Investigating change in network structure of eating disorder symptoms after delivery of a smartphone app-based intervention.

BACKGROUND: Eating disorder (ED) research has embraced a network perspective of psychopathology, which proposes that psychiatric disorders can be conceptualized as a complex system of interacting symptoms. However, existing intervention studies using the network perspective have failed to find that symptom reductions coincide with reductions in strength of associations among these symptoms. We propose that this may reflect failure of alignment between network theory and study design and analysis. We offer hypotheses for specific symptom associations expected to be disrupted by an app-based intervention, and test sensitivity of a range of statistical metrics for identifying this intervention-induced disruption. METHODS: Data were analyzed from individuals with recurrent binge eating who participated in a randomized controlled trial of a cognitive-behavioral smartphone application. Participants were categorized into one of three groups: waitlist (n = 155), intervention responder (n = 49), and intervention non-responder (n = 77). Several statistical tests (bivariate associations, network-derived strength statistics, network invariance tests) were compared in ability to identify change in network structure. RESULTS: Hypothesized disruption to specific symptom associations was observed through change in bivariate correlations from baseline to post-intervention among the responder group but were not evident from symptom and whole-of-network based network analysis statistics. Effects were masked when the intervention group was assessed together, ignoring heterogeneity in treatment responsiveness. CONCLUSION: Findings are consistent with our contention that study design and analytic approach influence the ability to test network theory predictions with fidelity. We conclude by offering key recommendations for future network theory-driven interventional studies.

Infant and preschool attachment, continuity and relationship to caregiving sensitivity: findings from a new population-based Australian cohort.

BACKGROUND: Here, we report new prevalence and temporal stability data for child attachment and parental caregiving behaviour, from infancy (1 year) to preschool (4 years). METHODS: Attachment (SSP) and caregiving data (MBQS) were from observations of parents and their infants and preschoolers, who represent the third generation of participants within an Australian longitudinal cohort. RESULTS: At 1 year (n = 314 dyads) and at 4 years (n = 368 dyads), proportions assessed secure were 59% and 71%, respectively. Proportions assessed avoidant were 15% and 11%; ambivalent 9% and 6%, and disorganised 17% and 12%, at 1 and 4 years. Continuity of attachment pattern was highest for the infant secure group. Of dyads initially classified disorganised in infancy, 36% remained so at the preschool assessment. Attachment and caregiving continuities across the infancy-preschool period were highest for the stable secure attachment group and lowest for the stable insecure attachment group. Loss of secure attachment to mother by age 4 years correlated with decreased maternal caregiving sensitivity, and acquisition of secure status by age 4 was associated with increased maternal sensitivity. We found no difference in caregiving sensitivity scores for mothers and fathers for female and male preschool children. CONCLUSIONS: The contemporary infant and preschool attachment proportions we report here closely mirror the patterns of those reported in prior decades, with an inclination towards secure base relationships. Our findings alert practitioners anew to the responsiveness of early attachment status to change in caregiving responsiveness and support ongoing investment in early identification of disorganised attachment.

Life course predictors of child emotional distress during the COVID-19 pandemic: Findings from a prospective intergenerational cohort study.

BACKGROUND: We examine precursors of child emotional distress during the COVID-19 pandemic in a prospective intergenerational Australian cohort study. METHODS: Parents (N = 549, 60% mothers) of 934 1-9-year-old children completed a COVID-19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7-8 to 27-28 years old; 1990-2010) and again when their children were 1 year old (2012-2019). RESULTS: After controlling for pre-pandemic socio-emotional behaviour problems, COVID-19 child emotional distress was associated with a range of pre-pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre-pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID-19 emotional distress. CONCLUSIONS: Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families.

Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study.

PURPOSE: Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life. METHODS: This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies: The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and The Triple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age. RESULTS: In ATP, social support was associated with lower offspring problems (pregnancy: ß = -0.15; post-birth: ß = -0.12) and greater competencies (pregnancy: ß = 0.12; post-birth: ß = 0.16) at 12 months. In Triple B, social support also predicted lower offspring problems (pregnancy: ß = -0.11; post-birth: ß = -0.07) and greater competencies (pregnancy: ß = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (ß = 0.06). CONCLUSIONS: Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.

Predicting the Trajectories of Parents' Relationship Well-Being During COVID-19 Lockdowns and Beyond: a Vulnerability, Stress and Adaptation Model Perspective.

Strict lockdowns have been employed by many of the world's nations as a public health response to COVID-19. However, concerns have been expressed as to how such public health responses disturb the human ecosystem. In this paper, we report on findings from a longitudinal study of Australian parents in which we investigated how state differences in government-mandated lockdowns affect the relationship well-being (i.e., relationship satisfaction and loneliness) of parents. We situated the study of the relational effects of strict lockdowns within the Vulnerability Stress Adaptation Model (VSAM, Karney & Bradbury, 1995) that considers the role of parents' pre-existing vulnerabilities (i.e., psychological distress and attachment insecurity), life stressors (pre-pandemic and COVID-19 stressors), and adaptive relationship processes (constructive communication and perceived partner support). A total of 1942 parents completed 14 waves of assessments of relationship satisfaction and loneliness over a 13.5-month period as well as baseline assessments of personal vulnerabilities, life stressors, and adaptive relationship processes. Parents with high relationship adaptations and low vulnerabilities evidenced the highest relationship well-being (i.e., high satisfaction and low loneliness) during changes in lockdown restrictions, while parents with moderate relationship adaptations and vulnerabilities experienced the poorest well-being. Differences in state lockdown restrictions (i.e., Victoria [long and strict lockdown policy] vs all other states) were associated with differences in relationship well-being for parents with high relationship adaptations. Specifically, Victorian parents experienced significant declines in relationship well-being compared to non-Victorian parents. Our findings provide novel insights into how government-mandated social restrictions can disrupt the relational ecology of parents.

Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium.

BACKGROUND: This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. METHODS: Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. RESULTS: Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. CONCLUSIONS: Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.

A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial.

OBJECTIVES: To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. DESIGN: Single-site, double-blinded randomised controlled trial. SETTING: Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program. PARTICIPANTS: Women aged 40 years or more, with or without a history of breast cancer and reporting any alcohol consumption, who attended the clinic for routine mammography during 5 February - 27 August 2021. INTERVENTION: Active arm: animation including brief alcohol intervention (four minutes) and lifestyle health promotion (three minutes). CONTROL ARM: lifestyle health promotion only. MAJOR OUTCOME MEASURE: Change in proportion of women who identified alcohol use as a clear risk factor for breast cancer (scaled response measure). RESULTS: The mean age of the 557 participants was 60.3 years (standard deviation, 7.7 years; range, 40-87 years); 455 had recently consumed alcohol (82%). The proportions of participants aware that alcohol use increased the risk of breast cancer were larger at four weeks than at baseline for both the active intervention (65% v 20%; odds ratio [OR], 41; 95% confidence interval [CI], 18-97) and control arms of the study (38% v 20%; OR, 4.9; 95% CI, 2.8-8.8), but the change over time was greater for the active intervention arm (arm × time: P < 0.001). Alcohol literacy also increased to a greater extent in the active than the control arm, but alcohol consumption did not significantly change in either arm. CONCLUSION: A tailored brief alcohol intervention for women attending breast screening was effective for improving awareness of the increased breast cancer risk associated with alcohol use and alcohol literacy more broadly. Such interventions are particularly important given the rising prevalence of risky drinking among middle-aged and older women and evidence that even very light alcohol consumption increases breast cancer risk. REGISTRATION: ClinicalTrials.gov, NCT04715516 (prospective; 20 January 2021).

The Legacy of Mental Distress Following Physical Illness in Childhood: Findings From the Australian Temperament Project.

OBJECTIVE: Childhood physical illnesses have been associated with heightened risk for mental health problems in adolescence and young adulthood; however, little is known about the natural history of this relationship. Here, we examine the nature of mental health adjustment to illness from diagnosis in childhood into adolescence and young adult life. METHODS: Data were drawn from a large population-based cohort. Parents reported whether their child had a physical illness at 5-6 and 7-8 years and whether they believed their child was so sick it was thought they might die. Depression and anxiety symptoms were reported by parents (for children 7-10 years) and self-reports (11-28 years). RESULTS: A total of 1,001 (56%) parents reported their child had a physical illness. Of these parents, 143 (8%) believed their child might die. Findings indicated there was some evidence of higher levels of depressive and anxious symptoms across late childhood and into early adolescence for those reporting a physical illness in childhood. A similar pattern was observed for those who were so sick it was thought they might die, although symptoms were elevated to a greater extent. CONCLUSION: Although physical illness in middle childhood is associated with higher levels of depressive and anxious symptoms, by early adolescence, these differences diminish, indicating a process of adaptation that persists into young adulthood. This suggests a potentially sensitive period of adjustment to illness for some, especially for children who it was feared might die. Additional psychosocial assessment and support may be warranted across the "acute" illness period.

Parental history of positive development and child behavior in next generation offspring: A two-cohort prospective intergenerational study.

This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (ßrange  = .11-.16) and fewer behavior problems (ßrange  = -.09 to -.11). Promoting strengths may secure a healthy start to life.

Factor structure of the Mini-Maternal Behavior Q-Sort and associations with infant attachment: Informing precision in research and intervention.

We examined the factor structure of parental sensitivity to infants as assessed by the Mini-Maternal Behavior Q-Sort (Mini-MBQS), a 25-item short-form of the original 90-item MBQS. We aimed to: (1) identify latent factors of the Mini-MBQS; and (2) validate each factor by testing associations with infant attachment classifications. Data on parent-infant dyads (n = 313; 222 mothers with 281 children, 29 fathers with 32 children) were drawn from a three-generation Australian cohort study. Exploratory Factor Analysis and Exploratory Structural Equation Modelling examined the structure of the Mini-MBQS. Two latent Mini-MBQS factors were identified, requiring 8 of 25 original items: (1) Attention and Responsiveness and (2) Contingency in Interactions. Infants with insecure attachment classifications had parents with lower sensitivity across both factors relative to infants classified secure. In particular, infants with resistant attachment classifications had parents with notably low Contingency in Interactions scores. Infants with disorganised attachment classifications had parents with the lowest relative sensitivity across both factors, and in these dyads Attention and Responsiveness scores were especially low. Results provide an empirically derived factor structure for the Mini-MBQS. Two subscales, each with significant infant attachment associations, may improve precision in clinical intervention and research translation.

Father trait anger and associations with father-infant bonding and caregiving: The mediating role of mentalizing.

Trait anger reflects a tendency to feel irritation, annoyance, and rage, and involves a narrowing of cognition and attention. This narrowed scope may impact the capacity to understand the mental states of oneself and others (mentalizing), which for fathers of infants may compromise bonding and caregiving involvement. Here, we investigated the extent to which mentalizing mediated the relationship between father trait anger and both father-infant bonding and father involvement in infant caregiving. Data were from 168 fathers (M = 30.04 years of age, SD = 1.36) of 190 infants (M = 7.58 months of age, SD = 5.06) in the longitudinal Men and Parenting Pathways (MAPP) study. We assessed fathers' preconception trait anger at Wave 1 and their mentalizing 2 years later at Wave 3. At Waves 3, 4, and/or 5, we assessed father-infant bonding and father involvement in infant caregiving when men had an infant younger than 18 months of age. Associations were examined using path analysis. Poorer mentalizing fully mediated the relationship between preconception trait anger and father-infant bonding (total score), but not involvement in infant caregiving. Further, poorer mentalizing fully mediated the relationships between trait anger and each component of the father-infant bond (i.e., patience and tolerance, affection and pride, and pleasure in interactions). Findings suggest that for men high on trait anger, targeted interventions that facilitate mentalizing capacities may help to develop a foundation for a strong father-infant bond. Interventions may be offered on becoming a father (perinatal), or prior to becoming a father (preconception) to prevent future bonding problems.

An exploratory application of machine learning methods to optimize prediction of responsiveness to digital interventions for eating disorder symptoms.

OBJECTIVE: Digital interventions show promise to address eating disorder (ED) symptoms. However, response rates are variable, and the ability to predict responsiveness to digital interventions has been poor. We tested whether machine learning (ML) techniques can enhance outcome predictions from digital interventions for ED symptoms. METHOD: Data were aggregated from three RCTs (n = 826) of self-guided digital interventions for EDs. Predictive models were developed for four key outcomes: uptake, adherence, drop-out, and symptom-level change. Seven ML techniques for classification were tested and compared against the generalized linear model (GLM). RESULTS: The seven ML methods used to predict outcomes from 36 baseline variables were poor for the three engagement outcomes (AUCs = 0.48-0.52), but adequate for symptom-level change (R2  = .15-.40). ML did not offer an added benefit to the GLM. Incorporating intervention usage pattern data improved ML prediction accuracy for drop-out (AUC = 0.75-0.93) and adherence (AUC = 0.92-0.99). Age, motivation, symptom severity, and anxiety emerged as influential outcome predictors. CONCLUSION: A limited set of routinely measured baseline variables was not sufficient to detect a performance benefit of ML over traditional approaches. The benefits of ML may emerge when numerous usage pattern variables are modeled, although this validation in larger datasets before stronger conclusions can be made.

Monitoring Australian parents' shifting receptiveness to digital mental health interventions during the COVID-19 pandemic.

BACKGROUND: Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. METHOD: The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. RESULTS: More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child's mental health. Between-person baseline predictors of higher intention ratings were parent's prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child's education, lower social support and financial hardship. CONCLUSION: Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need.

Parent and child mental health trajectories April 2020 to May 2021: Strict lockdown versus no lockdown in Australia.

OBJECTIVE: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. METHODS: Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children's Anxiety Scale). RESULTS: Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [ß] = 0.09-0.46), parent/child diagnoses (ß = 0.07-0.21), couple conflict (ß = 0.07-0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (ß = 0.12-0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). CONCLUSION: Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.

Examining Analytic Practices in Latent Dirichlet Allocation Within Psychological Science: Scoping Review.

BACKGROUND: Topic modeling approaches allow researchers to analyze and represent written texts. One of the commonly used approaches in psychology is latent Dirichlet allocation (LDA), which is used for rapidly synthesizing patterns of text within "big data," but outputs can be sensitive to decisions made during the analytic pipeline and may not be suitable for certain scenarios such as short texts, and we highlight resources for alternative approaches. This review focuses on the complex analytical practices specific to LDA, which existing practical guides for training LDA models have not addressed. OBJECTIVE: This scoping review used key analytical steps (data selection, data preprocessing, and data analysis) as a framework to understand the methodological approaches being used in psychology research using LDA. METHODS: A total of 4 psychology and health databases were searched. Studies were included if they used LDA to analyze written words and focused on a psychological construct or issue. The data charting processes were constructed and employed based on common data selection, preprocessing, and data analysis steps. RESULTS: A total of 68 studies were included. These studies explored a range of research areas and mostly sourced their data from social media platforms. Although some studies reported on preprocessing and data analysis steps taken, most studies did not provide sufficient detail for reproducibility. Furthermore, the debate surrounding the necessity of certain preprocessing and data analysis steps is revealed. CONCLUSIONS: Our findings highlight the growing use of LDA in psychological science. However, there is a need to improve analytical reporting standards and identify comprehensive and evidence-based best practice recommendations. To work toward this, we developed an LDA Preferred Reporting Checklist that will allow for consistent documentation of LDA analytic decisions and reproducible research outcomes.

Inequalities in the distribution of COVID-19-related financial difficulties for Australian families with young children.

BACKGROUND: We examine (1) the frequency of financial difficulties in Australian families with young children (0-8 years) in the early and later phases of the pandemic; (2) the extent to which parents' pre-pandemic socio-economic disadvantage (SED) predicted financial difficulties; and (3) whether grandparent intergenerational SED further amplified this risk. METHOD: Data: Australian Temperament Project (ATP; established 1983, N = 2443) and ATP Generation 3 study (ATPG3; established 2012; N = 702), of which 74% (N = 553) completed a COVID-specific module in the early (May-September 2020) and/or later (October-December 2021) phases of the pandemic. OUTCOMES: Parent-reported loss of employment/reduced income, difficulty paying for essentials, and financial strain. EXPOSURES: Pre-pandemic parent and grandparent education and occupation. ANALYSIS: Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre-pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders. RESULTS: At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30-38; later: 32%, 95% CI = 28-36). Each standard deviation increase in the parents' pre-pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04-1.78). There was little evidence of an interaction between the SED of parents and grandparents. CONCLUSIONS: Financial impacts related to the COVID-19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre-pandemic SED. Given the well-established relationship between disadvantage and child health and development, sustained and well-targeted government supports will be critical to minimizing adverse impacts in years to come.

Adolescent antecedents of maternal and paternal perinatal depression: a 36-year prospective cohort.

BACKGROUND: Rates of common mental health problems (depression/anxiety) rise sharply in adolescence and peak in young adulthood, often coinciding with the transition to parenthood. Little is known regarding the persistence of common mental health problems from adolescence to the perinatal period in both mothers and fathers. METHODS: A total of 393 mothers (686 pregnancies) and 257 fathers (357 pregnancies) from the intergenerational Australian Temperament Project Generation 3 Study completed self-report assessments of depression and anxiety in adolescence (ages 13-14, 15-16, 17-18 years) and young adulthood (ages 19-20, 23-24, 27-28 years). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms at 32 weeks pregnancy and 12 months postpartum in mothers, and at 12 months postpartum in fathers. RESULTS: Most pregnancies (81%) in which mothers reported perinatal depression were preceded by a history of mental health problems in adolescence or young adulthood. Similarly, most pregnancies (83%) in which fathers reported postnatal depression were preceded by a preconception history of mental health problems. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (ORwomen 5.7, 95% CI 2.9-10.9; ORmen 5.5, 95% CI 1.03-29.70). CONCLUSIONS: Perinatal depression, for the majority of parents, is a continuation of mental health problems with onsets well before pregnancy. Strategies to promote good perinatal mental health should start before parenthood and include both men and women.

Young adult mental health sequelae of eating and body image disturbances in adolescence.

OBJECTIVE: There has been interest in the antecedents and mental health impacts of eating and body image disturbances in adolescence. Less is known about longer-term mental health impacts into young adulthood, as longitudinal studies with data spanning this developmental period are rare. We capitalize on mental health data collected across adolescence and young adulthood from a population-based cohort study that has been following >2000 Australian children and their families from infancy to young adulthood. METHOD: This sample comprised 1,568 participants who completed the Eating Disorder Inventory drive for thinness and bulimic behavior (the severity of binge-purge patterns) subscales, and a modified version of the body dissatisfaction subscale in mid-adolescence (15-16 years), or the Depression Anxiety Stress Scales in young adulthood (19-20, 23-24, and 27-28 years). RESULTS: After adjusting for baseline demographic and prior mental health factors (<13 years of age), all three indices of eating and body image disturbances in adolescence predicted each mental health outcome in young adulthood. Mental health risks associated with adolescent body dissatisfaction and bulimic behavior scores remained stable across young adulthood, with men having more pronounced problems associated with bulimic behavior scores than women. In contrast, mental health risks associated with adolescent drive for thinness scores diminished across this period similarly for men and women. DISCUSSION: Findings suggest that adolescent eating and body image disturbances may have long-term mental health impacts that extend into young adulthood. This underscores the need for early preventative intervention, and longer-term monitoring and support for body image and eating disturbances.

Preconception depression and anxiety symptoms and maternal-infant bonding: a 20-year intergenerational cohort study.

Early maternal-infant bonding problems are often forerunners of later emotional and behavioural difficulties. Interventions typically target the perinatal period but many risks may be established well before pregnancy. Here we examine the extent to which adolescent and young adult depression and anxiety symptoms predict perinatal maternal-infant bonding difficulties. The Victorian Intergenerational Health Cohort Study (VIHCS, est. 2006) is following offspring born to the Victorian Adolescent Health Cohort Study (VAHCS; est. 1992). VAHCS participants were assessed for depression and anxiety symptoms nine times during adolescence and young adulthood (age 14-29 years), and then contacted bi-annually (from age 29-35 years) to identify pregnancies. The Postpartum Bonding Questionnaire (PBQ) was administered to mothers at 2 and 12 months postpartum. A total of 395 women (606 infants) completed the 2-month and/or 12-month postpartum interviews. For most infants (64%), mothers had experienced depression and/or anxiety before pregnancy. Preconception depression and anxiety symptoms that persisted from adolescence into young adulthood predicted maternal-infant bonding problems at 2 months (ß = 0.30, 95% CI 0.04, 0.55) and 12 months postpartum (ß = 0.40, 95% CI 0.16, 0.63). Depression and anxiety symptoms occurring in young adulthood only, also predicted bonding problems at 12 months postpartum (ß = 0.37, 95% CI 0.02, 0.71). Associations between preconception depression and anxiety symptoms and anxiety-related maternal-infant bonding problems at 12 months postpartum remained after adjustment for antenatal and concurrent postpartum depressive symptoms. This study puts forward a case for extending preconception health care beyond contraception and nutrition to a broader engagement in supporting the mental health of young women from adolescence.

Early childhood attachment stability and change: a meta-analysis.

Examining degrees of stability in attachment throughout early childhood is important for understanding developmental pathways and for informing intervention. Updating and building upon all prior meta-analyses, this study aimed to determine levels of stability in all forms of attachment classifications across early childhood. Attachment stability was assessed between three developmental epochs within early childhood: infancy, toddlerhood, and preschool/early school. To ensure data homogeneity, only studies that assessed attachment with methods based on the strange situation procedure were included. Results indicate moderate levels of stability at both the four-way (secure, avoidant, resistant, and disorganised; κ = 0.23) and secure/insecure (r = 0.28) levels of assessment. Meta-regression analysis indicated security to be the most stable attachment organisation. This study also found evidence for publication bias, highlighting a preference for the publication of significant findings.