Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families

INTRODUCTION

Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden.

METHODS

A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model.

RESULTS

A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families.

CONCLUSION

Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.

The link between infant regulatory problems, temperament traits, maternal depressive symptoms and children's psychopathological symptoms at age three: a longitudinal study in a German at-risk sample

BACKGROUND

Difficult conditions during childhood can limit an individual's development in many ways. Factors such as being raised in an at-risk family, child temperamental traits or maternal traits can potentially influence a child's later behaviour. The present study investigated the extent of regulatory problems in 6-month-old infants and their link to temperamental traits and impact on externalizing and internalizing problems at 36 months. Moderating effects of maternal distress and maternal depressive symptoms were tested as well.

METHODS

In a quasi-experimental, longitudinal study, a sample of 185 mother-infant dyads at psychosocial risk was investigated at 6 months with SFS (infants' regulatory problems) and at 3 years with CBCL (children's behavioural problems), EAS (children's temperament), ADS (maternal depressive symptoms) and PSI-SF (maternal stress).

RESULTS

A hierarchical regression analysis yielded a significant association between infants' regulatory problems and both externalizing and internalizing behaviour problems at age 3 (accounting for 16% and 14% variance), with both externalizing and internalizing problems being linked to current maternal depressive symptoms (12 and 9% of the variance). Externalizing and internalizing problems were found to be related also to children's temperamental difficulty (18 and 13% of variance) and their negative emotionality. With temperamental traits having been taken into account, only feeding problems at 6 months contributed near-significant to internalizing problems at 3 years.

CONCLUSIONS

Our results underscore the crucial role of temperament in the path between early regulatory problems and subsequent behavioural difficulties. Children's unfavourable temperamental predispositions such as negative emotionality and generally "difficult temperament" contributed substantially to both externalizing and internalizing behavioural problems in the high-risk sample. The decreased predictive power of regulatory problems following the inclusion of temperamental variables indicates a mediation effect of temperamental traits in the path between early regulatory problems and subsequent behavioural problems. Our results support the main effects of a child's temperament, and to some degree maternal depressive symptoms, rather than the diathesis stress model of interaction between risky environment and temperamental traits. Trial registration D10025651 (NZFH).

Wirksamkeit des Präventionsprojekts „Keiner fällt durchs Netz“ (KfdN) in Modellprojektstandorten im Saarland

Zusammenfassung. Ziel der Studie war es, die Wirksamkeit des Präventionsprojekts „Keiner fällt durchs Netz“ zur Unterstützung risikobelasteter Familien in Saarland zu evaluieren. Die Stichprobe von 182 Mutter-Kind-Dyaden setzte sich aus 91 risikobelasteten Dyaden, die am Präventionsprojekt teilnahmen und 91 risikobelasteten Dyaden aus Kontrollfamilien zusammen. Ergebnisse: Der erwartete bessere Entwicklungsstand der Kinder in der Treatmentgruppe nach der Intervention im Vergleich zu den Kindern aus der Kontrollgruppe konnte im Bereich der sozialen Entwicklung bestätigt werden (d = 0.53). Zudem schätzten die Mütter in der KfdN-Gruppe ihre einjährigen Kinder tendenziell als weniger temperamentsschwierig ein (d = 0.18). Interventionseffekte im Bereich mütterlicher Feinfühligkeit, Stressbelastung und depressiver Symptomatik waren nicht nachweisbar. Fazit: Die Intervention hat einen positiven Effekt auf die kindliche soziale Entwicklung und die elterliche Wahrnehmung des kindlichen Temperaments. Der ausbleibende Interventionseffekt im Bereich der mütterlichen Feinfühligkeit legt eine stärkere Berücksichtigung dieses Aspektes in der Konzeption des Projekts nahe.

Influence of early regulatory problems in infants on their development at 12 months: a longitudinal study in a high-risk sample

BACKGROUND

This study examined the extent to which regulatory problems in infants at 4 and 6 months influence childhood development at 12 months. The second aim of the study was to examine the influence maternal distress has on 4-month-old children's subsequent development as well as gender differences with regard to regulatory problems and development.

METHODS

153 mother-child dyads enrolled in the family support research project "Nobody slips through the net" constituted the comparison group. These families faced psychosocial risks (e.g. poverty, excessive demands on the mother, and mental health disorders of the mother, measured with the risk screening instrument Heidelberger Belastungsskala - HBS) and maternal stress, determined with the Parental Stress Index (PSI-SF). The children's developmental levels and possible early regulatory problems were evaluated by means of the Ages and Stages Questionnaires (ASQ) and a German questionnaire assessing problems of excessive crying along with sleeping and feeding difficulties (SFS).

RESULTS

A statistically significant but only low, inverse association between excessive crying, whining and sleep problems at 4 and 6 months and the social development of one-year-olds (accounting for 5% and 8% of the variance respectively) was found. Feeding problems had no effect on development. Although regulatory problems in infants were accompanied by increased maternal stress level, these did not serve as a predictor of the child's social development at 12 months. One-year-old girls reached a higher level of development in social and fine motor skills. No gender differences were found with regard to regulatory problems, nor any moderating effect of gender on the relation between regulatory problems and level of development.

CONCLUSIONS

Our results reinforce existing knowledge pertaining to the transactional association between regulatory problems in infants, maternal distress and dysfunctionality of mother-child interactions. They also provide evidence of a slight but distinct negative influence of crying and sleeping problems on children's subsequent social development. Easily accessible support services provided by family health visitors (particularly to the so-called "at-risk families") are strongly recommended to help prevent the broadening of children's early regulatory problems into other areas of behavior.

Das exzessive Schreien bei 5 Monate alten Säuglingen und prä-, peri- und postnatale Belastungen ihrer Mütter in einer Hoch-Risiko-Stichprobe

Fragestellung: Zusammenhänge zwischen persistierendem, exzessivem Schreien des Säuglings im fünften Lebensmonat und den prä- und perinatalen Belastungen sowie der postnatalen Befindlichkeit ihrer Mütter zu untersuchen. Methodik: Alle Daten wurden erhoben, als die Kinder im Durchschnitt 18.5 Wochen alt waren. Die Stichprobe von 300 Mutter-Kind-Dyaden war durch psychosoziale Risiken wie Armut, Mangel an sozialer Unterstützung, Minderjährigkeit der Mütter, Substanzmissbrauch oder psychische Störungen der Mutter belastet. Das exzessive Schreien wurde nach der Wessel-Regel erfasst, für die Erhebung von prä-, peri- und postnatalen Belastungen wurden Fragebögen vorgelegt. Ergebnisse: Multivariate Analysen zeigten ein erhöhtes Risiko für soziale Belastung in der Schwangerschaft (OR = 17.66) und für eine unerwünschte Schwangerschaft (OR = 13.77). Postnatal war das persistierende exzessive Schreien mit höheren Ausprägungen einer postpartalen depressiven Symptomatik der Mutter, mütterlicher Stressbelastung, Dysfunktionalität der Mutter-Kind-Interaktion, dem Wahrnehmen des Säuglings als «schwierig» sowie mit Schwierigkeiten bei der emotionalen Beziehungsaufnahme assoziiert. Schlussfolgerungen: Die Ergebnisse unterstreichen den Einfluss erhöhter pränataler Stressbelastung der Mütter und einer unerwünschten Schwangerschaft auf das persistierende exzessive Schreien der Säuglinge. Ein herabgesetztes Wohlbefinden der Mütter sowie ihre Schwierigkeiten bei der emotionalen Beziehungsaufnahme implizieren einen erhöhten Bedarf an Unterstützungsangeboten. Das Zusammenwirken von pränatalen und Beziehungsvariablen spielt eine Rolle für das Auftreten und die Aufrechterhaltung von frühen Regulationsproblemen.

Links between maternal postpartum depressive symptoms, maternal distress, infant gender and sensitivity in a high-risk population

BACKGROUND

Maternal postpartum depression has an impact on mother-infant interaction. Mothers with depression display less positive affect and sensitivity in interaction with their infants compared to non-depressed mothers. Depressed women also show more signs of distress and difficulties adjusting to their role as mothers than non-depressed women. In addition, depressive mothers are reported to be affectively more negative with their sons than with daughters.

METHODS

A non-clinical sample of 106 mother-infant dyads at psychosocial risk (poverty, alcohol or drug abuse, lack of social support, teenage mothers and maternal psychic disorder) was investigated with EPDS (maternal postpartum depressive symptoms), the CARE-Index (maternal sensitivity in a dyadic context) and PSI-SF (maternal distress). The baseline data were collected when the babies had reached 19 weeks of age.

RESULTS

A hierarchical regression analysis yielded a highly significant relation between the PSI-SF subscale "parental distress" and the EPDS total score, accounting for 55% of the variance in the EPDS. The other variables did not significantly predict the severity of depressive symptoms. A two-way ANOVA with "infant gender" and "maternal postpartum depressive symptoms" showed no interaction effect on maternal sensitivity.

CONCLUSIONS

Depressive symptoms and maternal sensitivity were not linked. It is likely that we could not find any relation between both variables due to different measuring methods (self-reporting and observation). Maternal distress was strongly related to maternal depressive symptoms, probably due to the generally increased burden in the sample, and contributed to 55% of the variance of postpartum depressive symptoms.

Reliability of retrospective assessments of childhood experiences in Germany

The retrospective assessment of adverse childhood experiences is a widely used technique. Few studies report heterogeneous results about the reliability and objectivity. A sample of 100 patients was independently interviewed by means of the Mainz Structured Biographical Interview by two different interviewers with mean time lag of 2.2 years. Reliability of reports of family situation, physical abuse, sexual abuse, and protective factors was assessed. The results show moderate to good reliability for most childhood experiences. Divorce/separation of parents had a kappa of .95, severe sexual abuse a kappa of .64, and regular harsh physical abuse a kappa of .56; protective factors were in the .50 range. The key features for obtaining good reliability seem to be the concreteness of the question and accuracy of the coding categories. There is some, but little, evidence that sensitive issues such as sexual abuse are more prone to errors in assessment than simple ones.

NHE3 kinase A regulatory protein E3KARP binds the epithelial brush border Na+/H+ exchanger NHE3 and the cytoskeletal protein ezrin

Cyclic AMP is a major second messenger that inhibits the brush border Na+/H+ exchanger NHE3. We have previously shown that either of two related regulatory proteins, E3KARP or NHERF, is necessary for the cAMP-dependent inhibition of NHE3. In the present study, we characterized the interaction between NHE3 and E3KARP using in vitro binding assays. We found that NHE3 directly binds to E3KARP and that the entirety of the second PSD-95/Dlg/ZO-1 (PDZ) domain plus the carboxyl-terminal domain of E3KARP are required to bind NHE3. E3KARP binds an internal region within the NHE3 C-terminal cytoplasmic tail, defining a new mode of PDZ domain interaction. Analyses of cellular distribution of NHE3 and E3KARP expressed in PS120 fibroblasts show that NHE3 and E3KARP are co-localized on the plasma membrane, but not in a distinct juxtanuclear compartment in which NHE3 is predominantly expressed. The distributions of NHE3 and E3KARP were not affected by treatment with 8-bromo-cAMP. As shown earlier for the human homolog of NHERF, we also found that the cytoskeletal protein ezrin binds to the carboxyl-terminal domain of E3KARP. These results are consistent with the possibility that E3KARP and NHERF may function as scaffold proteins that bind to both NHE3 and ezrin. Since ezrin is a protein kinase A anchoring protein, we suggest that the scaffolding function of E3KARP binding to both ezrin and NHE3 localizes cAMP-dependent protein kinase in the vicinity of the cytoplasmic domain of NHE3, which is phosphorylated by elevated cAMP.

[Effect of hemodialysis on the enzymatic reactivity of neutrophils in uremic patients]

In 22 patients with chronic renal failure treated with haemodialyses the enzymatic reactivity of the neutrophils was evaluated on the basis of the activity of 7 lysosomal enzymes. Induction of certain enzymes was noted, and after haemodialysis it was not changed significantly.