional guidance to support parents of children with developmental disabilities

Parents of children with developmental disabilities face many daily challenges that can lead to emotional and affective problems, difficulties in caregiving, and partial mental representations about themselves and their children. The multi-faceted nature of these parents' needs requires a multi-component approach that should include the analysis of priority support goals and the planning of tailored therapeutic actions. Despite different types of validated interventions are available, the choice of the most appropriate strategy to pursue a family-centered approach to support parents of infants with developmental disabilities is not obvious. In this scenario, we propose a multi-dimensional model, the porridge-like framework of parenting. It considers three interrelated domains in parents' experience - affective (A), behavioral (B), and cognitive (C) aspects - that are intertwined with the specific degree of the child's impairment (D). This ABCD model may provide professionals with pragmatically valid guidance to plan and deliver family-centered healthcare interventions. By covering the multi-dimensional nature of parenting challenges, it provides clinicians with conceptual categories to recognize the specific needs and to choose the most suitable therapeutic action to address them. In addition, it aims to promote an ethical approach to family-centered rehabilitation for children with developmental disabilities, maximizing the potentials of a collaborative assessment approach.

Maternal Alexithymic Traits Are Related to Lower Maternal Sensitivity and Higher Hostility in Maternal Caregiving Behavior-The FinnBrain Birth Cohort Study

Background: The quality of parental caregiving behavior with their child plays a key role in optimal mother–infant interaction and in supporting child adaptive development. Sensitive caregiving behavior, in turn, requires the ability to identify and understand emotions. Maternal alexithymia, with difficulties in identifying and describing feelings or emotions, as well as a concrete way of thinking, could potentially complicate the quality of caregiving. In this study, we aim to explore the possible association between maternal alexithymic traits and the quality of maternal caregiving behavior.

Methods: The study sample consisted of 158 mother–infant dyads within the FinnBrain Birth Cohort Study population with an available report of maternal alexithymic traits at 6 months postpartum and observational data on maternal caregiving behavior at 8 months postpartum. Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20) including three alexithymia dimensions—Difficulty Identifying Feelings, Difficulty Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Maternal caregiving behavior was assessed using the Emotional Availability Scale and in this study, all four parent dimensions (Sensitivity, Structuring, Non-intrusiveness and Non-hostility) were included. Maternal depressive and anxiety symptoms at 6 months postpartum were controlled for as potential confounders. In addition, background factors of mother's age and gestational weeks at the time of child birth, maternal educational level, monthly income and parity, as well as relationship status and the gender of the baby were assessed.

Results: Maternal TAS-20 total score correlated negatively with Sensitivity (r = −0.169, p = 0.034) and with non-intrusiveness (r = −0.182, p = 0.022). In addition, maternal DDF correlated negatively with Sensitivity (r = −0.168, p = 0.035) and EOT with Non-hostility (r = −0.159, p = 0.047). Furthermore, in regression analyses with controlling for the associated background factors, maternal total score of alexithymic traits (p = 0.034, η²p = 0.029) and higher DDF (p = 0.044, η²p = 0.026) remained significantly associated with lower Sensitivity and higher EOT remained significantly associated with lower Non-hostility (p = 0.030, η²p = 0.030).

Conclusions: In this explorative study we found preliminary evidence for the hypothesis that higher maternal alexithymic traits associate with lower maternal sensitivity and more hostile maternal caregiving behavior. Further studies are needed to explore these hypotheses and to investigate their possible implications for child development.

The Paternal Brain in Action: A Review of Human Fathers' fMRI Brain Responses to Child-Related Stimuli

As fathers are increasingly involved in childcare, understanding the neurological underpinnings of fathering has become a key research issue in developmental psychobiology research. This systematic review specifically focused on (1) highlighting methodological issues of paternal brain research using functional magnetic resonance imaging (fMRI) and (2) summarizing findings related to paternal brain responses to auditory and visual infant stimuli. Sixteen papers were included from 157 retrieved records. Sample characteristics (e.g., fathers’ and infant’s age, number of kids, and time spent caregiving), neuroimaging information (e.g., technique, task, stimuli, and processing), and main findings were synthesized by two independent authors. Most of the reviewed works used different stimuli and tasks to test fathers’ responses to child visual and/or auditory stimuli. Pre-processing and first-level analyses were performed with standard pipelines. Greater heterogeneity emerged in second-level analyses. Three main cortical networks (mentalization, embodied simulation, and emotion regulation) and a subcortical network emerged linked with fathers’ responses to infants’ stimuli, but additional areas (e.g., frontal gyrus, posterior cingulate cortex) were also responsive to infants’ visual or auditory stimuli. This review suggests that a distributed and complex brain network may be involved in facilitating fathers’ sensitivity and responses to infant-related stimuli. Nonetheless, specific methodological caveats, the exploratory nature of large parts of the literature to date, and the presence of heterogeneous tasks and measures also demonstrate that systematic improvements in study designs are needed to further advance the field.

Development and validation of the maternal blues scale through bonding attachments in predicting postpartum blues

BACKGROUND

Postpartum blues in Indonesia has a high prevalence at 37% to 67%. Postpartum blues syndrome has been described as varying changes in the affective domain, such as feelings, behavior, or thoughts, that can be influenced by the roles and tasks of women, along with their social, cultural, and economic support. Instruments that measure maternal blues through bonding attachment behavior have never before been developed in Indonesia.

OBJECTIVE

This study aimed to develop a maternal blues scale through bonding attachments to predict postpartum blues.

METHOD

The research design consisted of three stages: 1) phenomenology design and focus group discussion; 2) development and construction of the maternal blues scale, and 3) a cross-sectional study to measure validation of the scales. Respondents were postpartum mothers in the first week after birth. The sample comprised 501 participants. Sampling was done by consecutive sampling at the Public Health Center (PUSKESMAS) in the South Jakarta area. Data analysis used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), correlation, and a diagnostic testing .

RESULTS

Item analysis produced 32 items consisting of 24 items regarding the mother's role and duties as internal factors and eight factors involving social, cultural, and economic support as external factors. Both factors were valid and reliable in predicting postpartum blues with indicators (t loading factors ≥ 1.96, standardized loading factor (SLF) ≥.50, internal factors: construct reliability (CR) ≥ .70 and extraction variants (VE) ≥ .50 and external factors: CR ≥ .74 to .83 VE ≥ .50 to .63). The relationship with Kennerley's maternity blues as a gold standard was significant. Internal factors had a score of 53, with a sensitivity of 60.2%. The external factors score was 19, with a sensitivity of 77.3%.

CONCLUSION

The new scale for postpartum blues prediction developed displayed internal consistency and validity of each indicator (internal and external factors) that was good (CR ≥ .70; VE ≥ .50). This scale provides a feasible tool to predict postpartum blues.

Positive Youth Development: Parental Warmth, Values, and Prosocial Behavior in 11 Cultural Groups

The current cross-cultural study aimed to extend research on parenting and children's prosocial behavior by examining relations among parental warmth, values related to family obligations (i.e., children's support to and respect for their parents, siblings, and extended family), and prosocial behavior during the transition to adolescence (from ages 9 to 12). Mothers, fathers, and their children (N = 1107 families) from 8 countries including 11 cultural groups (Colombia; Rome and Naples, Italy; Jordan; Kenya; the Philippines; Sweden; Thailand; and African Americans, European Americans, and Latin Americans in the United States) provided data over 3 years in 3 waves (Mage of child in wave 1 = 9.34 years, SD = 0.75; 50.5% female). Overall, across all 11 cultural groups, multivariate change score analysis revealed positive associations among the change rates of parental warmth, values related to family obligations, and prosocial behavior during late childhood (from age 9 to 10) and early-adolescence (from age 10 to 12). In most cultural groups, more parental warmth at ages 9 and 10 predicted steeper mean-level increases in prosocial behavior in subsequent years. The findings highlight the prominent role of positive family context, characterized by warm relationships and shared prosocial values, in fostering children's positive development in the transition to adolescence. The practical implications of these findings are discussed.

Caring for the mother-child dyad as a family physician

Infant social, emotional and neurological development is shaped by the mother-child dyad. Dysfunction in this bond, as well as maternal mental health problems, can negatively impact child development. The family physician is well-placed to spot dysfunction in the mother-child dyad and screen for postnatal depression during well-child visits. If any issues are identified, the family physician can provide support and help the mother-child dyad to access community resources and specialist psychiatric services.

Early Parenting Intervention - Biobehavioral Outcomes in infants with Neurodevelopmental Disabilities (EPI-BOND): study protocol for an Italian multicentre randomised controlled trial

INTRODUCTION

Neurodevelopmental disability (ND) represents an adverse condition for infants' socio-emotional and behavioural development as well as for caregiving (eg, parental sensitivity) and mother-infant interaction. Adverse exposures are associated with altered neuroendocrine hormones concentrations (eg, oxytocin and cortisol) and epigenetic regulation (eg, methylation of stress-related genes), which in turn may contribute to less-than-optimal mother-infant interaction. Parental sensitivity is a protective factor for childrens' development and early parental interventions (eg, video-feedback intervention) can promote parental caregiving and better developmental outcomes in children. The present multi-centric and longitudinal randomised controlled trial aims to assess if and to which extent early VFI could benefit both infants and mothers in terms of behavioural outcomes as well as neuroendocrine and epigenetic regulation.

METHODS AND ANALYSIS

Dyads will be randomly assigned to the video-feedback Intervention Group or Control Group ('dummy' intervention: telephone calls). Infants with ND aged 3 to 18 months will be recruited from three major child neuropsychiatric units in northern Italy. A multi-layer approach to intervention effects will include videotapes of mother-infant interaction, maternal reports as well as saliva samples for hormones concentrations and target-gene methylation analysis (eg, BDNF, NR3C1, OXTR and SCL6A4) that will be obtained at each of the four assessment sessions: T₀, baseline; T₁, post-intervention; T₂, short-term follow-up (3 month); T₃, long-term follow-up (6 month). Primary effectiveness measures will be infant socio-emotional behaviour and maternal sensitivity. Neuroendocrine hormones concentrations and DNA methylation status of target genes will be secondary outcomes. Feasibility, moderation and confounding variables will be measured and controlled between the two groups.

ETHICS AND DISSEMINATION

Ethics approval has been obtained in all three participating units. Results of the main trial and each of the secondary endpoints will be submitted for publication in peer-reviewed journals and international conferences.

TRIAL REGISTRATION NUMBER

NCT03853564; Pre-results.

Maternal trauma and emotional availability in early mother-infant interaction: findings from the Mercy Pregnancy and Emotional Well-being Study (MPEWS) cohort

Understanding how a mother's traumatic experiences influence her interactions with her infant may have importance for understanding infant development and mental health. Data for this study were drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Maternal trauma from Childhood, Childbirth Experiences, and Stressful Life Events were examined. At six-months postpartum, 211 predominantly first-time mothers (mean age 31.5 years), and their infants, were video-recorded interacting for 40 minutes. Interactions were assessed with the Emotional Availability (EA) Scales. Using structural equation modelling to test multiple mediation pathways, moderate-to-severe childhood trauma had only a direct effect on reducing maternal EA with the infant (β=-.17, p=.031), as did current stressful life events (β=-.19, p=.019), after controlling for maternal depression, age, and tertiary education. This highlights that proximate trauma specific to the perinatal period may not account for the effect of distal childhood trauma on maternal EA at six-months postpartum.

The practical utility of the Welch Emotional Connection Screen for rating parent-infant relational health

Emotional Connection (EC) measured by the Welch Emotional Connection Screen (WECS) was related to the Parent-Infant Interaction Rating System (PIIRS), a 5-point adaptation of the rating system developed for the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (e.g., NICHD Early Child Care Research Network, 1999, Developmental Psychology, 35, 1399). Parent-infant dyads (n = 49 mothers; 43 fathers) were videotaped during face-to-face interaction at infant age 6 months; interactions were coded with both the WECS and PIIRS. At age 3, mothers completed the Child Behavior Checklist. WECS ratings of EC were associated with PIIRS rating items for both mother-infant and father-infant dyads. Mother-infant EC related positively to maternal sensitivity and positive regard for child, child positive mood and sustained attention, and dyadic mutuality, and negatively with maternal intrusiveness. Father-infant EC related positively to fathers' positive regard for child, child positive mood and sustained attention, and dyadic mutuality. Mother-infant EC predicted child behavior problems at age 3 better than mother-infant PIIRS ratings of dyadic mutuality. With fathers, neither EC nor dyadic mutuality ratings predicted mother-reported child behavior problems. Findings highlight the practical utility of the WECS for identifying potentially at-risk dyads and supporting early relational health.

Mediators of childhood trauma and suicidality in a cohort of socio-economically deprived Scottish men

BACKGROUND

There is little research investigating the relationship between childhood abuse, including neglect, and suicidality in adult men, despite epidemiological data suggesting that they are most at risk for suicide.

OBJECTIVE

To investigate the relationship between childhood abuse and neglect and suicidality, and the possible mediating roles of affect dysregulation and social inhibition.

PARTICIPANTS AND SETTING

a cohort of eighty-six socio-economically deprived male Caucasian participants previously identified as suicidal, attending a non-clinical community group.

METHODS

Participants completed self-report measures on childhood trauma, emotion regulation, interpersonal difficulties and suicidal behavior.

RESULTS

Mediation analysis indicated that emotion dysregulation and interpersonal difficulties significantly mediated the relationship between childhood trauma and suicidality with a medium effect size (R² = .41, p < .001).

CONCLUSIONS

Study results suggest that early childhood abuse and neglect results in dysfunctional emotion regulation, which leads to suicidality in the context of impoverished social environments. The provision of psychological interventions aimed at improving social and emotional functioning may help to safeguard men who are most at risk of suicide.

Persistence of Effects of VLBW/PT Birth Status and Maternal Emotional Availability (EA) on Child EA Trajectories

Few studies have examined the longitudinal impact of birth status on the infant-mother relationship and on children's socio-emotional development. In the present study we investigated developmental patterns of such relationships [using the Emotional Availability (EA) Scales] in fullterm and VLBW/PT infants from infancy to emerging school age. Our objectives were to: (a) model the developmental trajectories of EA dimensions (maternal sensitivity, structuring, non-hostility; child responsiveness, involvement) in a VLBW/PT and fullterm sample, (b) identify potential effects of VLBW/PT status on these trajectories, and (c) determine whether the effects of VLBW/PT status on children's socio-emotional development (child EA) remained after accounting for the effect of maternal EA. Child-mother dyads (n = 109) were observed in home-based interactions (face-to-face and free play) when children were 6, 12, 18, and 57-months-old in fullterm (37-41 weeks, >2500 g; n = 48) and healthy VLBW/PT (26-32 weeks gestation, birth weight 800-1500 g, corrected for gestational age; n = 61) children. Developmental trajectories of maternal and child EA were assessed using multilevel growth modeling in Mplus. Results indicated that, even after controlling for maternal EA, there was a persistent negative effect of VLBW/PT birth status on child EA trajectories. Both initially and over time, VLBW/PT infants lagged behind their fullterm counterparts on levels of responsiveness and involvement with mothers. There was also a persistent positive effect of maternal EA (sensitivity and structuring) on child EA trajectories. Higher average levels of maternal sensitivity and structuring across time were also associated with higher and persistent levels of child responsiveness and involvement of their mothers. Importantly, results held after modeling both effects together, and after controlling for maternal education and child gender. Our results have implications for VLBW/PT children's development, the parent-child relationship, and integrating family level factors and relationship dimensions in early prevention and intervention programs.

Developmental patterns of change in mother and child emotional availability from infancy to the end of the preschool years: A four-wave longitudinal study

In this four-wave longitudinal study, we examined intraindividual developmental patterns of change in mother-child emotional availability (EA) during infancy and the preschool years, the factors that promote or hinder it, and the longitudinal within-dyad association between maternal and child EA. Mother-infant dyads (N = 56) were observed at home when children were 6,12, 18 and 55-months-old. Multilevel growth modeling revealed that mother and child EA follow distinct trajectories across time. While maternal EA was found to be stable, a significant increase in child EA was found across the infancy years and into preschool. The results from the study also provide evidence for a sustained within-dyad relation between mother and child EA across time and suggest that mother, child, and contextual factors can create variations in the trajectories of maternal EA over time. The findings lead to a deeper understanding of the intraindividual changes that occur in mother and child EA across the infancy years and into preschool and the factors that can promote or hinder it.

The Face-to-Face Still-Face (FFSF) Paradigm in Clinical Settings: Socio-Emotional Regulation Assessment and Parental Support With Infants With Neurodevelopmental Disabilities

Background: The Face-to-Face Still-Face (FFSF) paradigm is a well-acknowledged procedure to assess socio-emotional regulation in healthy and at-risk infants. Although it was developed mainly for research purposes, the FFSF paradigm has potential clinical implications for the assessment of socio-emotional regulation of infants with neurodevelopmental disabilities (ND) and to supporting parenting. Aim: The present paper describes the application of the FFSF paradigm as an evaluation and intervention tool in clinical practice with infants with ND and their parents. Methods: Theoretical and methodological insights for the use of the FFSF paradigm in the clinical setting are provided. Single-case vignettes from clinical practice further illustrate and provide exemplifications for the use of the FFSF with infants with ND and their parents. Results: From a clinical point of view, the use of the FFSF paradigm (1) offers a unique observational perspective on socio-emotional regulation in infants with ND and (2) enhances parents' sensitivity to their infants' behavior. Discussion: The FFSF paradigm appears to be a useful tool for clinical assessment of socio-emotional regulation in infants with ND and promote the quality of parenting and early parent-infant interaction.

Emotional Availability Scale Among Three U.S. Race/Ethnic Groups

This study used a cross-sectional design to conduct a subgroup psychometric analysis of the Emotional Availability Scale among matched Hispanic ( n = 20), African American ( n = 20), and European American ( n = 10) English-speaking mother-child dyads in the United States. Differences by race/ethnicity were tested ( p < .05) among (a) Emotional Availability Scale dimensions with ANOVA, and (b) relationships of Emotional Availability Scale dimensions with select Dyadic Parent-Child Interaction Coding System variables with Pearson correlation and matched moderated regression. Internal consistency was .950 (Cronbach's α; N = 50). No significant differences in the six Emotional Availability Scale dimension scores by race/ethnicity emerged. Two Dyadic Parent-Child Interaction Coding System behaviors predicted two Emotional Availability Scale dimensions each for Hispanic and African American mother-child dyads. Results suggest emotional availability similarity among race/ethnic subgroups with few predictive differences of emotional availability dimensions by specific behaviors for Hispanic and African American subgroups.

The parental bonds of adolescent girls and next-generation maternal-infant bonding: findings from the Victorian Intergenerational Health Cohort Study

The purpose of this study was to examine the extent to which adolescent bonding problems with parents predict next-generation maternal-infant bonding problems at 2 and 12 months postpartum. Data were from a two-generation prospective cohort study of 1026 offspring (3 perinatal waves) born to participants of a two-decade (10-wave) study of 1943 adolescents. Dyads in this analysis were 395 mothers (29-36 years) of 606 offspring (305 female). At 16 years, we assessed adolescents' perceptions of their mother's and father's care and control, separately and in combination. Subsequently, when participants were adult mothers of infants 2 and 12 months postpartum, we assessed impaired maternal-infant bonding, infant-directed rejection-anger, and caregiving anxiety. Adolescent-parent bonding problems were strongly predictive of women's subsequent bonding problems with infants. In particular, impaired postpartum maternal bonding was predicted by adolescent reports of low paternal care (12 months: OR=3.1, 95% CI 1.1-8.6) and high maternal control (12 months: OR=3.7, 95% CI 1.4-9.7). In combination, high maternal control and low paternal control also predicted impaired postpartum bonding (2 months: OR=5.0, 95% CI 1.3-20; 12 months: OR=12, 2.6-56), caregiving anxiety (2 months: OR=4, 95% CI 1.5-11; 12 months: OR=8.8, 95% CI 1.8-43), and rejection/anger (12 months: OR=4.1, 95% CI 1.0-16). Further combinations of care and overprotection that significantly predicted postpartum bonding problems are presented. Our results indicate that adolescent girls who experience high maternal control and low paternal care are at higher risk for subsequent maternal-infant bonding problems. The strength of associations suggests that interventions should begin well before pregnancy.

Patterns of Emotional Availability between Mothers and Young Children: Associations with Risk Factors for Borderline Personality Disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low-socioeconomic backgrounds, 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non-intrusiveness, non-hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over-responsiveness and over-involvement. Using person-centered analyses, we identified four clusters: high-functioning, low-functioning, asynchronous (mothers above average on two of four dimensions, children below) and below average. Mothers in the low-functioning cluster had lower income, less social support, more of the borderline feature of negative relationships and more depression than did mothers in the high-functioning cluster. The children in the low-functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother-child relationship in their stories) than did children in the high-functioning group. The asynchronous group included older girls who were over-responsive and over-involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Emotional interactions in European American mother-infant firstborn and secondborn dyads: A within-family study

The developmental science literature is riven with respect to (a) parental similar versus different treatment of siblings and (b) sibling similarities and differences. Most methodologies in the field are flawed or confounded. To address these issues, this study employed a within-family longitudinal design to examine developmental processes of continuity and stability in emotional interactions in mothers with their firstborn and secondborn 5-month-old infants (ns = 61 mothers and 122 infants). As independently rated by the Emotional Availability Scales, mothers' observed and coded behavioral expressions of sensitivity, structuring, nonintrusiveness, and nonhostility were consistent in group mean levels between firstborns and secondborns and (largely) between daughters and sons. Neither firstborns and secondborns, nor girls and boys, differed in their responsiveness or involvement of mother. However, mothers' emotional interactions with their firstborn and secondborn children were uncorrelated, as were firstborn and secondborn infants' interactions with their mother. These group-mean consistencies and individual-differences inconsistencies in emotional interactions are discussed in relation to the shared and nonshared lives of siblings in the same family. (PsycINFO Database Record

THE FEASIBILITY OF USING "PREMIESTART," A MOTHER-PREMATURE INFANT INTERACTION PROGRAM, ON A NEONATAL UNIT IN ENGLAND

This article explores the feasibility of running "PremieStart," a nine-individual-session maternal-premature infant interaction program, within a neonatal unit (NNU) in England. Four mothers of premature infants completed seven sessions on the NNU and two at home. Mothers and NNU staff provided feedback on PremieStart. Measures of maternal-infant relationship, maternal well-being, and maternal reflective functioning were completed before and after intervention. Thematic analysis of mothers' feedback highlighted the emotional, but cathartic, experience of engaging with PremieStart. NNU staff feedback indicated the need to include them more in PremieStart. Both mothers and staff were supportive of future implementation of PremieStart and highlighted the ongoing need for psychological support on the NNU. PremieStart was implemented with positive feedback from mothers and staff, with support shown for the continued use of PremieStart in the NNU. However, for future implementation, the self-report outcome measures need reviewing, and more involvement of fathers and NNU staff is needed. In addition, a larger sample with a control group should be utilized.

Emotional Availability Modulates Electrophysiological Correlates of Executive Functions in Preschool Children

Executive functions (EFs) – a set of cognitive control abilities – mediate resilience to stress and are associated with academic achievement and health throughout life. They are crucially linked to prefrontal cortex function as well as to other cortical and subcortical brain functions, which are maturing throughout childhood at different rates. Recent behavioral research suggested that children’s EFs were related to parenting quality and child attachment security, but the neural correlates of these associations are unknown. With this study we tested in 4- to 6-year-old healthy children (N = 27) how emotional availability (EA) of the mother-child-interaction was associated with behavioral and electrophysiological correlates of response inhibition (a core EF) in a Go/Nogo task, using event-related potential recordings (ERPs), and with behavioral performance in a Delay of Gratification (DoG) and a Head-Toes-Knees-Shoulders task (HTKS). Our data showed that the Go/Nogo task modulated children’s ERP components resembling adult electrophysiological indices of response inhibition - the N2 and P3/LPC ERPs-, but the children’s N2 and P3/LPC ERPs showed longer latencies. Higher maternal autonomy-fostering behavior and greater child responsiveness were significantly associated with smaller children’s N2 Go/Nogo effects at fronto-central and parietal sites and with greater Go/Nogo effects in the N2 time window at occipital sites, over and above children’s age and intelligence. Additionally, greater maternal sensitivity and a higher dyadic EA quality of the mother-child-interaction went along with greater occipital Go/Nogo effects in the N2 time window, but this effect clearly diminished when we controlled for children’s age and intelligence. Higher maternal autonomy-support was also positively associated with better HTKS performance, and higher dyadic EA quality went along with higher HTKS and DoG scores. However, no significant associations were found between EA variables and the behavioral response inhibition measures of the Go/Nogo task. Our results suggest that parenting qualities modulate the functionality of neural circuits involved in response inhibition, an important component of EFs. This finding, thus, indicates that parent–child interactions shape the neurocognitive development underlying EFs.

Maternal depression and the learning-promoting effects of infant-directed speech: Roles of maternal sensitivity, depression diagnosis, and speech acoustic cues

The hypothesis that the associative learning-promoting effects of infant-directed speech (IDS) depend on infants' social experience was tested in a conditioned-attention paradigm with a cumulative sample of 4- to 14-month-old infants. Following six forward pairings of a brief IDS segment and a photographic slide of a smiling female face, infants of clinically depressed mothers exhibited evidence of having acquired significantly weaker voice-face associations than infants of non-depressed mothers. Regression analyses revealed that maternal depression was significantly related to infant learning even after demographic correlates of depression, antidepressant medication use, and extent of pitch modulation in maternal IDS had been taken into account. However, after maternal depression had been accounted for, maternal emotional availability, coded by blind raters from separate play interactions, accounted for significant further increments in the proportion of variance accounted for in infant learning scores. Both maternal depression and maternal insensitivity negatively, and additively, predicted poor learning.

Ebb and Flow in Parent-Child Interactions: Shifts from Early through Middle Childhood

OBJECTIVE

This study documents the strength of relations between key parent and child behaviors as they occur during typical encounters for both mothers and fathers and determines whether there were shifts in the strength of relations between parent and child behaviors during early and middle childhood.

DESIGN

Multivariate multi-level modeling was used to examine associations between three parent behaviors (respect for autonomy, stimulation of development, hostility) and two child behaviors (agency, negativity) as they occurred in typical parent-child activities at four time points from 54 months through 5th grade for 817 families.

RESULTS

For mothers and fathers, respect for autonomy and stimulation were associated with child agency. Paternal hostility was negatively associated with child agency, but for mothers the relation became more positive with age. Parental respect for autonomy and hostility were associated with child negativity for both mothers and fathers; however, for mothers, relations between autonomy support and child negativity became more positive, and relations between hostility and child negativity became less positive.

CONCLUSIONS

There are clear shifts in the strength of relations between some parenting behaviors and child behaviors from early to middle childhood, indicative of a changing dialectic as children become more independent and different dialectics for mothers and fathers. Parenting behavior links to child competence and adaptive behavior, and the findings may help resolve some uncertainties about relations between parental behavior and children's developmental trajectories.

Associations Between Parental Attachment and Course of Depression Between Adolescence and Young Adulthood

A study of the associations of maternal, paternal and peer attachment with the course of depression from adolescence to young adulthood. In the Youth and Mental Health study 242 adolescents completed the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version for depressive disorders at age 15 and 20. Attachment was measured with the inventory for parent and peer attachment, separately for mother, father, and peers, at age 15. Multinomial logistic regression, indicated insecure attachment relationships with both parents, but not with peers, and were associated with the course of depression. Less secure attachment to mothers was associated with becoming depressed. Less secure attachment to both parents was associated with becoming well and remaining depressed. These results suggest attachment relationships with parents as potential influences on the course of depression and may provide important framework for clinical work with adolescents and young adults.

Maternal responsiveness and sensitivity reconsidered: some is more

Is it always or necessarily the case that common and important parenting practices are better, insofar as they occur more often, or worse, because they occur less often? Perhaps, less is more, or some is more. To address this question, we studied mothers' microcoded contingent responsiveness to their infants (M = 5.4 months, SD = 0.2) in relation to independent global judgments of the same mothers' parenting sensitivity. In a community sample of 335 European American dyads, videorecorded infant and maternal behaviors were timed microanalytically throughout an extended home observation; separately and independently, global maternal sensitivity was rated macroanalytically. Sequential analysis and spline regression showed that, as maternal contingent responsiveness increased, judged maternal sensitivity increased to significance on the contingency continuum, after which mothers who were even more contingent were judged less sensitive. Just significant levels of maternal responsiveness are deemed optimally sensitive. Implications of these findings for typical and atypical parenting, child development, and intervention science are discussed.