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Maternal substance misuse affects caregiving, which influences children’s coping skills. However, little is known about how children of mothers with substance misuse describe their coping in stressful situations. We studied coping and caregiver support among 29 children 4 years of age recruited from a children’s health clinic serving families with maternal substance misuse in Finland. Children completed a revised Attachment Story Completion Task that we examined with qualitative content analysis. We identified children’s experiences with coping in stressful situations with optimal and non-optimal caregiver support. Experiences with optimal caregiver support included (a) empathy, (b) solicitude, (c) intimacy, (d) reassurance, (e) being a role model, (f) concrete help, and (g) shared joy. Ones with non-optimal caregiver support included (a) punishment, (b) abandonment, (c) unresponsiveness, (d) physical aggression, (e) aggressive protection, and (f) parentification. Children’s strategies for coping without caregiver involvement were (a) magic, (b) avoidance, (c) inappropriate laughing, (d) self-reliance, or (e) a lack of strategy. Our findings highlight that preschool children of mothers with substance misuse employ various coping strategies in stressful situations that either include caregiver support or indicate non-optimal support. Children also tended to use maladaptive coping strategies when a caregiver was not involved. Understanding children’s coping with stress in families with maternal substance misuse is essential to supporting their socioemotional development and providing adequate interventions. publishedVersion

Emotional availability (EA) is the ability to share an emotional connection within a dyad. The observational EA System includes the EA Scales and the EA Zones. The EA Scales consist of four adult dimensions (sensitivity, structuring, nonintrusiveness, nonhostility) and two child dimensions (responsiveness, involvement). Based on the EA Scales, EA Zones refer to “emotional attachment styles” and are patterned after traditional attachment categories (Ainsworth et al., 1978). Since the review on EA by Biringen et al. (2014), extensive research on EA has utilized the EA Scales or the EA Zones, especially with respect to clinical populations and applications. We address topics absent from the 2014 review, namely, utilizing the EA System for at-risk populations and in prevention and intervention studies. We consider EA research accounting for fathers or alternative caregivers and suggest using the whole EA system versus specific dimensions. We conclude with new directions in clinical applications of EA.

Purpose of Review Maternal prenatal substance use presents a multilevel risk to child development and parenting. Although parenting interventions are increasingly integrated into substance use treatment, prenatal parenting processes have not received equal attention within these interventions. This article aims to synthesize the evidence on the specific prenatal risk factors affecting the development of early parenting of substance-using mothers, as well as interventions focusing on those factors. Recent Findings Both neurobiological and psychosocial risk factors affect the prenatal development of parenting in the context of maternal substance use. Maternal–fetal attachment, mentalization, self-regulation, and psychosocial risks are important in treatment and highly intertwined with abstinence. Although parenting interventions seem to be highly beneficial, most studies have not differentiated between pre- and postnatal interventions or described pregnancy-specific intervention elements. Summary Due to the salience of pregnancy in treating substance-using parents, interventions should begin prenatally and include pregnancy-specific parenting focus. Further research on prenatal interventions is warranted.

Objective: To identify within-family groups according to sleep schedule, problems, and impact, reflecting similarities or differences in adolescents, mothers, and fathers and to examine how mental health and attachments associate with these triadic sleep groups. Background: Family relationships shape sleeping, but within-family research in adolescence is scarce. Method: Adolescents (17–18 years; 60% girls; n = 438), mothers (n = 448), and fathers (n = 358) filled in the Pittsburgh Sleep Quality Index. The adolescents reported mental health problems by the Behavior Assessment System and the parents by the General Health Questionnaire. All reported attachments by the Experiences in Close Relationships. Results: Cluster analysis identified four triadic sleep groups: “Good family sleep” (47%), “Poor adolescent and maternal sleep” (29%), “Poor paternal sleep” (16%), and “Poor family sleep” (8%). Adolescents in the “Poor family sleep” group had more mental health problems than they did in other groups, and fathers in the “Poor paternal sleep” group showed higher psychiatric symptoms than in the “Good family sleep” or “Poor adolescent and maternal sleep” groups. Adolescents in the “Poor family sleep” group reported higher insecure–anxious attachments than they did in other groups, and fathers reported higher insecure–avoidant and insecure–anxious attachments in the “Poor paternal sleep” than they did in other groups. Conclusion: A family systems approach provides new insight into sleep, mental health, and attachments. Implications: Interventions to improve sleep quality should consider family dynamics that may underlie potential sleep problems, and sleep as a public health issue can benefit from knowledge about family mental health and attachments. publishedVersion

Attachment theory proposes that the activation of the attachment system enacts emotion regulation (ER) to maintain security or cope with insecurity. However, the effects of ER on attachment states and their bidirectional influences remain poorly understood. In this ecological momentary assessment study, we examined the dynamics between attachment and ER. We hypothesised that attachment states and ER influence each other through time. Specifically, we hypothesised bidirectional short-term cycles between state attachment security and reappraisal, state attachment anxiety and rumination, and state attachment avoidance and suppression. We also tested how trait attachment is related to state attachment and ER. One hundred twenty-two participants (Mage = 26.4) completed the Experiences in Close Relationship-Revised and reported state attachment and ER seven times daily for seven days. The results were only partly consistent with our cycle hypotheses yet revealed a cycle between low state attachment security and rumination that was attenuated by reappraisal. Moreover, rumination and suppression predicted increased insecure states, and reappraisal predicted increased secure and insecure states. Finally, trait attachment showed associations with state attachment and ER. Our study suggests regulatory dynamics between attachment and ER and opens important questions about their functional relationship in maintaining attachment-related behavioural patterns and emotional well-being. ispartof: Cognition & Emotion vol:36 issue:6 pages:1109-1131 ispartof: location:England status: published

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions. publishedVersion

Optimal sleep quality fosters adolescents' wellbeing and, therefore, learning about its developmental determinants is essential. We examined how early family environment (i.e., parent-reported parenting, marital relationship quality, and mothers' mental health), obstetric factors (i.e., infertility history and assisted reproductive treatments, and pre- and perinatal complications and health risks), and children's emotion regulation in middle childhood predicted adolescents' sleep quality. We also tested the mediating role of emotion regulation in linking early determinants to adolescent sleep. Finnish families (N = 984) participated during pregnancy, infancy, middle childhood, and late adolescence. Results showed that only early maternal mental health problems predicted poor adolescent sleep quality. Contrary to hypotheses, emotion regulation did not mediate the effects of early family environment and obstetric factors on later sleep quality. Supporting the early family environment through improving maternal mental health can have long-term positive developmental impacts, including sleep. publishedVersion

Facial emotion recognition (FER) is a fundamental element in human interaction. It begins to develop soon after birth and is important in achieving developmental tasks of middle childhood, such as developing mutual friendships and acquiring social rules of peer groups. Despite its importance, FER research during middle childhood continues to be rather limited. Moreover, research is ambiguous on how the quality of one's early social-emotional environment shapes FER development, and longitudinal studies spanning from infancy to later development are scarce. In this study, we examine how the cohesive, authoritarian, disengaged and enmeshed family system types, assessed during pregnancy and infancy, predict children's FER accuracy and interpretative biases towards happiness, fear, anger and sadness at the age of 10 years (N = 79). The results demonstrated that children from disengaged families (i.e., highly distressed relationships) show superior FER accuracy to those from cohesive families (i.e., harmonious and stable relationships). Regarding interpretative biases, children from cohesive families showed a greater fear bias compared to children from disengaged families. Our findings suggest that even in a relatively low-risk population, variation in the quality of children's early family relationships may shape children's subsequent FER development, perhaps as an evolution-based adaptation to their social-emotional environment. publishedVersion

Positive parent–child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent–child relationship quality for families experiencing stress. We examined the moderating role of parent–child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children’s hair cortisol concentrations (HCCs)—a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent–child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children’s (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent–child relationship quality (e.g., EA) for the transmission of parents’ early life adversity on their children’s HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.

Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (M

Background Maternal pre- and postnatal psychological distress, such as anxiety and depression, may negatively affect mother-infant interaction quality. However, more information is needed on the role of specific types and timings of pre- and postnatal distress symptoms on mother-infant interaction. Research on the role of maternal anxiety is especially scarce. Methods We examined whether maternal pregnancy- related anxiety (gestational weeks 24 and 34), general anxiety or depressive symptoms (gw 14, 24 and 34 and at the infant age of 3 and 6 months) associate with the quality of mother-infant interaction when the child is eight months old. Maternal symptoms (N = 190) were measured with EPDS, SCL-90 anxiety subscale and PRAQ-R2. Mother-infant interaction was measured with the Emotional Availability Scales (EAS). Results After controlling for background factors, general anxiety at the 3rd pregnancy trimester was associated with higher maternal intrusiveness in EAS. Depressive symptoms at 6 months postpartum associated with lower maternal structuring behavior and with the child's lower involvement of the mother. Limitations A very small number of mothers with severe symptoms of depression and anxiety. Conclusions Prenatal anxiety and postnatal depressive symptoms may each have unique effects on the different areas of mother-infant interaction, suggesting the need to develop more targeted interventions for mothers with different symptom profiles and timings. Prenatally anxious mothers could potentially benefit from early interventions decreasing stress and anxiety symptoms and specifically promoting their ability to read infant cues appropriately. Infants of postnatally depressed mothers may need interventions where both members of the dyad receive help.

In the case of a mother with dysregulating attachment experiences and current enrolment in a parent-infant psychotherapy process, we explored which insecure, hostile/helpless, and prementalizing risk features were similar in her attachment and caregiving representations; which risk features were specific to her caregiving representations; and how these theory-defined features overlapped in detecting caregiving risks. Risk features in the attachment representations were assessed from the adult attachment interview and risk features in the caregiving representations from written psychotherapy notes. We found similar insecure (preoccupied and disorganized), prementalizing and hostile/helpless instances from both the attachment and the caregiving representations. However, confusion between self and child, greater variance in lapses into prementalizing, and specific and concrete fears and helplessness were unique to the caregiving representations. Hostile/helpless instances were found in tandem with almost all insecure and prementalizing instances, indicating this conceptualization captured risks in the caregiving representations most comprehensively. Fearful and helpless caregiving representations occurred somewhat independently from other risk conceptualizations, suggesting they need to be identified as independent phenomena. The results imply that detecting specific manifestations of intergenerational risks from caregiving representations is possible. peerReviewed

Maternal substance use has often been associated with insecure and disorganized child attachment. We evaluated this association with a meta-analysis of young children and, further, systematically reviewed mediating and moderating factors between maternal substance use and child attachment. We performed a systematic database search of quantitative English language studies on child attachment that included substance-using mothers and their children below 6 years of age. Eleven studies (N = 1,841) met the inclusion criteria and were included in the meta-analysis of attachment security and seven (N = 1,589) studies were included in the meta-analysis of attachment disorganization. We found that maternal substance use was negatively associated with secure attachment in children, but the effect size was small (r = −.10). The association with disorganized attachment was not significant (r = .15). Related to moderating and mediating factors (k = 6), we found evidence on the role of teratogenic and sociological factors on child attachment. Most importantly, the impact of cumulative risks was vital. However, literature was scarce, and studies varied in risk of bias, leaving many unanswered questions on other potential factors underlying the development of attachment in these high-risk children. We discuss the results considering clinical implications and future directions.

Background Maternal prenatal substance use disorder (SUD) represents a dual risk for child wellbeing due to teratogenic impacts and parenting problems often inherent in SUD. One potential mechanism transferring this risk is altered development of children's emotion regulation (ER). The present study examines how mother's prenatal SUD and early mother-infant interaction quality predict children's ER in middle childhood. Method The participants were 52 polysubstance using mothers and 50 non-users and their children. First-year mother-infant interaction quality was assessed with the Emotional Availability (EA) Scales and children's ER with the Children's Emotion Management Scales (CEMS), and its parent version (P-CEMS) at 8–12 years. Results Mother's prenatal SUD predicted a low level of children's adaptive ER strategies, whereas early mother-infant interaction problems predicted a high level of emotion dysregulation. The dyadic interaction also mediated the effect of SUD on emotion dysregulation. In the SUD group, more severe substance use predicted high emotion inhibition. Conclusion Early mother-infant interaction quality is critical in shaping children's ER, also in middle-childhood. Interventions aimed for mothers with prenatal SUD should integrate parenting components to support the optimal development of multiply vulnerable children., Maternal substance use; Prenatal exposure; Emotion regulation; Mother-infant interaction; Prospective study; Middle childhood.

This prospective longitudinal study examined how maternal prenatal substance use disorder (SUD) and early mother–infant interaction quality are associated with child social cognition (emotion recognition and mentalization) at school age. A sample of 52 poly-substance-using mothers receiving early interventions and 50 non-users, along with their children, was followed from pregnancy to school age. First-year mother–infant interaction quality was measured with EA scales. At school age, child facial emotion recognition was measured with DANVA and mentalization with LEAS-C. SUD group children did not differ from comparison children in social cognition, but higher severity of maternal prenatal addiction predicted emotion recognition problems. High early mother–infant interaction quality predicted better emotion recognition and mentalization, and mother–infant interaction quality mediated the effect of prenatal SUD on emotion recognition. The results highlight the need for early treatments targeting both parenting and addiction, as well as long-term developmental support for these children. Highlights: We examined how mother's prenatal substance use disorder (SUD) and early mother–infant interaction predict child social cognition at school age. Questionnaires, observational and computer tasks were used. Maternal prenatal addiction severity and early parenting problems predicted problematic child social cognition. Early interventions should simultaneously target addiction and parenting. Attention should also be paid to the long-term developmental support of children. publishedVersion

The goal of this study was to determine the extent to which a brief parenting intervention provided the context for helping families to support positive mother-child interactions as well as more optimal mother and child outcomes. Participants in this study were middle income mothers and their children were between 0-3 years of age (N = 25 dyads). Participants were filmed via Skype during a 20-minute mother-child free play and completed questionnaires (Time 1) before attending the brief intervention (involving: a single session of one-on-one parent feedback and coaching, and information via group meeting, texts, and reading) followed by a repeat of the 20-minute Skype interaction and the completion of the same questionnaires (Time 2). Paired samples t-tests were performed, revealing that mothers reported improvements in their personal well-being (using the Flourishing Scale), reports about the mother-child relationship (using the Emotional Availability Self Report), and observed interactions, particularly the child's side of the relationship (using the Emotional Availability System), from pretest to posttest. Results are discussed in terms of a single session of parent feedback and coaching (in conjunction with an informational group session and texts) potentially having a role in "planting a seed" for observed and self-reported parenting enhancement and child development.La meta de este estudio fue determinar hasta qué punto una intervención de crianza breve ofrecía el contexto para ayudar a familias a apoyar las positivas interacciones madre-niño, así como también resultados más óptimos en la madre y el niño. Las participantes en este estudio fueron madres de ingresos medios y sus niños de edad de 0 a 3 años (N = 25 díadas). Las participantes fueron filmadas a través de Skype durante una sesión de juego libre de 20 minutos entre madre y niño y ellas completaron cuestionarios (Primer momento) antes de asistir a la breve intervención (la cual estaba compuesta de una sola sesión de entrenamiento uno a uno de la madre, y de información por medio de reuniones de grupo, textos y lecturas) seguida de una repetida interacción de 20 minutos a través de Skype y volver a completar el mismo cuestionario (Segundo momento). Se llevaron a cabo muestras emparejadas de exámenes t, revelando así que las madres reportaron mejoras en su bienestar personal (usando la Escala Flourishing), reportes acerca de la relación madre-niño (usando el Auto Reporte de Disponibilidad Emocional), y observadas interacciones, particularmente el lado del niño en la relación (usando las Escalas de Disponibilidad Emocional), desde el pre-examen hasta el post-examen. Se discuten los resultados en términos de una sola sesión de entrenamiento de la madre (en conjunto con una sesión informativa de grupo y textos) que potencialmente juega un papel en el proceso de “plantar la semilla” para las observadas y auto-reportadas mejorías en la crianza y el desarrollo del niño.Le but de cette étude était de déterminer dans quelle mesure une brève intervention de parentage offrait un contexte pour aider des familles à soutenir des interactions mère-enfant positives ainsi que des résultats mère et enfant plus optimaux. Les participants à cette étude étaient des mères de classe moyenne et leurs enfants âgés de 0 à trois ans d’âge (N = 25 dyades). Les participants ont été filmés au moyen de Skype pendant une séance de jeu libre de 20 minutes et ont complété des questionnaires (Temps 1) avant de participer à une brève intervention (qui comprenait: une seule séance de coaching d'un à un avec le parent, et des renseignements avec une réunion de groupes, des textos, et des lectures) suivie d'une répétition de l'interaction de 20 minutes au moyen de Skype et du remplissage des mêmes questionnaires (Temps 2). Des tests t d’échantillons appariés ont été faits, révélant que les mères faisaient part d'amélioration dans leur bien-être personnel (en utilisant l'Echelle d'Epanouissement, soit en anglais Flourishing Scale), et ainsi que dans les rapports de la relation mère-enfant (en utilisant l'Auto Déclaration de Disponibilité Emotionnelle), et dans les interactions observées, en particulier le côté de l'enfant de la relation (en utilisant les Echelles de Disponibilité Emotionnelle), du prétest au posttest. Les résultats sont discutés en termes de séance unique de coaching du parent (en conjonction avec une séance d'information en groupe et de textos) ayant potentiellement un rôle et “plantant une graine” pour l'amélioration autodéclarée et observée du parentage et le développement de l'enfant. Mots clés: parent-enfant, disponibilité émotionnelle, intervention.Das „EA Brief“: Ein Einzelsitzungs-Eltern-Coaching zur Verbesserung der emotionalen Bindung und emotionalen Verfügbarkeit (Emotional Attachment and Emotional Availability; EA) Zusammenfassung: Ziel dieser Studie war die Untersuchung, ob es durch eine kurze Elternintervention gelingen kann, Familien bei der Umsetzung positiver Mutter-Kind-Interaktionen zu unterstützen sowie optimalere Mutter-Kind-Outcomes zu erzielen. An der Studie nahmen Mütter mit mittlerem Einkommen und ihre Kinder im Alter von 0 bis 3 Jahren (N = 25 Dyaden) teil. Die Teilnehmenden wurden 20 Minuten lang, während eines freien Mutter-Kind-Spiels, über Skype gefilmt und füllten Fragebögen aus (Messzeitpunkt 1), bevor sie an der kurzen Intervention teilnahmen (die Intervention beinhaltete eine einzelne Sitzung im Einzel-Eltern-Coaching und über Gruppentreffen vermittelte Informationen sowie Informationstexte). Danach erfolgte eine Wiederholung der 20-minütigen Skype-Interaktion und ein erneutes Ausfüllen derselben Fragebögen (Messzeitpunkt 2). Es wurden T-Tests mit gepaarten Stichproben durchgeführt, die von Messzeitpunkt 1 zu Messzeitpunkt 2 Verbesserungen im persönlichen Wohlbefinden der Mütter (unter Verwendung der Flourishing Scale), in der Mutter-Kind-Beziehung (unter Verwendung des Selbstberichts zur emotionalen Verfügbarkeit) und in der beobachteten Interaktionen, insbesondere auf der Seite des Kindes (unter Verwendung der Emotional Availability Scales) ergaben. Die Ergebnisse werden dahingehend diskutiert, dass Einzelsitzungs-Eltern-Coachings (in Verbindung mit einer Informationsgruppensitzung und Texten) möglicherweise eine Rolle beim „Pflanzen eines Samens“ für beobachtete und selbst berichtete Verbesserung der Elternkompetenz und der Entwicklung des Kindes spielen könnten. Schlüsselwörter: Eltern-Kind, emotionale Verfügbarkeit, Intervention.情緒的アタッチメントと情緒的応答性(EA)を向上させるための親コ ーチング１セッション 本研究の目的は、家族を支援するために、短期の養育への介入がどの程度、母親 と子どもの最良の成果を出し、肯定的な母子相互交流を向上させるのかを同定す ることである。本研究の被験者は、中所得の母親と0-3歳の乳幼児 (N = 25組) で ある。被験者は、短期介入 (に関するものは−1対1の親コーチングの１セッショ ンと、グループ・ミーティングでの情報や、文章等の情報) に参加する前に、20 分間母子で自由に遊んでいるところをスカイプを通して録画され、質問紙を完了 した(Time 1)。介入後、20分間の相互交流のスカイプ録画を再度撮り、同じ質問 紙を行った(Time 2)。Paired-samples t検定が行われ、母親個人の健康状態(Flourishing Scalesを使用)、母子関係についての報告(Emotional Availability Self Reportを使用)、特に乳幼児側からの関係性を観察した相互交流(Emotional Availability Scalesを使用)の改善が事前・事後間で明らかになった。結果は、 親コーチング1セッション (グループセッションからの情報や文章等の情報と共 に) について、観察されまた自己報告のあった養育能力の向上と子どもの発達に ついて潜在的に“種を蒔く”ものとして論じられた。.摘 要:本研究是为了确定, 在特定环境下开展的短暂育儿干预, 能在多大程度上帮助家庭构建积极的母子互动以及更理想的母子关系。本研究的参与者是中等收入的母亲及其0-3岁的孩子 (N = 25对母子) 。首先利用Skype拍摄了20分钟的母子自由互动, 母亲在参与短暂干预 (内容包括:一次一对一的亲子教练, 以及通过小组会议、文本和阅读所获得的信息) 前完成了调查问卷 (时间1) , 然后重复20分钟的Skype互动, 并完成相同的调查问卷 (时间2) 。开展配对样本t检验后, 得到了前、后测试结果:母亲个人幸福感的提高 (利用“心盛量表”) 、母子关系的报告 (利用“情感回馈度自陈报告”) , 以及观测到的互动行为, 尤其是母子关系中孩子的互动 (利用“情感回馈度量表”) 。测试结果显示, 单次亲子教练 (结合信息性的小组会议和文本) 对观测到的和自我报告的育儿能力提高及儿童的发展有潜在的“希望”。.جلسة تدريب أحد الوالدين لتحسين التعلق العاطفي والتوافر العاطفي (EA) كان الهدف من هذه الدراسة هو تحديد المدى الذي وفر فيه التدخل الأبوي القصير السياق لمساعدة الأسر على دعم التفاعلات الإيجابية بين الأم والطفل، فضلا عن النتائج المثلى للأم والطفل. وكان المشاركون في هذه الدراسة من الأمهات ذوات الدخل المتوسط وأطفالهن الذين تتراوح أعمارهم بين صفر و3 سنوات (N = 25 dyads). تم تصوير المشاركين عبر سكايب خلال 20 دقيقة من اللعب الحر بين الأم والطفل وبعد ذلك استكملوا استبيانات (وقت 1) قبل حضور جلسة التدخل المختصرة (والتي تنطوي على: جلسة واحدة لتدريب أحد الوالدين، ومعلومات من خلال لقاءات المجموعات، والنصوص، و القراءة) وتبع ذلك تكرار تفاعل سكايب لمدة 20 دقيقة واستكمال نفس الاستبيانات (وقت 2). تم إجراء اختبارات المقارنة والتي كشفت أن الأمهات أبلغن عن تحسنات في رفاههن الشخصي (باستخدام مقياس الازدهار) ، وتقارير حول العلاقة بين الأم والطفل (باستخدام التقرير الذاتي للتوافر العاطفي) ، وملاحظة التفاعلات، وخاصة جانب الطفل من العلاقة (باستخدام مقاييس التوافر العاطفي)، من الاختبار المسبق إلى الاختبار اللاحق. وتناقش النتائج من حيث التدريب الأبوي في جلسة واحدة (بالتزامن مع جلسة معلومات ونصوص مكتوبة) حيث يحتمل أن يكون لها دور في “غرس بذرة” لتعزيز الأبوة والأمومة الملحوظة والمبلغ عنها ذاتيا ونمو الطفل.

The first year with a child is one of the most challenging times for mothers due to repeated awakenings typical for young infants. Research has shown that persistent fragmented sleep increases a mother’s risk for low overall well-being, which can challenge the mother-infant relationship. In an effort to improve sleep for both mother and infant, healthcare providers often recommend infant behavioral sleep interventions. The primary focus of this pilot study was to assess the feasibility of the Possums Sleep Intervention, a psychoeducational group workshop for women with infants between the ages of 0-6 months. A second goal of the study was to evaluate the potential of the Possums curriculum in improving maternal and infant sleep and self-reported mother-infant emotional availability. Participants were 24 mothers with their 0-6 month old infants assessed at the start of the study and again at the completion of the 4-week workshop. Results showed improvements in the perceived emotional availability in the mother-infant relationship; however, positive effects related to maternal or infant sleep were only on a trend level.

BSTRACT Theraplay® is a short-term parent–child interaction therapy combining structured, attachment-based, joyful and adult-led playful sessions with reflective guidance work with the parents. This pilot study evaluates the impact of Theraplay® therapy in improving the quality of parent–child interaction and decreasing the internalizing and externalizing symptoms of children diagnosed with emotional and/or behavioral disorders. Participants were eighteen 4–8 year-old children (M = 4.42, SD = 1.54) from two outpatient child psychiatric clinics whose mothers, and in 13 of those cases fathers also participated in the Theraplay® therapy together with the child. Pre- and post- treatment measures included videotaped observations of parent–child interaction quality, and child psychiatric symptoms (CBCL). The results showed improvements in parent–child interaction quality as well as decreases in children’s internalizing and externalizing symptoms. The results of this pilot study indicate that Theraplay® therapy may be an effective treatment among children diagnosed with emotional and/or behavioral psychiatric disorders. Theraplay® is a short-term parent–child interaction therapy combining structured, attachment-based, joyful and adult-led playful sessions with reflective guidance work with the parents. This pilot study evaluates the impact of Theraplay® therapy in improving the quality of parent–child interaction and decreasing the internalizing and externalizing symptoms of children diagnosed with emotional and/or behavioral disorders. Participants were eighteen 4–8 year-old children (M = 4.42, SD = 1.54) from two outpatient child psychiatric clinics whose mothers, and in 13 of those cases fathers also participated in the Theraplay® therapy together with the child. Pre- and post-treatment measures included videotaped observations of parent–child interaction quality, and child psychiatric symptoms (CBCL). The results showed improvements in parent–child interaction quality as well as decreases in children's internalizing and externalizing symptoms. The results of this pilot study indicate that Theraplay® therapy may be an effective treatment among children diagnosed with emotional and/or behavioral psychiatric disorders.

Objective To identify interplay of early maternal and paternal mental health symptoms for predicting child mental health and development. Background Research on family mental health has largely excluded fathers, although the well-being of both parents is likely to be important for child development. In this study, we analyzed (a) intrafamilial dynamics between mothers' and fathers' early mental health symptoms and (b) the importance of separate (mother and father) and joint (additive, hierarchical, and buffering) theoretical models of parental mental health for predicting child mental health and development. Method Finnish mothers and fathers (N = 763), half of whom conceived through assisted reproductive treatments (ART), reported their symptoms of psychological distress and depression from the pregnancy to 2 months and 12 months postpartum. Later, when the child was 7–8 years of age, parents (N = 485) reported the child's internalizing and externalizing symptoms and social and cognitive developmental problems. Results We identified both co-occurrence and compensation in intrafamilial early parental mental health. Further, mothers' symptoms alone (separate mother model) predicted child internalizing symptoms, whereas joint parental symptoms (additive model) predicted problems in executive function. Conclusion The pre- and postnatal mental health of mothers and fathers is important for later child development. Implications To support healthy child development, both parents need to be screened for early mental health problems, and psychological help should be offered to families across the pre- and postpartum period.

Research has demonstrated the importance of early family characteristics, such as the quality of caregiving, on children's later mental health. Information is, however, needed about the role of more holistic family systems and specific child-related socioemotional mechanisms. In this study, we conceptualize families as dynamic family system types, consisting of both marital and parenting trajectories over the transition to parenthood. First, we examine how early family system types predict children's anxiety, depression, peer exclusion, and emotion regulation. Second, we test whether couples' infertility history and other family related contextual factors moderate the effects of family system types on child outcomes. Third, we test whether children's emotion regulation and peer exclusion mediate the effects of family system types on anxiety and depression. The participants were 452 families representing cohesive, distant, authoritative, enmeshed, and discrepant family types, identified on the basis of relationship autonomy and intimacy from pregnancy to the child's age of 2 and 12 months. Children's anxiety, depression, emotion regulation, and peer exclusion were assessed at the age of 7-8 years. Structural equation modeling showed that distant, enmeshed, and discrepant families similarly predicted children's heightened anxiety and depression. Infertility history, parental education, and parity moderated the associations between certain family system types and child outcomes. Finally, emotion regulation, but not peer exclusion, was a common mediating mechanism between distant and enmeshed families and children's depression. The results emphasize the importance of early family environments on children's emotion regulation development and internalizing psychopathology. (PsycINFO Database Record

Aim:This randomised control trial (RCT) study examined the effectiveness of a mentalisation-based perinatal group intervention, Nurture and Play (NaP), in improving mother–infant interaction quality and maternal reflective functioning and in decreasing depressive symptoms.Background:Few preventive prenatal interventions have been developed for primary health care settings for mothers with depressive symptoms. Furthermore, previous prenatal intervention studies have only concentrated on reducing depressive symptoms and have not directly addressed enhancing optimal parenting qualities.Methods:The participants were 45 pregnant women with depressive symptoms. Women in the randomly assigned intervention group (n= 24) participated in the manualised, short-term NaP intervention group from pregnancy until the baby’s age of seven months, whereas control group women received treatment as usual (TAU). Maternal emotional availability (EA), reflective functioning (RF) and depressive symptoms were measured before the intervention and at the infants’ 12 months of age, and changes were evaluated using repeated measure analyses of variances (ANOVAs).Findings:The results showed that the intervention group displayed higher maternal sensitivity and RF and more reduction in depressive symptoms than the control group when babies were 12 months old. These findings provide preliminary support for the effectiveness of the NaP intervention.

This study describes a new observational measure for assessing a mother’s prenatal emotional availability in relationship towards her unborn baby (Pre-EA). Concurrent associations between a mother’s Pre-EA, her adult attachment style (AAI), and prenatal maternal reflective functioning (RF) (Pregnancy Interview) were assessed among 45 pregnant women (gw 22-31) screened positive for depressive symptoms in a community-based sample. Pre-EA was measured from a videotaped, semi-structured maternal-fetal interaction assessment procedure (MIM). The two Pre-EA dimensions, sensitivity and non-hostility, were related to adult secure-autonomous attachment style and higher prenatal maternal RF. The results show that this observed emotional availability may be assessed during pregnancy.

A father’s mental health is important for family well-being, but research is scarce on paternal symptoms during the transition to fatherhood. This study identified fathers’ latent mental health trajectory classes from the pre- to postnatal period and examined their associations with early fathering experiences. It further analysed, whether a family’s infertility history was associated with mental health trajectory classes and moderated their effects on fathering experiences. Finnish fathers ( N = 773) reported psychological distress (General Health Questionnaire; GHQ-36) and depressive symptoms (Beck Depression Inventory; BDI-13) in pregnancy (T1), and at 2 months (T2) and 12 months (T3) postpartum. They further reported their fathering experience (Parenting Stress Index; PSI-36) at T2 and T3. Results revealed five paternal mental health trajectory classes, differing in timing and course of symptoms across the pre- and postpartum: stable low (79%) and moderate increasing (9%) levels of symptoms, and prenatal (5%), early fatherhood (3%) and heterogeneous high levels of (4%) problems. The trajectory classes were associated with fathering experiences within parental, interactive and child domains, across the child’s first year. The stable low levels of symptoms-class showed the most positive experiences and the heterogeneous high levels of problems-class the most negative ones; mental health problems in the early fatherhood-class reported negative fathering experience, but only when the child was 2 months old. A family’s infertility history neither showed any significant association with trajectory classes nor moderated their impact on early fathering, supporting the growing evidence that infertility treatments do not place an additional burden on early fatherhood.

Introduction The aim of this study was to compare the level of fear of childbirth, pregnancy-related anxiety and experience of childbirth in women who conceived with donated oocytes (OD), with that in women with in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) and spontaneous conception (SC). Material and methods This is a prospective cohort study. We compared women who received donated oocytes (n = 26) to matched controls, IVF/ICSI (n = 52) or SC (n = 52). Matching was made according to mothers' age, parity, plurality and the number of returned questionnaires. The participants completed the questionnaires during their second trimester and at 2 months postpartum. The Fear of Delivery Questionnaire and the Pregnancy Anxiety Scale served to study fear of childbirth, and the Delivery Satisfaction Scale served to study experience of childbirth. Results The level of fear of childbirth was lower in the women who received donated oocytes than in the women who received IVF/ICSI (p = 0.028), but similar to those in the SC group. The level of pregnancy-related anxiety was lower in the OD group than in the IVF/ICSI (p = 0.006) and SC groups (p = 0.019). The experience of childbirth did not differ between the groups. The mode of delivery was associated with the mothers' satisfaction with the delivery only in the OD group. Those who had an acute operative delivery were the most dissatisfied. Conclusions After receiving adequate support prior to OD treatment, the women require no more support with fear of childbirth than other pregnant women, but they may require support after acute operative deliveries.

Maternal mental health problems can negatively impact children's physiological stress regulation. Yet, little is known of their long-term effects, especially related to the timing of maternal symptoms. We examined how maternal mental health problems during pregnancy versus in the early postpartum period predict children's cortisol levels and diurnal patterns at 10–12 years. Participants were a selection (N = 102) of an original sample of 805 Finnish families, who were followed from the second trimester of pregnancy (T1) to child's age of 2 months (T2) and 12 months (T3), and again at child's age of 10–12 years (T4). Based on the timing of psychological distress and depressive symptoms (T1–T3), the mothers could be assigned to three distinct mental health trajectory groups: mothers with prenatal mental health problems (n = 15), mothers with early postpartum mental health problems (n = 15) and mothers without mental health problems (n = 72). Children's cortisol (T4) was measured by saliva samples through five within-1-day assessments. The results show that maternal prenatal mental health problems predicted a relatively steep increase of child cortisol from awakening to 1 h later, indicating an intensified cortisol awakening response (CAR). Mothers' early postpartum mental health problems instead predicted a reduced CAR. Both maternal prenatal and postnatal mental health problems thus predicted children's later stress regulation, but in unique ways. We discuss the specific roles of direct biochemical effects during pregnancy and postpartum mother–infant interaction quality as modifiers of the hypothalamic–pituitary–adrenal system. Copyright © 2015 John Wiley & Sons, Ltd.

STUDY QUESTION Do children born after assisted reproductive techniques (ART; IVF/ICSI) display more mental health issues or social and cognitive developmental problems at 7-8 years than naturally conceived (NC) controls, and does child gender play a role? SUMMARY ANSWER ART children do not differ with regard to mental health or social and cognitive developmental problems when compared with controls, but some gender-specific differences do exist. WHAT IS KNOWN ALREADY Systematic reviews have not found any evidence of delays in neurocognitive or sensorimotor development in ART children. However findings on the effect of the type of ART treatment (IVF versus ICSI) on the offspring's physical and mental development have not been uniform. Knowledge of the role of child gender in ART research is scarce. STUDY DESIGN, SIZE, DURATION This prospective follow-up study compares mental health and social and cognitive developmental problems between 7-8-year-old ART and NC children, controlling for the father's age, length of the parents' partnership, mother's parity, child's gestational age, and the need of neonatal intensive care unit (NICU). Further, within the ART group, we analysed whether the treatment type (IVF versus ICSI) and the child's gender are associated with the mental health and developmental outcomes. PARTICIPANTS/MATERIALS, SETTING, METHODS In this study, 255 singleton ART children (IVF and ICSI) were compared with 278 NC children on parent-reported internalizing and externalizing symptoms, and social (social skills and peer relations) and cognitive development (executive functioning, perception, memory, and language). Within the ART group, 164 IVF and 76 ICSI children were compared on the same outcomes. Statistics included analyses of covariates (ANCOVA) with group main effects, group and gender interaction effects, and Bonferroni post hoc tests. MAIN RESULTS AND THE ROLE OF CHANCE ART and NC children did not differ generally in terms of their internalizing and externalizing symptoms or in the number of social and cognitive developmental problems (Group main effects, P > 0.05), but gender-specific group differences existed. The ART boys showed lower levels of cognitive problems than the NC boys, whereas ART girls showed higher levels of cognitive problems than the NC girls (Group × Gender-interaction effects with Bonferroni post hoc tests on mother-reports, P < 0.01). Further, unlike in the NC group, where boys showed more externalizing symptoms and social and cognitive developmental problems than girls (Group × Gender-interaction effects with Bonferroni post hoc tests for both parents' reports, P < 0.05), gender differences were not found in the ART group. Within the ART group, IVF and ICSI children did not differ in terms of mental health or developmental outcomes, and no significant gender differences emerged. LIMITATIONS, REASONS FOR CAUTION The information on children's mental health and development was based on parental reports only. The dropout rate between the child's first year and the school age assessments was very high for fathers (57.4%) and substantial for mothers (30.1%), and the participating group was biased for older age of both parents and for better education of the fathers. WIDER IMPLICATIONS OF THE FINDINGS The findings indicate the importance of considering child gender in learning about multiple developmental outcomes among children born after ART. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Academy of Finland (#11232276), the Emil Aaltonen Foundation, The Family Federation of Finland, Helsinki University Central Hospital Research Funds, and the National Graduate School of Psychology. None of authors has any competing interests to declare.

The purpose of this controlled study was to examine the outcome of psychodynamic mother-infant group psychotherapy (PGT) outpatient intervention for drug-abusing perinatal mother-infant dyads. PGT comprised 20 to 24 weekly 3-hr sessions with 3 to 5 months of follow-up. A comparison intervention group was formed of mothers participating in individually tailored psychosocial support (PSS) lasting, on average, 12 months and providing mother-infant support and practical counseling. We hypothesized that positive changes would occur in maternal drug abuse, mental health, and mother-infant interaction, especially in the PGT group due to its more intensive therapeutic focus. Participants were 26 drug-abusing dyads in PGT, 25 in PSS, and 50 dyads in a non-drug-abusing comparison group. Assessments were pre-intervention and at 4 and 12 months' follow-up, including maternal depressive symptoms and mother-child interaction assessed by the Emotional Availability Scales (EA). As hypothesized, in dyadic interaction maternal hostility decreased significantly in the PGT group, and intrusiveness decreased in both intervention groups, but especially in the PTG group. However, both interventions showed a general improvement in the quality of mother-infant interaction. They also succeeded in sustaining high maternal abstinence, treatment retention, and alleviating depressive symptoms. The findings are discussed in relation to preventing negative transgenerational interaction patterns in the high-risk dyads.

Both negative and idealized maternal prenatal representations may constitute a risk for mother–infant interaction. This study analyzed the role of maternal prenatal representations and pre- to postnatal representational change in predicting mother–infant emotional availability (EA) among 51 drug-abusing mothers and their infants who participated in either psychodynamic group therapy (PGT) or received psychosocial support (PSS) and among 50 nonusing comparison dyads. Maternal representations of her child, the child's father, her own mother, self-as-mother, and self-as-woman were measured during pregnancy and at 4 and 12 months' postpartum with the Interview of Maternal Representations (M. Ammaniti et al., 1992; M. Ammaniti, R. Tambelli, & P. Perucchini, 1998). EA was measured with the Emotional Availability Scales, fourth edition (Z. Biringen, 2008) at 4 and 12 months. The results showed that drug-abusing mothers had more negative prenatal representations of the self-as-woman and of the child's father. Postnatally, PSS mothers tended to first idealize their child, but later to experience disillusionment of idealization. Both negative and idealized prenatal representations of the self-as-mother predicted mother–infant EA problems, but only among the PGT mothers. For all mothers, negative representational change was detrimental for the mother–infant EA whereas for drug-abusing mothers, also increasing idealization from the prenatal period to the postnatal period was harmful. Clinicians working with drug-abusing mothers should aim at supporting the development of a realistically positive view of motherhood. Tanto las negativas como las idealizadas representaciones maternales prenatales pudieran constituir un riesgo para la interaccion entre madre e infante. Este estudio analizo el papel de las representaciones maternales prenatales y del cambio representacional pre y postnatal en la prediccion de la disponibilidad emocional entre madre e infante (EA) entre 51 madres que habian abusado de drogas y sus infantes, todos los cuales participaron en una terapia de grupo sicodinamica, PGT, o recibieron apoyo sicosocial, PSS, y entre 50 diadas de madres-infantes donde no se habia dado el uso de drogas, como grupo de comparacion. Las representaciones maternales de su nino, del padre del nino, de la propia madre, ella como madre y ella como mujer, fueron medidas durante el embarazo y a los 4 y 12 meses con posterioridad al parto usando IRMAG. La disponibilidad emocional (EA) fue medida por medio de las Escalas de la Disponibilidad Emocional (4a edicion) a los 4 y 12 meses. Los resultados muestran que las madres que habian abusado de drogas tenian mas representaciones negativas prenatales de ellas como mujeres y del padre del nino. Postnatalmente, las madres PSS tendian a idealizar primero al nino, pero mas tarde a experimentar desilusion en cuanto a la idealizacion. Tanto las representaciones prenatales negativas como las idealizadas de ellas como madres predijeron los problemas de disponibilidad emocional (EA) entre madre e infante, lo cual no ocurrio entre las madres PGT. Para todas las madres, el cambio representacional negativo fue perjudicial para la disponibilidad emocional (EA) de madres e infantes, mientras que para las madres que habian abusado de drogas, tambien el aumento de la idealizacion del periodo prenatal al postnatal fue danino. Los clinicos que trabajan con madres que han abusado de drogas deben tener como meta el apoyo del desarrollo de una imagen de la maternidad realisticamente positiva. Les representations prenatales maternelles a la fois negatives et idealisees peuvent constituer un risque pour l'interaction mere-nourrisson. Cette etude a analyse le role des representations maternelles prenatales et le changement representationnel pre- a postnatal en predisant la disponibilite emotionnelle chez 51 meres toxicomanes et leurs nourrissons qui ont participe soit a un groupe psycho-dynamique de therapie, abrege ici PGT en suivant l'anglais, ou ont recu un soutien psychosocial, abrege PSS en anglais, et chez 50 dyades non toxicomanes de comparaison. Les representations maternelles de l'enfant, du pere de l'enfant, de sa propre mere, de soi-meme en tant que mere et de soi-meme en tant que femme ont ete mesurees durant la grossesse et a 4 et 12 mois postpartum avec l'Interview pour les Representations Maternelles pendant la Grossesse (IRMAG). La disponibilite emotionnelle a ete mesuree avec les Echelles de Disponibilite Emotionnelle (4eme edition) a 4 et 12 mois. Les resultats ont montre que les meres toxicomanes avaient plus de representations prenatales negatives d'elles-memes en tant que femme et du pere de l'enfant. Post-natalement, les meres ayant recu un soutien psychosocial avaient tendance a d'abord idealiser leur enfant, puis plus tard a faire l'experience de desillusion de l'idealisation. Les representations prenatales a la fois negatives et idealisees de soi-meme en tant que mere etait un facteur de prediction de problemes de disponibilite emotionnelle, mais uniquement chez les meres PGT. Pour toutes les meres, le changement representationnel negatif s'est avere nuisible a la disponibilite emotionnelle mere-nourrisson, alors que pour les meres toxicomanes, l'augmentation de l'idealisation de la periode prenatale a la periode postnatale etait aussi nuisible. Les cliniciens travaillant avec des meres toxicomanes devraient se donner pour but de soutenir le developpement d'une perception positive et realiste de la maternite. Sowohl negative als auch idealisierte mutterliche pranatale Reprasentationen konnen ein Risiko fur die Mutter-Kind Interaktion darstellen. Diese Studie analysierte die Rolle der mutterlichen pranatalen Reprasentationen und pra- zu postnataler Veranderung der Reprasentationen als Pradiktoren fur die Mutter-Sauglings Emotional Availability (EA) unter 51 drogenmissbrauchenden Muttern und ihren Sauglingen, die an einer Psychodynamischen Gruppentherapie, PGT, teilnahmen, oder psychosozieale Unterstutzung erhielten, PSS, sowie unter 50 nicht-missbrauchenden Vergleichsdyaden. Die mutterliche Reprasentation ihres Kindes, des, des Kindesvaters, der eigenen Mutter, und des Selbst-als-Mutter und Selbst-als-Frau wurden wahrend der Schangerschaft und 4 und 12 Monate nach der Geburt anhand des IRMAG gemessen. EA wurde mittels der Emotional Availability Scales (4th edition) zu 4 und 12 Monaten erfasst. Die Ergebnisse zeigten, dass negative pranatale Reprasentationen des Selbst-als-Frau und des Kindesvaters in drogenmissbrauchenden Mutter starker ausgepragt waren. Postnatal neigten PSS Mutter dazu zunachst ihr Kind zu idealisieren, erfuhren jedoch spater eine Desillusionierung der Idealisierung. Sowohl negative und idealisierte pranatale Reprasentationen des Selbst-als-Mutter sagten Probleme in der Mutter-Kind EA vorher, allerdings nur unter PGT Muttern. Fur alle Mutter war eine negative Veranderung der Reprasentationen schadlich fur die Mutter-Kind EA, wohingegen fur drogenmissbrauchende Muttern, auch eine Zunahme der Idealisierung von der pra- zur postnatalen Phase sich negativ auswirkte. Kliniker, die mit drogenmissbrauchenden Muttern zusammenarbeiten sollten die Forderung einer realistisch positiven Sicht des Mutterdaseins anstreben.

According to family systems theory, families consist of hierarchically ordered parts, from basic dyadic relations to marital and parental subsystems (Minuchin, 1985). In the transition to parenthood, family relationships change as the family system adapts to the new situation. Thechanges,suchasimprovementsanddeclines in relationship quality, are different and unique, depending on how emotions and responsibili- ties are shared in the family. For instance, fam- ilies with well-functioning relationships during pregnancy tend also to fare well in the postpar- tum period, whereas families with problematic relationships often experience further decline in their relationship quality across the tran- sition (Doss, Rhoades, Stanley, & Markman, 2009).Two basic dimensions, autonomy and inti- macy, define different family systems and typical relationship patterns. Autonomy refers to individuality and a sense of agency in rela- tions with others, reflecting family boundaries, whereas intimacy refers to sharing or withhold- ing emotions (Kagitcibasi, 2005; Olson, 2000). Well-functioning family systems are high and balanced on both dimensions, whereas a lack of one or both indicates potential problems (Sturge-Apple, Davies, & Cummings, 2010). Despite understanding families as dynamic systems changing over time, earlier researchers have mainly focused on separate aspects of marital and parenting quality. Our aim was there- fore to identify naturally occurring, dynamic family system types during the transition to parenthood and to examine their contextual predictors.Family System Types and Their Longitudinal ChangeThe typological approach depicts families as holistic systems that can be classified according to their unique patterns in relational dimensions (Mandara, 2003). Research suggests that there are at least four family types varying in levels of autonomy and intimacy (e.g., Baumrind, 1971; Minuchin, 1985; Sturge-Apple et al., 2010). The first type, Cohesive families, have an optimal balance between autonomy and intimacy, allow- ing members to maintain sufficient individuality but also to receive emotional support from each other (Stevenson-Hinde, 1990). They are characterized by high emotional warmth and absence of discord (Davies, Cummings, & Win- ter, 2004; Sturge-Apple et al., 2010). Second, Disengaged families lack both autonomy and intimacy, resulting in negative and poorly orga- nized family interactions (Stevenson-Hinde, 1990). They are characterized by poor overall interpersonal functioning, withdrawal between spouses, and low parental acceptance of the child (Davies et al., 2004; V. K. Johnson, 2003). The third type, Enmeshed families, lack autonomy between family members but have moderate to high levels of intimacy, often resulting in boundary disturbances and depen- dency (Kerig, 2005). They are characterized by hostility between spouses and intrusive parental control, but at least moderate levels of parental intimacy (Davies et al., 2004; Sturge-Apple et al., 2010). Fourth and finally, Authoritarian families have relatively low intimacy but high levels of autonomy, suggesting rigid bound- aries between family members (Kerig, 2005; Olson, 2000). In these families obedience typically overrides affective sharing (Jory, Xia, Freeborn, & Greer, 1997; Kagitcibasi, 2005).Despite the central assumption of families as dynamic systems that are prone to qualitative shifts in new situations (Cox & Paley, 2003; Mandara, 2003), only two studies have empir- ically examined longitudinal changes in holis- tic family systems. Favez et al. (2012) identi- fied longitudinal family trajectories based on the overall quality of triadic interactions among primiparous couples from the prenatal period to child's ages of 3, 9, and 18 months. Pre- natal interactions with the baby were simu- lated using a baby doll. Such prenatal interac- tions reflect both parental representations and direct experiences of the baby (achieved, i. …

Objective To determine how infertility and subsequent assisted reproductive treatment (ART) affect a woman's childbirth experience. Design Prospective multicenter case-control study. Setting We recruited women pregnant with a singleton fetus after either ART (n = 324) or spontaneous conception (n = 304) from five infertility clinics and one university maternity clinic in Finland. Methods We studied their childbirth experience with the Delivery Satisfaction Scale. We compared how psychosocial and obstetric factors affected satisfaction and dissatisfaction with childbirth between and within the ART and the control group. Logistic regression was then used to analyse the most important contributors to the experienced dissatisfaction. Results Dissatisfaction with childbirth was as common in the ART group (11%) as in the control (10%) group. In the ART group, the women's education level, cesarean section (CS) and their partner's absence from the delivery were associated with dissatisfaction. In the control group, significant factors for dissatisfaction were nulliparity, severe pregnancy-related anxiety, emergency CS, recalled intense pain and the partner's absence from the delivery. According to adjusted logistic regression analysis of the whole sample, the independent risk factors were elective CS [odds ratio (OR) 5.7; 95% confidence interval (CI) 2.2–14.1] and emergency CS (OR 2.9; 95% CI 1.3–6.5), recalled intense pain (OR 6.8; 95% CI 3.3–16.2) and the partner's absence from the delivery (OR 2.7; 95% CI 1.1–7.3). Conclusion ART is not a risk factor for dissatisfaction with childbirth by itself. However, the contributors to an unsatisfactory childbirth differ partly between women conceiving with ART and those conceiving spontaneously.

Parent-child relationship is created already in prenatal fantasies and expectations of the child-to-be. Negative violation of these expectations after the child is born is known to be harmful for the parent-child relationship. Yet, research is scarce about the medical and psychological factors contributing to violated expectations (VE). This study models the role of parent-, delivery- and infant-related underlying mechanisms for VE. It further compares parents with assisted reproductive treatment (ART) and spontaneous conception (SC), and primi- and multiparous couples. The couples (n = 743) separately filled in questionnaires concerning their prenatal expectations (T1) and 2 months postnatal representations (T2) of intimacy and autonomy in the relationship with their child, measured with Subjective Family Picture Test. A negative or positive discrepancy indicated violated expectations. The parent-related (mental health and marital quality), delivery-related (maternal and paternal birth experience, unplanned Caesarean, and amount of analgesia) and infant-related (infant health problems, difficult infant characteristics, and parental worry) factors were assessed at T2. Results show that among mothers, the associations were mostly indirect and mediated via mental health problems. Among fathers, the associations were direct, marital problems most crucially predicting VE. ART fathers were less susceptible to VE resulting from infant-related problems than SC fathers, but more susceptible to VE resulting from delivery problems. Delivery- and infant-related factors also predicted VE differently among primi- and multiparous mothers. Considering factors that contribute to VE is important when working with couples in transition to parenthood.

We studied how attachment representations contribute to central components of transition to motherhood, prenatal emotion processing (EP) and emotional availability (EA) of mother-infant interaction, and whether there are group specific differences. Participants were 51 treatment-enrolled substance-abusing (SA) mothers and their infants and 50 non-using comparison dyads with obstetric risk. Mother's attachment representations (AAI) and EP were assessed prenatally and EA when infants were four months. Results showed that autonomous attachment only had a buffering effect on prenatal EP among comparisons. All SA mothers showed more dysfunctional EP than comparisons and, contrary to comparisons, autonomous SA mothers reported more negative cognitive appraisals and less meta-evaluation of emotions than dismissing SA mothers. Preoccupied SA mothers showed high negative cognitive appraisals, suggesting under-regulation of emotions. Attachment representations were not associated with EA in either group; rather, SA status contributed to global risk in the relationship. Surprisingly, autonomous SA mothers showed a tendency towards intrusiveness. We propose that obstetric risk among comparisons and adverse relational experiences among almost all SA mothers might override the protective role of mother's autonomous representations for dyadic interaction. We conclude that prenatal emotional turbulence and high interaction risk of all SA mothers calls for holistic treatment for the dyad.

Early family relationships have been suggested to influence the development of children’s affect regulation, involving both emotion regulation and defense mechanisms. However, we lack research on the specific family predictors for these two forms of affect regulation, which have been conceptualized to differ in their functions and accessibility to consciousness. Accordingly, we examine how the (a) quality and (b) timing of family relationships during infancy predict child’s later emotion regulation and defense mechanisms. Parents ( N = 703) reported autonomy and intimacy in marital and parenting relationships at the child’s ages of 2 and 12 months, and the child’s use of emotion regulation and immature and neurotic defenses at 7 to 8 years. As hypothesized, the results showed that functional early family relationships predicted children’s efficient emotion regulation, whereas dysfunctional relationships predicted reliance on defense mechanisms in middle childhood. Further, results showed a timing effect for neurotic defenses, partially confirming our hypothesis of early infancy being an especially important period for the development of defense mechanisms. The findings are discussed from the viewpoints of attachment and family dynamics, emotional self-awareness, and sense of security.

Some mothers who have recently lost a significant attachment figure may become mentally incoherent and sporadically even enter a trancelike, dissociative state. Such states of mind have been shown to predict infant attachment disorganization. Infants born close to the time of a parental loss are at a greater risk for intergenerational trauma. A background of maternal substance abuse is also known to increase such risk. We illustrate by way of a case study how a mother–infant group psychotherapy programme aimed at substance-abusing mothers may help to prevent the transmission of mother’s unresolved trauma to the infant. Another goal was to discuss how attachment-derived methods (namely, Adult Attachment Interview, Strange Situation Procedure and the Emotional Availability Scales) may aid in understanding the effects of the intervention.

Pregnancy and early motherhood involve uncertainty and change, which can evoke mental health problems. We identified maternal mental health trajectories in pre- and postnatal period, and examined their association with later child mental health and development. Finnish mothers reported psychological distress (General Health Questionnaire [GHQ-36]) and depressive (Beck Depression Inventory [BDI-13]) symptoms in pregnancy (T1; N = 788) and two months (T2; N = 657) and 12 months (T3; N = 545) postpartum. Both parents accounted their child’s mental health (Behavior Assessment System for Children [BASC]) and social (Social Skills Rating System [SSRS], Child Behavior Scale [CBS]) and cognitive development (Five to Fifteen [FTF]) when the child was 7–8 years old (T4; N = 485). We identified five trajectories depicting unique timing and course of maternal mental health from pregnancy into 1 year of mothering: Stable low levels of mental health symptoms (75%) and prenatal (6%), early postpartum (9%) and late postpartum (6%) mental health problems. The fifth trajectory, heterogeneous high levels of mental health problems (4%) was an unclassified post hoc class, combining mothers with chronic high or highly variable mental health profiles. Results show some trajectory-related timing effects on children’s mental health and cognitive development. The trajectories of early postpartum and heterogeneous high levels of mental health problems predicted higher level of internalizing symptoms as compared to stable low-levels trajectory. The heterogeneous high-levels trajectory predicted higher levels of problems in executive functions than the stable low and late postpartum trajectories, and in memory tasks than children in other trajectories. We discuss the timing and course of maternal mental health from the viewpoint of infant and child development.

Prenatal expectations are important for the future parent-child relationship. The authors examined how maternal and paternal prenatal expectations of the relationship with the child predicted 1st-year parenting stress and whether these expectations were violated over the transition to parenthood. They further examined how former infertility affected these associations. The participants were 745 Finnish couples, 367 having undergone a successful assisted reproductive treatment and 378 conceiving spontaneously. Couples completed a questionnaire of family representations during pregnancy and when the child was 2 and 12 months old and Abidin's Parenting Stress Index at 2 and 12 months postpartum. The hypothesis of moderately high expectations predicting the lowest level of parenting stress was substantiated only concerning paternal expectations of own autonomy with the child. Generally, however, negative expectations of own and spouse's relationship with the child were linearly associated with higher parenting stress. Postnatal representations were more positive or equal to expectations, except for negative violation occurring in maternal expectation of the father-child relationship, especially among normative mothers. The results are discussed in relation to family dynamic considerations and special features of formerly infertile couples.

Maternal mental health and the contents of her representational world are important determinants of early parent‐child relationship. We examined, first, the role of prenatal and postnatal depressive symptoms and maternal attachment style in predicting the quality of mother‐child interaction. Second, we analysed whether the secure-autonomous attachment style can protect the dyadic interaction from the negative effects of maternal depression. The participants were 59 mother‐infant pairs examined during pregnancy (T1), 4‐5 months postpartum (T2) and when the children were approximately 14 months old (T3). Maternal attachment style was assessed with a modified Adult Attachment Interview -procedure, depressive symptoms with Edinburgh Postnatal Depression Scale, and observed mother‐child interaction with Care Index. The results show that autonomous mothers were more sensitive and responsive and their children more cooperative than dyads with dismissing maternal attachment style. As hypothesized, mothers with the combination of both prenatal and postpartum depressive symptoms were highly unresponsive in their dyadic interaction. Further, prenatal depressive symptoms had a stronger impact on maternal unresponsiveness than postnatal symptoms. As hypothesized, mother’s autonomous attachment style protected the mother‐child interaction from the negative impact of maternal postnatal depressive symptoms, whereas dyads with preoccupied mothers were especially at risk for interaction problems when mothers had postpartum depressive symptoms. Copyright r 2010 John Wiley & Sons, Ltd.