Positive Mother-child Interactions Research Articles

Oxytocin as a Biomarker of Differential Effects to SPACE vs. CBT Treatment of Child Anxiety Disorders

ABSTRACT Objective Two lines of research, on outcome moderators and on novel treatment targets, seek to improve the overall efficacy of child anxiety treatment, with mixed results. We propose that an integration of both lines of research can lead to improved treatment efficacy. In a first proof of concept of this approach, we studied whether the interaction between baseline levels and targeted changes in peripheral oxytocin (OT) can predict differential responses to two childhood anxiety treatments. Method A total of 124 mother-child dyads participated in the study. Children’s salivary OT levels were measured at baseline and again, immediately after an experimental dyadic interaction in the lab. Dyads were subsequently randomized to receive one of two treatments, differing in their targets: SPACE (Supportive Parenting for Anxious Childhood Emotions) and CBT (cognitive-behavioral therapy). Treatment outcomes were assessed using the Childhood Anxiety Related Emotional Disorders scale, reported by both mother and child. Results The findings suggest that in SPACE, where the mother is the main agent of change, higher baseline levels of child OT, coupled with increases in OT following a positive mother-child interaction, predicted greater treatment efficacy. By contrast, in CBT, where the child is the main agent of change, higher baseline levels of child OT, coupled with a decrease in OT following the interaction, predicted greater treatment efficacy. Conclusions The findings highlight the importance of the integration between moderators and targets of treatments for progress toward improving treatment efficacy through precision medicine.

Length of Maternity Leave Impact on Mental and Physical Health of Mothers and Infants, a Systematic Review and Meta-analysis.

Recent legislative decisions in the United States have encouraged discussion about national parental leave programs. Currently, over 47% of the United States workforce is female. However, the United States is the only nation of the 37 member countries in the Organization for Economic Co-Operation and Development (OECD) to have no national requirement for maternity leave. The first few months of a child's life are vital to their physical and mental development. Likewise, a gradual return to pre-partum functioning is important for a newly postpartum woman. While it has been shown that maternity leave positively impacts various measures of maternal and infant mental and physical health, we lack consensus on the optimal length of paid or unpaid maternity leave. Accordingly, we conducted a systematic review and meta-analysis to evaluate the optimal length of paid or unpaid maternity leave to encourage maternal and infant mental and physical health in the United States. A systematic review and meta-analysis were conducted to synthesize and critically evaluate the current research investigating the association between maternity leave and maternal and infant mental and physical health using the Preferred Reporting in Systematic Reviews and Meta-Analyses guidelines. Databases EMBASE, PsycInfo, and PubMed were searched using specific inclusion and exclusion criteria. Methodological Index for Non-Randomized Studies scale assessed the methodological quality of the included eligible studies. The magnitude of heterogeneity between-study was tested using The Cochrane χ2 test and the Moran's I2 statistic. Possible publication bias was assessed through the funnel plot and the Egger regression test. A p-value of < 0.10 will be considered as an indication for the existence of potential publication bias. All statistical analyses were carried out with Stata software version 15. A total of 21 studies were analyzed. It was found that longer maternity leave may decrease rates of maternal mental and physical health complaints. It was also found that longer maternity leave leads to more positive mother-child interactions, decreased infant mortality, and longer periods of breastfeeding. Maternity leave of 12weeks or more confers the greatest benefit for mothers and their infants.

Intrinsic brain activity associated with eye gaze during mother\u2013child interaction

Mother–child interactions impact child social development and psychological health. This study focused on eye-gaze interactions, especially eye contact as synchronized gaze, which is an important non-verbal communication tool in human interactions. We performed brain-image analysis of mothers and children using resting-state functional magnetic resonance imaging and quantitatively evaluated the quality of mother–child interactions using the Interaction Rating Scale to investigate how it is related to the frequency of mother–child eye contact. As a result, we found a positive correlation between the frequency of eye gaze and the right anterior insula (AI) or middle frontal gyrus in children and a positive correlation with the anterior cingulate cortex (ACC) and precuneus/cuneus in mothers.Especially, when eye contact was made, the association with the right AI in children and ACC in mothers was retained, suggesting the involvement of the salience network responsible for modulating internal and external cognition. In addition, the frequency of eye contact was positively associated with the quality of mother–child interaction. These results suggest that the salience network is a major candidate for the neural basis involved in maintaining efficient eye contact and that it plays an important role in establishing positive mother–child interactions.

The "EA brief": A single session of parent feedback and coaching to improve emotional attachment and emotional availability (EA).

The goal of this study was to determine the extent to which a brief parenting intervention provided the context for helping families to support positive mother-child interactions as well as more optimal mother and child outcomes. Participants in this study were middle income mothers and their children were between 0-3 years of age (N=25 dyads). Participants were filmed via Skype during a 20-minute mother-child free play and completed questionnaires (Time 1) before attending the brief intervention (involving: a single session of one-on-one parent feedback and coaching, and information via group meeting, texts, and reading) followed by a repeat of the 20-minute Skype interaction and the completion of the same questionnaires (Time 2). Paired samples t-tests were performed, revealing that mothers reported improvements in their personal well-being (using the Flourishing Scale), reports about the mother-child relationship (using the Emotional Availability Self Report), and observed interactions, particularly the child's side of the relationship (using the Emotional Availability System), from pretest to posttest. Results are discussed in terms of a single session of parent feedback and coaching (in conjunction with an informational group session and texts) potentially having a role in "planting a seed" for observed and self-reported parenting enhancement and child development.

Maternal perceptions of father involvement among refugee and disadvantaged families in Beirut, Lebanon.

The role of fathers in (co-)parenting their children among refugee and disadvantaged families in low and middle-income countries (LMICs) remains poorly understood. This study sought to examine the associations among mothers' perceptions of their husband's involvement (hereafter referred to as paternal involvement), and her perceptions of her own well-being and a number of other variables, as well as observed mother-child interactions in families living in refugee and disadvantaged communities in Beirut, Lebanon. We analyzed baseline data from 104 mother-child dyads (mean age of children = 4.34 years; range = 2.05 to 7.93 years of age) who participated in a randomized controlled trial aimed at evaluating the impact of the Mother-Child Education Program in Beirut. In addition to the mother's perception of paternal involvement and the videotaped mother-child interactions, data were collected concerning the mother's well-being and her level of social support, as well as her level of stress as a parent and the way her children were disciplined in the family. Mother-child pairs were videotaped while completing a puzzle together and dyadic interactions were coded. Path analysis showed that paternal involvement was significantly associated with a higher level of maternal well-being and lower distress levels. In addition, higher levels of maternal distress were associated with higher levels of harsh discipline and parenting stress. Correlation analysis showed that higher perceptions of paternal involvement were associated with more positive affect displayed by the child, more positive regard for the child, and better mother-child synchrony during the dyadic interactions. Limitations include the cross-sectional design and the modest sample size, which hinder causal inferences and generalizability of the findings. These preliminary findings suggest that higher levels of paternal involvement may have an impact on markers of maternal mental health and positive mother-child interactions in families living in disadvantaged communities or humanitarian settings. Paternal involvement should be considered when designing and implementing parenting programs in LMICs.

The Enduring Effects of Mother-Child Interactions on Episodic Memory in Adulthood.

To examine the enduring effects of retrospective reports of early life mother-child interactions on psychosocial and cognitive functioning later in life. Mother-child interactions have been linked to cognitive outcomes in childhood, however, little work has examined whether early life mother-child interactions have far-reaching effects on episodic memory in adulthood. Early life mother-child interactions may also influence cognitive functioning in adulthood indirectly through the development of academic competence (education attainment), social competence (marital satisfaction, social support, contact frequency), and/or depressive symptoms. Using longitudinal data from the Wisconsin Longitudinal Study sibling respondents (1993-2011; baseline: 29-79 years), we examined how retrospective positive mother-child interactions (PMCI) and negative mother-child interactions (NMCI) were independently associated with episodic memory. Structural equation modeling was used to model direct and indirect pathways from PMCI and NMCI to episodic memory and latent change in episodic memory. More PMCI retrospectively reported at T1 were associated with higher T2 memory and less memory decline from T2 to T3 via higher education. Additionally, more PMCI were associated with higher T2 memory through greater marital satisfaction. Independent of these indirect effects, more PMCI and NMCI were each associated with higher T2 memory, but not memory change. Mother-child interactions appeared to have an enduring effect on episodic memory in adulthood. These findings highlight the importance of taking a more integrative and lifespan perspective to assess how early life experiences affect socioemotional and cognitive development.

Home Visiting and Antenatal Depression Affect the Quality of Mother and Child Interactions in South Africa.

To examine whether maternal depressed mood at birth moderated the protective effect of a home-visiting intervention on the quality of caregiving for children growing up in a low- and middle-income country. Almost all pregnant mothers in 24 Cape Town neighborhoods were recruited into a cluster randomized controlled trial matched by neighborhoods to the Philani home-visiting condition (HVC) or the standard care condition (SC). At 3 years after birth, the quality of mother-child interactions between HVC and SC mothers with and without antenatal depressed mood was assessed in a representative subset by rating videotaped observations of mother-child interactions on 10 dimensions of caregiving. As predicted, maternal depressed mood at birth moderated the effect of the HVC on the quality of mother-child interactions. Among nondepressed mothers, mothers and their children in the HVC scored significantly higher on 5 of the 10 dimensions of the maternal-child interaction scale than mothers in the SC: mothers exhibited more maternal sensitivity, talked more, had more harmonious interactions, and had children who paid more attention and exhibited more positive affect. However, being in the HVC did not significantly affect the mother-child interaction scores among mothers with depressed mood. Among HVC children, those with mothers with depressed mood showed significantly less positive affect and talked less with their mothers than children with nondepressed mothers. SC children with mothers with depressed mood were more responsive and paid attention to their mothers than children with nondepressed mothers. Home visiting resulted in a better quality of caregiving for mothers without depressive symptoms. Future interventions need to specifically target maternal depression and positive mother-child interactions. Mentor Mothers: A Sustainable Family Intervention in South African Townships; https://clinicaltrials.gov; NCT00972699; Philani Home-based Nutrition Intervention Program; https://clinicaltrials.gov; NCT00995592.

The effect of marital and migrant status on the psychological distress of low socioeconomic mothers and their children in Israel

Children who live in conditions of poverty are at high risk for developmental and emotional difficulties. This study compared the psychological distress of migrant workers in Israel and their children with the psychological distress of low socioeconomic Israeli mothers and their children. We hypothesized that migrant working mothers and their children would show higher levels of distress than Israeli mothers and their children, and that single mothers and their children would show higher levels of distress than married mothers and their children. Three hundred and twenty-three mothers aged 25–59 and their children aged 6–12 participated in the study. One hundred and sixty-seven mothers were migrant workers, mostly from the Philippines, and 156 were Israeli working mothers of low socioeconomic status. One hundred and fifty-seven of the mothers were married and 143 were single. The mothers completed a measure of psychological distress and measures of their children's behavioral problems, psychological functioning, and satisfaction with life. The children completed measures of negative life events, subjective competence and psychological functioning. Overall, hypotheses were confirmed for children but not mothers, although migrant mothers reported higher levels of depressive symptoms than Israeli mothers. Levels of psychological distress were similar in single versus married mothers. In contrast, children whose mothers were migrant workers or single working mothers were at significantly higher psychological risk than children of Israeli mothers or married mothers respectively. This study contributes to an understanding of problem domains that should be addressed in welfare, and points to the need for psychological interventions for migrant and single-mother families that foster positive mother-child communication and interaction.

Maternal sensitivity and mental health: does an early childhood intervention programme have an impact?

Maternal sensitivity (MS) and mental health influence mother-child attachment and the child's mental health. Early interventions may promote resilience and facilitate healthy development of the children through an impact on mothers' outcomes such as their sensitivity and mental health. Play with Our Children (POC) is an early intervention programme aiming to promote a positive mother-child interaction for children who attend three family health centres of deprived areas of Santiago de Chile. To estimate the effect of the programme POC on MS and mental health. A quasi-experimental design with propensity score matching estimations was employed. MS was measured with the Q-Sort of Maternal Sensitivity, and maternal mental health was assessed with the Patient Health Questionnaire and the Parenting Stress Index. Mean-difference comparison and difference-in-difference method were used as statistical strategies. The sample included 102 children from 2 to 23 months of age, 54 of them participated in the intervention and 48 children were the comparison group. Estimates showed that participation in POC was positively associated with less stress in mothers of children younger than 12 months (P < 0.05) and positively associated with MS for mothers of children from 12 to 23 months (P < 0.05). There were no significant differences in maternal depression scores. The dyadic early intervention POC may influence mother's mental health and indirectly impact children's well-being during critical stages of their development by strengthening their mother's sensitivity towards them.

The psychosocial experiences of women with breast cancer across the lifespan: a systematic review protocol.

Review question/objective What are the psychosocial experiences of women with breast cancer across the lifespan, including similarities and differences in the psychosocial experiences of younger, middle-aged and older women with breast cancer? Inclusion criteria Types of participants This review will consider studies that include women with a breast cancer diagnosis of any type or stage, with the exception of a cancer recurrence. Women with a recurrence will be excluded since the experience of recurrence has been shown, through research, to be dissimilar to the experience of the first diagnosis and treatment of the disease. The experience of women in all treatment modalities will be included (i.e. lumpectomy, mastectomy of all types with or without breast reconstruction, chemotherapy, radiation therapy and hormone therapy). This review will consider studies that include age as a primary area of interest in the study design. That is, the study will focus on: 1) younger women or older women, or 2) a psychosocial issue and compare it across the lifespan from younger to older. The definition of “younger” and “older” will not be described by the reviewers prior to the review because no consensus has been reached in the literature about defining “young” and “old” in cancer. However, this will be observed in the studies and reported on in the analysis. Therefore, studies that identify the participants as “young” and/or “old”, and provide a range of ages of the participants, will be included. Studies will be excluded if they do not define their population(s) by age or if they combine younger and older populations together. Phenomenon of interest The phenomenon of interest is women’s psychosocial experience of breast cancer, including the social, psychological, emotional, spiritual and quality-of-life aspects of cancer. Context This review will include women from all geographical regions. It will also include all cancer care contexts (e.g. acute care hospital, ambulatory care setting, home care, primary health care).

Postpartum Mothers' Napping and Improved Cognitive Growth Fostering of Infants: Results From a Pilot Study

Little is known about how maternal sleep disturbances in the postpartum period affect mother–infant interaction. The study was designed to assess if less maternal sleep disturbance and less fatigue were associated with more positive mother–child interaction, independent of maternal depression symptoms. Twenty-three mothers completed 1 week of actigraphy and self-report measures of fatigue and depression symptoms. To determine the quality of mother–infant interaction, mothers and infants were then observed in a structured, video-recorded teaching episode. Greater maternal napping frequency was associated with better cognitive growth fostering of the infant (r s = .44, p < .05), a subscale of the interaction assessment. Maternal napping, not the quality or quantity of nocturnal sleep, appears to be associated with improvements in mother–infant interactions.

The Parenting Responsibility and Emotional Preparedness (PREP) Screening Tool

OBJECTIVE To test the ability of a 3-item screening tool (Parenting Responsibility and Emotional Preparedness [PREP]) to detect adolescent mothers at elevated risk for nonoptimal parenting and poor child development outcomes at 2 years of age. DESIGN A 4-site prospective cohort study conducted from December 2001 to August 2007 of adolescent mothers recruited in the third trimester of pregnancy and followed up at 4, 8, 18, and 24 months post partum. SETTING Community clinics and home settings in Birmingham, Alabama; Kansas City, Kansas and Missouri; South Bend, Indiana; and Washington, DC. PARTICIPANTS A total of 270 first-time adolescent mothers (aged 15-19 years) and their infants (birth to 2 years of age). MAIN EXPOSURES Naturalistic observations of parent-child interactions and quality of home environment during the first 2 years of life. OUTCOME MEASURES Maternal mental health and cognitive indicators, positive mother-child interactions, quality of home environment, child social-emotional development, and child cognitive development (Bayley scales). RESULTS PREP scores identified adolescent mothers with significantly elevated depressive symptoms and childhood trauma and lower scores of knowledge of infant development and maternal IQ. PREP predicted significantly lower quality of home environments and higher levels of nonoptimal mother-child interactions at 4, 8, and 18 months. PREP also predicted significantly lower child outcomes at 2 years of age for cognitive scores and higher levels of depressive and withdrawal symptoms and dysregulation and negative emotionality. CONCLUSIONS PREP is a low-cost, easily administered, nonstigmatizing screening tool that identifies adolescent mothers who self-recognize that they need help to meet their infants' social, emotional, and cognitive needs.

Expressive Arts Therapy for Mother–Child Relationship (EAT-MCR): A novel model for domestic violence survivors in Chinese culture

Domestic violence not only harms spousal relationships but also damages parent–child interactions. In the Chinese culture, tension between abused mothers and their children is likely to arise because of indirect and hierarchical communication customs. Therefore, an expressive arts-based model (EAT-MCR) was adapted for the Chinese culture to help improve mother–child relationships and to help victims cope with the trauma of domestic violence. Based on concepts derived from group and trauma therapies, this model prepares clients for personal transformation within a safe network formed by the participants, including family groups and a team of professionals. In this four-step model, we initiate clients by helping them find strengths from their positive mother–child interactions, guide them to explore the traumatic aspects of domestic violence, and then transform their perceptions to create a new family outlook that can be shared by mothers and their children. Finally, we conclude with a ceremony to fully integrate the transformed phase and interactive life skills. Detailed cultural considerations are discussed and illustrated by examples utilizing artistic creation and psychodrama techniques.

Families created through surrogacy: mother-child relationships and children's psychological adjustment at age 7.

Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy on mother-child relationships and children's psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child adjustment were administered to 32 surrogacy, 32 egg donation, and 54 natural conception families with a 7-year-old child. No differences were found for maternal negativity, maternal positivity, or child adjustment, although the surrogacy and egg donation families showed less positive mother-child interaction than the natural conception families. The findings suggest that both surrogacy and egg donation families function well in the early school years.

Consistency in infant sleeping arrangements and mother-infant interaction.

This study examined the association between infant sleeping arrangements (i.e., habitual co-sleeping, inconsistent co-sleeping, and non-co-sleeping) and quality of mother-infant interaction during play in a sample of mothers, each with a typically developing infant (N=70). Mother-infant dyads who experienced consistency in infant sleeping arrangements in a typical week at 6 months (i.e., habitual co-sleeping or non-co-sleeping) were characterized by more positive maternal and infant behavior and dyadic quality of interaction at 9 months compared with dyads who experienced inconsistency in sleeping arrangements. Additionally, a greater amount of co-sleeping per week was associated with an increased duration of breastfeeding, mothers working fewer hours, less infant temperamental intensity, and less maternal depression. This study underscores the advantages of empirically based studies that consider consistency in infant sleep experience as a factor that is associated with more positive mother-child interaction.

RESEARCH: Sanctification of Parenting: Links to Corporal Punishment and Parental Warmth Among Biblically Conservative and Liberal Mothers

A growing body of research has examined links between religious beliefs and parenting practices. This study used the theoretical construct of sanctification to examinethe degree to which parenting holds spiritual significance and meaning for parents and whether sanctification is related to parenting behaviors. Seventy—fourmothers completed questionnaires measuring sanctification of the parenting role, a biblical conservatism scale, and measures of parenting practices. Greater sanctificationof parenting was associated with less use of verbal aggression and, to some extent, increased parental consistency. Biblical conservatism moderated the link betweensanctification and (a) use of corporal punishment and (b) positive parent—child interactions. Specifically, greater sanctification of parenting was tied to decreasedcorporal punishment by mothers with liberal biblical beliefs but related to more use of corporal punishment among conservative mothers; greater sanctification was tiedto increased positive mother—child interactions by mothers with conservative biblical views but did not alter the uniformly high rates of positivity reported by liberal mothers.Findings are integrated with theoretical work on sanctification and existing empirical research on religion and parenting.

The Attachment Doll-play Interview for Preschoolers

Children’s narratives about attachment themes were elicited using the Attachment Doll-play Interview (ADI) and compared with measures of attachment based on a separation-reunion observation and on the Waters and Deane (1985) Attachment Q-sort. Two correlates of attachment, self-esteem and attention-seeking strategies, were also measured. Children who were more secure based on the ADI, as reflected in emotional openness and descriptions of positive mother-child interactions, behaved more independently during separations and reunions, and were rated by teachers as having higher levels of self-esteem and age-appropriate attention-seeking strategies. No significant correlations were found between ADI responses and the Attachment Q-sort. The results of this study converge with previous research which has used narratives to assess attachment among young children, and highlight the importance of open communication as an aspect of security.

Behavioural Parent Training Versus Dietary Education in the Treatment of Children with Persistent Feeding Difficulties

This controlled treatment-outcome study compared the effects of behavioural parent training (BPT) and standard dietary education (SDE) on the mealtime interaction, feeding behaviour, nutritional status, and adjustment of children with feeding disorders. Participants were 20 children (aged between 18 months and five years) with persistent feeding difficulties, and their families. Children underwent initial screening (involving medical assessment, behavioural observation of mealtime interaction, nutritional intake analysis, and self-report measures of parent and child adjustment) and were randomly assigned to BPT or SDE. Results indicated that children in both treatment conditions showed improvement on the child behaviour measures (e.g. food refusal, disruptive behaviour during mealtimes) at home and in mealtime observations in the clinic. Children in both conditions also showed an increase in the variety of foods sampled by follow-up. Following treatment, mothers who received BPT showed more positive mother–child interaction during mealtimes, and both parents were more satisfied with treatment than parents in SDE. Mothers in both conditions showed slight elevations in mood at posttest and follow-up, and increased marital satisfaction at posttest (which decreased by follow-up). All other treatment effects were maintained at a three- to four-month follow-up assessment.

Effectiveness of home-based early intervention on the language development of children of mothers with mental retardation

The authors evaluated the effects of a home-based parent training program for mothers with mental retardation on the language development of their children who were at risk for language delay. The participants, 28 mothers labelled mentally retarded with children under 28 months of age, initially showed significantly fewer positive mother-child interactions and child vocalizations and verbalizations than did a comparison group of 38 families with children of similar age whose mothers were not mentally retarded. The 28 mothers with low IQ were then matched on child entry age and randomly assigned to either an interaction training or attention-control group (this group received training in safety and emergency skills unrelated to interactions). Interaction training consisted of verbal instruction, modelling, feedback, and tangible reinforcement. After training, the training group scores were no longer lower than those of the comparison group of mothers without mental retardation and were also significantly higher than the scores of the attention-control group on all maternal positive interactions, child vocalizations, verbalizations, and language and social domains of the Bayley Scales of Infant Development. Speech emerged significantly sooner in the training group as compared to the control group. The training group parents and children maintained improvements up to 82 weeks following training, and the attention-control group, when subsequently trained, replicated the original training group results. Thus, home-based parent training increased positive maternal interactions of mothers with mental retardation, which facilitated language development in their young children.

Early Diagnosed Chronic Illness and Mother-Child Relationships in the First Two Years

As part of a longitudinal study, children in three groups (healthy, n = 33; cystic fibrosis (CF) n = 28; congenital heart disease (CHD) n = 23) were seen between the ages of 12 and 18 months to assess infant-mother attachment and at two years to observe parent-child negotiation of autonomy/dependence in a puzzle task. Although the healthy group included the highest proportion of securely attached infants and the CHD group the lowest, the distribution of attachment patterns did not differ significantly between groups, or between any of the groups and established norms. At two years the healthy children had the most positive experience in the puzzle task while the children in the CF group had the least positive experience. When diagnostic groups were divided according to prior attachment status, the data for the healthy group were consistent with the prediction that securely attached children would have the most positive mother-child interaction at age two. This was not the case in either of the medically diagnosed groups. These data suggest that the influence of the early parent-child relationship may be altered by a child's health status. We may need different models to account for development in healthy and medically compromised children.