Adverse Childhood Experiences: Associations with a Blunted Cortisol Stress Response During Pregnancy.

INTRODUCTION: Adverse Childhood Experiences (ACEs) are associated with a range of negative physical and mental health outcomes, yet there is limited research focused on the effect of ACEs on stress responses during pregnancy. Expectant mothers experience an increase in cortisol levels as pregnancy progresses, with this increase having important implications for fetal and early infant development. Little is known about the impact of ACEs on maternal cortisol levels. This study explored the relationship between maternal ACEs and cortisol response among expectant mothers nearing or in the third trimester of pregnancy. METHODS: 39 expectant mothers were exposed to a Baby Cry Protocol via an infant simulator, with salivary cortisol collected at five points in time (N = 181). Stepwise, multilevel model creation resulted in a random intercept and random slope model with an interaction term for total number of ACEs and week of pregnancy. RESULTS: The repeated measures data showed that cortisol levels decreased across collection times, from arrival at the lab, through the Baby Cry Protocol, to recovery. Predictive margins for the interaction term showed that while exposure to a greater number of ACEs was associated with higher cortisol levels early in the third trimester, the expected increase in cortisol late in pregnancy was blunted for expectant mothers who were exposed to a greater number of ACEs. DISCUSSION: These findings findings suggest the importance of ACEs screening and intervention efforts as part of prenatal care.

From the voices of supervisees: A theoretical model of reflective supervision (Part II).

Empirical study of reflective supervision/consultation (RS/C) has been gaining ground over the past decade. However, much of this literature is focused on the supervisor perspective of what RS/C is, what makes it effective, and how it impacts the work of the supervisee. This paper, Part II of a two-part series, presents a theoretical model of RS/C that was developed from the perspectives and experiences of supervisees who work with infants, young children, and families and participate in either group or individual RS/C. This qualitative study built upon themes that emerged from data obtained from 50 IECMH professionals in the United States who participated in focus groups or individual interviews aimed at investigating their experiences of RS/C. Data were analyzed using a Grounded Theory approach. A developmental and ecological theoretical model of RS/C emerged from the data that includes three domains of influence - individual, relational, and contextual - on the supervisee's capacity to understand and use their experience of RS/C in their work. These novel data contribute to our understanding of RS/C from the supervisee perspective. The theoretical model provides a framework from which to investigate outcomes, train supervisors and supervisees, and advocate for RS/C within agencies and programs.

El estudio empírico de la supervisión/consulta con reflexión (RS/C) ha estado ganando terreno en la pasada década. Sin embargo, la mayoría de estas publicaciones se enfocan en la perspectiva del supervisor acerca de lo que RS/C es, lo que la hace eficaz y qué impacto tiene en el trabajo del supervisado. Este ensayo, Parte II de una serie de dos partes, presenta un modelo teórico de RS/C que se desarrolló a partir de las perspectivas y experiencias de los supervisados que trabajan con infantes, niños pequeños y familias y participan en RS/C de grupo o individual. Este estudio cualitativo tuvo como base los temas que surgieron de datos obtenidos de cincuenta profesionales de IECMH en los Estados Unidos, quienes participaron en grupos de enfoque o entrevistas individuales dirigidas a investigar sus experiencias de RS/C. La información se analizó usando un acercamiento de Teoría Fundamentada. De la información surgió un modelo teorético de desarrollo y ecológico de RS/C que incluye tres dominios de influencia - individual, relacional y contextual - sobre la capacidad de los supervisados de comprender y usar sus experiencias de RS/C en el trabajo. Esta novedosa información contribuye a nuestro conocimiento de RS/C desde la perspectiva del supervisado. El modelo teórico provee un marco de trabajo desde el cual se investigan los resultados, se entrenan los supervisores y supervisados, y se aboga por la inclusión de RS/C dentro de agencias y programas.

Les études empiriques de la supervision / consultation réflexive (RS/C pour reprendre l'anglais) a gagné du terrain ces dix dernières années. Cependant beaucoup de ces recherches sont focalisées sur la perspective du superviseur de ce qu'est la RS/C, ce qui rend la rend efficace, et comment elle influence le travail de la personne supervisée. Cet article, la deuxième partie d'une série en deux parties, présente un modèle théorique de la RS/C qui a été développé à partir des perspectives et des expériences de personnes supervisées travaillant avec des nourrissons, de jeunes enfants et des familles et participant à soit une RS/C de groupe ou individuelle. Cette étude qualitative s'est bâtie sur des thèmes ayant émergé de données obtenues de cinquante professionnels de la santé mentale du nourrisson et de la petite enfance se trouvant aux Etats-Unis qui ont participé à des groupes de discussion ou à des entretiens individuels destinés à enquêter sur leurs expériences de la RS/C. Les données ont été analysées en utilisant une approche de Théorie Ancrée. Un modèle théorique développemental et écologique de RS/C a émergé des données, incluant trois domaines d'influence - individuel, relationnel, et contextuel - sur la capacité de la personne supervisée à comprendre et à utiliser ses expériences de la RS/C dans le travail. Ces nouvelles données contribuent à notre compréhension de la RS/C du point de vue de la personne supervisée. Le modèle théorique offre une structure à partir de laquelle on peut faire des recherches sur les résultats, former les superviseurs et les personnes supervisées, et se faire les avocats de la RS/C au sein des agences et des programmes.

Using machine learning to understand age and gender classification based on infant temperament.

Age and gender differences are prominent in the temperament literature, with the former particularly salient in infancy and the latter noted as early as the first year of life. This study represents a meta-analysis utilizing Infant Behavior Questionnaire-Revised (IBQ-R) data collected across multiple laboratories (N = 4438) to overcome limitations of smaller samples in elucidating links among temperament, age, and gender in early childhood. Algorithmic modeling techniques were leveraged to discern the extent to which the 14 IBQ-R subscale scores accurately classified participating children as boys (n = 2,298) and girls (n = 2,093), and into three age groups: youngest (< 24 weeks; n = 1,102), mid-range (24 to 48 weeks; n = 2,557), and oldest (> 48 weeks; n = 779). Additionally, simultaneous classification into age and gender categories was performed, providing an opportunity to consider the extent to which gender differences in temperament are informed by infant age. Results indicated that overall age group classification was more accurate than child gender models, suggesting that age-related changes are more salient than gender differences in early childhood with respect to temperament attributes. However, gender-based classification was superior in the oldest age group, suggesting temperament differences between boys and girls are accentuated with development. Fear emerged as the subscale contributing to accurate classifications most notably overall. This study leads infancy research and meta-analytic investigations more broadly in a new direction as a methodological demonstration, and also provides most optimal comparative data for the IBQ-R based on the largest and most representative dataset to date.

From the voices of supervisees: What is reflective supervision and how does it support their work? (Part I).

Reflective supervision/consultation (RS/C) is a relationship for learning that embraces reflection and reflective practice strategies. It is considered best practice within the infant and early childhood mental health (IECMH) field. Based on research with supervisors, essential components of RS/C have been operationalized and used to develop evaluative tools. Little is known, however, about the essential components that supervisees find most useful. This paper, part I of a two-part series, describes the essential components that supervisees identify as fundamental and ways they believe their work is supported by participation in RS/C. Fifty IECMH professionals located in the United States who received RS/C participated in focus groups or individual interviews. Data were analyzed using a Grounded Theory approach. Essential components of RS/C from the supervisee perspective included supervisee feelings of safety, the development of trust, holding a non-judgmental stance, being available and present, and consistency and predictability. Additionally, supervisees identified outcomes of RS/C that included components of professional wellness, personal growth, and infant and family engagement. This study adds the supervisee's voice to the identification and operationalization of essential RS/C components and elucidates outcomes of RS/C that supervisees view as connected to their professional role.

La supervisión/consulta con reflexión (RS/C) es una relación para el aprendizaje (Fenichel, 1992) que abarca la reflexión y las estrategias de reflexión en la práctica. La misma es considerada como una de las buenas prácticas dentro del campo de la salud mental del infante y la temprana niñez (IECMH). Con base en la investigación con supervisores, los componentes esenciales de RS/C han sido puestos en operación y usados para desarrollar herramientas de evaluación. Sin embargo, poco se sabe acerca de los componentes esenciales que los supervisados ven como los más útiles. Este ensayo, primera parte de una serie de dos partes, describe los componentes esenciales que los supervisados identifican como fundamentales y las maneras como ellos creen que su trabajo es apoyado por la participación en RS/C. Cincuenta profesionales de IECMH que recibieron RS/C participaron en grupos de enfoque o entrevistas individuales. Se analizaron los datos usando un acercamiento de la Teoría Fundamentada. Entre los componentes esenciales de RS/C desde la perspectiva del supervisado se incluyen los sentimientos de seguridad del supervisado, el desarrollo de la confianza, el mantener una actitud imparcial, estar disponible y presente, y consistencia y previsibilidad. Adicionalmente, los supervisados identificaron resultados de RS/C que incluyen componentes de bienestar profesional, crecimiento personal, así como la participación del infante y la familia. Este estudio agrega la voz del supervisado a la identificación y funcionamiento de los componentes esenciales de RS/C y dilucida resultados de RS/C que los supervisados ven como conectados con su papel profesional.

La supervision / consultation réflexive (RS/C pour reprendre l'anglais) est une relation d'apprentissage (Fenichel, 1992) qui embrasse la réflexion et des stratégies de pratique réflective. Elle est considérée comme étant la meilleure pratique au sein du domaine de la santé mentale du nourrisson et de la petite enfance. A partir des recherches avec des superviseurs les composants essentiels de la RS/C ont été opérationnalisés et utilisés pour développer des outils évaluatifs. On sait peu de choses, cependant, sur les composants essentiels que les personnes supervisées estiment être les plus utiles. Cet article, la première partie d'une série de deux parties, décrit les composants essentiels que les personnes supervisées identifient comme étant fondamentaux et les manières dont ils estiment que leur travail est soutenu par la participation à la RS/C. Cinquante professionnels de la santé mentale du nourrisson et de la petite enfance se trouvant aux Etats-Unis et ayant reçu la RS/C ont participé à des groupes de discussion ou à des entretiens individuels. Les données ont été analysées en utilisant une approche de Théorie Ancrée. Les composants essentiels à la RS/C du point de vue des personnes supervisées ont inclus le sentiment de sûreté de la personne supervisée, le développement de la confiance, le fait de ne pas juger, le fait d'être disponible et présent, ainsi que la cohérence et la prévisibilité. De plus les personnes supervisées ont identifié des résultats de la RS/C qui ont inclus des composants de bien-être professionnel, d'épanouissement personnel et d'engagement avec le nourrisson et la famille. Cette étude ajoute la voix de la personne supervisée à l'identification et à l'opérationnalisation des composants essentiels de la RS/C et élucide les résultats de la RS/C que les personnes supervisées considèrent comme étant lié à leur rôle professionnel.

Trauma Symptoms and Social Support Mediate the Impact of Violence Exposure on Parenting Competence Among Substance-Dependent Mothers.

Women with substance use disorders (SUDs) experience high rates of violence exposure and posttraumatic stress disorder (PTSD), which are associated with parenting anxiety and lower parenting satisfaction among mothers. Although social support may buffer the impact of violence and PTSD on parenting, violence exposure and PTSD may impair mothers' ability to create, perceive, and utilize social support. We examined the impact of violence exposure, trauma symptoms, and interpersonal support on parenting competence among 291 mothers with substance dependence, using ordinary least squares regression and path analysis. Greater violence exposure and trauma symptoms were associated with lower parenting competence. Greater interpersonal support was associated with greater parenting competence. Trauma symptoms and interpersonal support sequentially mediated the impact of violence exposure on parenting competence, suggesting one pathway through which violence exposure may affect parenting among substance-dependent mothers. Implications for practice include the need to utilize trauma-informed interventions that modify social support.

Maternal and Paternal Warmth Impact Recovery Support and Social Network Composition for Substance Dependent African American and Non-African American Women.

Poor early relationship experiences during the first 16 years of life may negatively impact adults' capacity to establish and utilize social support (Suchman, McMahon, Slade, & Luthar, 2005). This is especially of concern for women with substance use disorders (SUD) for whom social support is associated with recovery maintenance and treatment retention (Gregoire & Snively, 2001). The purpose of this study was to examine the influence of early relationship experiences, specifically paternal and maternal warmth, on recovery related social support and personal network characteristics among African American (AA) and non-AA women in treatment for SUD. Data were collected from 254 women in substance abuse treatment, 146 AA and 108 non-AA. Ordinal logistic, Poisson or multiple linear regressions were fitted to predict the impact of maternal and paternal warmth during childhood on adult social network composition and recovery support. Greater maternal warmth was associated with greater recovery-specific social support for both AA (ß = 0.12) and non-AA (ß = 0.15) women. Paternal, but not maternal, warmth significantly predicted the number of social network members who supported recovery for non-AA women (AOR = 1.04), and number of network members who used drugs and alcohol for AA women (IRR = 0.99). Developmental experiences associated with fathers appear to affect different domains of adult functioning than those associated with mothers, and those effects are different for AA versus non-AA women. Attention to these differences may inform culturally relevant substance abuse prevention and treatment efforts.

Mindfulness and trauma symptoms predict child abuse potential in risk-exposed, men and women during pregnancy.

BACKGROUND: Nearly a third of adults report childhood trauma in their youth and approximately 700,000 cases of child maltreatment were reported in 2016. Both history of childhood trauma and current trauma symptoms in adults are linked to child maltreatment, although many trauma-exposed individuals are warm and nurturing parents. Identifying resiliency factors in adults with risk factors for harsh parenting may illuminate new pathways to sensitive parenting. Mindfulness is reported to improve trauma and mental health symptoms but the relationship between mindfulness, trauma, and child abuse potential is not yet understood. OBJECTIVE: This cross-sectional study investigated the relationship between mindfulness, childhood trauma experiences, trauma symptoms and child abuse potential. PARTICIPANTS AND SETTING: Our participants were 102 expectant parents recruiting from obstetric clinics and agencies Detroit, MI (58.8% African American, 27.5% Caucasian). METHOD: Bivariate correlations were examined using validated, self-report questionnaires. Significant variables were included in a hierarchical linear regression to identify predicting factors that contribute to child abuse potential scores. RESULTS: Significant correlations between child abuse potential with current trauma symptoms (r = .53, p < .01) and mindfulness (r = -.32, p < .01) were found, but no link with past childhood trauma experiences and child abuse potential were identified. The model significantly predicts child abuse potential (ΔR2 = .10, F(5, 96), = 12.48, p < .001). Trauma symptoms (B = .09, p < .001, 95% confidence interval [CI][-.40, -.07]) and mindfulness nonreactivity (B = -.24, p < .01, 95% CI[.05, .14]) predicted higher potential for child abuse scores. CONCLUSION: Findings suggest increased mindfulness, especially nonreactivity to one's own thoughts, may be an important factor to protect against child abuse potential. Interventions to increase parental mindfulness may reduce child abuse potential and improve child well-being, but further mechanistic research is needed to determine this.

SEX DIFFERENCES IN THE SOCIAL ECOLOGY OF BREASTFEEDING: A MIXED METHODS ANALYSIS OF THE BREASTFEEDING VIEWS OF EXPECTANT MOTHERS AND FATHERS IN THE US EXPOSED TO ADVERSITY.

Despite the significant health benefits of breastfeeding for the mother and the infant, economic class and race disparities in breastfeeding rates persist. Support for breastfeeding from the father of the infant is associated with higher rates of breastfeeding initiation. However, little is known about the factors that may promote or deter father support of breastfeeding, especially in fathers exposed to contextual adversity such as poverty and violence. Using a mixed methods approach, the primary aims of the current work were to (1) elicit, using qualitative methodology, the worries, barriers and promotive factors for breastfeeding that expectant mothers and fathers identify as they prepare to parent a new infant, and (2) to examine factors that influence the parental breastfeeding intentions of both mothers and fathers using quantitative methodology. A sample (N=95) of expectant, third trimester mothers and fathers living in a low-income, urban environment in Midwestern USA, were interviewed from October 2013 to February 2015 about their infant feeding intentions. Compared with fathers, mothers more often identified the benefits of breastfeeding for the infant's health and the economic advantage of breastfeeding. Mothers also identified more personal and community breastfeeding support resources. Fathers viewed their own support of breastfeeding as important but expressed a lack of knowledge about the breastfeeding process and often excluded themselves from discussions about infant feeding. The results point to important targets for interventions that aim to increase breastfeeding initiation rates in vulnerable populations in the US by increasing father support for breastfeeding.

Acculturative stress and lack of social support predict postpartum depression among U.S. immigrant women of Arabic descent.

PURPOSE: To examine the relationships among acculturative stress, social support, and postpartum depression (PPD) symptoms among U.S. immigrant women of Arabic descent; and to examine if social support moderates the associations between acculturative stress and PPD symptoms. METHODS: Using a cross-sectional design, a sample of 115 U.S. immigrant women of Arabic descent, all between 1 and 12 months postpartum, were enrolled from clinics in Dearborn, MI. Data were analyzed using correlational and multiple linear regression. RESULTS: Women had a mean age of 29 ±â€¯5 years and were 5 ±â€¯4 months postpartum. Women had been in the U.S. for 7 ±â€¯6 years and had a mean education of 12 ±â€¯4 years. The majority had an annual household income of <$40,000 (88%), were unemployed (80%), and preferred Arabic language for interview (68%). Higher levels of acculturative stress, higher levels of education, antenatal anxiety, and lower levels of social support predicted PPD symptoms (all significant at p < .05). The moderating effect of social support on the association between acculturative stress and PPD symptoms was not supported. CONCLUSIONS: Acculturative stress, lack of social support, higher level of education, and antenatal anxiety predicted PPD symptoms. Future research is needed to examine acculturative stress among immigrant women in different U.S. SETTINGS: Longitudinal studies and utilizing diagnostic assessments of PPD is highly recommended. Nurses need to screen immigrant women of Arabic descent for anxiety and depression during antenatal visits and develop evidence-based interventions targeted to improve mental health during pregnancy and postpartum.

Depressive and trauma symptoms in expectant, risk-exposed, mothers and fathers: Is mindfulness a buffer?

BACKGROUND: Perinatal depression is reported in 15-20% of women (Marcus, 2009), 8-16% of men (Paulson and Bazemore, 2010) and low-SES, diverse populations are particularly at risk (Sareen, 2011). Trauma symptoms are commonly comorbid with depression, especially when individuals are exposed to risk factors such as community violence and poverty (Kastello et al., 2015; WenzGross et al., 2016). Parental mental illness places infants at risk for negative outcomes (Junge et al., 2016). Evidence supports that dispositional mindfulness is linked to mental health in many populations, however, a gap lies in the understanding of the relationship between mindfulness, trauma and depression in risk-exposed, pregnant populations, especially with fathers. We hypothesize that dispositional mindfulness is negatively associated with lower depression and trauma symptoms in pregnancy, in mothers and fathers. METHODS: Dispositional mindfulness, depressive and trauma symptoms were examined in women and men, exposed to adversity who were expecting a baby (N = 102). Independent t-tests, and bivariate correlations examined the relationships between these variables. Hierarchical regression was utilized to understand how mindfulness and trauma symptoms may contribute to antenatal depression symptoms. RESULTS: Significant differences were observed with mindfulness and depressive symptoms, with no differences reported across gender. Mindfulness, depressive and trauma symptoms were associated in the expected directions. Total mindfulness, specifically being non-reactive to one's own thoughts and trauma symptoms predicted depressive symptoms. LIMITATIONS: Limitations include small sample size, cross-sectional data and self-report measures. CONCLUSION: Mindfulness and trauma symptoms were found to be significant predictors of depressive symptoms in parents-to-be. Those with lower mindfulness exhibited higher levels of depression. These findings may be helpful in disseminated mindfulness-based interventions aimed at treating antenatal depression in both expectant mothers and fathers who are exposed to adversity. Further research is necessary to understand the mechanisms of mindfulness in risk-exposed, expectant parents.

MIXED-METHODS EVALUATION OF PARTICIPANT RECRUITMENT AND RETENTION IN THE MOM POWER PARENTING INTERVENTION PROGRAM.

Parenting group success begins with attendance. Using archival pilot data from 99 mothers who enrolled in the Mom Power (MP) parenting intervention, this study sought to understand the factors that influenced participant engagement and retention. MP is a group-based, early intervention program grounded in attachment theory that utilizes motivational interviewing as a core component to enhance program engagement. Study aims were to qualitatively describe the reasons why mothers were interested in participating in the program, including what they hoped to gain from the experience, and to quantitatively examine the extent to which attendance was associated with demographic, experiential, and psychosocial factors. The qualitative analysis of intake interviews revealed that mothers expected the MP intervention to provide a warm environment for themselves and their children as well as to support and enhance their parenting, and 95% revealed their hopes that the intervention would help them grow and develop as women. Attendance rates were relatively high, with 62% of mothers missing less than one group session. Quantitative analyses using multiple regression to test associations of demographic, experiential, and psychosocial factors with attendance rates were not significant. Results suggest that motivational interviewing may be an important component in promoting participant engagement efforts in parenting interventions.

Parent-child intervention decreases stress and increases maternal brain activity and connectivity during own baby-cry: An exploratory study.

Parental responses to their children are crucially influenced by stress. However, brain-based mechanistic understanding of the adverse effects of parenting stress and benefits of therapeutic interventions is lacking. We studied maternal brain responses to salient child signals as a function of Mom Power (MP), an attachment-based parenting intervention established to decrease maternal distress. Twenty-nine mothers underwent two functional magnetic resonance imaging brain scans during a baby-cry task designed to solicit maternal responses to child's or self's distress signals. Between scans, mothers were pseudorandomly assigned to either MP (n = 14) or control (n = 15) with groups balanced for depression. Compared to control, MP decreased parenting stress and increased child-focused responses in social brain areas highlighted by the precuneus and its functional connectivity with subgenual anterior cingulate cortex, which are key components of reflective self-awareness and decision-making neurocircuitry. Furthermore, over 13 weeks, reduction in parenting stress was related to increasing child- versus self-focused baby-cry responses in amygdala-temporal pole functional connectivity, which may mediate maternal ability to take her child's perspective. Although replication in larger samples is needed, the results of this first parental-brain intervention study demonstrate robust stress-related brain circuits for maternal care that can be modulated by psychotherapy.

DEVELOPMENT AND SOCIALIZATION OF PHYSICAL AGGRESSION IN VERY YOUNG BOYS.

The expression of physical aggression is normative in early child development; it peaks in the second year of life, with steep declines for most children by the third and fourth years as children learn alternatives to aggression. Some children, however, fail to demonstrate declines in aggressive acts, and many of these are boys. The current review uses a dynamic systems (DS) approach to identify early individual and contextual factors that may dynamically influence trajectories of aggression as a characteristic way of engaging within communities and relationships. Within the DS framework, we focus on the parent-infant relationship as central to the development of adaptive emotion-regulation capacities of the infant and young child. Biological sex differences that may influence this early relationship are highlighted, as is the influence of contextual processes such as family violence. Clinical implications suggested by both the empirical and theoretical literatures are then described.

The influence of interpersonal aggression on maternal perceptions of infant emotions: Associations with early parenting quality.

The current study tested the hypothesis that mothers who have experienced child maltreatment and aggression within their adult relationships may be at particular risk for misinterpreting infant emotions, leading to less sensitive parenting behaviors. Participants were 120 pregnant women recruited for a larger, longitudinal study investigating the role of psychosocial and environmental risk on women and their young children. Data were collected during the third trimester of pregnancy, and when children were 1 and 2 years of age. Participants completed a projective test designed to elicit individual differences in perceptions of infant emotions and an observer-rated assessment of parenting behaviors was conducted in the family home. Using structural equation modeling, we tested associations between maternal interpersonal aggression exposure and perceptions of infant emotion and parenting behaviors. Results demonstrated that a history of child abuse and intimate partner conflict were associated with a maternal tendency to view ambiguous infant facial expressions as negative (i.e., negative attribution bias), and in turn, with less parenting sensitivity over time. Findings suggest that negative attributions of infant emotion may be 1 mechanism by which a history of trauma and violence exposure contributes to less sensitive parenting for some mothers. Implications for intervention include the need for trauma-informed clinical services and psychoeducational methods that help mothers more accurately read and respond to infant emotional expression and bids for connection. (PsycINFO Database Record

What is the container/contained when there are ghosts in the nursery?: Joining Bion and Fraiberg in dyadic interventions with mother and infant.

"Ghosts in the nursery." "Visitors from the unremembered past." Fraiberg, Adelson, and Shapiro's (1975) words convey the relational "intruders" that they perceived while working with mothers and infants. A mother's unresolved past is a driving force within the treatment of mother-infant dyads. Working with these families, the therapist strives to process and metabolize the distress of the dyad while enabling the mother to contain the infant more fully. This article proposes that Fraiberg et al.'s metaphor may be newly elaborated utilizing Bion's (1962) original theoretical conceptualization of the "container and contained." He posited that an infant projects distressing affective states upon the mother, who contains the experience, transforms the feelings, and then enables the infant to reintroject a more tolerable experience. This lays the foundation for the relational experience of being known by another and facilitates the infant's development of self-knowledge and emotional regulation. We utilize Fraiberg et al.'s original case material to identify ways in which ghosts in the nursery disrupt the processes of the container and contained. Bion's ideas may help enrich our understanding of how the therapeutic relationship enables cycles of containment, transitioning the material "ghosts" from being contained by the infant to being contained by the therapist, and to ultimately being transformed so that the mother can reattribute them to the past.

Hush now baby: mothers' and fathers' strategies for soothing their infants and associated parenting outcomes.

OBJECTIVES: The purpose of this study was to examine the types of soothing behaviors used by mothers and fathers of infants, differences in use trajectories over time, and associated parenting outcomes. METHODS: A longitudinal study of 241 families expecting their second child was performed. Data were collected at 1, 4, and 8 postnatal months and included measures of parental soothing techniques, involvement in soothing, distress in response to infant crying, and parenting self-efficacy. RESULTS: The average number of soothing techniques used was 7.7 for mothers and 5.9 for fathers. Soothing frequency decreased over time, and change patterns of soothing differed over time by gender. In couples who shared responsibility for soothing, fathers felt more efficacious in parenting and mothers were less upset by infant crying. DISCUSSION: Clinicians are encouraged to support fathers' engagement in infant soothing, facilitate the development of fathers' parenting confidence, and promote fathers' involvement in children's health and health care.

Fathering after military deployment: parenting challenges and goals of fathers of young children.

Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.

Maternal parenting predicts infant biobehavioral regulation among women with a history of childhood maltreatment.

Early biobehavioral regulation, a major influence of later adaptation, develops through dyadic interactions with caregivers. Thus, identification of maternal characteristics that can ameliorate or exacerbate infants' innate vulnerabilities is key for infant well-being and long-term healthy development. The present study evaluated the influence of maternal parenting, postpartum psychopathology, history of childhood maltreatment, and demographic risk on infant behavioral and physiological (i.e., salivary cortisol) regulation using the still-face paradigm. Our sample included 153 women with high rates of childhood maltreatment experiences. Mother-infant dyads completed a multimethod assessment at 7 months of age. Structural equation modeling showed that maternal positive (i.e., sensitive, warm, engaged, and joyful) and negative (i.e., overcontrolling and hostile) behaviors during interactions were associated with concurrent maternal depressive symptoms, single parent status, and low family income. In turn, positive parenting predicted improved infant behavioral regulation (i.e., positive affect and social behaviors following the stressor) and decreased cortisol reactivity (i.e., posttask levels that were similar to or lower than baseline cortisol). These findings suggest increased risk for those women experiencing high levels of depressive symptoms postpartum and highlight the importance of maternal positive interactive behaviors during the first year for children's neurodevelopment.

Maternal sensitivity and latency to positive emotion following challenge: pathways through effortful control.

The ability to self-generate positive emotions is an important component of emotion regulation. In this study, we focus on children's latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and children's effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed.

Strong, safe, and secure: negotiating early fathering and military service across the deployment cycle.

Military fathers of young children often endure repeated separations from their children, and these may disrupt the early parent-child relationship. Postdeployment reunification also poses challenges; disruptions that have occurred must often be repaired in the context of heightened emotions on the part of each family member at a time when fathers are themselves readjusting to the routines and responsibilities of family life. The current study employed qualitative research with the central aim of informing a richer understanding of these experiences. Interviews were conducted with 14 military fathers of young children who had experienced separation from their families during deployment. Narratives were coded using principles of grounded theory, and common parenting themes were extracted. Fathers shared their hopes that their young children would develop qualities of strength, confidence, and self-sufficiency. They also discussed difficulty in supporting the development of these qualities in their young children due to problems dealing with the negative emotions and difficult behaviors that their children exhibited. Reliance on their parenting partner was commonly cited as an effective strategy as fathers transitioned back to family life. Implications for intervention programs include the provision of parenting and self-care skills and inclusion of the father's parenting partner in the intervention.