A cross-sectional study of father-daughter/son interactions from 1 Month to 3 years of age with the feeding and play scales: Exploring the psychometric properties.

The quality of father-infant/toddler interactions has become a focal point in studies of early child development. However, studies targeting early father-infant/toddler interactions may be hampered due to the lack of specific and validated measures; indeed, most of the applied observational instruments were originally designed to evaluate mother-child interactions. In a sample of 142 fathers-infant/toddler dyads, the current study aimed to test the reliability of the Feeding and Play Scales, which were initially created to assess mother-infant/toddler interactions. Also, we compared the father-infant/toddler feeding and play interactions at different developmental stages, from 1 month to 3 years of the child's age, and we evaluated the effect of the child's gender on the father-infant/toddler feeding and play interactions. Both scales showed satisfactory internal consistency, confirming that the measures are reliable in the evaluation of father-infant/toddler feeding and play interactions. Analyses showed significant correlations between the subscales of the Feeding and Play Scales, significant effects of the child's age and significant gender differences. Our research shows that the Feeding and Play Scales are promising instruments to study the role of fathers in the development of normal and disordered feeding in infants and toddlers.

Maternal perinatal depression, anxiety, fear of birth, and perception of infants' negative affectivity at three months.

The present study aimed to investigate whether a mother's anxiety, depression, prenatal perception of childbirth, and experience with delivery, assessed from pregnancy to three months postpartum, were associated with her perception of her infant's negative affectivity (NA). The participant sample was composed of 76 primiparous mothers and their healthy babies (58% boys, 42% girls). During pregnancy, mothers independently filled out the State-Trait Anxiety Inventory (STAI), the Edinburgh Postnatal Depression Scale (EPDS), and the Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) version A. One month after giving birth, the mothers filled out the W-DEQ version B. Finally, three months after giving birth, they completed the EPDS, the STAI, and the four Infant Behaviour Questionnaire (IBQ-R) scales of NA. Linear regression analyses showed that perinatal FoB, trait anxiety, and depression were associated with a maternal perception of higher infant NA. Studies on perinatal parental health and child outcomes should include assessments of the relation between anxiety during pregnancy and postpartum depression in order to prevent any negative impacts on the temperaments of children.

Attachment to Parents and Peers and Adolescent Mental Health: The Mediating Role of Alexithymia.

The current research aims to study the mediating role of alexithymia on the relationship between attachment to parents and peers and mental health problems in a sample of 242 non-referred adolescents. Participants completed the Inventory of Parent and Peer Attachment, the Toronto Alexithymia Scale, and the Symptom Check List-90-R. Mediation analysis shows that alexithymia fully mediates the relations between attachment to peers and mental health problems in both adolescent males and females. Findings suggest the importance to identify promptly vulnerabilities and risks in order to create prevention and intervention programs aimed to foster positive attachment experiences and to support emotional regulation.

DEVELOPMENT OF THE PARENT-CHILD PLAY SCALE FOR USE IN CHILDREN WITH FEEDING DISORDERS.

The Parent-Child Play Scale was developed as a scale that complements the Parent-Child Feeding Scale, created by I. Chatoor et al. (1997), to evaluate mother-infant/toddler interactions in two different caregiving contexts of a young child's everyday life, specifically play and feeding. This Play Scale can be used with infants and toddlers ranging in age from 1 month to 3 years and provides reliable global ratings of mother-child interactions during 10 min of videotaped free-play in a laboratory setting. The scale consists of 32 mother and infant/toddler interactive behaviors which are rated by trained observers from videotaped observations. Four subscales are derived: Dyadic Reciprocity, Maternal Unresponsiveness to Infant's/Toddler's Cues, Dyadic Conflict, and Maternal Intrusiveness. Construct validity and interrater and test-retest reliability of the Play Scale have been demonstrated. This Play Scale discriminates between children with and without feeding disorders as well as between children with different subtypes of feeding disorders as defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3R) (Feeding Disorder of State Regulation, Feeding Disorder of Caregiver-Infant Reciprocity, and Infantile Anorexia). It can be used for research or clinical practice in the diagnosis and treatment of early feeding problems, to assess the pervasiveness of mother-infant/toddler difficulties and to monitor changes following therapy.

Prenatal and postnatal maternal representations in nonrisk and at-risk parenting: exploring the influences on mother-infant feeding interactions.

The aim of this study was to investigate the mother-infant relationship in depressive, psychosocial, and cumulative-risk parenting by assessing prenatal and postnatal maternal representations and mother-infant interactions during feeding at 4 months of age. The sample consisted of 167 mother-infant pairs: 41 nonrisk women, 40 depressive-risk women, 40 psychosocial-risk women, and 46 cumulative-risk women. During pregnancy, the women were interviewed about psychosocial-risk variables. Maternal representations and depressive symptoms were evaluated during pregnancy and again when the infants were 3 and 4 months old, respectively. All mother-infant pairs were observed in 20-min video recordings during breast-feeding. Maternal Integrated/balanced representations were more frequent in the nonrisk group whereas the maternal Nonintegrated/ambivalent category was more represented in the cumulative-risk group during pregnancy and after the infant's birth. At 4 months, the cumulative-risk group of mothers and infants showed a lack of reciprocity, conflictual communicative exchanges, and higher food refusal behavior. Moreover, at 4 months, differences between the quality of mother-infant feeding interactions and the quality of prenatal and postnatal maternal representations emerged, showing less adequate maternal scaffolding in the Nonintegrated/ambivalent and Restricted/disengaged women. This study has rich implications for intervention to support the affective and communicative caregiving system and to prevent infant feeding problems and mother-infant relational disturbances in childhood.

Feeding disorders of early childhood: an empirical study of diagnostic subtypes.

OBJECTIVE: The aim of this study was to examine the differences among three subtypes of feeding disorders (FD), defined through the criteria of the DC:0-3R: "Infantile Anorexia" (IA), "Feeding Disorder Associated with Insults to the Gastrointestinal Tract" (FDIGT), and "Sensory Food Aversions" (SFA), by exploring mother-child interactions during feeding, children's temperament and emotional-adaptive functioning, and mothers' psychological profile and eating attitudes. METHOD: The sample consisted of 146 Italian mother-child pairs, of which 51 children with IA, 47 children with FDIGT, and 48 mothers and their children with SFA. All dyads were videotaped during feeding; mothers completed questionnaires assessing their psychological profiles and eating attitudes, as well as their children's temperament and emotional/behavioral functioning. RESULTS: Analyses revealed significant differences between the diagnostic groups of FD in relation to mother-child interactions during feeding, children's temperament and emotional-adaptive functioning, and mothers' psychological profile and eating attitudes. DISCUSSION: Both interactional and individual variables may contribute differently to specific FD and outcomes during childhood. Definitions by FD subtypes, using operational diagnostic criteria, and the assessment of mother-child interactions are relevant to target interventions strategies to treat specific disorders.

Parental Pre and Postnatal Depression: The Longitudinal Associations with Child Negative Affectivity and Dysfunctional Mother-Child Feeding Interactions.

BACKGROUND: Many studies have shown the influence of maternal perinatal depression on a child's emotional and behavioral regulation ability; yet there is scarce research on the impact of the father's perinatal depression on the caregiver-infant relationship and the child's development. METHODS: Through a longitudinal study, we investigated maternal and paternal depression and its association with infants' emotionality and mother-infant feeding interactions The sample was constituted of 136 first-time parents (68 couples, and their full-term babies at 3 and 6 months old). At T1 (28th week of pregnancy), T2 (three months old), and T3 (at six months age) parents responded to the Edinburgh Postpartum Depression Scale. At Times 2 and 3, mothers and fathers completed the Infant Behavior Questionnaire, and recorded mother-infant interactions were coded by means of the Feeding Scale. RESULTS: Statistical analyses indicated stability of maternal and paternal depression over time. Correlations emerged between mother's higher depression scores, negative affective state during interactions at three months age, infant food refusal and mother-infant interactional conflict at six months age. Paternal higher depressive scores were associated with the mother-child interactional conflict. To finish, higher parental depression scores were related with infant negative emotionality. CONCLUSION: The current study confirms the relevance of embracing a cumulative risk model to support the child's development with early caregiver-child interventions.

Failure to thrive in toddlers with lack of interest in eating and food and their cognitive development during later childhood.

Background: Experiencing Failure to Thrive or malnutrition in early years has been associated with children later displaying low Intelligence Quotient (IQ). The current study's aim was to examine whether Failure to Thrive in Toddlers with Lack of Interest in Eating and Food, a subtype of Avoidant/Restrictive Food Intake Disorder as defined by DSM-5, which has also previously been identified as Infantile Anorexia (IA), was associated with poor cognitive development outcomes during later childhood. Methods: The IQs and growth parameter of 30 children (53% female) previously diagnosed and treated for IA at 12 to 42 months of age, were reevaluated at a mean age of 10.0 years (SD = 2.1 years) and compared to 30 matched control children. Children's growth was assessed using Z-scores and their cognitive development was measured using the Wechsler Intelligence Scale for Children-4th Edition. Results: None of the growth parameters were significantly related to IQ. Further, IQ scores of children previously diagnosed with IA and control children were not significantly different. However, the education level of children's fathers had a significantly positive effect on IQ. Conclusions: Our study highlights the disjunction between growth parameters and IQ within our sample. Overall, our findings suggest that the primary target of intervention for these children should be the parent-child conflict around the feeding relationship, rather than a focus on the child's weight itself. Finally, our results confirm the relevance to include fathers in the intervention of these children.

Children with autism spectrum disorders and severe visual impairments: Some general principles for intervention according to the perspective of clinical psychology of disability.

In the last decades, an increasing number of researchers addressed the relationship between autism spectrum disorders (ASD) and severe visual impairment (SVI) (like blindness or very low visual acuity) and nowadays autism could be considered one of the most reported coexisting developmental disorders in children with blindness or other severe visual impairment. As ASD and SVI' signs and symptoms affect functioning and quality of life and different domains of functioning of children with this comorbidity, it is very important to support individuals and their families as soon as possible in the cycle of life and to promote specific interventions aimed to promote developmental potential of everyone with both ASD and VI, based on the unique balance between strengths, needs and abilities of everyone. Children and individuals with SVI and ASD and SVI are a very heterogeneous group, both about the areas of social interaction, communication, and behaviour, as well as about visual abilities and about all the other aspects of their neuropsychological and functional profiles that are influenced by their visual impairments itself, their ASD itself and the combination of them. In this paper, we aim to discuss some general principles useful to design and to develop specific interventions and to promote inclusion of children with ASD and SVI.

Feeding disorders of infancy: a longitudinal study to middle childhood.

OBJECTIVE: To evaluate over time feeding behavior and emotional-behavioral functioning in a sample of children diagnosed with Infantile Anorexia (IA) and a group of typically developing children; and to investigate the relationship between maternal psychological functioning and the children's feeding patterns and emotional-behavioral functioning. METHOD: Seventy-two children diagnosed with IA and 70 children in the control group were prospectively evaluated through several measures at two, five, and eight years of age. RESULTS: Our findings revealed partial improvement in the nutritional status of the children with IA. However, they continued to show ongoing eating problems and, in addition, anxiety/depression and withdrawal, as well as rule-breaking behaviors and social problems. There were significant correlations between the children's eating problems and their emotional difficulties and their mothers' increased emotional distress and disturbed eating attitudes. DISCUSSION: Our longitudinal study points out that the natural course of untreated IA is characterized by the persistence of difficulties in eating behavior and emotional-behavioral adjustment in both, the children and their mothers.

Attachment style and mental health during the later stages of COVID-19 pandemic: the mediation role of loneliness and COVID-19 anxiety.

BACKGROUND: An insecure attachment style is an important risk factor for psychological problems. The aim of this study was to use Bartholomew and Horowitz's model (Bartholomew and Horowitz in J Pers Soc Psychol 61(2): 226, 2019) to test a sample of Italian individuals to determine the mediation role of loneliness and COVID-19-related anxiety symptoms in the relationship between attachment styles and mental health issues in the context of the pandemic. METHOD: A cross-sectional research study was conducted using a sample of 330 Italian participants (82.1% women; mean age = 34.3 years; SD = 13.16) who completed online self-reported measures of attachment styles (RQ), loneliness (RULS), COVID-19-related anxiety symptoms (C-19ASS) and mental health problems (GHQ-12). Serial mediation analyses were performed, and bootstrap tests were included. RESULTS: Our results supported the hypothesized model with respect to each attachment style (p < 0.001). In particular, insecure attachment styles predict mental health problems both directly and indirectly, through loneliness and COVID-19-related anxiety symptoms. In addition, loneliness directly influences mental health problems and also mediates the relationship between insecure attachment styles and COVID-19-related anxiety symptoms which, in turn, positively predict mental health problems. CONCLUSIONS: Our findings reinforce the importance of attachment in people's processes of adapting to experiences during the coronavirus pandemic. The study makes an important contribution to developing effective prevention and intervention strategies to support people's wellbeing in the context of the pandemic.

Risk and Protective Factors Associated with Student Distress and School Dropout: A Comparison between the Perspectives of Preadolescents, Parents, and Teachers.

This study investigates the principal risk and protective factors associated with student distress and school dropout in a group of preadolescents, through a qualitative and quantitative comparison between the perspectives of students, parents, and teachers. We administered a questionnaire to evaluate student distress and school dropout in a middle school (student's age range 13-15 years). We afterwards analyzed the responses of students at risk of school dropout. We also administered a semi-structured interview with their parents and their teachers. The results indicated significant levels of school distress in students (Collective Distress > 8.75) and a problematic relationship between parents and students (22.42%). We also found a problematic relationship between teachers and students (24.39%). The main protective factor of student distress and school drop-out indicated by the students was a more sensitive and supportive relationship with both parents and teachers. On the contrary, parents and teachers indicated as possible causes of school distress and drop-out the intrinsic students' motivation or other external factors associated with the community. The results of our study highlight the importance to apply a multidimensional and transactional psycho-educational model, in which the relationship between the students and their caretaker plays a major role.

Mentalizing Emotions and Social Cognition in Bullies and Victims.

Mentalizing is the ability to represent mental states to navigate the social world. A reduced mentalizing ability is a risk factor for a variety of psychological issues. Several studies indicated deficits in social cognition in bullies and victims, specifically in mentalizing anger. However, only a few studies investigated mentalizing abilities related to both anger and happiness in pre-adolescence. Our study investigated possible differences in the ability to mentalize anger and happiness in preadolescent bullies and victims, compared to a control group. We interviewed 104 preadolescents (44% males; 56% females; M = 13.2 years; SD = 0.82) and administered the Olweus Questionnaire to identify bullies and victims. We applied a narrative approach to investigate the mental state language referred to anger and happiness. The results indicated a reduced ability to mentalize anger in bullies and victims compared to controls. Both bullies and victims tended to consider anger and happiness predominantly as behavioral conditions rather than a state of mind. These results highlight the need to promote effective intervention programs to prevent bullying by enhancing appropriate mentalization of emotions in pre-adolescents.

Depressive Symptoms and Quality of Life in a Sample of Italian Women with a Diagnosis of Fibromyalgia: The Role of Attachment Styles.

BACKGROUND: Women with fibromyalgia (FM) commonly suffer from depression, pervasive fatigue, and pain. The attachment style has been hypothesized to be an important factor for understanding the experience of these symptoms. Therefore, the present cross-sectional study is aimed at investigating the effect of attachment styles in women with a diagnosis of FM on depressive symptoms and quality of life. METHOD: Participants were 453 Italian women with a physician's diagnosis of FM with a mean age of 47 years (SD = 10.9). To assess attachment styles, quality of life, and depressive symptoms, women responded, respectively, to the Relationship Questionnaire, the World Health Organization Quality of Life Questionnaire, and the Beck Depression Inventory II. RESULTS: Our results showed that the incidence of depressive symptoms was elevated, with 59% of women reporting moderate to severe symptoms. Also, the statistical analyses showed that both preoccupied and avoidant/dismissing attachments were related with depression symptoms and low perception of QoL. CONCLUSIONS: Our study demonstrates that, when evaluating the impact of FM on the QoL of women, it is important to consider the complexity of the variables that are at play. Insecure attachment styles and depressive symptoms seem to increase the likelihood of the psycho-social-somatic malaise in FM women.

Maternal Attachment Representations during Pregnancy, Perinatal Maternal Depression, and Parenting Stress: Relations to Child's Attachment.

BACKGROUND: This paper aimed to explore the associations between maternal representations of attachment evaluated during pregnancy, pre and postnatal maternal depression, parenting stress and child's attachment at 15 months after childbirth. METHODS: Mothers (n = 71), and their infants participated in a longitudinal study of maternal attachment, pre and postnatal depression, parenting stress and child attachment. Adult Attachment Interview (AAI) was conducted between 24 and 26 weeks of pregnancy (Time 1), depression was assessed using the Edinburgh Perinatal Depression Scale (EPDS) (at Time 1 and 6 months after childbirth, i.e., Time 2), parenting stress was assessed using the Parenting Stress Index-Short Form (PS-SF) (at Time 2) and the Strange Situation Procedure (SSP) at child's 15 months of age (Time 3). RESULTS: Free-autonomous maternal classification of attachment increases the likelihood of secure child classification in her offspring, while decreases that of avoidance and ambivalence. Insecure maternal representation of attachment evaluated during pregnancy and higher levels of parenting stress at six months after childbirth was associated with higher rates of infant insecure attachment at 15 months. CONCLUSIONS: Our study validates the importance of considering maternal representations of attachment crucial in determining the quality of the caregiving environment, thereby the healthy development of children, despite the presence of other contextual risk.

Maternal psychopathology and child risk factors in infantile anorexia.

OBJECTIVE: This study examines a transactional and multirisk model for Infantile Anorexia (IA) and investigates the contributions of the parent, the child, and dyadic interactional variables related to this feeding disorder. METHOD: The sample consisted of 371 mother-child pairs (children aged 6-36 months), of which 187 pairs of mothers and normally developing children (ND-group), and 184 mothers and IA children. All dyads were videotaped during feeding; mothers completed questionnaires assessing their psychological profiles and eating attitudes, as well as their children's temperament and emotional/ behavioral functioning. RESULTS: Analyses revealed that the IA-group showed higher scores in symptomatic characteristics both of the mother and of the child, and dysfunctional interactions during feeding as compared with the ND-group. Further analyses revealed that both child and maternal characteristics are significant predictors of dyadic interactional conflict. DISCUSSION: Results confirm that a multidimensional assessment is critical in the evaluation of IA.

Reflective parenting home visiting program: A longitudinal study on the effects upon depression, anxiety and parenting stress in first-time mothers.

OBJECTIVE: Our study aimed to investigate the effects of a reflective parenting home visiting program in first time-mothers at risk for depression, anxiety, and parenting stress, from three to 12 months after their child's birth. STUDY DESIGN: The sample was composed by 77 first-time mothers and their healthy babies (53% boys and 47% girls). Mothers filled out the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, and the Parenting Stress Index-SF at 3, 6 and 12 months of the child. Thirty-six mothers were assigned to the experimental group and received the reflective parenting home-visiting program, the other 36 constituted the control group. RESULTS: Analyses showed a significant higher reduction in the level of depression, anxiety and parenting stress among mothers belonging to the experimental group, compared to the control group. CONCLUSION: Our findings confirm the benefits of reflective parenting home visiting programs and underline the need to constantly evaluate the levels of depression, anxiety and parenting stress throughout the perinatal period to target effective prevention programs to foster early mother-child attachment bond.

First-Time Mothers' and Fathers' Developmental Changes in the Perception of Their Daughters' and Sons' Temperament: Its Association With Parents' Mental Health.

OBJECTIVE: Most studies investigating the role of parenting behaviors on a child's development are directed to mothers. However, recent analyses show that mothers and fathers have a different influence on a child's functioning, specifically her/his temperament. The present study explored the developmental change of parents' perception of their daughters' and sons' temperament and its association with parental mental health problems. METHODS: The sample included 188 parents (94 couples) and their at-term 94 babies (55.3% boys, 44.7% girls). Assessments by self-reports were conducted at 3 (Time 1) and 12 (Time 2) months after the children's birth; at Time 1, mothers and fathers independently answered: the State-Trait Anxiety Inventory (STAI), the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Behavior Questionnaire (IBQ-R). At Time 2, EPDS, STAI, and IBQ-R were again administered to mothers and fathers. RESULTS: In general, mothers and fathers would give similar descriptions of their child's temperament throughout the first year of life; however, infant temperament showed developmental changes as well as gender differences. Mother and father anxiety and depression symptoms are associated with the infants' negative affectivity. Also, mothers with high anxiety and depression levels perceive their infants with a minor tendency to approach novelty, to seek environmental stimulation, and to express/experience positive emotions. CONCLUSION: The results highlight the need to screen for infants' temperament vulnerabilities in the context of maternal and paternal depression in order to protect the child from behavioral, cognitive, and emotional difficulties and to create specific programs aimed at preventing dysfunctional parent-infant relationships.

Adult attachment styles, self-esteem, and quality of life in women with fibromyalgia.

Recently, the research on pain-related disability has increasingly paid attention to the psychological and social factors that may influence the biological condition. In the current study, we aimed to explore attachment styles, self-esteem, and quality of life in individuals with a diagnosis of fibromyalgia. Participants were 371 diagnosed women, with a mean age of 42.7 years (standard deviation = 10.6). The average number of years since diagnosis was 7.4 years (standard deviation = 2.4) years. To assess attachment, quality of life, and self-esteem, women responded, respectively, to the Relationship Questionnaire, the World Health Organization Quality of Life Questionnaire, and the Rosenberg Self-Esteem Inventory. Our results showed that secure attachment relationships and high self-esteem represent protective factors for quality of life of women with fibromyalgia, while the contrary emerged for insecure attachments and low self-esteem. The understanding of the psychological components that contribute to fibromyalgia may improve the effectiveness of interventions.

Prevalence and correlates of mental disorders among adolescents in Italy: the PrISMA study.

BACKGROUND: While in the last 5 years several studies have been conducted in Italy on the prevalence of mental disorders in adults, to date no epidemiological study has been targeted on mental disorders in adolescents. METHOD: A two-phase study was conducted on 3,418 participants using the child behavior checklist/6-18 (CBCL) and the development and well-being assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians. RESULTS: The prevalence of CBCL caseness and DSM-IV disorders was 9.8% (CI 8.8-10.8%) and 8.2% (CI 4.2-12.3%), respectively. DSM-IV Emotional disorders were more frequently observed (6.5% CI 2.2-10.8%) than externalizing disorders (1.2% CI 0.2-2.3%). In girls, prevalence estimates increased significantly with age; furthermore, living with a single parent, low level of maternal education, and low family income were associated with a higher likelihood of suffering from emotional or behavioral problems. CONCLUSIONS: Approximately one in ten adolescents has psychological problems. Teachers and clinicians should focus on boys and girls living with a single parent and/or in disadvantaged socioeconomic conditions.