Preventing early harsh parenting and toddler behavior problems: The role of neighborhood collective efficacy among low-income Latine families.

Harsh parenting behaviors are alarmingly prevalent during infancy and toddlerhood. From an ecological perspective, predicting and preventing harsh parenting requires probing not only micro- and exosystem-level processes but also the interactions among them. In the current longitudinal study, we examined associations among maternal depressive symptoms, harsh parenting, and neighborhood collective efficacy in 142 low-income Latina mothers and their infants (Mchild age = 14.11 months, SD = 3.60). We hypothesized that there would be a mediated pathway from maternal depressive symptoms to harsh parenting to toddler behavior problems, and that neighborhood collective efficacy would moderate this pathway. As predicted, maternal depressive symptoms predicted toddler behavior problems, and harsh parenting significantly mediated this association. Moreover, neighborhood collective efficacy was a significant moderator such that this indirect pathway was maintained in the context of low neighborhood collective efficacy only. When collective efficacy was high, this pathway was not significant. Results are discussed in terms of the buffering potential of neighborhood collective efficacy. Tentative implications for leveraging neighborhood supports to prevent early harsh parenting are suggested.

Las duras conductas de crianza son alarmantemente prevalentes durante la infancia y la primera etapa de la niñez. Desde una perspectiva ecológica, predecir y prevenir la dura crianza requiere investigar no sólo los procesos de micro niveles y niveles de exosistemas, sino también las interacciones entre ellos. En el presente estudio longitudinal, examinamos las asociaciones entre los síntomas depresivos maternos, la dura crianza y la colectiva efectividad del vecindario en 142 mujeres latinas de bajos recursos económicos y sus infantes (M edad del niño = 14.11 meses, SD = 3.60). Nuestra hipótesis fue que habría un camino mediador entre los síntomas depresivos maternos y la dura crianza y los problemas de conducta del pequeño infante, y que la efectividad colectiva del vecindario moderaría este camino. Tal como se predijo, los síntomas depresivos maternos predijeron los problemas de conducta de los pequeños infantes, y la dura crianza significativamente medió esta asociación. Es más, la efectividad colectiva del vecindario fue un moderador significativo, de tal manera que este indirecto camino se mantuvo sólo dentro del contexto de la baja efectividad colectiva del vecindario. Cuando la efectividad colectiva fue alta, este camino no fue significativo. Los resultados se discuten en términos de la potencialidad amortiguadora de la efectividad colectiva del vecindario. Se sugieren tentativas implicaciones para la nivelación de los apoyos del vecindario para prevenir una temprana dura crianza.

Des comportements de parentage durs sont extrêmement prévalents durant la petite enfance (bébés et jeunes enfants). D'une perspective écologique, prédire et prévenir le parentage dur exige un examen non seulement des processus au niveau du microsystème et de l'exosystème mais aussi des interactions entre ces systèmes. Dans cette étude longitudinale nous avons examiné les liens entre les symptômes dépressifs maternels, le parentage dure et l'efficacité collective du voisinage chez 142 mères hispaniques ayant de faibles revenus et leurs bébés (M âge de l'enfant = 14,11 mois, SD = 3,60). Nous avons pris comme hypothèse qu'il y aurait une voie de médiation des symptômes dépressifs maternels au parentage dur et aux problèmes de comportement du petit enfant, et que l'efficacité collective du voisinage modérerait cette voie. Comme on l'avait prédit les symptômes dépressifs maternels ont prédit les problèmes de comportement du petit enfant, et le parentage dur a médiatisé ce lien. De plus, l'efficacité collective du voisinage s'est avéré être un modérateur important, à un tel point que cette voie indirecte était maintenue dans le contexte d'une efficacité collective de voisinage même faible. Quand l'efficacité collective était élevée cette voie n'était pas importante. Les résultats sont discutés en termes de potentiel de mise en tampon de l'efficacité collective du voisinage. De possibles implications pour tirer partie des soutiens des voisinages afin de prévenir un parentage dur précoce sont suggérées.

Couple Satisfaction, Depressive Symptoms, and the Therapeutic Alliance: A Systemic Perspective.

There is a well-established bidirectional, negative association between couple satisfaction and depressive symptoms. Yet, a family systems perspective emphasizes the role of the therapist in interrupting this recursive cycle between couple satisfaction and depressive symptoms. The current study utilized longitudinal data to explore the bidirectional associations between depressive symptoms and couple satisfaction, moderated by the therapeutic alliance over the course of therapy. The study included 108 couples participating in couple therapy at a university training clinic. Couples rated their depressive symptoms and couple satisfaction separately before the intake session and at the end of the fourth session, and they also reported their individual therapeutic alliance with the therapist at the end of the second and third sessions. Actor-partner interdependence moderation model analysis revealed several moderation effects. In general, with low therapeutic alliance, couples with higher initial symptoms (such as depressive symptoms and low couple satisfaction) reported more severe symptoms at the fourth session, compared to those who had fewer initial symptoms. The moderating effect of alliance on a couple's symptoms was found both among individuals, and between partners. Systemic clinical implications and suggestions for future research are discussed.

Hay una asociación bidireccional y negativa firmemente establecida entre la satisfacción en la pareja y los síntomas depresivos. Sin embargo, la perspectiva de sistemas familiares enfatiza el papel que desempeña el terapeuta en la interrupción de este ciclo recurrente entre la satisfacción en la pareja y los síntomas depresivos. El presente estudio utilizó datos longitudinales para analizar las asociaciones bidireccionales entre los síntomas depresivos y la satisfacción en la pareja, moderadas por la alianza terapéutica durante el transcurso de la terapia. El estudio incluyó 108 parejas que participaron en terapia de pareja en una clínica universitaria de formación. Las parejas calificaron sus síntomas depresivos y la satisfacción en la pareja por separado antes de la sesión de ingreso y al final de la cuarta sesión, y también informaron su alianza terapéutica individual con el terapeuta al final de la segunda y la tercera sesión. El análisis del modelo de moderación de la interdependencia entre el actor y la pareja reveló varios efectos de la moderación. En general, con una alianza terapéutica baja, las parejas con síntomas iniciales más altos (como síntomas depresivos y baja satisfacción en la pareja) informaron síntomas más intensos en la cuarta sesión en comparación con aquellos que tenían menos síntomas iniciales. El efecto moderador de la alianza en los síntomas de la pareja se halló tanto entre las personas como entre las parejas. Se debaten las consecuencias clínicas sistémicas y las sugerencias para futuras investigaciones.

Longitudinal changes in attachment patterns of preterm infants born in a non-Western country.

Unexpected early birth of an infant may affect the attachment formation of mother-child dyads. This longitudinal study aimed to explore mother-infant attachment patterns of very preterm (VPT) and preterm (PT) infants compared to their term-born peers in a non-Western country. Neurodevelopmental outcomes of infants, maternal anxiety and depressive symptoms, and sociodemographic features were evaluated to explore their effects on attachment. Eighteen VPT, 11 PT, 11 term infants and their mothers participated. Observations of attachment patterns and neurodevelopmental assessments were performed at 18 and 24 months of corrected age. This study identified a change in attachment patterns of VPT infants over time such that VPT infants tended to have less insecure attachment patterns with their mothers at the end of the infancy period. While motor and language development scores were associated with attachment patterns at 18 months, models predicting attachment patterns were no longer significant at 24 months. Therefore, change in VPT infants' developmental outcomes and attachment patterns over time suggests that preterm birth itself is not necessarily a risk factor for developing insecure attachment patterns; yet, developmental delays may account for insecure attachment patterns. It is suggested that efforts to promote developmental outcomes of preterm infants may improve mother-child attachment.

El inesperado nacimiento prematuro de un infante pudiera afectar la formación de la afectividad de las díadas madre-niño. Este estudio longitudinal se propuso explorar los patrones de afectividad madre-infante de infantes nacidos muy prematuramente (VPT) e infantes prematuros (PT) comparados con sus compañeros nacidos dentro del término regular en un país no occidental. Se evaluaron los resultados de desarrollo neurológico de los infantes, la ansiedad y síntomas depresivos maternos, así como las características socio-demográficas, con el fin de explorar sus efectos sobre la afectividad. Dieciocho VPT 11 PT, 11 infantes nacidos dentro del término regular y sus madres participaron. Las observaciones de patrones de afectividad y evaluaciones de desarrollo neurológico se llevaron a cabo a los 18 y 24 meses de la edad corregida. Este estudio identificó un cambio en los patrones de afectividad de los infantes VPT a lo largo del tiempo, de tal manera que los infantes VPT tendieron a tener menos patrones de afectividad insegura con sus madres al final del período de infancia. Mientras que los puntajes de desarrollo motor y de lenguaje se asociaron con patrones de afectividad a los 18 meses, los modelos que predijeron los patrones de afectividad ya no eran significativos a los 24 meses. Por tanto, el cambio en los resultados de desarrollo de los infantes VPT y los patrones de afectividad a lo largo del tiempo sugieren que el nacimiento prematuro en sí no es necesariamente un factor de riesgo para desarrollar patrones de afectividad insegura, pero los retardos en el desarrollo pudieran ser responsables de patrones de afectividad insegura. Se sugiere que los esfuerzos para promover los resultados de desarrollo de infantes prematuros pudieran mejorar la afectividad madre-niño.

Unexpected early birth of an infant may affect the attachment formation of mother-child dyads. This longitudinal study aimed to explore mother-infant attachment patterns of very preterm (VPT) and preterm (PT) infants compared to their term-born peers in a non-Western country. Neurodevelopmental outcomes of infants, maternal anxiety and depressive symptoms, and socio-demographic features were evaluated to explore their effects on attachment. Eighteen VPT, 11 PT, 11 term infants and their mothers participated. Observations of attachment patterns and neurodevelopmental assessments were performed at 18 and 24 months of corrected age. This study identified a change in attachment patterns of VPT infants over time such that VPT infants tended to have less insecure attachment patterns with their mothers at the end of the infancy period. While motor and language development scores were associated with attachment patterns at 18 months, models predicting attachment patterns were no longer significant at 24 months. Therefore, change in VPT infants' developmental outcomes and attachment patterns over time suggests that preterm birth itself is not necessarily a risk factor for developing insecure attachment patterns; yet, developmental delays may account for insecure attachment patterns. It is suggested that efforts to promote developmental outcomes of preterm infants may improve mother-child attachment.

A prospective study on the course of sleep disturbances in first-time fathers during the transition to parenthood.

INTRODUCTION: This study examined sleep disturbances in first-time fathers from the third trimester of their partner's pregnancy to 2 months postpartum to determine prevalence, incidence, and persistence of sleep disturbances and identify associated determinants. METHODS: Men expecting their first child were recruited from local prenatal classes and university-affiliated obstetric clinics. During their partner's third trimester of pregnancy and 2 months postpartum, 459 men completed standardized online self-report questionnaires measuring sociodemographics, lifestyle, and psychosocial variables and sleep quality. RESULTS: Disturbed sleep (Pittsburgh Sleep Quality Index [PSQI] global score >5) increased from 29.6% during the third trimester to 44.7% at 2 months postpartum. The incidence of poor sleep at 2 months postpartum was 33.7%. Among men with disturbed sleep at the antenatal assessment, 70.6% continued to have sleep disturbances at 2 months postpartum. An increase in depressive symptoms and higher parenting stress was independently associated with onset and persistence of disturbed sleep at 2 months postpartum. CONCLUSIONS: Sleep is compromised in expectant and new fathers. Strategies aimed at improving sleep, depressed mood, and managing the challenges of parenting may be important components to include in prenatal interventions aimed at enhancing the transition to parenthood and infant development.

The Associations between Mothers' and Grandmothers' Depressive Symptoms, Parenting Stress, and Relationship with Children: An Actor-Partner Interdependence Mediation Model.

Three-generation households that include parents and grandparents raising children together have become increasingly common in China. This study examined the relations among depressive symptoms, parenting stress, and caregiver-child relationships in the mother-grandmother dyadic context. Participants were mothers and grandmothers from 136 three-generation households. Results from Actor-Partner Interdependence Mediation Modeling indicated that mothers' depressive symptoms were indirectly related to mother-child conflict/closeness through own parenting stress; grandmothers' depressive symptoms were indirectly related to grandmother-child conflict through own parenting stress. Mothers' depressive symptoms were indirectly related to grandmothers' conflict with children through grandmothers' parenting stress, and grandmothers' depressive symptoms were indirectly related to mothers' conflict/closeness with children through mothers' parenting stress. The relation between mothers' parenting stress and mother-child closeness was stronger than the relation between grandmothers' parenting stress and grandmother-child closeness. Findings highlight the implications of using a family system perspective and the dyadic approach in understanding and improving family functioning in Chinese three-generation households.

Los hogares de tres generaciones integrados por padres y abuelos que crían a niños juntos son cada vez más comunes en China. Este estudio examinó las relaciones entre los síntomas depresivos, el estrés por la crianza y las relaciones entre cuidadores y niños en el contexto diádico madre-abuela. Las participantes fueron madres y abuelas de 136 hogares de tres generaciones. Los resultados del modelo de mediación de la interdependencia actor-pareja indicaron que los síntomas depresivos de las madres estuvieron relacionados indirectamente con el conflicto/la cercanía entre madre e hijo mediante el propio estrés por la crianza; los síntomas depresivos de las abuelas estuvieron indirectamente relacionados con el conflicto entre la abuela y el niño mediante el propio estrés por la crianza. Los síntomas depresivos de las madres estuvieron indirectamente relacionados con el conflicto de las abuelas con los niños mediante el estrés por la crianza de las abuelas, y los síntomas depresivos de las abuelas estuvieron indirectamente relacionados con el conflicto/la cercanía de las madres con los niños mediante el estrés por la crianza de las madres. La relación entre el estrés por la crianza de las madres y la cercanía entre madre e hijo fue más fuerte que la relación entre el estrés por la crianza de las abuelas y la cercanía entre abuela y niño. Los resultados destacan las implicancias de usar una perspectiva de sistema familiar y el enfoque diádico a la hora de comprender y mejorar el funcionamiento familiar en los hogares chinos de tres generaciones.

Community, Context, and Coping: How Social Connections Influence Coping and Well-Being for Military Members and Their Spouses.

Military members and their spouses (n = 223 families) were selected from an Active Duty Army installation and assessed with regard to their connections with the military community, their levels of coping with military culture demands, and their reports of individual (depression and life satisfaction) and family well-being. Guided by the contextual model of family stress and the social organization theory of action and change, results from a structural equation model indicated that military community connections, for both military members and their civilian spouses, were related to coping with the military culture and its demands, which in turn was related to both individual and family well-being. Unique actor and partner effects also emerged where both active duty military members' and their civilian spouses' perceptions of military community connections influenced the civilian spouses' satisfaction with military life, but only the active duty military members' community connections influenced their military-specific coping. Additionally, the associations between military-specific coping and individual and family well-being only had actor effects. When examined within the context of important military culture elements, namely rank and extent of military transitions (deployment and relocation), these core findings linking communities to coping and well-being were unchanged. Implications for theory, future research, and practice are shared.

Se seleccionaron militares y sus cónyuges (n = 223 familias) de una instalación de servicio activo del ejército y se evaluaron en términos de sus conexiones con la comunidad militar, sus niveles de afrontamiento de las demandas de la cultura militar, y sus informes de bienestar individual (depresión y satisfacción de vida) y familiar. Los resultados de un modelo de ecuaciones estructurales, guiado por el modelo contextual de estrés familiar y la teoría de acción y cambio de organizaciones sociales, indicaron que las conexiones con la comunidad militar, tanto para militares como para sus cónyuges civiles, se asociaron al afrontamiento con la cultura militar y sus demandas, asociado a su vez al bienestar individual y familiar. Además, efectos únicos de actor y de pareja emergieron cuando las percepciones de sus conexiones con la comunidad militar tanto de militares en servicio activo como de sus cónyuges influyeron en la satisfacción del cónyuge civil con la vida militar pero sólo las conexiones con la comunidad militar de los militares en servicio activo influyeron en su propio afrontamiento específicamente militar. Por otra parte, las asociaciones entre el afrontamiento específicamente militar y el bienestar individual y familiar sólo tuvieron efectos de actor. Al examinarse dentro del contexto de elementos de cultura militar importantes, específicamente de rango y alcance de transiciones militares (despliegue y reubicación), estas relaciones de la comunidad central al afrontamiento al bienestar se mantuvieron sin cambio. Se comparten las implicaciones para la teoría, investigaciones futuras y la práctica.

Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy.

The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.

El propósito del presente estudio fue investigar el papel de varios factores sicosociales de riesgo para predecir la sintomatología depresiva durante el embarazo en mamás y papás, respectivamente. Un total de 146 madres primerizas y 105 papás primerizos que habían reportado una condición de riesgo sicosocial fueron reclutados independientemente de los servicios de salud de maternidad e infantil, durante el segundo trimestre del embarazo. Todos los padres fueron evaluados con relación a la sintomatología depresiva, la ansiedad y el percibido apoyo social. Se llevaron a cabo dos análisis de regresión múltiple jerárquicos para determinar el papel de los factores sicosociales para predecir la sintomatología depresiva durante el embarazo, en mamás y papás. Se identificó la insatisfacción marital, la historia personal de depresión y el rasgo personal de ansiedad como factores significativos de predicción de la sintomatología depresiva durante el embarazo, tanto en mamás como en papás. Se identificó la historia familiar de abuso de sustancias, la conflictiva relación con los padres en el pasado año, así como el duelo en el pasado año como factores significativos que contribuyen a un nivel elevado de síntomas depresivos durante el embarazo en las mamás, pero no así en los papás. En este estudio, varios factores sicosociales de riesgo fueron consistentemente relacionados con un aumento en los síntomas depresivos maternos y paternos durante el embarazo: algunos de estos factores parecen estar específicamente relacionados con el estado depresivo materno.

Le but de cette étude était de rechercher le rôle de plusieurs facteurs psychosociaux dans la prédiction de symptopathologie dépressive durant la grossesse chez les mères et les pères. Un total de 146 mères primipares et de 105 pères primipares faisant état d'une condition de risque psychosocial ont été recrutés indépendamment des services de maternité et de soin de santé de l'enfant, durant le second trimestre de la grossesse. Tous les parents ont été évalués pour une symptomatologie dépressive, l'anxiété et le soutien social perçu. Deux analyses de régression multiples hiérarchiques ont été faites afin de déterminer le rôle de facteurs psychosociaux dans la prédiction de symptomatologie dépressive durant la grossesse, chez les mères et les pères. Le mécontentement conjugal, l'histoire personnelle de dépression et l'anxiété comme trait personnel ont été identifiés comme étant des prédicteurs importants de symptomatologie durant la grossesse, à la fois chez les mères et chez les pères. L'antécédent familial de toxicomanie, une relation conflictuelle avec les parents dans l'année précédente et un deuil durant l'année précédente ont tous été identifiés comme des facteurs importants contribuant à des symptômes dépressifs élevés durant la grossesse chez les mères mais pas chez les pères. Dans cette étude plusieurs facteurs de risque psychosocial étaient systématiquement liés à une augmentation des symptômes dépressifs maternels et paternels durant la grossesse : certains de ces facteurs semblaient liés plus spécifiquement à l'humeur dépressive maternelle.

UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS, SUBSTANCE-ABUSING MOTHERS.

This article tested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance-abusing mothers. Participants were 119 homeless mothers (ages 18-24 years) and their young children (ages 0-6 years). Mothers responded to questions about their depressive symptoms, emotion regulation, parenting stress, and child behavior problems. A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk. This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.

CAREGIVER'S DEPRESSIVE SYMPTOMS AND YOUNG CHILDREN'S SOCIOEMOTIONAL DEVELOPMENT DELAYS: A CROSS-SECTIONAL STUDY IN POOR RURAL AREAS OF CHINA.

Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross-sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. DS were assessed by the Zung Self-Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, ), and SED was evaluated by the Ages and Stage Questionnaires: Social-Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ2 test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low-income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single-parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.

A LONGITUDINAL, PERSON-CENTERED ANALYSIS OF EARLY HEAD START MOTHERS' PARENTING.

This study used a person-centered approach to examine stability and change in parenting typologies across early childhood. Profiles were associated within and across time with contextual covariates, including demographic characteristics, risk factors, and Early Head Start participation. Participants were drawn from the Early Head Start Research and Evaluation Project (N = 2, 876). Parenting profiles were identified based on observed parenting dimensions at 14, 24, and 36 months, and pre-Kindergarten (pre-K). Results suggested a four-profile solution at each time point: Supportive, Lukewarm (14 & 24 months)/Sufficient (36 months and pre-K), Harsh, and Detached. Supportive was the largest, most stable, and most likely transitioned into profile while Harsh and Detached represented rare profiles with moderate to low membership stability across time. Depression and family conflict emerged as important correlates of unsupportive parenting profiles both within and across time. Findings are discussed in terms of their relevance for both policy and implementation practices for low-income mothers with young children.

ASSOCIATIONS BETWEEN EARLY MATERNAL DEPRESSIVE SYMPTOM TRAJECTORIES AND TODDLERS' FELT SECURITY AT 18 MONTHS: ARE BOYS AND GIRLS AT DIFFERENTIAL RISK?

The goal of this study was to evaluate whether there are sex differences in children's vulnerability to caregiving risk, as indexed by trajectories of maternal depressive symptoms assessed from 2 to 18 months' postpartum, and children's rated attachment security in toddlerhood, adjusting for maternal social support and demographic risk. Analyses utilized longitudinal data collected for 182 African American mother-child dyads from economically diverse backgrounds. Participants were recruited at the time of the child's birth and followed to 18 months' postpartum. Results of conditional latent growth models indicated that an increasing rate of change in level of maternal depressive symptoms over time negatively predicted toddlers' felt attachment security. Higher social support was associated with decreasing levels of maternal depressive symptoms over time whereas higher demographic risk was associated with increasing levels of maternal depressive symptoms. A subsequent multigroup conditional latent growth model revealed that child sex moderated these associations. For male (but not female) children, a rapid increase in maternal depressive symptoms was associated with lower felt attachment security at 18 months. These findings suggest that boys, as compared to girls, may be more vulnerable to early caregiving risks such as maternal depression, with negative consequences for mother-child attachment security in toddlerhood.

Quality of life, sleepiness and depressive symptoms in adolescents with insomnia: A cross-sectional study.

OBJECTIVES: To determine the prevalence of insomnia in a sample of Portuguese adolescents and assess its repercussions on HRQoL, daytime sleepiness and depressive symptomatology. DESIGN: We carried out a cross-sectional school-based study evaluating students from Viseu. LOCATION: Students from twenty-six public secondary schools in the county of Viseu, Portugal. PARTICIPANTS: Of 9237 questionnaires distributed, 7581 were collected (82.1%). We excluded from analysis all questionnaires from adolescents younger than 12 or older than 18 years of age (211) and unfilled forms (451). The sample comprised 6919 adolescents, the 7th to 12th grade, from 26 public secondary schools. INTERVENTIONS: None. MEASUREMENTS: Data gathering was done using a self-applied questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders - IV criteria. HRQoL was evaluated with the Quality of Life Health Survey SF-36, depressive symptomatology with BDI-II and daytime sleepiness with the Epworth Sleepiness Scale. RESULTS: Prevalence of insomnia was 8.3% and the prevalence of adolescents with symptoms of insomnia without daytime impairment (disturbed sleepers) was 13.1%. HRQoL was significantly reduced among adolescents with insomnia compared to normal sleepers (p<0.001) and even when compared to disturbed sleepers (p<0.001). There was an increase in daytime sleepiness from normal sleepers to disturbed sleepers and to adolescents with insomnia (p<0.001). There was also an increase in the prevalence and severity of depressive symptoms (p<0.001). CONCLUSIONS: Our results show that insomnia is associated with a significantly lower health related quality of life among adolescents.

MOTHERS' AND FATHERS' PRENATAL REPRESENTATIONS IN RELATION TO MARITAL DISTRESS AND DEPRESSIVE SYMPTOMS.

Marital distress, parental depression, and weak quality of parental representations are all known risk factors for parent-child relationships. However, the relation between marital distress, depressive symptoms, and parents' prenatal representation is uncertain, especially regarding fathers. The present study aimed to explore how mothers' and fathers' prenatal experience of marital distress and depressive symptoms affects the organization of their prenatal representations in late pregnancy. Participants were 153 pregnant couples from a Finnish follow-up study called "Steps to the Healthy Development and Well-being of Children" (H. Lagström et al., ). Marital distress (Revised Dyadic Adjustment Scale; D.M. Busby, C. Christensen, D. Crane, & J. Larson, 1995) and depressive symptoms (Edinburgh Postnatal Depression Scale) were assessed at 20 gestational weeks, and prenatal representations (Working Model of the Child Interview; D. Benoit, K.C.H. Parker, & C.H. Zeanah, 1997; C.H. Zeanah, D. Benoit, M. Barton, & L. Hirshberg, 1996) were assessed between 29 and 32 gestational weeks. The mothers' risks of distorted representations increased significantly when they had at least minor depressive symptoms. Marital distress was associated with the fathers' prenatal representations, although the association was weak; fathers within the marital distress group had less balanced representations. Coexisting marital distress and depressive symptoms were only associated with the mothers' representations; lack of marital distress and depressive symptoms increased the likelihood for mothers to have balanced representations. The results imply that marital distress and depressive symptoms are differently related to the organizations of mothers' and fathers' prenatal representations.

Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms.

BACKGROUND: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. METHODS: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. RESULTS: The direct effect of IPV severity on the level of disability was not statistically significant (ß=0.09; P=0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was (ß=0.39; P<0.01). The total effect of IPV severity on the level of disability was even greater (ß=0.48; P=0.01). CONCLUSIONS: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

Combined effect of compassionate and uncompassionate self-responding on Chinese college students' mental health during the initial wave of the COVID-19 pandemic: a response surface analysis.

Background: The initial wave of the COVID-19 pandemic significantly deteriorated mental health, especially among college students. Self-compassion has demonstrated benefits for psychological outcomes such as depressive symptoms, life satisfaction, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Notably, existing literature suggests that the protective and vulnerable aspects within the Self-Compassion Scale, namely, compassionate and uncompassionate self-responding (CSR and USR), can coexist within individuals and influence their mental health through various coexisting patterns. However, this process has not been sufficiently explored.Objective: This study aimed to explore the combined effects of CSR and USR on college students' depressive symptoms, life satisfaction, PTSS, and PTG during the initial wave of the pandemic.Method: In this cross-sectional study, 4450 Chinese college students (51.9% females, Mage = 20.58 years, SD = 1.49) completed self-report measures amid the COVID-19 pandemic's initial wave in 2020. Response surface analyses were utilised to investigate the combined effects of CSR and USR.Results: Simultaneously increased CSR and USR were associated with a slight increase in depressive symptoms, PTSS, and life satisfaction, but a substantial increase in PTG. Conversely, increased CSR and decreased USR were associated with a considerable decrease in depressive symptoms and PTSS, a significant increase in life satisfaction, and a moderate increase in PTG.Conclusions: CSR and USR demonstrated protective and vulnerable impacts, respectively. It is imperative to analyse their combined effects as an interactive system and consider the specific characteristics of different psychological responses.

Increased CSR and decreased USR were associated with less depressive symptoms and PTSS as well as more life satisfaction.CSR mitigated the negative effects of USR on depressive symptoms, life satisfaction, and PTSS.Simultaneously increased CSR and USR were associated with a substantial increase in PTG.

Ultra-processed food intake and risk of depression: a systematic review.

Introduction: Objective: to conduct a systematic review of the observational studies analyzing the association between ultra-processed food (UPF) intake and the risk of depression. Design: the search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); a search for observational studies published until June 2020 was performed in PubMed, Embase, Cochrane Library, and Web of Science databases, followed by additional manual searches. Eight reviewers, working independently in teams of two, screened studies for eligibility, extracted data, and assessed risk of bias. We resolved disagreements through discussion or, if necessary, through adjudication by a third (LH). And the study assessed cross-sectional studies using the Agency for Healthcare Research and Quality (AHRQ) methodological checklist and cohort and case-control studies using the Newcastle-Ottawa Scale (NOS) for quality. We used a tabular format to summarize the articles. Results: twenty-eight studies evaluating UPF intake and risk of depression were finally selected, 21 of which had a cross-sectional design, 6 studies had a cohort design, and 1 had a case-control design. Of these, 4 cohort studies and 17 cross-sectional studies found that consumption of UPF were positively associated with depression or depressive symptoms. Conclusions: our review demonstrated that most studies included in the systematic review showed that UPF consumption is associated with the risk of depression. Future studies should consider the use of validated food intake assessments and standardized depression assessment methods to promote comparability between studies.

Introducción: Objetivo: realizar una revisión sistemática de los estudios observacionales que analizan la asociación entre la ingesta de alimentos ultraprocesados (UPF) y el riesgo de depresión. Diseño: la búsqueda se adhirió a las directrices Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); se realizó una búsqueda de estudios observacionales publicados hasta junio de 2020 en las bases de datos PubMed, Embase, Cochrane Library y Web of Science, seguida de búsquedas manuales adicionales. Ocho revisores, que trabajaron de forma independiente en equipos de dos, seleccionaron los estudios para su elegibilidad, extrajeron los datos y evaluaron el riesgo de sesgo. Los desacuerdos se resolvieron a través de la discusión o, si era necesario, a través de la adjudicación de un tercero. Se evaluaron los estudios transversales mediante la lista de comprobación metodológica de la Agency for Healthcare Research and Quality (AHRQ) y los estudios de cohortes y de casos y controles mediante la escala Newcastle-Ottawa (NOS) para la calidad. Se utilizó un formato tabular para resumir los artículos. Resultados: finalmente se seleccionaron 28 estudios que evaluaban la ingesta de UPF y el riesgo de depresión, 21 de los cuales tenían un diseño transversal, 6 un diseño de cohortes y 1 un diseño de casos y controles. De ellos, 4 estudios de cohortes y 17 estudios transversales encontraron que el consumo de UPF se asociaba positivamente con la depresión o los síntomas depresivos. Conclusiones: nuestra revisión demostró que la mayoría de los estudios incluidos en la revisión sistemática mostraron que el consumo de UPF está asociado con el riesgo de depresión. Los estudios futuros deberían considerar el uso de evaluaciones validadas del consumo de alimentos y métodos estandarizados de evaluación de la depresión para promover la comparabilidad entre los estudios.

Apoyo social y obesidad: el papel de los síntomas depresivos y la alimentación emocional en un modelo estratificado por sexo.

INTRODUCCIÓN: la obesidad es un problema de salud pública a nivel mundial, cuya prevalencia ha aumentado sostenidamente en Latinoamerica. En Chile, el 75% de la población tiene sobrepeso u obesidad, siendo esta última más prevalente en mujeres (38%) que en hombres (30%). Si bien la percepción de apoyo social ha sido identificada como un factor protector para el desarrollo de la obesidad, el papel de la sintomatología depresiva y la alimentación emocional como mecanismos mediadores ha sido menos estudiado. OBJETIVO: determinar si el vínculo entre la percepción de apoyo social y el perímetro de cintura está mediado por la sintomatología depresiva y la alimentación emocional en una muestra de adultos chilenos estratificada por sexo. MÉTODOS: trescientos veinticinco (n = 325) adultos chilenos de una región del sur de Chile fueron seleccionados mediante un muestreo no probabilístico intencional (55% mujeres, Medad mujeres = 57.21, Medad hombres = 58.34). Se midió el perímetro de cintura como indicador de obesidad y se utilizaron instrumentos de autorreporte para evaluar variables psicológicas, conductuales y sociodemográficas. RESULTADOS: la alimentación emocional medió totalmente el vínculo entre sintomatología depresiva y perímetro de cintura tanto en hombres (ß = 0.089, p = 0.042), como en mujeres (ß = 0.086, p = 0.013). La percepción de apoyo social se vinculó indirecta y negativamente con el perímetro de cintura a través de una secuencia de mediación que incluyó sintomatología depresiva y alimentación emocional solo en mujeres (ß = -0.043, p = 0.015). CONCLUSIONES: la alimentación emocional es una variable a través de la cual la sintomatología depresiva se vincula con obesidad tanto en hombres como mujeres. Los hallazgos avalan el papel protector de la percepción de apoyo social en obesidad en mujeres, lo que puede orientar el desarrollo de estrategias para disminuir las altas tasas de obesidad en población chilena adulta.

Does emotional dysregulation mediate the relationship between disability and depressive symptoms in older people?

BACKGROUND: Emotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known. OBJECTIVE: To examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults. METHODS: Two hundred eighty-three participants, aged 60-96 years (M±SD=74.22±8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). RESULTS: A mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (ß=0.20; p<.001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (ß=0.003; p<.01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group. CONCLUSIONS: Globally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S.

[Intimate partner violence and depression among adult women working in a health facility in Mexico]. / Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México.

OBJECTIVE: To assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women. METHOD: We analyzed data from the Mexican Health Workers' Cohort study (n=470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence. RESULTS: 41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR]=2.9; 95% confidence interval [95%CI]: 1.4-6.2) and with physical (aOR=4.3; 95%CI: 1.8-10.1), psychological (aOR=3.1; 95%CI: 1.4-6.6) and sexual (aOR=3.1; 95%CI: 1.2-8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence. CONCLUSIONS: Intimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence.

The reverse buffering effects of social support on the relationships between stresses and mental health: a survey of Chinese adults during the COVID-19 lockdown.

BACKGROUND: People lived through different types of stresses during the COVID-19 pandemic, and stresses from different sources are believed to associate differently with mental health. OBJECTIVES: The current study aims to examine the relationship between types of stresses and mental health among the general Chinese adult population, and further explore the moderating role of social support in these relationships. METHODS: This study was conducted from 1 to 10 February 2020, and 2441 participants were recruited through an online cross-sectional survey from 31 provinces in China. We used multiple linear regression analyses to examine the associations among stresses' types, social support, and mental health. RESULTS: The study revealed that all types of stresses were associated with more mental health symptoms. Stresses from lockdown policy presented stronger associations with mental health symptoms (Beta = 0.387 for depressive symptoms and Beta = 0.385 for post-traumatic stress symptoms (PTSS)) than stresses from pandemic fear (Beta = 0.195 for depressive symptoms and Beta = 0.221 for PTSS). Moreover, greater social support enhanced the positive associations between stresses and mental health symptoms. CONCLUSIONS: Stresses from lockdown policies during the early stage of the COVID-19 epidemic are worthy of more attention. We urge more interventions are required to reduce the side-effect of lockdown policies, and also discuss implications for mental health promotion.

Antecedentes: Las personas vivieron diferentes tipos de estrés durante la pandemia de COVID-19, y se cree que el estrés de diferentes fuentes se asocia de manera diferente con la salud mental.Objetivos: El presente estudio pretende examinar la relación entre los tipos de estrés y la salud mental entre la población general adulta china, y explorar además el papel moderador del apoyo social en estas relaciones.Métodos: Este estudio se llevó a cabo del 1 al 10 de febrero de 2020, y 2441 participantes fueron reclutados a través de una encuesta transversal en línea de 31 provincias de China. Se utilizaron análisis de regresión lineal múltiple para examinar las asociaciones entre los tipos de estrés, el apoyo social y la salud mental.Resultados: El estudio reveló que todos los tipos de estrés se asociaron con más síntomas de salud mental. El estrés derivado de la política de confinamiento presentó asociaciones más fuertes con los síntomas de salud mental (Beta=0,387 para los síntomas depresivos y Beta=0,385 para los síntomas de estrés postraumático (PTSS, en siglas en inglés)) que el estrés derivado del miedo a la pandemia (Beta=0,195 para los síntomas depresivos y Beta=0,221 para los PTSS). Además, un mayor apoyo social mejoró las asociaciones positivas entre el estrés y los síntomas de salud mental.Conclusiones: El estrés provocado por las políticas de confinamiento durante la fase inicial de la epidemia de COVID-19 merece más atención. Instamos a que se realicen más intervenciones para reducir el efecto secundario de las políticas de confinamiento, y también discutimos las implicaciones para la promoción de la salud mental.