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Andreasen K, Fernandez Lopez R, Wu C, Linde DS, Oviedo-Gutiérrez A, López Megías J, Martín-de-Las-Heras S, Ludmila Zapata-Calvente A, Ankerstjerne L, de-León-de-León S, Dokkedahl S, Schei B, Rasch V. The effect of a digital intervention on symptoms of depression in pregnant women exposed to Intimate partner violence in Denmark and Spain (STOP study). Eur J Obstet Gynecol Reprod Biol 2024; 301:120-127. [PMID: 39121647 DOI: 10.1016/j.ejogrb.2024.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/21/2024] [Accepted: 07/09/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION AND OBJECTIVE Intimate Partner Violence (IPV) during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women. STUDY DESIGN This intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the Abuse Assessment Screen (AAS) and the Women's Abuse Screening Tool (WAST). Those screening positive were offered a digital intervention comprising 3-6 video consultations with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression. RESULTS From February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) was found, with a mean difference of -3.9 (95 % CI: -5.3; -2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. CONCLUSION The findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.
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Affiliation(s)
- Karen Andreasen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Odense, Denmark.
| | | | - Chunsen Wu
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Ditte S Linde
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | | | - Jesús López Megías
- Brain and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain
| | - Stella Martín-de-Las-Heras
- Biomedical Research Institute IBIMA, University of Malaga, Malaga, Spain; Department of Forensic Medicine, University of Malaga, Malaga, Spain
| | | | - Lea Ankerstjerne
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | | | - Sarah Dokkedahl
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Berit Schei
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Institute of Public Health, Norwegian University of Science and Technology; St. Olav's Hospital, Trondheim University Hospital, Trondhjem, Norway
| | - Vibeke Rasch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
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Dufford AJ, Patterson G, Kim P. Longitudinal neuroanatomical increases from early to one-year postpartum. Brain Struct Funct 2024:10.1007/s00429-024-02852-x. [PMID: 39299954 DOI: 10.1007/s00429-024-02852-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 08/13/2024] [Indexed: 09/22/2024]
Abstract
Preclinical studies have provided causal evidence that the postpartum period involves regional neuroanatomical changes in 'maternal' brain regions to support the transition to offspring caregiving. Few studies, in humans, have examined neuroanatomical changes from early to one-year postpartum with longitudinal neuroimaging data and their association with postpartum mood changes. In the present study, we examined longitudinal changes in surface morphometry (cortical thickness and surface area) in regions previously implicated in the transition to parenthood. We also examined longitudinal volumetric neuroanatomical changes in three subcortical regions of the maternal brain: the hippocampus, amygdala, and ventral diencephalon. Twenty-four participants underwent longitudinal structural magnetic resonance imaging at 1-4 weeks and 1 year postpartum. Cortical thickness increased from early to one-year postpartum in the left (p = .003, Bonferroni corrected) and right (p = .02, Bonferroni corrected) superior frontal gyrus. No significant increases (or decreases) were observed in these regions for surface area. Volumetric increases, across the postpartum period, were found in the left amygdala (p = .001, Bonferroni corrected) and right ventral diencephalon (p = .01, Bonferroni corrected). An exploratory analysis of depressive symptoms found reductions in depressive symptoms from early postpartum to one-year postpartum were associated with greater cortical thickness in the superior frontal gyrus for both the left (p = .02) and right (p = .02) hemispheres. The findings expand our evidence of the neuroanatomical changes that occur across the postpartum period in humans and motivate future studies to examine how mood changes across this period are associated with cortical thickness of the superior frontal gyrus.
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Affiliation(s)
- Alexander J Dufford
- Center for Mental Health Innovation, Oregon Health & Science University, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | | | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, 80210, USA.
- Department of Psychology, Ewha Womans University, Seoul, South Korea.
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Miller ES, Costantine MM, Mele L, Varner MW, Reddy UM, Wapner RJ, Thorp JM, Saade GR, Tita ATN, Rouse DJ, Sibai B, Mercer BM, Caritis SN, Casey BM. The association between perinatal depressive symptoms and child neurodevelopment. Am J Obstet Gynecol MFM 2024; 6:101488. [PMID: 39293588 DOI: 10.1016/j.ajogmf.2024.101488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/23/2024] [Accepted: 08/20/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Perinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings. OBJECTIVE To evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age. STUDY DESIGN Secondary analysis of an ancillary study to a multicenter randomized trial of thyroxine therapy for pregnant individuals with subclinical hypothyroidism. Dyads of infants and birthing parent, with completed Center for Epidemiological Studies-Depression (CES-D) screens during pregnancy and postpartum and child neurodevelopment testing completed at five years of age (n=209) were included. CES-D screening was performed at 11-20 weeks, 34-38 weeks, and one-year postpartum. Depressive symptoms were categorized as antenatal (i.e., a positive screen at any point during pregnancy) or postpartum. The primary outcome was child IQ score < 85 at 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) Full Scale test. Secondary outcomes included other assessments of childhood neurodevelopment. Bivariable analyses and multivariable logistic regressions were utilized. RESULTS Of the 209 birthing people included, 72 (34%) screened positive for depression during pregnancy and 32 (15%) screened positive one year postpartum. Children born to individuals with a positive antenatal depression screen had a higher odds of IQ < 85 at 5 years of age compared with children born to individuals with a CES-D < 16 (35% vs. 18%, OR 2.4, 95% CI 1.2-4.7). Similar findings were seen for children born to individuals with a positive postpartum depression screen (47% vs. 21%, OR 3.3, 95% CI 1.5-7.3). These associations did not persist in multivariable analyses that controlled for social determinants of health and clinical characteristics (adjusted odd ratio [aOR] 1.4, 95% CI 0.7-3.1; aOR 2.1, 95% CI 0.9-5.1, for antenatal and postpartum depressive symptoms, respectively). Similar findings were observed for other adverse neurodevelopmental outcomes. CONCLUSIONS Having a positive perinatal depression screen was not associated with child cognitive outcomes after controlling for covariates including social determinants of health.
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Affiliation(s)
- Emily S Miller
- Departments of Obstetrics and Gynecology of Northwestern University, Chicago, IL (Miller).
| | | | - Lisa Mele
- George Washington University Biostatistics Center, Washington, DC (Mele)
| | - Michael W Varner
- University of Utah Health Sciences Center, Salt Lake City, UT (Varner)
| | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Reddy)
| | | | - John M Thorp
- University of North Carolina, Chapel Hill, NC (Thorp)
| | - George R Saade
- University of Texas Medical Branch, Galveston, TX (Saade)
| | - Alan T N Tita
- University of Alabama at Birmingham, Birmingham, AL (Tita)
| | | | - Baha Sibai
- University of Texas-Houston, Houston, TX (Sibai)
| | | | | | - Brian M Casey
- University of Texas-Southwestern, Dallas, TX (Casey)
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Menekşe D, Karakaya Suzan Ö, Çinar N. The effect of maternal concerns about childbirth and postpartum period on obsessive and compulsive behaviors related to baby care. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:379-390. [PMID: 39241244 PMCID: PMC11466422 DOI: 10.7705/biomedica.7146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 05/23/2024] [Indexed: 09/08/2024]
Abstract
INTRODUCTION Postpartum anxiety after childbirth is a common condition among pregnant women due to reasons such as the uncertainty of experiencing pregnancy and childbirth for the first time, or previous negative experiences. Fear of childbirth can affect the mother's baby care process. OBJECTIVE This study was conducted analytically with a single-subject design to determine the effects of maternal concerns about childbirth and the postpartum period on obsessive and compulsive behaviors related to baby care. MATERIALS AND METHODS The study was conducted with 260 mothers. Data were collected using a descriptive information form, and the scales 'Fear of Childbirth and Postpartum Period', and 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care'. The data were analyzed using the SPSS™ software to calculate percentages, mean values, t tests, ANOVA, Pearson's correlation, and simple linear regression analysis. RESULTS A statistically significant and positive correlation was found between participant scores of the 'Fear of Childbirth and Postpartum Period' and the 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care' scales (p < 0.01). The regression model showed that 18.0% of the total variance in the obsessive and compulsive behaviors of mothers in the postpartum was explained by the fear of childbirth and the postpartum period (corrected R2 = 0.180). CONCLUSIONS Fear of childbirth and the postpartum period were moderate. However, as the fear of women regarding childbirth and the postpartum period increased, their postpartum obsessive and compulsive behaviors about baby care also increased.
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Affiliation(s)
- Dilek Menekşe
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, TürkiyeSakarya UniversitySakarya UniversitySakaryaSakarya
| | - Özge Karakaya Suzan
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, TürkiyeSakarya UniversitySakarya UniversitySakaryaSakarya
| | - Nursan Çinar
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, TürkiyeSakarya UniversitySakarya UniversitySakaryaSakarya
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McDaniel BT, Uva S, Pater J, Cornet V, Drouin M, Radesky J. Daily smartphone use predicts parent depressive symptoms, but parents' perceptions of responsiveness to their child moderate this effect. FRONTIERS IN DEVELOPMENTAL PSYCHOLOGY 2024; 2:1421717. [PMID: 39391205 PMCID: PMC11466322 DOI: 10.3389/fdpys.2024.1421717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Introduction Smartphone use during caregiving has become increasingly common, especially around infants and very young children, and this use around young children has been linked with lower quality and quantity of parent-child interaction, with potential implications for child behavior, and parent-child attachment. To understand drivers and consequences of parent phone use, we were interested in the daily associations between parent phone use and depressed mood, as well as the potential for parent perceptions of their responsiveness toward their infant to alter the association between parent phone use and mood. Methods In the present study, we explored associations between day-to-day changes in parent smartphone use (objectively-measured via passive sensing) around their infant, depressed mood, and parent perceptions of their responsiveness to their infants among a sample of 264 parents across eight days. We utilized multilevel modeling to examine these within-person daily associations. Results Objectively-measured parent smartphone use during time around their infant was significantly associated with depressed mood on a daily basis. Interestingly, this was not true on days when parents perceived themselves to be more responsive to their infant. Discussion These results suggest that parent judgements and perceptions of their parenting behavior may impact the potential link between parent phone use and parent mood. This is the first study utilizing intensive daily data to examine how parent perceptions may alter the felt effects of phone use on their parenting. Future work examining potential impacts of smartphone use on parenting should consider the effects of both actual use and perceptions about that use.
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Affiliation(s)
- Brandon T. McDaniel
- Parkview Mirro Center for Research and Innovation, Health Services and Informatics Research, Fort Wayne, IN, USA
| | - Sabrina Uva
- Parkview Mirro Center for Research and Innovation, Health Services and Informatics Research, Fort Wayne, IN, USA
| | - Jessica Pater
- Parkview Mirro Center for Research and Innovation, Health Services and Informatics Research, Fort Wayne, IN, USA
| | - Victor Cornet
- Parkview Mirro Center for Research and Innovation, Health Services and Informatics Research, Fort Wayne, IN, USA
| | - Michelle Drouin
- Parkview Mirro Center for Research and Innovation, Health Services and Informatics Research, Fort Wayne, IN, USA
- Purdue University Fort Wayne, Department of Psychology, Fort Wayne, IN, USA
| | - Jenny Radesky
- University of Michigan Medical School, Ann Arbor, Michigan, USA
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Matte-Gagné C, Bernier A, Thériault-Couture F, Tarabulsy GM. Paternal and Maternal Depressive Symptoms and Sensitivity: Links with Trajectories of Socioemotional Problems in Toddlerhood. Res Child Adolesc Psychopathol 2024; 52:1261-1273. [PMID: 38700809 DOI: 10.1007/s10802-024-01200-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 07/31/2024]
Abstract
Parental depressive symptoms and sensitivity have well-documented consequences for children; however, studies considering both parents are still scarce. This longitudinal study aimed to investigate the respective roles of paternal and maternal depressive symptoms and sensitivity in predicting the development of child socioemotional problems during toddlerhood. We also investigated the buffering role of each parent's sensitivity in the associations between the other parent's depressive symptoms and toddlers' socioemotional problems. The sample consisted of 140 Canadian families who were visited in their homes when children were around 13 (T1), 19 (T2), and 27 (T3) months of age. At T1, both parents' sensitivity was assessed from observations of parent-child interactions at home and each parent reported on his or her own depressive symptoms. At T1, T2, and T3, maternal and paternal perceptions of their toddler's socioemotional problems were assessed and aggregated. Growth curve analyses revealed that paternal and maternal depressive symptoms as well as paternal sensitivity were unique and persistent predictors of child socioemotional problems and that sensitive fathering acted as a buffer in the context of maternal depressive symptoms. This study highlights the importance of considering both parents when studying risk and protective factors for young children's socioemotional problems.
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Affiliation(s)
- Célia Matte-Gagné
- School of Psychology, Laval University, 2325 Des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
| | - Annie Bernier
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | | | - George M Tarabulsy
- School of Psychology, Laval University, 2325 Des Bibliothèques, Quebec, QC, G1V 0A6, Canada
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7
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Borairi S, Deneault AA, Madigan S, Fearon P, Devereux C, Geer M, Jeyanayagam B, Martini J, Jenkins J. A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children. Attach Hum Dev 2024; 26:273-300. [PMID: 38860779 DOI: 10.1080/14616734.2024.2359689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b = .02) and internalizing psychopathology (b = .01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant.
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Affiliation(s)
- Sahar Borairi
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chloe Devereux
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Melissa Geer
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Julia Martini
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Jennifer Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
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Fox K, Hart CN, Phelan S, Ventura AK, Wing R, Jelalian E. Maternal depressive symptom trajectories and associations with child feeding. BMC Public Health 2024; 24:1636. [PMID: 38898428 PMCID: PMC11186209 DOI: 10.1186/s12889-024-19110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Responsive feeding, when caregivers attend to children's signals of hunger and satiation and respond in an emotionally supportive and developmentally appropriate way, is associated with the development of healthy eating behaviors, improved diet quality, and healthy weight status for children. However, gaps in the literature remain on how factors, such as maternal depressive symptoms and child temperament, influence feeding interactions. METHODS This longitudinal secondary data analysis explored the association between maternal depressive symptom trajectory and child temperament with maternal feeding practices in women with obesity who participated in a prenatal lifestyle intervention trial. Mothers self-reported depressive symptoms at baseline, 35 weeks gestation, and 6, 12, and 18 months postpartum. At 18- and 24-months postpartum, mothers completed self-reported assessments of feeding practices and child temperament and completed in-home video-recorded meals with their child, coded using the Responsiveness to Child Feeding Cues Scale. We used group-based trajectory modeling to identify distinct trajectories of depressive symptoms and generalized regressions to assess the association between symptom trajectory group and feeding. We also explored interactions between depressive symptoms and child temperament. RESULTS Three distinct trajectories of depressive symptoms were identified: No-Minimal and Decreasing, Mild-Moderate and Stable, and Moderate-Severe and Stable. At 18-months, when compared to the No-Minimal and Decreasing group, membership in the Moderate-Severe and Stable group was associated with higher observed responsiveness to child satiation cues ([Formula: see text] =2.3, 95%CI = 0.2, 4.4) and lower self-reported pressure to eat ([Formula: see text]=-0.4, 95%CI= -0.7, 0.0). When compared to the No-Minimal and Decreasing group, membership in the Mild-Moderate and Stable group was associated with higher self-reported restriction ([Formula: see text] =0.4, 95%CI = 0.0,0.7). The associations between trajectory group membership and feeding practices did not reach statistical significance at 24 months. Associations between depressive symptoms and restriction were moderated by child effortful control at 18 months [Formula: see text]) and surgency at 24 months [Formula: see text]). CONCLUSION A Moderate-Severe and Stable depressive symptom trajectory was associated with more responsive feeding practices and a Mild-Moderate and Stable trajectory was associated with higher restrictive feeding. Preliminary evidence suggests that depressive symptoms impact mothers' ability to match their use of restriction to the temperamental needs of their child.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA.
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA.
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences & Center for Obesity Research and Education, College of Public Health Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Suzanne Phelan
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Rena Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
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9
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Bérubé A, Pétrin R, Blais C. Parental depression moderates the relationship between childhood maltreatment and the recognition of children expressions of emotions. Front Psychiatry 2024; 15:1374872. [PMID: 38903632 PMCID: PMC11188386 DOI: 10.3389/fpsyt.2024.1374872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/05/2024] [Indexed: 06/22/2024] Open
Abstract
Background Sensitivity plays a crucial role in parenting as it involves the ability to perceive and respond appropriately to children's signals. Childhood maltreatment and depression can negatively impact adults' ability to recognize emotions, but it is unclear which of these factors has a greater impact or how they interact. This knowledge is central to developing efficient, targeted interventions. This paper examines the interaction between parents' depressive symptoms and childhood maltreatment and its influence on their ability to recognize the five basic emotions (happiness, anger, sadness, fear, and disgust) in children's faces. Method The sample consisted of 52 parents. Depressive symptoms were measured by the depression subscale of the Brief Symptom Inventory-18 (BSI-18), and maltreatment history was assessed by the Childhood Trauma Questionnaire (CTQ). Children's emotional stimuli were morphed images created using The Child Affective Facial Expression (CAFE) database. Results Our findings indicate that depressive symptoms moderate the relationship between parents' history of childhood maltreatment and emotion recognition skills. Parents with higher depressive symptoms had lower emotion recognition accuracy when they had not experienced maltreatment. When childhood maltreatment was severe, emotion recognition skills were more consistent across all levels of depression. The relationship between depression and emotion recognition was primarily linked to recognizing sadness in children's faces. Conclusion These findings highlight how different experiences can affect parental abilities in emotion recognition and emphasize the need for interventions tailored to individual profiles to improve their effectiveness.
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Affiliation(s)
- Annie Bérubé
- Ricochet, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Trois-Rivières, QC, Canada
| | - Rachel Pétrin
- Ricochet, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
| | - Caroline Blais
- Social and Visual Perception Laboratory, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
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10
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Dufford A, Patterson G, Kim P. Longitudinal Neuroanatomical Increases from Early to One-Year Postpartum. RESEARCH SQUARE 2024:rs.3.rs-4432804. [PMID: 38883787 PMCID: PMC11178002 DOI: 10.21203/rs.3.rs-4432804/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Preclinical studies have provided causal evidence that the postpartum period involves regional neuroanatomical changes in 'maternal' brain regions to support the transition to offspring caregiving. Few studies, in humans, have examined neuroanatomical changes from early to one-year postpartum with longitudinal neuroimaging data and their association with postpartum mood changes. In this study, we examined longitudinal changes in surface morphometry (cortical thickness and surface area) in regions previously implicated in the transition to parenthood. We also examined longitudinal volumetric neuroanatomical changes in three subcortical regions of the maternal brain: the hippocampus, amygdala, and ventral diencephalon. Twenty-four participants underwent longitudinal structural magnetic resonance imaging at 2-4 weeks and 1 year postpartum. Cortical thickness increased from early to one-year postpartum in the left (p = .003, Bonferroni corrected) and right (p = .02, Bonferroni corrected) superior frontal gyrus. No significant increases (or decreases) were observed in these regions for surface area. Volumetric increases, across the postpartum period, were found in the left amygdala (p = .001, Bonferroni corrected) and right ventral diencephalon (p = .01, Bonferroni corrected). An exploratory analysis of depressive symptoms found reductions in depressive symptoms from early postpartum to one-year postpartum were associated with greater cortical thickness in the superior frontal gyrus for both the left (p = .02) and right (p = .02) hemispheres. The findings expand our evidence of the neuroanatomical changes that occur across the postpartum period in humans and motivate future studies to examine how mood changes across this period are associated with cortical thickness of the superior frontal gyrus.
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11
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Wriedt SC, Müller M, Reck C, Nonnenmacher N, Zietlow AL, Woll CFJ. The effect of antepartum depressive and anxiety symptoms on mother-infant interaction: The mediating role of antepartum maternal emotional stress. Infant Behav Dev 2024; 75:101942. [PMID: 38522348 DOI: 10.1016/j.infbeh.2024.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/13/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024]
Abstract
Anxiety disorders, depression, and emotional stress during the antepartum period are interlinked with adverse child development. The quality of the dyadic interaction seems to play a crucial role in the transmission of these effects. In this study, we explored the mediating effect of antepartum maternal emotional stress (assessed via the Prenatal Emotional Stress Index) regarding the relationship of antepartum maternal depressive (assessed via the Edinburgh Postpartum Depression Scale), anxiety symptoms (assessed via the Stat-Trait-Anxiety-Inventory), and depressive and anxiety disorders (assessed according to the DSM-IV-TR) in the antepartum period on postpartum interactive quality in a longitudinal design. The Face-to-Face-Still-Face Paradigm (FFSF) and the Infant and Caregiver Engagement Phases (ICEP-R) coding system were used to assess the postpartum interactive qualities of the mother-infant dyads. The sample consisted of 59 women, 38 in the clinical and 21 in the control group. We found significant indirect effects of antepartum depressive symptoms and maternal diagnostic status on the mother's neutral engagement and on the latency to the first social positive interactive match during the interaction - effects that were mediated by antepartum stress. Moreover, there was an indirect effect of state anxiety on neutral engagement - mediated by antepartum stress. Therapeutic intervention studies focusing on maternal antepartum regulation of emotional stress and postpartum interactive patterns might be crucial to encounter maladaptive developmental trajectories.
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Affiliation(s)
- Sophia Cécile Wriedt
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, LMU Munich, Leopoldstraße 13, 80802 Munich, Germany
| | - Mitho Müller
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, LMU Munich, Leopoldstraße 13, 80802 Munich, Germany.
| | - Corinna Reck
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, LMU Munich, Leopoldstraße 13, 80802 Munich, Germany
| | - Nora Nonnenmacher
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, LMU Munich, Leopoldstraße 13, 80802 Munich, Germany; Department of Medical Psychology, Heidelberg University Hospital, Bergheimer Straße 20, 69115 Heidelberg, Germany
| | - Anna-Lena Zietlow
- Department of Psychology, Clinical Psychology of Childhood and Adolescence, Technical University Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany
| | - Christian Franz Josef Woll
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, LMU Munich, Leopoldstraße 13, 80802 Munich, Germany
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12
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Huffhines L, Parade SH, Martin SE, Gottipaty A, Kavanaugh B, Spirito A, Boekamp JR. Early childhood trauma exposure and neurocognitive and emotional processes: Associations in young children in a partial hospital program. Dev Psychopathol 2024:1-17. [PMID: 38711378 DOI: 10.1017/s0954579424000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E. P Bradley Hospital, Riverside, RI, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E. P Bradley Hospital, Riverside, RI, USA
| | - Sarah E Martin
- Department of Psychology, Simmons University, Boston, MA, USA
- Emma Pendleton Bradley Hospital, Riverside, RI, USA
| | - Anjali Gottipaty
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, Riverside, RI, USA
| | - Brian Kavanaugh
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, Riverside, RI, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - John R Boekamp
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, Riverside, RI, USA
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13
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Sacchi C, De Carli P, Gregorini C, Monk C, Simonelli A. In the pandemic from the womb. Prenatal exposure, maternal psychological stress and mental health in association with infant negative affect at 6 months of life. Dev Psychopathol 2024; 36:810-820. [PMID: 36794393 DOI: 10.1017/s0954579423000093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
For mother-infant health especially, the pandemic has brought multiple stressors inside a susceptible psychobiological system. We study the longitudinal associations between maternal prenatal and postpartum: (a) COVID-19 stressful events exposure, (b) pandemic psychological stress, and (c) mental health and infants' negative affect. A sample of 643 Italian pregnant women completed a web-based survey from April 8th to May 4th, 2020 and a follow-up at 6 months after delivery. Maternal assessment covered prenatal and postpartum measures for: COVID-19 stressful events exposure, pandemic psychological stress, mental health symptoms (i.e., depression, anxiety, posttraumatic stress disorder) and postpartum, social support and report of infants' negative affect. Maternal mental health symptoms during pregnancy, at the peak of pandemic, is longitudinally associated with infant negative affect, with postpartum mental health mediating this association. Also, maternal COVID-19 stressful events exposure in postpartum is associated with negative affect at 6 months mediated by postpartum mental health symptoms. Maternal pandemic psychological stress during pregnancy predicted mental health symptoms in postpartum. The study supports the association between pandemic-related maternal health across pregnancy and postpartum and offspring's development (i.e., negative affect). It also puts the spotlight on mental health risk in women experiencing lockdown during pregnancy, especially when feeling high psychological stress in pregnancy or when directly exposed to COVID-19 stressful events postpartum.
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Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Camilla Gregorini
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Catherine Monk
- Departments of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
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14
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Khoury JE, Atkinson L, Gonzalez A. A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID-19 pandemic. INFANCY 2024; 29:412-436. [PMID: 38329905 DOI: 10.1111/infa.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
Elevated psychological distress, experienced by pregnant women and parents, has been well-documented during the COVID-19 pandemic. Most research focuses on the first 6-months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2 years of the COVID-19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6-weeks, 6-months, and 15-months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother-reported toddler socioemotional functioning (using the Brief Infant-Toddler Social and Emotional Assessment) was measured at 15-months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6-weeks to 15-months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6 weeks and 15 months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID-19 pandemic.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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15
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Wass S, Greenwood E, Esposito G, Smith C, Necef I, Phillips E. Annual Research Review: 'There, the dance is - at the still point of the turning world' - dynamic systems perspectives on coregulation and dysregulation during early development. J Child Psychol Psychiatry 2024; 65:481-507. [PMID: 38390803 DOI: 10.1111/jcpp.13960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/24/2024]
Abstract
During development we transition from coregulation (where regulatory processes are shared between child and caregiver) to self-regulation. Most early coregulatory interactions aim to manage fluctuations in the infant's arousal and alertness; but over time, coregulatory processes become progressively elaborated to encompass other functions such as sociocommunicative development, attention and executive control. The fundamental aim of coregulation is to help maintain an optimal 'critical state' between hypo- and hyperactivity. Here, we present a dynamic framework for understanding child-caregiver coregulatory interactions in the context of psychopathology. Early coregulatory processes involve both passive entrainment, through which a child's state entrains to the caregiver's, and active contingent responsiveness, through which the caregiver changes their behaviour in response to behaviours from the child. Similar principles, of interactive but asymmetric contingency, drive joint attention and the maintenance of epistemic states as well as arousal/alertness, emotion regulation and sociocommunicative development. We describe three ways in which active child-caregiver regulation can develop atypically, in conditions such as Autism, ADHD, anxiety and depression. The most well-known of these is insufficient contingent responsiveness, leading to reduced synchrony, which has been shown across a range of modalities in different disorders, and which is the target of most current interventions. We also present evidence that excessive contingent responsiveness and excessive synchrony can develop in some circumstances. And we show that positive feedback interactions can develop, which are contingent but mutually amplificatory child-caregiver interactions that drive the child further from their critical state. We discuss implications of these findings for future intervention research, and directions for future work.
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Affiliation(s)
- Sam Wass
- UEL BabyDevLab, Department of Psychology, University of East London, London, UK
| | - Emily Greenwood
- UEL BabyDevLab, Department of Psychology, University of East London, London, UK
| | - Giovanni Esposito
- UEL BabyDevLab, Department of Psychology, University of East London, London, UK
| | - Celia Smith
- Institute of Psychology Psychiatry and Neuroscience, King's College, London, UK
| | - Isil Necef
- UEL BabyDevLab, Department of Psychology, University of East London, London, UK
| | - Emily Phillips
- UEL BabyDevLab, Department of Psychology, University of East London, London, UK
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16
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Helmikstøl B, Moe V, Smith L, Fredriksen E. Multiple Risk in Pregnancy- Prenatal Risk Constellations and Mother-Infant Interactions, Parenting Stress, and Child Externalizing and Internalizing Behaviors: A Prospective Longitudinal Cohort Study from Pregnancy to 18 Months Postpartum. Res Child Adolesc Psychopathol 2024; 52:399-412. [PMID: 37938409 PMCID: PMC10896821 DOI: 10.1007/s10802-023-01145-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
Multiple risk is associated with adverse developmental outcomes across domains. However, as risk factors tend to cluster, it is important to investigate formation of risk constellations, and how they relate to child and parental outcomes. By means of latent class analysis patterns of prenatal risk factors were identified, and relations to interactional quality, parenting stress, and child internalizing and externalizing behaviors were investigated. An array of prenatal risk factors was assessed in 1036 Norwegian pregnant women participating in a prospective longitudinal community-based study, Little in Norway. Mother-infant interactions were videotaped and scored with the Early Relational Health Screen (ERHS) at 12 months. The Parenting Stress Index (PSI) and Infant-Toddler Social and Emotional Assessment (ITSEA) were administered at 18 months. First, we analyzed response patterns to prenatal risks to identify number and characteristics of latent classes. Second, we investigated whether latent class membership could predict mother-child interactional quality, parenting stress, and child internalizing and externalizing behavior after the child was born. Results revealed three prenatal risk constellations: broad risk (7.52%), mental health risk (21.62%) and low-risk (70.86%). Membership in the broad risk group predicted lower scores on interactional quality, while membership in the mental health risk group predicted less favorable scores on all outcome measures. Prenatal risks clustered together in specific risk constellations that differentially related to parent, child and interactional outcomes.
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Affiliation(s)
- Beate Helmikstøl
- Department of Psychology, Ansgar University College, Fredrik Fransons Vei 4, 4635, Kristiansand, Norway.
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway.
| | - Vibeke Moe
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
| | - Lars Smith
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
| | - Eivor Fredriksen
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
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17
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Racine N, Wu P, Pagaling R, O'Reilly H, Brunet G, Birken CS, Lorenzetti DL, Madigan S. Maternal postnatal depressive symptoms and early achievement of developmental milestones in infants and young children: A meta-analysis. Infant Ment Health J 2024; 45:121-134. [PMID: 38213016 DOI: 10.1002/imhj.22097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/06/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Abstract
Screening for social determinants of health, including maternal depression, is a recommended pediatric practice. However, the magnitude of association between maternal and child screening tools remains to be determined. The current study evaluated the association between maternal postnatal depressive symptoms and child developmental milestones, as well as moderators of these associations. A comprehensive search strategy was carried out in four databases (MEDLINE, EMBASE, APA PsycINFO, and Cochrane Central Register of Controlled Trials) from database inception to September 2022. Studies that examine postnatal depressive symptoms and associations with infant and early child (<6 years) achievement of developmental milestones were included. Data were extracted by two independent coders and a random-effects meta-analysis was used to estimate pooled effect sizes and test for moderators. A total of 38 non-overlapping studies (95,897 participants), all focused on maternal postnatal depression, met inclusion criteria. The pooled effect size for the association between postnatal depressive symptoms and early achievement of infant and child developmental milestones (N = 38; r = -.12; 95% CI = -.18, -.06) was small in magnitude. Child age at maternal depression measurement was a moderator, whereby effect sizes became greater for older children. Despite small effects, maternal postnatal depressive symptoms should be included in screening during routine well-child visits to enhance child development outcomes.
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Affiliation(s)
- Nicole Racine
- School of Psychology, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Pauline Wu
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Rachel Pagaling
- Department of Psychology, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University ofCalgary, and Health Sciences Library, University of Calgary, Calgary, Canada
| | | | | | - Catherine S Birken
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University ofCalgary, and Health Sciences Library, University of Calgary, Calgary, Canada
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18
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Tesson S, Swinsburg D, Nielson-Jones C, Costa DSJ, Winlaw DS, Badawi N, Sholler GF, Butow PN, Kasparian NA. Mother-Infant Dyadic Synchrony and Interaction Patterns After Infant Cardiac Surgery. J Pediatr Psychol 2024; 49:13-26. [PMID: 37873696 DOI: 10.1093/jpepsy/jsad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/19/2023] [Accepted: 09/19/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Parents and their infants with complex congenital heart disease (CHD) face relational challenges, including marked distress, early separations, and infant hospitalizations and medical procedures, yet the prevalence of parent-infant interaction difficulties remains unclear. Using a standardized observational paradigm, this study investigated mother-infant dyadic synchrony, interactional patterns, and associated predictors in mother-infant pairs affected by CHD, compared with typically-developing pairs. METHODS In this prospective, longitudinal cohort study, mothers and their infants requiring cardiac surgery before age 6-months (n=110 pairs) and an age- and sex-matched Australian community sample (n=85 pairs) participated in a filmed, free-play interaction at 6.9±1.0 months. Mother-infant dyadic synchrony, maternal and infant interactional patterns, and relational risk were assessed using the Child-Adult Relationship Experimental (CARE) Index. Maternal and infant predictors were assessed at 32 weeks gestation, 3- and 6-months postpartum. RESULTS Most mother-infant interactions were classified as "high risk" or "inept" (cardiac: 94%, control: 81%; p=.007). Dyadic synchrony (p<.001), maternal sensitivity (p=.001), and infant cooperativeness (p=.001) were lower for cardiac than control pairs. Higher maternal traumatic stress at 6-months postpartum predicted lower dyadic synchrony for mother-infant pairs affected by CHD (B=-.04, p=.03). Dyadic synchrony was higher among older infants in the total (B=.40, p=.003) but not cardiac sample (B=.24, p=.06). CONCLUSIONS Relational difficulties were almost universal among mother-infant pairs affected by CHD and were also high in the Australian community sample. Widespread education initiatives are recommended to increase awareness of heightened mother-infant relational risk in congenital heart care and well-child settings, alongside relationally-focused prevention and early intervention programs.
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Affiliation(s)
- Stephanie Tesson
- Heart Centre for Children, The Sydney Children's Hospitals Network, Australia
- School of Psychology, The University of Sydney, Australia
- Faculty of Medicine and Health, The University of New South Wales, Australia
| | - Dianne Swinsburg
- Heart Centre for Children, The Sydney Children's Hospitals Network, Australia
- Faculty of Medicine and Health, The University of New South Wales, Australia
| | - Claudia Nielson-Jones
- Heart Centre for Children, The Sydney Children's Hospitals Network, Australia
- Faculty of Medicine and Health, The University of New South Wales, Australia
| | - Daniel S J Costa
- School of Psychology, The University of Sydney, Australia
- Pain Management Research Institute, Royal North Shore Hospital, Australia
| | - David S Winlaw
- Heart Institute, Cincinnati Children's Hospital Medical Center, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Australia
- Grace Centre for Newborn Care, The Children's Hospital at Westmead, Australia
| | - Gary F Sholler
- Heart Centre for Children, The Sydney Children's Hospitals Network, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Australia
| | - Phyllis N Butow
- School of Psychology, The University of Sydney, Australia
- Psycho-Oncology Co-operative Research Group, The University of Sydney, Australia
| | - Nadine A Kasparian
- Heart Institute, Cincinnati Children's Hospital Medical Center, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, USA
- Heart and Mind Wellbeing Center, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA
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19
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Pagani LS, Harandian K, Necsa B, Harbec MJ. Prospective Associations between Maternal Depressive Symptoms during Early Infancy and Growth Deficiency from Childhood to Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7117. [PMID: 38063547 PMCID: PMC10706675 DOI: 10.3390/ijerph20237117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
Maternal health represents an important predictor of child development; yet it often goes unnoticed during pediatric visits. Previous work suggests that mental state affects parenting. The relationship between infant exposure to maternal depressive symptoms suggests conflicting findings on physical growth. Body mass index (BMI) has not been rigorously examined across development. Using a prospective-longitudinal birth cohort of 2120 infants (50.7% boys), we estimated the prospective relationship between symptoms of maternal depressive symptoms at 5 months postpartum and later BMI in typically developing children. We hypothesized that maternal depressive symptom severity would predict later BMI through to adolescence. Mothers self-reported depressive symptoms at 5 months. Child BMI was measured by a trained research assistant at ages 6, 8, 10, 13, and 15 years. We estimated a series of sex-stratified regressions in which BMI was linearly regressed on maternal symptoms, while controlling for potential pre-existing/concurrent individual and family confounding factors. Boys born to mothers with more severe depressive symptoms at age 5 months had a significantly lower BMI than other boys at subsequent ages. There were no such associations observed for girls. Maternal depressive symptoms were prospectively associated with later BMI for sons and not daughters, predicting risk of faltering in growth through to adolescence. Health practitioners should routinely assess maternal psychological functioning during pediatric visits to optimize parent and child flourishment.
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Affiliation(s)
- Linda S Pagani
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
- Sainte-Justine's Pediatric Hospital Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada
| | - Kianoush Harandian
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Beatrice Necsa
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Marie-Josée Harbec
- Institut National de Santé Publique du Québec, Montreal, QC H2P 1E2, Canada
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20
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Ray JK, Stürmlinger LL, von Krause M, Lux U, Zietlow AL. Disentangling the trajectories of maternal depressive symptoms and partnership problems in the transition to parenthood and their impact on child adjustment difficulties. Dev Psychopathol 2023:1-16. [PMID: 37974466 DOI: 10.1017/s0954579423001335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Maternal perinatal depression (PND) and partnership problems have been identified to influence the development of later child adjustment difficulties. However, PND and partnership problems are closely linked which makes it difficult to draw conclusions about the exact transmission pathways. The aim of the present study was to investigate to what extent PND symptoms and partnership problems influence each other longitudinally and to examine the influence of their trajectories on child adjustment difficulties at the age of three. Analyses were based on publicly available data from the German family panel "pairfam". N = 354 mothers were surveyed on depressive symptoms and partnership problems annually from pregnancy (T0) until child age three (T4). Child adjustment difficulties were assessed at age three. Results of latent change score modeling showed that partnership problems predicted change in PND symptoms at T0 and T3 while PND symptoms did not predict change in partnership problems. Child adjustment difficulties at age three were predicted by PND symptoms, but not by partnership problems. Partnership problems predicted externalizing, but not internalizing symptoms. Results underline the effects of family factors for the development of child adjustment difficulties and emphasize the importance of early interventions from pregnancy onwards.
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Affiliation(s)
- J K Ray
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L L Stürmlinger
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - M von Krause
- Faculty of Behavioral and Cultural Studies, Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - U Lux
- Department Family and Family Policies, German Youth Institute (DJI), Munich, Germany
- Department of Psychology and Pedagogy, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - A-L Zietlow
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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21
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Ballarotto G, Murray L, Bozicevic L, Marzilli E, Cerniglia L, Cimino S, Tambelli R. Parental sensitivity to toddler's need for autonomy: An empirical study on mother-toddler and father-toddler interactions during feeding and play. Infant Behav Dev 2023; 73:101892. [PMID: 37839158 DOI: 10.1016/j.infbeh.2023.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/11/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
During the second year of life, children's need for autonomy grows, and their behaviors become increasingly complex. Parental sensitivity to children's different cues is important in supporting adaptive psycho-emotional development. The present study assumes that mothers and fathers may respond with varying levels of sensitivity to the child's different cues, with particular attention to requests for greater autonomy. The study also examines the possible role played by interactive contexts (ie., play and feeding) and children's and parents' individual factors. The sample comprised N = 91 families with children aged between 12 and 24 months. Mother-toddler and father-toddler interactions were assessed during feeding and play. Parents completed questionnaires assessing children's temperament, psychopathological risk, and parenting stress. RESULTS: showed that toddlers' demands for autonomy were the most frequent cues in both play and feeding contexts, both with mothers and fathers. Furthermore, parents were more sensitive to toddlers' requests for cooperation than their requests for autonomy, in both interactive contexts. Moreover, mothers and fathers showed higher sensitivity to toddlers' demands for greater autonomy in the play context rather than in the feeding context. Mothers were more sensitive than fathers to toddlers' cues of resistance to parents' actions and to toddlers' requests for cooperation. Results showed differences and specificities in mother-toddler and father-toddler interactions in the two interactive contexts, showing associations between child negative emotionality, parental psychopathological risk and parenting stress, and maternal and paternal sensitivity to toddlers' demands for greater autonomy during play and feeding, respectively. These results confirm the initial hypotheses regarding parental sensitivity and its differential expression according to child cues. Implications are discussed.
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Affiliation(s)
- G Ballarotto
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy.
| | - L Murray
- School of Psychology and Clinical Language Sciences, Earley Gate, University of Reading, United Kingdom
| | - L Bozicevic
- Institute of Population Health, Department of Primary Care & Mental Health, Faculty of Health and Life Sciences, University of Liverpool, United Kingdom
| | - E Marzilli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - L Cerniglia
- Department of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - S Cimino
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - R Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
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22
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Canfield SM, Canada KE, Rolbiecki AJ, Petroski GF. Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial. BMC Pregnancy Childbirth 2023; 23:739. [PMID: 37853333 PMCID: PMC10585730 DOI: 10.1186/s12884-023-06031-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Untreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples. METHODS We conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13-30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview. RESULTS There were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people's anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB. CONCLUSION Online dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous. TRIAL REGISTRATION ClinicalTrials.gov NCT05867680, 19/05/2023.
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Affiliation(s)
- Shannon M Canfield
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA.
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, MO, USA
| | - Abigail J Rolbiecki
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Family Medicine and Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory F Petroski
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, School of Medicine - University of Missouri, Columbia, MO, USA
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23
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Levkovich I, Elyoseph Z. Identifying depression and its determinants upon initiating treatment: ChatGPT versus primary care physicians. Fam Med Community Health 2023; 11:e002391. [PMID: 37844967 PMCID: PMC10582915 DOI: 10.1136/fmch-2023-002391] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To compare evaluations of depressive episodes and suggested treatment protocols generated by Chat Generative Pretrained Transformer (ChatGPT)-3 and ChatGPT-4 with the recommendations of primary care physicians. METHODS Vignettes were input to the ChatGPT interface. These vignettes focused primarily on hypothetical patients with symptoms of depression during initial consultations. The creators of these vignettes meticulously designed eight distinct versions in which they systematically varied patient attributes (sex, socioeconomic status (blue collar worker or white collar worker) and depression severity (mild or severe)). Each variant was subsequently introduced into ChatGPT-3.5 and ChatGPT-4. Each vignette was repeated 10 times to ensure consistency and reliability of the ChatGPT responses. RESULTS For mild depression, ChatGPT-3.5 and ChatGPT-4 recommended psychotherapy in 95.0% and 97.5% of cases, respectively. Primary care physicians, however, recommended psychotherapy in only 4.3% of cases. For severe cases, ChatGPT favoured an approach that combined psychotherapy, while primary care physicians recommended a combined approach. The pharmacological recommendations of ChatGPT-3.5 and ChatGPT-4 showed a preference for exclusive use of antidepressants (74% and 68%, respectively), in contrast with primary care physicians, who typically recommended a mix of antidepressants and anxiolytics/hypnotics (67.4%). Unlike primary care physicians, ChatGPT showed no gender or socioeconomic biases in its recommendations. CONCLUSION ChatGPT-3.5 and ChatGPT-4 aligned well with accepted guidelines for managing mild and severe depression, without showing the gender or socioeconomic biases observed among primary care physicians. Despite the suggested potential benefit of using atificial intelligence (AI) chatbots like ChatGPT to enhance clinical decision making, further research is needed to refine AI recommendations for severe cases and to consider potential risks and ethical issues.
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Affiliation(s)
| | - Zohar Elyoseph
- Department of Psychology and Educational Counseling, Max Stern Academic College Of Emek Yezreel, Emek Yezreel, Israel
- Department of Brain Sciences, Imperial College London, London, UK
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24
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Fitneva SA, Corbett BA, Prasad AN. Psychosocial correlates of neurodevelopmental disabilities in 2- to 3-year-olds. Epilepsy Behav 2023; 146:109370. [PMID: 37556967 DOI: 10.1016/j.yebeh.2023.109370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023]
Abstract
RATIONALE Canada's National Longitudinal Study of Children and Youth survey data provide insights into chronic health conditions in children. Children with neurodevelopmental disabilities (NDD) are at increased risk for adverse behavioral outcomes. METHODS We examined data from 3 cycles of Canada's National Longitudinal Survey of Children and Youth for the presence of epilepsy (Epi), cerebral palsy (CP), and intellectual disability (ID) in 2- to 3-year-olds. We then examined the relationship of NDD to composite measures of behavior: hyperactivity-inattention (HI), prosocial behaviors (PS), emotional disorder-anxiety (EA), physical aggression oppositional behavior (AO), and separation anxiety (SA). RESULTS There were 15 children with Epi, 25 with CP and 28 with ID in a sample of 10,879, which represented a population of 756,848 2- to 3-year-old Canadian children. Comparison of mean scores of the NDD groups and controls (Welch's ANOVA), indicated statistically significant differences in HI, PS, EA, and SA at the p < 0.001 level. Post hoc analysis showed significant intergroup differences. Children with epilepsy did not differ from controls on any of the behavioral measures. However, in comparison to controls, children with intellectual disability had higher EA and SA scores and lower PS scores, and those with cerebral palsy had lower PS scores. CONCLUSIONS Children with NDD show differences in behavioral outcomes at a very early age when compared with controls. Screening for these behaviors and early intervention programs may help avoid longer term psychiatric comorbidity associated with these disabilities.
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Affiliation(s)
| | - Bradley A Corbett
- Richard Ivey School of Business, Western University, London, ON, Canada
| | - Asuri N Prasad
- Division of Pediatric Neurology, Dept. of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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25
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Andrei AM, Webb R, Enea V. Health anxiety, death anxiety and coronaphobia: Predictors of postpartum depression symptomatology during the COVID-19 pandemic. Midwifery 2023; 124:103747. [PMID: 37276749 PMCID: PMC10229209 DOI: 10.1016/j.midw.2023.103747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/07/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine levels of postpartum depression symptoms and possible relevant predictors, such as death anxiety, health anxiety, and coronavirus-related anxiety. DESIGN Cross-sectional web-based survey using quantitative methods. SETTING Exclusively online recruiting via social media and unpaid cross-posting conducted during the third wave of the COVID-19 pandemic in Romania. PARTICIPANTS Women were eligible to take part in the study if they were mothers over the age of 18 and had a baby aged between 4 weeks - 12 months of age; 1024 women were included in the final sample. MEASUREMENTS AND FINDINGS Health anxiety, death anxiety, coronavirus-related anxiety, and postpartum depression symptoms were measured using validated instruments. Current depression symptomatology was 67.6%, 26.7% scored above the cut-off for high health anxiety, 1% for coronavirus-related anxiety, and 62.7% for death anxiety. Significant predictors for depressive symptomatology were breastfeeding, history of depression, family income, number of children, health anxiety, death anxiety, and coronavirus anxiety. Further, hierarchical multiple regression analysis indicated that death anxiety, health anxiety, and coronavirus anxiety predicted postpartum depression symptoms over and above socio-demographic factors. KEY CONCLUSIONS Supported by previous studies, our results suggest that postpartum depression symptomatology levels during the COVID-19 pandemic are high and that they are predicted by health and death anxiety, which are also increased during the pandemic. IMPLICATION FOR PRACTICE The findings provide information to identify the risk for depression symptoms in postpartum mothers during acute public health situations.
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Affiliation(s)
- Ana-Maria Andrei
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
| | | | - Violeta Enea
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania.
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26
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Speidel R, Behrens B, Lawson M, Cummings EM, Valentino K. Latent classes in preschoolers' internal working models of attachment and emotional security: Roles of family risk. Dev Psychopathol 2023; 35:1552-1569. [PMID: 35393923 PMCID: PMC9547040 DOI: 10.1017/s0954579422000293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children's relationships inform their internal working models (IWMs) of the world around them. Attachment and emotional security theory (EST) emphasize the importance of parent-child and interparental relationships, respectively, for IWM. The current study examined (a) data-driven classes in child attachment and emotional security IWM, (b) associations between IWM classes and demographic variables, maltreatment, intimate partner violence (IPV), and maternal depressive symptoms, and (c) consistency in attachment and emotional security IWM classes, including as a function of maltreatment, IPV, and maternal depressive symptoms. Participants were 234 preschool-aged children (n = 152 experienced maltreatment and n = 82 had not experienced maltreatment) and their mothers. Children participated in a narrative-based assessment of IWM. Mothers reported demographics, IPV, and maternal depressive symptoms. Latent class analyses revealed three attachment IWM classes and three emotional security IWM classes. Maltreatment was associated with lower likelihood of being in the secure attachment class and elevated likelihood of being in the insecure dysregulated attachment class. Inconsistencies in classification across attachment and emotional security IWM classes were related to maltreatment, IPV, and maternal depressive symptoms. The current study juxtaposes attachment and EST and provides insight into impacts of family adversity on children's IWM across different family relationships.
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Affiliation(s)
- Ruth Speidel
- Department of Psychology, Centre for Child Development, Mental Health, and Policy, University of Toronto Mississauga, Mississauga, ON, L5L 1C6, Canada
| | - Brigid Behrens
- Department of Psychology, Center for Children and Families, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Monica Lawson
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - E. Mark Cummings
- Department of Psychology, Center for Children and Families, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Kristin Valentino
- Department of Psychology, Center for Children and Families, University of Notre Dame, Notre Dame, IN 46556, USA
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27
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Laifer LM, DiLillo D, Brock RL. Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent-infant bonding as a mechanism. Dev Psychopathol 2023; 35:1036-1050. [PMID: 34649640 DOI: 10.1017/s0954579421000894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent-infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent-infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent-child relationship.
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28
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Georg AK, Meyerhöfer S, Taubner S, Volkert J. Is parental depression related to parental mentalizing? A systematic review and three-level meta-analysis. Clin Psychol Rev 2023; 104:102322. [PMID: 37572565 DOI: 10.1016/j.cpr.2023.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 08/14/2023]
Abstract
This systematic review and meta-analysis is aimed to summarize the state of research on the relation between parental depression and parental mentalizing. To account for the multifaceted nature of parental mentalizing, several conceptualizations and measures were included and compared. The last database search was conducted on March 13, 2023. Using three-level meta-analytic modelling, we analyzed a total of 12,665 participants from 63 studies with 233 effect sizes. Taken together, higher depression was only weakly associated with lower mentalizing (r = -0.06). Specifically, parents with higher depression scored lower on questionnaire measures of parental reflective functioning (r = -0.11). No significant correlations were found for interview measures of parental reflective functioning, the observational and interview measure of mind-mindedness, or insightfulness. The data showed substantial heterogeneity. The mean effect size for self-reported pre-mentalizing (r = -0.23 for reverse-coded subscale scores) was significantly stronger compared to other self-report subscales. In studies including parents with diagnosis and controls, there was limited evidence suggesting a larger negative correlation between depression, mind-mindedness, and insightfulness. Therefore, more research is needed in clinical samples. Due to their correlational nature, our results do not allow causal inferences. Future studies should target moderators that explain variability (e.g., comorbid psychological problems, coparenting, child behavior).
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany.
| | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany
| | - Jana Volkert
- Department of Psychology, MSB Medical School Berlin, Germany
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29
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Lean RE, Gerstein ED, Smyser TA, Smyser CD, Rogers CE. Socioeconomic disadvantage and parental mood/affective problems links negative parenting and executive dysfunction in children born very preterm. Dev Psychopathol 2023; 35:1092-1107. [PMID: 34725016 PMCID: PMC9058043 DOI: 10.1017/s0954579421000961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Poverty increases the risk of poorer executive function (EF) in children born full-term (FT). Stressors associated with poverty, including variability in parenting behavior, may explain links between poverty and poorer EF, but this remains unclear for children born very preterm (VPT). We examine socioeconomic and parental psychosocial adversity on parenting behavior, and whether these factors independently or jointly influence EF in children born VPT. At age five years, 154 children (VPT = 88, FT = 66) completed parent-child interaction and EF tasks. Parental sensitivity, intrusiveness, cognitive stimulation, and positive and negative regard were coded with the Parent-Child Interaction Rating Scale. Socioeconomic adversity spanned maternal demographic stressors, Income-to-Needs ratio, and Area Deprivation Index. Parents completed measures of depression, anxiety, inattention/hyperactivity, parenting stress, and social-communication interaction (SCI) problems. Parental SCI problems were associated with parenting behavior in parents of children born VPT, whereas socioeconomic adversity was significant in parents of FT children. Negative parenting behaviors, but not positive parenting behaviors, were related to child EF. This association was explained by parental depression/anxiety symptoms and socioeconomic adversity. Results persisted after adjustment for parent and child IQ. Findings may inform research on dyadic interventions that embed treatment for parental mood/affective symptoms and SCI problems to improve childhood EF.
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Affiliation(s)
- Rachel E Lean
- Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Emily D Gerstein
- Psychological Sciences, University Missouri-St. Louis, St. Louis, USA
| | - Tara A Smyser
- Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Christopher D Smyser
- Neurology, Washington University School of Medicine, St. Louis, USA
- Radiology, Washington University School of Medicine, St. Louis, USA
- Pediatrics, Washington University School of Medicine, St. Louis, USA
| | - Cynthia E Rogers
- Psychiatry, Washington University School of Medicine, St. Louis, USA
- Pediatrics, Washington University School of Medicine, St. Louis, USA
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30
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de Waal N, Boekhorst MGBM, Nyklíček I, Pop VJM. Maternal-infant bonding and partner support during pregnancy and postpartum: Associations with early child social-emotional development. Infant Behav Dev 2023; 72:101871. [PMID: 37544195 DOI: 10.1016/j.infbeh.2023.101871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
The first 1000 days after conception are considered critical for healthy development and well-being throughout life. Fundamental to health practices during pregnancy and positive parenting after birth is the development of maternal-infant bonding. Previous research has demonstrated the importance of having an involved partner during pregnancy and in parenting for optimal maternal-infant bonding. The current study examined maternal-infant bonding and partner support during pregnancy and the postpartum period, and their associations with early child social-emotional development. A total of 227 women completed the Pre- and Postnatal Bonding Scale (PPBS) and Tilburg Pregnancy Distress Scale (TPDS) during pregnancy (32 weeks of gestation) and at 8 months postpartum, assessing maternal-infant bonding and partner support. Additionally, a questionnaire on social-emotional behavior of the Bayley Scales of Infant and Toddler Development was administered to mothers to measure child development at 2 years of age. Path analyses revealed an indirect positive effect of prenatal maternal-infant bonding on child social-emotional development through postnatal maternal-infant bonding, as well as mediating effects of pre- and postnatal maternal-infant bonding on the association between pre- and postnatal partner support and child social-emotional development. Our findings support the notion that an emotional connection from mother to child originates in pregnancy and that experiencing positive feelings towards the fetus promotes positive maternal-infant bonding after birth and social-emotional capacities of the child. Additionally, having a supportive partner during pregnancy and postpartum, might be essential for the development of optimal maternal-infant bonding.
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Affiliation(s)
- Noor de Waal
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe G B M Boekhorst
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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31
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Doan SN, Burniston AB, Smiley P, Liu CH. COVID-19 Pandemic and Changes in Children's Behavioral Problems: The Mediating Role of Maternal Depressive Symptoms. CHILDREN (BASEL, SWITZERLAND) 2023; 10:977. [PMID: 37371209 DOI: 10.3390/children10060977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
The COVID-19 pandemic has been linked to a range of behavioral problems in children. To date, however, longitudinal studies with data prior to the pandemic are rare, and moreover, few studies have examined the family context. This is notable as evidence suggests that mothers were highly vulnerable to the effects of the pandemic, and stress proliferation models would argue that children's wellbeing are undoubtedly affected by maternal wellbeing. In the current investigation, we examine changes in maternal depressive symptoms and children's behavioral problems from prior to the pandemic to the first few months of COVID-19 in the U.S. The results suggest a significant increase in children's internalizing problems and maternal depressive symptoms. Consistent with stress proliferation models, the relationship between COVID-19-related stressors and children's behavioral problems were mediated by maternal mental health.
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Affiliation(s)
- Stacey N Doan
- Department of Psychological Science, Claremont McKenna College, Claremont, CA 91711, USA
- Department of Population Sciences, City of Hope National Medical Center, Claremont, CA 91711, USA
| | - Anna Beth Burniston
- Department of Psychological Science, Claremont McKenna College, Claremont, CA 91711, USA
| | - Patricia Smiley
- Department of Psychological Science, Pomona College, Claremont, CA 91711, USA
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine & Psychiatry, Brigham and Women's Hospital, Boston, MA 02215, USA
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32
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Fitzallen GC, Taylor HG, Liley HG, Bora S. Within- and between-twin comparisons of risk for childhood behavioral difficulties after preterm birth. Pediatr Res 2023:10.1038/s41390-023-02579-1. [PMID: 37041209 DOI: 10.1038/s41390-023-02579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Preterm birth and multiple gestation are independently associated with adverse neurodevelopmental outcomes. The objective of this study was to describe risks of screening positive for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and anxiety in preterm-born twin children by zygosity (monozygotic, dizygotic) and birth order (first-born, second-born). METHODS Caregivers of 349 preterm-born twin pairs (42% monozygotic) aged 3-18 years reported child behavioral outcomes on Strengths and Weaknesses of ADHD Symptoms and Normal Behavior; Social Responsiveness Scale, Second Edition; and Preschool Anxiety Scale or Screen for Child Anxiety and Related Emotional Disorders. RESULTS Concordance for behavioral outcomes in twin pairs ranged from 80.06 to 89.31% for ADHD, 61.01 to 84.23% for ASD, and 64.76 to 73.35% for anxiety. Monozygotic twins had a greater risk than dizygotic of screening positive for inattention (risk ratio = 2.91, 95% CI = 1.48-5.72) and social anxiety (1.79, 1.23-2.61). Relative to first-born, second-born twins had a greater risk of screening positive for hyperactivity/impulsivity (1.51, 1.06-2.16); overall ASD (2.38, 1.62-3.49); difficulties with social awareness (2.68, 1.94-3.71), social cognition (4.45, 3.06-6.46), and social communication (2.36, 1.56-3.57); restricted/repetitive behavior (1.91, 1.30-2.81); overall anxiety (1.34, 1.10-1.64); generalized anxiety (1.34, 1.11-1.60); and social anxiety (1.32, 1.06-1.64). CONCLUSION The current findings emphasize considering zygosity and birth order in preterm and multiple birth outcomes research, and highlight clinical implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support. IMPACT Zygosity and birth order are important determinants of behavioral and socioemotional outcomes in preterm-born twins. Among 349 preterm-born twin pairs aged 3-18 years (42% monozygotic), 61-89% demonstrated concordance for behavioral and socioemotional outcomes. Monozygosity had greater risks than dizygosity for positive screening of inattention and social anxiety. Second-born twins had greater risks than first-born for hyperactivity/impulsivity, social difficulties (awareness, cognition, communication), restricted/repetitive behavior, and anxiety (generalized, social). These findings have implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support.
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Affiliation(s)
- Grace C Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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33
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Cuijpers P, Franco P, Ciharova M, Miguel C, Segre L, Quero S, Karyotaki E. Psychological treatment of perinatal depression: a meta-analysis. Psychol Med 2023; 53:2596-2608. [PMID: 37310303 PMCID: PMC10123831 DOI: 10.1017/s0033291721004529] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 06/08/2021] [Accepted: 10/18/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line treatment and, although a considerable number of randomized trials have been conducted, no recent comprehensive meta-analysis has evaluated treatment effects. METHODS We used an existing database of randomized controlled trials of psychotherapies for adult depression and included studies aimed at perinatal depression. Random effects models were used in all analyses. We examined the effects of the interventions in the short and long term, and also examined secondary outcomes. RESULTS Forty-three studies with 49 comparisons and 6270 participants between an intervention and control group were included. The overall effect size was g = 0.67 [95% confidence interval (CI) 0.45~0.89; numbers needed-to-be-treated = 4.39] with high heterogeneity (I2 = 80%; 95% CI 75~85). This effect size remained largely unchanged and significant in a series of sensitivity analyses, although some publication bias was found. The effects remained significant at 6-12 months follow-up. Significant effects were also found for social support, anxiety, functional limitations, parental stress and marital stress, although the number of studies for each outcome was low. All results should be considered with caution because of the high levels of heterogeneity in most analyses. CONCLUSIONS Psychological interventions are probably effective in the treatment of perinatal depression, with effects that last at least up to 6-12 months and probably also have effects on social support, anxiety, functional impairment, parental stress, and marital stress.
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pamela Franco
- Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lisa Segre
- College of Nursing, University of Iowa, Iowa City, USA
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Çankaya S, Ataş A. The relationship of psychological well-being and cognitive emotions with breastfeeding self-efficacy in mothers in the postpartum period. Dev Psychobiol 2023; 65:e22371. [PMID: 36946683 DOI: 10.1002/dev.22371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/22/2022] [Accepted: 01/03/2023] [Indexed: 03/09/2023]
Abstract
To determine the relationship of psychological well-being and cognitive emotion regulation and breastfeeding self-efficacy in mothers in the postpartum period. The research was designed as cross-sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1-6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well-Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self-efficacy in 29% of the mothers (F = 14.536, p < .001): mothers' poor mental health, using self-blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well-being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well-being of the mothers and maladaptive cognitive coping subdimensions (p < .001). Breastfeeding self-efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.
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Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Ayşenur Ataş
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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35
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McMahon GE, Treyvaud K, Spittle AJ, Giallo R, Lee KJ, Cheong JL, Doyle LW, Spencer-Smith MM, Anderson PJ. Parental Mental Health and Parenting Behaviors Following Very Preterm Birth: Associations in Mothers and Fathers and Implications for Child Cognitive Outcome. J Pediatr Psychol 2023; 48:293-304. [PMID: 36655518 DOI: 10.1093/jpepsy/jsac094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To investigate the longitudinal associations between parental mental health symptoms within 4 weeks of birth, parenting behaviors at 1 year, and child general cognitive ability at 4.5-5 years in a sample of children born very preterm (VP). This study also examined whether these associations differed based on level of family social risk. METHODS Participants were 143 children born <30 weeks' gestation and their parents. Within 4 weeks of birth, mothers' and fathers' depressive and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and Hospital Anxiety Depression Scale-Anxiety Subscale. Parents' sensitive and structuring parenting behaviors were assessed at 1 year using the Emotional Availability Scales. Child general cognitive ability was assessed at 4.5-5 years using the Wechsler Preschool & Primary Scale of Intelligence-Fourth Edition. RESULTS Higher maternal depressive symptoms were associated with lower levels of sensitive and structuring parenting behavior, while higher maternal anxiety symptoms were associated with higher levels of structuring parenting behavior. There was weak evidence for positive associations between mothers' sensitive parenting behavior and fathers' structuring parenting behavior and child general cognitive ability. There was also weak evidence for stronger associations between mothers' mental health symptoms, parenting behaviors, and child general cognitive ability, in families of higher compared with lower social risk. CONCLUSIONS Depressive and anxiety symptoms experienced by mothers in the initial weeks following VP birth can have long-term effects on their parenting behaviors. Enquiring about parents' mental health during their child's hospitalization in the neonatal intensive care unit is crucial.
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Affiliation(s)
- Grace E McMahon
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
- Department of Psychology and Counselling, La Trobe University, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
- Neonatal Services, Royal Women's Hospital, Australia
- Department of Physiotherapy, University of Melbourne, Australia
| | - Rebecca Giallo
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Australia
- Intergenerational Health, Murdoch Children's Research Institute, Australia
| | - Katherine J Lee
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Australia
| | - Jeanie L Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
- Neonatal Services, Royal Women's Hospital, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Australia
| | - Megan M Spencer-Smith
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia
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Lux U, Müller M, Reck C, Liel C, Walper S. Linking maternal psychopathology to children's excessive crying and sleeping problems in a large representative German sample-The mediating role of social isolation and bonding difficulties. INFANCY 2023; 28:435-453. [PMID: 36397657 DOI: 10.1111/infa.12514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/21/2022]
Abstract
Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected children are burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent-child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N = 6598 mothers (M = 31.51 years) of children between zero to three years of age (M = 14.08 months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants' excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.
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Affiliation(s)
- Ulrike Lux
- National Centre for Early Prevention, German Youth Institute, Munich, Germany.,Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mitho Müller
- Ludwig-Maximilians-University Munich, Munich, Germany
| | - Corinna Reck
- Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christoph Liel
- National Centre for Early Prevention, German Youth Institute, Munich, Germany
| | - Sabine Walper
- National Centre for Early Prevention, German Youth Institute, Munich, Germany.,Ludwig-Maximilians-University Munich, Munich, Germany
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37
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Della Vedova AM, Santoniccolo F, Sechi C, Trombetta T. Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother-Baby Interactions at Three Months Post-Partum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4253. [PMID: 36901263 PMCID: PMC10002080 DOI: 10.3390/ijerph20054253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.
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Affiliation(s)
- Anna Maria Della Vedova
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | | | - Cristina Sechi
- Department of Pedagogy, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09126 Cagliari, Italy
| | - Tommaso Trombetta
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, Italy
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38
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Diemer MC, Paul RA, Gerstein ED. Health disparities associated with access to disability evaluations for toddlers in Early Head Start. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:136-147. [PMID: 36575049 DOI: 10.1111/jir.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The aim of this investigation was to examine developmental, sociodemographic and familial factors associated with parent reported access to an evaluation in an Early Head Start sample. Children with developmental disabilities often require evaluations to access early interventions, which can improve their long-term outcomes. METHODS This study (n = 191) examined how developmental, sociodemographic and parent factors at age 2 were associated with parent reporting the child being evaluated by age 3. Two logistic regression analyses were conducted. The first model included children at age 2 with scores at least in the monitoring zone of developmental risk, and the second model included children with high developmental risk. RESULTS The first model found that children in the monitoring zone of developmental risk were more likely to be evaluated per parent report if they were born preterm, male, with increased behaviour problems, higher economic risk, increased maternal education, increased parental depressive symptoms and in urban areas and less likely if they were of Black or Hispanic/Latino ethnicity, had no health insurance or more home disorganisation. The second model found that children with high developmental risk were less likely to be evaluated per parent report if they were female, of Hispanic/Latino ethnicity, had better language skills and increased home disorganisation and more likely if their parents reported increased depressive symptoms or less economic risk. CONCLUSIONS This study highlights barriers associated with access to developmental and disability evaluations for children in at-risk families. Health disparities are negatively associated with children's access to evaluations, even when supported by systems like Early Head Start.
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Affiliation(s)
- M C Diemer
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - R A Paul
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - E D Gerstein
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
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39
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Canfield SM, Canada KE. Systematic Review of Online Interventions to Reduce Perinatal Mood and Anxiety Disorders in Underserved Populations. J Perinat Neonatal Nurs 2023; 37:14-26. [PMID: 36707743 DOI: 10.1097/jpn.0000000000000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Online health interventions increase access to care, are acceptable to end users and effective for treating mental and physical health disorders. However, less is known about interventions to prevent and treat perinatal mood and anxiety disorders (PMADs). This review synthesizes existing research on PMAD prevention and treatment by exploring the treatment modalities and efficacy of online interventions and examining the inclusion of underserved populations in PMAD research. METHODS Using PRISMA guidelines, authors conducted a systematic review of peer-reviewed literature published between 2008 and 2018 on online interventions aimed to prevent or treat PMADs. The authors also assessed quality. Eligible articles included perinatal women participating in preventive studies or those aimed to reduce symptoms of PMADs and utilized a Web-based, Internet, or smartphone technology requiring an online component. This study excluded telephone-based interventions that required one-on-one conversations or individualized, text-based responses without a Web-based aspect. RESULTS The initial search yielded 511 articles, and the final analysis included 23 articles reporting on 22 interventions. Most studies used an experimental design. However, no study achieved an excellent or good quality rating. Psychoeducation and cognitive-behavioral therapies (CBTs) were most common. Several interventions using CBT strategies significantly decreased depression or anxiety. Four studies recruited and enrolled mainly people identifying as low-income or of a racial or ethnic minority group. Attrition was generally high across studies. DISCUSSION More research using rigorous study designs to test PMAD interventions across all perinatal times is needed. Future research needs to engage diverse populations purposefully.
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Affiliation(s)
- Shannon M Canfield
- Family and Community Medicine (Dr Canfield), Center for Health Policy (Dr Canfield), and School of Social Work (Dr Canada), University of Missouri-Columbia
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40
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Hendry A, Gibson SP, Davies C, McGillion M, Gonzalez-Gomez N. Toward a dimensional model of risk and protective factors influencing children's early cognitive, social, and emotional development during the COVID-19 pandemic. INFANCY 2023; 28:158-186. [PMID: 35993691 PMCID: PMC10086814 DOI: 10.1111/infa.12495] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/09/2022] [Accepted: 07/20/2022] [Indexed: 01/19/2023]
Abstract
Variation in infants' home environment is implicated in their cognitive and psycho-social development. The pandemic has intensified variations in home environments through exacerbating socioeconomic inequalities, and increasing psychological stressors for some families. This study investigates the effects of parental (predominantly maternal) mental health, enriching activities and screen use on 280 24- to 52-month-olds' executive functions, internalising and externalising problems, and pro-social behaviour; with socioeconomic status and social support as contextual factors. Our results indicate that aspects of the home environment are differentially associated with children's cognitive and psycho-social development. Parents who experienced sustained mental distress during the pandemic tended to report higher child externalising and internalising problems, and executive function difficulties at follow-up. Children who spent more time engaged in enriching activities with their parents showed stronger executive functions and social competence six months later. Screen use levels during the first year of the pandemic were not associated with outcomes. To mitigate the risk of persistent negative effects for this 'pandemic generation' of infants, our study highlights the importance of supporting parents' mental health. As our results demonstrate the impact of social support on mental health, investing in support services and interventions promoting building support networks are likely to be beneficial.
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Affiliation(s)
- Alexandra Hendry
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Catherine Davies
- School of Languages, Cultures and Societies, University of Leeds, Leeds, UK
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Lindblom J, Pajulo M, Nolvi S, Tervahartiala K, Karlsson H, Karlsson L, Korja R. Early pathways of maternal mentalization: Associations with child development in the FinnBrain birth cohort study. Front Psychol 2022; 13:855190. [PMID: 36582339 PMCID: PMC9792295 DOI: 10.3389/fpsyg.2022.855190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Parental mentalization refers to a parents' capacity and interest to consider the individual experience and mental state underlying the behaviors of the child. Higher mentalization is considered a key aspect for parental sensitivity in interaction, fostering child's socioemotional and self-regulatory development. Yet, previous studies have not examined the dynamic pathways through which the maternal mentalization may develop, nor their effects on child development. Thus, in the current person-oriented study, first, we identify distinct profiles and longitudinal trajectories of maternal mentalization from pregnancy to child's 2 years of age. Second, we test how the profiles and trajectories associate with children's internalizing and externalizing problems, social-emotional competence and effortful control at the age of 2 years. Third, we examine how the profiles and trajectories associate with contextual demographic and child related. The substudy was part of the FinnBrain Birth Cohort and included families from general population (n = 2,687). Mothers reported their parental reflective functioning (PRF) at late pregnancy, 6 months and 2 years of child's age. Both mothers (n = 1,437) and fathers (n = 715) reported the developmental child outcomes at the child's age of 2 years. Latent Profile Analysis and Latent Transition Analysis were used to identify PRF profiles and trajectories. The results showed decreasing heterogeneity in PRF from pregnancy to child's age of 6 months and 2 years (i.e., four, three and two latent classes, respectively). Most mothers progressed towards high PRF over time. Second, the profiles and trajectories depicting high PRF associated with child high social-emotional competence at the age of 2 years, yet no clear positive effects were found on child's problems and effortful control. The group of mixed PRF trajectories showed strongest association with child's internalizing and externalizing problems. Finally, there were theoretically meaningful associations between the PRF trajectories and both the contextual (e.g., parity) and child related (e.g., infant temperament) factors. This was the first study to explore the early unfolding of maternal mentalization. The results are discussed in relation with the potential mechanisms accounting for child development and with the nature and limitations of self-reported parental mentalization.
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Affiliation(s)
- J. Lindblom
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Faculty of Social Sciences, Tampere University, Tampere, Finland,*Correspondence: J. Lindblom,
| | - M. Pajulo
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - S. Nolvi
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Turku Institute for Advanced Studies, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
| | - K. Tervahartiala
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland
| | - H. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - L. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - R. Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
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Efficacy of a randomized controlled trial of a perinatal adaptation of COS-P in promoting maternal sensitivity and mental wellbeing among women with psychosocial vulnerabilities. PLoS One 2022; 17:e0277345. [PMID: 36454914 PMCID: PMC9714844 DOI: 10.1371/journal.pone.0277345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
Pregnant women with psychosocial vulnerabilities should be offered perinatal interventions that include a parenting component to ameliorate the potential negative effects of maternal mental health problems and/or poor social network on parenting. One such intervention program is the Circle of Security-Parenting intervention (COS-P). The COS-P is a manualized video-based intervention that based on attachment theory seek to enhance maternal sensitivity and decrease the risk on insecure and disorganized attachment. We carried out a randomized controlled trial examining the efficacy of a perinatal adapted version of COS-P for women with psychosocial vulnerabilities (e.g. histories of mental health problems and/or poor social networks). Eligible participants (N = 78) were recruited to the study by midwives during regular prenatal sessions. Interventions were delivered individually at home by trained health nurses both pre and post birth. The primary outcome was maternal sensitivity assessed with the Coding Interactive Behavior Manual by blinded coders from video-recordings of mother-infant free play interactions. Secondary outcomes were mother-reported depressive symptoms, parental reflective functioning, parental stress, infant socio-emotional functioning, and maternal wellbeing. All outcomes were assessed at nine months infant age. We did not find an effect of the intervention on the primary outcome of maternal sensitivity (β = -0.08; 95% CI [-0.41, 0.26], p = .66). Neither did we find intervention effects on the secondary outcomes of depressive symptoms, parental reflective functioning, maternal well-being, or infant socio-emotional functioning. We did however find that the intervention decreased parental stress (β = -8.51; 95% CI [-16.6;-0.41], p = .04). The results are discussed in light of existing findings on the effect of COS-P and sample heterogeneity. Furthermore, we discuss the challenges of adapting the COS-P for pregnant women, some without prior experiences with caregiving. Future research with larger at-risk samples examining moderation factors (e.g. adult attachment, depression maternal-fetal attachment) are recommended.
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Huffhines L, Bublitz MH, Coe JL, Seifer R, Parade SH. Maternal perinatal hypertensive disorders and parenting in infancy. Infant Behav Dev 2022; 69:101781. [PMID: 36323194 PMCID: PMC9793337 DOI: 10.1016/j.infbeh.2022.101781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/05/2022] [Accepted: 10/16/2022] [Indexed: 12/30/2022]
Abstract
Maternal mental health strongly influences parenting during infancy. However, it is unclear whether maternal physical health conditions in the perinatal period may also impact parenting. Examining the association of hypertensive disorders - a common physical health problem in pregnancy - with subsequent parenting behaviors is an important first step in understanding the connection between maternal physical health and parenting during this critical developmental period. This study evaluated whether hypertensive disorders of pregnancy (HDP) and hypertensive disorders (HD) diagnosed after the birth of the infant were associated with parenting self-efficacy, parenting stress, and observed parental responsiveness during mother-infant interactions at 6 and 12 months postpartum among a sample of racially and ethnically diverse mothers and their infants (N = 295). Results showed that mothers with an HDP or HD diagnosis had lower levels of parenting self-efficacy, higher levels of parenting stress, and lower levels of observed parental responsiveness compared to mothers without an HDP or HD diagnosis. Given that women with childhood adversity are at higher risk for experiencing HDP/HD and may have more difficulties with parenting compared to women without childhood adversity, we utilized a sample of mothers wherein most had experienced at least one form of adversity in their childhoods. Exploratory analyses revealed that HDP/HD moderated the relation between early life experiences and parenting outcomes in all but one model. Associations between HDP/HD and parenting are discussed, with implications for how we understand maternal physical health as a determinant of parenting in the perinatal period.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA.
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Women's Medicine Collaborative, The Miriam Hospital, Providence, RI, USA
| | - Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA; Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
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Eller J, Magro SW, Roisman GI, Simpson JA. The predictive significance of fluctuations in early maternal sensitivity for secure base script knowledge and relationship effectiveness in adulthood. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2022; 39:3044-3058. [PMID: 36381417 PMCID: PMC9662749 DOI: 10.1177/02654075221077640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Attachment theory suggests that both the quality and consistency of early sensitive care should shape an individual's attachment working models and relationship outcomes across the lifespan. To date, most research has focused on the quality of early sensitive caregiving, finding that receiving higher quality care predicts more secure working models and better long-term relationship outcomes than receiving lower quality care. However, it remains unclear whether or how the consistency of early sensitive care impacts attachment working models and adult relationship functioning. In this research, we utilized data from the Minnesota Longitudinal Study of Risk and Adaptation to examine to what extent the quality (i.e., mean levels) and consistency (i.e., within-person fluctuations) in behaviorally coded maternal sensitive care assessed 7 times from 3 months to 13 years prospectively predicts secure base script knowledge and relationship effectiveness (i.e., interpersonal competence in close relationships) in adulthood. We found that larger fluctuations and lower mean levels of early maternal sensitivity jointly predict lower relationship effectiveness in adulthood via lower secure base script knowledge. These findings reveal that nonlinear models of early caregiving experiences more completely account for relationship outcomes across the lifespan, beyond what traditional linear models have documented. Implications for attachment theory and longitudinal methods are discussed.
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Ilomäki M, Lindblom J, Salmela V, Flykt M, Vänskä M, Salmi J, Tolonen T, Alho K, Punamäki RL, Wikman P. Early life stress is associated with the default mode and fronto-limbic network connectivity among young adults. Front Behav Neurosci 2022; 16:958580. [PMID: 36212193 PMCID: PMC9537946 DOI: 10.3389/fnbeh.2022.958580] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to early life stress (ELS) is associated with a variety of detrimental psychological and neurodevelopmental effects. Importantly, ELS has been associated with regional alterations and aberrant connectivity in the structure and functioning of brain regions involved in emotion processing and self-regulation, creating vulnerability to mental health problems. However, longitudinal research regarding the impact of ELS on functional connectivity between brain regions in the default mode network (DMN) and fronto-limbic network (FLN), both implicated in emotion-related processes, is relatively scarce. Neuroimaging research on ELS has mostly focused on single nodes or bi-nodal connectivity instead of functional networks. We examined how ELS is associated with connectivity patterns within the DMN and FLN during rest in early adulthood. The participants (n = 86; 47 females) in the current functional magnetic resonance imaging (fMRI) study were young adults (18-21 years old) whose families had participated in a longitudinal study since pregnancy. ELS was assessed both prospectively (parental reports of family relationship problems and mental health problems during pregnancy and infancy) and retrospectively (self-reported adverse childhood experiences). Inter-subject representational similarity analysis (IS-RSA) and multivariate distance matrix regression (MDMR) were used to analyze the association between ELS and the chosen networks. The IS-RSA results suggested that prospective ELS was associated with complex alterations within the DMN, and that retrospective ELS was associated with alterations in the FLN. MDMR results, in turn, suggested that that retrospective ELS was associated with DMN connectivity. Mean connectivity of the DMN was also associated with retrospective ELS. Analyses further showed that ELS-related alterations in the FLN were associated with increased connectivity between the prefrontal and limbic regions, and between different prefrontal regions. These results suggest that exposure to ELS in infancy might have long-lasting influences on functional brain connectivity that persist until early adulthood. Our results also speak for the importance of differentiating prospective and retrospective assessment methods to understand the specific neurodevelopmental effects of ELS.
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Affiliation(s)
- Miro Ilomäki
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jallu Lindblom
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Viljami Salmela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjo Flykt
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Juha Salmi
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
| | - Tuija Tolonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kimmo Alho
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Advanced Magnetic Imaging Centre, Aalto NeuroImaging, Aalto University, Espoo, Finland
| | | | - Patrik Wikman
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Reinelt T, Suppiger D, Frey C, Oertel R, Natalucci G. Infant regulation during the pandemic: Associations with maternal response to the COVID-19 pandemic, well-being, and socio-emotional investment. INFANCY 2022; 28:9-33. [PMID: 36056543 PMCID: PMC9539181 DOI: 10.1111/infa.12497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 01/19/2023]
Abstract
In the transition to parenthood, the COVID-19 pandemic poses an additional strain on parental well-being. Confirmed infections or having to quarantine, as well as public health measures negatively affect parents and infants. Contrary to previous studies mainly focusing on the well-being of school-aged children and their parents during lockdown periods, the present study investigated how mothers of infants respond to the COVID-19 pandemic and whether this is related to maternal well-being, maternal socio-emotional investment, and infant regulation. Between April and June 2021, 206 mothers of infants (Mage = 7.14 months, SDage = 3.75 months) reported on COVID-19 infections, their response to the COVID-19 pandemic, their well-being, socio-emotional investment, and their infant's regulation. Exploratory factor analyses yielded five dimensions of maternal response to the COVID-19 pandemic: social distancing, worrying about the child, birth anxiety, distancing from the child, and information on COVID-19-related parenting behavior and support. These dimensions were related to mother-reported infant regulatory problems. Path analyses revealed paths via reduced maternal well-being and maternal socio-emotional investment. Maternal perceptions of infant regulatory problems are related to how the mothers respond to the COVID-19 pandemic. Better information about COVID-19-related parenting behavior and support might buffer against these effects.
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Affiliation(s)
- Tilman Reinelt
- Department of NeonatologyFamily Larsson‐Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the NewbornUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Debora Suppiger
- Department of NeonatologyFamily Larsson‐Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the NewbornUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Clarissa Frey
- Department of NeonatologyFamily Larsson‐Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the NewbornUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Rebecca Oertel
- Department of NeonatologyFamily Larsson‐Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the NewbornUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Giancarlo Natalucci
- Department of NeonatologyFamily Larsson‐Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the NewbornUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
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Parental embodied mentalizing: Associations with maternal depression, anxiety, verbal mentalizing, and maternal styles of interaction. J Affect Disord 2022; 311:472-478. [PMID: 35609764 DOI: 10.1016/j.jad.2022.05.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Maternal depression and anxiety in the perinatal period affect the quality of maternal sensitivity and mentalizing abilities. Few studies analyzed implicit mentalizing in relation to maternal distress. The aims of the study were: to examine the relation between nonverbal mentalizing - parental embodied mentalizing (PEM) - and maternal depression and anxiety, verbal mentalizing, and maternal styles of interaction; and to test PEM as a mediator of the effect of maternal distress on styles of interaction. METHOD 81 mother-infant dyads have been recruited. At infant three months, maternal depression was assessed using the Edinburgh Postnatal Depression Scale, anxiety with State Trait Anxiety Inventory, and reflective functioning with Reflective Functioning Scale. Mother-infant interactions were coded with various approaches: PEM for nonverbal mentalizing, Mind-mindedness coding system for Mind-mindedness, and CARE-Index for maternal styles of interaction. RESULTS Maternal depression and state anxiety were negatively correlated with PEM. PEM was also negatively correlated to maternal controlling style. Mothers with psychopathological problems (vs. mothers with no psychopathological problems) had lower PEM and sensitivity and more controlling style. Moreover, maternal depression and anxiety had direct effects on maternal sensitivity and had indirect effects mediated by PEM on controlling style. LIMITATIONS The study evaluates interactions at three months; longitudinal studies will be able to examine maternal mentalizing and sensitivity in various stages and identify the effect on the child's attachment. CONCLUSIONS PEM is associated to maternal anxiety and depression and mediates the effects of depression and anxiety on mother controlling style. These results emphasize the importance of early prevention programs for mothers focused also on implicit mentalizing.
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Olhaberry MP, León MJ, Coo S, Barrientos M, Pérez JC. An explanatory model of parental sensitivity in the mother-father-infant triad. Infant Ment Health J 2022; 43:714-729. [PMID: 35921446 DOI: 10.1002/imhj.22007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 04/20/2022] [Indexed: 11/09/2022]
Abstract
Quality of early family interactions has been associated with child development, bonding, and mental health. Childhood adversity, stress, and depression impact parenting, affecting the quality of the interaction within the mother-father-child triad. The aim of the present study was to analyze the influence of parents' adverse childhood experiences, depressive symptoms, and parental stress, on their sensitive response toward their tooddler and quality of traidic interactions. A correlational cross-sectional method was used. The sample included 80 mother-father-child triads, of toddlers with social-emotional difficulties. Parents early adverse experiences, parental stress, and depressive symptoms were assessed through self-report measures. Observational measures on parental sensitivity and triadic interaction were used. For mothers and fathers, adverse childhood experiences were associated with depressive symptoms in adulthood. Sensitivity toward their child and stress were positively associated among both parents. Symptoms of depression in mothers were associated with lower sensitivity toward their child, but in fathers, their sensitive response was influenced by the level of parental stress in the mother. In both parents, greater sensitivity in the dyadic interaction with the child was associated with a higher quality of the triadic interactions, in the triad as a whole, and in the regulation and involvement of the child.
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Affiliation(s)
- Marcia Paola Olhaberry
- Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile
| | - María José León
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile
| | - Soledad Coo
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | | | - J Carola Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile.,Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
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Abstract
BACKGROUND Postpartum depression (PPD) is a major public health concern and has, at its core, a sense of maternal 'disconnection' - from the self, the infant, and the support system. While PPD bears similarities with MDD, there is increasing evidence for its distinct nature, especially with the unique aspect of the mother-infant relationship. Current treatment modalities for PPD, largely based on those used in major depressive disorder (MDD), have low remission rates with emerging evidence for treatment resistance. It is, therefore, necessary to explore alternative avenues of treatment for PPD. OBJECTIVE In this narrative review, we outline the potential therapeutic rationale for serotonergic psychedelics in the treatment of PPD, and highlight safety and pragmatic considerations for the use of psychedelics in the postpartum period. METHODS We examined the available evidence for the treatment of PPD and the evidence for psychedelics in the treatment of MDD. We explored safety considerations in the use of psychedelics in the postpartum period. RESULTS There is increasing evidence for safety, and encouraging signals for efficacy, of psilocybin in the treatment of MDD. Psilocybin has been shown to catalyse a sense of 'reconnection' in participants with MDD. This effect in PPD, by fostering a sense of 'reconnection' for the mother, may allow for improved mood and maternal sensitivity towards the infant, which can positively impact maternal role gratification and the mother-infant relationship. CONCLUSION Psychedelic assisted therapy in PPD may have a positive effect on the mother-infant dyad and warrants further examination.
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Affiliation(s)
- Chaitra Jairaj
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,The National Maternity Hospital, Dublin, Ireland,Chaitra Jairaj, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK.
| | - James J Rucker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Bethlem Royal Hospital, South London and Maudsley National Health Service Foundation Trust, Beckenham, UK
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Ho SS, Nakamura Y, Gopang M, Swain JE. Intersubjectivity as an antidote to stress: Using dyadic active inference model of intersubjectivity to predict the efficacy of parenting interventions in reducing stress-through the lens of dependent origination in Buddhist Madhyamaka philosophy. Front Psychol 2022; 13:806755. [PMID: 35967689 PMCID: PMC9372294 DOI: 10.3389/fpsyg.2022.806755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Intersubjectivity refers to one person's awareness in relation to another person's awareness. It is key to well-being and human development. From infancy to adulthood, human interactions ceaselessly contribute to the flourishing or impairment of intersubjectivity. In this work, we first describe intersubjectivity as a hallmark of quality dyadic processes. Then, using parent-child relationship as an example, we propose a dyadic active inference model to elucidate an inverse relation between stress and intersubjectivity. We postulate that impaired intersubjectivity is a manifestation of underlying problems of deficient relational benevolence, misattributing another person's intentions (over-mentalizing), and neglecting the effects of one's own actions on the other person (under-coupling). These problems can exacerbate stress due to excessive variational free energy in a person's active inference engine when that person feels threatened and holds on to his/her invalid (mis)beliefs. In support of this dyadic model, we briefly describe relevant neuroimaging literature to elucidate brain networks underlying the effects of an intersubjectivity-oriented parenting intervention on parenting stress. Using the active inference dyadic model, we identified critical interventional strategies necessary to rectify these problems and hereby developed a coding system in reference to these strategies. In a theory-guided quantitative review, we used this coding system to code 35 clinical trials of parenting interventions published between 2016 and 2020, based on PubMed database, to predict their efficacy for reducing parenting stress. The results of this theory-guided analysis corroborated our hypothesis that parenting intervention can effectively reduce parenting stress if the intervention is designed to mitigate the problems of deficient relational benevolence, under-coupling, and over-mentalizing. We integrated our work with several dyadic concepts identified in the literature. Finally, inspired by Arya Nagarjuna's Buddhist Madhyamaka Philosophy, we described abstract expressions of Dependent Origination as a relational worldview to reflect on the normality, impairment, and rehabilitation of intersubjectivity.
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Affiliation(s)
- S. Shaun Ho
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, United States
| | - Yoshio Nakamura
- Pain Research Center, Division of Pain Medicine, Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Meroona Gopang
- Program of Population Health and Clinical Outcomes Research, School of Public Health, Stony Brook University, Stony Brook, NY, United States
| | - James E. Swain
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, United States
- Program of Population Health and Clinical Outcomes Research, School of Public Health, Stony Brook University, Stony Brook, NY, United States
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
- Department of Psychiatry and Psychology, University of Michigan, Ann Arbor, MI, United States
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