Classes of child-mother attachment disorganization from infancy to the preschool years.

Mary Main's operationalization of infant attachment disorganization contributed to our understanding of attachment and psychopathology. Her exploration of attachment patterns at age 6 with Jude Cassidy laid the foundations for studying attachment post-infancy. They found remarkable correspondence from age 1 to age 6 in the disorganization spectrum and documented the emergence of role-reversal. This study proposes a person-centered approach to explore classes of children with respect to attachment disorganization at four time points between infancy and late preschool. Participants (n = 205) were recruited in the UK and formed a socioeconomically diverse community sample of mother-child dyads. We identified three classes of children: 1) a stable organized group; 2) an unstable group becoming organized; and 3) an unstable group becoming disorganized. Results show that major loss predicts membership of the third class of children. These findings contribute to our understanding of disorganization across multiple periods, and thus to Mary Main's legacy.

Perceived Parental Distraction by Technology and Mental Health Among Emerging Adolescents.

Importance: The digital phenomenon termed technoference refers to interruptions in routine social interactions due to technology use. Technoference may negatively affect parents' attention to cues necessary for supporting children's mental health. Objective: To explore whether there are directional prospective associations between perceived parental technoference and emerging adolescents' mental health symptoms (anxiety, depression, inattention, and hyperactivity). Design, Setting, and Participants: This cohort study assessed a general population of mothers and emerging adolescents in Calgary, Alberta, Canada. Women were recruited during pregnancy between May 3, 2008, and December 13, 2010, with convenience sampling and repeated follow-up; eligible women were 18 years or older, spoke English, had a gestational age of at least 24 weeks, and received local prenatal care. Data collection for the present study took place when emerging adolescents were aged 9 (May 20 to July 15, 2020), 10 (March 4 to April 30, 2021), and 11 (November 22, 2021, to January 17, 2022) years. Mothers provided consent for their child to participate, and emerging adolescents provided assent. Data were analyzed from December 1 to 31, 2023, using random-intercept cross-lagged panel models. Exposure: Perceived parental technoference. Main Outcomes and Measures: Emerging adolescents completed questionnaires about their perception of parental technoference and their mental health symptoms (depression, anxiety, hyperactivity, and inattention) at the 3 study times. This study did not rely on statistical significance, but instead on the magnitude of effect sizes to determine meaningful effects. Results: Participants included 1303 emerging adolescents (mean [SD] age, 9.7 [0.8] years at time 1; of the 1028 reporting information, 529 [51.5%] were girls). Cross-sectional associations indicated correlations between perceptions of parental technoference and emerging adolescents' mental health (r range, 0.17-0.19). Higher levels of anxiety at 9 and 10 years of age were prospectively associated with higher parental technoference scores at 10 (ß = 0.11 [95% CI, -0.05 to 0.26]) and 11 (ß = 0.12 [95% CI, 0.001-0.24]) years of age, with small magnitudes of effect size. Higher parental technoference scores at 9 and 10 years of age were prospectively associated with higher hyperactivity at 10 (ß = 0.07 [95% CI, -0.07 to 0.22]) and 11 (ß = 0.11 [95% CI, -0.02 to 0.24]) years of age and inattention at 11 years of age (ß = 0.12 [95% CI, 0.001-0.24]), with small magnitudes of effect size. No gender differences were identified. Conclusions and Relevance: In this 3-wave longitudinal birth cohort study, perceived parental technoference was associated with emerging adolescents' mental health. The findings speak to the need to discuss digital technology use and mental health with parents and emerging adolescents as a part of routine care.

A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children.

The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b = .02) and internalizing psychopathology (b = .01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant.

Maternal and paternal sensitivity: Key determinants of child attachment security examined through meta-analysis.

Sensitive caregiving behavior, which involves the ability to notice, interpret, and quickly respond to a child's signals of need and/or interest, is a central determinant of secure child-caregiver attachment. Yet, significant heterogeneity in effect sizes exists across the literature, and sources of heterogeneity have yet to be explained. For all child-caregiver dyads, there was a significant and positive pooled association between caregiver sensitivity and parent-child attachment (r = .25, 95% CI [.22, .28], k = 174, 230 effect sizes, N = 22,914). We also found a positive association between maternal sensitivity and child attachment security (r = .26, 95% CI [.22, .29], k = 159, 202 effect sizes, N = 21,483), which was equivalent in magnitude to paternal sensitivity and child attachment security (r = .21, 95% CI [.14, 27], k = 22, 23 effect sizes, N = 1,626). Maternal sensitivity was also negatively associated with all three classifications of insecure attachment (avoidant: k = 43, r = -.24 [-.34, -.13]; resistant: k = 43, r = -.12 [-.19, -.06]; disorganized: k = 24, r = -.19 [-.27, -.11]). For maternal sensitivity, associations were larger in studies that used the Attachment Q-Sort (vs. the Strange Situation), used the Maternal Behavior Q-Sort (vs. Ainsworth or Emotional Availability Scales), had strong (vs. poor) interrater measurement reliability, had a longer observation of sensitivity, and had less time elapse between assessments. For paternal sensitivity, associations were larger in older (vs. younger) fathers and children. These findings confirm the importance of both maternal and paternal sensitivity for the development of child attachment security and add understanding of the methodological and substantive factors that allow this effect to be observed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence of Mental Health and Substance Use Difficulties Among Sexual and Gender Diverse Youth During COVID-19: A Systematic Review and Meta-Analysis.

Purpose: Sexual and gender diverse (SGD) youth have been particularly vulnerable to mental health difficulties and substance use during the COVID-19 pandemic. However, estimates have varied across studies pointing to the potential for moderator variables. This meta-analytic and narrative synthesis provides estimates of the prevalence of mental health difficulties (anxiety, depression, suicidal ideation, suicide attempts) and substance use during COVID-19 among SGD youth. Methods: A comprehensive search strategy combining keywords and subject headings was designed and used across seven databases from inception to October 7, 2022. The search yielded 826 nonduplicate records of which 191 full-text articles were retrieved, evaluated, and extracted by two study authors. Data were analyzed from February 27 to March 1, 2023. Results: Using random-effects meta-analyses, 19 studies from 18 independent samples with 10,500 participants were included. Pooled prevalence rates for clinically elevated anxiety, depression, and suicidal ideation were 55.4% [95% confidence interval (CI):45.9%-64.5%], 61.8% (95% CI: 50.9%-71.7%), and 50.9% (95% CI: 42.8%-59.0%). There was no evidence of publication bias. Suicide attempts and substance use were summarized narratively with rates of suicide attempts being greater than 20% across included studies and variable reporting of substance use across substance types. No moderators explained variability across studies. Conclusion: More than 50% of SGD youth experienced clinically elevated symptoms of anxiety, depression, and suicidal ideation during the COVID-19 pandemic, compared to prepandemic estimates for both SGD and non-SGD youth. Targeted resource allocation is needed to specifically address the needs of SGD youth.

A randomized waitlist control trial of the Make the Connection® online program for caregivers of infants and young children: Study protocol.

Background: A positive child-caregiver relationship is one of the strongest determinants of child health and development, yet many caregivers report challenges in establishing a positive relationship with their child. For over 20 years, Make the Connection® (MTC), an evidence-based parenting program, has been delivered in-person by child-caring professionals to over 120,000 parents to improve positive parenting behaviours and attitudes. Recently, MTC has been adapted into a 'direct to caregiver' online platform to increase scalability and accessibility. The purpose of this study is to evaluate the effectiveness of the online modality of MTC in increasing parenting knowledge, attitudes, and the perceived relationship with their child, and to understand barriers and facilitators to its access. Methods: Two hundred caregivers with children aged 0-3 years old will be recruited through Public Health agencies in Ontario, Canada. Participants will be randomly placed in the intervention or waitlist control group. Both groups will complete a battery of questionnaires at study enrolment and 8 weeks later. The intervention group will receive the MTC online program during the 8-week period, while the waitlist group will receive the program after an 8-week wait. The study questionnaires will address demographic information, caregivers' relational attitudes towards their infant, self-competence in their caregiver role, depression, and caregiver stress, as well as caregivers' and infants' emotion regulation. Discussion: Results from this study will add critical knowledge to the development, scaling, and roll out of the MTC online program, thus increasing its capacity to reach a greater number of families. Trial registration: The study was registered with ClinicalTrials.gov on 15 March 2023 (NCT05770414).

The PPSQ: assessing parental, child, and partner's playfulness in the preschool and early school years.

Introduction: Developmental research has traditionally focused on parenting behaviors such as nurturance and care, due to a focus on mothers' behaviors. Other parenting dimensions such as parental playfulness (i.e., use of creativity, imagination, and humor during parent-child interactions) have comparatively received little attention. Although some measures tap into parents' and children's playfulness, these measures are limited. Indeed, they do not assess multiple domains of playfulness (i.e., both parents' and the child's playfulness) or focus on one specific setting such as children's play with peers. Additionally, existing measures do not consider parents' reactions to their partners' playfulness. To address this gap, we created the Playful Parenting Style Questionnaire (PPSQ), which assesses three domains of playfulness: (a) parental domain, (b) child domain, and (c) partner domain. The current study is part of a validation effort of the PPSQ using a quantitative design. We aimed to explore the structure of the PPSQ by conducting an exploratory factor analysis (EFA) for each domain of playfulness; and assess the construct validity of the PPSQ factors by examining the association between factors and existing measures of playful parenting, child playfulness, and co-parenting. Method: The sample includes 347 parents (294 mothers and 53 fathers) of preschool/school-age children (M = 5.10 years; 182 girls, 127 boys). Parents were mostly White (76%) and from a low socioeconomic risk background. Parents completed a series of online questionnaires including the PPSQ, 3 existing measures of parent playfulness (Parental Playfulness Questionnaire; Adult Playfulness Scale; Challenging Parenting Behavior Scale), 2 existing measures of child playfulness (Child Behavior Inventory; Children's Playfulness Scale), a coparenting instrument (Co-parenting Relationship Scale), and sociodemographic information. Results: The EFA revealed 4 factors for parental playfulness, 1 factor for child playfulness, and 3 factors for partner's playfulness. The construct validity analyses identified multiple associations indicating convergence with existing measures for the parent and partners domain but not the child factor. Discussion: This study allowed for a better understanding of the playful dynamics that occur within a family.

Mentalizing in first-time fathers: reflective functioning as a mediator between attachment representation and sensitivity.

Sensitivity in parent-child interaction is essential for child development. Since fathers are increasingly involved in childrearing, identifying factors leading to paternal sensitivity is crucial. We examined the relation between attachment representation and reflective functioning (RF) as factors influencing paternal sensitivity in a longitudinal study including N = 40 first-time fathers (Mage = 33) and their 6-month-old children. We used the Adult Attachment Interview during pregnancy to assess paternal attachment representation and general RF, the Parental Development Interview to assess fathers' parental RF, and the Emotional Availability Scale to measure sensitivity at child's age of 6 month. Data show that secure paternal attachment representation, high general and parental RF are associated with higher levels of paternal sensitivity. Further, parental RF mediates the association between attachment representation and paternal sensitivity. These findings contribute to the identification of a causal interplay in that they suggest an explanatory effect of RF on the association between fathers' attachment representation, and sensitivity.

Intergenerational transmission of parent adverse childhood experiences to child outcomes: A systematic review and meta-analysis.

OBJECTIVE: The current meta-analytic review provides a comprehensive synthesis of studies examining parent exposure to ACEs and the developmental and mental health outcomes of their children. PARTICIPANTS AND SETTING: Eligible studies up to August 2021 were identified through comprehensive database searches in PsycINFO, MEDLINE, and Embase. Studies that were included examined the intergenerational effects of parent ACEs on child development (i.e., cognitive, language, motor, social difficulties, and early social-emotional development) or mental health (i.e., internalizing problems, externalizing problems) outcomes. METHODS: Data were extracted by two coders using a standardized extraction protocol. A multi-level meta-analytic approach was used to derive pooled effect sizes and test for moderators. RESULTS: A total of 52 studies were included in the meta-analysis. Parent ACEs were positively associated with child mental health problems (r=0.17, 95% CI [0.12, 0.21], p<.001), child externalizing difficulties (r=0.20, 95% CI [0.15, 0.26], p<.001), and child internalizing difficulties (r=0.17, 95% CI [0.11, 0.22], p<.001). There were no significant sociodemographic (i.e., child age, parent age, income level, child sex, or racial/ethnic minority status) or methodological (i.e., study type or quality) moderators of these associations. Preliminary evidence suggests that parent ACEs were not associated with offspring developmental outcomes, such as cognitive or language skills. CONCLUSIONS: Results suggest that parent ACEs are associated with some, but not all child outcomes. Additional research focused on the mechanisms of transmission are needed to inform policies and practices related to the intergenerational transmission of ACEs.

Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies.

Exposure to adverse childhood experiences (ACEs), including maltreatment and family dysfunction, is a major contributor to the global burden of disease and disability. With a large body of international literature on ACEs having emerged over the past 25 years, it is timely to now synthetize the available evidence to estimate the global prevalence of ACEs and, through a series of moderator analyses, determine which populations are at higher risk. We searched studies published between January 1, 1998 and August 5, 2021 in Medline, PsycINFO and Embase. Study inclusion criteria were using the 8- or 10-item ACE Questionnaire (±2 items), reporting the prevalence of ACEs in population samples of adults, and being published in English. The review protocol was registered with PROSPERO (CRD42022348429). In total, 206 studies (208 sample estimates) from 22 countries, with 546,458 adult participants, were included. The pooled prevalence of the five levels of ACEs was: 39.9% (95% CI: 29.8-49.2) for no ACE; 22.4% (95% CI: 14.1-30.6) for one ACE; 13.0% (95% CI: 6.5-19.8) for two ACEs; 8.7% (95% CI: 3.4-14.5) for three ACEs, and 16.1% (95% CI: 8.9-23.5) for four or more ACEs. In subsequent moderation analyses, there was strong evidence that the prevalence of 4+ ACEs was higher in populations with a history of a mental health condition (47.5%; 95% CI: 34.4-60.7) and with substance abuse or addiction (55.2%; 95% CI: 45.5-64.8), as well as in individuals from low-income households (40.5%; 95% CI: 32.9-48.4) and unhoused individuals (59.7%; 95% CI: 56.8-62.4). There was also good evidence that the prevalence of 4+ ACEs was larger in minoritized racial/ethnic groups, particularly when comparing study estimates in populations identifying as Indigenous/Native American (40.8%; 95% CI: 23.1-59.8) to those identifying as White (12.1%; 95% CI: 10.2-14.2) and Asian (5.6%; 95% CI: 2.4-10.2). Thus, ACEs are common in the general population, but there are disparities in their prevalence. They are among the principal antecedent threats to individual well-being and, as such, constitute a pressing social issue globally. Both prevention strategies and downstream interventions are needed to reduce the prevalence and mitigate the severity of the effects of ACEs and thereby reduce their deleterious health consequences on future generations.

A meta-analysis of the distribution of preschool and early childhood attachment as assessed in the strange situation procedure and its modified versions.

This meta-analysis synthesized the distribution of attachment classifications as coded with the Cassidy-Marvin Preschool Attachment Coding System and the Main-Cassidy Six-Year-Old System. These systems have extended scholars' capacity to measure differences in the developing child-parent attachment relationship, and its sequelae, beyond the infancy period; however, the global distribution of the attachment categories in these systems, and the potential factors influencing this distribution, remain unknown. The meta-analysis included 97 samples (N = 8,186 children; 55% boys), mostly drawn from North American or European populations (89%; M = 76% White). Results indicated that the distribution of child-mother attachment was 53.5% secure, 14.0% avoidant, 11.0% ambivalent, and 21.5% disorganized/controlling. Moderator analyses showed that rates of security were lower, and rates of disorganization were higher, in samples of at-risk families, specifically when children were exposed to maltreatment. Variations in the procedure also moderated the distribution. The discussion calls for greater unity around methodological practices.

A meta-analysis of child-parent attachment in early childhood and prosociality.

Although numerous individual studies have attempted to link child-parent attachment and prosociality, a systematic picture of that relationship requires a meta-analytic approach that considers different dimensions of prosociality and potential moderators. The current meta-analysis examined 41 studies drawn primarily from North America and Europe and published between 1978 to 2020. Child age ranged from 12 to 53 months at the assessment of child-parent attachment and 12 to 108 months at the assessment of prosociality. Across 35 studies (100 effect sizes, N = 4,611), child-mother attachment security and child prosociality were significantly associated (r = .19, 95% CI [.14, .23]). No moderators were identified. Exploratory estimates were also derived for subtypes of child-mother attachment insecurity. Across six studies (eight effect sizes, N = 402), child-father attachment security was significantly associated with prosociality (r = .11, 95% CI [.02, .23]). The magnitude of effect sizes did not differ based on parent gender. The discussion considers areas of growth for attachment and prosociality research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Depressive Symptoms in Individuals With Persistent Postconcussion Symptoms: A Systematic Review and Meta-Analysis.

Importance: Approximately 15% to 30% of individuals with a history of concussion present with persistent postconcussion symptoms (PPCS). Individuals with PPCS are at greater risk of experiencing depressive symptoms. Objective: To synthesize the association between depressive symptoms and PPCS in children, adolescents, and adults via meta-analysis and to investigate potential moderators of that association. Data Sources: Systematic search of Ovid Medline, CINAHL, PsycInfo, and Embase from 1995 to January 2022 was performed. Additionally, references from included studies were hand-searched to ensure relevant articles were captured in the search. Study Selection: Studies that involved participants who experienced PPCS and quantified depressive symptoms were included. The definition of PPCS was limited to physician-diagnosed or self-reported concussion, with symptoms lasting for a minimum of 4 weeks postinjury. Two authors independently screened all articles to determine study eligibility. Data Extraction and Synthesis: Study characteristics were extracted independently by 2 trained investigators. Study data were meta-analyzed using a random-effects meta-analysis. Exposure: PPCS. Main Outcomes and Measures: The the primary outcome was depressive symptoms. Results: Data were extracted from 18 studies with a total of 9101 participants. Of the 18 studies, all were cohort studies, and 13 (72%) comprised adult populations. The mean (SD) time since concussion was 21.3 (18.7) weeks. After accounting for potential publication bias, the random-effects meta-analysis found a significant positive association between PPCS and depressive symptoms, (odds ratio, 4.56; 95% CI, 2.82-7.37; P < .001). There were no significant moderators, likely due to the small number of studies included. Conclusions and Relevance: In this meta-analysis, experiencing PPCS was associated with a higher risk of experiencing depressive symptoms. There are several important clinical and health policy implications of the findings. Most notably, the development of strategies for effective prevention and earlier intervention to optimize mental health recovery following a concussion should be supported.

A meta-analysis on observed paternal and maternal sensitivity.

Two meta-analyses were conducted (N = 10,980 child-father dyads) with 93 studies published between 1983-2020, primarily in North America and Europe, on observed parental sensitivity to children (3-180 months; 48% girls; 14% non-White) in partnered mothers and fathers. The first meta-analysis found higher maternal mean levels of observed sensitivity, with a small effect size (d = -.27). Differences between parents were larger with micro coding and triadic/family assessments. Differences narrowed as a function of publication year and were not significant in European samples. The second meta-analysis identified a moderate correlation between observed maternal and paternal sensitivity (r = .23 after adjusting for probable publication bias). Correlations were larger in Middle Eastern samples and with composite sensitivity scales.

Parental sensitivity and child behavioral problems: A meta-analytic review.

Meta-analytic associations between observed parental sensitivity and child behavioral problems were examined (children aged 0-17 years). Studies (k = 108, N = 28,114) contained sociodemographically diverse samples, primarily from North America and Europe, reporting on parent-child dyads (95% mothers; 54% boys). Sensitivity significantly related to internalizing (k = 69 studies; N = 14,729; r = -.08, 95% CI [-.12, -.05]) and externalizing (k = 94; N = 25,418; r = -.14, 95% CI [-.17, -.11]) problems, with stronger associations found for externalizing. For internalizing problems, associations were significantly stronger among samples with low socioeconomic status (SES) versus mid-high SES, in peer-reviewed versus unpublished dissertations, and in studies using composite versus single scale sensitivity measures. No other moderators emerged as significant.

Do child-father and child-mother preschool insecure attachment types predict the development of externalizing behaviors in boys and girls during middle childhood?

Past meta-analyses show that both child-mother and child-father attachment insecurity are independently and jointly associated with more externalizing behaviors in children. Little is known, however, on the ways that different types of insecure attachment independently and jointly predict the development of externalizing behaviors over time. Existing work also neglects the impact of children's gender within the context of child-father relationships. The current study addresses these limitations by investigating how insecure type of child-father attachment, child-mother attachment, and their interaction in the preschool years predict boys' and girls' externalizing behaviors in middle childhood, when controlling for children's externalizing behaviors in the preschool years. The sample included 144 preschool-aged children (M = 46.89 months, SD = 8.77, 83 girls) and both of their parents. At Time 1, children completed independent separation-reunion procedures with each parent, which were coded using the Preschool Attachment Rating Scales. At Time 1 and Time 2 (5 years later), mothers and fathers completed the Strengths and Difficulties Questionnaire to report on their children's externalizing behaviors. Results showed no systematic differences in the way that child-mother and child-father attachment predicted the development of externalizing behaviors in boys and girls. Across all children, results identified an interaction of child-father and child-mother ambivalence, by which the presence of ambivalence toward both parents predicted the development of more externalizing behaviors. In addition, child-father controlling-caregiving attachment predicted the development of fewer externalizing behaviors. These results provide insight into the ways that insecure child-father and child-mother attachment predict later socioemotional adaptation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Challenging Parenting Behaviors in Ethnically Diverse Two-Parent Families in the United States: Association with Infants' Social Competence and Behavior Problems.

We used data from a sample of ethnically diverse first-time parents (N = 186) in the United States to examine differences between mothers' and fathers' challenging parenting behaviors (CPB) when infants were 9 months old as well as covariates of CPB. We also examined associations between CPB and infants' social competence and behavior problems when they were 12 months old. Results showed no differences between mothers and fathers in the level of CPB with their infants. Mothers with more depressive symptoms engaged in more CPB. Over and above the contributions of infants' gender and temperament and parents' education, mothers' and fathers' CPB was not associated with infants' social competence and behavior problems. This study expands our understanding of the universality of CPB and whether it is associated with social competence in ethnically diverse families.

Child-father attachment in early childhood and behavior problems: A meta-analysis.

This meta-analytic study examined the associations between child-father attachment in early childhood and children's externalizing and internalizing behavior problems. Based on 15 samples (N = 1,304 dyads), the association between child-father attachment insecurity and externalizing behaviors was significant and moderate in magnitude (r = 0.18, 95% CI: 0.10, 0.27 or d = 0.37, 95% CI: 0.20, 0.55). No moderators of this association were identified. Based on 12 samples (N = 1,073), the association between child-father attachment insecurity and internalizing behaviors was also significant, albeit smaller in magnitude (r = 0.09, 95% CI: 0.02, 0.15; or d = 0.17, 95% CI: 0.03, 0.31). Between-study heterogeneity was insufficient to consider moderators. When compared to the effect sizes of prior meta-analyses on child-mother attachment and behavior problems, the quality of the attachment relationship with fathers yields a similar magnitude of associations to children's externalizing and internalizing behaviors. Results support the need to consider the role of the attachment network, which notably includes attachment relationships to both fathers and mothers, to understand how attachment relationships contribute to child development.

Longitudinal and concurrent relationships between caregiver-child behaviours in the vaccination context and preschool attachment.

ABSTRACT: This article consists of 2 separate studies in which the overarching aim was to examine the relationships between caregiver-child behaviours in the vaccination context (infant and preschool) and preschool attachment outcomes. It provides for the first time an examination of acute pain behaviours during early childhood and how it relates to a critical aspect of child development (ie, attachment status) at the end of early childhood. Study 1 examined the longitudinal relationships between caregiver-infant behaviours during infants' first routine vaccination (2 months) and preschool attachment (n = 84). Study 2 examined the concurrent relationships between caregiver-preschooler behaviours during the last routine vaccination of preschool (4-5 years) and preschool attachment (n = 117). Hierarchical multiple regression analyses were used. Although there were several nonsignificant findings, the results revealed that higher caregiver sensitivity and higher proximal soothing 1 minute before the needle during infants' 2-month vaccinations predicted higher levels of preschooler avoidance and lower levels of preschooler ambivalence, respectively. In addition, higher infant pain-related distress at 2 minutes after the needle was related to higher preschooler security and lower preschooler disorganization and controlling-punitive attachments. In terms of concurrent relationships, only caregiver sensitivity was significantly related to preschool attachment outcomes. Specifically, higher caregiver sensitivity at preschoolers' 4- to 5-year vaccinations was related to higher preschooler attachment security. The study findings provide evidence that child-caregiver behavioural patterns during the infant and preschool routine vaccination relate to preschoolers' patterns of attachment. Moreover, it underscores the potential importance of health professionals teaching and supporting attuned caregiving to the child in pain.

The contributions of child-mother attachment, maternal parenting stress, and military status to the prediction of child behavior problems.

Studies show that children with a military parent are at heightened risk of the development of behavior problems. However, there is limited work examining how other factors experienced by military families may also influence behavior problems. In the current study, we recruited three types of Canadian families with a preschooler: families with a deployed military member, families with a nondeployed military member, and nonmilitary families. We examined whether the nonmilitary parent's (in all cases the mother) parenting stress and attachment relationship with the child are associated with behavior problems, and whether deployment status further contributes to the prediction. Child-mother dyads participated in an observed attachment assessment, and mothers reported on their stress levels and their child's behavior. Results showed that both child attachment insecurity and parenting stress were associated with elevated levels of internalizing problems; however, only parenting stress was associated with conduct problems. Military deployment predicted higher levels of internalizing and conduct problems beyond the contributions of attachment and stress. Furthermore, having a father in the military (whether deployed or not) also contributed to internalizing problems. These findings shed light on how the military lifestyle impacts early childhood mental health through the complex interplay between various parts of their environment.

Los estudios muestran que los niños con un progenitor en las fuerzas armadas se encuentran a un más alto riesgo para desarrollar problemas de comportamiento. Sin embargo, es limitado el trabajo que examina cómo otros factores experimentados por familias con miembros en las fuerzas armadas pudieran también influir en los problemas de comportamiento. En el presente estudio, reclutamos tres tipos de familias con un niño en edad prescolar: familias en las que un miembro había sido enviado al servicio militar activo; familias con un miembro que no había sido enviado al servicio militar activo, y familias sin un miembro en las fuerzas armadas. Examinamos si el estrés de la crianza del progenitor no miembro de las fuerzas armadas (en todos los casos la madre) y la relación de afectividad con el niño están asociadas con los problemas de comportamiento, y si la condición de haber sido enviado al servicio militar activo contribuye aún más a esta predicción. Las díadas madre-niño participaron en una evaluación observada de la afectividad, y las madres reportaron acerca de sus niveles de estrés y el comportamiento de sus niños. Los resultados mostraron que tanto la inseguridad de la afectividad en el niño como el estrés de la crianza estaban asociados con niveles elevados de problemas de internalización, sin embargo, sólo el estrés de la crianza estaba asociado con problemas de comportamiento. El hecho de ser enviado al servicio militar activo predijo más altos niveles de problemas de internalización y de comportamiento más allá de lo que contribuye la afectividad y el estrés. Es más, el tener un papá en las fuerzas armadas (ya sea que haya sido enviado al servicio militar activo o no), también contribuye a problemas de internalización. Estos resultados arrojan luz sobre cómo el estilo de vida de estas familias con un miembro de las fuerzas armadas impacta la salud mental en la temprana niñez a través de la compleja interacción entre varias partes de su entorno. Palabras claves: fuerzas armadas, asignación al servicio militar activo, afectividad, problemas de comportamiento, estrés de crianza.

Les études montrent que les enfants dont l'un des parents est dans les forces armées sont à un risque bien plus élevé de développer des problèmes de comportement. Cependant peu de recherches examinent comment d'autres facteurs dont font l'expérience les familles de militaires peuvent également influencer les problèmes de comportement. Dans cette étude nous avons recruté trois types de familles ayant un d'enfant d'âge préscolaire (avant la grande maternelle): des familles dont l'un des membres est un militaire déployé, des familles avec un membre militaire n'étant pas déployé, et des familles non-militaires. Nous avons examiné si le stress de parentage du parent non-militaire (dans tous les cas la mère) et la relation d'attachement avec l'enfant étaient liés aux problèmes de comportement, et si le statut de déploiement contribue plus à la prédiction. Les dyades enfant-mère ont participé à une évaluation d'attachement observée, et les mères ont fait état de leurs niveaux de stress et du comportement de leurs enfants. Les résultats ont montré qu'à la fois l'insécurité de l'attachement de l'enfant et le stress de parentage était lié à des niveaux élevés de problèmes d'internalisation. Cependant, seul le stress de parentage était lié à des problèmes de comportement. Le déploiement militaire prédisait des niveaux d'internalisation plus élevés et des problèmes de conduite au delà des contributions à l'attachement et au stress. De plus, le fait d'avoir un père dans les forces armées (qu'il soit déployé ou non) contribuait aussi aux problèmes d'internalisation. Ces résultats mettent en lumière la manière dont le style de vie militaire impacte la santé mentale de la petite enfance au travers d'une interaction complexe entre les différentes parties de leur environnement. Mots clés: militaire, déploiement, attachement, problèmes de comportement, stress de parentage.