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Park J, Song M, Cho A, Yang H, Lee H. Adverse childhood experiences of Korean mothers with young children: a latent class analysis. Eur J Psychotraumatol 2024; 15:2372994. [PMID: 38984740 PMCID: PMC11238651 DOI: 10.1080/20008066.2024.2372994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/17/2024] [Indexed: 07/11/2024] Open
Abstract
Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs.Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified.Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups.Results: The participants were classified into two subgroups: the 'high-ACEs group' and the 'low-ACEs group'. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group.Conclusion: The findings highlight the significant role of ACEs on the formation of an individual's psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.
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Affiliation(s)
- Jeongok Park
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - MinKyoung Song
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Ahyoung Cho
- Education of Counseling, Konkuk University, Gwangjin-gu, Seoul, South Korea
| | - HaYeJin Yang
- Yonsei University College of Nursing, Seodaemun-gu, Seoul, South Korea
| | - Hyojin Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seodaemun-gu, Seoul, South Korea
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Rost K, Ziegenhain U, Fegert JM, Buchheim A, Köhler-Dauner F. Maternal insecure attachment representation as a long-term risk factor for disrupted mother-child-interaction and child mental health. BMC Psychol 2024; 12:385. [PMID: 38982522 PMCID: PMC11234699 DOI: 10.1186/s40359-024-01874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother-child-interaction und maternal helplessness and fear. N = 103 mother-child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.
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Affiliation(s)
- Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany.
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany
- German Center for Mental Health (DZPG), partner site Ulm, Ulm, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany.
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Alptekin FB, Sucularlı E, Turgal E, Burhan HŞ, Güçlü O. Reducing the stress of mothers in the postpartum period: psychological inflexibility or mother-infant bonding. J Reprod Infant Psychol 2024:1-16. [PMID: 38899761 DOI: 10.1080/02646838.2024.2369578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Parental stress is a critical problem because it affects both the mental health of the mother and children's development. In addition to many factors related to birth and marriage, mother - infant bonding and psychological inflexibility are essential factors that can affect stress. In this study, we examined the effects of the psychological processes of mothers and factors related to pregnancy, mother, environment on parental stress, and their relationships. METHODS A sociodemographic variables scale, Acceptance and Action Questionnaire-II, Postpartum Bonding Questionnaire, and Parental Stress Scale were completed by 115 mothers in their first postpartum year. The model created with the correlation and regression results was subjected to path analysis. RESULTS Breastfeeding, psychological inflexibility, and mother - infant bonding are related to parental stress. The bonding problem is the mediator of the relationship between psychological inflexibility and parental stress. The entire effect of sleep quality on parental stress occurred through psychological inflexibility. CONCLUSION Efforts should be directed towards improving the bond between the mother and infant and enhancing the mother's psychological flexibility to lessen the negative impacts of stress. Breastfeeding should not be treated categorically, and its potential adverse effects should not be ignored.
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Affiliation(s)
| | - Eylül Sucularlı
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Ebru Turgal
- Faculty of Medicine, Department of Biostatistics, Ankara University, Ankara, Turkey
| | - Hüseyin Şehit Burhan
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Oya Güçlü
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
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Bailes LG, Blum A, Barnett W, Piersiak H, Takemoto S, Fleming B, Alexander C, Humphreys KL. Stressful life events and prenatal representations of the child. Attach Hum Dev 2024; 26:116-132. [PMID: 38655855 PMCID: PMC11218892 DOI: 10.1080/14616734.2024.2345242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
Caregivers' mental representations of their children can be assessed prenatally and are prospectively associated with later caregiving quality and caregiver-child attachment. Compared to balanced, distorted or disengaged representations are linked to insecure caregiver-child attachments. The present study explored factors (i.e. stressful life experiences and positive experiences) that may be linked to risk for distorted and disengaged representations. We used a brief version of the Prenatal Working Model of the Child Interview in a sample of 298 pregnant people (ages 19 to 45 years; M = 30.83, SD = 5.00) between gestational age 11-38 weeks (M = 23.49, SD = 5.70). A greater number of stressful events across three developmental periods (i.e., lifespan, childhood, and pregnancy) were related to increased odds of distorted, compared to balanced classification. Pregnancy stress had the largest association. Positive experiences from childhood did not buffer the association between stress and representations. Findings highlight the importance of stress on prenatal representations of one's child.
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Affiliation(s)
- Lauren G Bailes
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Abigail Blum
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Whitney Barnett
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Hannah Piersiak
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Sydney Takemoto
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Brooke Fleming
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Caelan Alexander
- Psychology and Human Development, Vanderbilt University, Nashville, USA
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Segre G, Clavenna A, Roberti E, Scarpellini F, Cartabia M, Pandolfini C, Tessarollo V, Costantino I, Bonati M. Pediatrician and parental evaluation of child neurodevelopment at 2 years of age. BMC Pediatr 2024; 24:137. [PMID: 38388376 PMCID: PMC10882900 DOI: 10.1186/s12887-024-04616-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The early identification of infants with a risk for neurodevelopmental disorders in the first few years of life is essential for better developmental outcomes. Screenings should be carried out by combining the family pediatricians' and parents' perspectives, the two fundamental sources of information on children's health. The present study has three aims: (a) to test the feasibility of parent-report instruments to detect warning signs in their children's development; (b) to ascertain whether there is an agreement between the family pediatricians' (FP) clinical judgments of warning signs and the parental perceptions; (c) to determine whether there is a link between parents' distress and child development. METHODS Within the NASCITA birth cohort, in addition to the family pediatrician's clinical evaluation with routine tools, the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) was completed by parents to assess the child's language, social skills, behavior, and sensory areas. Parents were also asked to complete the Parenting Stress Index, Short Form (PSI-SF) to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. RESULTS The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician's assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR 2.46, 95%CI: 1.23-4.91) and having sleep disorders (OR 2.43, 95% CI 1.17-5.04) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR = 3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). CONCLUSIONS Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.
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Affiliation(s)
- Giulia Segre
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Antonio Clavenna
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Elisa Roberti
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Francesca Scarpellini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
- Centro Psicodiagnostico Italiano, Milan, Italy
| | - Massimo Cartabia
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Chiara Pandolfini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Valeria Tessarollo
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Costantino
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Bonati
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy.
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Ahmadzadeh YI, Eilertsen EM, Cheesman R, Rayner C, Ystrom E, Hannigan LJ, McAdams TA. Mothers' symptoms of anxiety and depression and the development of child temperament: A genetically informative, longitudinal investigation. JCPP ADVANCES 2023; 3:e12171. [PMID: 38054053 PMCID: PMC10694534 DOI: 10.1002/jcv2.12171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/03/2023] [Indexed: 12/07/2023] Open
Abstract
Background Child temperament traits and mothers' emotional symptoms relating to anxiety and depression may drive changes in one another, leading to their 'co-development' across time. Alternatively, links between mother and child traits may be attributable to shared genetic propensities. We explored longitudinal associations between mothers' emotional symptoms and child temperament traits and adjusted for genetic effects shared across generations. Methods This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers (n = 34,060) reported on their symptoms of anxiety and depression, and temperament among offspring (n = 42,526), at child ages 1.5, 3 and 5 years. Structural equation models parameterised developmental change in traits, and an extended family design adjusted for genetic effects. Results We found individual differences in stable trait scores and rate of change for all study variables. Longitudinal stability in mothers' emotional symptoms was associated with longitudinal stability in offspring emotionality (r = 0.143), shyness (r = 0.031), and sociability (r = -0.015). Longitudinal change in mothers' symptoms showed very small or negligible correlations with longitudinal change in child temperament. Both genetic and environmental influences explained the stable longitudinal association between mothers' symptoms and child emotionality. Conclusions The studied associations between mother and child traits across time appeared to be due to stable, trait-like factors, involving genetic and environmental influence, rather than their co-development. Findings contribute knowledge on how emotional symptoms develop in families across time, and the methods with which we can explore such development.
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Affiliation(s)
| | | | - R. Cheesman
- PROMENTA Research CenterUniversity of OsloOsloNorway
| | - C. Rayner
- SGDP CentreKing's College LondonLondonUK
| | - E. Ystrom
- PROMENTA Research CenterUniversity of OsloOsloNorway
- Centre for Fertility and HealthNorwegian Institute of Public HealthOsloNorway
- School of PharmacyUniversity of OsloOsloNorway
| | - L. J. Hannigan
- Nic Waals InstituteLovisenberg Diaconal HospitalOsloNorway
- Department of Mental DisordersNorwegian Institute of Public HealthOsloNorway
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - T. A. McAdams
- SGDP CentreKing's College LondonLondonUK
- PROMENTA Research CenterUniversity of OsloOsloNorway
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Racine N, Deneault AA, Thiemann R, Turgeon J, Zhu J, Cooke J, Madigan S. Intergenerational transmission of parent adverse childhood experiences to child outcomes: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023:106479. [PMID: 37821290 DOI: 10.1016/j.chiabu.2023.106479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The current meta-analytic review provides a comprehensive synthesis of studies examining parent exposure to ACEs and the developmental and mental health outcomes of their children. PARTICIPANTS AND SETTING Eligible studies up to August 2021 were identified through comprehensive database searches in PsycINFO, MEDLINE, and Embase. Studies that were included examined the intergenerational effects of parent ACEs on child development (i.e., cognitive, language, motor, social difficulties, and early social-emotional development) or mental health (i.e., internalizing problems, externalizing problems) outcomes. METHODS Data were extracted by two coders using a standardized extraction protocol. A multi-level meta-analytic approach was used to derive pooled effect sizes and test for moderators. RESULTS A total of 52 studies were included in the meta-analysis. Parent ACEs were positively associated with child mental health problems (r=0.17, 95% CI [0.12, 0.21], p<.001), child externalizing difficulties (r=0.20, 95% CI [0.15, 0.26], p<.001), and child internalizing difficulties (r=0.17, 95% CI [0.11, 0.22], p<.001). There were no significant sociodemographic (i.e., child age, parent age, income level, child sex, or racial/ethnic minority status) or methodological (i.e., study type or quality) moderators of these associations. Preliminary evidence suggests that parent ACEs were not associated with offspring developmental outcomes, such as cognitive or language skills. CONCLUSIONS Results suggest that parent ACEs are associated with some, but not all child outcomes. Additional research focused on the mechanisms of transmission are needed to inform policies and practices related to the intergenerational transmission of ACEs.
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Affiliation(s)
- Nicole Racine
- University of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
| | - Audrey-Ann Deneault
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
| | | | - Jessica Turgeon
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
| | | | | | - Sheri Madigan
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
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Köhler-Dauner F, Peter L, Fegert JM, Ziegenhain U, Buchheim A. The role of attachment representation in the relationship between childhood maltreatment, mental health and parental load: A mediation analysis. CHILD ABUSE & NEGLECT 2023; 144:106334. [PMID: 37454555 DOI: 10.1016/j.chiabu.2023.106334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
| | - Lena Peter
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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Maru M, Paris R, Simhi M. The protective effects of social support and family functioning on parenting stress among Hispanic/Latino/a American immigrant parents with traumatic life experiences: A mediation analysis. Infant Ment Health J 2023; 44:348-361. [PMID: 36938714 PMCID: PMC10956510 DOI: 10.1002/imhj.22053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 10/03/2022] [Accepted: 01/02/2023] [Indexed: 03/21/2023]
Abstract
Despite high rates of traumatic experiences reported among Hispanic/Latino/a immigrants in the U.S., the effect of post-traumatic stress on parenting stress among Hispanic/Latino/a immigrant parents with young children has been overlooked. The present study tested the direct and indirect relationships of self-reported maternal post-traumatic stress symptoms on parenting stress, and the mediating role of protective factors among Hispanic/Latino/a mothers with young children. Baseline data collected from mothers participating in a community-based child-parent dyadic intervention were analyzed. Measures included the post-traumatic stress disorder (PTSD) Checklist, the Protective Factors Survey, and the Parenting Stress Index-Short Form (PSI). The sample included 80 mothers with a child between ages 0-6 years. About 75% of these mothers were migrants from Central America. A multivariate regression analysis showed that maternal post-traumatic stress symptoms predicted higher levels of PSI, and two protective factors (social support and family functioning/resilience) fully mediated the relationship between maternal post-traumatic stress symptoms and PSI. Higher social support and family functioning/resiliency may have protective effects on Hispanic/Latino/a mothers with post-traumatic stress, leading to lower levels of stress related to parenting. Findings underscore the importance of interventions that enhance access to social support and promote family functioning/resilience for Hispanic/Latino/a immigrant mothers with trauma histories to cope better with parenting stress.
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Affiliation(s)
- Mihoko Maru
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
| | - Ruth Paris
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Meital Simhi
- School of Social Work, Boston University, Boston, Massachusetts, USA
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Lotto CR, Altafim ERP, Linhares MBM. Maternal History of Childhood Adversities and Later Negative Parenting: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:662-683. [PMID: 34342253 DOI: 10.1177/15248380211036076] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.
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Affiliation(s)
- Camila Regina Lotto
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil
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Shih EW, Ahmad SI, Bush NR, Roubinov D, Tylavsky F, Graff C, Karr CJ, Sathyanarayana S, LeWinn KZ. A path model examination: maternal anxiety and parenting mediate the association between maternal adverse childhood experiences and children's internalizing behaviors. Psychol Med 2023; 53:112-122. [PMID: 34001294 PMCID: PMC9290334 DOI: 10.1017/s0033291721001203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/28/2020] [Accepted: 03/17/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Children of mothers with adverse childhood experiences (ACEs) are at increased risk for developmental problems. However, the mechanisms through which a mother's experience of ACEs are transmitted to her offspring are understudied. The current study investigates potential modifiable mediators (maternal psychopathology and parenting) of the association between maternal ACEs and children's behavioral problems. METHODS We utilized data from a pregnancy cohort study (N = 1030; CANDLE study) to investigate longitudinal associations between maternal ACEs, postpartum anxiety, observed parenting behavior, and child internalizing behaviors (meanage = 4.31 years, s.d. age = 0.38) in a racially diverse (67% Black; 33% White/Other) sample. We used structural equation modeling to test for direct associations between maternal ACEs and children's internalizing behaviors, as well as indirect associations via two simple mediations (maternal anxiety and parenting), and one serial mediation (sequence of maternal anxiety to parenting). RESULTS Simple mediation results indicated that maternal anxiety and cognitive growth fostering behaviors independently mediated the association between maternal ACEs and child internalizing. We observed no evidence of a serial mediation from ACEs to internalizing via the effects of maternal anxiety on parenting. CONCLUSIONS This study supports and refines extant literature by confirming the intergenerational association between maternal ACEs and child internalizing behaviors in a large, diverse sample, and identifies potential modifiable mediators: maternal anxiety and parenting behaviors related to fostering cognitive development. Findings may inform interventions targeting mothers who have experienced ACEs and suggest that providing support around specific parenting behaviors and addressing maternal anxiety may reduce internalizing behaviors in children.
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Affiliation(s)
- Emily W. Shih
- University of California, San Francisco, San Francisco, CA, USA
| | - Shaikh I. Ahmad
- University of California, San Francisco, San Francisco, CA, USA
| | - Nicole R. Bush
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Sheela Sathyanarayana
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Kaja Z. LeWinn
- University of California, San Francisco, San Francisco, CA, USA
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López-Fernández G, Barrios M, Gómez-Benito J. Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior. J Pediatr Nurs 2022; 69:e80-e87. [PMID: 36529595 DOI: 10.1016/j.pedn.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years. DESIGN AND METHODS A total of 432 mothers participated in a cross-sectional online survey. A three-way interaction model was used to test the moderating role of maternal stress and child behavioral problems in the relationship between breastfeeding and maternal attachment. RESULTS The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attachment. CONCLUSIONS This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attachment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship. PRACTICE IMPLICATIONS Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.
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Affiliation(s)
- Gemma López-Fernández
- Department of gynecology and obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain.
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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13
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Kiesswetter M, Danay E, Duschek S. Changes in Life Satisfaction in Couples after Successful In vitro Fertilization and Natural Pregnancy. FAMILY PROCESS 2022; 61:1559-1576. [PMID: 34939190 DOI: 10.1111/famp.12732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous research suggested reduced well-being and quality of life in couples with an unfulfilled desire to have a child. However, changes in psychological variables in infertile couples after successful in-vitro fertilization (IVF) have been scarcely investigated. PURPOSE This prospective study explored changes in life satisfaction, stress burden and habitual worry related to the birth of a child in couples undergoing IVF, and in those experiencing natural pregnancy. METHODS In total, 77 couples with successful IVF and 50 couples with natural pregnancy completed the Life Satisfaction Questionnaire, Perceived Stress Questionnaire and Penn State Worry Questionnaire; data were recorded before pregnancy (baseline) and 6 and 12 months after childbirth. Multi-level models were applied for data analysis. RESULTS Couples with IVF reported lower life satisfaction, and higher stress burden and worry, than those with natural pregnancy at baseline. Moreover, they showed a steep increase in life satisfaction at 6 and 12 months after childbirth, and decreased stress and worry. In couples with natural pregnancy, life satisfaction scores decreased, and those of stress and worry increased, at month 6 after childbirth and returned to initial state at month 12. CONCLUSIONS The group difference at baseline underlines the psychosocial burden of infertility. However, the increase in life satisfaction and decreases in stress and worry suggest that the burden is lessened after the birth of a child. The changes in couples with natural pregnancy reflect the impact of the typical challenges posed by childbirth and successful readjustment during the first year of the child´s life.
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Affiliation(s)
- Manuel Kiesswetter
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Erik Danay
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Stefan Duschek
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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14
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Huffhines L, Bublitz MH, Coe JL, Seifer R, Parade SH. Maternal perinatal hypertensive disorders and parenting in infancy. Infant Behav Dev 2022; 69:101781. [PMID: 36323194 PMCID: PMC9793337 DOI: 10.1016/j.infbeh.2022.101781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/05/2022] [Accepted: 10/16/2022] [Indexed: 12/30/2022]
Abstract
Maternal mental health strongly influences parenting during infancy. However, it is unclear whether maternal physical health conditions in the perinatal period may also impact parenting. Examining the association of hypertensive disorders - a common physical health problem in pregnancy - with subsequent parenting behaviors is an important first step in understanding the connection between maternal physical health and parenting during this critical developmental period. This study evaluated whether hypertensive disorders of pregnancy (HDP) and hypertensive disorders (HD) diagnosed after the birth of the infant were associated with parenting self-efficacy, parenting stress, and observed parental responsiveness during mother-infant interactions at 6 and 12 months postpartum among a sample of racially and ethnically diverse mothers and their infants (N = 295). Results showed that mothers with an HDP or HD diagnosis had lower levels of parenting self-efficacy, higher levels of parenting stress, and lower levels of observed parental responsiveness compared to mothers without an HDP or HD diagnosis. Given that women with childhood adversity are at higher risk for experiencing HDP/HD and may have more difficulties with parenting compared to women without childhood adversity, we utilized a sample of mothers wherein most had experienced at least one form of adversity in their childhoods. Exploratory analyses revealed that HDP/HD moderated the relation between early life experiences and parenting outcomes in all but one model. Associations between HDP/HD and parenting are discussed, with implications for how we understand maternal physical health as a determinant of parenting in the perinatal period.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA.
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Women's Medicine Collaborative, The Miriam Hospital, Providence, RI, USA
| | - Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA; Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
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15
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DeCandia CJ, Volk KT, Unick GJ. Evolving Our Understanding: Housing Instability as an ACE for Young Children. ADVERSITY AND RESILIENCE SCIENCE 2022; 3:365-380. [PMID: 36320362 PMCID: PMC9607722 DOI: 10.1007/s42844-022-00080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/25/2022]
Abstract
We investigated the conceptualization and impact of adverse childhood experiences (ACEs) in a sample of 231 children ages 3-5 living in poverty and experiencing homelessness, focusing specifically on caregiver well-being and housing instability. Data was collected using the Neurodevelopmental Ecological Screening Tool (NEST), which screens for developmental risk and resilience across three domains (neurodevelopmental, caregiver, and environment). We used structural equation modelling (SEM) to test the association between domains and ACE scores and assessed the impact on neurodevelopmental constructs. Fifty-five percent of the sample had high ACE scores (> 3), which were associated with lower attention, social skills, and emotional regulation. ACEs were strongly associated with 0.17 standard deviation units of higher levels of caregiver distress (p < .001), which was also associated with 0.26 standard deviation units of lower levels of child neurodevelopmental functioning (p = .001). For each unit increase in housing instability, there was a three-fourths increase in ACE (0.78 ACE at p = .004); four or more moves were associated with the worst neurodevelopmental outcomes (53% of the sample). We must use an ecological, developmental lens to understand how early adversity impacts children, at what age, and in what context. Housing stability plays a critical role in developmental well-being and should be accounted for in conceptualizations of child ACE scales. Caregiver and child relationships are reciprocal, and so the impacts of ACEs are also bidirectional. Our policies and practices at individual, community, and systemic levels should account for these dynamics to improve child well-being.
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Affiliation(s)
| | | | - George J. Unick
- grid.411024.20000 0001 2175 4264School of Social Work, University of Maryland, Baltimore, MD USA
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16
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Rassart CA, Paradis A, Bergeron S, Godbout N. Cumulative childhood interpersonal trauma and parenting stress: The role of self-capacities disturbances among couples welcoming a newborn. CHILD ABUSE & NEGLECT 2022; 129:105638. [PMID: 35468316 DOI: 10.1016/j.chiabu.2022.105638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/28/2022] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The birth of a child is a life-defining event which tends to widen the gap between parents' resources and the demands they face, generating parenting stress. In this regard, individuals who experienced childhood trauma, particularly cumulative childhood interpersonal trauma (CCIT), appear more vulnerable, with higher rates of parenting stress. However, dyadic studies are lacking and the mechanisms explaining the association between CCIT and parenting stress remain unknown, limiting the promotion of resilience in parental couples. OBJECTIVE Based on the Self-Trauma Model and the Actor-Partner Interdependence Model, this study examined the role of self-capacities disturbances (i.e., affect dysregulation, identity impairment and interpersonal conflicts) in the association uniting CCIT and parenting stress. PARTICIPANTS AND SETTINGS A randomly selected sample of 421 parental couples of an infant. METHODS Participants completed self-reported measures online. RESULTS Path analyses revealed that CCIT was associated to greater parenting stress through affect dysregulation and identity impairment, in both mothers and fathers (R2 = 22.4%; 20.7%). APIM modeling revealed a dyadic association between mothers' proneness to interpersonal conflicts and fathers' parenting stress, in addition to indirect effects involving all three self-capacities in the associations between one parent's CCIT and their partner's parenting stress. CONCLUSIONS CCIT-exposed individuals may experience parenting stress through difficulties with self-capacities at the individual and dyadic level, highlighting these capacities as promising intervention targets during the postpartum period, and emphasizing the need to involve both parents since intricate dyadic patterns may be at play.
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Affiliation(s)
- Camille Andrée Rassart
- Department of psychology, Université du Québec à Montréal, 100 Sherbrooke Ouest street, Montréal, Québec H2X 3P2, Canada.
| | - Alison Paradis
- Department of psychology, Université du Québec à Montréal, 100 Sherbrooke Ouest street, Montréal, Québec H2X 3P2, Canada.
| | - Sophie Bergeron
- Departement of Psychology, Université de Montréal, 90 Vincent-d'Indy avenue, Montréal, Québec H2V 2S9, Canada.
| | - Natacha Godbout
- Departement of Sexology, Université du Québec à Montréal, 1205 St-Denis street, Montréal, Québec H2L 4Y2, Canada.
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17
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Joseph HM, Khetarpal SK, Wilson MA, Molina BS. Parent ADHD Is Associated With Greater Parenting Distress in the First Year Postpartum. J Atten Disord 2022; 26:1257-1268. [PMID: 34937412 PMCID: PMC9098664 DOI: 10.1177/10870547211066488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Little is known about the experience of parenting infants when a mother or father has ADHD. This study examined cross-sectional predictors of parenting distress experienced by parents with and without ADHD who also have infants. METHODS Participants were 73 mother-father pairs (N = 146) of infants 6 to 10 months old. Half of the families included a parent with ADHD. Psychosocial predictors were tested using multilevel modeling. RESULTS Parent or partner ADHD, lower parent sleep quality, fewer social supports, and less infant surgency and effortful control were associated with greater parental distress. Infant negative affect and sleep were not associated. CONCLUSIONS Parents with ADHD and their partners experience greater parenting distress in the first year of their child's life than parents without ADHD. Addressing parent ADHD symptoms and co-occurring difficulties, including sleep disturbances, are potential targets for early interventions to maximize both parent and infant mental health outcomes.
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Affiliation(s)
- Heather M. Joseph
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Brooke S.G. Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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18
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Voegtline KM, Dhaurali S, Wainger J, Lauzon S. Ontogeny of the Dyad: the Relationship Between Maternal and Offspring Neuroendocrine Function. Curr Psychiatry Rep 2022; 24:297-306. [PMID: 35451797 PMCID: PMC9648681 DOI: 10.1007/s11920-022-01337-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW We review ontogeny of the maternal-offspring neuroendocrine relationship in human pregnancy. We present bidirectional genetic, physiological, and behavioral influences that enhance or disrupt HPA activity and its end product cortisol at the individual level and within the dyad. RECENT FINDINGS Consistent evidence supports that maternal mood and caregiving behavior are associated with maternal and offspring cortisol levels. Select studies support the buffering effects of antidepressant use and maternal positive affect on offspring cortisol. Growing research highlights evocative effects of fetal neuroendocrine activity, antenatal gene transfer, and infant behavioral distress and risk characteristics on maternal cortisol levels and dyadic attunement. There is potential to advance our understanding of the mother-offspring neuroendocrine relationship by consideration of other neuroactive steroids in addition to cortisol, and to consider developmental timing and measurement source in study design. Future study should emphasize in what context or for whom neuroendocrine attunement is adaptive versus maladaptive for mother and child.
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Affiliation(s)
- Kristin M. Voegtline
- Johns Hopkins School of Medicine, Department of Pediatrics,Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health
| | | | - Julia Wainger
- Johns Hopkins School of Medicine, Department of Gynecology and Obstetrics
| | - Sylvie Lauzon
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health
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19
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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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20
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Sledge H, Lawler M, Hourihane J, Franklin R, Boland F, Dunne S, McCallion N, O'Mahony L, Byrne S. Parenting a newborn baby during the COVID-19 pandemic: a qualitative survey. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001348. [PMID: 35984697 PMCID: PMC8905983 DOI: 10.1136/bmjpo-2021-001348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic caused long periods of lockdown, social isolation and intense challenges for parents. This study examines parenting in an infant cohort born at the pandemic onset. METHODS The CORAL study is a prospective longitudinal observational study looking at allergy, immune function and neurodevelopmental outcome in babies born between March and May 2020. Demographic information was collected, babies were reviewed at 6-monthly intervals, and serology for COVID-19 infection was recorded. When babies were 12 months old, parents were asked for 3-5 words to describe raising a baby during the pandemic. Frequency of word usage was compared between first time parents and parents with other children, and parents of babies with and without a diagnosis of COVID-19 infection. RESULTS 354 babies were recruited to CORAL study. Social circles were small. At 6 months the median number of people (including parents) who had kissed the baby was 3, and by 12 months one-quarter of babies had never met another child of similar age. 304 parents completed the word choice. Commonly reported words were lonely (44.4%), isolating (31.9%) and strong bond (15.8%). 12 of those 304 babies had COVID-19 in their first year of life and there was no significant difference in reported negative or positive word number compared with parents of babies without a COVID-19 infection, or by first time parents or those who already had children. CONCLUSION The lockdowns and social restrictions made raising an infant challenging for all parents in Ireland. It is important parents know this was a shared experience.
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Affiliation(s)
- Hailey Sledge
- Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marguerite Lawler
- Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Paediatrics, Children's Health Ireland, Dublin, Ireland
| | - Jonathan Hourihane
- Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Paediatrics, Children's Health Ireland, Dublin, Ireland
| | - Ruth Franklin
- Department of Paediatrics, Children's Health Ireland, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sumi Dunne
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Naomi McCallion
- Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Maternity Hospital, Rotunda Hospital, Dublin, Ireland
| | - Liam O'Mahony
- Department of Medicine and School of Microbiology, University College Cork, Cork, Ireland.,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Susan Byrne
- Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland .,Department of Paediatrics, Children's Health Ireland, Dublin, Ireland.,FutureNeuro, Royal College of Surgeons in Ireland, Dublin, Ireland
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21
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Bohne A, Høifødt RS, Nordahl D, Landsem IP, Moe V, Wang CEA, Pfuhl G. The role of early adversity and cognitive vulnerability in postnatal stress and depression. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02651-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe purpose of the present study was to examine vulnerability factors in expecting parents that might lead to mental illness in the perinatal period. Specifically, we studied how parental early adversity, attentional bias to infant faces, repetitive negative thinking, and demographic factors, were associated with pre- and postnatal depressive symptoms and parenting stress. Participants were expecting parents taking part in the Northern Babies Longitudinal Study, where assessments were made both pre- and postnatally. Assessments included both questionnaires and cognitive tasks. About half of the participants received the Newborn Behavior Observation (NBO)-intervention after birth, between pre- and postnatal assessments. Results show that repetitive negative thinking was a significant predictor of both depressive symptoms and parenting stress, while education, social support, and parity came out as protective factors, especially in mothers. Parental early adversity had an indirect effect on postnatal depressive symptoms and parenting stress, mediated by prenatal and postnatal depressive symptoms, respectively. The NBO intervention did not affect the results, signifying the importance of early childhood adverse events and negative thinking on parents' postnatal adjustment and mood, even when an intervention is provided. In conclusion, repetitive negative thinking is a significant vulnerability factor independent of the presence of depressive symptoms, and health professionals must be aware of parents’ thinking style both during pregnancy and after birth.
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22
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Smith BT, Brumage MR, Zullig KJ, Claydon EA, Smith ML, Kristjansson AL. Adverse childhood experiences among females in substance use treatment and their children: A pilot study. Prev Med Rep 2022; 24:101571. [PMID: 34976635 PMCID: PMC8683959 DOI: 10.1016/j.pmedr.2021.101571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022] Open
Abstract
Women with substance use disorder (SUD) often have experienced adverse childhood experiences (ACEs). The intergenerational nature of ACEs also put their children at risk for experiencing ACEs. However, no research has explored the prevalence of ACEs in children whose mothers have SUD. This study assessed ACE scores in mothers with SUD and their children and compared them with non-SUD participants. Females with SUD were recruited from a treatment center (n = 50) and compared to females without SUD from the same area (n = 50). The ACE scores of the participants and their children were measured as well as sociodemographic variables. ANOVA and Fisher’s Exact tests were used to examine univariate differences. Multivariate regression models assessed the difference in ACE scores between the groups and their children and the relationship between maternal and child ACE scores while including sociodemographic confounders. The mean ACE score was significantly higher in SUD participants (4.9, SD = 2.9) when compared to non-SUD participants (1.9, SD = 2.0) after controlling for sociodemographic variables (p < .01). Children of treatment participants also had significantly higher mean ACE scores (3.9, SD = 2.3) than children of comparison participants (1.3, SD = 2.0, p < .01). Maternal ACE score was positively related to children’s ACE score after controlling for sociodemographic variables. Given the intergenerational nature of ACEs and their high burden in both mothers and children in substance use treatment, these preliminary findings suggest that mother–child trauma-informed interventions may be appropriate for this population.
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Affiliation(s)
- Brittany T Smith
- Department of Social and Behavioral Sciences West Virginia University School of Public Health, 64 Medical Center Drive P.O. Box 9190, Morgantown, WV 26506-9190, United States
| | - Michael R Brumage
- Post-Deployment Health Services, Veterans Health Administration, Washington, DC, United States
| | - Keith J Zullig
- Department of Social and Behavioral Sciences West Virginia University School of Public Health, 64 Medical Center Drive P.O. Box 9190, Morgantown, WV 26506-9190, United States
| | - Elizabeth A Claydon
- Department of Social and Behavioral Sciences West Virginia University School of Public Health, 64 Medical Center Drive P.O. Box 9190, Morgantown, WV 26506-9190, United States
| | - Megan L Smith
- Department of Community and Environmental Health Boise State University Boise, ID, United States
| | - Alfgeir L Kristjansson
- Department of Social and Behavioral Sciences West Virginia University School of Public Health, 64 Medical Center Drive P.O. Box 9190, Morgantown, WV 26506-9190, United States
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23
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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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24
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Fuchs A, Resch F, Kaess M, Moehler E. Early Parenting Stress Links Obstetric Complications and Child Psychopathology in Middle Childhood in an At-Risk Sample. J Dev Behav Pediatr 2022; 43:e48-e55. [PMID: 33908374 DOI: 10.1097/dbp.0000000000000960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Obstetric complications (OCs) are adverse events during pregnancy, birth, or immediately after birth. Evidence on cumulative OC and longitudinal associations with child psychopathology is sparse. Prospective studies testing mediating pathways such as parenting stress are needed. This study aimed to investigate the impact of OC on child psychopathology in middle childhood and to highlight whether and which type of parenting stress specifically mediates this association. METHODS We investigated n = 54 mother-child dyads from 5 months to 8 years of age. Child psychopathology at 8 years and parenting stress at 12 months were assessed using the Child Behavior Checklist (CBCL) and the Parenting Stress Index. OCs were evaluated by the Steinhausen Questionnaire and through access to official pregnancy records at the 5-month visit. Half of the mothers had experienced early-life maltreatment (ELM), assessed with the Childhood Trauma Questionnaire. RESULTS There was a significant indirect effect of maternal parenting stress at 12 months mediating the association between OC and child psychopathology at 8 years (β = 0.26; p < 0.01; 95% [0.35-1.83]). A significant proportion of 35% of CBCL-variance was explained. The significant effect remained even when maternal ELM and maternal psychological distress were controlled for. On the subscale level, only the "Difficult Child" subscale was a significant mediator. CONCLUSION Our findings suggest that parenting stress should be targeted to prevent adverse effects of OC on child psychopathology. More research focusing on families subjected to OC is needed to highlight how maternal parenting stress and child regulatory functioning interact to affect child development longitudinally.
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Affiliation(s)
- Anna Fuchs
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- Department of Psychology, Pennsylvania State University, University Park, PA
| | - Franz Resch
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Eva Moehler
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Saarland, Homburg, Germany
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Madsen EB, Smith-Nielsen J, Egmose I, Lange T, Vaever MS. The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms. Scand J Psychol 2021; 63:47-54. [PMID: 34743339 DOI: 10.1111/sjop.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes. In a cross-sectional study using a sample of mothers of 2-10 month-old infants (N = 367) we first examined depressive symptoms as a mediator, and then, the indirect effect of adult attachment through depressive symptoms between childhood adversity and parenting stress. Results showed that the effect of childhood adversity on parenting stress was mediated by an indirect pathway through depressive symptoms alone, and an indirect pathway of adult attachment through depressive symptoms. The indirect effect of adult attachment through depressive symptoms was found to be stronger than the indirect effect of depressive symptoms alone, supporting the hypothesis that adult attachment insecurity together with depressive symptoms are particularly important risk factors to be considered in this relationship. Results suggest that childhood adversity is a risk factor for parenting stress, and not a determinant of later parenting stress per se. Instead, mediators in this association, adult attachment, and depressive symptoms, were identified as potential targets of intervention to prevent negative effects of childhood adversity on parenting stress. A limitation of the study lies in its cross-sectional design. Future studies should examine these associations longitudinally to allow for interpretation of causality.
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Affiliation(s)
- Eva Back Madsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Quintigliano M, Trentini C, Fortunato A, Lauriola M, Speranza AM. Role of Parental Attachment Styles in Moderating Interaction Between Parenting Stress and Perceived Infant Characteristics. Front Psychol 2021; 12:730086. [PMID: 34744898 PMCID: PMC8564486 DOI: 10.3389/fpsyg.2021.730086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
By employing the transactional model of development and focusing on the multifactorial nature of parenting, this study aimed to (1) examine whether important risk factors, particularly mothers' insecure attachment styles and parenting stress contribute to the perception of their infants' characteristics and (2) explore whether maternal attachment styles moderate the relationship between parenting stress and perceived infants' characteristics. We recruited 357 mothers (age: 34.23; ± 5.38) who had 1-year-old infants (161 males and 196 females; age: 12.70; ± 1.60 months). All the mothers completed three self-report instruments: Parenting Stress Index-Short Form (PSI-SF), Attachment Style Questionnaire (ASQ), and 1st-Year Inventory (FYI). Although the latter was originally developed to determine the risk for autism in 1-year-olds, it was employed in this study to measure infant's characteristics within two domains: social communication and sensory regulatory functions. Multiple regression analyses revealed that one of the PSI-SF dimensions - specifically the Parent-Child Dysfunctional Interaction - contributed to mothers' perceptions of their children's social communication abilities, whereas the attachment style did not. Other multiple regression analyses showed that all the dimensions of parenting stress - that is, Parenting Distress (PD), Parent-Child Dysfunctional Interaction (PCDI), and Difficult Child (DC) - contributed to mothers' perceptions of their sensory regulatory abilities. The attachment styles, particularly anxious attachment, contributed significantly to a biased perception of these abilities controlled for parenting stress. Mothers reporting high levels of avoidance and high levels of PD viewed their children as less able in the social communicative domain (SC Dom) than if they had low levels of PD. By contrast, when levels of avoidance were low, mothers with high PD perceived their children as less difficult in the SC Dom than those with low levels of PD. Moreover, high avoidance levels influenced how mothers who considered the interaction with their children as difficult perceived them as having greater difficulties in relation to sensory regulatory domain (SR Dom). By contrast, mothers with high levels of anxiety high levels of PD view their children as less able in the SC Dom than if they had low levels of PD. When mothers' levels of anxiety were very low, those with high PD viewed their children as less difficult in the SC Dom in comparison to those with low levels of PD.
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Affiliation(s)
- Maria Quintigliano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Cristina Trentini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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27
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van Dijk W, Oosterman M, Jansen I, de Vente W, Huizink A. Stress- and smoke free pregnancy study protocol: a randomized controlled trial of a personalized eHealth intervention including heart rate variability-biofeedback to support pregnant women quit smoking via stress reduction. BMC Public Health 2021; 21:905. [PMID: 33980201 PMCID: PMC8115871 DOI: 10.1186/s12889-021-10910-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Maternal smoking and stress during pregnancy are associated with adverse health effects for women themselves and are risk factors for adverse developmental outcomes of the unborn child. Smoking and stress seem to be intertwined in various ways. First, the majority of smoking pregnant women is of lower socio-economic status, which is associated with higher levels of perceived stress. Second, smoking women often report to smoke because they feel stressed. Third, quitting smoking often increases perceived stress levels initially. Therefore, effective interventions are needed to support women with smoking cessation by reducing stress. The aim of this study is to test the effectiveness of an eHealth intervention on stress reduction and smoking cessation. METHODS/DESIGN The Stress- and Smoke Free Start of Life (SSFSL) study is a randomized controlled trial (RCT) comparing a personalized eHealth intervention with a control condition. Inclusion criteria for the women are: (1) > 18 years of age, (2) < 28 weeks pregnant at recruitment, (3) currently smoking. Consenting participants will be randomly assigned to the intervention or control group. Participants allocated to the intervention group will receive an 8-week intervention delivered on their smartphone. The application includes psycho-education on pregnancy, stress, and smoking (cessation); stress-management training consisting of Heart Rate Variability-biofeedback; and a personalized stop-smoking-plan. Participants in the control condition will be invited to visit a webpage with information on pregnancy, stress, and smoking (cessation). Study outcomes will be collected via online questionnaires, at four timepoints: pre-intervention (baseline; t0), post-intervention (8 weeks + 1 day after t0; t1), follow up at two weeks after birth (t2), and follow up at three months after birth (t3). The primary outcome measure is self-reported smoking cessation. Secondary outcomes include daily self-reported number of cigarettes smoked, perceived stress, pregnancy experience, birth outcomes, and negative affectivity scores of the baby. Moreover, the mediating effect of stress reduction on smoking cessation will be examined, and possible moderators will be tested. DISCUSSION If the eHealth intervention is effective in smoking cessation among pregnant smoking women, it can be implemented as a tool into the health care in the Netherlands. TRIAL REGISTRATION Netherlands Trial Register, ID: NL8156 . Registered on 11 November 2019.
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Affiliation(s)
- Willeke van Dijk
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands.
| | - Mirjam Oosterman
- Department of Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Imke Jansen
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Wieke de Vente
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Anja Huizink
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
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Wiseman KB, Warner-Czyz AD, Nelson JA. Stress in Parents of School-Age Children and Adolescents With Cochlear Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:209-222. [PMID: 33442726 DOI: 10.1093/deafed/enaa042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
Parents of children with cochlear implants (CIs) face unique challenges in caring for their child, potentially fostering parental stress. Most studies of stress in parents of CI users do not examine stress specific to having a deaf and hard-of-hearing (DHH) child. This study compares general and condition-specific stress (via the Family Stress Scale) in 31 parents of CI users (8-16 years) to previously published samples of DHH children, and it examines child- and CI-related factors associated with parental stress. Parents of modern-day CI users reported significantly lower stress than parents of children using older-generation CI technology and similar levels of overall stress to parents of young children preimplantation. However, significant item-level differences emerged (e.g., communication, device management) pre- versus postimplant. Child temperament significantly predicted parental stress after controlling for other variables. Intervention strategies for children with CIs should engage a family systems approach to reduce parental stress and better support the child.
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Affiliation(s)
- Kathryn B Wiseman
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - Andrea D Warner-Czyz
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
- Callier Advance Hearing Research Center, The University of Texas at Dallas, Dallas, Texas, USA
| | - Jackie A Nelson
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
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Abuhammad S, AlAzzam M, AbuFarha R. Infant temperament as a predictor of maternal attachment: A Jordanian study. Nurs Open 2021; 8:636-645. [PMID: 33570267 PMCID: PMC7877151 DOI: 10.1002/nop2.668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/25/2020] [Accepted: 10/05/2020] [Indexed: 01/17/2023] Open
Abstract
AIM To investigate the relationship between maternal bonding and infant temperament during the first year of infant's life. Moreover, it also wanted to explore which perinatal factors could influence the quality of maternal attachment. METHOD A cross-sectional study design was used to collect data from a sample of 277 mothers during the period of May-October 2018. The participants were asked to complete a three-part survey that was developed to collect data on maternal attachment and infant temperament. Data was collected between March 2019-June 2019. RESULTS The analysis of the data revealed that there was a significant relationship between infant temperament and maternal attachment [F(2, 95) = 6.783, p-value = .001]. It also revealed that the factors that most influenced maternal attachment were infant temperament and planned pregnancy, which together explained 54% of the variance in maternal attachment (R2 = 7.5). CONCLUSION Maternal attachment in Jordanian mothers can be explained by two significant factors: infant temperament and planning for pregnancy.
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Affiliation(s)
- Sawsan Abuhammad
- Faculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Manar AlAzzam
- Princess Salma Faculty of NursingAl‐Albayt UniversityMafraqJordan
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30
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Finlay-Jones AL, Davis JA, O'Donovan A, Kottampally K, Ashley RA, Silva D, Ohan JL, Prescott SL, Downs J. Comparing Web-Based Mindfulness With Loving-Kindness and Compassion Training for Promoting Well-Being in Pregnancy: Protocol for a Three-Arm Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19803. [PMID: 33052131 PMCID: PMC7593853 DOI: 10.2196/19803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Promoting psychological well-being and preventing distress among pregnant women is an important public health goal. In addition to adversely impacting the mother's health and well-being, psychological distress in pregnancy increases the risk of poor pregnancy outcomes, compromises infant socioemotional development and bonding, and heightens maternal and child vulnerability in the postpartum period. Mindfulness and compassion-based interventions show potential for prevention and early intervention for perinatal distress. As there is an established need for accessible, scalable, flexible, and low-cost interventions, there is increased interest in the delivery of these programs on the web. This project aims to pilot a three-arm randomized controlled trial (RCT) to determine the feasibility of a full-scale RCT comparing 2 web-based interventions (mindfulness vs loving-kindness and compassion) with a web-based active control condition (progressive muscle relaxation). OBJECTIVE The primary objective of this study is to assess the feasibility of an RCT protocol comparing the 3 conditions delivered on the web as a series of instructional materials and brief daily practices over a course of 8 weeks. The second objective is to explore the experiences of women in the different intervention conditions. The third objective is to estimate SD values for the outcome measures to inform the design of an adequately powered trial to determine the comparative efficacy of the different conditions. METHODS Pregnant women (n=75) participating in a longitudinal birth cohort study (the ORIGINS project) will be recruited to this study from 18 weeks of gestational age. We will assess the acceptability and feasibility of recruitment and retention strategies and the participants' engagement and adherence to the interventions. We will also assess the experiences of women in each of the 3 intervention conditions by measuring weekly changes in their well-being and engagement with the program and by conducting a qualitative analysis of postprogram interviews. RESULTS This project was funded in September 2019 and received ethics approval on July 8, 2020. Enrollment to the study will commence in September 2020. Feasibility of a full-scale RCT will be assessed using ADePT (a process for decision making after pilot and feasibility trials) criteria. CONCLUSIONS If the study is shown to be feasible, results will be used to inform future full-scale RCTs. Evidence for flexible, scalable, and low-cost interventions could inform population health strategies to promote well-being and reduce psychological distress among pregnant women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Number 12620000672954p; http://anzctr.org.au/ACTRN12620000672954p.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/19803.
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Affiliation(s)
- Amy Louise Finlay-Jones
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia.,University of Western Australia, Crawley, Australia
| | - Jacqueline Ann Davis
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia.,University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia
| | | | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia.,Edith Cowan University, Joondalup, Australia.,Joondalup Health Campus, Joondalup, Australia
| | | | - Susan L Prescott
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia.,Perth Children's Hospital, Nedlands, Australia
| | - Jenny Downs
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia
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Association of maternal sleep before and during pregnancy with preterm birth and early infant sleep and temperament. Sci Rep 2020; 10:11084. [PMID: 32632276 PMCID: PMC7338358 DOI: 10.1038/s41598-020-67852-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/15/2020] [Indexed: 02/07/2023] Open
Abstract
This study aimed to investigate the association of maternal sleep before and during pregnancy with preterm birth, infant sleep and temperament at 1 month of age. We used the data of the Japan Environment and Children’s Study, a cohort study in Japan, which registered 103,099 pregnancies between 2011 and 2014. Participants were asked about their sleep before and during pregnancy, and the sleep and temperament of their newborns at 1 month of age. Preterm birth data were collected from medical records. Maternal sleep was not associated with preterm birth, but subjective sleep quality during pregnancy was associated with late preterm birth (birth at 34–36 weeks of gestation). For example, participants with extremely light subjective depth of sleep were more likely to experience preterm birth (RR = 1.19; 95% confidence interval [CI] = 1.04–1.35). Maternal sleep both before and during pregnancy seemed to be associated with infant sleep and temperament at 1 month of age. Infants, whose mothers slept for less than 6 hours before pregnancy, tended to cry intensely (RR = 1.15; 95% CI = 1.09–1.20). Maternal sleep problems before and during pregnancy were associated with preterm birth and child sleep problems and temperament.
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Skjothaug T, Smith L, Wentzel-Larsen T, Stänicke E, Moe V. Antecedents of fathers' perception of child behavior at child age 12 months. Infant Ment Health J 2020; 41:495-516. [PMID: 32515863 DOI: 10.1002/imhj.21862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study investigates whether fathers' adverse childhood experiences (ACE) and attachment style reported during pregnancy predict fathers' perception of child behavior assessed 12 months postpartum, expressed by the Parenting Stress Index (PSI), Child Domain. Prospective fathers (N = 835) were recruited to "The Little in Norway (LiN) study" (Moe & Smith) at nine well-baby clinics in Norway, with data collection composed of five time points during pregnancy and two time points postpartum (6 and 12 months). The main analyses included linear regression, path-analysis modeling, and intraclass correlation based on mixed effects modeling. First, linear regression analyses showed that neither fathers' ACE nor attachment style significantly predicted perceived child behavior postpartum directly. Furthermore, path analyses showed that ACE and less secure attachment style (especially avoidant attachment) measured early in pregnancy strongly predicted negatively perceived child behavior, mediated by fathers' mental health symptoms during pregnancy and partner disharmony postpartum. Second, intraclass correlation analyses showed that fathers' perceived child behavior showed substantial stability between 6 and 12 months postpartum. Family interventions beginning in pregnancy may be most beneficial given that fathers' early experiences and perceptions of attachment in pregnancy were associated with later partner disharmony and stress.
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Affiliation(s)
- Thomas Skjothaug
- BUP Vest, Diakonhjemmet Hospital, Oslo, Norway.,University of Oslo, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | | | - Tore Wentzel-Larsen
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | | | - Vibeke Moe
- University of Oslo, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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Nordahl D, Rognmo K, Bohne A, Landsem IP, Moe V, Wang CEA, Høifødt RS. Adult attachment style and maternal-infant bonding: the indirect path of parenting stress. BMC Psychol 2020; 8:58. [PMID: 32513300 PMCID: PMC7278048 DOI: 10.1186/s40359-020-00424-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/21/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The quality of maternal-infant bonding is related to important child outcomes. The literature has assumed that the ability to form relationships is a relatively stable trait, and research studies have suggested that a mother's attachment style in close adult relationships is related to mother-infant bonding. The transition to parenthood is also often stressful, and the adult attachment style may relate to parenting stress in the first year after birth. Such stress could possibly have a negative relationship with the mother-infant bond. In the present study, we examined the associations between maternal adult attachment styles and the quality of mother-infant bonding and whether this relationship is mediated by parenting stress. METHODS The present study sample comprised 168 women (mean age 31.0 years, SD 4.23 years). Between weeks 31 and 41 of gestation, the anxious and avoidant adult attachment dimensions were measured with the Experiences in Close Relationships questionnaire (ECR). Between 5 and 15 weeks after birth mother-infant bonding and parenting stress were measured with the Maternal Postnatal Attachment Scale (MPAS) and the Parenting Stress Index-Parent Domain (PSI-PD), respectively. RESULTS Both attachment-related avoidance and attachment-related anxiety correlated significantly and negatively with mother-infant bonding. However, a regression analysis showed that only attachment-related avoidance was a significant predictor of mother-infant bonding when controlling for demographic variables and maternal mental health history. The relationship between the adult attachment style and bonding was mediated by parenting stress. Higher scores on attachment avoidance and anxiety were related to increased stress, which was related to decreased quality of bonding. The overall parent domain and the subscale of competence in the parent-related stress dimension mediated between attachment avoidance and bonding, and the overall parent domain and the subscales of competence and role restriction mediated between attachment anxiety and bonding. There was no direct relationship between the adult attachment style and mother-infant bonding when parenting stress was included as a mediator. CONCLUSIONS This study illustrates that maternal adult attachment style relates to mother-infant bonding. This relationship was mediated by parenting stress. The results may have implications for the early identification of mothers at risk of having bonding difficulties.
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Affiliation(s)
- Dag Nordahl
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway.
| | - Kamilla Rognmo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Agnes Bohne
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
| | - Inger Pauline Landsem
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway
| | | | - Ragnhild Sørensen Høifødt
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Selviana, Masni, Tamar M. Determinant of parenting self efficacy with parents have children ages 0–12 month at the talise health centre work area Palu city. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.10.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Moe V, Fredriksen E, Kjellevold M, Dahl L, Markhus MW, Stormark KM, von Soest T, Olafsen KS, Vannebo UT, Smith L. Little in Norway: a prospective longitudinal community-based cohort from pregnancy to child age 18 months. BMJ Open 2019; 9:e031050. [PMID: 31892648 PMCID: PMC6955541 DOI: 10.1136/bmjopen-2019-031050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Little in Norway (LiN) project is a cross-disciplinary prospective longitudinal study starting in pregnancy. It was set up to investigate maternal and paternal mental health functioning in the transition to parenthood, detect pathways to healthy and aberrant child development and generate new knowledge about mechanisms underlying differential child mental health susceptibility. PARTICIPANTS The LiN cohort is a community-based sample comprising 1036 families (1036 mothers, 884 partners, 1017 children). All pregnant women and their partners receiving routine prenatal care at well-baby clinics at nine geographically selected sites across Norway were invited to participate. Enrolment took place from September 2011 to October 2012. This cohort profile comprises 10 data collection waves spanning from enrolment in pregnancy until child age 18 months. FINDINGS TO DATE Four types of information have been collected: multi-informant questionnaire reports, direct observation of interaction, test data and biological samples. The most significant findings so far relate to three domains of results. First, when examining risk factors for parental mental health problems, results showed that the parents' own adverse childhood experiences and attachment style were related to anxiety, depression and stress in the perinatal period. The perception of difficult child temperament was also found to contribute to parenting stress in the first year after birth. Second, we studied how parental mental health risk factors were related to later child development and social emotional functioning, for example, linking maternal symptoms to social-emotional outcomes and paternal symptoms to language outcomes. Third, we investigated the relation between maternal nutrition during pregnancy and aspects of early child development. Results showed that mild to moderate maternal iodine deficiency in pregnancy was associated with poorer language skills up to 18 months, but not with reduced cognitive or fine and gross motor skills. FUTURE PLANS A data collection point at 36 months is completed and currently being analysed. A new data collection wave is planned when the children are 8 years of age. TRIAL REGISTRATION NUMBER ISRCTN66710572.
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Affiliation(s)
- Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Eivor Fredriksen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | | | | | | | - Kjell Morten Stormark
- Centre for Child and Adolescent Mental Health Uni Health, Uni Research, Bergen, Norway
| | - Tilmann von Soest
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Kåre Sten Olafsen
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Unni Tranaas Vannebo
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Lars Smith
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Wikenius E, Moe V, Smith L, Heiervang ER, Berglund A. DNA methylation changes in infants between 6 and 52 weeks. Sci Rep 2019; 9:17587. [PMID: 31772264 PMCID: PMC6879561 DOI: 10.1038/s41598-019-54355-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/14/2019] [Indexed: 12/16/2022] Open
Abstract
Infants undergo extensive developments during their first year of life. Although the biological mechanisms involved are not yet fully understood, changes in the DNA methylation in mammals are believed to play a key role. This study was designed to investigate changes in infant DNA methylation that occurs between 6 and 52 weeks. A total of 214 infant saliva samples from 6 or 52 weeks were assessed using principal component analyses and t-distributed stochastic neighbor-embedding algorithms. Between the two time points, there were clear differences in DNA methylation. To further investigate these findings, paired two-sided student’s t-tests were performed. Differently methylated regions were defined as at least two consecutive probes that showed significant differences, with a q-value < 0.01 and a mean difference > 0.2. After correcting for false discovery rates, changes in the DNA methylation levels were found in 42 genes. Of these, 36 genes showed increased and six decreased DNA methylation. The overall DNA methylation changes indicated decreased gene expression. This was surprising because infants undergo such profound developments during their first year of life. The results were evaluated by taking into consideration the extensive development that occurs during pregnancy. During the first year of life, infants have an overall three-fold increase in weight, while the fetus develops from a single cell into a viable infant in 9 months, with an 875-million-fold increase in weight. It is possible that the findings represent a biological slowing mechanism in response to extensive fetal development. In conclusion, our study provides evidence of DNA methylation changes during the first year of life, representing a possible biological slowing mechanism. We encourage future studies of DNA methylation changes in infants to replicate the findings by using a repeated measures model and less stringent criteria to see if the same genes can be found, as well as investigating whether other genes are involved in development during this period.
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Affiliation(s)
- Ellen Wikenius
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Lars Smith
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Einar R Heiervang
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo University Hospital, Oslo, Norway
| | - Anders Berglund
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
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Wikenius E, Myhre AM, Page CM, Moe V, Smith L, Heiervang ER, Undlien DE, LeBlanc M. Prenatal maternal depressive symptoms and infant DNA methylation: a longitudinal epigenome-wide study. Nord J Psychiatry 2019; 73:257-263. [PMID: 31070508 DOI: 10.1080/08039488.2019.1613446] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Prenatal maternal stress increases the risk of offspring developmental and psychological difficulties. The biological mechanisms behind these associations are mostly unknown. One explanation suggests that exposure of the fetus to maternal stress may influence DNA methylation. However, this hypothesis is largely based on animal studies, and human studies of candidate genes from single timepoints. Aim: The aim of this study was to investigate if prenatal maternal stress, in the form of maternal depressive symptoms, was associated with variation in genome-wide DNA methylation at two timepoints. Methods: One-hundred and eighty-four mother-child dyads were selected from a population of pregnant women in the Little-in-Norway study. The Edinburgh Postnatal Depression Scale (EPDS) measured maternal depressive symptoms. It was completed by the pregnant mothers between weeks 17 and 32 of gestation. DNA was obtained from infant saliva cells at two timepoints (age 6 weeks and 12 months). DNA methylation was measured in 274 samples from 6 weeks (n = 146) and 12 months (n = 128) using the Illumina Infinium HumanMethylation 450 BeadChip. Linear regression analyses of prenatal maternal depressive symptoms and infant methylation were performed at 6 weeks and 12 months separately, and for both timepoints together using a mixed model. Results: The analyses revealed no significant genome-wide association between maternal depressive symptoms and infant DNA methylation in the separate analyses and for both timepoints together. Conclusions: This sample of pregnant women and their infants living in Norway did not reveal associations between maternal depressive symptoms and infant DNA methylation.
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Affiliation(s)
- Ellen Wikenius
- a Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway.,b Child & Adolescent Mental Health Research Unit , Oslo University Hospital , Oslo , Norway
| | - Anne Margrethe Myhre
- a Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway.,b Child & Adolescent Mental Health Research Unit , Oslo University Hospital , Oslo , Norway
| | - Christian Magnus Page
- c Oslo Centre for Biostatistics and Epidemiology , Oslo University Hospital , Oslo , Norway.,d Centre for Fertility and Health , Norwegian Institute of Public Health , Oslo , Norway
| | - Vibeke Moe
- e The Department of Psychology, Faculty of Social Sciences , University of Oslo , Oslo , Norway.,f Center for Child and Adolescent Mental Health , Eastern and Southern Norway (RBUP) , Oslo , Norway
| | - Lars Smith
- e The Department of Psychology, Faculty of Social Sciences , University of Oslo , Oslo , Norway
| | - Einar Røshol Heiervang
- a Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway.,b Child & Adolescent Mental Health Research Unit , Oslo University Hospital , Oslo , Norway
| | - Dag Erik Undlien
- a Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway.,g Department of Medical Genetics , Oslo University Hospital , Oslo , Norway
| | - Marissa LeBlanc
- c Oslo Centre for Biostatistics and Epidemiology , Oslo University Hospital , Oslo , Norway
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