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Purpose: To study the relation of infant characteristics and home environment on maternal sleep, depression, and fatigue in late postpartum., Study Design and Methods: Forty-two healthy mother-infant dyads completed a home-based study at infant age 32 weeks. Maternal measures included Patient Reported Outcomes Measurement Information System (PROMIS) sleep and wake disturbance, depression, and fatigue scales. Home regularity was assessed using the Confusion, Hubbub, and Order Scale (CHAOS). Infant sleep and regulation were measured respectively by the Brief Infant Sleep Questionnaire (BISQ) and Infant-Toddler Symptom Checklist (ITSC)., Results: Significant correlations among maternal sleep and wake disturbance, fatigue, and depression were detected (r = .519 to .746, p < .01), but not with infant variables. Home regularity was significantly related with maternal variables (r = .597 to .653, p < .01)., Clinical Implications: Regularity of the home environment appears to contribute to maternal sleep, depression, and fatigue. Implications for intervention include establishment of daily routines and household management to improve regularity and consequently improve maternal outcomes.

Background: Mutual circadian rhythm is an early and essential component in the development of maternal-infant physiological synchrony., Aims: The aim of this to examine the longitudinal pattern of maternal-infant circadian rhythm and rhythm synchrony as measured by rhythm parameters., Study Design: In-home dyadic actigraphy monitoring at infant age 4, 8, and 12 weeks., Subjects: Forty-three healthy mother-infant pairs., Outcome Measures: Circadian parameters derived from cosinor and non-parametric analysis including mesor, magnitude, acrophase, L5 and M10 midpoints (midpoint of lowest 5 and highest 10h of activity), amplitude, interdaily stability (IS), and intradaily variability (IV)., Results: Mothers experienced early disruption of circadian rhythm, with re-establishment of rhythm over time. Significant time effects were noted in increasing maternal magnitude, amplitude, and IS and decreasing IV (p<.001). Infants demonstrated a developmental trajectory of circadian pattern with significant time effects for increasing mesor, magnitude, amplitude, L5, IS, and IV (p<.001). By 12 weeks, infant phase advancement was evidenced by mean acrophase and M10 midpoint occurring 60 and 43 min (respectively) earlier than at 4 weeks. While maternal acrophase remained consistent over time, infants became increasingly phase advanced relative to mother and mean infant acrophase at 12 weeks occurred 60 min before mother. Mother-infant synchrony was evidenced in increasing correspondence of acrophase at 12 weeks (r=0.704), L5 (r=0.453) and M10 (r=0.479) midpoints., Conclusions: Development of mother-infant synchrony reflects shared elements of circadian rhythm., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

It is increasingly recognized that early sensitive care-giving predicts a secure attachment in infancy and early childhood.This preliminary report details the development, implementation and evaluation of a clinical programme that used a targeted prevention approach following a universally-offered screening of parent-infant interactions. The CARE-Index was used to assign dyads to low, medium and high risk groups, and interventions - featuring reflective videotape-based feedback - were tailored to each risk group in order to increase maternal sensitivity and improve infant attachment status. Results showed improved maternal sensitivity in the intervention conditions compared to comparisons. In addition, infants in the intervention conditions were significantly more likely to be classified as secure, and significantly less likely to be classified as having DMM complex attachment strategies. Methodological shortcomings, however, mean that these findings should be regarded as tentative.

This study compared two methods for classifying preschool-age children's behavior in the Strange Situation procedure, the MacArthur (MAC) and the Preschool Assessment of Attachment (PAA), to determine whether they operationalized converging or diverging approaches to attachment theory. Strange Situations of 306 randomly selected 3-year-old children and their mothers in the NICHD Study of Early Child Care and Youth Development were classified with the MAC and PAA. The methods showed 50% agreement. A block of seven demographic, child and family predictors was unrelated to MAC classifications, but accounted for 19% of the variance in PAA classifications. The MAC and PAA each had associations with some child outcomes in grades 1-5 (ages 6-10) totaling 5% and 12% of the variance respectively, but some of the MAC associations were counter to the hypothesis. The MAC and PAA were sufficiently different to reflect both different classificatory methods and different theoretical understandings of attachment. Results are discussed in terms of limitations of the sample and measures available to compare the two methods, and clinical implications.

This study examines associations between psychological distress and alcohol and drug use across the first five years of raising a child and parenting quality at child age six for 185 adolescent mothers. Overall, alcohol and other drug use in this sample was relatively low, but drug use was associated with more mother-reported unrealistic expectations of child behavior and more attributions of child intent to annoy parent by misbehaving. Maternal psychological distress was associated with maternal reports of negative control (yelling, pushing, spanking, etc.), and alcohol use moderated the association between psychological distress and negative control. At low levels of alcohol use, more maternal distress was associated with greater negative control; at higher levels of alcohol use, maternal distress was not related to negative control, but the absolute level of negative control was similar to that reported by more distressed mothers. Neither psychological distress nor alcohol and other drug use were related to maternal behavior during an interaction task. Overall, much stronger associations with parenting outcomes were found for an index of maternal vocabulary, compared with maternal psychological distress or maternal alcohol and other drug use.

Parenting is a demanding role. Traditionally societies provide mechanisms for supporting major caregivers. For most parents the partner relationship is a source of refueling energy. In addition, often the extended family members provide support for the parent(s). In a prior research study dealing with early intervention where the family demonstrated double vulnerability, defined by pregnancy complications and social problems, we found the mothers most resistant to help were women who both had a lot of situational problems and few if any friends or family supporting them (Barnard et al. 1985). This finding prompted us to think about parents who did not have the supportive mechanisms cultures generally provide.