1
|
Masefield S, Ellwood A, Blower S, Dickerson J, Moss RH, Ahern SM. Study protocol for a systems evaluation of an infant mental health service: Integration of 'Little Minds Matter' into the early years system. PLoS One 2024; 19:e0286835. [PMID: 38452100 PMCID: PMC10919861 DOI: 10.1371/journal.pone.0286835] [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: 05/22/2023] [Accepted: 10/11/2023] [Indexed: 03/09/2024] Open
Abstract
Infant Mental Health relates to how well a child develops socially and emotionally from birth to age three. There is a well-established link between parent-infant relationship quality, Infant Mental Health, and longer-term social and emotional development there is a lack of evidence-based interventions that support the parent-infant relationship and/or protect against poor Infant Mental Health. Little Minds Matter is a specialist Infant Mental Health service developed in Bradford (UK) to support parent-infant relationships by providing training and consultation for professionals and direct clinical work to families. The successful implementation of this intervention depends upon how well it becomes embedded within, or integrated into, the early years system. For the purposes of this study, the early years system includes health, social and education services that support child health and development from conception to primary school entry at age five. This study protocol aims to apply a systems approach to evaluate this service and provide a perspective on the process of embedding a complex service within a healthcare system. Multiple methods will be used to investigate embeddedness within the wider early years system. Routinely collected quantitative data about the service will be used to develop a system map showing interaction with related services. Qualitative data will be collected at two time points through interviews with individuals involved in the design and provision of the service, and professionals working within the early years system. Framework analysis will be used to analyse the data inductively and deductively within a systems approach. The findings from this study will provide evidence to inform the ongoing implementation of the service for providers and commissioning bodies. Exploring the application of a systems approach in this clinical context will have application more broadly for researchers evaluating complex interventions and services within a wider system.
Collapse
Affiliation(s)
- Sarah Masefield
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
| | - Alison Ellwood
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, West Yorkshire, United Kingdom
| | - Sarah Blower
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
| | - Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, West Yorkshire, United Kingdom
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, West Yorkshire, United Kingdom
| | - Sara M. Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, West Yorkshire, United Kingdom
| |
Collapse
|
2
|
Armstrong VG, Ross J. Art at the Start: A controlled trial and close observation of parent-infant art therapy intervention. Infant Ment Health J 2023; 44:720-737. [PMID: 37552614 DOI: 10.1002/imhj.22078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/21/2023] [Accepted: 06/29/2023] [Indexed: 08/10/2023]
Abstract
This two-part study seeks to evidence art therapy intervention for parent-infant attachment relationships, looking at improvements to wellbeing and relationships. Study one was a controlled trial with 105 participating parent/caregivers and their infants (0-3-years), identified due to concerns about their relationship. They were quasi-randomized to attend a 12-week art therapy group or treatment as usual. Measures focused on parents' wellbeing and their perceptions of their relationship with their infant. In study 2 we analyzed video footage from the first and penultimate sessions of a sample of 37 dyads, looking for observable changes in the different channels of communication upon which attachments are predicated. The controlled trial showed intervention participants had significantly improved parental wellbeing, significant increases in attachment warmth and significant decreases in intrusion. This contrasted with the control sample who showed a significant decrease in wellbeing, stable warmth, and significant increases in intrusion. The observation study showed that there was a significant increase in the communicative behaviors from the parents to the infant which would support attachments between the first and penultimate sessions. We conclude that these results make a robust case for the inclusion of art therapy within the range of interventions available for at risk early relationships.
Collapse
|
3
|
Willis DW, Condon MC, Moe V, Munson L, Smith L, Eddy JM. The context and development of the early relational health screen. Infant Ment Health J 2022; 43:493-506. [PMID: 35537064 DOI: 10.1002/imhj.21986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022]
Abstract
Early relational experiences are key drivers for developing social emotional capacities, educational achievement, mental health, physical health, and overall wellbeing. The child health sectors are committed to promotion, prevention, and early intervention that optimize children's health and development, often employing evidence-based screening as foundational practices. Despite a variety of validated parent-infant observational assessment tools, few are practical within busy practice settings, acceptable with all racial and ethnic groups and ready for universal adoption. In response to this need, a team of clinicians, early childhood educators, researchers and infant mental health specialists collaborated to develop and test a novel video-based, dyadic relational screening and monitoring tool, the Early Relational Health Screen (ERHS). This tool uniquely focuses on the early parent-child relationship (6-24 months), within the construct of early relational health (ERH). Initial testing demonstrated that the ERHS is a valid, reliable, feasible, and useful screening and monitoring tool for clinical applications. The ERHS was further developed within a population-based, prospective research study and adapted with brief video feedback for parents in the home visiting and child health sectors. The ERHS and its adaptations appear to advance ERH and equity within the transforming child health and public health care systems of today.
Collapse
Affiliation(s)
- David W Willis
- Center for the Study of Social Policy, Washington, District of Columbia, USA
| | | | - Vibeke Moe
- Department of Psychology, University of Oslo, and the Regional Centre for Child and Adolescent Mental Health for Eastern & Southern Norway, Oslo, Norway
| | - Leslie Munson
- Department of Special Education, Portland State University, Portland, Oregon, USA
| | - Lars Smith
- Department of Psychology, University of Oslo, and the Regional Centre for Child and Adolescent Mental Health for Eastern & Southern Norway, Oslo, Norway
| | - J Mark Eddy
- Family Translational Research Group, College of Dentistry, New York University, New York City, New York, USA.,Texas Center for Equity Promotion, College of Education, University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
4
|
Zimmer-Gembeck MJ, Rudolph J, Edwards EJ, Swan K, Campbell SM, Hawes T, Webb HJ. The Circle of Security Parenting Program (COS-P): A Randomized Controlled Trial of a Low Intensity, Individualized Attachment-Based Program With at-Risk Caregivers. Behav Ther 2022; 53:208-223. [PMID: 35227399 DOI: 10.1016/j.beth.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 12/12/2022]
Abstract
The Circle of Security-Parenting Intervention (COS-P; Cooper et al., 2009) is a psychoeducational program for caregivers of young children that has been widely disseminated. The program is founded in attachment theory and relies on computer-delivered content and parent reflection and discussion to teach concepts of safety and security to promote better caregiver-child relationships and child wellbeing. The present study is a randomized controlled trial of COS-P, individually delivered to 85 Australian caregivers (51 COS-P, 34 waitlist control) who reported parenting distress and child disruptive behaviors. Caregivers completed a baseline assessment and repeated the assessment after completion of COS-P or 8 weeks on the waitlist. Caregivers completed surveys to report child symptoms, and parenting stress, anxious and avoidant attachment, reflective functioning, parenting practices, and depressive symptoms. No differences in COS-P vs. waitlist participants were found at baseline. Analyses of complete data (35 COS-P, 25-26 waitlist) revealed a greater decline in caregivers' attachment anxiety and negative parenting relative to waitlist, but only attachment anxiety in intent-to-treat analyses. Other improvements were found, but these extended to both the COS-P and waitlist conditions and did not differ between conditions. Overall, effects of COS-P were small and rarely significant, suggesting the need to consider alternative programs that have evidence of effectiveness when providing services to at-risk families.
Collapse
Affiliation(s)
| | | | | | - Kellie Swan
- Griffith University, School of Applied Psychology and Menzies Health Institute of Queensland
| | - Shawna M Campbell
- Griffith University, School of Applied Psychology and Menzies Health Institute of Queensland
| | - Tanya Hawes
- Griffith University, School of Applied Psychology
| | - Haley J Webb
- Griffith University, School of Applied Psychology
| |
Collapse
|
5
|
Bywater T, Dunn A, Endacott C, Smith K, Tiffin PA, Price M, Blower S. The Measurement Properties and Acceptability of a New Parent–Infant Bonding Tool (‘Me and My Baby’) for Use in United Kingdom Universal Healthcare Settings: A Psychometric, Cross-Sectional Study. Front Psychol 2022; 13:804885. [PMID: 35237212 PMCID: PMC8883030 DOI: 10.3389/fpsyg.2022.804885] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The National Institute for Health and Care Excellence (NICE) guidelines acknowledge the importance of the parent–infant relationship for child development but highlight the need for further research to establish reliable tools for assessment, particularly for parents of children under 1 year. This study explores the acceptability and psychometric properties of a co-developed tool, ‘Me and My Baby’ (MaMB). Study design A cross-sectional design was applied. The MaMB was administered universally (in two sites) with mothers during routine 6–8-week Health Visitor contacts. The sample comprised 467 mothers (434 MaMB completers and 33 ‘non-completers’). Dimensionality of instrument responses were evaluated via exploratory and confirmatory ordinal factor analyses. Item response modeling was conducted via a Rasch calibration to evaluate how the tool conformed to principles of ‘fundamental measurement’. Tool acceptability was evaluated via completion rates and comparing ‘completers’ and ‘non-completers’ demographic differences on age, parity, ethnicity, and English as an additional language. Free-text comments were summarized. Data sharing agreements and data management were compliant with the General Data Protection Regulation, and University of York data management policies. Results High completion rates suggested the MaMB was acceptable. Psychometric analyses showed the response data to be an excellent fit to a unidimensional confirmatory factor analytic model. All items loaded statistically significantly and substantially (>0.4) on a single underlying factor (latent variable). The item response modeling showed that most MaMB items fitted the Rasch model. (Rasch) item reliability was high (0.94) yet the test yielded little information on each respondent, as highlighted by the relatively low ‘person separation index’ of 0.1. Conclusion and next steps MaMB reliably measures a single construct, likely to be infant bonding. However, further validation work is needed, preferably with ‘enriched population samples’ to include higher-need/risk families. The MaMB tool may benefit from reduced response categories (from four to three) and some modest item wording amendments. Following further validation and reliability appraisal the MaMB may ultimately be used with fathers/other primary caregivers and be potentially useful in research, universal health settings as part of a referral pathway, and clinical practice, to identify dyads in need of additional support/interventions.
Collapse
Affiliation(s)
- Tracey Bywater
- Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
- *Correspondence: Tracey Bywater,
| | - Abigail Dunn
- Department of Social Policy and Social Work, University of York, York, United Kingdom
| | - Charlotte Endacott
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Karen Smith
- Rotherham Doncaster and South Humber NHS Foundation Trust, Doncaster, United Kingdom
| | - Paul A. Tiffin
- Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
| | - Matthew Price
- Little Minds Matter Bradford Infant Mental Health Service, Bradford District Care NHS Foundation Trust, Bradford, United Kingdom
| | - Sarah Blower
- Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
| |
Collapse
|
6
|
Xu X, Liu Z, Gong S, Wu Y. The Relationship between Empathy and Attachment in Children and Adolescents: Three-Level Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1391. [PMID: 35162410 PMCID: PMC8835466 DOI: 10.3390/ijerph19031391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 01/20/2023]
Abstract
Empathy is one of the leading social abilities to understand or feel the emotions of other people. Attachment is thought to be a critical influential factor of empathy, as revealed by attachment theory and experimental studies, while empathy is also believed to facilitate the quality of attachment. Although many studies are conducted concerning the two subjects, the direction and magnitude of their relationship still remain unclear. In order to clarify the discrepant results in the previous study and explore the moderators in the empathy-attachment association, three-level meta-analyses were conducted in the present work. Based on 212 effect sizes from 59 samples in 50 studies with a total of 24,572 participants, random effect model analyses showed that empathy was insignificantly correlated with anxious attachment, significantly negatively correlated with avoidant attachment, and significantly positively correlated with secure attachment. The meta-analytic results indicated that children and adolescents with high secure attachment tend to show more empathy than those with low secure attachment. The meta-regression model revealed significant effects of the empathy dimension, culture, empathy measurement tools, and publication state. Additionally, implications and future directions for the empathy-attachment relationship were also discussed.
Collapse
Affiliation(s)
- Xizheng Xu
- School of Psychology, Central China Normal University (CCNU), Wuhan 430079, China; (X.X.); (Z.L.)
- Hunan Police Academy, Changsha 410138, China
| | - Zhiqiang Liu
- School of Psychology, Central China Normal University (CCNU), Wuhan 430079, China; (X.X.); (Z.L.)
- Center of Students’ Psychological Development, Yancheng Polytechnic College (YCPC), Yancheng 224000, China
| | - Shaoying Gong
- School of Psychology, Central China Normal University (CCNU), Wuhan 430079, China; (X.X.); (Z.L.)
| | - Yunpeng Wu
- School of Teacher Education, Dezhou University, Dezhou 253023, China;
| |
Collapse
|
7
|
Midgley N, Mortimer R, Cirasola A, Batra P, Kennedy E. The Evidence-Base for Psychodynamic Psychotherapy With Children and Adolescents: A Narrative Synthesis. Front Psychol 2021; 12:662671. [PMID: 33986713 PMCID: PMC8110733 DOI: 10.3389/fpsyg.2021.662671] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers (28 distinct studies). When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers (82 distinct studies). The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations (small sample sizes, lack of control groups etc.), and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people.
Collapse
Affiliation(s)
- Nick Midgley
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.,Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Rose Mortimer
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Antonella Cirasola
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.,Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Prisha Batra
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Eilis Kennedy
- Research and Development Unit, Tavistock and Portman NHS Trust, London, United Kingdom
| |
Collapse
|
8
|
Parent-directed intervention versus controls whilst their child waits for diagnostic assessment: a systematic review protocol. Syst Rev 2021; 10:67. [PMID: 33663597 PMCID: PMC7931343 DOI: 10.1186/s13643-021-01615-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Waiting lists are an ongoing issue for publicly funded community and hospital-based health services. Parents and caregivers are instrumental supports in the health and well-being of young and school-aged children, yet little is known about the way they can be supported during waiting periods. Given mounting evidence about the value of early intervention in physical and mental health literature, and waits for some public health services extending past 12 months, it is both timely and warranted to explore interim interventions that may be applied in this period. METHODS Intervention studies that have applied an educational programme, information, group-based support or individualised therapy to primary caregivers of children (heron referred to as parent-directed interventions), waiting for diagnostic assessment at any inpatient or outpatient health service and aged between 1 and 12 years of age, will be reviewed. These will include intervention studies of any type that have included more than 5 participants or participant groups and where a control or comparison group has been included. Abstract screening, full-text review, data extraction and risk of bias will be conducted by two reviewers. Relevant databases in health and education will be systematically searched using key words and Medical Subject Headings (MeSH) and grey literature will be explored. Databases will include PubMed, Ovid for MEDLINE and PsycINFO, EBSCO for the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and the Education Resources Information Center (ERIC). Covidence© will be used to support abstract and full text screening, which will be completed by two main reviewers. Results will be tabulated, summarised and meta-analysed using a random-effects model, in any instance where concordant outcome measures have been applied. Results will be published and reported in line with PRISMA reporting guidelines. DISCUSSION Given little is known about effective support for families when children are awaiting diagnostic assessment for any medical, developmental or behavioural condition, the authors will synthesise existing evidence about parent-directed interventions in this period. It is hoped that by understanding the existing evidence interventions that are proven to be effective will be adopted and intervention innovation can occur. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2020 CRD42020159360.
Collapse
|
9
|
Gregory M, Kannis‐dymand L, Sharman R. A review of attachment‐based parenting interventions: Recent advances and future considerations. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12270] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Mary Gregory
- Discipline of Psychology, School of Social Sciences, University of the Sunshine Coast, Maroochydore, Queensland, Australia,
- Sunshine Coast Mind and Neuroscience – Thompson Institute, University of the Sunshine Coast, Maroochydore, Queensland, Australia,
| | - Lee Kannis‐dymand
- Discipline of Psychology, School of Social Sciences, University of the Sunshine Coast, Maroochydore, Queensland, Australia,
- Sunshine Coast Mind and Neuroscience – Thompson Institute, University of the Sunshine Coast, Maroochydore, Queensland, Australia,
| | - Rachael Sharman
- Discipline of Psychology, School of Social Sciences, University of the Sunshine Coast, Maroochydore, Queensland, Australia,
| |
Collapse
|
10
|
Byrne G, Murphy S, Connon G. Mentalization-based treatments with children and families: A systematic review of the literature. Clin Child Psychol Psychiatry 2020; 25:1022-1048. [PMID: 32493055 DOI: 10.1177/1359104520920689] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Over the past decade, mentalization-based treatment (MBT) approaches have been developed specifically for children, adolescents and families. This study provides a systematic review of MBT applicable to both children and families. METHOD Five databases were searched to identify reports of MBT studies published up to February 2020. Studies were screened and reported according to PRISMA guidelines. RESULTS A total of 34 studies were included in this review. Of these, 14 focused on parent-child dyads, two on child therapy, seven applied the approach to parenting, four evaluated the application of MBT to the school environment and seven focused on adolescent populations. CONCLUSION Despite methodological shortcomings and heterogeneity in design, the existing literature does provide tentative support for the use of MBT approaches for these populations, specifically in increasing mentalizing/reflective functioning. Further controlled and methodologically rigorous studies are required.
Collapse
Affiliation(s)
- Gary Byrne
- Primary Care Psychology, Health Service Executive, Ireland
| | - Síle Murphy
- Primary Care Psychology, Health Service Executive, Ireland
| | - Graham Connon
- Primary Care Psychology, Health Service Executive, Ireland
| |
Collapse
|
11
|
Aarestrup AK, Skovgaard Væver M, Petersen J, Røhder K, Schiøtz M. An early intervention to promote maternal sensitivity in the perinatal period for women with psychosocial vulnerabilities: study protocol of a randomized controlled trial. BMC Psychol 2020; 8:41. [PMID: 32345375 PMCID: PMC7189589 DOI: 10.1186/s40359-020-00407-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 04/12/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Maternal mental well-being and social circumstances during pregnancy and early childhood impact the child's well-being and development. Supportive and sensitive parenting is one of the strongest predictors of positive emotional, social and behavioral outcomes for the child. Knowledge is needed about how to detect and support vulnerable families already during pregnancy and in the postnatal period. The aim of this study is to assemble and evaluate an interdisciplinary cross-sectoral intervention to promote maternal sensitivity among women with psychological or social vulnerabilities. METHODS/DESIGN This randomized controlled trial tests the efficacy of an intervention program in the perinatal period compared to care as usual in enhancing maternal sensitivity in a group of psychologically or socially vulnerable women in the Capital Region of Denmark. The intervention consists of four components: 1) detecting symptoms of mental illness in vulnerable pregnant women and initiating treatment if indicated, 2) strengthening parenting skills using the Circle of Security Parenting program, 3) supporting breastfeeding, and 4) sharing knowledge and organizing treatment pathways for families across sectors. Seventy-six families will be randomly assigned to the intervention or care-as-usual. Data will be obtained at study inclusion at 3-5 months of pregnancy, eight weeks after childbirth, and nine months after childbirth. The primary outcome is maternal sensitivity. Secondary outcomes include infant's socio-emotional development, parents' mentalization, parental stress, depressive symptoms, and parental wellbeing. Qualitative data will provide insight into the implementation process. DISCUSSION This paper presents the rational and background for developing the intervention. Furthermore, the design and protocol of the randomized controlled trial. It is hypothesized that the intervention will be associated with positive changes in primary and secondary outcomes. If effective, the intervention will provide insights into prenatal risk profiles among an identified group of psychosocial vulnerable women important for early screening and point to effective preventive interventions that can support women in the perinatal period, increase maternal sensitivity and promote positive child development -starting before the child is born. TRIAL REGISTRATION ClinicalTrials.gov: ID: NCT03190707. Registered June 16, 2017.
Collapse
Affiliation(s)
- Anne Kristine Aarestrup
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Nordre Fasanvej 57, Vej 8, Indgang 1, 1.sal, 2000 Frederiksberg, Denmark
| | - Mette Skovgaard Væver
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Janne Petersen
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Nordre Fasanvej 57, Vej 8, Indgang 1, 1.sal, 2000 Frederiksberg, Denmark
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Røhder
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Nordre Fasanvej 57, Vej 8, Indgang 1, 1.sal, 2000 Frederiksberg, Denmark
| | - Michaela Schiøtz
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Nordre Fasanvej 57, Vej 8, Indgang 1, 1.sal, 2000 Frederiksberg, Denmark
| |
Collapse
|
12
|
Anderson LE, Connor JP, Voisey J, Young RM, Gullo MJ. The unique role of attachment dimensions and peer drinking in adolescent alcohol use. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.05.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
13
|
Letourneau NL, Tryphonopoulos PD, Novick J, Hart JM, Giesbrecht G, Oxford ML. Nursing Child Assessment Satellite Training Parent-Child Interaction Scales: Comparing American and Canadian Normative and High-Risk Samples. J Pediatr Nurs 2018; 40:47-57. [PMID: 29776479 DOI: 10.1016/j.pedn.2018.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Many nurses rely on the American Nursing Child Assessment Satellite Training (NCAST) Parent-Child Interaction (PCI) Teaching and Feeding Scales to identify and target interventions for families affected by severe/chronic stressors (e.g. postpartum depression (PPD), intimate partner violence (IPV), low-income). However, the NCAST Database that provides normative data for comparisons may not apply to Canadian families. The purpose of this study was to compare NCAST PCI scores in Canadian and American samples and to assess the reliability of the NCAST PCI Scales in Canadian samples. METHODS This secondary analysis employed independent samples t-tests (p < 0.005) to compare PCI between the American NCAST Database and Canadian high-risk (families with PPD, exposure to IPV or low-income) and community samples. Cronbach's alphas were calculated for the Canadian and American samples. RESULTS In both American and Canadian samples, belonging to a high-risk population reduced parents' abilities to engage in sensitive and responsive caregiving (i.e. healthy serve and return relationships) as measured by the PCI Scales. NCAST Database mothers were more effective at executing caregiving responsibilities during PCI compared to the Canadian community sample, while infants belonging to the Canadian community sample provided clearer cues to caregivers during PCI compared to those of the NCAST Database. Internal consistency coefficients for the Canadian samples were generally acceptable. CONCLUSIONS The NCAST Database can be reliably used for assessing PCI in normative and high-risk Canadian families. PRACTICAL IMPLICATIONS Canadian nurses can be assured that the PCI Scales adequately identify risks and can help target interventions to promote optimal parent-child relationships and ultimately child development.
Collapse
Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada.
| | | | - Jason Novick
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta Canada
| | - J Martha Hart
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics and Community Health Sciences), Faculty of Arts (Psychology), University of Calgary, Alberta Canada
| | - Monica L Oxford
- Center on Human Development & Disability, School of Nursing (Family & Child Nursing), Washington University, Seattle, WA United States
| |
Collapse
|
14
|
Væver MS, Smith-Nielsen J, Lange T. Copenhagen infant mental health project: study protocol for a randomized controlled trial comparing circle of security -parenting and care as usual as interventions targeting infant mental health risks. BMC Psychol 2016; 4:57. [PMID: 27876079 PMCID: PMC5120549 DOI: 10.1186/s40359-016-0166-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/10/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Infant mental health is a significant public health issue as early adversity and exposure to early childhood stress are significant risk factors that may have detrimental long-term developmental consequences for the affected children. Negative outcomes are seen on a range of areas such as physical and mental health, educational and labor market success, social network and establishing of family. Secure attachment is associated with optimal outcomes in all developmental domains in childhood, and both insecure and disorganized attachment are associated with a range of later problems and psychopathologies. In disadvantaged populations insecure and disorganized attachment are common, which points to the need of identifying early risk and effective methods of addressing such problems. This protocol describes an experimental evaluation of an indicated group-based parental educational program, Circle of Security-Parenting (COS-P), currently being conducted in Denmark. METHODS/DESIGN In a parallel randomized controlled trial of two intervention groups this study tests the efficacy of COS-P compared to Care as Usual (CAU) in enhancing maternal sensitivity and child attachment in a community sample in the City of Copenhagen, Denmark. During the project a general population of an estimated 17.600 families with an infant aged 2-12 months are screened for two known infant mental health risks, maternal postnatal depression and infant social withdrawal. Eligible families (N = 314), who agree to participate, will be randomly allocated with a ratio of 2:1 into the COS-P intervention arm and into CAU. Data will be obtained at inclusion (baseline) and at follow-up when the child is 12-16 months. The primary outcome is maternal sensitivity. Secondary outcomes include quality of infant attachment, language, cognitive and socioemotional development, family functioning, parental stress, parental mentalizing and maternal mental wellbeing. DISCUSSION The potential implications of the experimental evaluation of an indicated brief group-based parenting educational program to enhance parental sensitivity and attachment are discussed. TRIAL REGISTRATION ClinicalTrials.govID: NCT02497677 . Registered July 15 2015.
Collapse
Affiliation(s)
- Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Johanne Smith-Nielsen
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Theis Lange
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
| |
Collapse
|