RESUMO
Parental depressive symptoms and sensitivity have well-documented consequences for children; however, studies considering both parents are still scarce. This longitudinal study aimed to investigate the respective roles of paternal and maternal depressive symptoms and sensitivity in predicting the development of child socioemotional problems during toddlerhood. We also investigated the buffering role of each parent's sensitivity in the associations between the other parent's depressive symptoms and toddlers' socioemotional problems. The sample consisted of 140 Canadian families who were visited in their homes when children were around 13 (T1), 19 (T2), and 27 (T3) months of age. At T1, both parents' sensitivity was assessed from observations of parent-child interactions at home and each parent reported on his or her own depressive symptoms. At T1, T2, and T3, maternal and paternal perceptions of their toddler's socioemotional problems were assessed and aggregated. Growth curve analyses revealed that paternal and maternal depressive symptoms as well as paternal sensitivity were unique and persistent predictors of child socioemotional problems and that sensitive fathering acted as a buffer in the context of maternal depressive symptoms. This study highlights the importance of considering both parents when studying risk and protective factors for young children's socioemotional problems.
Assuntos
Depressão , Pai , Mães , Humanos , Feminino , Masculino , Depressão/psicologia , Pré-Escolar , Lactente , Estudos Longitudinais , Mães/psicologia , Pai/psicologia , Adulto , Canadá/epidemiologia , Relações Pais-Filho , Poder Familiar/psicologiaRESUMO
BACKGROUND: The COVID-19 pandemic created new challenges and barriers for the work of child protection professionals (CPPs) and intensified existing hardships for families and children, increasing the risk of child maltreatment. As new restrictions and precautions were implemented by governments worldwide to stop the virus from spreading, CPPs had to adapt to a new reality of working remotely. However, limited research has investigated how remote work impacted CPPs and child protection work and how CPPs handled this alternative work style. OBJECTIVE: This review aims to address gaps in the research to reveal the creative and effective approaches CPPs developed to overcome the challenges presented by COVID-19, defined as the 'positive legacy' of CPPs, particularly in adapting to remote work challenges. METHOD: This review was conducted using a scoping review, followed by two rounds of thematic analysis. The scoping review was conducted in six languages: Hebrew, Arabic, French, Portuguese, Spanish, and English. RESULTS: The first round of thematic analysis found 18 articles relevant to this review. The second round extracted two main themes: 1) the challenges of remote work and 2) overcoming the challenges of no contact. CONCLUSIONS: The findings of this review may be used to inform future strategies for child protection during a pandemic. They also provide an opportunity to rethink the relationship child protection work has with technology to systematically reform current and future protection policies and practices, including outside of a pandemic.
RESUMO
Under-diagnosed and thus under-treated, maternal depression remains the most common complication of childbearing. Varying symptoms suggest persistence up to more than a decade following childbirth. This implies distinct vulnerabilities for the physical and emotional care of children. Using a prospective-longitudinal sex-stratified birth cohort of 2120 infants, we examined the relationship between early maternal depression symptoms and subsequent child psycho-social and relational characteristics. Mothers self-reported the severity and frequency of depressive symptoms 5 months after childbirth. Parents, teachers, and target participants reported on child mental health and relationships with adults, from kindergarten to tenth grade. A series of least-squares regressions were estimated, while controlling for pre-existing/concurrent child and family confounds. Both sons and daughters of mothers with more depressive symptoms were at risk of experiencing greater psycho-social impairment, classroom rule defiance, difficult relationships with teachers, less enjoyable mealtimes (age 6 years) and sleep, and coercive or inconsistent parenting practices in childhood and adolescence. For boys, these prospective associations were mostly consistent through ages 12 and 15 years. Girls also experienced more problematic interactions through to age 15 years. This study provides observations of distinct long-term vulnerabilities for sons and daughters in association with early maternal distress at important transitional periods of development in early, middle, and later childhood.
Assuntos
Depressão , Núcleo Familiar , Masculino , Criança , Lactente , Feminino , Adulto , Adolescente , Humanos , Depressão/epidemiologia , Depressão/psicologia , Mães/psicologia , Relações Familiares , Educação Infantil , Estudos LongitudinaisRESUMO
BACKGROUND: COVID-19 significantly worsened already challenging circumstances for children and their families and globally increased the likelihood of child maltreatment. This risk heightened the urgency of child protection professionals in preventing child maltreatment and defending children's rights. The vast and growing body of research on protecting children from child maltreatment during COVID-19 has emphasized practitioners' tremendous difficulty in this arena. OBJECTIVE: The current international study sought to identify the experiences and responses of child protection professionals to child maltreatment during COVID-19. PARTICIPANTS AND SETTING: Five real-time, virtual focus groups were conducted among professionals who work with children from countries around the globe. METHOD: Reflexive thematic analysis was employed to analyze the focus group transcripts. RESULTS: The participants identified their experiences and challenges in performing their role of protecting children. Additionally, they shared context-adapted and innovative responses to child maltreatment, while emphasizing self-care and their mental health. CONCLUSIONS: The results highlighted that child protection was significantly more challenging during the COVID-19 pandemic. Furthermore, they underlined the importance of establishing practices and policies for child protection in crisis times as well as ensuring both children's and professionals' well-being and mental health.
RESUMO
Introduction: Interest in studying the parental embodied mentalizing (PEM), which refers to implicit and non-verbal processes of parental mentalization, is relatively recent. Therefore, little is known about how PEM, in complementarity with the verbal parental mentalization, is associated with maternal characteristics regarding mother-infant interaction contexts. This exploratory study aimed to investigate the associations between the non-verbal and verbal dimensions of parental mentalization- PEM and mind-mindedness, respectively, - in relation to a wide spectrum of parental characteristics in different interactive mother-infant contexts (toys and no toys). Methods: Among a sample of 107 mother-infant dyads at moderate psychosocial risk, mothers' sociodemographic information (age, education, and income), psychological characteristics (depression and anxiety), cognitions (self-efficacy and perceived maternal impact), and attitudes (overprotection and parental warmth) were assessed via self-report questionnaires when the infant was 4 and 8 months old. The PEM and mind-mindedness were evaluated through observation made during a videorecorded sequence of mother-infant interaction in a context of free play with and without toys at 8 months of age. Results: The results showed distinct associations between PEM and mind-mindedness regarding maternal characteristics: PEM was associated with the mother's age, education, anxiety and maternal warmth, whereas mind-mindedness was related to cognitions. Both were linked to family income. Regarding mother-infant interaction contexts (toys vs. no toys), the results indicate that the capacity to verbally and non-verbally mentalize differs. Discussion: These findings shed light on distinctive associations between non-verbal and verbal parental mentalization in relation to certain maternal characteristics, and highlight that the mother-infant interaction context may play an important role in the expression of maternal mentalizing capacity.
RESUMO
The COVID-19 pandemic has generated numerous stressors among the general population, but more specifically in pregnant women because of disruptions in prenatal care and delivery conditions. Studies suggest that prenatal maternal stress increased during the pandemic (Berthelot et al., 2020; Perzow et al., 2021; Tomfohr-Madsen et al., 2021). Considering what is known about the fetal programming potential of prenatal maternal stress, several researchers, early in the pandemic, raised concerns over the significant negative consequences that the pandemic context could have on birth outcomes. Studies comparing birth outcomes during versus before the pandemic suggest a marginal increase in birthweight and a significant decrease in preterm birth (Yang et al., 2022), but individual variations in prenatal maternal stress during the pandemic have received less attention. The objective of the present study is to examine the association between prenatal maternal stress during the COVID-19 pandemic and birth outcomes. During pregnancy, 195 expecting mothers reported on their general and pandemic-related stress. When their child was 6 months old, mothers completed a questionnaire collecting information on birth outcomes (gestational age, birthweight, head circumference and Apgar scores). Hierarchical linear regressions show that none of the maternal prenatal stress variables significantly predicted variations in birth outcomes. Potential pandemic-related protective factors (e.g., changes in life and hygiene habits, rest imposed by lockdowns) and the need to offer support to pregnant women are discussed.
Assuntos
COVID-19 , Complicações na Gravidez , Nascimento Prematuro , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Peso ao Nascer , Controle de Doenças Transmissíveis , COVID-19/epidemiologia , Pandemias , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologiaRESUMO
BACKGROUND: Alongside deficits in children's wellbeing, the COVID-19 pandemic has created an elevated risk for child maltreatment and challenges for child protective services worldwide. Therefore, some children might be doubly marginalized, as prior inequalities become exacerbated and new risk factors arise. OBJECTIVE: To provide initial insight into international researchers' identification of children who might have been overlooked or excluded from services during the pandemic. PARTICIPANTS AND SETTING: This study was part of an international collaboration involving researchers from Brazil, Canada, Colombia, Israel, South Africa, Uganda, the UK and the USA. Researchers from each country provided a written narrative in response to the three research questions in focus, which integrated the available data from their countries. METHOD: Three main questions were explored: 1) Who are the children that were doubly marginalized? 2) What possible mechanisms may be at the root? and 3) In what ways were children doubly marginalized? The international scholars provided information regarding the three questions. A thematic analysis was employed using the intersectional theoretical framework to highlight the impact of children's various identities. RESULTS: The analysis yielded three domains: (1) five categories of doubly marginalized children at increased risk of maltreatment, (2) mechanisms of neglect consisting of unplanned, discriminatory and inadequate actions, and (3) children were doubly marginalized through exclusion in policy and practice and the challenges faced by belonging to vulnerable groups. CONCLUSION: The COVID-19 pandemic can be used as a case study to illustrate the protection of children from maltreatment during worldwide crises. Findings generated the understanding that child protective systems worldwide must adhere to an intersectionality framework to protect all children and promote quality child protection services.
Assuntos
COVID-19 , Maus-Tratos Infantis , COVID-19/epidemiologia , Criança , Maus-Tratos Infantis/prevenção & controle , Serviços de Proteção Infantil , Humanos , Internacionalidade , Pandemias/prevenção & controleRESUMO
INTRODUCTION: The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have psychological and social consequences, mainly on vulnerable individuals, that will remain once the pandemic is contained and will most likely exacerbate existing social and gender health inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. The MAVIPAN (Ma vie et la pandémie/ My Life and the Pandemic) study aims to document how individuals, families, healthcare workers and health organisations are affected by the pandemic and how they adapt. METHODS AND ANALYSIS: MAVIPAN is a 5-year longitudinal prospective cohort study launched in April 2020 across the province of Quebec (Canada). Quantitative data will be collected through online questionnaires (4-6 times/year) according to the evolution of the pandemic. Qualitative data will be collected with individual and group interviews and will seek to deepen our understanding of coping strategies. Analysis will be conducted under a mixed-method umbrella, with both sequential and simultaneous analyses of quantitative and qualitative data. ETHICS AND DISSEMINATION: MAVIPAN aims to support the healthcare and social services system response by providing high-quality, real-time information needed to identify those who are most affected by the pandemic and by guiding public health authorities' decision making regarding intervention and resource allocation to mitigate these impacts. MAVIPAN was approved by the Ethics Committees of the Primary Care and Population Health Research Sector of CIUSSS de la Capitale-Nationale (Committee of record) and of the additional participating institutions. TRIAL REGISTRATION NUMBER: NCT04575571.
Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Saúde Global , Humanos , Estudos Prospectivos , Saúde PúblicaRESUMO
Birthweight is an important predictor of newborn health and has been linked to maternal psychological stress during pregnancy. However, it is unclear whether prenatal stress affects birthweight similarly for both male and female infants. We used a well-established pregnancy cohort to investigate the impact of high maternal psychological stress during pregnancy on birthweight as a function of infant sex. Overall, 5702 mother-newborn pairs were analysed. Of these, 198 mothers reported high levels of stress using the Psychological Stress Measure (nine-items version; PSM-9). Maternal psychological stress was assessed between the 24th and 28th week of gestation and analyses were performed jointly and independently as a function of neonatal sex (separate analyses for male and female infants). Newborns exposed to high maternal psychological stress during pregnancy (a score above 26 measured using the PSM-9 questionnaire, corresponding to >97.5th percentile) were compared to newborns of mothers who reported lower stress. ANCOVAs revealed that high levels of maternal stress during pregnancy were linked to infant birthweight as a function of infant sex. Male infants of mothers who reported high levels of stress had a greater birthweight whereas female infants had a lower birthweight under the same conditions, in comparison to mothers who did not report greater levels of stress. Although the effect size is small, these results underline the possibility that male and female fetuses may use different strategies when adapting to maternal adversity and highlight the need to consider infant sex as a moderator of the association between maternal psychological stress during pregnancy and infant birthweight.
Assuntos
Peso ao Nascer/fisiologia , Mães/psicologia , Estresse Psicológico/diagnóstico , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Fatores Sexuais , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: A year has passed since COVID-19 began disrupting systems. Although children are not considered a risk population for the virus, there is accumulating knowledge regarding children's escalating risk for maltreatment during the pandemic. OBJECTIVE: The current study is part of a larger initiative using an international platform to examine child maltreatment (CM) reports and child protective service (CPS) responses in various countries. The first data collection, which included a comparison between eight countries after the pandemic's first wave (March-June 2020), illustrated a worrisome picture regarding children's wellbeing. The current study presents the second wave of data across 12 regions via population data (Australia [New South Wales], Brazil, United States [California, Pennsylvania], Colombia, England, Germany, Israel, Japan, Canada [Ontario, Quebec], South Africa). METHOD: Regional information was gathered, including demographics, economic situation, and CPS responses to COVID-19. A descriptive analysis was conducted to provide an overview of the phenomenon. RESULTS: Across all of the countries, COVID-19 had a substantial negative impact on the operation of CPSs and the children and families they serve by disrupting in-person services. One year into the COVID-19 pandemic, new reports of CM varied across the regions.1 In some, the impact of COVID-19 on CPS was low to moderate, while in others, more significant changes created multiple challenges for CPS services. CONCLUSIONS: COVID-19 created a barrier for CPS to access and protect children. The dramatic variance between the regions demonstrated how social, economic and structural contexts impact both CM reports and CPS responses.
Assuntos
COVID-19 , Maus-Tratos Infantis , COVID-19/epidemiologia , Criança , Serviços de Proteção Infantil , Proteção da Criança , Humanos , Ontário , Pandemias , Estados UnidosRESUMO
BACKGROUND: Little attention has been given to intergenerational transmission of risk, mainly whether caregivers' history of childhood maltreatment is linked to behavioral symptoms in their children and which protective/risk factors are involved in this transmission process. OBJECTIVE: This study examined if parental Hostile/Helpless (H/H) state of mind with respect to attachment moderated the association between parental childhood trauma and behavior problems in maltreated children. PARTICIPANTS AND SETTING: The sample included 61 parents and their children victims or at very high risk of maltreatment, aged between 1 and 6 years old. METHOD: Parents retrospectively reported their childhood trauma and completed a measure of their children's behavior problems. Independent observers assessed H/H attachment representations. RESULTS: Among parents with H/H states of mind, more severe traumatic childhood experiences were associated with more externalizing and internalizing behavior problems in their children. Among non-H/H parents, associations between parental childhood trauma and child behavior problems were not significant. CONCLUSIONS: In the context of trauma, this study suggests that the absence of a H/H state of mind in parents (i.e., the presence of an organized attachment state of mind) is a protective factor for child adjustment. H/H mental representations of self and attachment experiences as targets of intervention for parents with histories of maltreatment may help reduce the transmission of risk in maltreating families.
Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis , Comportamento Problema , Sintomas Comportamentais , Criança , Comportamento Infantil , Pré-Escolar , Humanos , Lactente , Pais , Estudos RetrospectivosRESUMO
Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child's need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration.
Assuntos
Custódia da Criança , Apego ao Objeto , Criança , HumanosRESUMO
Externalizing behavior problems are a salient issue in the context of child protection services, where associations with placement stability and caregiving behavior have been documented. Moreover, although research on the association between contact with biological parents and foster child externalizing behavior problems is scarce and has yielded mixed results, several studies have shown links between the two variables. The purpose of this study is to determine the association of face-to-face contact with biological parents and externalized behaviors, while taking into account placement instability and foster parent interactive sensitivity. Fifty preschoolers and their foster parents were visited at home. Child externalizing behavior problems were self-reported by foster parents, foster parent sensitivity was measured via play observations, and information relative to placement was collected through interviews with biological parents and gathered from social services data. Results reveal that more frequent contact with biological parents and lower levels of foster parent sensitivity are independently linked to greater levels of externalizing behavior problems even after controlling for placement instability. Discussion focuses on the importance of children's relationship experiences during foster care and the necessity to investigate their role to more clearly understand foster child socioemotional development.
Assuntos
Transtornos do Comportamento Infantil , Criança Acolhida , Comportamento Problema , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Cuidados no Lar de Adoção/psicologia , Humanos , Relações Pais-Filho , Pais/psicologiaRESUMO
Interest in studying the relative contributions of verbal (e.g., maternal mind-mindedness [MM]) and non-verbal dimensions (i.e., parental embodied mentalizing [PEM]) of parental mentalization to child socio-emotional development is relatively recent. To date, only one study has addressed this issue in relation to child attachment security, suggesting a complementary and unique contribution of each one. The purpose of the present study was to further examine the specific contribution of PEM to infant attachment security by considering MM. In addition, this study aimed to explore the mediating role of maternal sensitivity linking PEM, MM to infant attachment security within 110 mother-infant dyads at moderate psychosocial risk. The two dimensions of parental mentalization (PEM and MM) were assessed on the basis of observations made during a videorecorded sequence of mother-child interactions in a context of free play with and without toys when the infants were 8 months old. The Maternal Behavior Q-Sort was used to measure the mothers' sensitivity in a natural setting based on observations of daily mother-child interactions, also when the infants were about 8 months old. Attachment security was measured using The Strange Situation Procedure at infant age 16 months. The results showed positive correlations between maternal sensitivity and both verbal and non-verbal measures of parental mentalization. The mediation analyses first revealed that PEM had a significant indirect effect on attachment security, with sensitivity being identified as a mediator in this association. No indirect effect linking MM and attachment security via sensitivity was observed. These results highlight the contribution of PEM to maternal sensitivity and show maternal sensitivity to be a factor that partly explains the influence of PEM on attachment security in children.
Assuntos
Mentalização , Feminino , Humanos , Lactente , Comportamento Materno , Relações Mãe-Filho , Mães , Apego ao Objeto , PaisRESUMO
BACKGROUND: COVID-19 has become a worldwide pandemic impacting child protection services (CPSs) in many countries. With quarantine and social distancing restrictions, school closures, and recreational venues suspended or providing reduced access, the social safety net for violence prevention has been disrupted significantly. Impacts include the concerns of underreporting and increased risk of child abuse and neglect, as well as challenges in operating CPSs and keeping their workforce safe. OBJECTIVE: The current discussion paper explored the impact of COVID-19 on child maltreatment reports and CPS responses by comparing countries using available population data. METHOD: Information was gathered from researchers in eight countries, including contextual information about the country's demographics and economic situation, key elements of the CPS, and the CPS response to COVID-19. Where available, information about other factors affecting children was also collected. These data informed a discussion about between-country similarities and differences. RESULTS: COVID-19 had significant impact on the operation of every CPS, whether in high- income or low-income countries. Most systems encountered some degree of service disruption or change. Risk factors for children appeared to increase while there were often substantial deficits in CPS responses, and in most countries there was at a temporary decrease in CM reports despite the increased risks to children. CONCLUSIONS: The initial data presented and discussed among the international teams pointed to the way COVID-19 has hampered CPS responses and the protection of children more generally in most jurisdictions, highlighting that children appear to have been at greater risk for maltreatment during COVID-19.
Assuntos
COVID-19 , Maus-Tratos Infantis , Serviços de Proteção Infantil , Adulto , Austrália , Brasil , COVID-19/psicologia , Canadá , Criança , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/estatística & dados numéricos , Serviços de Proteção Infantil/estatística & dados numéricos , Colômbia , Feminino , Alemanha , Humanos , Renda , Israel , Masculino , Pobreza , Fatores de Risco , SARS-CoV-2 , África do SulRESUMO
There has been increasing scholarly attention to the study of maternal sensitivity as a multidimensional construct. This report investigated the predictive value of three dimensions of sensitivity during mother-infant interactions in an effort to gain greater understanding of how specific facets of sensitivity relate to child socioemotional outcomes. Maternal cooperation/attunement (accurate interpretation of infant cues and capacity to adjust the interaction correspondingly), positivity (positive attitude toward the infant), and accessibility/availability (consistent attentiveness) were assessed observationally in 195 mothers of 1-year-old infants. Child socioemotional functioning was assessed using behavioral tasks and maternal and teacher reports when children were 4 years of age. The results revealed that maternal accessibility/availability was predictive of less externalizing behavior, more prosocial behavior (mother- and teacher-reported), and better theory of mind, while maternal positivity predicted effortful control. These results highlight the advantages of a multidimensional assessment in understanding how sensitivity predicts different developmental outcomes.
Assuntos
Desenvolvimento Infantil , Emoções , Comportamento Materno/psicologia , Relações Mãe-Filho , Habilidades Sociais , Feminino , Humanos , Lactente , Relações Mãe-Filho/psicologia , Projetos Piloto , Gravação em VídeoRESUMO
The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICCmean = .84, SD = 0.10), with 89% meeting the reliability standards of ICC ≥ .70. In response to queries, 100% of participants indicated that they would recommend the AMBIANCE-Brief training to their colleagues, 85% reported that the AMBIANCE-Brief measure would be useful or very useful for their clinical practice, and 56% of participant clinicians believed that parents would find the measure acceptable or very acceptable for integration into intervention or support planning. Altogether, these findings speak to the feasibility of using the AMBIANCE-Brief in community settings. Future studies are needed in diverse clinical and community contexts to evaluate whether use of this assessment tool can inform more targeted interventions tailored to the specific needs of families.
El Instrumento Abreviado para Evaluación y Clasificación de la Conducta Materna Atípica (AMBIANCE-Abreviado; Madigan, Bronfman, Haltigan y Lyons-Ruth, 2018) se desarrolló para ofrecer a quienes practican en la comunidad una evaluación clínicamente útil y sicométricamente acertada de la conducta de crianza trastornada. Con la anterior evidencia de la confiabilidad y validez de esta herramienta en el marco de los laboratorios (Cooke, Eirich, Racine, Lyons-Ruth y Madigan, 2020), este estudio se propuso determinar si se podría confiar en quienes proveen el servicio como parte de las agencias de servicio a las familias después de un breve entrenamiento. Los proveedores (N = 46) de tres lugares de agencias participaron en un entrenamiento de dos días sobre AMBAIANCE-Abreviado y, al final del entrenamiento, codificaron ocho interacciones madre-niño grabadas en video. Se comparó la forma de codificar de los novatos con el puntaje consenso de los expertos usando correlaciones dentro de clases. El acuerdo entre los evaluadores fue bueno (ICC media = .84, SD = 0.10), con un 89% de los participantes que lograron el estándar de confiabilidad de ICC > .70. En respuesta a preguntas, el 100% de los participantes indicó que ellos recomendarían el entrenamiento de AMBIANCE-Abreviado a sus colegas, 85% reportó que la medida AMBIANCE-Abreviado sería útil o muy útil en su práctica clínica, y 56% creían que los progenitores encontrarían la medida aceptable o muy aceptable para ser integrada en la intervención o el planeamiento de apoyo. En conjunto, estos resultados hablan de la factibilidad de usar AMBIANCE-Abreviado en el marco comunitario.
L'Instrument d'Evaluation et de Classification-Brève du Comportement Maternel Atypique (AMBIANCE-Bref; Madigan, Bronfman, Haltigan, & Lyons-Ruth, 2018) a été développé afin d'offrir une évaluation du comportement de parentage perturbé, cliniquement utile et saine du point de vue psychométrique, pour les acteurs communautaires. Avec des preuves préalables de la fiabilité et de la validité de cet outil en laboratoire (Cooke, Eirich, Racine, Lyons-Ruth, & Madigan, 2020), cette étude s'est donné pour but de déterminer si les prestataires des agences de service à la famille pouvaient devenir fiables pour son utilisation après une formation courte. Des prestataires (N = 46) de trois sites d'agence ont participé à une formation AMBIANCE-Bref de deux jours et à la fin de la formation ont codé huit interactions mère-enfant filmées. Le codage du participant débutant a été comparé aux évaluations par consensus d'expertes en utilisant des corrélations intraclasses. Le coefficient d'objectivité était bon (moyenne des coefficient de corrélation intraclasse [ICC] = 84, SD = 0,10), avec 89% des participants remplissant les standards de fiabilité d'ICC ICC ³,70. En répondant aux questions, 100% des participants ont indiqué qu'ils ou elles recommanderaient la formation AMBIANCE-bref à leurs collègues, 85% ont indiqué que la mesure AMBIANCE-bref serait utile ou très utile pour leur pratique clinique, et 56% ont déclaré qu'ils ou elles croyaient que les parents trouveraient cette mesure acceptable ou très acceptable pour une intégration à une intervention ou le plan de soutien. Au total, ces résultats parlent de la viabilité de l'utilisation de l'AMBIANCE-bref dans des contextes communautaires.
Assuntos
Comportamento Materno , Relações Mãe-Filho , Estudos de Viabilidade , Feminino , Humanos , Poder Familiar , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Child protection is and will be drastically impacted by the COVID-19 pandemic. Comprehending this new reality and identifying research, practice and policy paths are urgent needs. OBJECTIVE: The current paper aims to suggest a framework for risk and protective factors that need to be considered in child protection in its various domains of research, policy, and practice during and after the COVID-19 pandemic. STRATEGY: From an international collaboration involving researchers and child protection professionals from eight countries, the current paper examines various factors that were identified as playing an important role in the child protection system. THE INITIAL SUGGESTED FRAMEWORK: Through the use of an ecological framework, the current paper points to risk and protective factors that need further exploration. Key conclusions point to the urgent need to address the protection of children in this time of a worldwide pandemic. Discussion of risk and protective factors is significantly influenced by the societal context of various countries, which emphasizes the importance of international collaboration in protecting children, especially in the time of a worldwide pandemic. CONCLUSION: The COVID-19 pandemic has stressed the urgent need to advance both theory and practice in order to ensure children's rights to safety and security during any pandemic. The suggested framework has the potential to advance these efforts so that children will be better protected from maltreatment amidst a pandemic in the future.
Assuntos
COVID-19 , Maus-Tratos Infantis , Adulto , Pesquisa Biomédica , Criança , Serviços de Proteção Infantil , Feminino , Saúde Global , Política de Saúde , Humanos , Masculino , Pandemias , SARS-CoV-2RESUMO
OBJECTIVE: The study aimed to evaluate the impact of prenatal maternal stress on birth weight using a large cohort of predominantly White women living in an urban area. METHOD: Women were recruited between 2005 and 2010. Data collection took place between the 24th and the 28th week of gestation. The Measure of Psychological Stress (MSP-9), a validated tool to assess stress symptoms, was used to collect data on prenatal maternal stress (independent variable). Birth weight (dependent variable) was classified as low birth weight (<2,500 g), normal birth weight (2,500-4,000 g), and macrosomia (>4,000 g). Adjusted odds ratios (aOR) were obtained after performing multivariate logistic regressions adjusted for potential cofounders. At the final stage, 5,721 women were included in analysis. RESULTS: When compared with women experiencing low stress, participants with high stress scores were at increased risk of delivering a newborn with low birth weight before adjustment (OR = 2.06, 95% CI [1.04, 4.09]), but after adjustment, only a nonsignificant trend remained. However, women experiencing intermediate and high levels of stress were at increased risk of delivering a newborn with macrosomia, even after adjustment (aOR = 1.23, [1.02, 1.49]) and (aOR = 1.76, [1.11, 2.77]) compared to those who scored low on the psychological stress scale. CONCLUSION: Women exposed to high psychological stress during the second trimester (24th to 28th weeks) of pregnancy have a 1.8-fold increased risk for delivering a newborn with macrosomia when compared to women exposed to low psychological stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Assuntos
Peso ao Nascer/fisiologia , Macrossomia Fetal/fisiopatologia , Recém-Nascido de Baixo Peso/fisiologia , Complicações na Gravidez/fisiopatologia , Diagnóstico Pré-Natal/métodos , Estresse Psicológico/psicologia , Adulto , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos ProspectivosRESUMO
BACKGROUND: We investigated the association between antidepressant and anxiolytic exposure during the first and early second trimester of pregnancy (< 16 weeks), and hypertensive disorders of pregnancy (including preeclampsia and gestational hypertension) in women with singleton pregnancy. METHODS: This study is based on a large prospective cohort of 7866 pregnant women. We included pregnant women aged 18 years or older without chronic hepatic or renal disease at the time of recruitment. Participants lost to the follow-up, with multiple pregnancies and pregnancy terminations, miscarriages or fetal deaths before 20 weeks of gestation were excluded from the study, as well as women with no data on the antidepressant/anxiolytic medication use during pregnancy. Information concerning antidepressant or anxiolytic medication use was extracted from hospital records after delivery. The associations between their use and the risk of gestational hypertension or preeclampsia were calculated. RESULTS: The final sample for analysis included 6761 participants including 218 (3.2%) women who were exposed to antidepressant and/or anxiolytic medication before the 16th week of gestation. Forty-one women had a non-medicated depression or anxiety during the pregnancy. Moreover, 195 (2.9%) and 122 (1.8%) women developed gestational hypertension and preeclampsia respectively. When compared to women unexposed to antidepressant/anxiolytic medication, depression and anxiety, those using antidepressant and/or anxiolytic drugs before the 16th week of gestation were at increased risk of preeclampsia (adjusted odd ratio (aOR) 3.09 [CI95% 1.56-6.12]), especially if they continued their medication after the 16th week (aOR 3.41 [CI95% 1.66-7.02]) compared to those who did not (1.60 [CI95% 0.21-12.34]). CONCLUSIONS: Women exposed to antidepressant and/or anxiolytic medication before the 16th week of pregnancy have a 3-fold increased risk for preeclampsia when compared to women unexposed to antidepressant/anxiolytic medication, depression and anxiety. Also, our results suggested that women who stopped their medication before the 16th week of pregnancy could be benefit from reduced preeclampsia risk.