Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying.

Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N = 389) of infant carrying (six times a week or daily) and parents reporting low levels (N = 128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.

Cargar al infante pudiera tener efectos beneficiosos para la relación progenitor­infante, pero sólo una limitada investigación se ha llevado a cabo en esta área. Por tanto, el objetivo principal del presente estudio fue investigar si cargar al infante se asocia con que el funcionamiento con reflexión del progenitor, los lazos de afectividad del progenitor, así como las respuestas de comportamiento (emocional) del progenitor al llanto del infante, elementos claves dentro de la relación progenitor­infante, promueven el desarrollo del infante. Se incluyó en el presente estudio a los progenitores que reportaron altos niveles (N=389) de llanto del infante (seis veces por semana o diariamente) y a los progenitores que reportaron bajos niveles (N=128) del llanto del infante (menos de una vez por semana o nunca), quienes participaron en una encuesta electrónica acerca de la relación progenitor­infante en desarrollo, en Alemania. Se usaron cuestionarios estandarizados para evaluar el funcionamiento con reflexión del progenitor, los impedimentos de lazos afectivos del progenitor, así como las respuestas emocionales al llanto del infante. Se evaluaron además comportamientos insensibles (sin respuesta afectiva y hostil) como respuesta al llanto del infante. Los progenitores con altos niveles de cargar al infante demostraron un mejor funcionamiento con reflexión del progenitor, más bajos problemas en cuanto a lazos de afectividad del progenitor, menos emociones negativas y menos comportamientos insensibles como respuesta al llanto del infante.

Porter un bébé peut avoir des effets bénéfiques sur la relation parent­bébé mais il n'existe que peu de recherches sur ce domaine. C'est pour cette raison que le but principal de cette étude était d'investiguer si le fait de porter un bébé est lié avec une fonction réflexive parentale, le lien parental et les réactions parentales (émotionnelles) et comportementales aux pleurs du bébé, des éléments clef au sein de la relation parent­bébé, promouvant le développement du bébé. Les parents faisant état de niveaux élevés (N=389) de portage du bébé (six fois par semaine ou tous les jours) et les parents faisant état de niveaux bas (N=128) de portage du bébé (moins d'une semaine ou pas du tout) qui ont participé à un questionnaire en ligne sur la relation parent­bébé se développant en Allemagne ont été inclus dans cette étude. Des questionnaires standardisés ont été utilisés afin d'évaluer la fonction réflexive parentale, les troubles du lien parental, et les réactions émotionnelles aux pleurs du bébé. D'autres comportement insensibles (non­réactifs et hostile) en réaction aux pleurs du bébé ont été évalués. Les parents avec des niveaux élevés de portage du bébé ont fait preuve d'une meilleure fonction réflexive parentale, de moins de problèmes de lien parental, de moins d'émotions négatives, et de moins de comportements insensibles en réaction aux pleurs du bébé.

Clinical factors and early life experiences associated with therapeutic alliance development in treatment for depression or binge eating.

OBJECTIVE: This study examines childhood and clinical factors theorized to impact therapeutic alliance development over the course of psychotherapy. METHOD: Raters assessed the therapeutic alliance of 212 client-therapist dyads, participating in two randomized controlled trials of schema therapy and cognitive behavioural therapy for binge eating or major depression, at three time points. Linear mixed models were used to characterize therapeutic alliance development over time and assess the influence of childhood trauma, perceived parental bonding, diagnosis and therapy type on scores. RESULTS: Participants differed in initial alliance ratings for all subscales but had similar growth trajectories in all but the patient hostility subscale. A diagnosis of bulimia nervosa or binge eating disorder predicted greater initial levels of client distress, client dependency and overall client contribution to a strong therapeutic alliance, compared with a diagnosis of depression. Therapy type, childhood trauma and perceived parental bonds did not predict alliance scores. CONCLUSION: Findings highlight the potential influence of clinical and personal characteristics on alliance strength and development, with implications for maximizing treatment outcomes through anticipating and responding to these challenges.

Parental bonding style and illness severity in a longitudinal study of individuals with first episode psychosis.

A parenting style with high amounts of control combined with low caring or nurturing behaviour has been reported in association with mental disorders including schizophrenia. However, the association of parenting style with illness severity in individuals with schizophrenia has never been evaluated retrospectively or over a longitudinal time course. In a subset (n = 84) of the participants included in the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses)-10 study, we evaluated participants' perceptions of their own parents' bonding style at the time of their first episode of psychosis using the parental bonding instrument (PBI). We then examined the association between different bonding styles, illness course and severity, and global functioning over a 10-year follow-up. Participants who perceived that their fathers had a more caring and less controlling parenting style showed better functioning at follow-up. However, in contrast to previous research, participants who reported having been subject to uncaring and controlling parenting styles were not found to have a notably worse course of illness or symptom severity over the follow-up period. These results indicate that more optimal parental bonding styles may be associated with better overall functioning in individuals with psychosis but not with other measures of illness outcome.

Delusional Misidentification Syndromes in Postpartum Psychosis: A Systematic Review.

INTRODUCTION: Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how these syndromes present in perinatal mental illness. METHODS: In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period. RESULTS: Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient's husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs. CONCLUSION: This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized.

An intergenerational study of parental bonding on perceptions of parental and spousal criticism and marital relationship quality in Singapore.

Criticism is a form of interpersonal social rejection and destructive conflict behavior which has been associated with poor relationship outcomes in both parent-child and marital relationships. However, the role of the individual's perceptions of parental and spousal criticism in influencing the perceptions of criticism of other members in the family unit has not been examined. This study investigated the associations between parental bonding and perceptions of parental and spousal criticism across generations in Singapore. In all, 134 Singaporean married parent dyads (G2) and one child (G3) of each dyad were recruited. G2 parent participants completed the Perceived Criticism measure for their parents (G1) and spouses, the Parental Bonding Instrument and the Quality of Marriage Index. G3 children participants completed the Perceived Criticism measure for their parents (G2). Path analysis found that G2 perceptions of parental bonding were significant predictors of G2's perceptions of G1 parental criticism, which significantly predicted both G2's perceptions of spousal criticism and G3's perceptions of G2 parental criticism. Perceptions of spousal criticism were also found to predict marital relationship quality in G2 participants. Findings highlight the intergenerational transmission of perceptions of criticism across relationships in the family unit, providing support that parenting practices and communication patterns in one generation can predict those in the next generation in the Singaporean context. Future studies can look to replicate the findings in other cultures and include further investigations into sibling relationships as well.

Sex-specific role of alexithymia in associations between parental bonding and mental health: A moderated mediation model.

OBJECTIVE: This study aimed to explore the role of alexithymia and potential sex differences in the associations between perceived parental bonding and mental health. METHODS: The sample consists of 2421 parents from the FinnBrain Birth Cohort Study who completed the parental bonding instrument, the Toronto alexithymia scale, the Edinburgh postnatal depression scale, and the anxiety subscale of the symptom checklist-90. Moderated mediation analyses were conducted to examine the possible mediating role of alexithymia and moderating role of sex in the associations between parental bonding and depressive/anxiety symptoms. RESULTS: Alexithymia was found to be a potential mediator and sex be a moderator in the relations between perceived dysfunctional parental bonding and the psychological symptoms. Specifically, dysfunctional paternal bonding, especially paternal overprotection, had stronger indirect effects (via alexithymia) on the psychological symptoms in males. CONCLUSIONS: This study indicates the importance of alexithymia in the parenting-related mental health impacts and highlights the significance of paternal bonding for the development of alexithymia and mental health problems in male populations. The findings improve the limited understanding of sex-related parental factors for alexithymia and mental health problems. Future studies in longitudinal designs are warranted to clarify the causal process of the mediation.

Effects of parental care and overprotection on adolescents' diurnal cortisol profiles.

Parental bonding is a strong determinant of children's health. One of the proposed pathways through which parenting impacts children's health is by altering the functioning of stress response systems. The current study aims to investigate the associations between two types of parental bonding (care and overprotection) and functioning of hypothalamic-pituitary-adrenal (HPA) axis (i.e., diurnal cortisol secretion) in a sample of 255 healthy adolescents (46.3% girls; aged 11-14 years). Participants completed the Parental Bonding Instrument and provided eight cortisol samples across two consecutive days to assess patterns of diurnal cortisol secretion. Multilevel modeling and multiple linear regression were utilized to test the main effects and interactive effects of parental care and overprotection on adolescents' wakeup cortisol, cortisol awakening response, cortisol slope, and total cortisol secretion. Results showed that parental care was associated with higher cortisol levels at awakening, while parental overprotection was associated with lower cortisol levels at awakening. Parental overprotection, but not parental care, was associated with flatter cortisol slopes. No interactive effects between parental care and overprotection on cortisol parameters emerged. The current findings add to the existing literature on parenting behavior and HPA functioning by showing that parental care and overprotection differently regulated daily cortisol parameters implicated in health.

Exploring the connection between parental bonding and smartphone addiction in Chinese medical students.

BACKGROUND: Smartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students. METHOD: Binary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models. RESULTS: A total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989). CONCLUSIONS: Chinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.

Risk factors for binge eating severity among adolescent girls and boys. A structural equation modeling approach.

OBJECTIVE: Parental bonding, low self-esteem, emotion dysregulation, and eating style are correlated with each other and are associated with binge eating among adolescents. However, no studies have yet examined all these variables simultaneously. In the current study, the independent and combined influences of such constructs on binge eating were tested with structural equation modeling. METHOD: A sample of 973 students aged between 12 and 16 (M = 14.17, SD = 1.25) years was screened by means of self-report measures assessing parental bonding, self-esteem, emotion dysregulation, eating styles and binge eating severity. RESULTS: Self-esteem (ß = -0.205) and eating styles (emotional ß = 0.313, external ß = 0.133, and restrained ß = 0.178) had a direct effect on binge eating severity. The model (χ2(22) = 57.679; RMSEA = 0.041; CFI = 0.987; TLI = 0.949; SRMR = 0.024) revealed that the paths from both maternal and paternal care and maternal overprotection to binge eating were mediated through low self-esteem, emotion dysregulation and each eating style, explaining 35% of the variance. DISCUSSION: Findings provide support for a comprehensive theoretical-based model of risk factors for binge eating and suggest the possible mechanisms through which the quality of early parental relationships contribute to developing dysfunctional eating patterns. Treatment and prevention efforts should improve self-esteem and emphasize emotion regulation capabilities.

Parental Bonding in Trichotillomania and Skin Picking Disorder.

BACKGROUND: One means of understanding the effect of environmental factors on psychiatric disorders is by examining perceived parenting behavior in the childhood of individuals with trichotillomania and skin picking disorder (i.e. body focused repetitive behaviors (BFRBs)). We hypothesized that adults with BFRBs would show higher scores on dimensions of "care" and "overprotection". Specifically, we predicted that adults with BFRBs would have parents in the "affectionate constraint" quadrant, based on a combination of high care and high protection scores. METHODS: We assessed demographic and clinical differences in 184 adults between the ages of 18 and 65 with Trichotillomania (TTM) (n = 43) and Skin Picking Disorder (SPD) (n = 75), and both (n = 66). The Parental Bonding Instrument (PBI) measured "care" and "overprotection" items. Results from the PBI were compared across groups and with normal control data using independent sample t-tests. RESULTS: Individuals in the BFRB group had significantly lower maternal and paternal care scores compared to controls. The TTM, SPD, and TTM + SPD (combined) groups all had lower maternal care scores than controls. The TTM + SPD (combined) group had significantly lower paternal care scores and higher maternal protection scores than the normative averages. The most common parenting patterns in subjects with BFRBs were maternal and paternal affectionless control (low care/high protection). From our sample, only 27 % reported optimal maternal parenting and 28 % reported optimal paternal parenting. DISCUSSION: These preliminary data suggest that low maternal and paternal care may be associated with BFRBs. However, the nature of this relationship should be further explored, as these results do not necessarily mean that affectionless control parenting leads to a predisposition to BFRBs, and there may in fact be other environmental factors at play. Identifying how individuals perceive familial relationships may provide direction for clinicians in developing tools to address the burden caused by BFRBs.

Parental bonding styles in schizophrenia, depressive and bipolar patients: a comparative study.

BACKGROUND: Numerous bio-psychosocial factors play a role in the etiology of psychiatric disorders. In this regard, the relationship between parents and their children is significantly involved in developing the offspring mental health. However, there is no clear-cut answer as to which parental bonding style is more strongly associated with psychiatric diseases of patients. This study aimed to compare parental bonding styles in patients with schizophrenia, depression, and bipolar disorder in Bushehr province, Iran in 2018. METHODS: In this cross-sectional comparative study, 130 patients with schizophrenia, depression, and bipolar disorder who referred to four outpatients psychiatric centers in Bushehr were selected using quota sampling. The patients were assessed and compared in terms of parental bonding styles. Data were collected using a valid and reliable parental bonding instrument (PBI). Data were analyzed using SPSS software (ver. 22), Chi-square and Kruskal-Wallis tests at a significant level of 0.05. RESULTS: Results showed that the optimal parental bonding style (low control, high care) in bipolar disorder (43.05%), major depression (47.7%), and schizophrenia (38.5%) was the most prevalent style of parental bonding; however, 62.30% of the above patients suffered from inefficient paternal bonding styles and 51.53% from inefficient maternal bonding styles. Furthermore, the patients' maternal bonding styles were significantly different (p = 0.007) while their paternal bonding styles did not show any significant differences (p = 0.848). CONCLUSIONS: Most of the patients with psychiatric disorders were affected by ineffective parenting styles. The results also confirmed that despite the several bio-psycho-social factors involved in the development of psychiatric disorders, the crucial roles of parents, especially mothers, should not be ignored. It was further suggested that parents and parental bonding were important and fundamental factors for mental health promotion.

Prevalence of conduct problems and social risk factors in ethnically diverse inner-city schools.

BACKGROUND: In the UK, around 5% of 11-16-year olds experience conduct problems of clinical importance. However, there are limited data on prevalence of conduct problems by ethnic group, and how putative social risk factors may explain any variations in prevalence. This study has two main aims: (1) to estimate the prevalence and nature of conduct problems overall, and by ethnic group and gender, among adolescents in diverse inner-city London schools; (2) to assess the extent to which putative risk factors - racial discrimination, socioeconomic status, parental control, and troublesome friends - explain any observed differences in prevalence of conduct problems between ethnic groups. METHODS: This study uses baseline data from REACH, an accelerated cohort study of adolescent mental health in inner-city London. Self-report questionnaire data were collected on conduct problems and a range of distinct putative social risk factors (including racial discrimination, free school meals, troublesome friends, and parental care and control). A total of 4353 pupils, 51% girls, aged 11-14 participated. We estimated prevalence of conduct problems and used multilevel logistic regression to examine differences by ethnicity and gender and associations with putative risk factors. RESULTS: Prevalence of conduct problems in inner-city schools was around three times higher than reported in national studies (i.e., 16% [95%CI: 15·2-17·5] vs. 5% [95%CI 4·6-5·9]). Compared with overall prevalence, conduct problems were lower among Indian/Pakistani/Bangladeshi (RR: 0.53 [95% CI:0.31-0.87]) and white British (RR: 0.65 [0.51-0.82]) groups, and higher among black Caribbean (RR: 1.39 [95%CI:1.19-1.62]) and mixed white and black (RR: 1.29 [95% CI: 1.02-1.60]) groups. Risk of conduct problems was higher among those who were exposed to racial discrimination compared with those who were not (RR: 1.95 [95% CI: 1.59-2.31]). CONCLUSIONS: Conduct problems are markedly more common in inner-city schools, and variations in the prevalence of conduct problems are, to some extent, rooted in modifiable social contexts and experiences, such as experiences of racial discrimination.

Childhood trauma, parental bonding, and social cognition in patients with schizophrenia and healthy adults.

OBJECTIVE: This study investigated associations between childhood trauma, parental bonding, and social cognition (i.e., Theory of Mind and emotion recognition) in patients with schizophrenia and healthy adults. METHODS: Using cross-sectional data, we examined the recollections of childhood trauma experiences and social cognitive abilities in 74 patients with schizophrenia and 116 healthy adults. RESULTS: Patients had significantly higher scores compared with healthy participants on childhood trauma, and lower scores on parental bonding and social cognitive measures. Physical neglect was found to be the strongest predictor of emotion recognition impairments in both groups. Optimal parental bonding attenuated the impact of childhood trauma on emotion recognition. CONCLUSION: The present study provides evidence of an association between physical neglect and emotion recognition in patients with schizophrenia and healthy individuals and shows that both childhood trauma and parental bonding may influence social cognitive development. Psychosocial interventions should be developed to prevent and mitigate the long-term effects of childhood adversities.

Impact of perceived social support and parental bonding in predicting suicidal intent among self-harm patients.

OBJECTIVE: To investigate the impact of perceived social-support and parental bonding in predicting suicidal intent among self-harm patients. METHODS: The cross-sectional study was conducted at Foundation University, Rawalpindi, Pakistan, from February to September 2019, and comprised self-harm patients from mental health department of different hospitals in Rawalpindi, Jhelum and Peshawar. Data was collected using multidimensional scale of perceived social support, parental-bonding instrument and the Beck suicide intention scale. Data was analysed using SPSS 23. RESULTS: There were 50 patients aged 18-35 years. Social support and parental bonding factor 'care' had significant negative correlation with suicide intent (p<0.05). Parental bonding factor 'overprotectiveness' had significant positive correlation with suicide intent (p<0.05). CONCLUSIONS: Social support and parental bonding can both play substantial role in saving lives.

Basic Family Relations, Parental Bonding, and Dyadic Adjustment in Families with a Member with Psychosis.

The aim of the current study is to describe and explore basic family relations, parental bonding, and dyadic adjustment in families with offspring diagnosed with a psychotic disorder. The sample was made up of 120 participants, 60 in the clinical group (GCL) and 60 in the comparison group (GCP). All participants were assessed using the basic family relations evaluation questionnaire (CERFB), the parental bonding instrument (PBI), and the dyadic adjustment scale (DAS). The results showed differences between the clinical and comparison groups in terms of perceptions of basic family relations, dyadic adjustment and parental bonding. The clinical group recorded less favorable results for all of these variables. More specifically, the study observed significant differences between the groups in parental function, overprotection and caring. This study deepens our understanding of how family assessment and relational diagnoses can serve as prevention and intervention tools for families affected by a psychotic disorder.

Psychometric Properties of the Parental Bonding Instrument in a Sample of Canadian Children.

The parental bonding instrument (PBI) is a self-report questionnaire that was initially designed to retrospectively assess perceived parenting style during childhood in adult respondents. Recent studies have used the PBI to assess current perception of parenting in children. However, few studies have evaluated the psychometric properties of the PBI in children. This study examined the factor structure and reliability of the PBI in a sample of Canadian children aged 7-18 years (n = 257). Confirmatory factor analyses (CFA) were conducted separately for the mother and father form of the PBI and composite reliability was used to determine internal consistency of the PBI. A four-factor model (care, overprotection, autonomy, indifference) showed the best fit to the data. The PBI exhibited good internal consistency but poor convergent validity. Configural invariance was not found for the PBI between two age groups (7-12 and 13-18 years), however these findings should be interpreted with caution due to the small sample size in each age group. This study suggests the PBI may be a valid and reliable self-report measure of parental bonding in children but further research is needed.

Does body shame mediate the relationship between parental bonding, self-esteem, maladaptive perfectionism, body mass index and eating disorders? A structural equation model.

PURPOSE: Body shame has been strongly associated with eating pathology. However, less is known about the predisposing factors linked to these feelings and how they interact with other variables in eating disorder development. Thus, the aim of the present study was to provide a preliminary understanding of the relationship between body shame and some of the major risk factors for eating disorder onset, identifying the possible mechanisms of action. Specifically, we tested a structural equation model in which perceived parental bonding, self-esteem, perfectionism, and body mass index are associated with eating disorder risk via body shame. METHODS: 1156 high school students aged 13-20 were screened by means of self-report measures of parental behavior, self-esteem, perfectionism, body shame and eating disorder risk. The height and weight of each individual were measured. RESULTS: In predicting eating disorder risk, parental protectiveness (ß = 0.09), body mass index (ß = 0.18), self-esteem (ß = - 0.14) and body shame (ß = 0.58) had a direct effect on this variable and overall our model accounted for 58% of its variance. The experience of shame related to one's body appeared to have a considerably significant influence on eating disturbances vulnerability and it also serves as a mediator between other risk factors and eating disturbance risk. A series of multi-group analyses indicated no significant difference between males and females. CONCLUSION: The emotion of shame may enhance our understanding of eating disorders, as well as being a salient factor for the development of preventive programs and treatment approaches. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

[Study of parental bonding in childhood in children and adolescents with anorexia nervosa]. / Étude du lien parental dans l'enfance chez les enfants et adolescents avec anorexie mentale.

INTRODUCTION: Anorexia nervosa constitutes a severe and complex eating disorder occurring principally in adolescence. It is one of the most deadly psychiatric disorders. Considering the multifactorial nature of anorexia nervosa, the important place of the family and the growing interest in the theory of attachment in eating disorders, parental bonding is questioned in anorexia nervosa. The main study goal is to analyze parental bonding in a population of children and adolescents with anorexia nervosa. The secondary objective is to study differences according to the age group. METHOD: We realized an observational pilot study in Bordeaux over a period from June 2015 to April 2017. Twenty five young girls with anorexia nervosa, aged 10 to 17 years, hospitalized in the department of child and adolescent psychiatry and department of eating disorders have been included and divided into two groups: peripubertal for children under 14 and pubertal for children aged 14 to 17 years. We met them individually to complete a series of questionnaires including the Parental Bonding Instrument (for assessing attachment), the Mini International Neuropsychiatry Interview for Children and Adolescent (for detecting the presence of comorbidity) and a structured questionnaire for collecting general information on anorexia nervosa. RESULTS: Results revealed high parental care, high maternal and paternal overprotection with predominantly "optimal" parenting style followed by "affectionate constraint" style. Significant differences were observed in anorexia nervosa patients with maternal (P=0.011) and paternal (P=0.085) overprotection in pubes compared to peripubertal. In correlation analysis, there was a positive correlation between maternal protection and age of diagnosis and a negative correlation between parental care and duration of illness. Furthermore, the maternal overprotection tended to be correlated significantly and positively with the age of the diagnosis and the paternal overprotection with the body mass index. CONCLUSION: Our study shows a rating by the parents of warm and understanding parents, an over-protective mother and a father encouraging autonomy. There is maternal and paternal overprotection in pubertal anorexia nervosa compared with peripubertals. Our results suggest the importance of analyzing parenting style in addition to Parental Bonding Instruments results and of supporting the importance of the development of family therapy in the anorexia nervosa.

What's parenting got to do with it: emotional autonomy and brain and behavioral responses to emotional conflict in children and adolescents.

Healthy parenting may be protective against the development of emotional psychopathology, particularly for children reared in stressful environments. Little is known, however, about the brain and behavioral mechanisms underlying this association, particularly during childhood and adolescence, when emotional disorders frequently emerge. Here, we demonstrate that psychological control, a parenting strategy known to limit socioemotional development in children, is associated with altered brain and behavioral responses to emotional conflict in 27 at-risk (urban, lower income) youth, ages 9-16. In particular, youth reporting higher parental psychological control demonstrated lower activity in the left anterior insula, a brain area involved in emotion conflict processing, and submitted faster but less accurate behavioral responses-possibly reflecting an avoidant pattern. Effects were not replicated for parental care, and did not generalize to an analogous nonemotional conflict task. We also find evidence that behavioral responses to emotional conflict bridge the previously reported link between parental overcontrol and anxiety in children. Effects of psychological control may reflect a parenting style that limits opportunities to practice self-regulation when faced with emotionally charged situations. Results support the notion that parenting strategies that facilitate appropriate amounts of socioemotional competence and autonomy in children may be protective against social and emotional difficulties.

Prospective associations between recalled parental bonding and perinatal depression: a cohort study in urban and rural Turkey.

PURPOSE: Recalled experiences of parental bonding may be important in the aetiology of perinatal depression. We hypothesized that lower recalled parental bonding would be associated with perinatal depression. METHOD: In a cohort study of perinatal depression in Turkey, 677 women were recruited in their third trimester. Parental Bonding Inventory (PBI) scores at baseline were investigated as predictors of depression on the Edinburgh Postnatal Depression Scale (EPDS) at 4, 14 and 21 months after childbirth in mothers without depression at baseline. RESULTS: Poor parental bonding scores, apart from paternal control and overprotection, were independently associated with antenatal depression. Incident postnatal depression at 4 months was predicted by parental overprotection, at 14 months by parental care and overprotection, and at 21 months by paternal control and overprotection. CONCLUSIONS: Less satisfactory parenting recalled in the antenatal period was an independent predictor of postnatal depression; however, the different bonding subscales varied as predictors according to the timing of the depression assessment after childbirth.