Maternal Reflective Functioning Research Articles

# 125 - - Maternal reflective functioning and attachment outcomes of an online s inging intervention for postnatal depression: SHAPER-PNDO, a s ingle-arm clinical trial

Parental reflective functioning (PRF), or mentalization, is critical for offspring development. Postnatal depression (PND) may negatively impact this ability, resulting into impairments in menta liza tion and reduced attachment to the child. The aim of present work is s tudying the effectiveness of 6-weeks online s inging interventions, Melodies for Mums (M4M), in improving PRF and attachment to the child in a group of mothers suffering from PND.37 mothers were recruited. Demographic characteristics were collected at base line. At base line, week 6, and week 32 PND was evaluated with the Edinburgh Postnatal Depression Scale (EPDS); mentalization was assessed using the Parental Reflective Functioning Questionnaire (PRFQ) focusing on pre-menta lizing (PM) subsca le; maternal attachment to the child eva lua ted with the Maternal Postnatal Attachment Scale (MPAS).Participants experienced s ignifica nt reductions in depression on the EPDS (16.6 ± 3.7 to 11.2 ± 5.3, p<.001, t (36) = 7.56, p <.001), showed a reduction of PM scores on the PRFQ (2.24 ± 0.66 to 1.86 ± 0.71, (t(34)=3.889, p<0.001)), and reported improvements in attachment scores on MPAS (66.89 ± 10.11 to 73.73 ± 7.57, t(33)= -3.735, p<0.001). Overall, there was a s ignificant effect of time across the s tudy, such that a total decline in EPDS (F(4,144) = 24.48, p <.001) and PM scores (F(2,148) = 13.315 (p<0.001), and increase of attachment scores (F(2,66) = 15.785 (p<0.001).Participating in M4M online may help mothers in reduction of depressive symptoms and also improve mentalization and bonding towards their infants.

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

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. 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. 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. 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'.

Factor Structure of Parental Reflective Functioning Questionnaire for Mothers Working at Qazvin University of Medical Sciences

Background: Maternal reflective functioning refers to a mother's ability to understand the mental states of herself and her child. This capacity is related to the attachment styles of the mother and child, as well as the mentalizing capacity of the child and his/her behavioral problems. The Parental Reflective Functioning Questionnaire (PRFQ) was developed to evaluate the capacity of mothers. Objectives: This study aimed to determine the factor structure, structural validity, and psychometric properties of PRFQ in mothers working at Qazvin University of Medical Sciences. Methods: The study was a methodological one conducted by structural equation modeling to investigate the factor structure of PRFQ designed by Luyten et al. in 2017. Two samples, including 183 and 120 mothers working at Qazvin University of Medical Sciences in 2021, were selected using convenience sampling for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. For data collection, the participants completed PRFQ, Adult Attachment Inventory (AAI), Symptom Checklist-25 (SCL-25), RFQ, and Emotional Availability Self-Report (EA-SR). For data analysis, statistical methods, including EFA, CFA, and correlation analysis, were used in SPSS and AMOS software packages. Results: The Cronbach’s alpha for the total questionnaire was equal to 0.6. The exploratory factor analysis showed that PRFQ had a 3-factor structure with a shared variance of 38.03%. Item 11 loaded on all factors, and items 6 and 18 loaded on the pre-mentalization factor. The developed model was approved by removing item 11 and loading items 6 and 18 on the pre-mentalization factor in CFA (comparative fit index [CFI] = 0.93, normed fit index [NFI] = 0.82, Tucker-Lewis index [TLI] = 0.92, and root mean square error of approximation [RMSEA] = 0.05). The results also revealed that the developed questionnaire had adequate concurrent and predictive validity. Conclusions: Overall, the 3-factor structure of PRFQ for mothers showed adequate validity and reliability.

Maternal Reflective Functioning and Intergenerational Transmission of Attachment Orientations in Poland, the Netherlands, and Turkey

Maternal Reflective Functioning and Intergenerational Transmission of Attachment Orientations in Poland, the Netherlands, and Turkey

The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology

BackgroundA large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters.MethodsThirty-two family triads (fathers, mothers, and daughters) of female adolescent and young adult inpatients with AN were compared with thirty-three non-clinical family triads (N = 195). The mentalizing ability of all the participants was assessed using semi-structured interviews and coded using the Reflective Functioning Scale (RFS). Self-report questionnaires were administered to the daughters to evaluate ED symptomatology and ED related psychological traits (e.g., low self-esteem, interpersonal insecurity, emotional dysregulation).ResultsDecreased reflective functioning (RF) levels were found among mothers and fathers of patients with AN compared to their control peers. Examining the entire sample, clinical and non-clinical groups together, showed that both paternal and maternal RF were associated with the daughters' RF and each were found to have a significant and distinct contribution to the daughters' RF. Significant associations were found between lower levels of maternal and paternal RF and increased ED symptoms and ED related psychological traits. The use of a mediation model suggested a serial relationship in which low maternal and paternal RF contributes to the daughters' low RF, which in turn is associated with higher levels of psychological maladjustment, and ultimately contributes to the increased severity of ED symptoms.ConclusionsThe present results provide strong empirical support for theoretical models that suggest that deficits in parental mentalizing may represent important correlates of the presence and severity of ED symptoms in AN. Furthermore, the results highlight the relevance of fathers' mentalizing ability in the context of AN. Finally, clinical and research implications are discussed.

Examining a Complex Model Linking Maternal Reflective Functioning, Maternal Meta-Emotion Philosophies, and Child Emotion Regulation.

Parental Reflective Functioning (PRF) refers to parents' ability to understand their children's behavior in light of underlying mental states such as thoughts, desires, and intentions. This study aimed to investigate whether maternal meta-emotion philosophies (i.e., emotion coaching, emotion dismissing) mediated the relation between maternal RF and child emotion regulation (ER). Additionally, children's genders and ages were examined as moderators of the associations between maternal RF and maternal meta-emotion philosophies. The sample comprises 667 Chinese mothers of children aged 4-6 years. Mothers completed questionnaires assessing their reflective functioning, emotion coaching and dismissing, and child emotion regulation. Results indicated both a direct link between maternal RF and child emotion regulation, as well as indirect pathways mediated by emotion coaching and dismissing. A child's gender and age also moderated the relations between maternal RF and meta-emotion philosophies. Specifically, the negative association between maternal pre-mentalizing modes and emotion coaching was stronger for mothers of girls than boys; whereas the negative association between maternal certainty of mental states and emotion dismissing, as well as the positive association between maternal interest and curiosity and emotion coaching were both stronger for mothers of younger children than older children. The findings suggest that emotion coaching and dismissing mediate the relation between maternal PRF and the emotion regulation of children.

The contribution of adverse childhood experiences to postpartum maternal reflective functioning: A prospective examination of the role of maternal disintegrative responses and personal growth

BackgroundAdverse childhood experiences (ACE) may negatively impact a mother's parental reflective functioning. However, if coping with this difficulty generates personal growth, it may help her to function in a positive reflective manner with her child. ObjectiveIn a two-phase prospective study, we examined a mediation model and a moderated mediation model depicting the contribution of ACE (Phase 1), maternal disintegrative responses (intrusive thoughts and dissociative experiences; Phase 1), and personal growth (Phase 2) to maternal reflective functioning (Phase 2) as expressed in three dimensions: Pre-mentalizing Modes (PM), Certainty about Mental States (CMS), and Interest and Curiosity (IC). MethodThree hundred and eighty-five Israeli women participated in the study 16 weeks after childbirth (Phase 1) and again 6–10 months postpartum (Phase 2). FindingsThe mediation model revealed that maternal dissociative experiences fully mediated the relationship between ACE and PM, and maternal intrusive thoughts fully mediated the relationship between ACE and CMS. However, the moderated mediation model showed that these mediation relationships were dependent on the level of personal growth reported by the mother. ConclusionsThe findings highlight the vulnerability of mothers with ACE to function in a less reflective manner, as well as the effect of personal growth on their maternal functioning.

The influence of maternal reflective functioning and parenting behavior on infant development in the context of perinatal intimate partner violence: a study protocol

BackgroundIntimate partner violence (IPV) affects 25% of children under the age of five worldwide, yet the impact of perinatal IPV and its underlying mechanisms on infant development remains poorly understood. IPV indirectly affects infant development through the mother’s parenting behavior, but research on maternal neuro and cognitive processes, such as parental reflective functioning (PRF), is scarce, despite its potential as an unfolding mechanism. The objective of our study, Peri_IPV, is to examine the direct and indirect pathways linking perinatal IPV and infant development. We will analyze the direct impact of perinatal IPV on mothers’ neuro and cognitive parental reflective functioning (PRF) and parenting behavior during the postpartum period, the direct impact of perinatal IPV on infant development, and whether maternal PRF mediates the link between perinatal IPV and parenting behavior. We will also explore the mediation role of parenting behavior in the association between perinatal IPV and infant development and whether the impact of perinatal IPV on infant development occurs through the links between maternal PRF and parenting behavior. Finally, we will examine the moderation role of mother’s adult attachment in the impact of perinatal IPV on maternal neuro and cognitive PRF and parenting behavior during the postpartum period, as well as on infant development.MethodsOur study will use a multi-method, prospective design to capture different levels of PRF, parenting behavior, and infant development. Three-hundred and forty pregnant women will participate in a 4-wave longitudinal study from the 3rd trimester of pregnancy to 12 months postpartum. In the 3rd trimester and 2 months postpartum, women will report on their sociodemographic and obstetric characteristics. In all assessment waves, mothers will complete self-reported measures of IPV, cognitive PRF, and adult attachment. At 2 months postpartum, women’s neuro PRF will be monitored, and at 5 months postpartum, their parenting behavior will be assessed. The infant-mother attachment will be assessed at 12 months postpartum.DiscussionOur study’s innovative focus on maternal neuro and cognitive processes and their impact on infant development will inform evidence-based early intervention and clinical practices for vulnerable infants exposed to IPV.

Temperament and Emotional and Behavioral Problems in Children: The Moderating Role of Maternal Reflective Functioning

ABSTRACT Parental Reflective Functioning (PRF) describes parents’ capacity to reflect on their child’s and their own mental states in the context of their relationship with the child. This study investigated the moderating role of PRF in the relationship between children’s temperament and internalizing and externalizing problems among 357 Iranian mothers (M = 37.34, SD = 5.29) and their children (M = 7.26, SD = 2.96; 48.7% girls). The instruments were the Children’s Behavior Questionnaire, Parental Reflective Functioning Questionnaire, and Child Behavior Checklist. The results showed that effortful control was negatively correlated with pre-mentalizing, internalizing, and externalizing problems and positively correlated with certainty and interest and curiosity. Negative affectivity was positively associated with pre-mentalizing, internalizing, and externalizing problems. Moreover, surgency/extraversion showed a negative correlation only with internalizing problems. Findings of regression analyses revealed that pre-mentalizing moderated the relationship between effortful control and internalizing and externalizing problems, and between negative affectivity and externalizing. In addition, certainty moderated the relationship between surgency/extraversion and internalizing. However, the interest and curiosity subscale indicated no moderating effect on the relationship between children’s temperament and emotional and behavioral problems. These findings highlight the significance of the role of PRF and a child’s temperament in emotional and behavioral difficulties.

Maternal Impaired Cognition and Infant Neglect: Exploring the Independent and Combined Effects of Maternal Executive Function and Reflective Function.

Infant neglect is a common type of child maltreatment. According to the Social Information Processing theory, maternal executive function (EF) and reflective function (RF) are assumed to be important contributing factors to infant neglect. However, empirical evidence about this assumption is sparse. This was a cross-sectional study. A total of 1010 eligible women participated. The Behavior Rating Inventory of Executive Function-Adult Version, Parental Reflective Function Questionnaire, and Signs of Neglect in Infants Assessment Scale (SIGN) were used to assess maternal EF, RF, and infant neglect, respectively. Random forest was used to assess the relevant importance of maternal EF and RF. K-means clustering was used to identify the profiles of maternal EF and RF. Multivariable linear regression and generalized additive models were used to examine the independent and combined effects of maternal EF and RF on infant neglect. Each dimension of EF was linearly related to infant neglect. The associations between each dimension of RF and infant neglect were nonlinear. The inflection point for each dimension of RF was indicated. Random forest showed EF was more closely related to infant neglect. EF and RF had accumulative effects on infant neglect. Three profiles were identified. Among them, those with globally impaired EF had the highest level of infant neglect compared with those who had normal cognition or only impaired RF. Maternal EF and RF had independent and combined effects on infant neglect. Interventions with maternal EF and RF as targets are promising for reducing infant neglect.

Association between maternal reflective function and preschool children's cognitive abilities.

Children's cognitive abilities (e.g., working memory) are associated with mental health, adaptive behaviors, and academic achievement, and may be enhanced by parental reflective function (i.e., capacity to reflect on mental states, feelings, thoughts, and intentions in one's child and oneself). We evaluated associations between maternal reflective function and children's cognitive abilities alone and while controlling for parent-child attachment and interaction quality, and psychosocial (i.e., maternal depressive symptoms, adverse childhood experiences) and sociodemographic (e.g., socioeconomic status) factors. Our sample, recruited in Canada, was primarily white and included 73 mothers and their 4-5 year old preschool children. Maternal reflective function was measured with the Reflective Functioning Scale applied to the Parent Development Interview and the Parental Reflective Functioning Questionnaire. Multiple regression analyses revealed that maternal reflective function was associated with children's cognitive abilities. The Parent Development Interview rated child-reflective function was associated with children's higher verbal comprehension alone and while adjusting for covariates (e.g., parent-child interaction quality, socioeconomic status), and the Parental Reflective Functioning Questionnaire Interest and Curiosity with higher verbal comprehension while adjusting for parent-child interactions and attachment pattern. The Parental Reflective Functioning Questionnaire Certainty in Mental States was associated with higher working memory scores for children while adjusting for covariates. Full Scale IQ and Visual Spatial Index were not significantly associated with maternal reflective function. Associations were found between secure and disorganized attachment with higher verbal comprehension and lower working memory, respectively. These findings highlight the importance of high maternal reflective function to cognitive abilities in early childhood.

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures.

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.

The Structural Relationships among Maternal Reflective Function, Preschoolers' Empathy, Executive Functions, and Caring Behaviors

The purpose of this study was to explore the relationships among mothers’ reflective function, preschoolers’ empathy, executive function, caring behaviors. Subjects for this study were 498 preschoolers and their mothers. Mothers’ reflective function was assessed by the Parental Reflective Functioning Questionnaire(PRFQ). Preschoolers’ empathy was assessed by the Questionnaire of Cognitive and Affective Empathy(QCAE). Preschoolers’ executive function was assessed by the Behavioral Rating Inventory of Executive Functions-Preschool Version(BRIEF-P), and caring behaviors were assessed by the caring behaviors scale(Kim, 2015). Data were analyzed using descriptive statistics, confirmatory factor analysis(CFA), and structural equation model(SEM) with the SPSS 25.0 and AMOS 23.0 program.&lt;/br&gt;The major results of this study were as follows. First, mothers’ reflective function showed direct effects on preschoolers’ empathy, executive function, and caring behaviors. Second, the preschoolers’ empathy and executive function showed direct effects on preschoolers’ caring behaviors. Third, preschoolers’ empathy mediated the effects of mothers’ reflective function on preschoolers’ caring behaviors. The findings of this study will contribute to designing intervention programs to improve preschoolers’ empathy, executive function, and caring behaviors.

Exploring maternal reflective functioning as a predictor of mother-child dyadic behaviour over time in a clinical context.

The current study examined 20 participants from group attachment based intervention (GABI), who completed the adult attachment interviews (AAI; George, et al., 1985) as part of a RCT to test the efficacy of GABI compared with treatment as usual, in order to explore the possible benefits higher RF for treatment outcome in terms of interactive mother and child behaviour. Mothers’ AAIs were analyzed using the reflective functioning (RF) rating scale (Fonagy, et al., 1998), yielding overall RF scores, prompted/demand RF scores, and spontaneous RF scores, and parent-child dyadic interactive behaviour was coded utilizing the coding interactive behaviour (CIB: Feldman, 1998) manual. Children’s age ranged from 2-25 months, mean=14 months. 86.7% of the sample identified English as their primary language, with 13.3% identified speaking both Spanish and English. RF in AAIs obtained at intake from some GABI mothers was expected to be linked to the quality of the parent-child interaction (observed with the CIB), at intake (T1), at end-of treatment T2), and at sixmonth follow-up (T3). Results confirmed this impression insofar as lower overall RF was linked to T1 levels of higher intrusiveness from mothers. At end of treatment (T2), mothers’ higher spontaneous RF scores were significantly linked to maternal praising (of the child), child positive affect, child alertness. At 6-month follow up (T3), mother’s spontaneous RF scores correlated significantly and positively with maternal elaborating with child positive affect. Discussion focuses on the importance of assessing RF in parents entering therapy with their children as it may provide insight into what parent or child behaviours may be targeted. And the RF scores will highlight which mothers need special attention to stimulate their interest and attention to attachment-related processes in themselves, and in their children.

Psychopathological and Psychosocial Risk Profile, Styles of Interaction and Mentalization of Adolescent and Young Mother-Infant Dyads.

This study examined the psychopathological and psychosocial risk profile and the quality of mother–infant interaction in 98 adolescent and young mother–infant dyads. At their infant’s age of 3 months, mothers filled in a socio-demographic form and completed a test battery: EPDS for depression, STAY-I for anxiety, PSI-SF for parenting stress, MPSS for social support, AAI for maternal attachment and reflective functioning, CECA for adverse childhood experiences, Care-Index and Mind-mindedness coding system for mother–infant interaction. Results showed that motherhood in adolescence was associated with several psychosocial risk factors. Adolescent and young mothers have depression (25%), anxiety (29%) and insecure attachment (65%), with low reflective functioning, of whom 18% have disorganized attachment. A total of 54% of the mothers had at least one adverse childhood experience. Furthermore, adolescent mothers had low sensitivity and mind-mindedness and high intrusiveness, and their infant had low responsiveness and high passive behaviors. Mothers under 18 have experienced more sexual abuse, are more likely to be single and have been followed by child social services more than mothers aged 18–21. Adolescent mothers have a high-risk psychopathological and psychosocial profile that affects their ability to mentalize and build an adequate relationship with the child. It appears to be important to support the adolescent mother–child relationship.

Maternal mentalization and child emotion regulation: A comparison of different phases of early childhood

Parental reflective functioning refers to the parents' ability to reflect on the internal mental states of their children, which will make them respond more sensitively to their children´s need. The relation between parental reflective functioning and child emotion regulation has been considered a key factor in early childhood parenting but further research is needed about this relationship throughout child's development. The aim of this paper was to analyze this interaction considering the early childhood development stages. Three hundred and eighty one mothers of babies between 0 and 26 months of age participated in the study. The PRFQ and ASQ:SE-2 questionnaires were administered to assess parental reflective functioning and child emotion regulation, respectively. Results showed that maternal RF and child emotion regulation do not follow a linear process according to the childhood development stages, and also that the maternal PM dimension generates a conditional effect in children's emotion regulation. These results highlight the importance of paying attention to specific early childhood developmental stages to understand how maternal reflective functioning influences child´s ability to calm and adjust to her/his environment.

Maternal caregiving representations of the infant in the first year of life: Associations with prenatal and concurrent reflective functioning.

Few studies have examined whether maternal caregiving representations are associated with maternal reflective functioning (MRF), especially when MRF is evaluated longitudinally beginning in pregnancy. This study addresses this gap by evaluating whether prenatal and postnatal MRF are associated with mothers' caregiving representations assessed at 7 months postpartum, and by exploring theoretically unexpected MRF scores in each of the representational categories. Forty-seven mothers were recruited during their last trimester of pregnancy from an obstetrics clinic at a university hospital located in a large mid-western city in the United States. During pregnancy, mothers completed the Pregnancy Interview, and at 7 months postpartum they completed the Parent Development Interview (PDI) and the Working Model of the Child Interview. Results indicate that higher prenatal and postnatal MRF increased the odds of being classified as balanced versus disengaged. At 7 months, MRF also increased the odds of being balanced vs. distorted. Ten mothers who were classified as balanced or distorted had unexpected prenatal MRF scores, and six mothers had unexpected MRF scores when representations were assessed concurrently. Mothers classified as balanced with low MRF scores tended to have a low level of education, whereas mothers classified as distorted with high MRF scores had responses that were hostile, helpless, and role-reversed.

Maternal Reflective Functioning and Attachment Security in Girls and Boys: A Closer Look into the Middle Childhood.

Child attachment undergoes major changes during middle childhood. Maternal reflective functioning (RF) is hypothesized to be an important correlate of a child’s attachment security during this period; however, the child’s gender role in this association has not been examined yet. In the present study, we used 64 mother-child (6–11 years old) dyads from a community sample to analyze the association between maternal RF and child attachment security and whether this link is moderated by gender. Maternal RF was assessed on the Parent Development Interview Revised (PDI-R2) and child attachment classifications were examined by the Child Attachment Interview (CAI). Results revealed the positive and statistically significant association between maternal RF and child attachment security in the whole sample. Further evaluations of this link in the groups of girls and boys separately indicated its significance for girls only. Finally, moderation analysis demonstrated the relation between child attachment security and maternal RF to be moderated by gender. These findings provide a new knowledge on gender role in attachment security in relation to maternal RF as well as suggest possible differentiation in the correlates on the pathway of secure attachment between girls and boys during middle childhood.

Maternal Psychological Distress and Children's Internalizing/Externalizing Problems during the COVID-19 Pandemic: The Moderating Role Played by Hypermentalization.

In order to explore the psychological impact of the COVID-19 outbreak on the caregiver–child relationship, we investigated the interplay among COVID-19 exposure and children’s internalizing/externalizing problems during the Italian lockdown, hypothesizing a mediation effect played by maternal distress. Additionally, we included maternal reflective functioning (i.e., hypermentalization) as a moderator factor among this interplay. A total of 305 Italian mothers of children aged 6–13 years (M = 10.3; SD = 2.4) filled in an online survey. Findings revealed an indirect effect of maternal COVID-19 exposure on children’s anxious/depressed (k2 = 0.46) and attention problems (k2 = 0.32) via maternal distress. Hypermentalization moderated the impact of maternal COVID-19 exposure on children’s anxious/depressed problems (β = −1.08, p = 0.04). Hypermentalization moderated both the relation between maternal distress and children’s aggressive behaviors (β = 12.226; p < 0.001) and between maternal distress and children’s attention problems (β = 5.617, p < 0.001). We found pivotal significant effects of maternal hypermentalization on children’s anxious/depressed and attention problems, indicating that the higher the mother’s hypermentalization was, the higher the children’s problems were. Our results broaden what we knew on the role of maternal reflective and emotional functioning on children’s emotional/behavioral adjustment during stressful situations.

The ATTACH™ program and immune cell gene expression profiles in mothers and children: A pilot randomized controlled trial

BackgroundChildren exposed to adversity and toxic stress are at increased risk for poor health across the lifespan, possibly through alterations to immune pathways. Parenting interventions could buffer the effect of adversity on child immune activity. The purpose of this study was to test whether mothers and children who were randomly assigned to a parenting intervention (ATTACH™) had healthier post-intervention immune cell gene expression patterns, as indexed by the Conserved Transcriptional Response to Adversity (CTRA), compared with mothers and children in a wait-list control group. MethodsA sample of 20 mother-child dyads were recruited from a domestic violence shelter in Calgary, AB, Canada. The ATTACH™ program is a 10-week psycho-educational intervention that fosters maternal reflective function, i.e. how to understand and respond to mental states. Dyads were randomly assigned to an intervention or wait-list group. Dried blood spots were collected from both groups post-intervention, subjected to RNA sequencing, and assessed for CTRA gene expression using mixed effect linear model analysis. Covariates were age, child sex, maternal race/ethnicity, and maternal medication use. ResultsIn unadjusted models, differences by treatment group were detected, F(1,1794) ​= ​4.26, p ​= ​.039. Mothers and children who completed the ATTACH™ intervention had lower CTRA scores, indicating healthier immune cell gene expression profiles (Mn ​= ​−0.36, SE ​= ​0.17), compared with mothers and children in the wait-list control group (Mn ​= ​0.11, SE ​= ​0.15). Results persisted after controlling for covariates. DiscussionATTACH™ participation predicted healthier immune cell gene expression profiles post-intervention compared with wait-list controls. Parenting interventions could decrease the impact of toxic stress on maternal-child immune health.