Search

Objectives We evaluated the effects of the family mindfulness-based intervention (MBI) “MYmind” for children with ADHD and their parents, and examined child and parent predictors of child outcome. Methods Using a pragmatic quasi-experimental waitlist design, children aged 7–19 years (n = 167), clinically referred with a DSM-IV ADHD diagnosis, and both their parents completed waitlist (average waiting time was 8 weeks), pre-test, post-test, 8-week, and 1-year follow-up measurements. MYmind consisted of eight weekly 1.5-h mindfulness-based group sessions for children and parallel for parents, and a follow-up session. We assessed children’s and both parents’ ADHD symptoms and other psychopathology, child executive function, parental stress, parental overreactivity, and mindful parenting. Results Multilevel analyses revealed medium-to-large effect-sized reduced child ADHD symptoms between pre- and post-test, becoming stronger at follow-ups, while no waitlist effects occurred. Parents above the ADHD threshold improved on adult ADHD symptoms with similar sized effects. Children’s and parents’ other psychopathology, child executive function, parental overreactivity, and mindful parenting improved, whereas parental stress only improved at 1-year follow-up. Child age, child gender, ADHD medication, parental ADHD, and parent participation did not predict child outcome. Parent gender however interacted with parental ADHD to predict child outcome; children of fathers (but not mothers) above the ADHD threshold improved more than children of fathers below the ADHD threshold at post-test and at 8-week follow-up. Reduced paternal ADHD from pre- to post-test mediated this effect. Conclusions Family MBI (MYmind) may reduce childhood ADHD and improve parental functioning. Fathers with ADHD symptoms appear important in helping offspring with ADHD.

Mindful parenting (MP) as a group-based training for parents of clinically referred children with psychopathology has shown to effectively reduce child and parent mental health problems. This study investigated the effects of MP as a “preventive” intervention for parents who experienced parental stress or problems in parenting (non-clinical setting) compared to MP as a “curative” intervention (clinical setting). Parents from a non-clinical setting (n = 98, 18% fathers) and a clinical setting (n = 87, 21% fathers) completed questionnaires about themselves, their partner relationship, and their child at waitlist (non-clinical setting only), pre-test, post-test, and 8-week follow-up. Before the intervention, the children of parents in the non-clinical setting, as expected, showed higher well-being and lower behavior problems, but parental stress levels, parental overreactivity, mindful parenting, partner relationship, and parental well-being were no different in the clinical and preventive group pre-intervention. No improvement was observed at waitlist, except for parental well-being, while improvement on parent and child functioning measures did occur after MP. No differences in MP effects in both settings were found in improved parental functioning (parental stress, overreactivity, mindful parenting, partner relationship, and well-being [small to medium effect size improvements]) and child functioning (well-being and behavior problems, small effect size improvements). Improvements in child functioning were associated with improved mindful parenting. Results suggest that MP training may be an effective intervention not only for families of children referred to mental health care because of child mental disorders but also for parents who experience parental stress or parenting problems as it is.

ObjectivesMindful parenting (MP) interventions show promising results, but they mostly target parents (of children) with mental health problems. This study examined an online MP intervention for mothers with toddlers in a population-based sample. Aims were to assess acceptability and effectiveness of the intervention for mothers with and without parental stress, and examine their predetermined personal goals.MethodsThe study included 157 mothers with toddlers from the general population of whom 73 reported parental stress. The mothers participated in an 8-week online MP training. Questionnaires were completed at waitlist, pretest, posttest, and follow-up.ResultsMothers rated the training positively, although only 23.1% completed the training. Personal goals were analyzed qualitatively, establishing four different themes: attention, well-being, patience, and balance. Significant improvements in personal goals posttest and follow-up were found (large and very large effect size, respectively). We found no significant improvements from waitlist to pretest for all outcome variables, except personal goals (medium effect size). Mixed-linear model analyses showed significant improvements posttest and follow-up as compared to pretest regarding Self-compassion, Parental over-reactivity and Symptoms of anxiety and depression (small to medium effect sizes). There was an effect at posttest for Parenting problems, and for Parental role restriction at follow-up (small effect sizes). Levels of parental stress and theme of personal goal did not influence the effectiveness of the intervention.ConclusionsThe current study provides initial evidence that an online MP training could be an easily accessible, inexpensive, and valuable intervention for parents without an indication for a therapist-assisted intervention.Trial RegistrationDutch Trial Register (NTR7401)

Objectives Parental stress has been associated with adverse child outcomes and maternal functioning. Yet, maternal factors during pregnancy that can potentially protect against later parental stress, such as mindfulness, have not been studied. Therefore, we aimed to address the possible associations between prenatal mindfulness and levels of parental stress in mothers raising toddlers. Methods Women in the current study (n = 165) were prospectively followed from pregnancy until 3 years after childbirth, as part of a longitudinal population based cohort (HAPPY study). At 22 weeks of pregnancy, women completed the Three Facet Mindfulness Questionnaire–Short Form (TFMQ-SF) to assess facets of mindfulness (acting with awareness, non-judging, and non-reacting). Women completed the Parenting Stress Questionnaire (PSQ) 3 years after childbirth, reporting on three components of parental stress: (1) parent-child relationship problems, (2) parenting problems, and (3) role restriction. Results Results of multiple linear regression analyses showed that the acting with awareness facet of mindfulness during pregnancy was a significant predictor of fewer parent-child relationship problems and parenting problems, even when adjusted for prenatal and maternal distress and child behavior problems. Higher levels of non-reacting during pregnancy were also significantly associated with fewer parenting problems in mothers raising toddlers. Conclusions The current study emphasizes that mindfulness during pregnancy may be a protective factor for later parental stress. More research is needed to confirm these findings and to evaluate the possible benefit of a mindfulness intervention training during pregnancy on parenting and child outcomes.

Background Psychological distress during pregnancy is common: up to 20% of the childbearing women experience symptoms of depression and anxiety. Apart from the adverse effects on the woman herself, pregnancy distress can negatively affect pregnancy outcomes, infant health, postpartum mother-child interaction and child development. Therefore, the development of interventions that reduce pregnancy distress is very important. Mindfulness-based interventions (MBIs) show promising positive effects on pregnancy distress, but there is a need for randomized controlled trials with sufficient power. Trials on online MBIs, which are readily accessible and not expensive, also show positive effects on stress reduction in non-pregnant populations. Moreover, specific working mechanisms of MBIs remain unclear. The aim of the current study is to test the effectiveness of an online MBI in pregnant women with pregnancy distress, as well as exploring potential working mechanisms. Methods The current study is a randomized controlled trial with repeated measures. Consenting women with elevated levels of pregnancy distress will be randomized into an intervention group (MBI) or control group (care as usual) around 12 weeks of pregnancy, with an intended sample size of 103 women in each group. The primary outcome, pregnancy distress, will be assessed via questionnaires at baseline, halfway through the intervention and post intervention in both intervention and control group, and after 8 weeks follow-up in the intervention group. Secondary outcomes are mindfulness skills, rumination and self-compassion, which are also seen as potential working mechanisms, and will be assessed via questionnaires before intervention, halfway through the intervention, post intervention and after 8 weeks follow-up in the intervention group. Tertiary outcome variables are obstetric data and will be collected from the obstetric records for both intervention and control group. Analyses will be based on the intention-to-treat principle. Multilevel regression models for repeated measures (mixed models) will be used to evaluate changes in primary and secondary outcome variables. Tertiary outcomes will be compared between groups using independent t-tests and Chi Square analyses. Discussion The trial is expected to increase knowledge about the effectiveness of online MBIs during pregnancy in women with pregnancy distress and to evaluate potential working mechanisms. Trial registration ClinicalTrials.gov: NCT03917745, registered on 4 March 2019. Protocol Version 3.0., 20 February 2020.

Background Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p). Methods Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432). Results The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during a previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms. Conclusions This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.

Emerging evidence supports the positive effects of mindful parenting as a clinical intervention in the context of child psychopathology; however, previous studies have not considered the specific parenting predictors of improvements in child outcomes. Parents accessing a child and youth secondary mental health care center participated in an 8-week mindful parenting training (n = 89). The effects of the mindful parenting training were assessed on parent-reported child’s psychopathology, parents’ own psychopathology, mindfulness, and parenting factors from pre- to post-intervention, 8-week and 1-year follow-up. Multi-level analyses indicated immediate and delayed improvements in most child and parent outcomes. Changes in experiential avoidance in parenting partially predicted improvements in child internalizing problems. In combination with mindful parenting, experiential avoidance in parenting fully accounted for improvements in child attention problems. Changes in parental over-reactivity fully accounted for improvements in child externalizing problems. The mindful parenting training successfully improved the targeted (mindful) parenting factors, which in turn predicted improvements across different child outcomes.

Many mothers experience difficulties after the birth of a baby. Mindful parenting may have benefits for mothers and babies, because it can help mothers regulate stress, and be more attentive towards themselves and their babies, which may have positive effects on their responsivity. This study examined the effectiveness of Mindful with your baby, an 8-week mindful parenting group training for mothers with their babies. The presence of the babies provides on-the-spot practicing opportunities and facilitates generalization of what is learned. Forty-four mothers with their babies (0–18 months), who were referred to a mental health clinic because of elevated stress or mental health problems of the mother, infant (regulation) problems, or mother-infant interaction problems, participated in 10 groups, each comprising of three to six mother-baby dyads. Questionnaires were administered at pretest, posttest, 8-week follow-up, and 1-year follow-up. Dropout rate was 7%. At posttest, 8-week follow-up, and 1-year follow-up, a significant improvement was seen in mindfulness, self-compassion, mindful parenting, (medium to large effects), as well as in well-being, psychopathology, parental confidence, responsivity, and hostility (small to large effects). Parental stress and parental affection only improved at the first and second follow-ups, respectively (small to medium effects), and maternal attention and rejection did not change. The infants improved in their positive affectivity (medium effect) but not in other aspects of their temperament. Mindful with your baby is a promising intervention for mothers with babies who are referred to mental health care because of elevated stress or mental health problems, infant (regulation) problems, or mother-infant interaction problems.

Minor neurological dysfunction (MND) is present in one quarter to one third of children born very preterm (VP). The more severe form, complex (c)-MND has been associated with learning disabilities, behavioural and motor problems. To study the association between c-MND and neurocognitive and motor disabilities at age five in VP children without CP. Ninety-four children born with gestational age

1000 g, and term children (n = 84) were assessed at corrected age of 5 using a mother–child interaction observation. Disabilities were assessed using an intelligence test, behaviour questionnaires for parents and teachers, and motor and neurological examinations. Results: Mothers of preterm-born children were less supportive of and more interfering with their children’s autonomy than mothers of term-born children. This difference was only partly explained by sociodemographic factors. Dyads showed a lower quality of mother–child interaction if children had a severe disability, especially when mothers had a lower level of education. Conclusion: Five years after birth, mother–child interaction of very premature children and their mothers compared unfavourably with term children and their mothers. Mothers with sociodemographic disadvantages, raising a preterm child with severe disabilities, struggle most with giving adequate sensitive support for the autonomy development of their child. Focused specialized support for these at risk groups is warranted.

Objectives To describe the prevalence and co-occurrence of disabilities and their association with parental education in preterm children and term control subjects. Study design In a prospective study, preterm children (n = 104), born at

Aim To elucidate the relation between motor impairment and other developmental deficits in very preterm-born children without disabling cerebral palsy and term-born comparison children at 5 years of (corrected) age. Method In a prospective cohort study, 165 children (81 very preterm-born and 84 term-born) were assessed with the Movement Assessment Battery for Children - 2nd edition, Touwen's neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire. Results Motor impairment (≤15th centile) occurred in 32% of the very preterm-born children compared with 11% of their term-born peers (p=0.001). Of the very preterm-born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%, and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [OR]=41.7, 95% confidence intervals [CI] 7.5–232.5) and Full-scale IQ (OR=7.3, 95% CI 1.9–27.3) were significantly and independently associated with motor impairment. Processing speed (OR=4.6, 95% CI 1.8–11.6) and attention (OR=3.2, 95% CI 1.3–7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment. Interpretation Complex minor neurological dysfunctions, low IQ, slow processing speed, and hyperactivity/inattention should be taken into account when very preterm-born children are referred for motor impairment.