Maternal Psychological Well-being Research Articles

Prenatal exposure to maternal very severe obesity is associated with impaired neurodevelopment and executive functioning in children.

BackgroundPrenatal maternal obesity has been associated with an increased risk of neurocognitive problems in childhood, but there are fewer studies on executive functioning.MethodsTests and questionnaires to assess neurodevelopment, executive functioning, and the ability to delay gratification were conducted in 113 children (mean (SD)=4.24 (0.63) years of age) born to mothers with very severe obesity (SO, body mass index (BMI)⩾40 kg/m2, n=51) or to lean mothers (BMI⩽25 kg/m2, n=62).ResultsPrenatal maternal SO predicted poorer neurodevelopment (unstandardized regression coefficient (B)=-0.42, 95% confidence interval (CI) (-0.82; -0.02)), worse problem-solving (odd ratio (OR)=0.60, 95% CI (1.13; 0.07)), and fine motor skills (OR=4.91, 95% CI (1.27; 19.04)), poorer executive functioning in areas of attention, inhibitory control, and working memory (standardized B=3.75, 95% CI (1.01; 13.93)) but not in self-gratification delay. The effects were independent of maternal concurrent psychological well-being and child's BMI, but not independent of maternal education.ConclusionFuture studies should investigate whether perinatal management of maternal obesity could prevent adverse outcomes in child neurodevelopment.

Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial

Background: Many researchers have pointed out the strong relationship between maternal psychological well-being and fetal welfare during pregnancy. The impact of music interventions during pregnancy should be examined in depth, as they could have an impact on stress reduction, not only during pregnancy but also during the course of delivery, and furthermore induce fetal awareness. Objective: This study aimed to investigate the effect of music on maternal anxiety, before and after a non-stress test (NST), and the effect of music on the birthing process. Material and method: The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) stimulation during an NST. The primary outcome was considered as the maternal state anxiety score before and after the NST, and the secondary outcome was the birthing process. Results: Before their NST, full-term pregnant women who had received music intervention were found to have a similar state-trait anxiety score to those from the control group, with 38.10 ± 8.8 and 38.08 ± 8.2, respectively (p = .97). After the NST, the mean state-trait anxiety score of each group was recorded, with results of 30.58 ± 13.2 for those with music intervention, and 43.11 ± 15.0 for those without music intervention (p < .001). In the control group, the NST was followed by a statistically significant increase in the state-trait anxiety score (38.08 ± 8.2 versus 43.11 ± 15.0, p < .001). However, listening to music during the NST resulted in a statistically significant decrease in the state-trait anxiety score of the study group (38.10 ± 8.8 versus 30.58 ± 13.2, OR = 0.87, p < .001). Furthermore, the first stage of labor was shorter in women who received music stimulation (OR = 0.92, p < .004). They also presented a more natural delivery beginning (spontaneous) and less medication (stimulated and induced) than those who were not stimulated musically, with statistically significant differences (p < .01). Conclusions: Prenatal music intervention could be a useful and effective tool to reduce anxiety in full-term pregnant women during an NST and improve the delivery process by reducing the first stage of labor in nulliparous women.

The relationship between common patterns of prenatal alcohol exposure and neurodevelopment in two‐year old children

Background: Around 60% of women drink some alcohol while pregnant. There is conflicting evidence on the effect on the fetus of common patterns of prenatal alcohol exposure (PAE) e.g. low level or sporadic drinking. Guidelines recommend abstinence as the safest option, creating problems for those advising women who drink at these levels before pregnancy recognition or beyond. The Asking QUestions about Alcohol (AQUA) study aimed to accurately measure PAE and account for important cofactors, to reduce uncertainty about child outcomes. Method: Detailed data on PAE were prospectively collected in a pre-birth cohort of over 1500 mother/child dyads. There was also extensive data collection of predictors of child development at one and two-year's post-partum. A sub-group of children was followed up at two years of age with a neurodevelopmental assessment (Bayley III). Two-step multivariable regression analyses of an effect of PAE accounted for independent risk factors that related to 1) pregnancy, including sociodemographic, psychologic and lifestyle variables such as diet and supplement use, and 2) the postnatal care-giving environment, including breastfeeding and maternal psychological wellbeing. Results: Adjustment for independent risk factors ameliorated any putative associations between PAE and cognitive, language and motor development in 554 two year-old children spread evenly across six PAE groups. Conclusions: Assessing neurodevelopmental outcomes associated with PAE is strongly influenced by other modifiable and non-modifiable risk factors. Although we found no adverse neurodevelopmental outcomes at two years of age, follow-up will be necessary in these children when complex higher-level cognitive, language and motor skills are required.

Infant Massage and Quality of Early Mother-Infant Interactions: Are There Associations with Maternal Psychological Wellbeing, Marital Quality, and Social Support?

Infant massage programs have proved to be effective in enhancing post-natal development of highly risk infants, such as preterm newborns and drug or HIV exposed children. Less studies have focused on the role of infant massage in supporting the co-construction of early adult–child relationships. In line with this lack of literature, the present paper reports on a pilot study aimed at investigating longitudinally the quality of mother–child interactions, with specific reference to emotional availability (EA), in a group of mother–child pairs involved in infant massage classes. Moreover, associations between mother–child EA, maternal wellbeing, marital adjustment, and social support were also investigated, with the hypothesis to find a link between low maternal distress, high couple satisfaction and high perceived support and interactions of better quality in the dyads. The study involved 20 mothers and their children, aged between 2 and 7 months, who participated to infant massage classes. The assessment took place at three stages: at the beginning of massage course, at the end of it and at 1-month follow-up. At the first stage of assessment self-report questionnaires were administered to examine the presence of maternal psychiatric symptoms (SCL-90-R), perceived social support (MSPSS), and marital adjustment (Dyadic Adjustment Scale); dyadic interactions were observed and rated with the Emotional Availability Scales (Biringen, 2008) at each stage of data collection. The results showed a significant improvement in the quality of mother–child interactions, between the first and the last evaluation, parallel to the unfolding of the massage program, highlighting a general increase in maternal and child’s EA. The presence of maternal psychological distress resulted associated with less optimal mother–child emotional exchanges, while the hypothesis regarding couple satisfaction and social support influence were not confirmed. These preliminary results, if replicated, seem to sustain the usefulness of infant massage and the importance of focusing on early mother–infant interactions.

Does maternal psychological distress affect neurodevelopmental outcomes of preterm infants at a gestational age of ≤ 32 weeks

BackgroundThere is some evidence that maternal psychological status in the prenatal and postnatal periods is associated with infants' cognitive, behavioural, and emotional functions. AimThe aim of this study was to examine the relationships of maternal depression and anxiety with neurodevelopmental outcomes of preterm infants with a gestational age of ≤32weeks, examined at a corrected age of 18 to 22months. Study designCross-sectional study. SubjectsIn total, 220 preterm infants with a gestational age of ≤32weeks who were born from January 2008 to September 2011 and admitted to the neonatal intensive care unit were prospectively examined. Outcome measuresNeurodevelopmental evaluation was performed at a corrected age of 18 to 22months by a developmental paediatrician using the Bayley Scales of Infant Development II (BSID-II). The Beck Depression Inventory and Beck Anxiety Inventory were used to assess maternal depression and anxiety at the same visit as the neurodevelopmental evaluation. ResultsThe depression scores of mothers of infants with a Mental Development Index (MDI) score of <70 were significantly higher than those of mothers of infants with an MDI score of >70 (16.3±12.8 vs 8.8±7.0, p<0.001). The depression scores of mothers of infants with neurodevelopmental impairment were also significantly higher than those without neurodevelopmental impairment (12.8±10.5 vs 8.8±7.3, p=0.003). There was no relationship between the presence of cerebral palsy or a Psychomotor Developmental Index (PDI) score of <70 and the mothers' depression scores. Multiple regression analysis revealed that maternal depression and the occurrence of more than two sepsis attacks were associated with an MDI score of <70, and grade III to IV intraventricular haemorrhage was associated with neurodevelopmental impairment and a PDI score of <70. ConclusionMaternal depression is negatively associated with the neurodevelopment of preterm infants at a gestational age of ≤32weeks. Maternal psychological well-being should be taken into consideration during the long-term follow-up of preterm infants.

The Relationship between Job-Role Quality and Parenting Behaviors among Employed Mothers in Korea

The purpose of this study was to examine the relationship between the job-role quality of employed Korean mothers and their parenting behaviors, as well as the mediating roles of maternal parenting strain and psychological wellbeing. We analyzed the data from 172 employed Korean mothers of children of school transition age who lived in Seoul, Korea. Results from structural equation modeling indicated that better quality of mothers’ job-role experience predicted greater psychological well-being and reduced parenting strain. Better job-role quality and less parenting strain were associated with greater psychological well-being, which in turn predicted more positive parenting practices. The mediation effects of psychological well-being and parenting strain were significant. Implications and suggestions for future research on working mothers’ parenting are discussed.

Parental Divorce and Children's Schooling in Rural Malawi.

A growing body of literature has examined the impact of different types of family structures on children's schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children's schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children's schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children's schooling.

Parenting hassles mediate predictors of Chinese and Korean immigrants' psychologically controlling parenting

We examined: (1) the mediating role of parenting daily hassles in the associations between three predictors (child temperament, maternal psychological well-being, and marital quality) and psychologically controlling practices in two Asian immigrant samples. We also explored the moderating role of maternal acculturation in the path from parenting daily hassles to psychological control. Participants were 152 Chinese and 165 Korean immigrant mothers with preschool children in the U.S. Multi-group path analysis revealed that easier child temperament, higher psychological well-being, and better marital quality were each associated with fewer parenting daily hassles, which in turn were associated with less psychological control. These general mediating effects held for both groups. However, the indirect effects of child temperament, maternal psychological well-being, and marital quality through parenting daily hassles were further moderated by acculturation for Chinese immigrant mothers, but not Korean immigrant mothers. The culturally similar and different findings across the two groups were discussed.

The impact of autism services on mothers' psychological wellbeing.

Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. Mothers (n = 119) of children (mean child age 10.1 years; range 2-24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables.

Mothers' Psychological Distress and Feeding of Their Preterm Infants.

To examine the change in psychological distress of mothers of preterm infants and its association with maternal feeding behaviors as the infant transitions to full oral feeding. This descriptive exploratory study used a subset of data from a study of the effects of a coregulated feeding intervention for 34 mothers and hospitalized preterm infants in a Level-III neonatal intensive care unit (NICU). Maternal psychological distress was measured by maternal worry (Child Health Worry Scale), depression (Center for Epidemiology-Depression Scale), and role stress (Parental Stress Scale: NICU-Role Alteration) at three time points: within 1 week prior to the first oral feeding (T1), and at achievement of half (T2) and full oral feeding (T3). Feedings were videotaped at T2 and T3. An observational coding system measured maternal feeding behaviors. Linear mixed modeling evaluated the change in maternal psychological distress and its association with mothers' feeding behaviors as the infant transitioned to full oral feeding. Maternal depressive symptoms were highest at T1 and declined over time. Maternal worry and role stress were also highest at T1 but remained stable from T2 to T3. Increased maternal psychological distress, particularly depressive symptoms and role stress, were associated with less use of developmentally supportive feeding behaviors, that is, minimizing tactile stimulation, providing steady touch to contain or stabilize the infant, and regulating milk flow. Supporting maternal psychological well-being while infants are learning to feed orally may be an appropriate target for interventions to support mother-infant early feeding interactions.

사회적 지지, 어머니의 심리적 안녕감, 애착유형과 영유아의 사회정서유능성 및 문제행동 간의 구조적 관계

사회적 지지, 어머니의 심리적 안녕감, 애착유형과 영유아의 사회정서유능성 및 문제행동 간의 구조적 관계

Maternal distress and child neuroendocrine and immune regulation

RationaleNeuroendocrine-immune regulation is essential for maintaining health. Early-life adversity may cause dysregulation in the neuroendocrine-immune network through repeated activation of the stress response, thereby increasing disease risk. ObjectiveThis paper examined the extent to which maternal psychological well-being moderates neuroendocrine-immune relations in children. MethodsWe used data from a laboratory-based study of mothers and their five-year old children (n = 125 mother–child pairs) conducted from 2011 to 2013 in Baltimore, Maryland. Child saliva was assayed for markers of immune function (i.e., cytokines: interleukin [IL]-1β, IL-6, IL-8, tumor necrosis factor alpha [TNF-α]) and hypothalamic-pituitary-adrenal activity (i.e., cortisol). A composite score for depressive symptoms, anxiety, and parenting stress characterized maternal psychological distress. Multilevel mixed models examined the relationship between maternal psychological well-being and child neuroendocrine-immune relations. ResultsSignificant cytokine × maternal distress interactions indicated that as maternal distress increased, expected inverse cytokine–cortisol relations within children became weaker for IL-1β, IL-6, and TNF-α. Sex-stratified models revealed that these interactions were only significant among girls. Among boys, there were inverse cytokine–cortisol relations for all cytokines, and, while in the same direction as observed among girls, the cytokine × maternal distress interactions were non-significant. ConclusionThe findings suggest that maternal distress is associated with child neuroendocrine-immune relations in saliva and may alter the sensitivity of inflammatory immune processes to cortisol's inhibitory effects. This desensitization may place the child at risk for inflammatory diseases. The findings support efforts for the early detection and treatment of at-risk mothers to protect maternal and child health and well-being.

The development and implementation of a theory-informed, integrated mother-child intervention in rural Uganda

RationaleA randomised cluster effectiveness trial of a parenting intervention in rural Uganda found benefits to child development among children 12–36 months, relevant parenting practices related to stimulation, hygiene and diet, and prevented the worsening of mothers' depressive symptoms. An examination of underlying implementation processes allows researchers and program developers to determine whether the program was implemented as intended and highlight barriers and facilitators that may influence replication and scale-up. ObjectivesThe objectives of this study were to describe and critically examine a) perceived barriers and facilitators related to implementation processes of intervention content, training and supervision and delivery from the perspectives of delivery agents and supervisors; b) perceived barriers and facilitators related to enactment of practices from the perspective of intervention mothers participating in the parenting program; and c) whether the program was implemented as intended. MethodsSemi-structured interviews were conducted at midline with peer delivery agents (n = 12) and intervention mothers (n = 31) and at endline with supervisors (n = 4). Content analysis was used to analyze qualitative data in terms of barriers and facilitators of intervention content, training and supervision, delivery and enactment. Additionally, mothers' recall and enactment of practices were coded and analyzed statistically. Monitoring of group sessions and home visits were examined to reveal whether the program was implemented as intended. ResultsAmong the program's five key messages, ‘love and respect’ targeting maternal psychological well-being was the most practiced by mothers, easiest to implement by delivery agents, and mothers reported the most internal facilitators for this message. A detailed manual and structured monitoring forms were perceived to facilitate training, intervention delivery, and supervision. Interactive and active strategies based on social-cognitive learning theory were reported as facilitators to intervention delivery. Only program attendance, but not barriers, facilitators or message recall, was significantly positively related to message enactment. Monitoring of group sessions and home visits showed that the program was largely implemented as intended. ConclusionsThis implementation assessment revealed a number of important barriers and facilitators from the perspectives of delivery agents, supervisors and program participants. The methods and results are useful to examining and informing the content, delivery, and scaling up of the current program as well as future mother-child interventions in LMIC settings.

Effects of a midwife psycho-education intervention to reduce childbirth fear on women's birth outcomes and postpartum psychological wellbeing.

BackgroundHigh levels of childbirth fear impact birth preparation, obstetric outcomes and emotional wellbeing for around one in five women living in developed countries. Higher rates of obstetric intervention and caesarean section (CS) are experienced in fearful women. The efficacy of interventions to reduce childbirth fear is unclear, with no previous randomised controlled trials reporting birth outcomes or postnatal psychological wellbeing following a midwife led intervention.MethodBetween May 2012 and June 2013 women in their second trimester of pregnancy were recruited. Women with a fear score ≥ 66 on the Wijma Delivery Expectancy / Experience Questionnaire (W-DEQ) were randomised to receive telephone psycho-education by a midwife, or usual maternity care. A two armed non-blinded parallel (1:1) multi-site randomised controlled trial with participants allocated in blocks of ten and stratified by hospital site and parity using an electronic centralised computer service. The outcomes of the RCT on obstetric outcomes, maternal psychological well-being, parenting confidence, birth satisfaction, and future birth preference were analysed by intention to treat and reported here.Results1410 women were screened for high childbirth fear (W-DEQ ≥66). Three hundred and thirty-nine (n = 339) women were randomised (intervention n = 170; controls n = 169). One hundred and eighty-four women (54 %) returned data for final analysis at 6 weeks postpartum (intervention n = 91; controls n = 93).Compared to controls the intervention group had a clinically meaningful but not statistically significant reduction in overall caesarean section (34 % vs 42 %, p = 0.27) and emergency CS rates (18 % vs 25 %, p = 0.23). Fewer women in the intervention group preferred caesarean section for a future pregnancy (18 % vs 30 %, p = 0.04). All other obstetric variables remained similar. There were no differences in postnatal depression symptoms scores, parenting confidence, or satisfaction with maternity care between groups, but a lower incidence of flashbacks about their birth in the intervention group compared to controls (14 % vs 26 %, p = 0.05). Postnatally women who received psycho-education reported that the ‘decision aid’ helped reduce their fear (53 % vs 37 %, p = 0.02).ConclusionFollowing a brief antenatal midwife-led psycho-education intervention for childbirth fear women were less likely to experience distressing flashbacks of birth and preferred a normal birth in a future pregnancy. A reduction in overall CS rates was also found. Psycho-education for fearful women has clinical benefits for the current birth and expectations of future pregnancies.Trial registrationAustralian New Zealand Controlled Trials Registry ACTRN12612000526875, 17th May 2012

Role of Perceived Maternal Favoritism and Disfavoritism in Adult Children's Psychological Well-Being.

The detrimental consequences of parents' differential treatment on children's well-being have been documented in earlier stages of the life course; however, little is known about this pattern in midlife. Drawing from theories of equity and social comparison, we tested whether psychological well-being was affected only by adult children's perceptions that their mothers treated some offspring in the family differently or by their perceptions that they were favored or disfavored. Further, we explored the extent to which these patterns differed by race. Multilevel regression modeling was conducted using data collected from 725 adult children nested within 309 later-life families as part of the Within-Family Differences Study-II. Depressive symptoms were higher when offspring perceived that they had the most emotional closeness to mothers or the greatest conflict with mothers. Depressive symptoms were also higher when respondents identified themselves as being the children in whom the mothers were most disappointed. The findings shed new light on the role of intergenerational relations in adult children's well-being in midlife by taking into consideration the respondents' direct reports of their perceptions of their mothers' favoritism and disfavoritism. Further, the findings provide evidence that the association between maternal differentiation and psychological well-being in adulthood is stronger in Black than in White families. These patterns suggest that the association between psychological well-being and both favoritism and disfavoritism can be accounted for by processes involving social comparison rather than equity for both Black and White adult children in midlife.

The role of the health visitor in the promotion of maternal perinatal psychological wellbeing

This review and synthesis of the literature investigates how health visitors contribute to the promotion and protection of maternal perinatal psychological wellbeing. Following systematic searches nine studies were critically appraised and the findings discussed. Social support, self-efficacy and preparedness emerged as themes from the literature and were found to be protective factors that influence the transition to motherhood and, subsequently, psychological wellbeing. Health visitors promote these protective factors through provision of the universal service; therefore recognition of the ways in which such promotion is achieved can enhance practice and increase maternal resilience. Focusing on wellbeing, rather than mental illness, will ensure health visiting interventions and approaches are in keeping with the profession's principles of health promotion, prevention and early intervention.

Effects of a parenting intervention to address maternal psychological wellbeing and child development and growth in rural Uganda: a community-based, cluster randomised trial.

Parenting interventions have been implemented to improve the compromised developmental potential among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is important for child development, especially in children younger than 3 years who are vulnerable and dependent on their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that targeted both child development and maternal wellbeing in rural Uganda. In this community-based, cluster randomised trial, we assessed the effectiveness of a manualised, parenting intervention in Lira, Uganda. We selected and randomly assigned 12 parishes (1:1) to either parenting intervention or control (inclusion on a waitlist with a brief message on nutrition) groups using a computer-generated list of random numbers. Within each parish, we selected two to three eligible communities that had a parish office or a primary school in which a preschool could be established, more than 75 households with children younger than 6 years, and at least 15 socially disadvantaged families (ie, maternal education of primary school level or lower) with at least one child younger than 36 months. Participants within communities were mother-child dyads, where the child was 12-36 months of age at enrollment, and the mother had low maternal education. In the parenting intervention group, participants attended 12 fortnightly peer-led group sessions focusing on child care and maternal wellbeing. The primary outcomes were cognitive and receptive language development, as measured with the Bayley Scales of Infant Development, 3rd edn. Secondary outcomes included self-reported maternal depressive symptoms, using the Center for Epidemiologic Studies Depression Scale, and child growth. Theoretically-relevant parenting practices, including the Home Observation for Measurement of the Environment inventory, and mother-care variables, such as perceived spousal support, were also assessed as potential mediators. Baseline assessments were done in January, 2013, and endline assessments were done in November, 2013, 3 months after completion of the programme. Ethics approval was received from Mbarara and McGill universities. This trial is registered with ClinicalTrials.gov, NCT01906606. Between December, 2012, and January, 2013, 13 communities (194 dyads) were randomly assigned to receive intervention, and 12 communities (154 dyads) were assigned to a waitlist control. 319 dyads completed baseline measures (171 in the intervention group and 148 in the control group), and 291 dyads completed endline measures (160 in the intervention group and 131 in the control group). At endline, children in the intervention group had significantly higher cognitive scores (58·90 vs 55·65, effect size 0·36, 95% CI 0·12-0·59) and receptive language scores (23·86 vs 22·40, 0·27, 0·03-0·50) than did children in the control group. Mothers in the intervention group reported significantly fewer depressive symptoms (15·36 vs 18·61, -0·391, 95% CI -0·62 to -0·16) than did mothers in the control group. However, no differences were found in child growth between groups. The 12 session integrated parenting intervention delivered by non-professional community members improved child development and maternal wellbeing in rural Uganda. Because this intervention was largely managed and implemented by a local organisation, using local community members and minimal resources, such a programme has the potential to be replicated and scaled up in other low-resource, village-based settings. Plan Uganda via Plan Finland (Ministry of Foreign Affairs) and Plan Australia (Australian Aid).

Prosocial skills in young children with autism, and their mothers’ psychological well-being: Longitudinal relationships

The study aimed to explore the longitudinal association between prosocial skills in young children with an ASD and maternal psychological well-being. Participants were 132 children with autism drawn from the British Millennium Cohort Study (aged 9 months, 3 and 5 years). Three-wave cross-lagged structural equation models tested whether children's prosocial skills were reciprocally related to maternal psychological distress and life satisfaction. Findings indicated that relationships were not bidirectional, as both maternal outcomes were not associated with children's prosocial skills two years later. However, prosocial skills at 3 years were associated with improved maternal well-being (less distress and more life satisfaction) when children were 5-years-old. The study adds to the limited evidence base on bidirectional relationships between prosocial skills in ASD and proximal environmental variables. Findings highlight the importance of testing for reciprocal relationships rather than assuming unidirectional effects. In addition, they indicate that other-directed behaviors in children with autism have the potential to boost maternal well-being.

Parents' psychological well-being and parental self-efficacy in relation to the family's triadic interaction.

The aim of the study was to assess whether a parent's psychological well-being and/or self-efficacy relate to interaction within the family. This study is part of a Finnish follow-up study called Steps to the Healthy Development and Well-Being of Children (STEPS;). The study group included 120 families. Mother's and father's social anxiety and depression were assessed during pregnancy and at 18months of the child's age using self-report questionnaires; the mother's and father's self-efficacy were assessed at 18months using a parental self-efficacy scale validated within the STEPS study. Mother-father-child triadic interaction was studied at 18months within a Lausanne Triadic Play setting. Results showed that maternal symptoms of depression during pregnancy and maternal social anxiety at 18months were related to triadic interaction within the family. There was no relation between father's psychological well-being and triadic interaction within the family. Father's self-efficacy in teaching tasks and the Mother's self-efficacy in emotional support were associated with family interaction. The findings suggest that maternal psychological well-being and self-efficacy in emotional support may be important components of family triadic interaction whereas paternal self-efficacy in teaching tasks seems to support family coordination in triadic interaction.

Emotional Cost of Emotional Support? The Association Between Intensive Mothering and Psychological Well-Being in Midlife

Studies of intensive mothering suggest that fulfilling societal expectations of the “good mother” diminishes maternal psychological well-being; however, studies tend to focus on young mothers. We examine the association between intensive mothering and psychological well-being using a sample of mothers in midlife ( n = 1,388) drawn from the 2004-2006 National Survey of Midlife Development in the United States. Intensive mothering is measured as provision of high levels of emotional support to children, high degree of thought and effort put into these relationships, and reduction of paid work to provide more care. Psychological well-being is measured as depressive symptoms, self-rated mental health, and positive and negative affect. Ordinary least squares regression results are mixed: While providing high levels of emotional support predicts more depressive symptoms, worse self-rated mental health, and higher negative affect, higher investments of thought and effort predict better mental health.