Fathers' sensitive parenting enhanced by prenatal video-feedback: a randomized controlled trial using ultrasound imaging.

BACKGROUND: The aim of this study was to evaluate an interaction-based prenatal parenting intervention program aimed at promoting parental sensitivity and involvement in expectant fathers using ultrasound images: Prenatal Video-Feedback Intervention to Promote Positive Parenting (VIPP-PRE). METHODS: In this randomized controlled trial, 73 first-time, healthy expectant fathers were enrolled. Participants were randomly assigned to the VIPP-PRE intervention (n = 39) or a dummy intervention (n = 34). Parental sensitivity was coded from video-recorded 10-min interactions with an infant simulator at a prenatal pretest and with fathers' own infant at a postnatal posttest. Prenatal and postnatal involvement was assessed via an application on participants' smartphones. RESULTS: Fathers receiving VIPP-PRE demonstrated increased sensitivity across the perinatal period, relative to fathers receiving a dummy intervention. Fathers' involvement with the infant increased significantly from the prenatal to postnatal period, regardless of the intervention. CONCLUSIONS: Prenatal video-feedback using ultrasound imaging of the unborn child has the potential to promote the quality of parenting in an important, but understudied, population and period: men in the transition to fatherhood. Future research should examine the long-term effectiveness of VIPP-PRE and its effectiveness in increasing parenting quality in at-risk families. IMPACT: This study identifies a brief and focused prenatal intervention using assisted interactions between the father and his baby by means of ultrasound imaging as a promising strategy to improve sensitive fathering in the early postnatal phase. Our study shows that pregnancy provides a window of opportunity for promoting prenatal involvement and bonding in expectant fathers, with potential long-term benefits for the future father-child relationship. Ultrasound measures are currently used to monitor fetal growth and development, but our results suggest that they may also create an opportunity for stimulating father-infant interaction to promote postnatal caregiving quality.

Exploring everyday state attachment dynamics in middle childhood.

The current study explored dynamics of secure state attachment expectations in everyday life in middle childhood, specifically state attachment carry-over and reactivity to experiences of caregiver support in the context of stress. In two independent samples (one community sample, N = 123; one adoption sample, N = 69), children (8-12 years) daily reported on their state attachment for respectively 14 and 7 consecutive days. Additionally, they reported daily on their experiences of distress and subsequent experiences of caregiver support. Results in both samples indicated that secure state attachment on a day-to-day basis is characterized by a significant positive carry-over effect, suggesting that state attachment fluctuations are (partially) self-predictive. In Study 1, experiencing no support following distress significantly related to intraindividual decreases in secure state attachment; in Study 2, experiencing effective support during distress related to intra-individual increases in secure state attachment. Taken together, the current studies provide novel and important insights into how state attachment temporally evolves on a day-to-day basis in middle childhood.

Effects of oxytocin and vasopressin administration on human fathers' sensitive and challenging parenting: A randomized within-subject controlled trial.

This randomized, double-blind, placebo-controlled within-subject study examined the effects of intranasal administration of oxytocin and vasopressin on fathers' sensitive and challenging parenting behaviors. Furthermore, we examined the moderating role of fathers' early childhood experiences. The sample consisted of 70 fathers with their 2- to 12-month-old infants. All fathers were assigned to each of the three experimental sessions (oxytocin, vasopressin, and placebo), on three separate days, with random order and intervening periods of one to two weeks. Sensitive and challenging parenting behaviors (CPB) were observed during a 10-minute free play task. Results showed no effects of vasopressin administration on paternal sensitivity. Fathers in the oxytocin condition were less sensitive than fathers in the placebo condition, and this effect was moderated by fathers' own childhood experiences: Fathers who reported higher levels of experienced parental love withdrawal were less sensitive in the oxytocin condition as compared to the placebo condition, whereas fathers with less experienced parental love withdrawal showed no difference in sensitivity between the oxytocin and placebo condition. No effects were found of oxytocin and vasopressin administration on fathers' CPB. Our results, although partly unexpected, are largely in line with previous literature showing that oxytocin administration can exert negative effects in individuals with adverse childhood experiences.

An empirical test of prototype and revisionist models of attachment stability and change from middle childhood to adolescence: A 6-year longitudinal study.

We examined the prototype v. revisionist models of attachment stability with a five-wave, 6-year, longitudinal study of attachment security from middle childhood to adolescence in a White Western European sample (N = 157; Wave 1 Mage  = 10.91, SD = 0.87; 52% female). Attachment was assessed using both questionnaire (Experiences in Close Relationships) and narrative-based measures (Attachment Script Assessment). In addition, a set of potential moderators of prototype-like stability were examined. Results indicated that data from both attachment assessments best fit the prototype model. Moderator analyses indicated that male sex significantly undermined the influence of an attachment prototype and parent-child conflict and parental divorce enhanced the influence of an attachment prototype on stability.

The prenatal video-feedback intervention to promote positive parenting for expectant fathers (VIPP-PRE): Two case studies.

Although parenting interventions including expectant fathers are scarce, they yield promising results. The Prenatal Video-feedback Intervention to promote Positive Parenting (VIPP-PRE) is a recently developed intervention, that is both manualized and personalized, aiming to enhance paternal sensitivity and involvement before the birth of the baby. Illustrating the intervention process, the current study presents two case studies of expectant fathers receiving VIPP-PRE (clinical trial registration NL62696.058.17). The VIPP-PRE program is described along with the individual dyads' prenatal video fragments and feedback specific for each father-fetus dyad. In addition, changes in paternal sensitivity and involvement levels are presented, as well as fathers' and intervener's evaluation of the intervention. VIPP-PRE promises to be a feasible short-term and potentially effective parenting intervention for expectant fathers. Currently, a randomized controlled trial (RCT) is under review that systematically investigates the efficacy of the VIPP-PRE. Here we aim to provide further information on the intervention process, as well as fathers' and intervener's evaluations of this process, and the benefits of using ultrasound imaging in a parenting intervention.

Aunque las intervenciones de crianza incluyendo a los papás en espera son escasas, las mismas producen resultados prometedores. La Intervención Prenatal de Información en Video para promover la Crianza Positiva (VIPP-PRE) es una intervención recientemente desarrollada, la cual es manejada a mano y personalizada, con el objetivo de mejorar la sensibilidad y la participación paterna antes del nacimiento del bebé. Demostrando el proceso de intervención, el presente estudio presenta dos casos de estudio de papás en espera que reciben VIPP-PRE (registro de ensayo clínico NL62696.058.17). El programa VIPP-PRE se describe junto con los fragmentos e información del video prenatal de las díadas individuales específicas para cada díada papá-feto. Adicionalmente, se presentan los cambios en los niveles de sensibilidad y participación paterna, así como también la evaluación de la intervención por parte de los papás y de quien condujo la intervención. VIPP-PRE promete ser una intervención de crianza factible a corto plazo y potencialmente efectiva para papás en espera. Actualmente, se encuentra bajo revisión un ensayo controlado al azar (RCT) que sistemáticamente investiga la efectividad de VIPP-PRE. Aquí nos proponemos ofrecer mayor información sobre el proceso de intervención, así como también las evaluaciones que del proceso hicieron los papás y quien condujo la intervención, y los beneficios de usar las imágenes de ultrasonido en una intervención de crianza.

Bien que les interventions de parentage in incluent des futurs pères soient rares, elles donnent des résultats prometteurs. L'Intervention de Retour-Vidéo Prénatale pour promouvoir le Parentage Positif (abrégé en anglais VIPP-PRE) est une intervention récemment développée. Elle est à la fois manualisée et personnalisée, se donnant pour but de renforcer la sensibilité et l'engagement avant la naissance du bébé. Illustrant le processus d'intervention cette étude présente deux études de cas de futurs pères recevant la CVIP-PRE (enregistrement des essais cliniques NL62696.058.17). Le programme VIPP-PRE est décrit ainsi que les fragments vidéo prénatale des dyades individuelles et le retour spécifique pour chaque dyade père-fœtus. De plus les changements dans la sensibilité paternelle et dans les niveaux d'engagement sont présentés, ainsi que l'évaluation des pères et des intervenants de l'intervention. La VIPP-PRE promet d'être une intervention de parentage viable à court terme et potentiellement efficace pour les futurs pères. Pour l'instant un essai contrôlé randomisé est à l'étude, étudiant systématiquement l'efficacité de la VIPP-PRE. Ici nous nous donnons pour but d'offrir des informations plus amples sur le processus d'intervention, ainsi que sur les évaluations du processus faites par les pères et les intervenants, et sur les bénéfices qu'il y a à utiliser les images ultrasons dans une intervention de parentage.

Exploring the hormonal and neural correlates of paternal protective behavior to their infants.

Infant protection is an important but largely neglected aspect of parental care. Available theory and research suggest that endocrine levels and neural responses might be biological correlates of protective behavior. However, no research to date examined associations between these neurobiological and behavioral aspects. This study, preregistered on https://osf.io/2acxd, explored the psychobiology of paternal protection in 77 new fathers by combining neural responses to infant-threatening situations, self-reported protective behavior, behavioral observations in a newly developed experimental set-up (Auditory Startling Task), and measurements of testosterone and vasopressin. fMRI analyses validated the role of several brain networks in the processing of infant-threatening situations and indicated replicable findings with the infant-threat paradigm. We found little overlap between observed and reported protective behavior. Robust associations between endocrine levels, neural responses, and paternal protective behavior were absent.

Attachment and the Development of Depressive Symptoms in Adolescence: The Role of Regulating Positive and Negative Affect.

Although widely accepted, attachment theory's hypothesis that insecure attachment is associated with the development of depressive symptoms through emotion regulation strategies has never been longitudinally tested in adolescence. Additionally, previous research only focused on strategies for regulating negative affect, whereas strategies for regulating positive affect may also serve as a mechanism linking insecure attachment to depressive symptoms. This study aimed to fill these research gaps by testing whether the association between attachment and change in depressive symptoms over time is explained by strategies for regulating negative and positive affect in adolescence. Adolescents (N = 1706; 53% girls; Mage = 12.78 years, SDage = 1.54 at Time 1) were tested three times, with a 1-year interval between measurement times. They reported on their attachment anxiety and avoidance at Time 1, depressive symptoms at Times 1 and 3, and regulation of negative affect (brooding and dampening) and positive affect (focusing and reflection) at Time 2. The results from multiple mediation analyses showed that more anxiously attached adolescents developed more depressive symptoms via increased brooding and dampening. More avoidantly attached adolescents developed more depressive symptoms via decreased focusing. These findings provide longitudinal support for attachment theory's emotion regulation hypothesis, and show that the regulation of both negative and positive affect is important.

Is paternal oxytocin an oxymoron? Oxytocin, vasopressin, testosterone, oestradiol and cortisol in emerging fatherhood.

How do hormonal levels in men change from pregnancy to after the birth of their firstborn child, and what is the role of oxytocin, alone or in interplay with other hormones, in explaining variance in their parenting quality? We explored in 73 first-time fathers the development of five hormones that have been suggested to play a role in parenting: oxytocin (OT), vasopressin (AVP), testosterone (T), oestradiol (E2) and cortisol (Cort). In an extended group of fathers (N = 152) we examined associations with fathers' behaviour with their 2-month-old infants. OT and E2 showed stability from the prenatal to the postnatal assessments, whereas AVP and T decreased significantly, and Cort decreased marginally. OT on its own or in interplay with other hormones was not related to paternal sensitivity. Using an exploratory approach, the interaction between T and E2 emerged as relevant for fathers' sensitive parenting. Among fathers with high E2, high T was associated with lower sensitivity. Although we did not find evidence for the importance of OT as stand-alone hormone or in interplay with other hormones in this important phase in men's lives, the interaction between T and E2 in explaining variation in paternal behaviour is a promising hypothesis for further research. This article is part of the theme issue 'Interplays between oxytocin and other neuromodulators in shaping complex social behaviours'.

State Attachment Variability: Between- and within-Person Level Associations with Trait Attachment and Psychological Problems.

Research suggests that inter-individual differences in the degree of state attachment variability are related to differences in trait attachment and psychological problems between children. In this study, we tested whether such associations are also relevant at a within-person level, and if so, whether intra-individual fluctuations in the degree of variability were predictive of or predicted by intra-individual fluctuations in trait attachment and psychological problems. Children (N = 152; Mage = 10.41 years, SDage = 0.60 at time 1) were tested three times over a period of one year. At each timepoint, children reported on their expectations of maternal support in different distressing situations. Additionally, we administered measures of trait attachment to children and psychological problems to children and their mothers. We used Random-Intercept Cross-Lagged Panel Models to distinguish between-person from within-person associations between these constructs over time. The results revealed that the degree of state attachment variability was mainly relevant to understand differences between children in trait attachment and psychological problems: children who overall showed more state attachment variability were overall less securely attached at a trait-level and reported more psychological problems. Although evidence for within-person associations was less robust, there was some indication that the degree of state attachment variability might be related to the development of trust and psychological problems at a within-person level.

Child maltreatment affects fathers' response to infant crying, not mediated by cortisol or testosterone.

Parents' ability to appropriately respond to infant crying is essential for parental care and has been found to relate to parents' own childhood experiences. Additionally, childhood experiences can affect endocrine factors, which may subsequently affect behavior. In the current study, preregistered on https://osf.io/hwgtu, we examined in expectant and new fathers (N = 152) associations between experiences of maltreatment in their own childhood, hair cortisol and testosterone concentrations and their ability to modulate handgrip force when exposed to infant crying. Cortisol and testosterone were quantified from the 1 cm of hair most proximal to the scalp using Liquid chromatography-tandem mass spectrometry. Participants were asked to squeeze a handgrip dynamometer at full and half strength while listening to infant cries and control sounds. Results indicated that fathers who experienced more childhood maltreatment used more excessive handgrip force during infant cry sounds. Hair cortisol and testosterone were not related to either experienced childhood maltreatment or handgrip strength modulation. These findings confirm that fathers' early experiences of maltreatment reduce their ability to modulate their behavioral responses during infant cries, but suggest that hair cortisol and testosterone concentrations do not identify the underlying mechanism of this association.

A soft baby carrier intervention enhances amygdala responses to infant crying in fathers: A randomized controlled trial.

New fathers may grow into their parental role through active involvement in childcare. Spending time in physical contact with the child may promote an adaptive transition to fatherhood. In this randomized controlled trial, we tested the effects of a baby carrier intervention on fathers' hormonal and neural functioning. Using functional magnetic resonance imaging (fMRI), we examined whether infant carrying affects neural reactivity to infant crying in first-time fathers, taking into account the role of the hormone oxytocin as a mediating mechanism and fathers' own childhood experiences as a potential moderating factor. Sixty first-time fathers (infant age M = 11.18 weeks, SD = 2.08) were randomly assigned to a baby carrier intervention group (n = 32 fathers) or a control group (n = 28 fathers). Fathers in the intervention group were instructed to use a baby carrier for three weeks, whereas fathers in the control group were instructed to use a baby seat. Before and after the intervention salivary oxytocin was measured and neural reactivity to infant crying was assessed using fMRI. Results showed that the infant carrier intervention increased amygdala reactivity to infant crying compared to the infant seat users. This effect was most pronounced in fathers with experiences of childhood abuse. The carrier intervention did not affect fathers' oxytocin levels. Our findings indicate that spending time in physical contact with the infant may promote attention to and accurate perception of infant signals, in particular in fathers with more adverse childhood experiences. Soft baby carriers may, therefore, facilitate an adaptive transition to fatherhood.

A learning theory of attachment: Unraveling the black box of attachment development.

Attachment is an inborn behavioral system that is biologically driven and essential for survival. During child development, individual differences in (in)secure attachment emerge. The development of different attachment behaviors has been traditionally explained as a process during which experiences with (lack of) responsive and supportive care are internalized into working models of attachment. However, this idea has been criticized for being vague and even untestable. With the aim of unraveling this black box, we propose to integrate evidence from conditioning research with attachment theory to formulate a Learning Theory of Attachment. In this review, we explain how the development of individual differences in attachment security at least partly follows the principles of classical and operant conditioning. We combine observed associations between attachment and neurocognitive and endocrinological (cortisol, oxytocin, and dopamine) processes with insights in conditioning dynamics to explain the development of attachment. This may contribute to the explanation of empirical observations in attachment research that are insufficiently accounted for by traditional attachment theory.

Combining oxytocin and cognitive bias modification training in a randomized controlled trial: Effects on trust in maternal support.

BACKGROUND AND OBJECTIVES: Research on the social effects of intranasal oxytocin in children is scarce. Oxytocin has been proposed to have clearer beneficial effects when added to social learning paradigms. The current study tested this proposition in middle childhood by assessing effects of cognitive bias modification (CBM) training and oxytocin on trust in maternal support. METHODS: Children (N = 100, 8-12 years) were randomly assigned to one of two training conditions: CBM training aimed at increasing trust or neutral placebo training. Within each training condition, half the participants received oxytocin and half a placebo. Main and interaction effects were assessed on measures of trust-related interpretation bias and trust. We explored whether child characteristics moderated intervention effects. RESULTS: Children in the CBM training were faster to interpret maternal behaviour securely versus insecurely. Effects did not generalize to interpretation bias measures or trust. There were no main or interaction effects of oxytocin. Exploratory moderation analyses indicated that combining CBM training with oxytocin had less positive effects on trust for children with more internalizing problems. LIMITATIONS: As this was the first study combining CBM and oxytocin, replication of the results is needed. CONCLUSIONS: This study combined a social learning paradigm with oxytocin in children. CBM training was effective at an automatic level of processing. Oxytocin did not enhance CBM effects or independently exert effects. Research in larger samples specifying when oxytocin might have beneficial effects is necessary before oxytocin can be used as intervention option in children.

A Further Validation of the Cognitive Bias Modification Effect on Trust in Middle Childhood.

Recent middle childhood research suggests that children's trust in maternal support can be manipulated using Cognitive Bias Modification (CBM) aimed at changing children's interpretation of ambiguous maternal support-related behavior. The current study with 60 children (40 girls, Mage = 10.62, SDage = 1.20) aimed to replicate previous research and to test whether the CBM effect is specific to trust or generalizes to other child evaluations of maternal behavior. More specifically, CBM effects on children's evaluation of parenting behavior were tested. Trust and maternal parenting behaviors were assessed using children's self-report. Results largely replicated previous findings, including the positive effect of CBM on children's trust in maternal support. Suggesting that this effect was specific for trust, the CBM manipulation did not affect children's appraisal of maternal parenting behavior. This finding supports the validity of CBM effects.

Strengthening Attachment-Based Therapies: A Case for Cognitive Bias Modification?

A recent article published in the Journal describes the effectiveness of attachment-based family therapy in decreasing suicidal ideation and depressive symptoms in adolescents. 1Because insecure attachment is a transdiagnostic risk factor in the development of psychological problems in children and adolescents, improving attachment relationships is an important therapeutic endeavor. In their article, Diamond et al. suggest that programs such as attachment-based family therapy might become more effective or "fortified by integrating more specific cognitive and emotional skills training." 1In the current letter, we want to argue that such a claim is theoretically meaningful, how such fortification might be achieved, and which training components might be added. Most importantly, we want to plea for clinical research that puts this claim to a test.

No side-effects of single intranasal oxytocin administration in middle childhood.

BACKGROUND: Despite growing interest in the (therapeutic) use of intranasal oxytocin administration in children, the potential side-effects of intranasal oxytocin have remained largely unclear to date. The current study is the first double-blind randomized controlled trial to examine side-effects following single administration of oxytocin nasal spray in elementary school-aged children. METHODS: One hundred children (8-12 years old) were randomly assigned to receive oxytocin or placebo nasal spray. We assessed side-effects by means of a standardized, drug-specific questionnaire and an open-ended question at two time points: 90 min after nasal spray administration and 24 h after administration. RESULTS: There were no significant associations between nasal spray condition and total frequency of reported side-effects or reports of specific side-effects. Children and their mothers were unable to correctly guess nasal spray allocation, further supporting that the subjective experience of oxytocin versus placebo nasal spray effects was similar. Moreover, the majority of reported side-effects were classified as mild and ceased within 24 h after the procedure, indicating that the nasal sprays were well tolerated. CONCLUSION: In all, this study is the first randomized controlled trial to provide information on the safety of intranasal oxytocin administration in middle childhood. The current study suggests that single administration of intranasal oxytocin is likely safe in elementary school-aged children.

The effects of Cognitive Bias Modification training and oxytocin administration on trust in maternal support: study protocol for a randomized controlled trial.

BACKGROUND: Lack of trust in parental support is a transdiagnostic risk factor for the development of psychological problems throughout the lifespan. Research suggests that children's cognitive attachment representations and related information processing biases could be an important target for interventions aiming to build trust in the parent-child relationship. A paradigm that can alter these biases and increase trust is that of Cognitive Bias Modification (CBM), during which a target processing bias is systematically trained. Trust-related CBM training effects could possibly be enhanced by oxytocin, a neuropeptide that has been proposed to play an important role in social information processing and social relationships. The present article describes the study protocol for a double-blind randomized controlled trial (RCT) aimed at testing the individual and combined effects of CBM training and oxytocin administration on trust in maternal support. METHODS/DESIGN: One hundred children (aged 8-12 years) are randomly assigned to one of four intervention conditions. Participants inhale a nasal spray that either contains oxytocin (OT) or a placebo. Additionally, they receive either a CBM training aimed at positively modifying trust-related information processing bias or a neutral placebo training aimed to have no trust-related effects. Main and interaction effects of the interventions are assessed on three levels of trust-related outcome measures: trust-related interpretation bias; self-reported trust; and mother-child interactional behavior. Importantly, side-effects of a single administration of OT in middle childhood are monitored closely to provide further information on the safety of OT administration in this age group. DISCUSSION: The present RCT is the first study to combine CBM training with oxytocin to test for individual and combined effects on trust in mother. If effective, CBM training and oxytocin could be easily applicable and nonintrusive additions to interventions that target trust in the context of the parent-child relationship. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02737254 . Registered on 23 March 2016.

Contributions of emotional state and attention to the processing of syntactic agreement errors: evidence from P600.

The classic account of language is that language processing occurs in isolation from other cognitive systems, like perception, motor action, and emotion. The central theme of this paper is the relationship between a participant's emotional state and language comprehension. Does emotional context affect how we process neutral words? Recent studies showed that processing of word meaning - traditionally conceived as an automatic process - is affected by emotional state. The influence of emotional state on syntactic processing is less clear. One study reported a mood-related P600 modulation, while another study did not observe an effect of mood on syntactic processing. The goals of this study were: First, to clarify whether and if so how mood affects syntactic processing. Second, to shed light on the underlying mechanisms by separating possible effects of mood from those of attention on syntactic processing. Event-related potentials (ERPs) were recorded while participants read syntactically correct or incorrect sentences. Mood (happy vs. sad) was manipulated by presenting film clips. Attention was manipulated by directing attention to syntactic features vs. physical features. The mood induction was effective. Interactions between mood, attention and syntactic correctness were obtained, showing that mood and attention modulated P600. The mood manipulation led to a reduction in P600 for sad as compared to happy mood when attention was directed at syntactic features. The attention manipulation led to a reduction in P600 when attention was directed at physical features compared to syntactic features for happy mood. From this we draw two conclusions: First, emotional state does affect syntactic processing. We propose mood-related differences in the reliance on heuristics as the underlying mechanism. Second, attention can contribute to emotion-related ERP effects in syntactic language processing. Therefore, future studies on the relation between language and emotion will have to control for effects of attention.