Paternal Mental Health Problems Research Articles

Dyadic associations and prediction of maternal and paternal sexual satisfaction in couples–Findings from an 18-year longitudinal study

Background: Sexual satisfaction is one of many crucial factors for the long-term success of romantic relationships. Longitudinal studies examining the dyadic associations between maternal and paternal factors in middle adulthood for predicting sexual satisfaction in later adulthood are scarce. MethodThe German longitudinal intervention study "Future Family” followed families with at least one child over 18-years (Pre: N = 477, mothers: M = 35.2 years, fathers: M = 38.8 years, children: M = 4.1 years). At the time of the 18-year follow-up, N = 150 mothers (M = 54.1 years) were still living together with the biological fathers (M = 56.1 years; mean relationship duration: 32 years). Dyadic associations between individual and dyadic factors at Pre were analyzed with Actor-Partner Interdependence models to predict sexual satisfaction 18 years later. ResultsHigher relationship quality was significantly associated with higher levels of one's own sexual satisfaction 18 years later. Higher levels of maternal and paternal mental health problems were linked to lower levels of sexual satisfaction in both the individual themselves and their partner. General life satisfaction of mothers and fathers only predicted their own sexual satisfaction. The model for dysfunctional parenting yielded no significant effects. ConclusionsThe results indicate that relationship quality, mental health problems, and general life satisfaction of both parents could be starting points for preventive and therapeutic interventions to achieve long-term effects in sexual satisfaction in married couples.

Fathers’ mental health and coping strategies: a qualitative study in Mwanza, Tanzania

ObjectivesTo investigate the nature of paternal mental health problems, their causes and the coping strategies used by fathers of young children under the age of 2 years.Design and settingWe conducted...

Symptoms of depression and internalizing problems in early adulthood – associated factors from birth to adolescence

Purpose Even though the mechanisms behind the development of depression and internalizing problems remains unknown, many different factors have been shown to increase the risk. Longitudinal studies enable the investigation of exposure during different developmental periods during childhood. This study aims to examine factors associated with depressive and internalizing problems at age 20 in terms of sociodemographic factors, previous mental health problems and stressful life events during childhood, adolescence, and early adulthood. Methods A birth cohort of 1723 children were followed to age 20. At the 20-year follow-up, n = 731 (44%) participated. Standardized instruments were filled out at baseline and the 3-,12- and 20-year follow-ups. Results Depressive problems at age 20 were associated with female gender, experience of interpersonal life events reported at age 20, bullying victimization and reports on paternal mental health problems. Participants with depressive problems were also less likely to have experienced adolescence as happy and to report that their father had been a good father. Internalizing problems at age 20 were, in addition, associated with internalizing problems at age 12 and reports on maternal mental health problems. Internalizing problems were associated with a lower likelihood of experiencing adolescence as happy in the final model. Conclusion Recent events (i.e. interpersonal life events and bullying) seemed to be the most influential factors on the development of internalizing and depressive problems. Internalizing problems during childhood increased the risk for internalizing problems in early adulthood, emphasizing the importance of early intervention. Fewer factors were found to increase the risk for depressive problems compared to internalizing problems.

Association of Paternal Workplace and Community Social Capital With Paternal Postnatal Depression and Anxiety: A Prospective Study.

ObjectiveThe aim of this study is to examine the association between workplace and community social capital and fathers' postpartum depression and anxiety at 3 months after delivery in Japan.MethodsFathers who had babies delivered in two obstetric clinics in Tokyo, Japan were recruited to take part in the study (response rate = 76.2%). Participants completed questionnaires measuring workplace and community social capital, depression, and anxiety at 1 week and a follow-up at 3 months post-delivery (N = 398). Multiple linear regression analyses were performed with multiple imputation for missing data (at most, N = 60, 15.1%).ResultsCommunity social capital was inversely associated with both depressive symptoms (β = −0.21, 95%CI = −0.33 to −0.08) and anxiety (β = −0.38, 95%CI = −0.66 to −0.11) at 3 months, after adjusting for covariates. No association was found between workplace social capital and depressive symptoms and anxiety.ConclusionPaternal community social capital, but not workplace social capital, was shown to be a preventive factor for paternal depression and anxiety up to 3 months post-delivery. To prevent paternal mental health problems during the postpartum period, an intervention to promote paternal community, rather than workplace, social capital may be warranted.

Anxiety among fathers in the postnatal period: Links to depression, attachment insecurity and emotion regulation

Background: Recent research has established postnatal anxiety as a common mental health problem among fathers, yet our knowledge regarding its underlying mechanisms is limited. The aim of the present study was to assess postnatal anxiety symptoms in fathers, to investigate comorbidity with postnatal depressive symptoms, and to examine the unique and shared contribution of attachment and emotion regulation as potential underlying mechanisms of postnatal anxiety, as compared to postnatal depression. Methods: A community sample of fathers (N=186) of infants 1–18 months were assessed with the Perinatal Anxiety Screening Scale (PASS), the Edinburgh Gotland Depression Scale (EGDS), the Attachment Style Questionnaire (ASQ-SF), and the Emotion Regulation Questionnaire (ERQ). Assessment was based on self-reports. Results: Over 30% of fathers reported high levels of postnatal anxiety, and a majority reported in addition burdening depressive symptoms. The strongest unique predictor for both outcomes was attachment anxiety, also after controlling for previous paternal mental health problems, and concurrent maternal depression. Emotion regulation strategy did not predict postnatal anxiety, but cognitive reappraisal predicted depressive symptoms negatively. For both anxiety and depression, the severity of symptoms in the one condition uniquely explained variance in the other condition. Limitations: The use of self-report measures does not allow clinical diagnosis. The unavoidable self-selected bias in recruitment posits limits to generalization. Conclusion: Despite high comorbidity between the two mental health outcomes, predictors of postnatal anxiety differ from those of postnatal depression in fathers, suggesting different underlying mechanisms and a need for distinct treatment approaches.

The impact of parental mental health problems on the educational outcomes of their offspring: Findings from the Raine Study.

There is limited evidence on the impact of parental mental health problems on offspring's educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring. We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring's self-reported education attainment-not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver's reports of offspring's academic performance at age 17. A total of 1033, 1307 and 1364 parent-offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring's academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment. Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.

Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study

Epidemiological studies indicate that children of parents with mental health problems are at an increased risk of developing anxiety disorders. Few studies have investigated this relationship in young adults. Participants were from the Raine Study, which is a multi-generational birth cohort study in Australia. Maternal anxiety and depression in late childhood were assessed using the Depression, Anxiety, and Stress Scale (DASS-42), and paternal lifetime mental health problems were assessed using a self-reported questionnaire. The short form of DASS-42 (DASS-21) was used to assess anxiety symptoms among offspring at age 20. Negative binomial regression model was used to quantify the association. Data were available for 1,220 mother-offspring and 1,190 father-offspring pairs. After adjusting for potential confounders, we found an increased risk of anxiety in young adult offspring exposed to maternal anxiety in late childhood and paternal lifetime mental health problems. However, we observed no increased risks of anxiety in offspring exposed to maternal depressive symptoms. Our sensitivity analysis based on the log-binomial model (binary outcome) as well as the linear model (log-transformed data) confirmed the robustness of the main results. Our findings suggest there can be value to consider and apply targeted screening and intervention programs of anxiety in the young adult offspring with parental mental health problems.

Maternal and paternal mental health problems and the risk of offspring depression in late adolescence: findings from the Raine study

Background There are limited studies on the risk of depressive symptoms in adolescent offspring exposed to parental mental health problems in middle childhood. Aim We investigated the association between parental mental health problems, particularly paternal emotional problems and maternal symptoms of anxiety and depression, and the risk of depressive symptoms in adolescent offspring aged 17. Methods The study included 995 parent-offspring pairs from the 1989–91 birth cohort (the Raine Study) in Western Australia. Log-binomial regression was used to assess the associations. Results An increased risk of depression symptoms was observed in the adolescent offspring of mothers with depressive [RR 1.45, 95% CI 1.13–1.86] as well as anxiety symptoms [RR 1.43, 95% CI 1.09–1.87].Compared to those non-exposed, offspring whose mothers reported comorbid anxiety and depressive symptoms were more likely to have developed depressive symptoms by late adolescence [RR 1.63, 95%CI 1.11–2.38]. An increased risk of depressive symptoms was also seen in the offspring of fathers with emotional problems [RR 1.29, 95%CI 1.01–1.53]. Conclusion Our findings suggest an increased risk of depressive symptoms in the adolescent offspring of parents with mental health problems, specifically paternal emotional problems (29%) and maternal anxiety (43%), depression (45%), as well as comorbid anxiety and depressive symptoms (63%).

Adverse childhood experiences and early life inflammation in the Avon longitudinal study of parents and children

BackgroundAdverse childhood experiences (ACEs) have been associated with poorer health across the life course. Previous studies have used cumulative risk scores (ACE scores) or individual ACEs but these two approaches have important shortcomings. ACE scores assume that each adversity is equally important for the outcome of interest and the single adversity approach assumes that ACEs do not co-occur. Latent class analysis (LCA) is an alternative approach to operationalising ACEs data, identifying groups of people co-reporting similar ACEs. Here we apply these three approaches for ACEs operationalisation with inflammation in childhood with the aim of identifying particular ACEs or ACE combinations that are particularly associated with higher inflammation in early life. MethodsUsing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) we compare ACE scores, single adversities and LCA-derived ACE clusters in their relationships with Interleukin-6 at age 9 (n = 4935) and C-Reactive Protein (CRP) at age 9 (n = 4887). ACEs included were parental separation/divorce, parental alcohol problems, parental mental health problems, parental offending, inter-parental violence, parental drug misuse, and physical, emotional and sexual abuse. ResultsTwo thirds of the sample reported at least one ACE. Mother’s mental health problems was the most frequently reported ACE (32.3 %). LCA identified four ACE classes – ‘Low ACEs’ (81.1 %), ‘Maternal mental health problems’ (10.3 %), ‘Maternal mental health problems and physical abuse’ (6.3 %) and ‘Parental conflict, mental health problems and emotional abuse’ (2.4 %). Parental separation/divorce was associated with higher IL-6. Parental alcohol problems, paternal mental health problems, parental convictions and emotional abuse were associated with lower levels of IL-6. Associations for paternal mental health problems and emotional abuse were only observed for boys. ACE score and LCA-derived ACE classes were not associated with differences in IL-6. Girls in the ‘Maternal mental health problems’ cluster had lower CRP levels. ConclusionsSpecific adversities and adversity combinations are important for differences in childhood inflammation. Some associations were only observed for girls or boys.

Fathers of Children With Congenital Heart Disease: Sources of Stress and Opportunities for Intervention.

To examine sources of stress for fathers of children with congenital heart disease and opportunities for intervention to prevent or reduce paternal mental health problems. Qualitative study using online crowdsourcing, an innovative research methodology to create an online community to serve as a research sample. Yammer, an online social networking site. Geographically diverse sample of 70 parents (25 fathers and 45 mothers) of young children with congenital heart disease. Participants joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process, and themes regarding sources of stress for fathers of children with congenital heart disease and opportunities for intervention were identified. Four broad themes regarding sources of stress for fathers of children with congenital heart disease emerged from the qualitative data from both mothers and fathers: societal expectations for fatherhood and standards of masculinity, balancing work and family responsibilities, feeling overlooked as a partner in care, and lack of father supports. To begin to address these sources of stress, participants recommended that care teams acknowledge and normalize the impact of congenital heart disease on fathers, provide support for balancing work and family responsibilities, recognize and promote father knowledge and engagement, and provide formal and informal supports for fathers of children with congential heart disease. Fathers of children with congenital heart disease experience unique sources of stress in the absence of targeted interventions to meet their needs. Care teams play an important role in acknowledging the experiences of fathers and including and engaging fathers in care.

Traumatic Birth and Paternal Mental Health Problems; A Systematic Literature Review

Traumatic birth is a complicated concept. It is a term used to describe experiences of and negative psychological responses to childbirth. There is controversy in the literature over what constitutes birth trauma. The American Psychiatric Association (APA) (2013) defines it as childbirth-related post-traumatic stress disorder (PTSD). This definition pertains more to the evaluation of the event and the individual’s reactions to it, than to the event itself. Conversely, the medical definition of traumatic birth is widely used in literature and relates to operative births – focusing solely on the birth itself (Greenfield et al 2016). The National Health Service (NHS) (2010) notes that postnatal depression (PND) is only clinically defined for women. This fact, combined with a scarcity of literature on fathers’ mental health post-birth, warrants a review such as this. The National Childbirth Trust (NCT) (2017) reports that one in three new fathers suffers from PND. Symptoms of paternal PND are varied and can range in severity from low mood to PTSD. Schumacher et al (2008) describe how PND in men can often lead to drug and alcohol abuse. There appears to be an abundance of literature that supports the theory that paternal PND is not a rare phenomenon. This literature review explores the possible correlation between paternal depression and exposure to traumatic birth.

Perspectives on supporting fathers affected by postnatal depression and a history of violence

Intimate partner violence in the perinatal period is a significant problem that remains underscreened, underdiagnosed and undertreated. The establishment of evidence-based guidelines to enable health visitors to identify couples experiencing violence and offer appropriate support has been hampered by the complex interplay between maternal and paternal mental health problems and violence. This study explored the experiences of UK fathers who voluntarily engaged with services designed to eliminate their ideation to violence. The findings indicate that the tendency to violence is increased by stresses associated with the transition to parenthood. Men felt pressured by concerns for their partner's mental health, changes in the relationship, sleep disturbances and the burden of infant care they assumed when the mother was unable to cope. Health visitors are ideally placed to assess for factors linked to the emergence of violence and put in place interventions to minimise occurrence.

Fathers\u2019 views and experiences of their own mental health during pregnancy and the first postnatal year: a qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort

BackgroundThe prevalence of fathers’ depression and anxiety in the perinatal period (i.e. from conception to 1 year after birth) is approximately 5–10%, and 5–15%, respectively; their children face increased risk of adverse emotional and behavioural outcomes, independent of maternal mental health. Critically, fathers can be protective against the development of maternal perinatal mental health problems and their effects on child outcomes. Preventing and treating paternal mental health problems and promoting paternal psychological wellbeing may therefore benefit the family as a whole. This study examined fathers’ views and direct experiences of paternal perinatal mental health.MethodsMen in the Born and Bred in Yorkshire (BaBY) epidemiological prospective cohort who met eligibility criteria (baby born <12 months; completed Mental Health and Wellbeing [MHWB] questionnaires) were invited to participate. Those expressing interest (n = 42) were purposively sampled to ensure diversity of MHWB scores. In-depth interviews were conducted at 5–10 months postpartum with 19 men aged 25–44 years. The majority were first-time fathers and UK born; all lived with their partner. Data were analysed using thematic analysis.ResultsFour themes were identified: ‘legitimacy of paternal stress and entitlement to health professionals’ support’, ‘protecting the partnership’, ‘navigating fatherhood’, and, ‘diversity of men’s support networks’. Men largely described their ‘stress’ with reference to exhaustion, poor concentration and irritability. Despite feeling excluded by maternity services, fathers questioned their entitlement to support, noting that services are pressured and ‘should’ be focused on mothers. Men emphasised the need to support their partner and protect their partnership as central to the successfully navigation of fatherhood; they used existing support networks where available but noted the paucity of tailored support for fathers.ConclusionsFathers experience psychological distress in the perinatal period but question the legitimacy of their experiences. Men may thus be reluctant to express their support needs or seek help amid concerns that to do so would detract from their partner’s needs. Resources are needed that are tailored to men, framed around fatherhood, rather than mental health or mental illness, and align men’s self-care with their role as supporter and protector. Further research is needed to inform how best to identify and manage both parents’ mental health needs and promote their psychological wellbeing, in the context of achievable models of service delivery.

Survey on examining prevalence of paternal anxiety and its risk factors in perinatal period in Hong Kong: a longitudinal study.

BackgroundThere is emerging evidence of the significance of paternal mental health problems among the expectant fathers during the antenatal and postnatal period. The present study aims at determining the prevalence of paternal perinatal anxiety and identifying its risk factors among the fathers.MethodsA total of 622 expectant fathers were recruited in Hong Kong. The expectant fathers were assessed using standardized and validated psychological instruments on three time points including early pregnancy, late pregnancy and 6 week postnatal. Independent samples t-test, one way ANOVA, Pearson’s correlation and multiple linear regression were used to examine the effect of hypothesized risk factors. Hierarchical multiple regression and mixed effect model were also conducted with potential confounding factors controlled for.ResultsResults showed that a significant proportion of expectant fathers experienced anxiety during the perinatal period. Low self-esteem and poor social support were found to be risk factors of paternal anxiety across pregnancy to postnatal period. Work-family conflict could significantly predict paternal anxiety in the pregnancy period.ConclusionsThe present study points to the need for greater research and clinical attention to paternal anxiety, given that it is a highly prevalent problem and could be detrimental to their partner’s well-being and children development. The present findings contributes to the theoretical understanding of the prevalence and risk factors of paternal perinatal anxiety and have implications for the design of effective identification, prevention, and interventions of these clinical problems.

Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio‐Emotional and Behavioural Problems at School Entry

Research on the effect of paternal mental health problems, particularly on young children, is based predominantly on clinical levels of depression. Furthermore, potential mediators such as marital discord have often been overlooked. This longitudinal community study assessed the association between paternal mental health symptoms in a community sample (N = 705) assessed at 3 months postnatally (Edinburgh Postnatal Depression Scale) and 36 months (General Health Questionnaire) and children's socio‐emotional and behavioural problems at 51 months (Strengths and Difficulties Questionnaire) as reported by mother, father and teacher. Controlling for socioeconomic status and maternal mental health symptoms at 3 and 36 months, paternal postnatal depressive symptoms predicted more father‐reported child problems at 51 months but, in contrast to previous findings, not mother‐reported problems. Paternal mental health symptoms at 36 months predicted both maternal and paternal reports of child problems at 51 months controlling for both paternal and maternal postnatal symptoms. Paternal mental health symptoms at 3 and 36 months were not significant predictors of teacher‐reported child problems. Postnatal marital discord and paternal mental health problems at 36 months both mediated the relationship between paternal postnatal symptoms and later child emotional and behavioural problems. Child gender did not moderate the relationship. Implications for interventions are discussed. Copyright © 2013 John Wiley &amp; Sons, Ltd.

Paternal Depressive Symptoms and Child Behavioral or Emotional Problems in the United States

The negative effects of maternal mental health problems on child health are well documented. In contrast, there is a profound paucity of information about paternal mental health's association with child health. To investigate the association of paternal mental health problems and depressive symptoms and children's emotional or behavioral problems. We analyzed Medical Expenditure Panel Survey data, which included a representative sample of US children (N = 21 993) aged 5 to 17 years and their mothers and fathers. The main outcome measure was child emotional or behavioral problems assessed by using the Columbia Impairment Scale. Paternal depressive symptoms, as assessed using the Patient Health Questionnaire-2, and mental health problems, more generally, assessed by using the Short-Form 12 Scale, were independently associated with increased rates of child emotional or behavioral problems even after controlling for numerous potential confounders including maternal depressive symptoms and other mental health problems. The adjusted odds ratio (aOR) for emotional or behavioral problems among children of fathers with depressive symptoms was 1.72 (95% confidence interval [CI]: 1.33-2.23) and the aOR associated with abnormal paternal scores on the mental component scale of the Short-Form 12 was 1.33 (95% CI: 1.10-1.62) for those within 1 SD below average and 1.48 (95% CI: 1.20-1.84) for those >1 SD below average. To the best of our knowledge, this is the first study to use a representative US sample to demonstrate that living with fathers with depressive symptoms and other mental health problems is independently associated with increased rates of emotional or behavioral problems of children.

Childhood adversities as risk factors for adult mental disorders

The sex-specific role of stressful or traumatic childhood experiences and adverse circumstances in developing adulthood mental disorders is complex and still in need of comprehensive research. Within the Health 2000 project in Finland, a representative sample of 4,076 subjects aged 30-64 years were investigated to examine associations between a set of retrospectively self-reported adverse environmental factors during childhood (0-16 years) and mental disorders diagnosed in the past 12 months by the Munich Composite International Diagnostic Interview. Of the 60% of adults reporting at least one childhood adversity, 17% had a current (past 12 months) mental disorder, compared to 10% of the non-reporters. A moderate dose-response relationship between the total number of adversities and current disorders was observed. Paternal mental health problems associated particularly strongly with male depressive disorders (OR 4.46), and maternal mental health problems with female depressive disorders (OR 3.20). Although seldom reported, maternal alcohol problems associated with alcohol use disorders in both sexes. Being bullied at school and childhood family discord predicted a variety of adulthood disorders in both sexes. All these four adversity items were more typical for depressive disorders with an earlier onset. Among females, more adversities were associated with mental disorders and their statistical significance was greater than among males. There are marked sex differences and several diagnosis-related patterns in the associations between reported childhood experiences and environmental circumstances and adulthood mental disorders. The impact of adversities is probably composed of a wide range of factors from direct causal associations to complex, interacting environmental effects. Variations in the reported associations reflect the differing genetic and environmental transmission mechanisms of mental disorders.