Cohort profile: the Men and Parenting Pathways (MAPP) Study: a longitudinal Australian cohort study of men's mental health and well-being at the normative age for first-time fatherhood

Shame and depressive symptoms in men: The moderating role of environmental mastery and purpose in life

BACKGROUND

Feelings of shame are linked to increased risk for depression. Little is known about protective factors that may buffer this effect, particularly in men. Using prospective data from a community sample of Australian men, we examine the extent to which shame is associated with depressive symptoms, and the protective role of psychological wellbeing, specifically environmental mastery and purpose in life.

METHODS

Participants (n = 448) were from the longitudinal Men and Parenting Pathways (MAPP) Study. Measures were the Event Related Shame and Guilt Scale for shame, the DASS-21 for depressive symptoms and Ryff's Scales of Psychological Well-Being for environmental mastery and purpose in life. Linear regressions were used to test associations between shame and depressive symptoms concurrently and 1-year later, and the moderating effects of mastery and purpose in life.

RESULTS

Shame was strongly associated with concurrent depressive symptoms (βunadj = .76, p < .001; βadj = .63, p < .001). This effect was weaker in men with high compared to low environmental mastery (β+1SD = .46, p < .001; β-1SD = .55, p < .001) and purpose in life (β+1SD = .48, p < .001; β-1SD = .62, p < .001). Shame also predicted subsequent depressive symptoms after adjustment for prior depressive symptoms (βunadj = .59, p = .001; βadj = .34, p = .004), although environmental mastery or purpose in life did not moderate these associations.

CONCLUSIONS

Our findings suggest that promoting a sense of psychological wellbeing in men may confer protective proximal effects in the context of shame, potentially attenuating depression severity. The current study aligns with calls for strength-based approaches to reducing mental health problems in men.

Designing Child Nutrition Interventions to Engage Fathers: Qualitative Analysis of Interviews and Co-Design Workshops

BACKGROUND

Fathers play a pivotal role in parenting and child feeding, but they remain underrepresented in intervention studies, especially those focused on disadvantaged populations. A better understanding of fathers' experiences and needs regarding support access and child nutrition information in the context of disadvantage can inform future interventions engaging fathers.

OBJECTIVE

This study aims to explore fathers' experiences; perceived enablers; and barriers to accessing support and information related to parenting, child feeding, and nutrition and to co-design principles for tailoring child nutrition interventions to engage fathers.

METHODS

Australian fathers of children aged 6 months to 5 years with lived experience of disadvantage participated in semistructured interviews and co-design workshops, primarily conducted via videoconference. Creative analogies were used to guide the ideation process in the workshops.

RESULTS

A total of 25 interviews and 3 workshops (n=10 participants) were conducted, with data analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation-Behavior model. The interview data illuminated factors influencing fathers' initiation in seeking support for parenting, child feeding, and nutrition, including their experiences. It highlighted fathers' diverse information needs and the importance of an inclusive environment and encouragement. Enablers and barriers in accessing support related to parenting and child nutrition were identified at the individual (eg, personal goals and resource constraints), interpersonal (family support and false beliefs about men's caregiving role), organizational (inadequate fathering support), and systemic levels (father-inclusive practice and policy). Digital data collection methods enabled Australia-wide participation, overcoming work and capacity barriers. Videoconferencing technology was effectively used to engage fathers creatively. Key principles for engaging fathers were co-designed from the workshop data. Interventions and resources need to be father specific, child centered, and culturally appropriate; promote empowerment and collaboration; and provide actionable and accessible strategies on the what and how of child feeding. Fathers preferred multiformat implementation, which harnesses technology-based design (eg, websites and mobile apps) and gamification. It should be tailored to the child's age and targeted at fathers using comprehensive promotion strategies.

CONCLUSIONS

Fathers faced barriers to accessing support and information related to parenting and feeding that may not adequately address their needs. Future interventions could integrate the co-designed principles to engage fathers effectively. These findings have implications for health service delivery and policy development, promoting father-inclusive practice.

Social network investment of men: Cross-sectional and longitudinal associations with mental health problems

Internationally, there is growing attention on links between social isolation and mental health problems. Here, we use unique Australian longitudinal data to investigate associations between adult men's (n = 507; age M = 29.90, SD = 1.31) social network investments and their concurrent and subsequent mental health problems. In linear regressions, using generalised estimating equations (GEEs), we examined associations between social network investment (time with friends, network size and various activities with friends) and mental health symptoms (depression, anxiety and stress) across five timepoints. Models were adjusted for waves of outcome and potential confounders. Cross-sectionally, each social network investment variable, except for drinking with friends, was negatively associated with depressive symptoms. Men's extended friendship network size and sharing a meal with friends were negatively associated with concurrent anxiety and stress. Time spent and physical activity with friends was also negatively associated with concurrent stress. In longitudinal analyses, after adjusting for prior depressive symptoms, only the number of friends in close and extended networks remained protective against depressive symptoms 1 year later. Results did not differ by fatherhood or relationship status. Programs designed to strengthen men's investment in social networks are recommended to reduce men's depressive symptoms.

An exploration of masculinity, social support and depression in new and experienced fathers

OBJECTIVE

This study aimed to explore the relationship between masculinity, perceived social support and depression symptomology in the postpartum period in new and experienced fathers.

DESIGN

Cross-sectional questionnaire study.

PARTICIPANTS

A total of 118 first- and second-time fathers (N = 48) of infants aged under 12-months, currently residing in the United Kingdom.

MEASUREMENTS AND FINDINGS

Questionnaires consisted of the Edinburgh Postnatal Depression Scale, the Conformity to Masculine Norms Inventory, and the Multidimensional Scale of Perceived Social Support. Data were analysed through inferential statistics.

KEY CONCLUSIONS

Masculine norms of self-reliance and primacy of work were positively related to depression symptomology in both father groups. Perceived social support was negatively related to depression symptomology. Further analyses revealed significant effects regarding partner health status and depression symptomology. No significant differences were found between presentation of first- and second-time fathers.

IMPLICATIONS FOR PRACTICE

Main findings support partners as a part of the family unit. Findings have implications for midwives in that an increased understanding of these factors in early fatherhood could improve family outcomes.

Father trait anger: Associations with father–infant bonding and subsequent parenting stress

Introduction

Parent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father–infant bonding.

Method

Data were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father–infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent–child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father–infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome.

Results

Patience and tolerance was the only domain of father–infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent–child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress.

Discussion

Father trait anger both directly and indirectly (through patience and tolerance in the father–infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father–infant bonding may benefit fathers and children.

Interventions for Perinatal Depression and Anxiety in Fathers: A Mini-Review

Background and Objectives

Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men.

Methods

We drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both.

Results

Eleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms.

Discussion

There was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.

Pre-pandemic Predictors of Loneliness in Adult Men During COVID-19

Loneliness is a major public health issue, with its prevalence rising during COVID-19 pandemic lockdowns and mandated "social distancing" practices. A 2020 global study (n = 46,054) found that, in comparison to women, men experienced the greatest levels of loneliness. Although research on predictors of loneliness during COVID-19 is increasing, little is known about the characteristics of men who may be particularly vulnerable. Studies using prospective data are needed to inform preventative measures to support men at risk of loneliness. The current study draws on rare longitudinal data from an Australian cohort of men in young to mid-adulthood (n = 283; aged M = 34.6, SD = 1.38 years) to examine 25 pre-pandemic psychosocial predictors of loneliness during COVID-19 social restrictions (March-September 2020). Adjusted linear regressions identified 22 pre-pandemic predictors of loneliness across a range of trait-based, relational, career/home and mental health variables. Given the extensive set of predictors, we then conducted penalized regression models (LASSO), a machine learning approach, allowing us to identify the best fitting multivariable set of predictors of loneliness during the pandemic. In these models, men's sense of pre-pandemic environmental mastery emerged as the strongest predictor of loneliness. Depression, neuroticism and social support also remained key predictors of pandemic loneliness (R 2 = 26, including covariates). Our findings suggest that men's loneliness can be detected prospectively and under varying levels of social restriction, presenting possible targets for prevention efforts for those most vulnerable.

Hidden in Plain Sight? Men's Coping Patterns and Psychological Distress Before and During the COVID-19 Pandemic

Individuals cope with stress using multiple strategies, yet studies of coping profiles are rare. We draw data from a longitudinal study of Australian men (n = 272; 30-37 years), assessed before (T1) and during (T2) a nation-wide COVID-19 lockdown. We aimed to: (1) identify men's multi-strategy coping profiles before and during the pandemic; (2) assess cross-sectional (T1-T1, T2-T2) and prospective (T1-T2) associations between profiles and symptoms of psychological distress (stress, anxiety, depression, and anger); and (3) examine relationships between coping profiles and appraisals of pandemic-related stressors and options for coping. In latent profile analyses of 14 coping strategies, three profiles emerged that were largely consistent across T1 and T2: (1) Relaxed Copers (low use of all strategies), (2) Approach Copers, and (3) Dual Copers (high avoidant and moderate-high approach-oriented strategies). Compared to Relaxed and Approach Copers, men who were Dual Copers had elevated psychological distress cross-sectionally before (T1) and during (T2) the pandemic, but not prospectively. Post hoc analyses suggested this was because many men changed coping profiles in the context of the pandemic. Men with stable (T1-T2) or new (T2 only) Dual Coping profiles experienced greater psychological distress and more negative appraisals of pandemic stressors and options for coping. In sum, at the sample level, the composition of men's coping profiles and associations with mental health risk were relatively stable over time and contexts; however, many men appeared to respond to pandemic conditions by changing coping profile groups, with mostly positive mental health outcomes. Of concern were men who adopted more avoidant strategies (e.g., denial, self-distraction, disengagement, substance use, and self-blame) under pandemic conditions. These Dual Coper men also engaged in commonly observable approach-oriented behaviours (e.g., planning, active coping, humour, seeking practical social support) that may mask their vulnerability to mental health risk. Our findings highlight the clinical importance of enquiring about escalating or frequent avoidant coping even in the presence of more active and interactive approach-oriented behaviours.