Relationship between maternal anxiety and infants' temperament: The mediating role of mindful parenting

Research has indicated that maternal anxiety does have an effect on infant temperament. Therefore, it is important to study the variables that could play a role in this relationship. In this study, we propose that mindful parenting could act as a mediator in this relationship. Thus, the main objective was to evaluate the relationship between maternal anxiety and child temperament (i.e., negative affectivity, surgency, and effortful control) through the mindful parenting of mothers. Mothers (N = 225) self-reported their anxiety, mindful parenting use, and the temperament of their old infants (aged 4-18 months). First, the reliability and validity results showed that the infant version of the Interpersonal Mindful Parenting questionnaire was a good tool for the assessment of mindful parenting among parents with infants. The five-factor structure of the questionnaire was confirmed; it involved self-regulation in the parenting relationship, listening with full attention, emotional awareness of the child, compassion for the child, and non-judgmental acceptance of parenting behavior. Correlational analyses showed that maternal anxiety was related to negative affectivity and effortful control in infants. Furthermore, mediational analyses indicated that the relation between maternal anxiety and infant negative affectivity was mediated by self-regulation in parenting and the emotional awareness of the child. In addition, the relation between maternal anxiety and infant effortful control was mediated by compassion for the child and listening with full attention. These results contribute to knowledge about the relation between maternal anxiety and child temperament, which may increase the risk of psychological symptoms. The results of this study suggest that promoting mindful parenting skills may be beneficial for affectivity and effortful control in infants.

Genetic variability in the oxytocin system is linked to individual differences in cuddliness among human infants

Pleasant touch facilitates social interactions, affiliative behavior and emotional bonding, contributing to positive infant and child development. Oxytocin is presumed to play an important role in mediating these effects of pleasant touch on brain, body and behavior. However, little is known about the role the oxytocin system plays in pleasant touch during infancy. This study examined the hypothesis that genetic variability in the oxytocin system is linked to individual differences in infants' cuddliness operationalized as parent-reported behaviors indexing an infant's motivation to seek out and enjoy caregiver touch. Our results (N = 82) show that a polymorphism in CD38 (rs3796863), previously linked with increased release of oxytocin in adults, was associated with higher reported rates of cuddliness. In contrast, infants with CD38 genotype previously linked to autism spectrum disorder (ASD) and reduced release of oxytocin in adults, was associated with lower rates of cuddliness. These findings support the hypothesis that, from early in human ontogeny, genetic variation in the oxytocin system is systematically linked to individual differences in the reported motivation to seek out, and the enjoyment of receiving, pleasant caregiver touch. This provides novel insights into the neurohormonal processes involved in pleasant touch.

Prenatal anticipatory stress: Baby preparation and worry scale-revised in the Dutch context

BACKGROUND

Prenatal distress encompasses a range of different emotions, worries, and experiences of stress. The Baby Preparation and Worry Scale (Baby-PAWS) was recently developed to target anticipatory worries during pregnancy about the postnatal period. However, the Baby-PAWS questionnaire was only examined in the United States of America, limiting the questionnaire's generalizability to different countries. To address this issue, we performed a psychometric evaluation of the questionnaire in a Dutch sample and examined associations between the Baby-PAWS questionnaire and established measures of maternal distress (i.e., EPDS, STAI, PRAQ-R) and infant temperament (i.e., IBQ-R).

METHODS

Healthy pregnant women (N = 521) completed questionnaires during their third trimester and postnatally, including the Baby-PAWS and distress measures. A subsample of mothers (N = 194) also reported on infant temperament at 12 weeks postpartum.

RESULTS

Exploratory factor analysis suggested a four-factor structure for the 16-item questionnaire in our Dutch sample, as compared to the expected three-factor structure found in the original psychometric evaluation with the American sample. The total Baby-PAWS score was related to pre-and postnatal depression, anxiety, stress, and specific scales of infant temperament. American women scored higher on the Baby-PAWS items than Dutch women.

LIMITATIONS

Our participants had higher-than-average socioeconomic status, limiting the generalizability of the findings.

CONCLUSION

The current analyses indicate good validity of the Baby-PAWS in a Dutch sample. Furthermore, our results highlight cross-cultural differences in perinatal mental health and show the importance of examining instrument structure of context-dependent constructs, such as prenatal worries.

Infant fearful distress, parent intrusiveness, and adversity in families experiencing homelessness

Infants experiencing homelessness face risk for developing mental health problems in the future. Parents residing in shelters experience adverse events at elevated rates compared to non-homeless individuals, which can impact their infants during a time of rapid development depending on how the parent copes. For some, trauma linked to these events may manifest in an intrusive parenting style that interferes with the child's developing capacity for self-regulation. We utilized a sample of 60 parent-infant dyads recruited while residing in emergency homeless shelters to evaluate associations among parents' history of adversity, intrusive parenting behaviors, and infants' fearful distress. Observed parent intrusiveness during a free play interaction was significantly associated with infant fearfulness observed in a separate behavioral task during which infants viewed a series of masks. Furthermore, there was a moderating effect for parent history of adversity such that the association between parent intrusiveness and infant fearful distress was stronger among parents with more past experiences of adversity.

Infant's difficult temperament characteristics predict poor quality of life in parents of infants with complex CHDs post-cardiac surgery

BACKGROUND & AIMS

Parents of infants with complex CHDs often describe their infants as especially fussy, irritable, and difficult to sooth, which together with the illness caretaking demands add to their stress. Little is known about how the behavioural style or temperament in the early months after discharge relates to parental quality of life. This study aimed to explore the associations between early infant temperament characteristics and parental quality of life in parents of infants with complex CHD.

METHODS

This descriptive, cross-sectional study, utilised data collected in a previously described multisite randomised clinical trial in the United States. Multivariable linear regression models were used to examine the associations of interest.

FINDINGS

Results demonstrated negative significant associations between most infant temperament subscales and parental quality of life. Higher scores on the Activity (β = -3.03, p = 0.021), Approach (β = -1.05, p = 0.021), Adaptability (β = -3.47, p = 0.004), Intensity (β = -2.78, p = 0.008), Mood (β = -4.65, p < 0.001), and Distractibility (β = -3.36, p = 0.007 were all significantly associated with lower parental quality of life scores, adjusting for parental dyadic adjustment, insurance type, number of medications, and number of unscheduled cardiologist visits.

CONCLUSIONS

Parental perceptions of infant's difficult behavioural style or temperament characteristics appear to be associated with poorer quality of life in parents of infants with complex CHD post-cardiac surgery. Findings can be used in the screening process of families at potential risk of increased stress and poor illness adaptation and in the design of interventions to target parental mental health in this vulnerable patient population.

Trait continuity: Can parent-rated infant temperament predict HEXACO personality in early adulthood?

Examining the Raine cohort study, we tested the trait continuity hypothesis by examining the extent that young adults' (25-29 years old) self-reported HEXACO personality can be statistically predicted from multi-dimensional parental temperament ratings collected in infancy (1-2 years old). The study incorporated a lagged design (two waves), a large sample size (n = 563), and examined both temperament and personality as both dimensions and profiles. Overall, we found very limited evidence of trait continuity, with generally very weak and few statistically significant observed associations of infant temperament with early adulthood personality. Relations were weak whether profile or dimension-based operationalizations of both phenomena were adopted. Additionally, controlling for sex affected the relations of temperament and personality only to a small extent for most of the traits, and moderation effects of sex were generally zero-to-trivial in size. Altogether, parent-rated temperament in infancy seems to provide little information about HEXACO personality in early adulthood.

Preterm infant body composition, working memory, and temperament

Altered body composition in preterm infants is associated with risks to cognitive development, but the effect specific to prefrontal cortex (PFC) development is unknown. We were interested in the impact of fat mass (FM) and fat free mass (FFM) gains out to 4 months corrected gestational age (CGA) on PFC development, as indexed by working memory and temperament. This is a prospective observational pilot study recruiting 100 preterm (<33 weeks gestation), appropriate for gestational age, and very low birth weight infants, of which 49 infants met inclusion criteria. Body composition was measured using air displacement plethysmography at hospital discharge and 4 months CGA. Questionnaire based temperament assessments were completed at 12 and 24 months CGA and a working memory assessment was completed at 24 months CGA. Associations between developmental tests and body composition obtained at term and 4 months were analyzed. Increased FM at discharge was associated with increased fear and decreased soothability at 12 months. Increased FM at 4 months was associated with increased activity level, increased distress from limitations at 12 months and decreased attentional shifting, decreased frustration, and decreased inhibitory control at 24 months. Increased FFM at 4 months was associated with increased activity level at 12 months and increased impulsivity and decreased low intensity pleasure at 24 months. In this exploratory pilot study, increased FM out to 4 months and increased FFM after discharge are associated with negative markers of infant temperament. Infant temperament may be sensitive to body composition status at least to 4 months CGA.

Prenatal hair cortisol concentrations during the COVID-19 outbreak: Associations with maternal psychological stress and infant temperament

BACKGROUND

Maternal psychological stress during pregnancy, including stress resulting from disasters and trauma, has been linked to temperamental difficulties in offspring. Although heightened cortisol concentrations are often hypothesized as an underlying mechanism, evidence supporting this mechanism is not consistent, potentially because of methodological issues and low stress in the population.

AIM

To address these issues, this preregistered study investigated the following associations between: 1) prenatal psychological stress and hair cortisol, as a biomarker for chronic stress, during the COVID-19 outbreak (i.e., as a major worldwide psychological stressor), and 2) maternal hair cortisol during the COVID-19 outbreak and later infant temperamental negative affectivity and orienting/regulation. Additionally, we explored whether associations were different for women with low versus high socioeconomic status (SES; maternal education and annual household income) and at different stages of pregnancy.

METHOD

Pregnant women (N = 100) filled out online questionnaires during the first COVID-19 lockdown. Six months later, when most mothers were still pregnant or had just given birth, maternal hair samples were collected during home visits. When infants were six months old, mothers reported on their infant's temperament.

RESULTS

Although hierarchical regression analyses revealed no associations between prenatal COVID-19 psychological stress and hair cortisol during the COVID-19 outbreak, SES proved to be a moderator in this association. Only pregnant women with higher levels of SES, not lower levels, showed a positive association between work-related and social support-related COVID-19 worries and hair cortisol. Finally, prenatal hair cortisol was not associated with later infant temperamental negative affectivity and orienting/regulation.

CONCLUSION

Although the COVID-19 outbreak proved to be a major psychological stressor worldwide, the physiological impact of the crisis might be different for pregnant women with higher SES as compared to lower SES.

Prenatal internalizing symptoms as a mediator linking maternal adverse childhood experiences with infant temperament

BACKGROUND

Maternal adverse childhood experiences are known to significantly influence offspring development. However, mediators linking maternal early-life adversity with infant temperament remain largely unknown.

AIMS

The current study investigated whether prenatal internalizing symptoms mediate the association between maternal adverse childhood experiences and infant temperament at two months. Maternal sensitivity/responsiveness during the postpartum period was also examined as a moderator of these associations.

STUDY DESIGN

We used a repeated-measures design, with self-report measures administered during pregnancy. Self-report and observational data were also collected at 2 months postpartum.

SUBJECTS

The study included a community sample of 64 pregnant women and their infants.

OUTCOME MEASURES

Participants completed measures assessing their early-life adversity and current depression/anxiety symptoms. At two months postpartum, mothers reported on their infant's temperament and participated in a parent-child interaction task designed to assess maternal sensitivity/responsiveness.

RESULTS AND CONCLUSIONS

Maternal adverse childhood experiences indirectly predicted poor self-regulation during early infancy via prenatal internalizing symptoms. Maternal sensitivity/responsiveness was also found to moderate the association between maternal adverse childhood experiences and certain aspects of infant regulatory capacity and positive affectivity at two months. This research has implications for mental health screening procedures during pregnancy and the development of early intervention programs.

Maternal depressive symptoms and infant temperament in the first year of life predict child behavior at 36 months of age

In a longitudinal study, mothers (N = 50) self-reported on their depressive symptoms (DS) and their child's behavior during the first year and at 36 months postpartum. Maternal DS during infancy were associated with child conduct problems (CP), suggesting a long-term association between maternal mental health and the development of child behavior. Infant temperament was also associated with child behavior so that negative affect predicted child CP, while infant surgency was associated with later hyperactivity-inattention. This study contributes to the literature by jointly assessing the role of maternal DS and infant temperament and showing that these are independent predictors of childhood behavior.

Prenatal PM2.5 exposure and infant temperament at age 6 months: Sensitive windows and sex-specific associations

BACKGROUND

Prenatal exposure to fine particulate matter with a diameter of ≤2.5 μm (PM2.5) has been linked to adverse neurodevelopmental outcomes in later childhood, while research on early infant behavior remains sparse.

OBJECTIVES

We examined associations between prenatal PM2.5 exposure and infant negative affectivity, a stable temperamental trait associated with longer-term behavioral and mental health outcomes. We also examined sex-specific effects.

METHODS

Analyses included 559 mother-infant pairs enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) cohort. Daily PM2.5 exposure based on geocoded residential address during pregnancy was estimated using a satellite-based spatiotemporal model. Domains of negative affectivity (Sadness, Distress to Limitations, Fear, Falling Reactivity) were assessed using the Infant Behavior Questionnaire-Revised (IBQ-R) when infants were 6 months old. Subscale scores were calculated as the mean of item-specific responses; the global Negative Affectivity (NA) score was derived by averaging the mean of the four subscale scores. Bayesian distributed lag interaction models (BDLIMs) were used to identify sensitive windows for prenatal PM2.5 exposure on global NA and its subscales, and to examine effect modification by sex.

RESULTS

Mothers were primarily racial/ethnic minorities (38% Black, 37% Hispanic), 40% had ≤12 years of education; most did not smoke during pregnancy (87%). In the overall sample, BDLIMs revealed that increased PM2.5 at mid-pregnancy was associated with higher global NA, Sadness, and Fear scores, after adjusting for covariates (maternal age, education, race/ethnicity, sex). Among boys, increased PM2.5 at early pregnancy was associated with decreased Fear scores, while exposure during late pregnancy was associated with increased Fear scores (cumulative effect estimate = 0.57, 95% CI: 0.03-1.41). Among girls, increased PM2.5 during mid-pregnancy was associated with higher Fear scores (cumulative effect estimate = 0.82, 95% CI: 0.05-1.91).

CONCLUSIONS

Prenatal PM2.5 exposure was associated with negative affectivity at age 6 months, and the sensitive windows may vary by subdomains and infant sex.

Infant temperament is associated with maternal feeding behaviors in early infancy

Parental feeding practices shape infant eating behaviors and may impact obesity risk. For example, feeding on a schedule and using food to soothe have been associated with greater infant weight gain and future obesity risk. Most studies focus on parental determinants of feeding practices, but infant temperament might influence feeding practices parents select. Studies examining associations of infant temperament with parental feeding practices in early infancy are needed. Thus, the purpose of this cross-sectional, observational study was to test the hypothesis that infant temperament would be associated with use of food to soothe and feeding on a schedule. Mother-infant dyads (N = 98) from 3 parent birth cohort studies presented for clinic visits at infant age of 3-5 months. Mothers completed a demographic questionnaire. Feeding practices (use of food to soothe and feeding on a schedule) and maternal perceptions of 3 dimensions of infant temperament (surgency, orienting/regulating, and negative affect) were collected by survey. Spearman partial correlations were used to examine if any of the 3 infant temperament dimensions were associated with use of food to soothe or feeding on a schedule, adjusting for maternal marital status, race/ethnicity, BMI, infant age at the visit, and infant weight-for-length z-score. Greater perceived infant surgency/extraversion was associated with greater use of food to calm (Spearman partial r = 0.25, p < 0.05), but not feeding on a schedule (Spearman partial r = -0.11, p = 0.31). Greater perceived infant negative affect was associated with greater use of food to calm (Spearman partial r = 0.21, p < 0.05). Perceived infant orienting/regulating was not associated with either of the feeding practices examined. These results provide evidence that as early as 3-5 months of age, perceived infant temperament is associated with maternal feeding practices which influence infant growth outcomes.

Infant sleep and temperament characteristics in association with maternal postpartum depression

OBJECTIVE

Aim of this study was to examine the association between infant temperament and sleep characteristics and postpartum depressive symptoms among mothers.

STUDY DESIGN

Research data were collected at the baseline (2nd -4th days postpartum) and the follow-up (6-8 weeks postpartum), Slovak version of the (EPDS) was used, along with questions focused on perceived sleeping problems of an infant, and temperament Linear regression models were employed.

SETTING

Two public hospital sites in Slovakia.

PARTICIPANTS

204 women participated in both time points (mean age 30.9 ± 4.8, age range: 20-44; 78.9% vaginal births; 56.9% primiparas).

RESULTS

Significant differences in the EPDS scores were found according to infant sleeping problems (p ≤ 0.05) and duration of infant night sleep (p ≤ 0.01). Both night sleep and day sleep duration were significant predictors for the level of postpartum depression symptoms at the 6-8 weeks follow-up in the linear regression model after adjusting for confounding variables (β= -0.13; 95%CI: -3.04;-0.01; β= -0.15; 95%CI: -3.02;-0.28, total explained variance 39.0%). Infant temperament characteristics have not been found significant predictors of postpartum depression symptoms in this study.

KEY CONCLUSIONS

Significant differences in depression levels were found among postpartum women according to perceived sleeping problems of infant, and the duration of infant night sleep. It is important to focus more attention on the role of infant sleeping problems as a possible risk factor for the increased occurrence of postpartum depressive symptoms.

Are our samples representative? Understanding whether temperament influences infant dropout rates at 3 and 7 months

In this study, we examined whether infant temperament predicted study dropout at 3.5 and 7 months and whether dropout was stable across time. Dropout was measured across four experimental tasks (free-play, ERP, still-face, and eye tracking). Temperament was not related to dropout at either timepoint. Dropout was not stable across time, nor was it stable across tasks. These findings suggest that individual differences in temperament are not systematically related to study completion across experimental tasks with varied requirements. These findings additionally suggest that dropout is not consistent across tasks, which may support the utility of multi-study data collection methods.

Psychometric properties of Arabic translated temperament instrument

Background

Investigating temperament has been a multi-subject exercise that attempts to determine the contribution of temperament to additional measurable phenomena like behavior. The existing research not only evaluates temperament as a variable with the ability to influence additional characteristics but has included interventions that can result in adapted outcomes. Develop an Arabic translation of the Infant Characteristics Questionnaire (ICQ).

Purpose

Examine the psychometric properties of the translation and establish modified criteria for evaluating the questionnaire.

Methods

Cross sectional design was used. Translation of the ICQ was achieved through translation/back translation. The population that used the ICQ translation on convenience sample of 40 Arabic-speaking women with children between the ages of 3–12‐months old; this same group also completed a demographic survey.

Results

The internal consistency of the translated instrument was almost equivalent to or higher than the reported from the United States (US) review. The alpha coefficients calculated from subscales varied between .47 and .87.

Conclusion

This research study described the translation of the ICQ into the Arabic language for use in the research and clinical setting. The ICQ is a useful tool for evaluating infant difficulty by describing and summarizing parents’ ratings.

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In nursing for infants, the parent-child, is very significant and is often understood as bilateral, correlative and interdependent.

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Infant temperament is described as regularities in responding to different situations, and reflect a infant's behavioral characteristics.

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The information gathered from infant-temperament questionnaires can help health care professionals inform parents of interventions for improving infant temperament.

Associations between maternal technology use, perceptions of infant temperament, and indicators of mother-to-infant attachment quality

BACKGROUND

Previous research suggests parents' use of technological devices, such as TV and mobile devices, within family contexts may decrease the quality of parent-child interactions. During early infancy, mothers report engaging with technological devices during infant feeding and care interactions, however, few studies have explored potential associations between maternal technology use and the quality of mother-to-infant attachment.

AIM

To examine associations between maternal technology use during mother-infant interactions and indicators of mother-to-infant attachment during early infancy.

STUDY DESIGN

Cross-sectional survey.

METHODS

Mothers (n = 332) of infants aged 2 to 6 months were recruited via MTurk, a crowdsourcing platform, to participate in an online survey. Participants responded to a series of validated questionnaires that assessed maternal technology use during mother-infant interactions (Maternal Distraction Questionnaire), infant temperament (Infant Behavior Questionnaire-Revised Very Short Form), and indicators of mother-to-infant attachment, including quality of attachment, absence of hostility toward motherhood, and pleasure in mother-infant interactions (Maternal Postnatal Attachment Questionnaire).

RESULTS

Greater technology use during mother-infant interactions was significantly associated with greater infant negative affectivity (β = 0.26, p < .0001). Greater technology use was also significantly associated with lower mother-to-infant attachment quality (β = -0.21, p = .0001), and greater hostility toward motherhood (β = -0.39, p < .0001). Associations between technology use and indicators of mother-to-infant attachment were not mediated by infant negative affectivity.

CONCLUSIONS

Maternal technology use was associated with greater perceptions of infant negative affectivity and poorer mother-to-infant attachment quality; further research is needed to understand mechanisms underlying these associations.

Maternal-infant bonding and perceptions of infant temperament: The mediating role of maternal mental health

BACKGROUND

There are associations between maternal mental health (anxiety and depression), maternal-infant bonding, and infant temperament. However, few studies have examined these variables simultaneously, and none have applied a parallel mediation analysis to consider maternal mental health as an explanatory variable. We aimed to examine these relationships, and whether mental health (anxiety and/or depression) mediates the observed association between maternal-infant bonding and infant temperament.

METHODS

Mothers with babies between zero and twelve months (N=527) were recruited to a cross-sectional online survey containing a battery of psychometric measures.

RESULTS

Correlation analyses examined relationships between the predictor (maternal-infant bonding), outcome (infant temperament), and mediator (maternal mental health; anxiety and/or depression). All associations were highly significant (p<.001). A parallel mediation (anxiety and/or depression) model was conducted, showing a significant indirect effect of maternal-infant bonding on infant temperament through anxiety, B = .04 (SE= .01) 95% CI= .01 to .07, but not through depression.

LIMITATIONS

Homogeneous sampling was an issue with mainly UK, married mothers, with higher socio-economic status and educational attainment participating. Therefore, further replication in diverse samples is required.

CONCLUSION

Associations were identified between maternal-infant bonding, infant temperament, and maternal mental health (anxiety and depression). However, only anxiety mediated the relationship between bonding and temperament. Healthcare professionals should consider the role of maternal anxiety when working with mothers who present with relational issues or report their infant as excessively challenging. These results signify the need to address maternal anxious and depressive symptoms as distinct issues considering their differential effects on parenting behaviour.

More than meets the eye: The neural development of emotion face processing during infancy

This study explored the impact of infant temperament and maternal stress on the development of the infant medial prefrontal cortex (mPFC) among sixteen 6-8-month-old infants. Functional Near Infrared Spectroscopy (fNIRS) was used to measure activation of the infant mPFC in response to angry, happy, and sad faces. Infant temperament and dimensions of maternal stress were measured with the Infant Behavior Questionnaire and the Parenting Stress Index Respectively. Infants with high negative emotionality demonstrated increased mPFC activation in association with all emotion face conditions. Negative emotionality moderated the effect of total maternal stress on mPFC activation to angry and sad faces. Mother-infant dysfunctional interaction was related to increased mPFC activation associated with happy faces, supporting the "novelty hypothesis", in which the mPFC responds more strongly to unique experiences. Therefore, this study provides additional evidence that infant temperament and the quality of the mother-infant relationship influence the development of the mPFC and how infants process emotions.

Specific relations of dimensional anxiety and manifest anxiety disorders during pregnancy with difficult early infant temperament: a longitudinal cohort study

Anxiety in the antenatal period is a common experience, associated with adverse consequences for mother and child. Specific types of prenatal anxiety may have unique associations with infant temperament. This study examines the prospective relationships between general prenatal anxiety, fear of childbirth, and specific prenatal anxiety disorders and early infant temperament 8 weeks postpartum. Data were derived from the Akershus Birth Cohort (ABC), a longitudinal cohort study which targeted all women scheduled to give birth at Akershus University Hospital, Norway. Psychometric measures pertained to general prenatal anxiety (Hopkins Symptom Checklist), fear of childbirth (Wijma delivery expectancy questionnaire), screening for manifest prenatal anxiety disorders based on questions from the mini-international neuropsychiatric interview, and difficult infant temperament (Infant Characteristics Questionnaire). The sample for the present study included 2206 women. General prenatal anxiety, fear of childbirth, agoraphobia, generalized anxiety disorder, and specific phobia presented unique significant prospective contributions to difficult infant temperament 8 weeks postpartum. Separate hierarchical regression models indicated that general prenatal anxiety and fear of childbirth provided the strongest unique contributions. Considering the burden on mothers and the potential long-term effects on child development, the findings of this study highlight the importance of screening women for different types of prenatal anxiety in routine obstetric care. Clinical awareness of the condition and its consequences is warranted. Due to the complexity of infant temperament as a construct with various influences, future research should consider mechanisms and influential factors pertaining to the relationship between prenatal anxiety and infant temperament.

The Relationship between Maternal Confidence, Infant Temperament, and Postpartum Depression

Background

Although several studies have emphasized the correlation of infant temperament and maternal confidence, this topic has not been explored in different culture and geographical contexts. We study association of maternal confidence, infant temperament, and postpartum depression among postnatal mothers.

Materials and Methods

This cross-sectional study was conducted at Sriramachandra Institute of Higher Education and Research, India from July 2017 to May 2018. The sample population comprised of mothers at 6 weeks of postnatal period attending the Immunization Clinic. The instruments used were standardized Karitane's Parenting Confidence Scale (KPCS), Bates Infant Characteristics Questionnaire (BICQ), and Edinburgh Postnatal Depression Scale (EPDS). A structured questionnaire was used to collect data from postnatal mothers. Data were analyzed with Statistical Package for the Social Sciences (SPSS) ver. 19, using analysis of variance, correlation coefficient, multivariable regression.

Results

In this study, 64.40% of the population had high level of confidence and 80% postnatal mothers had no depression. A significant association (t ₂= 18.15, p = 0.001) was seen between maternal confidence, family support, and place of living. Regression analysis showed that confidence of postnatal mothers has a significant influence (t ₂= 12.48, p < 0.005) on infant temperament.

Conclusions

Two-third of the postnatal mothers had high confidence level with no depression. A positive correlation between postpartum depression and infant temperament was found to be associated with income, parity, and maternal confidence. A significant association was also seen of infant temperament with type of family, income, place of living, and sex of the baby.

Infant sleep moderates the effect of infant temperament on maternal depressive symptoms, maternal sensitivity, and family functioning

Observed infant temperamental difficulty and infant sleep efficiency and sleep variability were examined as predictors of maternal depressive symptoms, maternal sensitivity, and family functioning. Eight observations at 8-months postpartum were used to assess infant temperament, and actigraphy was used to measure infant sleep for 1-week at the time of the 8-month assessment. Structured clinical interviews were used to assess maternal depressive symptoms between 5 and 12 months postpartum and at 15 months postpartum, and observational assessments were used to assess maternal sensitivity and family functioning at 15 months postpartum. Variability in infant sleep moderated the effect of infant temperament on maternal depressive symptoms, maternal sensitivity, and family functioning. Infant temperament was positively associated with maternal depressive symptoms when variability in infant sleep efficiency was high, but not when variability in infant sleep efficiency was low. Likewise, infant temperament was negatively associated with maternal sensitivity and family functioning when variability in infant sleep efficiency was high, but not when variability in infant sleep efficiency was low. Results underscore the importance of infant sleep for maternal and family health.

Does childbirth experience affect infant behaviour? Exploring the perceptions of maternity care providers

OBJECTIVE

High levels of childbirth interventions are known to increase risk of health complications for mother and infant, alongside having a negative impact upon maternal wellbeing. However less is understood about how childbirth experience may affect infant behaviour (e.g. how calm or unsettled an infant is). This study explores maternity care provider perceptions of how and why childbirth experience may affect infant behaviour.

DESIGN

A qualitative semi-structured interview study.

SETTING

Bristol, Swansea and West Wales, UK.

PARTICIPANTS

18 maternity care providers.

MEASUREMENTS AND FINDINGS

A semi-structured interview schedule was developed to explore maternity care providers' perceptions of how maternal experience of childbirth could influence infant behaviour. Findings highlighted how maternity care providers perceived childbirth experience to sometimes impact positively or negatively on infant behaviour. A calmer birth and postnatal experience was believed to lead to a calmer infant, whilst physical and emotional stress was associated with more challenging infant behaviours such as crying and being unsettled. Pathways were perceived to be direct (pain and stress during birth might physiologically affect the infant) and indirect (birth was perceived to affect maternal wellbeing and subsequently her interactions with her baby). However, postnatal factors such as skin to skin, postnatal environment and emotional support were believed to mediate these impacts.

KEY CONCLUSIONS

Birth experience was considered to affect infant behaviour. Promoting as positive a birth experience as possible, including postnatal care, was viewed as significant in supporting positive infant behaviours. Maternity care providers believed this could help facilitate bonding, attachment, and mother-infant wellbeing in the postnatal period.

IMPLICATIONS FOR PRACTICE

The findings highlight maternity care providers' views concerning supporting normal birth and protecting emotional wellbeing during birth and postnatally. Where interventions are necessary, ensuring a calm environment, and enabling normal postnatal behaviours such as skin to skin and breastfeeding were perceived as important. Midwives, it was claimed, need time to nurture mothers alongside providing physical care.

LIMITATIONS

Participants were self-selecting and might therefore have been biased.

Infant temperament and perinatal depressive and anxiety symptoms in Mexican women

AIM

This study explores the association between infant temperament at six months postpartum and pre- and postpartum depressive and anxiety symptoms. The association between infant temperament and stressful life events is also evaluated.

METHOD

A total of 210 Mexican women were assessed during pregnancy (gestational age 32.39 ± 4.01) and at six months postpartum. The instruments used were: Patient Health Questionnaire (PHQ-9), the Anxiety Subscale of the Hopkins Symptoms Checklist (SCL-90R), a short form of Stressful Life Events and The Infant Characteristics Questionnaire, when infants were six months old.

RESULTS

Although a mother's emotional state during pregnancy (depressive and anxiety symptoms and stressful life events) was not associated with difficult infant temperament, it was associated with depressive and anxious symptomatology during the postpartum period. Mothers with prenatal depressive symptoms who remained depressed and mothers who only had depression symptoms during the postpartum period reported having more difficult infants. Likewise, mothers with prenatal anxiety symptoms who maintained anxiety symptoms postpartum and mothers with anxiety symptoms during the postpartum period alone reported having more difficult infants. Comorbidity was found between depressive and anxious postnatal symptomatology in its association with difficult infant temperament.

CONCLUSION

In this study, postpartum depressive and anxiety symptoms played an important role in shaping difficult infant temperament. Comorbidity between the two conditions warrants clinical attention and additional research, since it is related to maternal perception of difficult infant temperament. Psychological interventions are required, since these women may require assistance with emotional adaptation in the transition to motherhood.

Interaction between maternal and paternal parenting styles with infant temperament in emerging behavior problems

This study examined the interaction effects of infant temperament (negative affect, orienting/regulatory capacity, surgency) on the relationship between maternal and paternal parenting styles (authoritative, authoritarian, permissive) and externalizing and internalizing behaviors simultaneously. A diverse sample of mothers (N = 186) and fathers (N = 142) reported on infant temperament of their 6-month-olds and their children's internalizing and externalizing behaviors one year later. Significant interactions revealed: (a) surgency moderated maternal authoritative and paternal permissive parenting style and externalizing behaviors; and (b) surgency moderated maternal authoritarian and paternal authoritative parenting style and internalizing behaviors. No significant interactions were found between maternal and paternal parenting styles and their report of their infants' orienting/regulatory capacity and negative affect. Findings suggest interaction effects may appear beginning in infancy.

Maternal prenatal depression predicts infant negative affect via maternal inflammatory cytokine levels

Maternal depressive symptoms during pregnancy are associated with risk for offspring emotional and behavioral problems, but the mechanisms by which this association occurs are not known. Infant elevated negative affect (increased crying, irritability, fearfulness, etc.) is a key risk factor for future psychopathology, so understanding its determinants has prevention and early intervention potential. An understudied yet promising hypothesis is that maternal mood affects infant mood via maternal prenatal inflammatory mechanisms, but this has not been prospectively examined in humans. Using data from a pilot study of women followed from the second trimester of pregnancy through six months postpartum (N = 68) our goal was to initiate a prospective study as to whether maternal inflammatory cytokines mediate the association between maternal depressive symptoms and infant offspring negative affect. The study sample was designed to examine a broad range of likely self-regulation and mood-regulation problems in offspring; to that end we over-selected women with a family history or their own history of elevated symptoms of attention-deficit/hyperactivity disorder. Results supported the hypothesis: maternal pro-inflammatory cytokines during the third trimester (indexed using a latent variable that included plasma interleukin-6, tumor necrosis factor-alpha and monocyte chemoattractant protein-1 concentrations as indicators) mediated the effect, such that higher maternal depressive symptoms were associated with higher maternal inflammation, and this mediated the effect on maternal report of infant negative affect (controlling for maternal affect during the infant period). This is the first human study to demonstrate that maternal inflammatory cytokines mediate the association between prenatal depression and infant outcomes, and the first to demonstrate a biological mechanism through which depressive symptoms impact infant temperament.

Prenatal alcohol consumption and infant and child behavior: Evidence from the Growing Up in New Zealand Cohort

BACKGROUND

High levels of alcohol exposure during pregnancy can damage developing brains and influence child behavior and learning.

AIM

To examine the effects of lower levels of alcohol and very early exposure to alcohol on infant temperament and child behavior.

STUDY DESIGN, SUBJECTS, AND OUTCOME MEASURES

The Growing Up in New Zealand study involves a prospective birth cohort of 6822 pregnant women of whom 6156 provided information on their child's temperament using the Infant Behavior Questionnaire-Revised (IBQ-R VSF) at 9 months and their child's behavior using the Strengths and Difficulties Questionnaire at 2 years.

RESULTS

A series of adjusted linear regression models controlling for socio-demographic factors found alcohol consumption during pregnancy was most consistently related to Lower Positive Affect, Affiliation/Regulation, and Orienting Capacity temperament scores. Mothers who stopped drinking after becoming aware of their pregnancy, but had an unplanned pregnancy (hence may have a baby exposed to alcohol for longer), also reported infants with lower Orienting Capacity, Affiliation/Regulation, and Fear temperament scores compared to those that did not drink. Children whose mothers drank four or more drinks per week during pregnancy were more likely to report their child as having conduct problems, with higher total difficulties scores at age 2.

CONCLUSIONS

Alcohol consumption during pregnancy has a negative effect especially on infant temperament, even if small amounts of alcohol are consumed. Our findings have implications for men and women who drink, medical professionals, and for the availability of contraception to those who drink, but do not plan to get pregnant.

Experimental manipulation of infant temperament affects amygdala functional connectivity

In this functional magnetic resonance imaging (fMRI) study we examined neural processing of infant faces associated with a happy or a sad temperament in nulliparous women. We experimentally manipulated adult perception of infant temperament in a probabilistic learning task. In this task, participants learned about an infant's temperament through repeated pairing of the infant face with positive or negative facial expressions and vocalizations. At the end of the task, participants were able to differentiate between “mostly sad” infants who cried often and “mostly happy” infants who laughed often. Afterwards, brain responses to neutral faces of infants with a happy or a sad temperament were measured with fMRI and compared to brain responses to neutral infants with no temperament association. Our findings show that a brief experimental manipulation of temperament can change brain responses to infant signals. We found increased amygdala connectivity with frontal regions and the visual cortex, including the occipital fusiform gyrus, during the perception of infants with a happy temperament. In addition, amygdala connectivity was positively related to the post-manipulation ratings of infant temperament, indicating that amygdala connectivity is involved in the encoding of the rewarding value of an infant with a happy temperament.

Health-related quality of life, temperament, and eating behavior among formula-fed infants in the Philippines: a pilot study

BACKGROUND

The rising prevalence of childhood obesity in Asia has led to interest in potential risk factors such as infant health-related quality of life (HRQoL), temperament and eating behaviors. This pilot study evaluated the utility of administering parent-reported outcome measures (PROMs) to explore these factors in Filipino infants and examined the relationships between these factors and infant sex, formula intake and weight, over time.

METHODS

Forty healthy, 4-week-old, formula-fed infants (n = 20 males) were enrolled in this 6-week, prospective, uncontrolled study during which infants were exclusively fed a standard term infant formula enriched with alpha-lactalbumin. On Day-1 and 42, anthropometrics were measured and mothers completed a 97-item measure of HRQoL [Infant Toddler Quality of Life Questionnaire (ITQOL)] covering 6 infant-focused and 3 parent-focused concepts and a 24-item measure of infant temperament [Infant Characteristics Questionnaire (ICQ)]. At Day-42, mothers also completed an 18-item measure of infant appetite [Baby Eating Behaviour Questionnaire (BEBQ)]. A 3-day formula intake diary was completed before Day-42. Nonparametric statistics were used to evaluate correlations among outcomes and compare outcomes by visit and sex.

RESULTS

Thirty-nine infants completed the study; similar results were observed in males and females. Completion of PROMs was 100% with no missing responses, but Cronbach's α was low for many concept scales scores. ITQOL scores [range 0 (worst)-100 (best)] were generally high (median ≥ 80) except for Day-1 and Day-42 Temperament and Mood and Day-1 General Health Perceptions scores. ITQOL but not ICQ temperament scores improved significantly between Day-1 and Day-42 (P < 0.01). Mean ± standard deviation BEBQ scores (range 1-5) were high for Enjoyment of Food (4.59 ± 0.60) and Food Responsiveness (3.53 ± 0.81), and low for Satiety Responsiveness (2.50 ± 0.73) and Slowness in Eating (1.71 ± 0.60). Better HRQoL scores were significantly (P < 0.05) associated with high General Appetite scores (3 ITQOL concepts, r = 0.32 to 0.54), greater Enjoyment of Food (4 ITQOL concepts, r = 0.35 to 0.42) and low levels of Slowness in Eating (7 ITQOL concepts, r = - 0.32 to - 0.47).

CONCLUSION

Findings demonstrated the utility of the ITQOL, ICQ and BEBQ for measuring HRQoL, temperament and eating behavior, and the need for further adaptations for use in Filipino infants.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT02431377; Registered May 1, 2015.

Prenatal maternal distress seems to be associated with the infant's temperament and motor development: an explorative study

According to the concept of fetal programming, prenatal distress has long-lasting consequences on the offspring's health later in life. The hypothalamic-pituitary-adrenal axis is considered a mediating system by which maternal distress is transferred to the fetus in intrauterine environment. In this longitudinal explorative study on 30 mother-child-dyads, reported maternal distress and salivary cortisol were collected during pregnancy. Infant temperament, motor and cognitive development were assessed at 16 months. Additionally, infant cortisol levels throughout the day and in reaction to a psycho-social stressor where measured. As expected, infants whose mothers had experienced higher prenatal distress expressed a more difficult temperament and lower fine motor development at 16 months. No association could be shown between prenatal maternal distress and infant salivary cortisol.

Maternal depressed mood moderates the impact of infant sleep on mother-infant bonding

Parent-infant bonding has long-term consequences for the psychological wellbeing of the child. Considering the centrality of infant sleep patterns in infant-caregiver interactions in the first year of life, we propose that infant sleep patterns act as a catalyst or disruptor for mother-infant relationship, such that infant sleep patterns contribute to maternal mood, maternal sleep quality, perception of infant temperament, and her bonding experience. One hundred fifty-two Israeli mothers, of 5-8-month-old infants, responded to Internet-based questionnaires regarding their sleep, their mood, their infant's sleep, the infant's temperament, and their bonding experience. Eight percent of the mothers reported clinically significant depression, while 67 % reported significant sleep difficulties. Infant sleep difficulties correlated with maternal mood and sleep quality, infant fussiness, and bonding. Structural equation modeling demonstrated that maternal sleep partially mediated the relationship between infant sleep and maternal mood. Additionally, 22 % of the variance in bonding was explained by infant sleep problems and temperament. Notably, maternal depression moderated this effect such that infant sleep problems correlated with bonding only in those mothers who were depressed. The results suggest that infant sleep is a vector by which maternal cognitions and mood are transmitted to her child, with long-term implications for psychological development.

The mediated effects of maternal depression and infant temperament on maternal role

We examined prenatal depression, postpartum depression, and infant temperament, respectively, in a mediated process model to predict maternal role. Using a prospective, observational design, we surveyed 168 women during pregnancy and then in postpartum. Data analyses supported the contribution of each variable in an ascending fashion (ab = -0.01, SE = 0.004, 95 % CI [-0.021, -0.004]), such that infant temperament had the strongest effects (sr(2) = .124, p < .001). Further, postpartum depression was found to influence maternal role with both direct effects and indirect effects via infant temperament. These results highlighted the significant impact postpartum depression may have on maternal role. Future interventions targeting mothers experiencing or who are at risk for depression may consider tools to improve mother-baby interactions. The effects of such intervention may subsequently improve both infant temperament and maternal role evaluation.

Early family regularity protects against later disruptive behavior

Infants' temperamental anger or frustration reactions are highly stable, but are also influenced by maturation and experience. It is yet unclear why some infants high in anger or frustration reactions develop disruptive behavior problems whereas others do not. We examined family regularity, conceptualized as the consistency of mealtime and bedtime routines, as a protective factor against the development of oppositional and aggressive behavior. This study used prospectively collected data from 3136 families participating in the Generation R Study. Infant anger or frustration reactions and family regularity were reported by mothers when children were ages 6 months and 2-4 years, respectively. Multiple informants (parents, teachers, and children) and methods (questionnaire and interview) were used in the assessment of children's oppositional and aggressive behavior at age 6. Higher levels of family regularity were associated with lower levels of child aggression independent of temperamental anger or frustration reactions (β = -0.05, p = 0.003). The association between child oppositional behavior and temperamental anger or frustration reactions was moderated by family regularity and child gender (β = 0.11, p = 0.046): family regularity reduced the risk for oppositional behavior among those boys who showed anger or frustration reactions in infancy. In conclusion, family regularity reduced the risk for child aggression and showed a gender-specific protective effect against child oppositional behavior associated with anger or frustration reactions. Families that ensured regularity of mealtime and bedtime routines buffered their infant sons high in anger or frustration reactions from developing oppositional behavior.

Infant outcomes following treatment of antenatal depression: Findings from a pilot randomized controlled trial

INTRODUCTION

Maternal antenatal depression is associated with an increased risk of emotional and behavioural problems in children. More recently antenatal depression has been associated with shorter sleep duration, higher number of awakenings and sleep problems in infants. Examining the effect of treatment of depression on child development is the next step in unravelling the complex association between antenatal depression and offspring development.

METHODS

We used data from a pilot RCT of women with antenatal depression who received either Cognitive Behavioural Therapy (CBT) or Treatment as Usual (TAU), to examine infant sleep duration and temperament two months postpartum. Data was available for n=14 in the CBT group and n=11 in the TAU group.

RESULTS

No differences by treatment arm were evident. Improvement in depression scores during pregnancy was associated with easier temperament (β=-.45, p=.024) and shorter nocturnal sleep duration (β=-.58, p=.003). The findings were more pronounced in the CBT group compared to the TAU group.

LIMITATIONS

This was a pilot RCT and as such the sample size was small and there was some loss to follow up between the baseline and postnatal assessment.

CONCLUSION

Improvement in antenatal depressive symptoms may have beneficial effects for the infant; whether these are directly through effects on foetal development or indirectly through changes in the postnatal mother-infant relationship remains to be determined.

Breastfeeding and maternal sensitivity predict early infant temperament

AIM

Research findings are inconclusive when it comes to whether breastfeeding is associated with the mother-infant relationship or infant temperament. We examined the association between breastfeeding at three months postpartum and infant temperament at 18 months postpartum and whether this link was affected by the mothers' anxiety and mediated by her sensitivity.

METHODS

We assessed 170 mothers for breastfeeding and anxiety using the Spielberger State-Trait Anxiety Inventory (STAI) at three months postpartum, maternal sensitivity using the Ainsworth Sensitivity Scale at six months postpartum and infant temperament using the Early Childhood Behaviour Questionnaire at 18 months postpartum.

RESULTS

Mothers who breastfed at three months postpartum were more sensitive in their interactions with their infants at six months postpartum, and elevated sensitivity, in turn, predicted reduced levels of negative affectivity in infant temperament at 18 months postpartum. This indirect mediation persisted after controlling for confounders (effect ab = -0.0312 [0.0208], 95% CI = -0.0884 to -0.0031). A subsequent analysis showed that the mediation through sensitivity only occurred in women experiencing higher anxiety, with a STAI score ≥33.56 at three months (ab = -0.0250 [0.0179], 95% CI = -0.0759 to -0.0013).

CONCLUSION

Our results suggest that breastfeeding and maternal sensitivity may have a positive impact on the early development of infant temperament.

Infant emotion regulation: relations to bedtime emotional availability, attachment security, and temperament

The present study examines the influences of mothers' emotional availability toward their infants during bedtime, infant attachment security, and interactions between bedtime parenting and attachment with infant temperamental negative affectivity, on infants' emotion regulation strategy use at 12 and 18 months. Infants' emotion regulation strategies were assessed during a frustration task that required infants to regulate their emotions in the absence of parental support. Whereas emotional availability was not directly related to infants' emotion regulation strategies, infant attachment security had direct relations with infants' orienting toward the environment and tension reduction behaviors. Both maternal emotional availability and security of the mother-infant attachment relationship interacted with infant temperamental negative affectivity to predict two strategies that were less adaptive in regulating frustration.

The effects of 'does not apply' on measurement of temperament with the Infant Behavior Questionnaire-Revised: A cautionary tale for very young infants

BACKGROUND

The Infant Behavior Questionnaire-Revised (IBQ-R) is a widely used parent report measure of infant temperament. Items marked 'does not apply' (NA) are treated as missing data when calculating scale scores, but the effect of this practice on assessment of infant temperament has not been reported.

AIMS

To determine the effect of NA responses on assessment of infant temperament and to evaluate the remedy offered by several missing data strategies.

STUDY DESIGN

A prospective, community-based longitudinal cohort study.

SUBJECTS

401 infants who were born>37 weeks of gestation.

OUTCOME MEASURES

Mothers completed the short form of the IBQ-R when infants were 3-months and 6-months of age.

RESULTS

The rate of NA responses at the 3-month assessment was three times as high (22%) as the rate at six months (7%). Internal consistency was appreciably reduced and scale means were inflated in the presence of NA responses, especially at 3-months. The total number of NA items endorsed by individual parents was associated with infant age and parity. None of the missing data strategies completely eliminated problems related to NA responses but the Expectation Maximization algorithm greatly reduced these problems.

CONCLUSIONS

The findings suggest that researchers should exercise caution when interpreting results obtained from infants at 3 months of age. Careful selection of scales, selecting a full length version of the IBQ-R, and use of a modern missing data technique may help to maintain the quality of data obtained from very young infants.

Infant temperament and feeding history predict infants' responses to novel foods

The purpose of the present study was to investigate whether infant temperament and previous feeding history were associated with infants' acceptance and rejection of a novel food at 12 months of age. Mother-infant dyads (n = 89) were video-recorded during a novel food (hummus, cottage cheese) feeding task. Infants' reactions (acceptance and rejection behaviors) and maternal responsiveness and affect during the interaction were coded from the recordings by teams of coders. Mothers reported on their infants' temperamental approach via the Infant Behavior Questionnaire-Revised (IBQ-R) and their infants' feeding history (previous exposure to solid foods and exclusive breastfeeding). Regression analyses revealed that infants rated lower on approach showed less acceptance of the first offer of novel food than infants rated higher on approach. Additionally, low approach infants who were previously exposed to a greater number of solid foods showed fewer rejection behaviors in response to the later offers of food. Exclusive breastfeeding for 4 months did not appear to have an effect on acceptance or rejection. Finally, greater maternal responsiveness was related to the infants' acceptance of the new food whereas lower maternal responsiveness was associated with rejection of the novel food. These results suggest that the acceptance and rejection of new foods by infants is dependent upon their temperament and previous exposure to solid foods, as well as the manner in which mothers present the novel food.

Paternal influences on infant temperament: effects of father internalizing problems, parenting-related stress, and temperament

Temperament ratings were obtained from 98 fathers when their infants were 4 and 6 months of age to examine effects of paternal characteristics on infant temperament. Parental stress, internalizing symptoms, and father's temperament were considered as factors possibly contributing to differences in their child's temperament.

Temperamental precursors of infant attachment with mothers and fathers

The degree to which parent sensitivity and infant temperament distinguish attachment classification was examined. Multilevel modeling was used to assess the effect of parent sensitivity and infant temperament on infant-mother and infant-father attachment. Data were collected from mothers, fathers, and their infants (N = 135) when the infant was 3-, 5-, 7-, 12-, and 14-months old. Temperament was measured using the Infant Behavior Questionnaire-Revised (Gartstein & Rothbart, 2003); parent sensitivity was coded during the Still Face Paradigm (Tronick, Als, Adamson, Wise, & Brazelton, 1978); attachment was coded using the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978). Results indicate that mothers and fathers were less sensitive with insecure-avoidant infants. Whereas only one difference was found for infant-mother attachment groups and temperament, five significant differences emerged for infant-father attachment groups, with the majority involving insecure-ambivalent attachment. Infants classified as ambivalent with fathers were higher in perceptual sensitivity and cuddliness and these infants also showed a greater increase in low-intensity pleasure over time compared with other infants. Results indicate the importance of both parent sensitivity and infant temperament, though operating in somewhat different ways, in the development of the infant-mother and infant-father attachment relationship.

Parenting stress in mothers of very preterm infants -- influence of development, temperament and maternal depression

OBJECTIVE

To measure levels of parenting stress and postnatal depression in mothers of very preterm infants in comparison with mothers of infants born at term is the objective of this study. The study also aimed to explore factors associated with parenting stress in the mothers of the preterm infants.

METHODS

One hundred and five mothers who delivered 124 babies at ≤30 weeks gestation were enrolled together with 105 term mothers who delivered 120 babies. At one year of age (corrected for prematurity for the preterm cohort), the mothers completed the Parenting Stress Index Short Form (PSI), the Edinburgh Postnatal Depression Scale (EPDS) and the Short Temperament Scale for Toddlers. The infants had neurodevelopmental assessment. The preterm and term groups were compared.

RESULTS

Questionnaires were completed by 101 of the preterm mothers and 98 of the term mothers. The mean PSI Total Stress score was significantly higher for the preterm mothers (70.28 vs 64.52, p = 0.022), with 19% of the preterm group and 9% of the term group having high scores (p = 0.038).There was no group difference on the EPDS or measures of temperament, with disability being greater in the preterm infants. For the preterm group, maternal depression and infant temperament were independent predictors of Total Stress scores on multivariate analysis.

CONCLUSIONS

Parenting stress in mothers of preterm infants at one year of age is significantly greater than that found in mothers of term infants. For preterm mothers, symptoms of depression and infant temperament are independent risk factors for higher levels of parenting stress.

Temperament in context: Infant temperament moderates the relationship between perceived neighborhood quality and behavior problems

Hypotheses that positive affect and fear in infancy moderate later relationships between neighborhood quality and behavior problems were examined in a sample of children from the National Longitudinal Survey of Youth. Results suggested that poor neighborhood quality was associated with antisocial behavior at age 6 for children who in infancy were characterized by either high positive affect and low fear or by low positive affect and high fear. Depression/anxiety increased from age 6 to age 12 for children in poor quality neighborhoods who were characterized in infancy by low positive affect. A combination of low fear and high positive affect in infancy appeared to be protective, as it was associated with decreases in depression/anxiety during childhood. These findings suggest the utility of examining multiple dimensions of temperament and of integrating multiple levels of influence into moderational models to understand and prevent the development of childhood symptomatology.