Mothers' and their children's emotional and behavioral symptom trajectories and subsequent maternal adjustment: Twenty-seven years of motherhood.

BACKGROUND: This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems). METHODS: The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4-5, 8-9, 16-17, and 26-27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4-5, 8-9, and 16-17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26-27 years after the birth of the first child. Complete follow-up data were available for 168 mothers. RESULTS: We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning. LIMITATIONS: Maternal and child measures were based on maternal reports only. CONCLUSIONS: The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children.

Associations between social anxiety, physiological reactivity, and speech disfluencies in autistic young adults and controls.

INTRODUCTION: The aim of this study was to examine possible associations of social anxiety (SA) and speaking-related physiological reactivity with the frequencies of a) total disfluencies, b) typical disfluencies, and c) stuttering-like disfluencies, as well as d) stuttering-severity in autistic young adults and controls. METHODS: Thirty-two autistic young adults and 35 controls participated in this study. Participants were presented with video clips (viewing condition) and were then asked to talk about the videos (narrating condition). SA was measured by the self-report Social Phobia and Anxiety Inventory (SPAI). Speaking-related physiological reactivity was measured by the electrodermal activity (EDA), an index of emotional arousal. The speech samples from the narrating condition were analyzed for type and frequency of speech disfluencies and used for determining the stuttering severity. SA and speaking-related physiological reactivity were compared between the groups. Correlation between SA, physiological reactivity, disfluency frequencies, and stuttering severity were tested separately for both groups. RESULTS: No between-group differences were found in the overall SA, yet differences were found in SPAI subscales of social interaction, group interaction, and avoidance, as well as in agoraphobia. Both groups had higher physiological arousal in narrating condition in comparison to the video viewing condition, yet there was no between-group difference in the reactivity. No associations were found between SPAI measures, physiological reactivity, disfluency frequencies, and stuttering severity in the autistic group. In the control group, a negative association was found between physiological reactivity and total and typical disfluency frequencies. CONCLUSIONS: SA or speaking-related physiological reactivity were not associated with disfluency frequencies or stuttering severity in autistic persons. Negative association between physiological reactivity and disfluency frequencies found in the control group may indicate that the physiological arousal may impact the speech production process by reducing the overt disfluencies.

Factor analysis of the autism spectrum screening questionnaire in a population-based child sample.

PURPOSE: The aim of this study was to investigate several possible factor structures of the Autism Spectrum Screening Questionnaire (ASSQ). MATERIALS AND METHODS: We used the 27-item screening tool for school-aged children in a general population of 8-year-old children (n = 3,538) and compared the occurring solutions to previously published factor models. RESULTS: A one-factor solution and a four-factor solution were identified in Exploratory Factor Analysis (EFA) and confirmed with Confirmatory Factor Analysis (CFA), while two-, three-, five- and six-factor solutions were rejected. In CFA, our four-factor solution showed the best goodness-of-fit indexes when compared with factor models previously presented by Posserud et al. and Ehlers et al. CONCLUSIONS: The results indicate a strong underlying connection between all ASSQ items which is elicited by the one-factor solution. Although as a screening tool, ASSQ is functioning with the unifactorial solution, the four factors can help to identify certain clusters of autism spectrum traits.

Maternal and infant characteristics connected to shared pleasure in dyadic interaction.

The aim of the study was to analyze which maternal factors (depressive symptoms, effect of life events, maternal sensitivity and structuring) and infant characteristics (temperament, social withdrawal symptoms, interactive behavior, genotype, gender) contribute to shared pleasure (SP) in parent-infant interaction. Participants were 113 mother-infant dyads. The mothers filled in the Edinburgh Postnatal Depression Scale, the Infant Behavior Questionnaire, and the Life Events Questionnaire. The dyads were videotaped in a free-play situation, and the videos were analyzed using the Alarm Distress Baby Scale and the Emotional Availability Scales. The infants were genotyped for four genes involved in emotion regulation. The occurrence and duration of SP (SP-MD) in mother-infant interactions were analyzed from the videotapes. Higher maternal sensitivity and depressive symptoms, better infant responsiveness, and the infant having the GG variant of the gene tryptophan hydroxylase isoform 2 (TPH2) -307 were associated with the occurrence of SP. Lower level depressive symptoms, better maternal structuring, and greater infant involvement were associated with the longer duration of SP. Those dyads where the mother and infant were best able to read each other's positive cues and to respond to them were more likely to experience mutual positive affect, as seen in SP.

El propósito de este estudio fue analizar cuáles factores maternos (síntomas depresivos, efectos de eventos vividos, sensibilidad y estructuración maternas) y características del infante (temperamento, síntomas de despego social, comportamiento interactivo, genotipo, género sexual) contribuyen al placer compartido (SP) en la interacción progenitor-infante. En el estudio participaron 113 díadas madre-infante. Las madres completaron la Escala de Depresión Postnatal de Edimburgo, el Cuestionario de Comportamiento del Infante y el Cuestionario de Eventos de Vida. A las díadas se les grabó en video durante una sesión de juego libre y los videos se analizaron usando la Escala de Alarma de la Angustia del Bebé y las Escalas de Disponibilidad Emocional. A los infantes se les determinó el genotipo en el caso de cuatro genes que tienen que ver con la regulación emocional. Con base en las videograbaciones, se analizó la incidencia y duración de SP (SP-MD) en las interacciones madre-infante. Una más alta sensibilidad materna y síntomas depresivos, mejor sensibilidad por parte del infante, y el hecho de que el infante tenía la variante GG del gen TPH2 -307 se asociaron con la incidencia de SP. Síntomas depresivos de bajo nivel, una mejor estructuración materna y una mayor participación del infante se asociaron con una más larga duración de SP. Aquellas díadas en que la madre y el infante eran más capaces de comprender las señales positivas de cada uno y de responder a las mismas, estaban en mejor condición de experimentar un mutuo afecto positivo, como el que se ve en SP.

Le but de cette étude était d'analyser quels facteurs maternels (symptômes dépressifs, effet d'événements de la vie, sensibilité maternelle et structuration maternelle) et quelles caractéristiques du nourrisson (tempérament, symptômes de retrait social, comportement interactif, génotype, genre) contribuent au plaisir partagé (abrégé ici en français PP) dans l'interaction parent-nourrisson. Les participants ont consisté en 113 dyades mère-nourrisson. Les mères ont rempli l'Echelle de Dépression Postnatale d'Edinbourg, le Questionnaire du Comportement du Nourrisson, et le Questionnaire d'Evénements de la Vie. Les dyades ont été filmées à la vidéo pendant une situation de jeu libre et les vidéos ont été analysées en utilisant l'Echelle d'Alarme de Détresse du Bébé et les Echelles de Disponibilité Emotionnelle. Les nourrissons ont été génotypés pour quatre gènes impliqués dans la régulation de l'émotion. L'apparition et la durée du PP (en anglais SP-MD) dans les interactions mère-nourrisson ont été analysées à partir des vidéos. Une sensibilité maternelle plus élevée et des symptômes dépressifs, une meilleure réaction du nourrisson, le nourrisson ayant la variante GG du gène TPH2 -307 étaient liés à l'apparition du PP. Des niveaux plus bas de symptômes dépressifs, une meilleure structuration maternelle et un engagement plus important du nourrisson étaient liés à une durée plus longue du PP. Les dyades où la mère et le nourrisson étaient le plus capables de lire leurs signaux positifs réciproques et d'y répondre étaient moins à même de faire l'expérience d'une affect positif mutuel, comme on le voit dans le PP.

Shared pleasure in early mother-infant interaction: predicting lower levels of emotional and behavioral problems in the child and protecting against the influence of parental psychopathology.

Shared pleasure (SP) was analyzed in fifty-eight 2-month-old infants and their mothers in face-to-face interaction (T1, at 2 months). The association of SP with child's emotional and behavioral outcome at 2 years (T2) was examined. SP as a possible protecting factor in the presence of parental psychopathology also was studied. Mean duration of SP moments (SP-MD) was related to subsequent socioemotional outcome of the child: Infants of dyads with longer SP-MD showed fewer internalizing and externalizing problems 2 years later. In hierarchical linear regressions, SP-MD uniquely and significantly contributed to internalizing problems after adjusting for infant and maternal factors and mother's interactive behavior. SP protected the child against the influence of parental psychopathology. Father's mental health problems during the follow-up increased the child's risk for higher externalizing and internalizing problems, but only among children with short SP-MD at T1. Internalizing symptoms at T2 increased when moving from the category "no mental health problems" to "mental health problems in one parent" and further to "mental health problems in both parents," but this increase was found only among those with short SP-MD at T1. SP in parent-child interaction is an important feature that fosters positive psychological development and moderates the health effects of other risks such as parental psychopathology.

[Child psychiatric viewpoint towards early childhood feading disorders]. / Miksi pienokaiseni ei syö?--Lastenpsykiatrinen näkökulma varhaislapsuuden syömishäiriöihin.

Early childhood feading disorders are estimated to occur in 20% to 40% of normally developing young children. In most severe cases, troubles associated with feading interfere with the child's growth and development and may continue until adulthood. Early childhood feading disorders are discernible into different types of disorder, such as early childhood anorexia, sensory food aversion and posttraumatic feading disorder. Early childhood feading disorders are often associated with problems in parent-child interaction either primarily or secondarily as factors maintaining the disorder. Interactive therapy is often beneficial regardless of the etiology of the disorder.

Fathers' postnatal depressive and anxiety symptoms: an exploration of links with paternal, maternal, infant and family factors.

BACKGROUND: Postnatal psychological symptoms have been studied less often in fathers than in mothers. However, recent research shows that fathers' psychopathology may have long-term effects on their children's emotional and behavioural development independently of maternal psychopathology. More research is needed on factors associated with paternal symptoms at the early stage of child development. AIMS: The aim of the study was to examine the paternal, maternal, infant and family factors associated with the occurrence of depressive and anxiety symptoms in fathers of infants. METHODS: As part of a study conducted in Tampere, Finland, on infants' social withdrawal symptoms, both parents of 4-, 8- and 18-month-old infants (n = 194) completed the Edinburgh Postnatal Depression Scale (EPDS) and general information questionnaires during routine check-ups of the infants in well-baby clinics. Parental depressive and anxiety symptoms were screened using the recommended cut-off points for this purpose (5/6 for fathers and 7/8 for mothers on the EPDS). The associations between the fathers' symptoms and paternal, maternal, infant and family factors were explored. RESULTS: Twenty-one per cent of the fathers and 24% of the mothers scored above the cut-off points for depressive and anxiety symptoms on the EPDS. Both paternal and maternal factors predicted high paternal symptom level in regression models. Infant factors were not statistically significantly associated with paternal symptoms. CONCLUSIONS: Father's psychological symptoms were associated with many facets of both parents' impaired well-being. The whole family system should be considered whenever there are concerns about either parent's psychological well-being.

Predicting internalizing and externalizing problems at five years by child and parental factors in infancy and toddlerhood.

This study examined child and parental factors in infancy and toddlerhood predicting subclinical or clinical levels of internalizing and externalizing problems at 5 years of age. Ninety-six children and their families participated. They were assessed when the children were 4-10 weeks old (T1), 2 years (T2) and 5 years old (T3). Child risks (difficult temperament, health problems, early emotional and behavioral problems), parental risks (psychopathology, parenting stress and perception of the child) and family risks (socio-economic status, quality of marital relationship and family violence) were examined. At 5 years, internalizing problems were predicted by family violence during the child's infancy and parenting stress at age 2. Externalizing problems were predicted by psychiatric problems of the mother before pregnancy and child's externalizing problems at 2 years of age. When interventions aiming at preventing emotional and behavioral problems in children are considered, these issues should be recognized early and effective intervention initiated.

Serotonin and early cognitive development: variation in the tryptophan hydroxylase 2 gene is associated with visual attention in 7-month-old infants.

BACKGROUND: Allelic variation in the promoter region of a gene that encodes tryptophan hydroxylase isoform 2 (TPH2), a rate-limiting enzyme of serotonin synthesis in the central nervous system, has been associated with variations in cognitive function and vulnerability to affective spectrum disorders. Little is known about the effects of this gene variant on cognition during development and about possible intermediate developmental steps that lead to the adult phenotype. Here, we examined the hypothesis that the TPH2 -703 may act during early stages of development and bias the acquisition of elementary cognitive processes involved in attention and emotion regulation. METHODS: Seven-month-old infants (n = 66) were genotyped for the TPH2 -703 G/T polymorphism (rs4570625) and tested for the efficiency of attention shifts from a stimulus at fixation to a new stimulus in the visual periphery. RESULTS: Compared to TPH2 G/G homozygotes, infants with the T-carrier genotype exhibited a significantly higher number of missing attention shifts. This genotype effect tended to be particularly pronounced when infants had to disengage from an affectively salient stimulus before shifting attention to the peripheral stimulus. The results also showed that TPH2 genotype was indirectly associated, via its effect on attention disengagement, with temperamental emotion regulation (soothability). CONCLUSIONS: Together, these results implicate serotonin system genes in early cognitive development and suggest variations in the early-emerging cognitive capacities as a potential developmental precursor of individual differences in emotion regulation and vulnerability to affective disorders.

Infants' social withdrawal symptoms assessed with a direct infant observation method in primary health care.

Distressed infants may withdraw from social interaction, but recognising infants' social withdrawal is difficult. The aims of the study were to see whether an infant observation method can be reliably used by front line workers, and to examine the prevalence of infants' social withdrawal symptoms. A random sample of 363 families with four, eight or 18-month-old infants participated in the study. The infants were examined by general practitioners (GPs) in well-baby clinics with the Alarm Distress BaBy Scale (ADBB), an observation method developed for clinical settings. A score of five or more on the ADBB Scale in two subsequent assessments at a two-week interval was regarded as a sign of clinically significant infant social withdrawal. Kappas were calculated for the GPs' correct rating of withdrawn/not withdrawn against a set of videotapes rated by developer of the method, Professor Guedeney and his research group. The kappas for their ratings ranged from 0.5 to 1. The frequency of infants scoring above the cut off in two subsequent assessments was 3%. The ADBB Scale is a promising method for detecting infant social withdrawal in front line services. Three percents of infants were showing sustained social withdrawal as a sign of distress in this normal population sample.

Infants' social withdrawal and parents' mental health.

This study examined the association of infants' sustained social withdrawal with parents' self-reported current depressive symptoms and perceived mental health. Two hundred and sixty infants aged 4, 8 and 18 months were examined with the Baby Alarm Distress Scale (ADBB). Parents' depressive symptoms and perceived mental health during the preceding year were elicited through questionnaires. Mother's current depressive symptoms and father's perceived moderate or poor mental health during the preceding year both independently increased the infant's risk of withdrawal. When both parents had mental health problems, the infant was more likely to be withdrawn. Infant's social withdrawal should alert clinicians to examine parental mental health. Also, if the parent has mental health problems, the infant's social behavior and possible withdrawal should be examined. Families where both parents experience poor mental health should be identified, and treated, while the infants of these families in particular seem to be at risk for social withdrawal.

Detecting infants in need: Are complicated measures really necessary?

The object of this paper was to study how the Baby Alarm Distress Scale (ADBB), developed as a simple screening tool for front line professionals working with infants, correlates with the more detailed assessment method of the Global Rating Scale (GRS) for Mother-Infant Interaction at two and four months. A sample of 127 eight- to eleven-week-old infants was videotaped in free interaction with their mothers, and infant interaction behavior was rated with both methods by independent researchers. Compared to the GRS infant scales the sensitivity of the ADBB, using the recommended cutoff point of 5 or more, was 0.77 and specificity 0.80. In further analyses it was found that deviant ratings of two items of the ADBB, the quality of eye contact between the infant and the caregiver and assessment of the sense of relationship between the infant and the caregiver, were the items most strongly associated with poor interaction skills of the infant on the GRS. Mothers of infants found deviant in the ADBB performed more poorly in the interaction with their infants when compared to mothers of infants found healthy in the ADBB. For the purpose of detecting deviations in infant interaction skills as signs of possible problems in early parent-infant interaction the ADBB seems to be a sufficiently sensitive and specific instrument. However, the results of this study still need to be tested with larger samples and against other observation methods.

Mother's early perception of her infant's difficult temperament, parenting stress and early mother-infant interaction.

The current study investigated factors contributing to mother's early perception of her infant's difficult temperament. One hundred and twenty-four mother-infant dyads participated in the study. Mother's perception of the infant's temperament was assessed with the Infant Characteristics Questionnaire (ICQ). The influence of mother-infant interaction, mother's mental health and parenting stress were investigated. Mother-infant interaction was videotaped during a face-to-face interaction and analysed using the Global Rating Scale. Mother's mental health was assessed through a structured interview (Structured Clinical Interview for DSM-IV, SCID) and parenting stress was examined by a questionnaire (Parenting Stress Index). First, the difficulty scale of the ICQ was used as a continuous variable and factors contributing to mother's perception of her infant's temperament as more or less difficult were examined. Secondly, infants were categorized into difficult and non-difficult, and factors increasing the infant's risk of being perceived as difficult were examined. The model including mother's mental health and parental distress accounted for 24% of the variance in perceived infant difficulty, with parental distress in particular being an influential contributor. When infants categorized as difficult were examined, mother's intrusiveness and infant's poor interactive behaviour in early mother-infant interaction as well as parental distress significantly increased the infant's risk of being perceived as difficult.

A longitudinal study of maternal depressive symptoms, negative expectations and perceptions of child problems.

The aim of this longitudinal study was to examine the associations between maternal depressive symptoms and perceptions of children's problems. One hundred and nineteen mother-child dyads were followed from the third trimester of pregnancy for almost 10 years. Depressive symptoms and background factors of the mothers and the anticipated/perceived problems of their firstborn were assessed prenatally, postnatally, and when the child was 4-5 years and 8-9 years old. The simultaneous and long-term associations between maternal depressive symptoms and child's problems were examined. Maternal prenatal depressive symptoms, the continuity of negative expectations to postnatal problem perceptions, and high problem level at 4-5 years of child's age predicted high problem level in 8-9-year-olds.