Observations of Positive Parenting from Online Parent-Child Interactions at Age 1.

Objective: Brief, reliable, and cost-effective methods to assess parenting are critical for advancing parenting research. Design: We adapted the Three Bags task and Parent Child Interaction Rating System (PCIRS) for rating online visits with 219 parent-child dyads (White, n = 104 [47.5%], Black, n = 115 [52.5%]) and combined the video data with survey data collected during pregnancy and when children were aged 1. Results: The PCIRS codes of positive regard, stimulation of child cognitive development, and sensitivity showed high reliability across the three parent-child interaction tasks. A latent positive parenting factor combining ratings across codes and tasks showed good model fit, which was similar regardless of parent self-identified race or ethnicity, age, socioeconomic disadvantage, marital/partnered status, and parity, as well as methodological factors relevant to the online video assessment method (e.g., phone vs. laptop/tablet). In support of construct validity, observed positive parenting was related to parent-reported positive parenting and child socioemotional development. Finally, parent reports of supportive relationships in pregnancy, but not neighborhood safety or pandemic worries, were prospectively related to higher positive parenting observed at age 1. With the exception of older parental age and married/partnered status, no other parent, child, sociodemographic, or methodological variables were related to higher overall video exclusions across tasks. Conclusions: PCIRS may provide a reliable approach to rate positive parenting at age 1, providing future avenues for developing more ecologically valid assessments and implementing interventions through online encounters that may be more acceptable, accessible, or preferred among parents of young children.

Childhood conduct problems and parent-child talk during social and nonsocial play contexts: a naturalistic home-based experiment.

Parent-child interactions are a critical pathway to emotion socialization, with disruption to these processes associated with risk for childhood behavior problems. Using computational linguistics methods, we tested whether (1) play context influenced parent-child socioemotional language, and (2) child conduct problems or callous-unemotional traits were associated with patterns of socioemotional or nonsocial language across contexts. Seventy-nine parent-child dyads (children, 5-6 years old) played a socioemotional skills ("social context") or math ("nonsocial context") game at home. We transcribed and analyzed game play, which had been audio recorded by participants. The social context elicited more socioemotional and cognitive words, while the nonsocial context elicited more mathematical words. The use of socioemotional language by parents and children was more strongly correlated in the social context, but context did not moderate the degree of correlation in cognitive or mathematical word use between parents and children. Children with more conduct problems used fewer socioemotional words in the social context, while children with higher callous-unemotional traits used fewer cognitive words in both contexts. We highlight the role of context in supporting socioemotionally rich parent-child language interactions and provide preliminary evidence for the existence of linguistic markers of child behavior problems. Our results also inform naturalistic assessments of parent-child interactions and home-based interventions for parents and children facing socioemotional or behavioral challenges.

Promoting Empathy and Affiliation in Relationships (PEAR) study: protocol for a longitudinal study investigating the development of early childhood callous-unemotional traits.

INTRODUCTION: Children with callous-unemotional (CU) traits are at high lifetime risk of antisocial behaviour. Low affiliation (ie, social bonding difficulties) and fearlessness (ie, low threat sensitivity) are proposed risk factors for CU traits. Parenting practices (eg, harshness and low warmth) also predict risk for CU traits. However, few studies in early childhood have identified attentional or physiological markers of low affiliation and fearlessness. Moreover, no studies have tested whether parenting practices are underpinned by low affiliation or fearlessness shared by parents, which could further shape parent-child interactions and exacerbate risk for CU traits. Addressing these questions will inform knowledge of how CU traits develop and isolate novel parent and child targets for future specialised treatments for CU traits. METHODS AND ANALYSIS: The Promoting Empathy and Affiliation in Relationships (PEAR) study aims to establish risk factors for CU traits in children aged 3-6 years. The PEAR study will recruit 500 parent-child dyads from two metropolitan areas of the USA. Parents and children will complete questionnaires, computer tasks and observational assessments, alongside collection of eye-tracking and physiological data, when children are aged 3-4 (time 1) and 5-6 (time 2) years. The moderating roles of child sex, race and ethnicity, family and neighbourhood disadvantage, and parental psychopathology will also be assessed. Study aims will be addressed using structural equation modelling, which will allow for flexible characterisation of low affiliation, fearlessness and parenting practices as risk factors for CU traits across multiple domains. ETHICS AND DISSEMINATION: Ethical approval was granted by Boston University (#6158E) and the University of Pennsylvania (#850638). Results will be disseminated through conferences and open-access publications. All study and task materials will be made freely available on lab websites and through the Open Science Framework (OSF).

Prospective associations between pandemic-related adversity, harsh parenting, and the development of prosociality across middle to late childhood.

Parenting behaviors and children's prosociality (i.e., voluntary behaviors intended to benefit others) are linked across development. Contextual risk and environmental stressors may undermine parenting behaviors known to promote children's prosocial behavior. The COVID-19 pandemic provides a unique context in which to examine how stress and contextual risk disrupt parenting practices and the development of children's prosociality over time. To explore the associations between pandemic-related adversity, parenting practices, and child prosocial behavior, we used survey data from 303 families (child Mage = 6.43; 51.4% female, 48.6% male; 65.7% White) who participated in a three-wave longitudinal study during the first year of the pandemic. Families were recruited from two northeastern cities in the United States. Growth mixture modeling identified two groups of parents who varied in their experience of pandemic-related adversity. The high-adversity group reported significantly more symptoms of depression and anxiety, parental burnout, and pandemic-related worries than the low-adversity group. At baseline, parents in the high-adversity group reported harsher parenting and perceived less prosocial behavior in their children. Across the full sample, there were no significant changes in harsh parenting and parental perceptions of child's prosociality across the first year of the pandemic. However, within the high-adversity group, increases in harsh parenting were related to reductions in children's prosociality over time. Results are interpreted in the context of family systems theory and contribute to our understanding of the links between parenting and children's prosociality and patterns of risk and resilience in the context of the COVID-19 pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the "Prenatal to Preschool" study protocol.

Introduction: Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children's development and mental health are adversely impacted by their mothers' experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families. Methods: This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months. Results: Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children's development and mental health may be adversely impacted by their caregiver's experiences of racism. Discussion: This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.

The COVID-19 pandemic, mask-wearing, and emotion recognition during late-childhood.

Face masks are an effective and important tool to prevent the spread of COVID-19, including among children. However, occluding parts of the face can impact emotion recognition, which is fundamental to effective social interactions. Social distancing, stress, and changes to routines because of the pandemic have also altered the social landscape of children, with implications for social development. To better understand how social input and context impact emotion recognition, the current study investigated emotion recognition in children (7-12 years old, N = 131) using images of both masked and unmasked emotional faces. We also assessed a subsample of participants ("pre-pandemic subsample," n = 35) who had completed the same emotion recognition task with unmasked faces before and during the pandemic. Masking of faces was related to worse emotion recognition, with more pronounced effects for happy, sad, and fearful faces than angry and neutral faces. Masking was more strongly related to emotion recognition among children whose families reported greater social disruption in response to the pandemic. Finally, in the pre-pandemic subsample, emotion recognition of sad faces was lower during versus before the pandemic relative to other emotions. Together, findings show that occluding face parts and the broader social context (i.e., global pandemic) both impact emotion-relevant judgments in school-aged children.

Clinician-reported childbirth outcomes, patient-reported childbirth trauma, and risk for postpartum depression.

Childbirth trauma is common and increases risk for postpartum depression (PPD). However, we lack brief measures to reliably identify individuals who experience childbirth trauma and who may be at greater prospective risk for PPD. To address this gap, we used data from a racially diverse prospective cohort (n=1082). We collected survey data during pregnancy and at 12 weeks postpartum, as well as clinician-reported data from medical records. A new three-item measure of patient-reported childbirth trauma was a robust and independent risk factor for PPD, above and beyond other known risk factors for PPD, including prenatal anxiety and depression. Cesarean birth, greater blood loss, and preterm birth were each associated with greater patient-reported childbirth trauma. Finally, there were prospective indirect pathways whereby cesarean birth and higher blood loss were related to higher patient-reported childbirth trauma, in turn predicting greater risk for PPD. Early universal postpartum screening for childbirth trauma, targeted attention to individuals with childbirth complications, and continued screening for depression and anxiety can identify individuals at risk for PPD. Such efforts can inform targeted interventions to improve maternal mental health, which plays a vital role in infant development.

Association of COVID-19 and Endemic Systemic Racism With Postpartum Anxiety and Depression Among Black Birthing Individuals.

Importance: The intersection of endemic structural racism and the global health crisis secondary to the COVID-19 pandemic represents a syndemic, defined as the aggregation of 2 or more endemic and epidemic conditions leading to adverse repercussions for health. Long-standing inequities have placed Black individuals at disproportionate risk for negative postpartum mental health outcomes. Studies are urgently needed to understand how the COVID-19 pandemic has added to this risk (eg, syndemic associations). Objective: To examine the association between the syndemic and the postpartum mental health of Black birthing individuals. Design, Setting, and Participants: A longitudinal cohort of Black birthing individuals were followed up from pregnancy (April 17 to July 8, 2020) through the early postpartum period (August 11, 2020, to March 2, 2021) from urban university medical center prenatal clinics. Pregnant Black participants were recruited via email and completed 2 online surveys. Main Outcomes and Measures: Composite variables capturing negative experiences of the COVID-19 pandemic and racism (structural racism [general], structural racism [neighborhood], and interpersonal racism) were created. Logistic regressions examined main and interactive associations between these variables and postpartum depression (Edinburgh Postnatal Depression Scale) and anxiety (Generalized Anxiety Disorder 7-item scale). Results: The mean (SD) age of 151 Black participants was 30.18 (5.65) years. The association between higher negative COVID-19 pandemic experiences and postpartum depression may be influenced by experiences of interpersonal racism and general systemic racism. Negative COVID-19 pandemic experiences were associated with greater likelihood of screening positive for depression only at higher levels of systemic racism (odds ratio, 2.52; 95% CI, 1.38-4.60) and interpersonal racism (odds ratio, 1.90; 95% CI, 1.04-3.48) but not at lower levels of systemic or interpersonal racism. Similarly, negative COVID-19 experiences were associated with anxiety only at higher levels of interpersonal racism (odds ratio, 1.85; 95% CI, 0.86-4.01) but not at lower levels of interpersonal racism. Overall, 44 (29%) met screening criteria for postpartum depression and 20 (13%) for postpartum anxiety. Conclusions and Relevance: In this longitudinal cohort study of Black birthing individuals, the experience of the syndemic was associated with negative postpartum mental health. Associations between interpersonal racism, structural racism, and negative COVID-19 pandemic experiences were associated with greater risk for postpartum depression and anxiety. Research is needed to address how systemic racism perturbs biobehavioral pathways to magnify associations between acute stressors and mental health. Such research can inform the creation of effective, culturally informed preventive interventions to improve the postpartum mental health of Black individuals.

Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19.

Acute stress during pregnancy can have adverse effects on maternal health and increase the risk for postpartum depression and impaired mother-infant bonding. The COVID-19 pandemic represents an acute environmental stressor during which it is possible to explore risk and resilience factors that contribute to postpartum outcomes. To investigate prenatal risk and resilience factors as predictors of postpartum depression and impaired mother-infant bonding, this study recruited a diverse cohort of 833 pregnant women from an urban medical center in Philadelphia, Pennsylvania, and assessed them once during pregnancy in the early phase of the COVID-19 pandemic (April-July 2020) and again at approximately twelve weeks postpartum. Adverse childhood experiences, prenatal depression and anxiety, and COVID-19-related distress predicted a greater likelihood of postpartum depression. Prenatal depression was the only unique predictor of impaired maternal-infant bonding after postpartum depression was controlled for. Women reporting greater emotion regulation, self-reliance, and nonhostile relationships had healthier postpartum outcomes. Policies to increase the number of nonspecialty providers providing perinatal mental health services as well as reimbursement for integrated care and access to mental health screening and care are needed to improve lifelong outcomes for women and their children.

The Impact of the COVID-19 Pandemic on Children's Conduct Problems and Callous-Unemotional Traits.

The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health.