Attachment security and problematic media use in infancy: A longitudinal study in the United States.

Media use during childhood has quickly become a norm across the United States and in other countries. One area still not well understood is the development of problematic (or maladaptive and disruptive) media use in children. This research examines the role of attachment security as a central component in the development of problematic media use over time in a sample of 248 parent-child dyads (9.50% African American, 20.66% Hispanic, 62.81% White, 2.07% Asian, 4.96% other ethnicities). We examined the relationship between attachment security and problematic media use one and 2 years later. We then constructed a mediation model examining parent responsiveness while jointly engaging in media use and during play as mediators between infant attachment security and problematic media use over time. Results suggest that while infant attachment security may be protective against developing problematic media use patterns, this relationship does not seem to be mediated by parent-child interactions while engaging in media or during play.

Real-world clinical outcomes and treatment patterns in patients with MDD treated with vortioxetine: a retrospective study.

BACKGROUND: This study included evaluation of the effectiveness of vortioxetine, a treatment for adults with major depressive disorder (MDD), using patient-reported outcome measures (PROMs) in a real-world setting. METHODS: This retrospective chart review analyzed the care experiences of adult patients with a diagnosis of MDD from Parkview Physicians Group - Mind-Body Medicine, Midwestern United States. Patients with a prescription for vortioxetine, an initial baseline visit, and ≥ 2 follow-up visits within 16 weeks from September 2014 to December 2018 were included. The primary outcome measure was effectiveness of vortioxetine on depression severity as assessed by change in Patient Health Questionnaire-9 (PHQ-9) scores ~ 12 weeks after initiation of vortioxetine. Secondary outcomes included changes in depression-related symptoms (i.e., sexual dysfunction, sleep disturbance, cognitive function, work/social function), clinical characteristics, response, remission, and medication persistence. Clinical narrative notes were also analyzed to examine sleep disturbance, sexual dysfunction, appetite, absenteeism, and presenteeism. All outcomes were examined at index (start of vortioxetine) and at ~ 12 weeks, and mean differences were analyzed using pairwise t tests. RESULTS: A total of 1242 patients with MDD met inclusion criteria, and 63.9% of these patients had ≥ 3 psychiatric diagnoses and 65.9% were taking ≥ 3 medications. PHQ-9 mean scores decreased significantly from baseline to week 12 (14.15 ± 5.8 to 9.62 ± 6.03, respectively; p < 0.001). At week 12, the response and remission rates in all patients were 31.0% and 23.1%, respectively, and 67% continued vortioxetine treatment. Overall, results also showed significant improvements by week 12 in anxiety (p < 0.001), sexual dysfunction (p < 0.01), sleep disturbance (p < 0.01), cognitive function (p < 0.001), work/social functioning (p = 0.021), and appetite (p < 0.001). A significant decrease in presenteeism was observed at week 12 (p < 0.001); however, no significant change was observed in absenteeism (p = 0.466). CONCLUSIONS: Using PROMs, our study results suggest that adults with MDD prescribed vortioxetine showed improvement in depressive symptoms in the context of a real-world clinical practice setting. These patients had multiple comorbid psychiatric and physical diagnoses and multiple previous antidepressant treatments had failed.

The impact of parent and child media use on early parent-infant attachment.

With the rise in affordability of digital media and mobile devices, children under age 2 on average spend significantly more time with digital media than is recommended. Although concerns have been expressed about how parent and child media use might negatively impact parent-child attachment, there continues to be a scarcity of research on the topic. The current study assessed both the amount and the way in which children (11-26 months) and their parents engage with digital media and the impact on early attachment after controlling for temperament, parent income, parent age, marital status, and access to support. The study utilizes data from a diverse sample: 248 parents of infants completed an attachment q-sort and surveys assessing the amount of media use, parental absorption in media, types of parental mediation, temperament, and demographics. Results showed that for both parent and child, time using digital media and co-viewing was not predictive of attachment insecurity. Parental absorption in media was found to significantly predict attachment insecurity. Greater child TV media use was associated with poorer attachment security when there was limited to no parental active mediation. Active mediation served as a protective factor for attachment while parental absorption in media serves as a risk factor for attachment.

Chapter II: New Fathers' and Mothers' Daily Stressors and Resources Influence Parent Adjustment and Family Relationships.

To understand new fathers' experiences and well-being, we examine links between fathers and their partners' replenishing and stressful daily experiences-exercise, sleep, work, chores, general stress, and parenting stress-and their own and their partners' well-being and family relations. Fathers and mothers of ten-month old infants (N=143/140 mothers/fathers) in the U.S. reported on daily experiences for eight consecutive days. Results of multilevel models indicated that more replenishing and fewer stressful daily experiences were generally linked to more parent happiness, better couple relations, and greater closeness with the infant. Several gender differences also emerged that may reflect different stress and coping processes or different social roles for mothers and fathers; most striking was that on days that fathers spent more time on chores, mothers reported greater couple closeness but fathers reported more arguments. This exploration of new parents' daily experiences demonstrates the value of the method to generate intervention-relevant insights, as well as the importance of examining fathers' (and mothers') experiences in the context of couple-level dynamics.

Advancing Research and Measurement on Fathering and Child Development.

Fathers are more than social accidents. Research has demonstrated that fathers matter to children's development. Despite noted progress, challenges remain on how best to conceptualize and assess fathering and father-child relationships. The current monograph is the result of an SRCD-sponsored meeting of fatherhood scholars brought together to discuss these challenges and make recommendations for best practices for incorporating fathers in studies on parenting and children's development. The first aim of this monograph was to provide a brief update on the current state of research on fathering and to lay out a developmental ecological systems perspective as a conceptual framework for understanding the different spaces fathers inhabit in their children's lives. Because there is wide variability in fathers' roles, the ecological systems perspective situates fathers, mothers, children, and other caregivers within an evolving network of interrelated social relationships in which children and their parents change over time and space (e.g., residence). The second aim was to present examples of empirical studies conducted by members of the international working group that highlighted different methods, data collection, and statistical analyses used to capture the variability in father-child relationships. The monograph ends with a commentary that elaborates on the ecological systems framework with a discussion of the broader macrosystem and social-contextual influences that impinge on fathers and their children. The collection of articles contributes to research on father-child relationships by advancing theory and presenting varied methods and analysis strategies that assist in understanding the father-child relationship and its impact on child development.

Technoference: longitudinal associations between parent technology use, parenting stress, and child behavior problems.

BACKGROUND AND OBJECTIVES: Heavy parent digital technology use has been associated with suboptimal parent-child interactions and internalizing/externalizing child behavior, but directionality of associations is unclear. This study aims to investigate longitudinal bidirectional associations between parent technology use and child behavior, and understand whether this is mediated by parenting stress. METHODS: Participants included 183 couples with a young child (age 0-5 years, mean = 3.0 years) who completed surveys at baseline, 1, 3 and 6 months. Cross-lagged structural equation models of parent technology interference during parent-child activities, parenting stress, and child externalizing and internalizing behavior were tested. RESULTS: Controlling for potential confounders, we found that across all time points (1) greater child externalizing behavior predicted greater technology interference, via greater parenting stress; and (2) technology interference often predicted greater externalizing behavior. Although associations between child internalizing behavior and technology interference were relatively weaker, bidirectional associations were more consistent for child withdrawal behaviors. CONCLUSIONS: Our results suggest bidirectional dynamics in which (a) parents, stressed by their child's difficult behavior, may then withdraw from parent-child interactions with technology and (b) this higher technology use during parent-child interactions may influence externalizing and withdrawal behaviors over time.

Technoference: Parent Distraction With Technology and Associations With Child Behavior Problems.

Heavy parent digital technology use has been associated with suboptimal parent-child interactions, but no studies examine associations with child behavior. This study investigates whether parental problematic technology use is associated with technology-based interruptions in parent-child interactions, termed "technoference," and whether technoference is associated with child behavior problems. Parent reports from 170 U.S. families (child Mage  = 3.04 years) and actor-partner interdependence modeling showed that maternal and paternal problematic digital technology use predicted greater technoference in mother-child and father-child interactions; then, maternal technoference predicted both mothers' and fathers' reports of child externalizing and internalizing behaviors. Results suggest that technological interruptions are associated with child problem behaviors, but directionality and transactional processes should be examined in future longitudinal studies.

Marital and emotional adjustment in mothers and infant sleep arrangements during the first six months.

Although parents' structuring of infant sleep is complexly determined, little attention has been given to parents' marital and personal adjustment in shaping sleep arrangement choices. Linkages were examined between infant sleep arrangements at 1 and 6 months and mothers' marital adjustment, co-parenting quality, and depressive symptoms. The final study sample was composed of 149 families (53% girl infants, 86% European American). Bed sharing mothers had lower co-parenting quality, and, at 6 months, more depressive symptoms than mothers of infants in solitary sleep. One-month co-parenting quality was associated with predictable shifts in sleep arrangements from 1 to 6 months, but 1-month sleep arrangements did not predict changes in personal or co-parenting quality. Findings emphasize the need for greater attention to marital and emotional health in influencing family-level decisions about infant sleep arrangements.

Daily smartphone use predicts parent depressive symptoms, but parents' perceptions of responsiveness to their child moderate this effect.

Introduction: Smartphone use during caregiving has become increasingly common, especially around infants and very young children, and this use around young children has been linked with lower quality and quantity of parent-child interaction, with potential implications for child behavior, and parent-child attachment. To understand drivers and consequences of parent phone use, we were interested in the daily associations between parent phone use and depressed mood, as well as the potential for parent perceptions of their responsiveness toward their infant to alter the association between parent phone use and mood. Methods: In the present study, we explored associations between day-to-day changes in parent smartphone use (objectively-measured via passive sensing) around their infant, depressed mood, and parent perceptions of their responsiveness to their infants among a sample of 264 parents across eight days. We utilized multilevel modeling to examine these within-person daily associations. Results: Objectively-measured parent smartphone use during time around their infant was significantly associated with depressed mood on a daily basis. Interestingly, this was not true on days when parents perceived themselves to be more responsive to their infant. Discussion: These results suggest that parent judgements and perceptions of their parenting behavior may impact the potential link between parent phone use and parent mood. This is the first study utilizing intensive daily data to examine how parent perceptions may alter the felt effects of phone use on their parenting. Future work examining potential impacts of smartphone use on parenting should consider the effects of both actual use and perceptions about that use.

Effect of Weighted Blanket Versus Traditional Practices on Anxiety and Pain in Patients Undergoing Elective Surgery: A Multicenter Randomized Controlled Trial.

Perioperative anxiety is common in surgical patients and linked to poor outcomes. This multicenter randomized controlled trial assessed the effect of the use of a warm weighted blanket on presurgical anxiety and pain, as well as postsurgical restlessness, nausea, and vomiting. Levels of anxiety and pain were measured in adult patients using a 100-point visual analog scale before elective surgery. Patients received either a warm weighted blanket (n = 74) or a traditional sheet or nonweighted blanket (n = 74). Patients in the intervention group had significantly lower preoperative anxiety scores (mean [SD] = 26.28 [25.75]) compared to the control group (mean [SD] = 38.73 [30.55], P = .008). However, the intervention had no significant effect on presurgical pain or postsurgical nausea, vomiting, or restlessness. These results suggest that weighted blankets reduce preoperative anxiety in adult patients.

Parents' Desire to Change Phone Use: Associations with Objective Smartphone Use and Feelings About Problematic Use and Distraction.

We examined objective smartphone use (via a mobile sensing application) and self-reported desire to change phone use among a sample of 268 U.S. parents of infants. Using the Transtheoretical Stages of Change model as a conceptual foundation, we contextualized their attitudes and behaviors and explored how phone use and desire to change relate to perceptions of distraction and problematic phone use around their child. Latent profile analysis of parents' precontemplation, contemplation, and action scores revealed two classes-precontemplators (15%) and contemplators (85%). Contemplators-those considering or desiring change-showed more bedtime phone use and general social networking than precontemplors; however, there were no significant differences between groups on other objective use measures (e.g., total daily duration of phone use, phone use around child, etc.). Contemplators also showed greater perceptions of problematic use around their child and parenting distraction. Moreover, parents' problematic use and distraction were predictive of higher contemplation scores, even after controlling for demographic and objective phone use variables. Taken together, these results suggest that perceptions of phone use as problematic may be more important than actual phone habits, especially total phone use duration, for desire to change. Suggestions for future research and intervention are provided.

New mothers and media use: associations between blogging, social networking, and maternal well-being.

Drawing on Bronfenbrenner's ecological theory and prior empirical research, the current study examines the way that blogging and social networking may impact feelings of connection and social support, which in turn could impact maternal well-being (e.g., marital functioning, parenting stress, and depression). One hundred and fifty-seven new mothers reported on their media use and various well-being variables. On average, mothers were 27 years old (SD = 5.15) and infants were 7.90 months old (SD = 5.21). All mothers had access to the Internet in their home. New mothers spent approximately 3 hours on the computer each day, with most of this time spent on the Internet. Findings suggested that frequency of blogging predicted feelings of connection to extended family and friends which then predicted perceptions of social support. This in turn predicted maternal well-being, as measured by marital satisfaction, couple conflict, parenting stress, and depression. In sum, blogging may improve new mothers' well-being, as they feel more connected to the world outside their home through the Internet.

Relational impacts of capitalization in early parenthood.

Relationship difficulties are common during the transition to parenthood and may persist for years. Strategies that enhance couples' daily relational experiences early in the parenting years may serve a protective role. In general, engaging in a capitalization attempt (i.e., sharing personal good news) with one's romantic partner and perceiving the partner to be responsive are associated with better relationship outcomes among committed couples. However, it is unknown whether these relational benefits extend to the early parenting years or to other relational domains such as coparenting, which plays a central role in family functioning. The current study examined same-day associations between couples' capitalization process and relationship closeness and perceived coparenting support in a dyadic context during the first year of parenthood. A subsample of primarily non-Hispanic White coresident mixed-gender couples who participated in a randomized controlled trial of a transition to parenthood program (N = 141) completed daily diaries at 10 months postpartum for 8 consecutive days. On days when mothers shared, both partners reported greater closeness. On days when fathers shared, mothers reported greater closeness and perceived coparenting support. Furthermore, perceived partner responsiveness was associated with greater closeness for both partners and greater coparenting support for fathers. Fathers also perceived greater closeness and coparenting support on days when mothers shared about the child. Findings highlight the potential benefits of capitalization in early parenthood for both closeness and perceived coparenting support and suggest that capitalization may be a low cost, high yield strategy for enhancing new parents' daily relational experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Are You Going to Delete Me? Latent Profiles of Post-Relationship Breakup Social Media Use and Emotional Distress.

When a relationship ends, former partners must make decisions about their online, often public, connections and history, which involve a complex disentangling process. We examined post-breakup behaviors including monitoring, interacting, deleting posts/photos, deleting the former partner, deleting the partner's family/friends, stopping social media (SM) use, and keeping digital possessions. Participants (N = 256) who had experienced a breakup within the last year completed an online survey. Approximately 38 percent reported experiencing distress over the breakup sometimes or more often. Utilizing latent profile analysis, we identified four latent classes (or profiles) of breakup SM behaviors; we also examined associations between the class and breakup emotional distress. Most participants were clean breakers (61.3 percent), who did zero to very little monitoring, interacting, or deleting and were unlikely to delete their ex-partner, stop use, or keep digital possessions. Wistful reminiscers (12.9 percent) were similar to clean breakers in terms of engaging in very little of any deleting behaviors, stopping use, or keeping digital possessions; however, they engaged in frequent amounts of monitoring their ex-partner as well as interacting with their ex-partner and their ex-partner's family/friends. Ritual cleansers (15.6 percent) were similar to clean breakers in terms of engaging in very little to no monitoring and interacting; however, they engaged in deleting their SM history, their ex-partner's family/friends, and their ex-partner. Impulsives (10.2 percent) engaged in high amounts of all the SM behaviors. In terms of emotional distress, impulsives showed the highest levels of distress, followed by wistful reminiscers, ritual cleansers, and then clean breakers.

Longitudinal Associations Between Early Childhood Externalizing Behavior, Parenting Stress, and Child Media Use.

Limited research has examined bidirectional associations between modern media (e.g., smartphone, tablet) use and behavior in early childhood. This study aimed to test the hypotheses that, over 6 months, (H1) child externalizing behavior would predict later media use, mediated by parenting stress, and (H2) media use would predict later externalizing behavior. Participants included mothers and fathers from 183 heterosexual couples with a child 1-5 years old, followed for 6 months-assessed at baseline, 1, and 6 months. Frequency of child media use was assessed at baseline and 6 months through parent report across eight items (e.g., television [TV], smartphone, tablet use). Child externalizing behavior was assessed through the Child Behavioral Checklist, and parent stress through the Parenting Stress Index. Hypotheses were tested using structural equation modeling. Mothers were 31.8 (standard deviation [SD] = 4.2), fathers 33.3 (SD = 4.9), and children 3.0 years old (SD = 1.2). Structural equation models showed good overall fit. As hypothesized, we found that (H1) greater child externalizing behavior predicted greater parenting stress (ß = 0.48, p < 0.001), which predicted increases in child media use (ß = 0.15, p < 0.05); however, (H2) child media use did not predict later externalizing behavior (ß = 0.06, p = 0.23). In post hoc analyses, results differed slightly by specific type of media; for example, externalizing behavior was associated with later tablet and game use, whereas TV use predicted increases in externalizing behavior. Our results suggest that child behavior problems associate with later media use habits, possibly as a parent coping strategy, which should be considered when providing clinical guidance.

How Parents and Their Children Used Social Media and Technology at the Beginning of the COVID-19 Pandemic and Associations with Anxiety.

In this study, we examined parents' (n = 260) perceptions of their own and their children's use of social media and other types of communication technologies in the beginning stages of coronavirus disease 2019 (COVID-19) related sanctions (e.g., social distancing) in the United States. We also examined associations between social media and technology use and anxiety. On average, parents reported that both they and their children (especially teenagers aged 13-18) had increased technology and social media use since the beginning of social distancing. Moreover, even after controlling for demographic factors, structural equation models showed that parents and children with higher levels of anxiety (as reported by parents) were more likely to increase their technology use and use social media and phones to connect. Among parents, higher anxiety was related to using social media for both social support and information seeking. Based on these results, we advocate for the utilization of social media by public health officials for collecting, collating, and dispersing accurate crisis-related information. As social media use is widespread, and there is potential for false rumors to cause erroneous behavioral action and/or undue stress and anxiety, we also suggest that social media campaigns be thoughtfully designed to account for individual differences in developmental stages and psychological vulnerabilities.

Daily Technology Interruptions and Emotional and Relational Well-Being.

The current abundance of technology in daily life creates opportunities for interruptions in couple interactions, termed technoference or phubbing. The current study examined reports from both partners in 173 romantic relationships who completed daily surveys on technoference and relational well-being measures across 14 days. By using daily diary data, we were able to examine within-person associations and more closely approximate everyday life. Utilizing multilevel modeling, we found that on days when participants rated more technoference than usual, they felt worse about their relationship, perceived more conflict over technology use, rated their face-to-face interactions as less positive, and experienced more negative mood. These relationships existed even after controlling for general feelings of relationship dissatisfaction, depression, and attachment anxiety, and there were no significant differences between women and men in these associations. This suggests that regardless of an individual's or a couple's current level of well-being, if individuals perceive technology use as interfering in their interactions with their partner, these perceptions may affect their daily assessments of their relationship and mood.