Associations of maternal sensitivity and embodied mentalizing with infant-mother attachment security at one year in depressed and non-depressed dyads.

Parental Embodied Mentalizing (PEM) captures the parent's capacity to extrapolate the child's mental states from movement and respond on a nonverbal level. Little is known about PEM's relation to other established measures of parent-child interactive behavior, such as maternal sensitivity and attachment. This is investigated in a sample of four months old infants and mothers with (n = 27) and without a diagnosis of postpartum depression (n = 44). Video-recorded infant-mother interactions were coded independently using PEM and Coding Interactive Behavior. Attachment was assessed at 13 months using the Strange Situation Procedure. Sensitivity and PEM was positively associated, but only sensitivity predicted attachment security and only the nonclinical group. This indicates that PEM and sensitivity are moderately related as well as capturing different aspects of infant-mother interactions. The study confirms previous findings of sensitivity predicting attachment in nonclinical groups. More research is required to further understand predictors of attachment in clinical samples.

The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health.

The parents' capacity to reflect upon the psychological processes in their child, termed parental reflective functioning (PRF) can be impaired by parental mental health problems. The present study aimed to investigate the factor structure of an infant version of the Parental Reflective Functioning Questionnaire (PRFQ-I) in a low-risk sample of 259 Danish fathers of 1-11-month-old infants to investigate measurement invariance of the PRFQ-I between fathers and mothers; and to examine the association between PRF and paternal depressive symptoms, psychological distress, and parenting stress. Confirmatory factor analysis supported a three-factor model of the PRFQ-I. Multi-group factor analysis indicated partial measurement invariance. Multiple linear regressions showed that paternal depressive symptoms were not associated with PRF. There was an interaction effect of paternal depressive symptoms and general psychological distress on paternal interest and curiosity in their infant's mental state and certainty of infant mental state. Increased parenting stress was associated with impaired PRF on all three subscales of the PRFQ-I. These results provide further evidence for a multidimensional, brief assessment of paternal reflective skills and insight into how variability in paternal psychological functioning relates to impaired PRF in the postpartum period.

La capacidad de los progenitores de reflexionar sobre los procesos sicológicos en sus niños, a lo cual se le denomina funcionamiento reflexivo de los progenitores (PRF), puede ser debilitado por los problemas de salud mental de los progenitores. El presente estudio se propuso investigar la estructura de factores de una versión infantil del Cuestionario de Funcionamiento Reflexivo de los Progenitores (PRFQ-I) en un grupo muestra de bajo riesgo de 259 papás daneses de infantes de 1-11 meses de nacidos para investigar la invariabilidad de las medidas del PRFO-I entre papás y mamás; y para examinar la asociación entre PRF y los síntomas depresivos paternos, la angustia sicológica y el estrés de crianza. Los confirmatorios análisis de factores apoyaron un modelo de tres factores del PRFQ-I. Los análisis de factores de multigrupos indicaron la parcial invariabilidad de las medidas. Regresiones múltiples lineales mostraron que los síntomas depresivos paternos no estaban asociados con PRF. Se dio un efecto de interacción de los síntomas depresivos paternos y la angustia sicológica general sobre el interés y la curiosidad paternas en cuanto al estado mental de sus infantes, así como la certeza en cuanto al estado mental infantil. Se asoció el aumento de estrés de crianza con un debilitado PRF en todas las tres subescalas del PRFQ-I. Estos resultados proveen evidencia adicional para una evaluación multidimensional, breve, de las habilidades reflexivas del progenitor e información acerca de cómo la variabilidad en el funcionamiento sicológico paterno se relaciona con el debilitado PRF en el período posterior al parto.

La capacité des parents à réfléchir aux processus psychologiques chez leur enfant, appelée fonctionnement de réflexion parentale (PRF en anglais) peut être compromise par des problèmes de santé mentale parentale. Cette étude s'est donné pour but d'étudier le facteur de structure d'une version nourrisson du Questionnaire de Fonctionnement de Réflexion Parentale (abrégé en anglais PRFQ-I) chez un échantillon à faible risque de 259 pères danois de bébé de 1-11 mois pour étudier l'invariance de mesure du PRFQ-I entre les pères et les mères; et pour examiner le lien entre le PRF et les symptômes dépressifs paternels, la détresse psychologique, et le stress de parentage. Une analyse factorielle confirmatoire a soutenu le modèle à trois facteurs du PRFQ-I. Une analyse factorielle multi-groupes a indiqué une invariance de mesure partielle. De multiples régressions linéaires ont montré que les symptômes dépressifs paternels n'étaient pas liés au PRF. On a noté un effet d'interaction des symptômes dépressifs paternels et de la détresse psychologique générales sur l'intérêt paternel et la curiosité pour l'état mental de leur bébé et la certitude de l'état mental du bébé. Le stress de parentage accru était lié à un PRF altéré sur toutes les trois sous-échelles du PRFQ-I. Ces résultats offrent une justification pour une évaluation brève et pluridimensionnelle des compétences de réflexion paternelles et un aperçu sur la manière dont la variabilité dans les fonctionnement psychologique paternel se rapporte au PRF altéré dans la période postpartum.

Influence of introducing a story stem in an interactive play context on maternal and their four-year-old children's use of mental state language.

Maternal and child mental state language is associated with improved socioemotional and cognitive child development. This study examined if introducing a story stem (a narrative playing out socioemotional conflicts) in a play situation facilitated maternal and child mental state language compared to a free-play (baseline) situation, and if mothers and children with low baseline mental state language profited more from the story stem situation. Participants were 101 four-year-old children and their mothers. Maternal and child mental state language correlated and providing the story stem increased both maternal and child mental state language. Providing a story stem increased mental state language more for mothers and children groups with lowest mental state language at baseline compared to a high mental state language group. The results indicate a validation of the use of story stems to increase maternal and child mental state language within a typical population.

The significance of parental mentalizing for four-year-old children's solitary pretend play.

BACKGROUND: Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play). Based on the assumption that child solitary pretend play reflects the child's 'baseline' pretend play ability, in this study, we investigated children's pretend play at its peak, i.e., during the preschool age, without the facilitation of another player. The overall objective was to investigate if parental mentalizing increases pretend play complexity in children. METHODS: The sample consisted 99 Danish mothers and their 4-year-old children. Employing a cross-sectional design, we hypothesized that parental mental state language, as an indicator of 'online' mentalizing during interaction with the child, is a mechanism through which 'offline' mentalizing, measured as parental reflective functioning, is associated with child solitary pretend play. Child pretend play complexity was observed and coded with an adapted version of the 12-Step Play Scale. Maternal offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire, and maternal online mentalizing was assessed by coding the mothers' mental state language during interaction with the child using a modified version of the mind-mindedness coding scheme. RESULTS: While there was no direct effect of maternal offline reflective functioning on child pretend play, online mental state language mediated the link between offline maternal reflective functioning and child pretend play. CONCLUSIONS: These results provide support for the theoretically assumed link between parental mentalizing and children's capacity for pretend play. Furthermore, our study contributes to the literature on parental mentalization, suggesting that parental mentalizing facilitates child development only if the parent can translate this ability into 'mentalizing in action'.

Story stems in early mother-infant interaction promote pretend play at 30 months.

During early childhood, play develops through levels of sensory exploration and manipulation, to functional activities and during the second year of life to the level of pretend and symbolic play. However, little is known about the factors contributing to individual variations in the development of play. The present study investigated associations between maternal sensitivity and play conditions with different ways of engaging and participating and children's development of pretend play. Participants were 64 primiparous mothers and their 30-months-old children. Sensitivity was assessed using the Coding Interactive Behavior (CIB) coding system, and children's play was coded using the 12 Step Play Scale. Analyses showed no significant associations between sensitivity and children's play development but a play condition introducing a story stem was associated with a higher developmental play level and longer duration of pretend play compared to free interactive play. The findings suggest that the use of a story stem may promote pretend play in interactive settings with the mother.

Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort.

Infant social withdrawal is a risk factor for non-optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2-3, 4-7 and 8-12 months postpartum. Linear regressions showed that prematurity predicted higher infant social withdrawal at all time points, and maternal symptoms of PPD were positively associated with withdrawal at 2-3 months. Logistic regressions showed that odds for elevated social withdrawal were increased with elevated levels of maternal symptoms of PPD at 2-3 and 8-12 months. Partner's symptoms of PPD were not associated with withdrawal. Future studies should investigate how PPD symptoms and prematurity may impact the individual development of social withdrawal.

How are mothers negatively affected and supported by following parenting-related Instagram profiles? A mixed-methods study.

Many parents use social media to seek knowledge about child development and parenting, but parents are an understudied population in social media research. In this study, we use a mixed-methods approach to examine mothers' experience of following three different types of Instagram profiles: InstaParents, i.e. influencers sharing their personal experiences with parenthood, professional profiles disseminating knowledge about parenting and child development, and a university-based profile disseminating knowledge about child socioemotional development. The participants were 270 mothers with children aged 0-6 years, who completed an online questionnaire regarding their experience and use of Instagram. Generalized Estimating Equations were used to examine associations between mothers' social comparison orientation and their experience of following the different types of profiles. Content analysis of mothers' responses to open-ended questions was used to examine how mothers were negatively affected and supported by the different profiles. Results showed that mothers with higher levels of social comparison orientation were more negatively affected by following all three types of profiles, but also more supported by following InstaParents. The content analysis suggested that mothers were negatively affected by InstaParents by making upward comparisons and supported by making horizontal comparisons. Mothers were supported by professional profiles, including the university-based profile, by improved knowledge, but these profiles could also lead to a decreased sense of parenting competence. Results inform professionals in relation to how to support mothers through content on Instagram and how to talk to mothers about their digital use and well-being.

Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents.

BACKGROUND: Infant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, i.e. the caregiver's ability to notice and interpret the child's behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant's behavioral cues. METHODS: This study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants' behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors' register. DISCUSSION: Results will provide evidence regarding the efficacy of UYB in promoting parenting competences. If proved effective, the study will represent a notable advance to initiating the UYB intervention as part of a better infant mental health strategy in Denmark. Conversely, if UYB is inferior to CAU, this is also important knowledge in regard to promoting parenting competence and infant mental health in a general population. Trial registration https://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416.

Temporal coordination between maternal looming and infant gaze in depressed and nondepressed dyads: A bootstrapping approach.

In this study, we examine the convergent validity of a measure of maternal looming derived using a motion capture system, and the temporal coordination between maternal loom and infant gaze using an event-based bootstrapping procedure. The sample comprised 26 mothers diagnosed with postpartum depression, 43 nondepressed mothers, and their 4-month-old infants. Mother-infant interactions were recorded during a standard face-to-face setting using video cameras and a motion capture system. First, results showed that maternal looming was correlated with a globally coded measure of maternal overriding. Maternal overriding is an intrusive behavior occurring when the mother re-directs the infant's attention to parent-led activities. Thus, this result confirms that maternal looming can be considered a spatial intrusion in early interactions. Second, results showed that compared to nondepressed dyads, depressed dyads were more likely to coordinate maternal loom and infant gaze in a Loom-in-Gaze-pattern. We discuss the use of automated measurement for analyzing mother-infant interactions, and how the Loom-in-Gaze pattern can be interpreted as a disturbance in infant self-regulation.

A longitudinal examination of daily amounts of screen time and technoference in infants aged 2-11 months and associations with maternal sociodemographic factors.

This study aimed to examine longitudinal developmental patterns in the daily amounts of screen time and technoference in infants aged 2, 4, 7, and 11 months and to examine associations with maternal sociodemographic factors across all age groups. The results showed that the amount of screen time varied between 6 and 17 min a day, while interruptions in mother-infant interactions due to maternal use of digital technology occurred between 5 and 6 times a day. There was a significant increase in infant screen time from 2 to 4 months, from 4-7 months, and from 7-11 months, and in technoference from 2 to 4 months and from 4-7 months. Maternal age and household income were not associated with infant screen time, but maternal educational level was negatively associated with infant screen time throughout the first year. No associations were found between technoference and maternal age, maternal educational level, or household income. Future research focusing on infant screen time and technoference should aim at including samples that reflect the general population, include measures of screen time and technoference that do not rely on parental report, and include measures of the effects of early infant screen time and technoference on later development.

Does Postpartum Depression Affect Parental Embodied Mentalizing in Mothers With 4-Months old Infants?

Parental Embodied Mentalizing (PEM) regards parents' nonverbal capacity to understand the infant's bodily manifested mental states and adjust his or her own movements accordingly. Little is known about how mothers suffering from postpartum depression (PPD) mentalize the infant on an embodied level. The aims of the present study were to investigate whether mothers meeting criteria for a PPD diagnosis differ from non-clinical mothers in regard to their PEM capacities and whether the severity of depressive symptoms was associated with PEM in mothers meeting criteria for a PPD diagnosis compared to non-clinical mothers. 10-minute long lab-based face-to-face interactions were coded with the PEM coding scheme at 4-months postpartum in mother-infant dyads with mothers meeting criteria for a PPD diagnosis (n = 29) and non-clinical mothers (n = 51). Results showed that mothers with and without a PPD diagnosis differ in their capacity to mentalize on an embodied level, but only when controlling for scores on the Edinburgh Postnatal Depression Scale (EPDS). However, more depressive symptoms as measured with the EPDS was not in itself associated with lower PEM in either group. This finding may indicate the presence of a threshold effect, i.e. that maternal PEM may be affected only when a certain degree of severity and duration in depressive symptoms is beyond a certain threshold. The importance of the findings in regard to the assessment of depression as well as more clinical perspectives are discussed.