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Letourneau N, Anis L, Novick J, Pohl C, Ntanda H, Hart M. Impacts of the Attachment and Child Health (ATTACH TM) Parenting Program on Mothers and Their Children at Risk of Maltreatment: Phase 2 Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3078. [PMID: 36833770 PMCID: PMC9961631 DOI: 10.3390/ijerph20043078] [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: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Early adversity (e.g., family violence, parental depression, low income) places children at risk for maltreatment and negatively impacts developmental outcomes. Optimal parental reflective function (RF), defined as the parent's ability to think about and identify thoughts, feelings, and mental states in themselves and in their children, is linked to secure attachment and may protect against suboptimal outcomes. We present the results of Phase 2 randomized control trials (RCTs) and quasi-experimental studies (QES) of the Attachment and Child Health (ATTACHTM) parental RF intervention for families with children at risk for maltreatment. Phase 2 parents experiencing adversity, along with their children aged 0-5 years (n = 45), received the 10-12-week ATTACHTM intervention. Building on completed Phase 1 pilot data, Phase 2 examined outcomes of long-standing interest, including parental RF and child development, as well as new outcomes, including parental perceived social support and executive function, and children's behavior, sleep, and executive function. RCTs and QES revealed significant improvements in parents' RF, perception of social support, and executive function, children's development (i.e., communication, problem-solving, personal-social, and fine motor skills), and a decrease in children's sleep and behavioral problems (i.e., anxiety/depression, attention problems, aggressive behavior, and externalizing problems), post-intervention. ATTACH™ positively impacts parental RF to prevent negative impacts on children at risk of maltreatment.
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Affiliation(s)
- Nicole Letourneau
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Faculty of Nursing, and Cumming School of Medicine, Departments of Pediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lubna Anis
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jason Novick
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Carrie Pohl
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Henry Ntanda
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Martha Hart
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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Evers O, Georg AK, Wegener C, Sidor A, Taubner S. Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families. Psychopathology 2023; 56:29-40. [PMID: 35537443 DOI: 10.1159/000524101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/13/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden. METHODS A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model. RESULTS A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families. CONCLUSION Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.
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Affiliation(s)
- Oliver Evers
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anna Katharina Georg
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Wegener
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anna Sidor
- Social Pediatric Centre Frankfurt, Frankfurt, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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Goecke TW, Schöberl GI, Beckmann MW, Beetz AM. Der Bindungsstil der Mutter und ihr perinatales Wohlbefinden
beeinflussen die frühkindliche Entwicklung. Z Geburtshilfe Neonatol 2022; 226:325-332. [DOI: 10.1055/a-1872-1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungImmer mehr Kinder zeigen bereits in der frühen Kindheit Anzeichen von
Verhaltensauffälligkeiten und Dysregulationen. Es wird ein Einfluss der
pränatalen Bindung der Schwangeren zu ihrem ungeborenen Kind sowie ihres
peripartalen Wohlbefindens angenommen. In einer prospektiven Studie an 161
Erstgebärenden wurde über standardisierte Fragebögen im
dritten Trimenon und 3 Wochen, 6 Monate und 18 Monate postpartum die
pränatale Bindung der Mutter zum Kind, den maternalen Bindungsstil, die
Bindung in der Paarbeziehung und die prä- und postpartale
Depressivität, sowie Entwicklungsauffälligkeiten des Kindes im
Alter von 18 Monaten erfasst. Im allgemeinen linearen Modell (ALM) waren eine
länger vorliegende prä- und postpartale Depressivität
der Mutter sowie Anzeichen einer unsicheren pränatalen Bindung zum Kind
mit einer höheren Rate an kindlichen Verhaltensauffälligkeiten
assoziiert. Die Befunde untermauern die Bedeutung der frühzeitigen
Wahrnehmung von Depressivität bei Frauen während und nach der
Schwangerschaft durch medizinische Fachkräfte und der Einleitung von
entsprechenden Hilfen, um die Häufigkeit kindlicher
Verhaltensauffälligkeiten zu reduzieren.
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Affiliation(s)
- Tamme W. Goecke
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen,
Germany
- Klinik für Gynäkologie und Geburtshilfe, RoMed Klinikum
Rosenheim, Rosenheim, Germany
| | | | | | - Andrea M. Beetz
- Professur für Heilpädagogik und
Inklusionspädagogik, IU Internationale Hochschule, Erfurt,
Germany
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Georg AK, Bark C, Wiehmann J, Taubner S. Frühkindliche Regulationsstörungen: Störungsbilder und Behandlungskonzepte. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-022-00594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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[Parental Mentalization and Early Parent-Child Interaction in Mothers with Affective Disorders or Borderline Personality Disorder: A Systematic Review]. Prax Kinderpsychol Kinderpsychiatr 2022; 71:220-244. [PMID: 35301922 DOI: 10.13109/prkk.2022.71.3.220] [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: 11/27/2022]
Abstract
The ability to mentalize is central in the context of the parent-child relationship.The parental competence to see the child'smental state as an independent individual is an essential prerequisite for perceiving and interpreting child signals appropriately.These abilities are crucial but not always available under elevated stress levels when confronted with a child's affects and parenting challenges. Despite the clinical and conceptual relevance of mentalization with borderline personality disorder (BPD) and affective disorders, the subject has rarely been systematically addressed in parents.This review provides a systematic overview of parental mentalization in mothers with affective disorders or BPD and its impact on the quality of maternal interactive behaviour. The findings generally revealed a negative association between mothers' parental mentalization and depression or BPD, which varied greatly depending on the mentalization constructs. Both psychiatric diagnosis and current severity of symptoms were found to be relevant. However, some positive aspects of mentalization were not markedly impaired. Further, a lowermentalizing abilitywas associatedwith reduced sensitive behaviour in depressedmothers. The results contribute to a better understanding of the association between mentalization and maternal psychopathology and help refine early interventions in parent-child settings.
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Dollberg DG, Hanetz-Gamliel K. Mediation-Moderation Links Between Mothers' ACEs, Mothers' and Children's Psychopathology Symptoms, and Maternal Mentalization During COVID-19. Front Psychiatry 2022; 13:837423. [PMID: 35370808 PMCID: PMC8968198 DOI: 10.3389/fpsyt.2022.837423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Research has suggested adverse childhood experiences (ACEs) as a transdiagnostic risk factor for a variety of affective disorders. They are also linked with a parent's tendency toward affect dysregulation and hyperarousal, which may interfere with parenting and children's wellbeing. On the other hand, maternal mentalization can serve as a moderating factor that can help parents regulate their arousal, shielding children during adverse circumstances. We studied the mediated links between ACEs and mothers' and children's psychopathology symptoms during COVID-19 to determine whether maternal mentalization and the child's age moderate these links. Using results from 152 Israeli mothers of children aged 3-12 years recruited during the month-long lockdown in Israel, we documented that the mothers' ACEs were linked with increased risk of depressive and anxiety symptoms and with children's internalizing and externalizing behaviors. Moreover, as hypothesized, the mothers' symptoms of depression and anxiety mediated the links between their ACEs and their children's internalizing behaviors. In addition, the mothers' mentalization skills and, in the case of their depressive symptoms, their child's age, moderated these indirect links. For mothers of young children (3-6 years old) with higher mentalization levels, the link between the mothers' ACEs and the children's behavior problems was weaker compared to mothers with low mentalization levels. For mothers of older children (6-12 years old), and only in the case of maternal depressive symptoms, higher levels of maternal mentalization were linked with more internalizing behaviors. We discuss the potential clinical implications of the findings.
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Affiliation(s)
- Daphna G. Dollberg
- School of Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
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7
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Stuhrmann LY, Göbel A, Bindt C, Mudra S. Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review. Front Psychol 2022; 13:765312. [PMID: 35310277 PMCID: PMC8927808 DOI: 10.3389/fpsyg.2022.765312] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Background Parental reflective functioning (PRF) refers to parents' mental capacity to understand their own and their children's behaviors in terms of envisioned mental states. As part of a broader concept of parental mentalization, PRF has been identified as one of the central predictors for sensitive parenting. However, the unique contribution of PRF to the quality of various parenting behaviors has not yet been addressed systematically. Thus, the present article provides a systematic overview of current research on the associations between PRF or its sub-dimensions and observed parenting behaviors in infancy and early childhood, while considering the influence of contextual factors. Methods The review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Systematic searches were carried out in five electronic databases. The eligibility and methodological quality of the identified studies were assessed using pre-defined criteria and a standardized checklist. Results Sixteen studies with moderate to high quality on a total of 15 parenting behaviors were included, the majority of which examined positive parenting behaviors, while negative parenting behaviors were rarely investigated. Most of the associations indicated a positive effect of PRF on parenting behavior, with mostly small-sized effects. The strength and direction of the associations varied depending on the dimensionality of PRF, observation settings, sample types, socioeconomic factors, and cultural background. Moreover, five assessment instruments for PRF and 10 observation instruments for parenting behaviors were identified. Conclusion In summary, PRF has shown a positive association with parenting quality. However, its complex interaction with further contextual factors emphasizes the need for differentiation of PRF dimensions and the consideration of the observation settings, assessment time points, psychosocial risks, and sample types in observational as well as intervention studies. Further high-quality studies with multivariate analyses and diverse study settings are required.
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Affiliation(s)
- Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent-infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. METHODS As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. RESULTS Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. LIMITATIONS Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. CONCLUSIONS The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
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Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Dollberg DG, Harlev Y, Malishkevitch S, Leitner Y. Parental Reflective Functioning as a Moderator of the Link Between Prematurity and Parental Stress. Front Psychiatry 2022; 13:804694. [PMID: 35280157 PMCID: PMC8905191 DOI: 10.3389/fpsyt.2022.804694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
We examined group differences between parents, both mothers and fathers, of premature and full-term infants to determine whether they differed in their reports of subjective parenting stress and in their level of parental reflective functioning (PRF). We also tested whether each parent's reflective functioning moderated the links between birth status (prematurity vs. full-term) and parenting stress. A sample of 73 cohabiting, heterosexual Israeli families with a premature (28-36th week gestational age, N = 34) or full-term infant (37th week and above gestational age, N = 39) participated, comprising the two parents' groups. Infants' age averaged 7.07 months (SD = 1.28). Each parent completed the Parent Stress Inventory (PSI) individually to determine his/her subjective personal and childrearing stress levels. The Parent Development Interview (PDI-R2-S) was used to obtain each parent's PRF (self and child/relation-focused) level. Findings showed that the premature and full-term parents did not differ in their PSI scores or PRF levels. However, mothers' self-focused PRF moderated the link between prematurity and personal parenting stress, whereas fathers' self-focused PRF moderated the link between prematurity and childrearing parenting stress. Furthermore, fathers' and mothers' PRF operated differently in the premature and full-term parents' groups. The findings highlight the importance of mothers' and fathers' PRF in predicting parents' subjective stress in general and particularly in the case of infant prematurity. We discuss these findings and their relevance for preventive and therapeutic perinatal interventions.
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Affiliation(s)
- Daphna G Dollberg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Harlev
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Sivan Malishkevitch
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Leitner
- Child Development Center, Dana-Dwek Children's Hospital, Sourasky Medical Center, Tel Aviv, Israel
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Stephanie K, Brigitte R. Various mentalizing concepts in mothers with postpartum depression, comorbid anxiety, and personality disorders. Infant Ment Health J 2021; 42:488-501. [PMID: 33759190 DOI: 10.1002/imhj.21914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mentalization is defined as the human capacity to reflect upon one's own or others' behaviors in terms of underlying mental states and intentions. Several concepts of mentalizing exist, which differ in content, assessment, and clinical prediction. AIMS The present study examines the relationship between the three main concepts of mentalizing, namely, reflective functioning (RF), parental reflective functioning (PRF), and Mind-Mindedness (MM), in mothers with postpartum depression. It was hypothesized that mentalizing concepts differ in their convergent and divergent variance, as well as their clinical validity regarding comorbid anxiety and personality disorders (PDs). METHOD Fifty clinically referred mothers with postpartum depression and infants aged 3-10 months were examined by means of the Reflective Functioning Scale, Parental Reflective Functioning Questionnaire, and Mind-Mindedness Coding-System. RESULTS No significant associations were found between RF and PRF, or between PRF and MM; higher RF was associated with more MM-nonattuned mind-related comments. Increased depression and anxiety were linked to lower PRF in terms of higher PRF-prementalizing. Lower RF, but not PRF, was associated with comorbid PDs. Specifically, obsessive-compulsive PD was associated to considerably fewer MM-nonattuned mind-related comments. CONCLUSION Distinct concepts of mentalizing represent divergent competencies, differentially linked to maternal postpartum psychopathology.
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Affiliation(s)
- Krink Stephanie
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Psychology, University of Münster, Muenster, Germany
| | - Ramsauer Brigitte
- Faculty of medicine, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Hamburg, Germany
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Family Minds: A randomized controlled trial of a group intervention to improve foster parents' reflective functioning. Dev Psychopathol 2021; 34:1177-1191. [PMID: 33583462 DOI: 10.1017/s095457942000214x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Family Minds is a brief group psychoeducational parenting intervention designed to increase the reflective functioning (RF) and mentalization skills of foster parents. RF is important for foster parents who have to build relationships with children whose adverse experiences increase their risk for psychosocial challenges. A randomized controlled trial (RCT) for Family Minds was conducted in Texas with 89 foster parents. The main aims of this study were to examine whether the intervention could significantly increase the RF/mentalization skills of the foster parents and decrease their parenting stress. After 6 weeks, compared with the control group, intervention foster parents improved their RF via a lowering of pre-mentalizing and also significantly decreased parenting stress related to parent-child dysfunctional interactions. Other measures of RF and parenting stress showed no significant differences between groups. Foster child behavior was not significantly different between groups, although data at 6 months showed a possible lowering of internalizing symptoms for children of intervention parents. This RCT provides some encouraging evidence that Family Minds may increase RF in foster parents, improve parental sensitivity and their ability to emotionally regulate, decrease parenting stress related to challenging interactions with their foster children, and possibly decrease children's internalizing behavior.
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12
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Georg AK, Schröder-Pfeifer P, Cierpka M, Taubner S. Maternal Parenting Stress in the Face of Early Regulatory Disorders in Infancy: A Machine Learning Approach to Identify What Matters Most. Front Psychiatry 2021; 12:663285. [PMID: 34408674 PMCID: PMC8365191 DOI: 10.3389/fpsyt.2021.663285] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: Early regulatory disorders (ERD) in infancy are typically associated with high parenting stress (PS). Theoretical and empirical literature suggests a wide range of factors that may contribute to PS related to ERD. The aim of this study was to identify key predictors of maternal PS within a large predictor data set in a sample of N = 135 mothers of infants diagnosed with ERD. Methods: We used machine learning to identify relevant predictors. Maternal PS was assessed with the Parenting Stress Index. The multivariate dataset assessed cross-sectionally consisted of 464 self-reported and clinically rated variables covering mother-reported psychological distress, maternal self-efficacy, parental reflective functioning, socio-demographics, each parent's history of illness, recent significant life events, former miscarriage/abortion, pregnancy, obstetric history, infants' medical history, development, and social environment. Variables were drawn from behavioral diaries on regulatory symptoms and parental co-regulative behavior as well as a clinical interview which was utilized to diagnose ERD and to assess clinically rated regulatory symptoms, quality of parent-infant relationship, organic/biological and psychosocial risks, and social-emotional functioning. Results: The final prediction model identified 11 important variables summing up to the areas maternal self-efficacy, psychological distress (particularly depression and anger-hostility), infant regulatory symptoms (particularly duration of fussing/crying), and age-appropriate physical development. The RMSE (i.e., prediction accuracy) of the final model applied to the test set was 21.72 (R 2 = 0.58). Conclusions: This study suggests that among behavioral, environmental, developmental, parent-infant relationship, and mental health variables, a mother's higher self-efficacy, psychological distress symptoms particularly depression and anger symptoms, symptoms in the child particularly fussing/crying symptoms, and age-inappropriate physical development are associated with higher maternal PS. With these factors identified, clinicians may more efficiently assess a mother's PS related to ERD in a low-risk help-seeking sample.
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Paul Schröder-Pfeifer
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Psychological Institute, University Heidelberg, Heidelberg, Germany
| | - Manfred Cierpka
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
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13
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Ruiz N, Witting A, Ahnert L, Piskernik B. Reflective functioning in fathers with young children born preterm and at term. Attach Hum Dev 2019; 22:32-45. [PMID: 30898032 DOI: 10.1080/14616734.2019.1589059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present study assessed 322 parents of 173 children aged between 12 and 20 months (74 children born preterm) with the Parent Development Interview (PDI) to capture parents' Reflective Functioning (RF). RF scores were obtained, and topics were disclosed, for which modeling with Latent Dirichlet Allocation (LDA) was applied. The study addressed (a) whether RF scores differed between fathers of children born preterm and at term, and diverged from the mothers' RF and, (b) whether topics on fathers' minds differed regarding parenting preterm or at-term children, and diverged from topics on parenting raised by mothers. Results indicated that parents of at-term children revealed similar RF scores, though fathers of children born preterm scored lower than mothers of children born preterm. Whereas fathers' RF scores were associated with topics about the paternal role, interests and activities, mothers' RF was related to concerns about how to meet the child's needs.
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Affiliation(s)
- Nina Ruiz
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Andrea Witting
- Faculty of Psychology, University of Vienna, Vienna, Austria
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14
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Georg A, Kress S, Taubner S. Strengthening mentalizing in a depressed mother of an infant with sleep disorders. J Clin Psychol 2019; 75:859-873. [DOI: 10.1002/jclp.22762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anna Georg
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, University Hospital HeidelbergHeidelberg Germany
| | - Sandra Kress
- Institut für analytische Kinder‐ und Jugendlichen‐ Psychotherapie Heidelberg e.V.Lessingstr. 24 Heidelberg Germany
| | - Svenja Taubner
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, University Hospital HeidelbergHeidelberg Germany
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Bark C, Georg A, Taubner S. Säuglings-/Kleinkind-Eltern-Psychotherapie (SKEPT). PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0302-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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