High Levels Of Maternal Anxiety Research Articles

The Role of Maternal Anxiety in Treatment Response for Youth with ASD and Co-occurring Anxiety.

Anxiety disorders occur at higher rates in youth with ASD than in neurotypical youth. Although the efficacy of CBT for anxiety in children with ASD is widely supported, factors that influence treatment outcomes are not well understood. This study examined the role of maternal anxiety in treatment outcomes for youth with ASD. Youth with ASD and anxiety (ages 8 to 14), along with their mothers (n = 87), participated in a group CBT intervention. Results indicated that maternal anxiety did not improve over the course of treatment. However, findings suggest that high levels of maternal anxiety at pre-treatment predicted higher levels of youth anxiety post-treatment. Importantly, the relationship between parent anxiety and youth outcomes was moderated by child age. The findings of the present study may provide initial insight into the role that maternal anxiety plays in treatment outcomes for children with ASD and co-occurring anxiety, particularly when considering child age.

Single low-dose exposure to cow's milk at diagnosis accelerates cow's milk allergic infants' progress on a milk ladder programme.

BackgroundCow's milk protein allergy (CMPA) is one of the most common food allergies in infancy. Most infants with CMPA tolerate baked milk from diagnosis and gradually acquire increased tolerance. Nevertheless, parents often display significant anxiety about this condition and a corresponding reluctance to progress with home introduction of dairy due to concerns about possible allergic reactions.ObjectiveTo evaluate the impact on gradual home introduction of foods containing cows’ milk after a supervised, single low‐dose exposure to whole milk at time of diagnosis.MethodsInfants less than 12 months old referred with suspected IgE‐mediated cow's milk allergy were recruited to an open‐label randomized, controlled trial of intervention—a single dose of fresh cow's milk, using the validated dose of milk that would elicit reactions in 5% of CMPA subjects—the ED05 – vs routine care. Both groups implemented graded exposure to CM (using the 12 step MAP Milk Tolerance Induction Ladder), at home. Parents completed food allergy quality of life questionnaires and State and Trait Anxiety Inventories (STAI). Main outcome measures were milk ladder position at 6 months and 12 months post‐randomization.ResultsSixty patients were recruited, 57 (95%) were followed to 6 months. By 6 months, 27/37 (73%) intervention subjects had reached step 6 or above on the milk ladder compared to 10/20 (50%) control subjects (p = .048). By 6 months, 11/37 (30%) intervention subjects had reached step 12 (i.e. drinking unheated cow's milk) compared to 2/20 (10%) of the controls (p = .049). Twelve months post‐randomization, 31/36(86%) of the intervention group and 15/19(79%) of the control group were on step 6 or above. However, 24/37 (65%) of the intervention group were at step 12 compared to 7/20 (35%) of the control group (p = .03). Maternal STAIs were significantly associated with their infants’ progress on the milk ladder and with changes in skin prick test and spIgE levels at 6 and 12 months.ConclusionThis study demonstrates the safety and effectiveness of introduction of baked milk implemented immediately after diagnosis of cows’ milk allergy in a very young cohort. A supervised single dose of milk at the ED05 significantly accelerates this further, probably by giving parents the confidence to proceed. Maternal anxiety generally reflects infants’ progress towards completion of the milk ladder, but pre‐existing high levels of maternal anxiety are associated with poorer progress.

Parental Psychological Control: Maternal, Adolescent, and Contextual Predictors.

Parental psychological control (PC) hinders the development of autonomy, identity formation, and the attainment of self-determination and individuation of adolescents. The aim of this study was to deepen the understanding of which conditions increase the risk of the use of maternal PC by simultaneously considering the contribution of adolescent temperament, maternal separation anxiety, and adolescents’ perception of interparental conflict. A correlational study involving a sample of 106 Chilean adolescent-mother dyads was done. Adolescents were, on average, 15.42 years old (SD = 1.09) and 77% male. Mothers were, on average, 45.46 years old (SD = 6.39). We administered self-report questionnaires to the adolescent measuring effortful control and frustration as temperamental dimensions, along with the perception of interparental conflict. Mothers reported on their separation anxiety. Both the adolescents and their mothers reported on the use of maternal PC. Adolescents reported higher levels of maternal PC than their mothers did. All predictors were associated with PC reports. Higher levels of maternal anxiety about adolescent distancing, inter-parental conflict, and adolescent frustration were associated with higher reported levels of PC. In contrast, higher levels of adolescent effortful control were associated with lower levels of maternal PC. Finally, when maternal separation anxiety and inter-parental conflict were high there was a higher use of maternal PC. The present findings inform on how adolescent’s self-regulatory skills could reduce the risk of being exposed to maternal PC. And highlight the importance of using a systemic and interactional conceptualization when trying to understand their use.

Single Dose Oral Food Challenge at Diagnosis Accelerates Cows Milk Allergic Infants’ Acquisition of Oral Tolerance to Milk, But Progress is Influenced by Maternal Anxiety

Background: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infancy. Parents often display significant anxiety about this condition. Single dose challenges are a new method of assessing dose reactivity in food allergic children. Methods: We recruited children referred for evaluation of CMPA to a randomised, controlled trial of single dose challenge to cow’s milk, using the validated dose of milk that would elicit reactions in 5% of CMPA subjects - the ED 05 - before implementation of graded exposure to CM (using the 12 step iMAP Milk Tolerance Induction Ladder) at home. Parents completed food allergy quality of life and State and Trait Anxiety Inventories (STAI). Results: Sixty patients were recruited, 57 (95%) were followed to 6 months. By 6 months 27/37 (73%) intervention subjects had reached step 6 or above on the milk ladder compared to 10/20 (50%) control subjects (p=0.048). By 6 months 11/37 (30%) intervention subjects had reached step 12 (ie drinking unheated cow’s milk) compared to 2/20 (10%) of the controls (p=0.049). Twelve months post randomisation 31/36(86%) of the intervention group and 15/19(79%) of the control group were on step 6 or above. However, 24/37 (65%) of the intervention group were at step 12 compared to 7/20 (35%) of the control group (p=0.03). Maternal STAIs were significantly associated with their infants’ response/progress on the milk ladder and with changes in skin prick test and spIgE levels at 6 and 12 months. Conclusion: Using the 12 step iMAP milk ladder accelerates natural tolerance induction in infants under 12 months with CMPA. A supervised single dose at the ED 05 significantly accelerates this further, probably by giving parents the confidence to proceed. Maternal anxiety generally reflects infants’ progress towards tolerance but preexisting high levels of maternal anxiety are associated with poorer progress. Funding: YD was in receipt of a Clinical Research Fellowship from the National Childrens Research Centre Ireland. Declaration of Interest: AM received research funding from Aimmune Therapeutics, RvR declares consultancies for HAL Allergy BV, Citeq BV, Angany Inc, speaker fees from HAL Allergy BV, ThermoFisher Scientific, ALK and stock options from Angany Inc. ADG receives research funding and speaker fees from Aimmune Therapeutics JO’BH receives research funding, speaker fees and consultancy fees from Aimmune Thereputics, research funding and speaker fees from DBV Technologies, research funding from Johnson&Johnson, Clemens von Pirquet Foundation and Temple st Hospital Research Foundation. Ethical Approval: Ethical approval was obtained from the Clinical Research Ethics Committees of the Cork Teaching Hospitals and Crumlin Hospital. Approval was granted on 26th September 2017.

Does anxiety impact the neural processing of child faces in mothers of school-aged children? An ERP study using an emotional Go/NoGo task

ABSTRACT Maternal anxiety during pregnancy and the early postpartum period is associated with heightened neural processing of neutral infant faces as measured by event-related potentials (ERPs). However, less is known about how anxiety shapes neural face processing in mothers of older children. In our study, 36 mothers of 8–10 year old children completed a Go/NoGo task consisting of neutral and emotional (happy, fearful) facial expressions posed by unfamiliar school-aged children while EEG was recorded. Higher levels of maternal anxiety -indexed via self-report- were associated with delayed behavioral responses to children’s fearful faces and increased N170 and LPP amplitudes elicited by children’s neutral faces. While anxiety was also positively related to the LPP elicited by children’s emotional faces, it only led to increased N170 amplitude responses to children’s fearful, but not happy, faces and only when they were NoGo cues. The study replicates and extends prior findings examining the impact of maternal anxiety on neural responses to neutral infant faces to later stages of parenting with further neural markers and emotional expressions being affected. Findings evidence the importance of studying these associations beyond infancy to increase our knowledge about processes potentially underlying the relation between anxiety and less optimal parenting across development.

BDNF Methylation and Maternal Brain Activity in a Violence-Related Sample

It is known that increased circulating glucocorticoids in the wake of excessive, chronic, repetitive stress increases anxiety and impairs Brain-Derived Neurotrophic Factor (BDNF) signaling. Recent studies of BDNF gene methylation in relation to maternal care have linked high BDNF methylation levels in the blood of adults to lower quality of received maternal care measured via self-report. Yet the specific mechanisms by which these phenomena occur remain to be established. The present study examines the link between methylation of the BDNF gene promoter region and patterns of neural activity that are associated with maternal response to stressful versus non-stressful child stimuli within a sample that includes mothers with interpersonal violence-related PTSD (IPV-PTSD). 46 mothers underwent fMRI. The contrast of neural activity when watching children—including their own—was then correlated to BDNF methylation. Consistent with the existing literature, the present study found that maternal BDNF methylation was associated with higher levels of maternal anxiety and greater childhood exposure to domestic violence. fMRI results showed a positive correlation of BDNF methylation with maternal brain activity in the anterior cingulate (ACC), and ventromedial prefrontal cortex (vmPFC), regions generally credited with a regulatory function toward brain areas that are generating emotions. Furthermore we found a negative correlation of BDNF methylation with the activity of the right hippocampus. Since our stimuli focus on stressful parenting conditions, these data suggest that the correlation between vmPFC/ACC activity and BDNF methylation may be linked to mothers who are at a disadvantage with respect to emotion regulation when facing stressful parenting situations. Overall, this study provides evidence that epigenetic signatures of stress-related genes can be linked to functional brain regions regulating parenting stress, thus advancing our understanding of mothers at risk for stress-related psychopathology.

Development of a measure for maternal confidence in knowledge and understanding and examination of psychosocial influences at the time of a child's heart surgery.

The purpose was to develop a maternal confidence in knowledge and understanding scale (Maternal Knowledge and Understanding Scale [MKUS]) and examine the effect of psychosocial factors at the time of a child's heart surgery. Using cross-sectional design, the MKUS was developed and tested. Validated instruments were used to examine the impact of psychosocial factors. The MKUS showed acceptable internal consistency (Cronbach's alpha .78). Higher levels of maternal anxiety and lower levels of social support were associated with lower MKUS scores (p < .05). A measure of maternal confidence in knowledge and understanding could draw attention to psychosocial factors and opportunities to enhance nursing support.

Maternal Anxiety and Attention Deficit Hyperactivity Disorder (ADHD) in Children

Background: According to the previous studies, anxiety along with some other psychiatric disorders is common among mothers of children with attention deficit hyperactivity disorder (ADHD). Since maternal anxiety affects mother-child interactions, early treatment plays an important role in the prognosis of ADHD in children. This study aimed to determine the relationship between maternal anxiety and hyperactivity in children. Methods: This study was conducted on 112 mothers of ADHD children (aged 6-12 years), selected via convenience sampling from October to December 2012. The subjects lived in districts 2 and 6 of Tehran and were referred to consultation centers. Depression Anxiety Stress Scale 42 (DASS-42) and Swanson, Nolan and Pelham (SNAP-IV) questionnaires were completed by the subjects. Pearson’s correlation coefficient was used for the analysis of the relationship between variables. Results: A positive correlation was found between maternal anxiety and children’s hyperactivity (P=0.05). In fact, high levels of maternal anxiety are accounted for various child-rearing problems such as children’s hyperactivity. Conclusion: High levels of maternal anxiety lead to child rearing problems, which in turn cause various disorders such as hyperactivity in children.

Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children

To investigate the effects of sociodemographic factors and maternal anxiety levels on behaviour in children undergoing surgery. This study included children aged 3-12 years who were scheduled for surgery, and their respective mothers. Each mother completed a questionnaire concerning sociodemographic and economic characteristics. Maternal anxiety was assessed using the State-Trait Anxiety Inventory (STAI) form Tx-1, following transfer of the child to the operating room. An anaesthesiologist rated preoperative anxiety in each child using the Frankl Behaviour Rating Scale (FBRS) and Venham Picture Test (VPT). One hundred children (mean ± SD age 7 ± 2.7 years) who received dental (47%), plastic (39%) or urological (14%) surgery, and 100 mothers (mean ± SD age 34 ± 6.6 years) were included. A statistically significant difference between maternal STAI Tx-1 scores and children's VPT scores was revealed. There was no significant difference between maternal STAI Tx-1 scores and children's FBRS scores. Maternal education level and socioeconomic status had no effect on FBRS, VPT and STAI Tx-1 scores. Maternal knowledge and experience of anaesthesia, and high levels of maternal anxiety, may be related to increased anxiety in children undergoing surgery.

Social competence of preschool children born very preterm

BackgroundRelatively little is known about the early social development of children born very preterm despite clear suggestions of later interpersonal difficulties. AimsTo compare the social competence of very preterm (VPT) and full term (FT) born children at age 4 and identify infant, social and family factors associated with later risk. Study designProspective longitudinal study. SubjectsA regionally representative cohort of 103 VPT (≤32weeks gestation) children and a comparison group of 105 FT children (36–41weeks gestation) born between 1998 and 2000. Outcome measuresAt corrected age 4years, a range of parent report, observational and laboratory measures assessed children's emotional and behavioral adjustment, emotional regulation, social interactive behavior and theory of mind understanding. Extensive perinatal, social background and family functioning data were also available from birth to age 4. ResultsCompared to their FT peers, VPT born children had poorer emotional and behavioral adjustment, were less effective in regulating their emotions, had lower levels of positive peer play and had less synchronous interactions with their parents. Within the VPT group, predictors of poor social competence included family socioeconomic disadvantage, extreme prematurity, severity of cerebral white matter abnormalities and early childhood exposure to high levels of maternal anxiety and negative parenting. ConclusionsVPT pre-schoolers are characterized by a range of subtle social difficulties likely to adversely affect their ability to establish and maintain positive relationships with others. These difficulties need to be monitored alongside other potential neurodevelopmental concerns and parents supported to actively nurture child social competence.

Maternal Concepts and Expectations regarding a Preterm Infant

The objective of the present study was: (a) to identify the concerns, verbally expressed, of 50 mothers regarding their preterm infants (PT) and then compare their verbal expression with those of 25 mothers of full-term infants (FT); and (b) to correlate the mothers' verbal expressions with maternal and infant variables. The following instruments were used to compose and characterize the sample: Structure Clinical Interview for DSM III-R Non-Patient (SCID/NP), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and medical charts. Results showed that there was no difference between groups in term of mothers' expectations and conceptualizations; both groups exhibited predominantly positive expectations and concepts. In comparison with FT mothers, PT mothers verbally expressed more feelings and reactions predominantly negative or conflicting in relation to infant birth. Higher levels of maternal anxiety and depression in the PT Group were correlated with more verbal expressions about negative or conflicting emotions. In addition, lower birth weight, higher neonatal risk and longer length of stay in intensive care nursery of the infants were related with more negative or conflicting concepts by the mothers.

Maternal anxiety in the pre- and postnatal period: a literature review

This study intended to present a systematic review to analyze the empirical studies published between 1998 and 2003 about maternal anxiety in the prenatal and postnatal periods, focusing on pre-term and term births. Nineteen studies were found; six of which evaluated maternal anxiety in the prenatal period, 12 studies evaluated anxiety in mothers in the postnatal period and only one study evaluated maternal anxiety in both periods. The results showed that high levels of maternal anxiety in the prenatal phase were associated with obstetric problems, emotional damages to fetal development, behavioral problems in childhood and adolescence. The mothers presented higher anxiety levels when compared with the fathers. The co-occurrence of maternal anxiety and depression was found. The maternal anxiety assessment is relevant to identify both maternal mental health and child development at risk.

The influence of prematurity, maternal anxiety, and infants' neurobiological risk on mother-infant interactions.

In this study, we investigated how the birth of a very low birth weight preterm (VLBW) infant influences the mother-infant interaction at 3 months. We also focused on the impact of the infant's neurobiological risk and maternal anxiety, and their interaction. The comparison of the VLBW preterm sample (n = 79) with an external full-term sample (n = 35) showed mother-infant interactions of the families with the preterm infant to be more vocally responsive during the interaction, but less facially responsive during the interaction. Additionally, higher levels of maternal anxiety were associated with preterm infants being less facially responsive in interaction with their mother. While neurobiological risk of the infant played a part in this association, with higher risk infants also being less facially responsive, the relationship with maternal anxiety and the mother-child interaction was stronger. How these findings may influence therapeutic interventions is discussed.

Factors Affecting Maternal Anxiety Levels in Neonatal Hearing Screening† 76

It has been suggested that universal neonatal hearing screening may cause unnecessary maternal anxiety (Bess, 1994). The objective of this cross-sectional interview study was to identify and compare the prevalence and degree of maternal anxiety at the time of initial hearing screen and at a 2-4 week rescreen for first stage refers (fails). A second objective was to identify the maternal demographic factors that affect levels of anxiety in each sample of mothers. The 157 mothers interviewed at the time of initial hearing screen were unaware of the screen results. The 20 mothers interviewed at the time of a rescreen were aware of the results of the initial screen but had not yet received the results of the rescreen. Results n(%) shown: Although only 3.8% of mothers in the initial screen population were worried or very worried, this increased to 40% in the rescreen population, p =.001. Higher levels of maternal anxiety in the initial screen population were associated with: lower maternal education, p =.023, ↑ number of children, p =.002, lack of knowledge of screen during admission to hospital (vs. before admission), p =.012, and a trend for non-private insurance, p =.083 and lower SES, p=.07. In the rescreen population, ↑ levels of maternal anxiety were associated with low maternal education (p =.027), non-white maternal race, p=.001 and a trend for non English speaking, p =.06. We conclude that the incidence of significant maternal anxiety at the time of neonatal hearing screening is low, and that maternal anxiety during rescreens increases significantly. Therefore, efforts must be directed to minimizing the first stage false positive rate for neonatal hearing screening to limit unnecessary anxiety during rescreens. These data also indicate that poorly educated, non-insured, non-white, uninformed mothers are at increased risk of experiencing anxiety about their infant's hearing screen and hearing screen programs must direct their educational efforts towards these socially at risk mothers. Table

Maternal separation anxiety in infancy: precursors and outcomes.

The relationships among aspects of mothers' childhood memories, her maternal anxiety--when separated from her infant and the child's attachment pattern were studied with 58 low risk dyads participating in a longitudinal investigation. It was found that mother's perceived relationships with her own mother significantly predicted her offspring's attachment to her. While maternal separation anxiety was equally characteristic of secure and insecure mothers at early infancy, by the end of the first year preoccupied mothers reported higher levels of maternal anxiety and separation concerns compared to the secure mothers. Although not designed as a clinical study, the present results highlight important psychological constructs and measurements which may be relevant for assessment and intervention.