The association between maternal and child posttraumatic stress symptoms among families living in southern Israel: The buffering role of maternal executive functions.

Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high-level cognitive processes that enable self-regulation of thoughts and actions to achieve goal-directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress-buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent-child interactions.

Maternal Perceptions and Responsiveness to Cry in Armed Conflict Zones: Links to Child Behavior Problems.

Crying is a typical infant behavior that activates parental caregiving behaviors, acting as "human alarms" important for the infant's survival. When living under war-related threat, the auditory system may be sensitized given its importance for survival, potentially impacting maternal cry processing. Children living in armed-conflict zones are at increased risk for behavior problems, which may relate to both direct exposure and indirect effects through their parents' perceptions and behaviors. This hypothesis was examined in a sample of mothers and their first-born children (aged 10-45 months) living in the Gaza vicinity area in Israel, chronically exposed to missile alarms (high-exposure; n = 45), and a comparison group (low-exposure; n = 86). Group differences in child behavior problems and maternal perceptions of and responsiveness to cry were investigated. A moderated indirect-effect of maternal cry perceptions on child behavior problems via maternal responsiveness to cry was examined. In the high-exposure group, children had more externalizing problems and mothers rated cries as more aversive. Maternal cry perception was indirectly related to child behavior problems via responsiveness to cry only in the high-exposure group: higher perceptions of cry as aversive or the child as distressed were related to faster responding to crying, and faster cry responsiveness was linked with fewer behavior problems. Results suggest that in armed-conflict zones with auditory warning signals, the parental caring system may be easily activated by cries due to the strong association between alarms and threat. Furthermore, children may need their mothers to react faster when feeling distressed, possibly because of the surrounding threat.

Explaining the influence of non-shared environment (NSE) on symptoms of behaviour problems from preschool to adulthood: mind the missing NSE gap.

BACKGROUND: Individual differences in symptoms of behaviour problems in childhood and adolescence are not primarily due to nature or nurture - another substantial source of variance is non-shared environment (NSE). However, few specific environmental factors have been found to account for these NSE estimates. This creates a 'missing NSE' gap analogous to the 'missing heritability' gap, which refers to the shortfall in identifying DNA differences responsible for heritability. We assessed the extent to which variance in behaviour problem symptoms during the first two decades of life can be accounted for by measured NSE effects after controlling for genetics and shared environment. METHODS: The sample included 4,039 pairs of twins in the Twins Early Development Study whose environments and symptoms of behaviour problems were assessed in preschool, childhood, adolescence and early adulthood via parent, teacher and self-reports. Twin-specific environments were assessed via parent-reports, including early life adversity, parental feelings, parental discipline and classroom environment. Multivariate longitudinal twin model-fitting was employed to estimate the variance in behaviour problem symptoms at each age that could be predicted by environmental measures at the previous age. RESULTS: On average across childhood, adolescence and adulthood, parent-rated NSE composite measures accounted for 3.4% of the reliable NSE variance (1.0% of the total variance) in parent-rated, symptoms of behaviour problems, 0.5% (0.1%) in teacher-rated symptoms and 0.9% (0.5%) in self-rated symptoms after controlling for genetics, shared environment and error of measurement. Cumulatively across development, our parent-rated NSE measures in preschool, childhood and adolescence predicted 4.7% of the NSE variance (2.0% of the total variance) in parent-rated and 0.3% (0.2%) in self-rated behaviour problem symptoms in adulthood. CONCLUSIONS: The missing NSE gap between variance explained by measured environments and total NSE variance is large. Home and classroom environments are more likely to influence behaviour problem symptoms via genetics than via NSE.

When COVID-19 Met Families Living in Armed-Conflict Zones: The Importance of Maternal Trauma and Child Self-Regulation.

The COVID-19 outbreak began in Israel at the end of February 2020, and on March 17, 2020, a general lockdown was announced. Families were instructed to stay at home and schools and non-essential businesses were closed. Aiming to understand how families who were already living in areas of high exposure to armed conflict would be affected by another external stressful condition, data were collected before and after the outbreak. Mothers and children (aged 10-45 months) were recruited from areas with high (n = 40) and low (n = 78) exposure to armed conflict. Mothers reported on their posttraumatic stress symptoms (PTSS) and on their child's effortful control tendencies prior to the outbreak. Toward the end of the first lockdown, mothers were interviewed regarding adverse effects of the outbreak on their family. No group differences were found for maternal perceptions of adverse effects of COVID-19. However, a moderation model was revealed, indicating that maternal PTSS as well as child effortful control predicted adverse effects of COVID-19 only in the high-exposure group. Results are discussed considering cumulative stress and risk factors.

Household Chaos and Child Behavior Problems Predict Maternal Well-being.

The aim of the study was to investigate predictors of maternal well-being in mothers of twins. As well as being important in its own right, maternal well-being is a crucial predictor of parenting (Belsky in Child Dev. 55(1):83, 1984). Based on previous research (Pike et al. in Int J Beh Dev. 30(1):55-66, 2006) we expected that household chaos (Confusion, Hubbub, and Order) and child behavior problems would predict maternal depression, stress and anxiety. The data for the study was taken from the Twins, Family and Behavior Study (TFaB) -- a longitudinal UK study of twins born in 2009 and 2010. One hundred and fifty-eight mothers of twins (Mchild age= 6.01 years, SDage = 0.50) reported on household chaos, child disruptive behaviors and their own well-being. Higher levels of household chaos were linked to maternal depressive, anxiety and stress related symptoms. More child behavior problems were related to more depressive and stress symptoms but not anxiety. The findings show promise for future research investigating different types of maternal well-being and suggested practical implications, such as intervening on concrete aspects of household chaos to improve maternal well-being.

Co-parenting and Marital Satisfaction Predict Maternal Internalizing Problems When Expecting a Second Child.

Purpose: Internalizing problems during and after pregnancy are important for parenting and child outcomes. The study aimed to understand correlates (i.e., marital satisfaction, co-parenting) of maternal internalizing problems during pregnancy with a second child. Method: We investigated levels of depression, anxiety, and stress symptoms of mothers in the third trimester of pregnancy with their second children. Fifty-one mothers and their firstborn children were visited in their homes and mothers completed questionnaires. Results: Results showed that co-parenting and marital satisfaction were related to internalizing outcomes. More specifically, co-parenting predicted depression and stress when controlling for marital satisfaction, whereas marital satisfaction predicted anxiety over co-parenting. Conclusion: The findings highlight the importance of studying prenatal internalizing problems differentially and can inform future intervention studies to prevent poor psychological outcomes.

Helping parents to help children overcome fear: The influence of a short video tutorial.

OBJECTIVES: Anxiety runs in families, and its transmission is largely environmental. However, studies rarely explore this process in clinically anxious parents or ask participants to face a genuine fear. We also do not know whether this process is modifiable. This study will explore these questions using a sample of clinically anxious parents. DESIGN: Experimental design comparing clinically anxious parents with non-anxious parents, and exploring the effects of a tutorial intervention versus a control group. METHODS: Parents with and without anxiety disorders and their children (5-9 years) participated (N = 72). Children chose two fearful animal stimuli. Parents helped the child approach the first in graded steps. The following parental behaviours were recorded: positive/negative verbal information; positive/negative modelling; encouragement/praising of approach/avoidance behaviours. Half the parents were then randomly assigned to a short video tutorial advising how to help children cope with fearful situations. The remainder watched a control video. The approach task was repeated with the second stimulus. RESULTS: Parenting behaviours fell into two categories: 'approach parenting' (encouraging/praising/modelling approach; positive verbal information) and 'avoidance parenting' (encouraging/praising/modelling avoidance; negative verbal information). The parenting tutorial increased 'approach parenting' and decreased 'avoidance parenting' and was associated with increased child approach towards fearful stimuli. This was not moderated by parent or child anxiety. CONCLUSIONS: Parenting, particularly 'avoidance parenting', is associated with children's approach and avoidance. A short video tutorial modified these parenting behaviours and reduced avoidance. These effects were apparent regardless of parent or child anxiety level. PRACTITIONER POINTS: Avoidance and approach parenting may influence children's response to fearful stimuli. Avoidance parenting may be more problematic than lack of approach parenting. Approach and avoidance parenting are amenable to manipulation by short video tutorial. Parenting improvement resulted in increased approach behaviour in children.

Scaffolding under the microscope: Applying self-regulation and other-regulation perspectives to a scaffolded task.

BACKGROUND: Typical scaffolding coding schemes provide overall scores to compare across a sample. As such, insights into the scaffolding process can be obscured: the child's contribution to the learning; the particular skills being taught and learned; and the overall changes in amount of scaffolding over the course of the task. AIMS: This study applies a transition of regulation framework to scaffolding coding, using a self-regulation and other-regulation coding scheme, to explore how rich and detailed data on mother-child dyadic interactions fit alongside collapsed sample-level scores. SAMPLE: Data of 78 mother-child dyads (M age = 9 years 10 months) from the Sisters and Brothers Study (SIBS: Pike et al., 2006, Family relationships in middle childhood. National Children's Bureau/Joseph Rowntree Foundation) were used for this analysis. METHODS: Videos of the mother and child completing a multiple-trial block design puzzle task at home were coded for their different self- and other-regulation skills at the end of every block design trial. RESULTS: These constructs were examined at a sample level, providing general findings about typical patterns of self-regulation and other-regulation. Seven exemplar families at different ends of the spectrum were then extracted for fine-grained examination, showing substantial trial- and behaviour-related differences between seemingly similarly scoring families. CONCLUSION: This coding scheme demonstrated the value of exploring perspectives of a mother-child tutoring task aligned to the concept of other-regulation, and investigating detailed features of the interaction that go undetected in existing scaffolding coding schemes.

Mother-child positivity and negativity: Family-wide and child-specific main effects and interactions predict child adjustment.

Links between positive and negative aspects of the parent-child relationship and child adjustment are undisputed. Scholars recognize the importance of parental differential treatment (PDT) of siblings, yet, less is known about PDT in the context of the shared (family-wide) parent-child relationship climate, or about the extent to which positivity may buffer children's adjustment from negativity. Controlling for behavioral stability, we examined the potential for positive and negative parent-child processes to interact across and between child-specific and family-wide levels in the prediction of children's adjustment. Specifically, in a sample of 2,039 United Kingdom families, we used multilevel models to examine child-specific and family-wide mother-child relationships (at 4 years)-including interactive processes-in the prediction of prosocial behavior and conduct problems (at 7 years). The majority of variance in children's adjustment resided within-families: siblings were strikingly different. Accounting for behavioral stability, family-wide negativity and negative PDT associated with both prosociality and conduct problems. More important, we demonstrated interactions between, (a) family-wide negativity and negative PDT for conduct problems, as well as, (b) positive and negative PDT in the prediction of both prosocial behavior and conduct problems. Results suggest negative PDT associates with increased conduct problems over time, even when the overall family climate is low in negativity. They also indicate a buffering role of positive PDT on the deleterious effects of negative PDT for children's adjustment. Implications for both research and practice are discussed, including the importance of information gained by considering more than one child in the family. (PsycINFO Database Record

The Maternal Emotional Climate Predicts Twin Sibling Relationship Quality.

We investigated the association between maternal expressed emotion and twin relationship quality, after controlling for a maternal questionnaire measure of the mother-child relationship. This was explored within a community sample of 156 mothers and their two young twin children (M child age = 3.69 years; SD child age = 0.37). Mothers reported on the twin-twin relationship and the mother-child relationship via questionnaire. They were also interviewed about each child using the innovative Preschool Five Minute Speech Sample (Daley et al., 2003), which yields information about relative positive:negative maternal expressed emotion. Mothers who expressed more family-wide positive emotion and less family-wide negative emotion also reported more positivity, but not negativity, within the twin relationship - even when controlling for questionnaire reports of the mother-child relationship. Counter to expectations, discrepancies in mothers' expressed emotion between their twins also predicted more positive sibling relationships. Our findings corroborate the well established spill-over effect, whereby families are viewed as emotional units of interdependent individuals, none of whom can be understood in isolation from one another. Most importantly, the Preschool Five Minute Speech Sample provides information about mothering that questionnaire reports may not, and thus it is a useful tool in better understanding the twin family system.

Using Twins to Better Understand Sibling Relationships.

We compared the nature of the sibling relationship in dyads of varying genetic relatedness, employing a behavioural genetic design to estimate the contribution that genes and the environment have on this familial bond. Two samples were used-the Sisters and Brothers Study consisted of 173 families with two target non-twin children (mean ages = 7.42 and 5.22 years respectively); and the Twins, Family and Behaviour study included 234 families with two target twin children (mean age = 4.70 years). Mothers and fathers reported on their children's relationship with each other, via a postal questionnaire (the Sisters and Brothers Study) or a telephone interview (the Twins, Family and Behaviour study). Contrary to expectations, no mean level differences emerged when monozygotic twin pairs, dizygotic twin pairs, and non-twin pairs were compared on their sibling relationship quality. Behavioural genetic analyses also revealed that the sibling bond was modestly to moderately influenced by the genetic propensities of the children within the dyad, and moderately to substantially influenced by the shared environment common to both siblings. In addition, for sibling negativity, we found evidence of twin-specific environmental influence-dizygotic twins showed more reciprocity than did non-twins. Our findings have repercussions for the broader application of results from future twin-based investigations.

Child behavior and sibling relationship quality: A cross-lagged analysis.

Bidirectional associations between sibling relationships and children's problem behaviors are robust, and links with prosocial behavior have also been reported. Using cross-lagged models, we were able to conservatively test temporal directions of links between positive and negative aspects of sibling relationships and children's prosocial behavior and conduct problems across a 3-year time span in middle childhood. The Avon Longitudinal Study of Parents and Children (ALSPAC; http://www.bristol.ac.uk/alspac/researchers/data-access/data-dictionary/) is an ongoing population-based study designed to investigate the effects of a wide range of factors on children's health and development. For the purposes of the current analyses, we included 2,043 ALSPAC families who had just 1 older sibling as well as the target child, with an age gap of no more than 5 years. Mothers reported about the quality of the sibling relationship and both children's prosocial behavior and conduct problems when the target child was 4 years of age and again when the target child was 7 years old. Confirming our hypothesis, individual child behavior was predictive of sibling relationship quality, and sibling relationship quality was predictive of later child behavior, providing robust evidence of bidirectionality for both prosocial behavior and conduct problems. It would be consistent to expect that an improvement in either sibling relationship quality or individual children's behavior could have a positive spill over effect. We also found evidence of older sibling dominance in the domain of prosocial behavior and the positive aspects of sibling interaction. (PsycINFO Database Record

Mealtime dynamics in child feeding disorder: the role of child temperament, parental sense of competence, and paternal involvement.

OBJECTIVE: We examined how child temperament, parental sense of competence, and paternal involvement predicted observed mealtime dynamics. METHOD: 97 families of children with feeding disorder (FD), sleep problems (SP), and typically developing (TD) children participated in the study. Data were collected during home visits, where mother-child and father-child mealtime dynamics were videotaped and parents completed questionnaires. RESULTS: More mother-child and father-child conflict and control was observed during mealtimes in the FD than SP and TD groups. Among the FD group, maternal sense of competence was negatively correlated with mother-child conflict and control, and child temperament was linked to father-child conflict and control, but only for families in which fathers were highly involved. These correlations were not significant among the SP and TD groups. CONCLUSION: Different patterns of results were seen for mothers and fathers and among the FD and control groups. Clinical implications for the treatment of FD are discussed.

The role of adult attachment style, birth intervention and support in posttraumatic stress after childbirth: a prospective study.

BACKGROUND: There is converging evidence that between 1% and 3% of women develop posttraumatic stress disorder (PTSD) after childbirth. Various vulnerability and risk factors have been identified, including mode of birth and support during birth. However, little research has looked at the role of adult attachment style in how women respond to events during birth. This study prospectively examined the interaction between attachment style, mode of birth, and support in determining PTSD symptoms after birth. METHOD: A longitudinal study of women (n=57) from the last trimester of pregnancy to three months postpartum. Women completed questionnaire measures of attachment style in pregnancy and measures of PTSD, support during birth, and mode of birth at three months postpartum. RESULTS: Avoidant attachment style, operative birth (assisted vaginal or caesarean section) and poor support during birth were all significantly correlated with postnatal PTSD symptoms. Regression analyses showed that avoidant attachment style moderated the relationship between operative birth and PTSD symptoms, where women with avoidant attachment style who had operative deliveries were most at risk of PTSD symptoms. LIMITATIONS: The study was limited to white European, cohabiting, primiparous women. Future research is needed to see if these findings are replicated in larger samples and different sociodemographic groups. CONCLUSIONS: This study suggests avoidant attachment style may be a vulnerability factor for postpartum PTSD, particularly for women who have operative births. If replicated, clinical implications include the potential to screen for attachment style during pregnancy and tailor care during birth accordingly.

The impact of parents' mental health on parent-baby interaction: a prospective study.

The aims of the current study were to examine the effect of fathers' and mothers' pre and postnatal mental health on mother-infant and father-infant interactions. Mental health was broadly defined to include anxiety, depression and PTSD. A community sample of 44 mothers and 40 fathers from 45 families completed questionnaire measures of mental health in late pregnancy and three months postpartum. Mother-infant and father-infant interactions were observed and videoed three months postpartum and analysed using the CARE-index. Results showed that prenatal mental health, in particular anxiety, was associated with parent-infant interactions to a greater extent than postnatal mental health. Fathers' prenatal symptoms were associated with higher paternal unresponsiveness and infant passivity whilst fathers' postnatal symptoms were associated with higher levels of infant difficulty in the father-baby interaction. The results also indicated that mothers and fathers interaction with their babies were similar, both on average and within the couples, with 34% being inept or at risk. These findings highlight the need for early detection and prevention of both mental health and parent-infant relationship problems in fathers as well as mothers. However, further prospective and longitudinal studies are needed to understand the influences of parental mental health on the parent-infant interactions further. Also it should be noted that the mental health scores were low in this sample, which may reflect the sample characteristics. Future studies therefore would benefit from focusing on more vulnerable groups of parents.

Maternal scaffolding behavior: links with parenting style and maternal education.

The purpose of this study was to specify the relationship between positive and harsh parenting and maternal scaffolding behavior. A 2nd aim was to disentangle the effects of maternal education and parenting quality, and a 3rd aim was to test whether parenting quality mediated the association between maternal education and scaffolding practices. We examined associations between positive and harsh parenting practices and contingent and noncontingent tutoring strategies. Ninety-six mother-child dyads (49 boys, 47 girls) from working- and middle-class English families participated. Mothers reported on parenting quality at Time 1 when children were 5 years old and again approximately 5 years later at Time 2. Mother-child pairs were observed working together on a block design task at Time 2, and interactions were coded for contingent (contingent shifting) and noncontingent (fixed failure feedback) dimensions of maternal scaffolding behavior. Positive and harsh parenting accounted for variance in contingent behavior over and above maternal education, whereas only harsh parenting accounted for unique variance in noncontingent scaffolding practices. Our findings provide new evidence for a more differentiated model of the relation between general parenting quality and specific scaffolding behaviors.

Metoclopramide or domperidone for increasing maternal breast milk output: a randomised controlled trial.

OBJECTIVE: To compare the effects of metoclopramide and domperidone on the breast milk output of mothers with infants in neonatal intensive care. DESIGN: Double-blind randomised controlled trial. SETTING: Tertiary level neonatal intensive care unit (NICU). SAMPLE: Eighty mothers expressing breast milk for their infants (mean gestational age 28 weeks) based in NICU and the amounts expressed fell short of the prescribed target. INTERVENTION: Mothers were randomised to receive domperidone or metoclopramide for 10 days (10 mg three times a day). OUTCOME MEASURES: Total milk volume daily for up to 10 days before the medication, 10 days during the trial and up to 10 days after medication. Adverse side effects were also recorded. RESULTS: Mothers produced more milk in the domperidone group and achieved a mean of 96.3% increase in milk volume (mean increase/pretrial volume) compared with a 93.7% increase for metoclopramide. After adjusting for the amount of milk produced prior to medication, the mean amount of milk produced while taking medication for those on domperidone was 31.0 ml/24 h (95% CI -5.67 to 67.6) greater than the mean for those on metoclopramide. Seven mothers taking metoclopramide reported side effects and three taking domperidone; a further eight women (of 29) who had a follow-on prescription for metoclopramide also reported side effects. CONCLUSIONS: Oral domperidone and metoclopramide increased the volume of milk produced by mothers who are expressing to feed their babies in NICU. There were small differences in milk output between the two medications and in the incidence of side effects, but the differences were non-significant.

Associations between adolescent siblings' relationship quality and similarity and differences in values.

Theoretically framed by a self-determination perspective on value acquisition and taking into account research into sibling similarity and differences, the current study examined links between sibling relationship quality and adolescents' intrinsic values (benevolence and universalism) and extrinsic values (power, achievement, and materialism). Positive sibling experiences were expected to be positively linked to intrinsic values and negatively linked to extrinsic values, and negative experiences were hypothesized to fuel extrinsic values and thwart intrinsic values. Using a sample of 205 adolescent sibling pairs (older children M = 17.61 years, younger children M = 14.63 years) and multilevel modeling, we assessed within- and between-dyads differences to identify whether the sibling relationship functions as a correlate of values in a similar or different way for 2 siblings. Although siblings were not very similar in their values, sibling competition predicted sibling similarity in higher levels of extrinsic values and lower levels of intrinsic values. Implications for value acquisition research that so far has focused almost solely on parents and failed to acknowledge other processes within families are discussed.

Links between nonshared friendship experiences and adolescent siblings' differences in aspirations.

Using a sibling design, this study examined the association between adolescents' friendship experiences and their aspirations for self-acceptance, affiliation, and financial success. We hypothesized that adolescent siblings would differ in their aspirations and that unique experiences in friendships would be associated with these differences. Within our sample of 102 same-sex sibling pairs (mean age older sibling 16 years, younger sibling 14 years), only a small degree of sibling similarity was found for aspirations as well as friendship experiences. Self-acceptance and affiliation were positively linked to general friendship positivity as well as to positive features of the adolescents' closest friend. Bivariate model-fitting techniques revealed that nonshared processes (i.e., unique to each child in the family) explained these links between friendship experiences and aspirations. The results indicate that growing up in one home and being socialized by the same parents does not make adolescent siblings similar in their aspirations but rather that nonshared experiences like those with close friends are related to aspiration dissimilarity of siblings.