Resilience in Infancy: A Relational Approach

The Protective Effects of Maternal and Paternal Factors on Children's Social Development

The goal of this study is to examine associations among family and child protective factors, maternal and paternal levels of distress, and children's social competence in a sample of 156 ethnically and socioeconomically diverse first-time mothers, fathers, and their children, followed from 9 months to 30 months of age. Using multiple linear regression modeling, our results indicate that dyadic synchrony and children's positive temperament during infancy are significantly associated with fewer behavior problems and paternal optimism with high levels of social competence at 21 months (main effects). Father optimism and child positive temperament are only significantly related to higher levels of social competence and fewer behavioral problems, respectively, in the context of low levels of paternal distress (interaction effects). These results suggest that in our sample maternal dyadic synchrony operates in the same way across levels of maternal distress as it relates to children's behavior problems, with the exception of paternal optimism and children's positive temperament. Results also suggest that protective factors are different for mothers, fathers, and children.

Resilience in palliative healthcare professionals: a systematic review

Purpose

Exposure to end-of-life and chronic illness on a daily basis may put palliative healthcare professionals’ well-being at risk. Resilience may represent a protective factor against stressful and demanding challenges. Therefore, the aim is to systematically review the quantitative studies on resilience in healthcare professionals providing palliative care to adult patients.

Methods

A literature search on PubMed, Scopus, Web of Science and PsycINFO databases was performed. The review process has followed the international PRISMA statement guidelines.

Results

At the initial search, a total of 381 records were identified. Twelve articles were assessed for eligibility and, finally, 6 studies met all the inclusion criteria. Of these, four researches were observational and two interventional pilot studies. From the systematic synthesis, palliative care providers’ resilience revealed to be related to other psychological constructs, including secondary traumatic stress, vicarious posttraumatic growth, death anxiety, burnout, compassion satisfaction, hope and perspective taking.

Conclusions

The current systematic review reported informative data leading to consider resilience as a process modulator and facilitator among palliative care professionals. A model on palliative healthcare providers’ experience and the role of resilience was proposed. Further studies may lead to its validation and implementation in assessment and intervention contributing to foster palliative healthcare professionals’ well-being.

Psychodynamic formulation in the era of the brain - towards integration

OBJECTIVE

The objectives of this study were to describe advances in neurosciences and their relationship to psychodynamic models of psychopathology and to present an integrative approach to psychodynamic formulation which incorporates the neurobiological underpinnings of self-functioning and a model of relational trauma.

CONCLUSION

Developmental psychopathology is now better able to describe the significance of early developmental periods and the interpersonal context of self-development. These findings contribute to an integrated biopsychosocial psychodynamic formulation based on core principles of early development.

Infants and the decision to provide ongoing child welfare services

BACKGROUND

Infants are the most likely recipients of child welfare services; however, little is known about infants and families who come into contact with the child welfare system and factors that are associated with service provision. Investigations involving infants and their families present an unparalleled opportunity for the child welfare sector to enhance infants' safety and well-being through early identification, referral and intervention. Understanding how the child welfare system responds to the unique needs of infants and caregivers is critical to developing appropriate practice and policy responses within the child welfare sector and across other allied sectors. This study examines maltreatment-related investigations in Ontario involving children under the age of one to identify which factors are most influential to predicting service provision at the conclusion of a child welfare investigation.

METHODS

A secondary analysis of the fifth cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) for 2013 was conducted. The OIS is a cross-sectional child welfare study that is conducted every 5 years. The most influential factors that were associated with the decision to transfer a case to ongoing services were explored through a multivariate tree-classification technique, Chi square automatic interaction detection.

RESULTS

There were an estimated 7915 maltreatment-related investigations involving infants in 2013. At least one caregiver risk factor was identified in approximately three-quarters (74%) of investigations involving infants. In the majority of investigations (57%), at least one referral for specialized services was provided. Primary caregiver with few social supports was the most highly significant predictor of the decision to provide ongoing child welfare services. Primary caregiver risk factors were predominant in this model. The analysis identified subgroups of investigations involving infants for which the likelihood of being transferred to ongoing services ranged from approximately 11-97%.

CONCLUSION

Caregivers of infants are struggling with numerous challenges that can adversely compromise their ability to meet the unique developmental needs of their infant. The findings underscore the importance of community and social supports in decision-making.

What is resilience? An Integrative Review of the empirical literature

AIM

To use systematic methods to examine how resilience is defined in empirical research.

BACKGROUND

Resilience is a term that is increasingly being used to describe and explain the complexities of individual and group responses to traumatic and challenging situations. It is now frequently mentioned in relation to many areas of nursing practice, including research. Given the increasing use of the term, it is timely to examine how resilience has been defined in empirical research.

DESIGN

An integrative review of the empirical literature (2000-2015).

DATA SOURCES

Three health-related databases were searched: Medline, PsycINFO and the Cumulative Index for Nursing and Allied Health (CINAHL). Reference and citation tracking was performed on all articles included in the review.

REVIEW METHODS

The methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis.

RESULTS

One hundred articles were included in the final data analysis. The most significant finding of the review was that there is no universal definition of resilience. There were, however, some common themes identified: rising above, adaptation and adjustment, dynamic process, 'ordinary magic' and mental illness as a marker of resilience.

CONCLUSION

Despite the increasing use of the term 'resilience', this review has identified that there is no universal definition of resilience adopted in the research literature. Further research is required to explore this construct in the context of nursing.

The moderating effect of relationships on intergenerational risk for infant neglect by young mothers

Infant neglect is the form of child maltreatment that occurs most often, yet has been least amenable to prevention. A maternal history of childhood maltreatment is a potent risk factor for child neglect, yet most maltreated mothers break intergenerational cycles of child abuse and neglect. Little is known about what protective factors support discontinuity in intergenerational transmission. This study examined whether certain factors (positive childhood care, older maternal age, social support) buffer intergenerational risk for neglect among the infants of young mothers, a population at high risk of being victimized. For young mothers in the sample (<21 years at birth; n=447), the effect of a maternal history was assessed separately for different maltreatment types according to data on substantiated reports from Child Protective Services. Early risk for neglect was assessed using maternal self-report of parenting empathy. The results revealed that both infants and their mothers experienced neglect more often than any other maltreatment type. However, approximately 77% of maltreated mothers broke the cycle with their infants (<30 months). Maternal age moderated the relation between a maternal history of neglect and infant neglect, and social support moderated the relation between childhood neglect and maternal empathy. Neglected mothers had considerably higher levels of parenting empathy when they had frequent access to social support than when they had less frequent support, whereas the protective effect of social support was not nearly as strong for non-maltreated mothers. Study findings highlight resilience in parenting despite risk for infant neglect, but underscore the context specificity of protective processes.

An ecological analysis of infant neglect by adolescent mothers

To inform efforts to prevent child neglect, we investigated a wide range of risk factors that have been largely unexamined in relation to infant neglect, the most commonly occurring form of child maltreatment. Using an ecological model of child neglect, we assessed the influence of characteristics at the level of the child, the mother, the family, and broader childrearing contexts on adolescent mothers' likelihood of being a perpetrator in a substantiated case of neglect against their firstborn infants (n=383, M=12 months). Several factors were associated with infant neglect by young mothers: median block income, low infant birth weight, maternal smoking, maternal childhood history of neglect and of positive care, intimate partner violence (IPV) perpetrated by either the mother or her partner, and maternal use of mental health services. In multivariate models, income, a maternal childhood history of positive care, IPV by either a mother or her partner, and mental health service usage made significant contributions to the odds that a mother neglected her infant. Our findings suggest that these factors have particular salience to policymakers' and practitioners' efforts to identify high risk families and to intervene during the earliest months of life to prevent child neglect.

Early resilience in the context of parent-infant relationships: a social developmental perspective

The growth of infants' regulatory capacities is foundational to the capacity for resilience. Variations in the quality of early social--emotional experience can promote or undermine infants' regulatory capacities. Such capacities are also dynamically sculpted by the relationships among infant, parent, and contextual--cultural factors. Brief periods of disorganization in parent-infant relationships are inevitable, common, and reflect everyday demands on parents and infants. The uneven nature of parent-infant interactions fosters the emergence of new infant capacities. Parental depression and anxiety as well as infant medical, behavioral, and temperamental issues can result in prolonged periods of dyadic disorganization and maladaptive infant outcomes. Child health clinicians can help parents anticipate the normal periods of disorganization and assist parents as they strive to develop optimal parent-infant relationships.