Early childhood attachment stability to mothers, fathers, and both parents as a network: associations with parents' well-being, marital relationship, and child behavior problems.

This study examines the stability of child attachment to mothers and fathers separately, and to both parents as a network between the infancy and preschool periods using a sample of 143 biparental families and their children (73 boys) recruited from the general population. Attachment was assessed at 15 months with the Strange Situation Procedure (SSP) and at 45 months with the Preschool Attachment Classification Coding System (PACS). First, results show no stability in attachment to mothers, to fathers, or to both parents as a network. Second, parents' mental health, life satisfaction, marital satisfaction, and child externalizing behavior are associated with attachment stability. Taken altogether, group comparisons reveal that children with a stable secure attachment to both parents as a network have parents with higher levels of well-being and exhibit less problem behaviors than children with 1) a stable secure attachment to one parent and an unstable attachment to the other parent (from secure to insecure or from insecure to secure), or 2) who never had a stable secure attachment to either parent. This study highlights the significance of attachment to both parents as a network over time as it is associated with developmental outcomes.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach.

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.

ANXIETY AND ATTACHMENT TO THE MOTHER IN PRESCHOOLERS RECEIVING PSYCHIATRIC CARE: THE FATHER-CHILD ACTIVATION RELATIONSHIP AS A PROTECTIVE FACTOR.

This 49-family study is the first to explore the father-child relationship in a clinical population of preschoolers (at a tertiary care child psychiatry clinic) and to examine its relation to child anxiety and attachment to the mother. A moderation model of the father-child activation relationship on the relation between attachment to the mother and child anxiety was tested and discussed. Analyses confirmed the expected independence between mother-child attachment and father-child activation as well as the association between mother-child attachment and anxiety. The highest levels of anxiety were found in insecure children, and more specifically, in insecure-ambivalent children and insecure disorganized-controlling children of the caregiving subtype. Hypotheses regarding the relation between anxiety and activation were only partially confirmed. Finally, the activation relationship with the father was shown to have a moderating effect on the relation between attachment to the mother and child anxiety; activation by the father may be considered either a protective or a risk factor. Results for this clinical population of young children are discussed in the light of attachment theory and activation relationship theory. The study's findings have the potential to contribute to the development of preventative, diagnostic, and intervention programs that take both parental figures into account.

Proximate and ultimate mechanisms of human father-child rough-and-tumble play.

The aim of this contribution is to attempt to understand the adaptive functions of father-child rough-and-tumble play (RTP) in humans. We first present a synthesis of the known proximate and ultimate mechanisms of peer-peer RTP in mammals and compare human parent-child RTP with peer-peer RTP. Next, we examine the possible biological adaptive functions of father-child RTP in humans, by comparing paternal behavior in humans versus biparental animal species, in light of the activation relationship theory and the neurobiological basis of fathering. Analysis of analogies reveals that the endocrine profile of fathers is highly variable across species, compared to that of mothers. This can be interpreted as fathers' evolutionary adjustment to specific environmental conditions affecting the care of the young. Given the high unpredictability and risk-taking features of RTP, we conclude that human adult-child RTP appears to have a biological adaptive function, one of 'opening to the world'.

An Attachment-Based Parental Capacity Assessment to Orient Decision-Making in Child Protection Cases: A Randomized Control Trial.

Two parenting capacity assessment (PCA) protocols, with a short parent-child intervention embedded in each protocol, evaluated the potential for enhanced parenting to orient child placement decision. Parents (n = 69), with substantiated reports of maltreatment by child protective services, and their children (0-6) were randomly assigned to one of two PCAs with either the Attachment Video-feedback (PCA-AVI) or a psychoeducational intervention (PCA-PI) as the embedded intervention component. The PCA-AVI group showed the highest increases in parent-child interaction quality at post-test. Also, at PCA completion, evaluators' conclusions about the parents' capacity to care for both PCA groups were associated with parent-child interactive improvements at post-test, the court's placement decision at post-test, and child placement one year later. However, only conclusions drawn by PCA-AVI evaluators were predictive of child re-reports of maltreatment in the year following PCA. PCAs, relying on short attachment interventions to assess the potential for enhanced parenting, are promising tools to orient child placement decisions.

Exploring the sex and gender correlates of cognitive sex differences.

The correlates of cognitive sex differences are yet to be fully understood. Many biological and psychosocial factors modulate these cognitive abilities leading to mixed results in the scientific literature. The current study aims to explore the different parameters potentially influencing cognitive abilities acting in synergy. Sex and gender correlates of cognitive functioning were assessed in a sample of individuals ages 18 to 45 years (N = 87) from diverse sexual orientations. Sex hormones were assessed via saliva samples at four timepoints throughout the testing. Gender roles, sexual orientation and socio-demographics were measured via self-report questionnaires. Participants completed mental rotation and verbal fluency tasks. Men performed better than women at mental rotation, while no significant difference was found for verbal fluency. Significant positive associations were observed between estradiol and word fluency for the naturally cycling women compared to the women using oral contraception. While controlling for sex hormones, a significant interaction effect of sex by gender roles was identified for mental rotation among masculine women. These exploratory results suggest an effect principally driven by sex and sex hormones on cognitive performance that will need to be furthered with larger studies.

Prenatal tobacco exposure and cortisol levels in infants of teen mothers.

AIMS: prenatal tobacco exposure (PTE) is an important public health concern for the offspring of teen mothers. We examined whether PTE is associated with baseline cortisol levels in four-month-old infants of teenage mothers. METHODS: we assessed salivary cortisol levels of 212 infants. PTE was measured by using self-reports of cigarette smoking during pregnancy. We used a propensity scores matching analysis to compare infants with PTE and those without. RESULTS: of 212 mothers, 151 smoked during pregnancy. However, there was no association between PTE and infant cortisol levels. CONCLUSIONS: we could not support a relation between PTE and cortisol levels in a sample of four-month-old infants of teenage mothers.

Rough-and-tumble play and the regulation of aggression: an observational study of father-child play dyads.

Rough-and-tumble play (RTP) is a common form of play between fathers and children. It has been suggested that RTP can contribute to the development of selfregulation. This study addressed the hypothesis that the frequency of father-child RTP is related to the frequency of physically aggressive behavior in early childhood. This relationship was expected to be moderated by the dominance relationship between father and son during play. Eighty-five children between the ages of 2 and 6 years were videotaped during a free-play session with their fathers in their homes and questionnaire data was collected about father-child RTP frequency during the past year. The play dyads were rated for the degree to which the father dominated play interactions. A significant statistical interaction revealed that RTP frequency was associated with higher levels of physical aggression in children whose fathers were less dominant. These results indicate that RTP is indeed related to physical aggression, though this relationship is moderated by the degree to which the father is a dominant playmate.

Quebec breast cancer screening program: a study of the perceptions of physicians in Laval, Que.

OBJECTIVE: To identify physicians' perceptions of breast cancer prevention in order to generate strategies to increase women's participation in the Quebec breast cancer screening program (QBCSP). DESIGN: Qualitative study using archival data and in-depth interviews. SETTING: Laval, Que, a suburban city north of Montreal. PARTICIPANTS: Twenty family physicians and 1 gynecologist practising in Laval who had received at least 1 screening mammography report in 2004 or 2005. METHODS: Archival data were obtained in order to refine our understanding of the QBCSP. In-depth individual interviews were conducted with participating physicians until data saturation was reached in order to determine physicians' knowledge of, beliefs and attitudes about, and behaviour toward preventive breast cancer practices, as well as their suggestions for enhancing patient compliance. The interviews were recorded, transcribed, and coded, and the content was analyzed. MAIN FINDINGS: Respondents indicated that the screening age groups, the age for beginning clinical breast examination, and the instructions to patients about breast self-examination should be harmonized. Letters to patients should be shortened, simplified, and endorsed by physicians. Screening mammography reports should include more details and be clearer about patient follow-up. The need for patients to sign authorization forms for transmission of information related to their participation in the QBCSP should be reinforced by their physicians. Following abnormal mammogram results, services and procedures should be simplified and delays in appointments decreased. Referral for "orphan patients" (ie, patients without family physicians) should be supervised by nurse practitioners, with physician consultations when needed. CONCLUSION: This study provides a qualitative understanding of improvements or modifications needed in order to reach a screening mammography participation rate sufficient to reduce breast cancer mortality in women.

The association of major depression, conduct disorder, and maternal overcontrol with a failure to show a cortisol buffered response in 4-month-old infants of teenage mothers.

BACKGROUND: Adolescent pregnancy can be associated with major depression (MD) and conduct disorder (CD). Some infants of adolescent mothers are prenatally exposed to these factors, which may result in heightened risk for perturbations of their stress systems. Between 2 and 4 months, a normal shift occurs in the adrenocortical system in which we observe a marked decrease in infant cortisol response when facing mild stressors. This study aimed to explore whether MD (lifetime, during pregnancy, postpartum), CD, and maternal overcontrol are associated with increased cortisol reactivity in 4-month-old infants of teenage mothers. METHODS: Using arm restraint as a stressor, morning salivary cortisol was taken prestressor and poststressor in 212 infants during a laboratory visit. Major depression and CD were measured with the computerized National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS), postpartum depressive mood was measured with the Edinburgh Postnatal Depression Scale, and overcontrol was observed with the CARE-Index. RESULTS: Independent of the predictors, there was a dampened cortisol response. Infants of mothers with lifetime MD and of average to highly overcontrolling mothers showed increased cortisol reactivity. Conduct disorder and cortisol levels were not associated. CONCLUSIONS: Future studies should detect whether the absence of a dampened cortisol response in infants whose mothers have lifetime MD or display overcontrolling parenting is stable over time.

[Prevalence and co-occurrence of five types of ill-treatment in relation with depression and conduct disorder in adolescent mothers]. / Prévalence et cooccurrence de cinq formes de maltraitance en lien avec la dépression et le trouble de la conduite chez les mères adolescentes.

In this article, the authors reflect on co-occurrence of different types of maltreatment that adolescent mothers have suffered during their childhood in order to better understand intergenerational transmission of maltreatment. They underline that studies on maltreatment that adults or adolescents have been subjected to during their childhood generally do not take into account co-occurrence of different types of maltreatment. The authors first attempt to verify if adolescent mothers are different from women of the general population in regards to prevalence and co-occurrence of various types of maltreatment suffered during their own development. They then try to establish prevalence and co-occurrence of types of maltreatment in relation to diagnoses of major depression or conduct disorder in adolescent mothers.

Child attachment and sensory regulation in psychiatric clinic-referred preschoolers.

BACKGROUND: Individuals with sensory regulation disorders present with many difficulties in terms of managing emotions, behavior, and motor control. Children with such difficulties are often referred to psychiatric clinics for assessment of their behavioral and emotional problems. Few studies have investigated the role of environmental factors on sensory dysfunctions, and none have specifically studied its association with child attachment in a clinical sample. OBJECTIVE: In this cross-sectional study, we examined the association between sensory regulation and child attachment among preschoolers referred to a psychiatric clinic. METHOD: A sample of 60 preschoolers and their mothers were recruited through a child psychiatric clinic. Child attachment was assessed with the gold standard separation-reunion procedure for preschoolers. Parents completed the sensory profile, which assesses the presence of child hypersensitivity (sensitivity and avoidant scale) and hyposensitivity (sensory seeking and registration scale). RESULTS: Data showed that 57% of the children were presented with clinical symptoms of sensory regulation. In addition, 53% of the children were classified insecure behaviorally disorganized or insecure disorganized controlling. In particular, results revealed that children classified as insecure disorganized controlling were significantly more likely to show hypersensitivity avoidance and sensory-seeking behaviors. CONCLUSION: This study underscores the importance of the parent-child relationship for children with sensory regulation difficulties.

Histories of child maltreatment and psychiatric disorder in pregnant adolescents.

OBJECTIVE: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. METHOD: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a psychiatric interview on lifetime conduct and major depressive disorders. Latent class analysis was used to model the association between child maltreatment and psychiatric disorder. RESULTS: Analyses indicated two latent classes: pregnant adolescents with no reported child maltreatment history (79%) and those with multiple forms of maltreatment (21%). There was no association between the child maltreatment latent variable and major depressive disorder. Rather, depression was related specifically to one form of maltreatment (i.e., sexual abuse, odds ratio = 2.60). Depression also showed a significant relationship with conduct disorder (odds ratio = 3.70). Pregnant adolescents with multiple forms of child maltreatment had a fourfold risk of also having conduct disorder, compared with nonmaltreated adolescents. CONCLUSIONS: In this sample of pregnant adolescents, prior experience of multiple forms of child maltreatment was prevalent, as were depression and conduct disorder. Clinicians need to screen for histories of child maltreatment and psychiatric disorder and to introduce effective interventions for pregnant adolescents and their children.

Cortisol levels and conduct disorder in adolescent mothers.

OBJECTIVE: To examine the association between cortisol levels and conduct disorder (CD) in adolescent mothers. Past research has shown that low levels of cortisol were associated with CD, particularly with its aggressive symptoms. The authors tested the hypothesis that adolescent mothers with CD would show lower levels of salivary cortisol compared to mothers without CD at 4 and 9 months postpartum. METHOD: Midmorning salivary cortisol levels were measured in 228 adolescent mothers (age at delivery 16.9 +/- 1 years [mean +/- SD]) during a laboratory visit at 4 and 9 months postpartum. CD was diagnosed during pregnancy according to the CD subsection on the criteria for antisocial personality disorder (DSM-III-R). RESULTS: Results did not confirm the hypothesis. Lower cortisol levels were not significantly associated with a CD diagnosis, the number of CD symptoms, or aggressive symptoms. CONCLUSIONS: Despite valid measures and strong statistical power, this study failed to find an association between cortisol levels and CD in a sample of adolescent mothers. The results may have been influenced by the fact that participants were 4 and 9 months postpartum and by comparisons of mothers with CD to mothers living in stressful circumstances.

[Validation of the French version of the CTQ and prevalence of the history of maltreatment]. / Validation de la version française du CTQ et prévalence de l'histoire de maltraitance.

This study demonstrates that the five maltreatment scales in the long and short versions of the CTQ are valid and usable with French-speaking populations. It also shows emotional neglect to be the most common form of maltreatment in its general population sample, and physical neglect to be the least common. Physical, emotional and sexual abuse prevalences in the convenience sample roughly correspond to the rates generally obtained in non-clinical samples. Finally, women in the sample display greater co-occurrence of different forms of maltreatment, especially involving sexual abuse, than men.

Pesquisas transculturais em psicologia do desenvolvimento: considerações teórico-metodológicas / Cross-cultural research in developmental psychology: theoretical and methodological considerations / Investigaciones transculturales en psicología del desarrollo: consideraciones teórico-metodológicas

A cultura e os contextos sociais são aspectos importantes na investigação de fenômenos concernentes ao desenvolvimento humano. Tem-se como objetivo apresentar considerações teórico-metodológicas, baseadas na experiência de uma pesquisa realizada por pesquisadores brasileiros e canadenses, acerca dos procedimentos adotados na produção científica envolvendo a Psicologia Transcultural e a Psicologia do Desenvolvimento, apontando desafios e possibilidades para superá-los. Salienta-se a importância da adequação da pesquisa para diferentes culturas e recomenda-se atentar para os seguintes procedimentos: definição do tema de pesquisa, escolha e adaptação dos instrumentos de medida, definição do construto, treinamento dos pesquisadores e estudo piloto. A indicação de critérios dessa natureza tem como objetivo aprimorar a sistematização e descrição de estudos transculturais na área da Psicologia do Desenvolvimento para que se possam produzir resultados consistentes e válidos

The culture and social contexts are important in the investigation of aspects related to human development. The objective was to present theoretical and methodological considerations, based on our experience related to a research carried out by Brazilian and Canadian researchers, on the procedures adopted in the scientific literature involving the Transcultural Psychology and Developmental Psychology, pointing challenges and possibilities of overcoming them. The importance of adequacy of research for different cultures was stressed and it is recommended be attentive to the following: definition of the research topic, choice of the measuring instrument, definition of the construct, instrument adaptation, training researchers and pilot study. Indication criteria of this nature aims to improve the systematization and description of cross-cultural studies in Developmental Psychology, in order to make possible to produce consistent and valid results

La cultura y los contextos sociales son aspectos importantes en la investigación de fenómenos concernientes al desarrollo humano. Se tiene como objetivo presentar consideraciones teórico-metodológicas, basadas en la experiencia de una investigación realizada por investigadores brasileños y canadienses, acerca de los procedimientos adoptados en la producción científica envolviendo la Psicología Transcultural y la Psicología del Desarrollo, apuntando desafíos y posibilidades. Se destaca la importancia de la adecuación de la investigación para diferentes culturas y se recomienda atentar para los siguientes procedimientos: definición del tema de investigación, elección y adaptación de los instrumentos de medida, definición del constructo, entrenamiento de los investigadores y estudio piloto. La indicación de criterios de esa naturaleza tiene como objetivo mejorar la sistematización y descripción de estudios transculturales en el área de la Psicología del Desarrollo para que se puedan producir resultados consistentes y válidos

Cross-Cultural Adaptation and Evidence of Validity of the Questionnaire d'Engagement Paternel / Adaptação Transcultural e Evidências de Validade do Questionário de Engajamento Paterno

Abstract This study aimed to investigate the internal structure and reliability indices of the Questionnaire d'Engagement Paternel (QEP). It describes the process of cross-cultural adaptation and results of the evaluation of the psychometric proprieties of the instrument. The sample consisted of 300 participants (150 mothers and 150 fathers), who formed two-parent families. The psychometric analyses involved procedures including back translation, factor analysis, and reliability analyses of the instrument. The Brazilian version of the QEP is presented, containing a total of 36 items, divided into five dimensions. Twenty items were excluded, according to statistical and theoretical criteria. The results demonstrated satisfactory evidence of validity of the scale. Considerations regarding limitations of the study and recommendations for use in future research were indicated.

Resumo Este estudo teve como objetivo investigar a estrutura interna e os índices de confiabilidade do Questionário de Engajamento Paterno (QEP). Propõe-se descrever o processo de adaptação transcultural e os resultados da avaliação das propriedades psicométricas do instrumento. A amostra foi composta por 300 participantes (150 mães e 150 pais), que formavam famílias biparentais. Nas análises psicométricas, foram seguidos procedimentos envolvendo back translation, análise fatorial e análise da confiabilidade do instrumento. Apresenta-se a versão brasileira do QEP, contendo o total de 36 itens, divididos em cinco dimensões. Houve exclusão de 20 itens, conforme critérios estatísticos e teóricos. Os resultados demonstraram evidências satisfatórias de validade e precisão da escala. Considerações sobre limitações do estudo e indicações de uso para pesquisas futuras foram apontadas.

[Not Available]. / Le renforcement de l'interface entre les services de santé publique et de première ligne : enjeux et pistes de solution.

The development of close relationships between public health and clinic services, particularly those provided by primary care family physicians, is supported in all western healthcare systems. Collaborations leading to such interface are supposed to have positive impacts on the quality of care, the burden of diseases and the equity in the healthcare system. If players in both fields accept the relevance of the interface and support in principle its development, there are still many barriers that impede the collaborations in reality. That said, little is known about the barriers in the Quebec healthcare system. The purpose of this study is to answer to this lack of information by studying the interface from an organizational perspective. Two conceptual frameworks have been used: the Lasker's typology (1997) and the Hinings and Greenwood archetypes (1988).The analysis highlights two of the six forms of collaboration proposed by the typology used: the coordination of services provided to individuals and the use of clinic visits for the purpose of public health. Activities associated to these forms of collaboration, which are important with regard to the public health mandate, are of interest essentially for public health and are practically unilaterally determined by public health. Moreover, the lack of coordination in activities involving a collaboration with physicians is an obstacle for the development of such activities and generates irritants for the physicians. Thus, in the Quebec healthcare system there are opportunities for the development of the interface where the collaboration occurs also at the benefit of the clinic practice and where it takes into account the constraints of the clinic sector.

Improved cardiovascular prevention using best CME practices: a randomized trial.

INTRODUCTION: It was hypothesized that after a continuing medical education (CME) event, practice enablers and reinforcers addressing main clinical barriers to preventive care would be more effective in improving general practitioners' (GPs) adherence to cardiovascular guidelines than a CME event only. METHODS: A cluster-randomized trial was conducted on a convenience sample of 122 GPs who were randomly assigned to either CME only (control group) or CME with practice enablers and reinforcers (PER group). In the PER group, nurses visited GPs' offices once a month to implement the clinical intervention on patients > or = 55 years old with a scheduled visit in the month following the nurse visit: (1) screening medical records for potentially undermanaged high-risk patients; (2) prompting physicians to reassess preventive care in these patients; (3) enclosing a checklist reporting most recent information relevant to guidelines' implementation; and (4) enclosing a summary of experts' recommendations in the form of a follow-up and treatment algorithm. RESULTS: A retrospective chart audit of 2344 consenting patients, potentially undermanaged at baseline, demonstrated that the PER intervention following CME significantly improved adherence to guidelines compared to CME alone (OR: 1.78, 95% CI: 1.32-2.41). DISCUSSION: The intervention was designed for self-implementation in primary care practices that have their own nursing staff. PER GPs were highly satisfied with the intervention; the majority said that they would implement it in their practice if someone trained their nurse, thus suggesting support for development of a multiprofessional CME program to disseminate this clinical approach to primary care practice groups.