The impact of parents' stress on parents' and young childrens' mental health-Short- and long-term effects of risk and resilience factors in families with children aged 0-3 in a representative sample.

Stress in parents has a significant impact on parenting and infant's development. However, few studies have examined cross-sectional and longitudinal links on risk and resilience of burdened families. Thus, this study aimed to investigate subjective risk and resilience factors on family well-being. Data stem from the 2015 nationwide study "Children in Germany" ("Kinder in Deutschland" - KiD 0-3). Parents of children aged zero to 3 years (N = 8.063) were recruited from random probability-sampled paediatric clinics (n = 271) across Germany. Risk and resilience variables such as parents' perceived stress (PSS-4), competence, isolation and attachment (PSI), as well as parental inner anger (items from CAP), relationship quality (DAS-4) and the child's negative emotionality (items from SGKS) were assessed at baseline in addition to demographic variables to predict parents' mental health (PHQ-4) and negative emotionality of the child at baseline (T1) and in the 2-year follow-up (T2) using linear regression models. At baseline, parents' mental health was predicted by inner anger, the child's negative emotionality and being a single parent (R2 = 45.1%) at baseline, but only by parenting competence at the two-year-follow-up (R2 = 25.1%). The child's negative emotionality was predicted (R2 = 27.5%) by the child's age, and parental inner anger and competence, attachment, perceived stress, mental health as well as education background. At two-year-follow-up, the child's age, single parenthood, social welfare benefit, child's negative emotionality at baseline, relationship quality and competence were significant predictor variables (R2 = 22.8%). This study highlights the impact of specific risk and resilience factors not only on parents' mental health but also the child's negative emotionality in the short and long-term in early childhood. Universal, but also selective prevention programs should increase parents' resilience (e.g., focusing on self-efficacy, competence, coping strategies).

[Stressful Living Conditions in Nuclear, Single Parent and Stepfamilies and Use of Prevention Services. Findings of Two Representative German Studies]. / Belastungslagen von Alleinerziehenden-, Stief- und Kernfamilien Inanspruchnahme von Unterstützungsangeboten. Befunde aus zwei repräsentativen deutschen Studien.

AIM OF THE STUDY: Comparison of (stressful) living conditions and use of universal, selective and indicated prevention services in nuclear, single parent and stepfamilies with young children. METHODS: Using two representative German surveys of mothers with children aged 0-3 years (KiD 0-3 2015, n=6,671, and AID:A 2019, n=1,501), mothers' reported burden and the use of various prevention services in different family types were examined descriptively and with Chi²-tests. RESULTS: Overall, single parent families and, to some extent, stepfamilies showed increased socioeconomic stress compared to nuclear families (e. g., young motherhood, higher poverty risk). In particular, universal prevention services (e. g., prenatal classes, parent-child courses) were used less frequently by single parent families, while selective and indicated services such as family or child guidance counselling services and offers of youth welfare agencies were used more frequently. CONCLUSION: Increased socioeconomic stress suggests a higher need for support among single parents compared to nuclear families. Universal group offers are possibly not sufficient to meet these needs, whereas selective individual counselling offers such as pregnancy and child guidance counseling are used more frequently by single parent families and stepfamilies compared to nuclear families. There seems to be a lack of (group) offers tailored to single parent families - particularly in the first developmental phase of a child's life.

Psychosocial Stressors and Resources in Parents Using Home-Visiting Programs in Early Childhood: A Study Protocol.

Psychosocial stressors and resources present in the early life of a child play a crucial part in determining outcomes later in life. Preventive early childhood intervention services aim to reduce negative and increase positive outcomes. Home-visiting programs are an example for preventive services that are common in many countries.The present study focusses on a wide spread home-visiting program in Germany and has three main objectives: First, to characterize the professionals that conduct and the families who participate in the program. Second, to study relations between a broad range of resources and stressors. Third, to analyse potential outcome variables for future efficacy studies on early childhood intervention services. The goal is to recruit 130 professionals and 500 families from 20 cities and municipalities in Germany. For families with two caregivers, both are invited to participate. Questionnaire topics for professionals and families include a range of stressors and resources, need for support, and the work focus of the professionals. Statistical analyses will mainly be descriptive, exploring the complex interplay of stressors and resources in vulnerable families.These results will not only provide insights into how the program is currently conducted and whom it serves, but might also help to further accelerate the program and the training of professionals.

Resolving relationship dissolution-What predicts emotional adjustment after breakup?

Relationship dissolution is a critical life event individuals have to cope with. Factors like relationship duration and relationship quality or having a new partner are likely to affect how people recover emotionally from a separation, which is linked to long-term adjustment. However, prospective evidence on the role of these factors is scarce. Hence, this study aims to investigate predictors of emotional recovery following relationship dissolution. Pooled data of the German Family Panel pairfam on 3734 separation events of 2709 individuals aged 18 to 48 were used, applying a statistical model called seemingly unrelated regressions to predict emotional outcomes (relief, anger, guilt, and sadness) and the general emotional state regarding separation. Sociodemographic and relationship characteristics, indicators of relationship quality, conditions of the separation, and features of the current situation were considered as potential predictors. Regression analyses evidence strong links of initiator status, having a new partner, time since separation, and satisfaction with the social network to less negative emotional outcomes following separation. Relationship quality or serious problems before the separation only affected some of the investigated emotional outcomes. Interestingly, the predictors investigated were less powerful in explaining respondents' feelings of guilt compared to the other emotions. Overall, these findings provide deeper insight into short-term adjustment to separation. Understanding these processes may help to assess risk factors for negative coping mechanisms and improve tailored counseling strategies.

I-PREGNO - prevention of unhealthy weight gain and psychosocial stress in families during pregnancy and postpartum using an mHealth enhanced intervention: a study protocol of two cluster randomized controlled trials.

BACKGROUND: The transition to parenthood represents a critical life period with psychosocial, and behavioral changes and challenges for parents. This often increases stress and leads to unhealthy weight gain in families, especially in psychosocially burdened families. Although universal and selective prevention programs are offered to families, specific support often fails to reach psychosocially burdened families. Digital technologies are a chance to overcome this problem by enabling a low-threshold access for parents in need. However, there is currently a lack of smartphone-based interventions that are tailored to the needs of psychosocially burdened families. AIMS: The research project I-PREGNO aims to develop and evaluate a self-guided, smartphone-based intervention in combination with face-to-face counseling delivered by healthcare professionals for the prevention of unhealthy weight gain and psychosocial problems. The intervention is specifically tailored to the needs of psychosocially burdened families during the pregnancy and postpartum period. METHODS: In two cluster randomized controlled trials in Germany and Austria (N = 400) psychosocially burdened families will be recruited and randomized to i) treatment as usual (TAU), or ii) I-PREGNO intervention (self-guided I-PREGNO app with counseling sessions) and TAU. We expect higher acceptance and better outcomes on parental weight gain and psychosocial stress in the intervention group. DISCUSSION: The intervention offers a low cost and low-threshold intervention and considers the life situation of psychosocially burdened families who are a neglected group in traditional prevention programs. After positive evaluation, the intervention may easily be implemented in existing perinatal care structures in European countries such as Germany and Austria. TRIAL REGISTRATION: Both trials were registered prospectively at the German Clinical Trials Register (Germany: DRKS00029673; Austria: DRKS00029934) in July and August 2022.

How are families in Germany doing in 2022? Study protocol of a nationally representative, cross-sectional study of parents with children aged 0-3 years.

BACKGROUND: In order for Early Childhood Intervention (ECI) to be effective, data-based information on families' resources, burden and current use of support services for families with young children, as well as on children's health and development is needed. The study Kinder in Deutschland [Children in Germany]-KiD 0-3 2022 aims at providing these data to help us understand families' situation and needs in Germany now, including families' experience of the COVID-19 pandemic. METHOD: The study will recruit up to 300 pediatricians who will invite parents of children aged up to 48 months to participate in the study during a well-child visit. Parents (goal N = 8,000) will complete an online-questionnaire with their own web-enabled device. Pediatricians will complete a short questionnaire about each participating family. The questionnaires cover family psychosocial burden and resources, child health and development, use of family support services, as well as the families' experiences of the COVID-19 pandemic. Data will be analyzed to assess patterns of families´ psychosocial burdens and resources, use of support services for families with young children, and children´s health and development. Concordance between parent and pediatrician report will be assessed and comparisons with the predecessor study of 2015 will be drawn. DISSEMINATION: Findings will be disseminated through scientific conferences, open access peer-reviewed journals, and dissemination channels of the National Centre for Early Prevention. DISCUSSION: The present study will provide parent and pediatrician reports on how families with young children are doing in Germany. These data will be used to inform Germany's early childhood intervention (ECI) program ("Frühe Hilfen") on current needs of families with young children.

Linking maternal psychopathology to children's excessive crying and sleeping problems in a large representative German sample-The mediating role of social isolation and bonding difficulties.

Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected children are burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent-child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N = 6598 mothers (M = 31.51 years) of children between zero to three years of age (M = 14.08 months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants' excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.

[Families with Increased Parenting Stress and Conflict Potential: a Target Group for Psychosocial Support Services?] / Familien mit erhöhtem elterlichen Stress und Konfliktpotential: Eine Zielgruppe für psychosoziale Unterstützungsangebote?

STUDY AIM: Psychosocial stress can complicate the first phase of life for young families. One group that has received little attention so far are families with increased parental stress and conflict potential. This paper aims to 1) classify knowledge and use of support services for families with increased parental stress and conflict potential and 2) describe the psychosocial characteristics and parenting behaviours of these families. METHODS: For this purpose, data from a representative cross-sectional study in 2015 with n=7 549 families as well as the follow-up study with n=905 families were analyzed. Parents who took their child to a pediatrician's office for a screening examination (U3-U7a) completed a written questionnaire. Knowledge and use of services were assessed using four pre-defined stress groups (unstressed, socioeconomically stressed, with parental stress and conflict potential, and highly burdened). RESULTS: Families with increased parental stress and conflict potential are less likely to receive support offers. Despite high knowledge of selective prevention services, they use these offers less frequently than socioeconomically or highly stressed families. They are more likely to report dysfunctional parenting behaviors. CONCLUSION: This raises the question of whether families with increased parental stress and conflict potential receive too little support because they have no clearly visible need for help or whether they are adequately provided for due to the high socioeconomic resources, service knowledge, and use of universal medical and family education services. The results provide important information for the care of families in various stressful situations and contribute to the assessment of the need for support.

[An urban-rural comparison of family stress and early childhood intervention: Data linkage between two cross-sectional studies]. / Ein Stadt-Land-Vergleich familialer Belastungen und Früher Hilfen.

An urban-rural comparison of family stress and early childhood intervention: Data linkage between two cross-sectional studies Abstract. Background: So far, there is insufficient information about where in Germany which families are reached by home-visiting programs and how well. One example is the provision of home-visiting program by health service professionals (LaB) in early childhood intervention. Research questions: Are there urban-rural differences in psychosocial stress among families? What differences exist in terms of expanding support services, receiving a service, and using the offered LaB? Methods: Data from a representative family survey on psychosocial stress characteristics and the use of services, and a nationwide survey of professionals on the development and expansion of early childhood intervention at the community level were linked. Analyses included descriptive statistics and regression models. Results: Most psychosocial stress characteristics were reported with similar rates in rural and urban areas. Although the LaB program is more widespread in urban regions, it was more likely to be used in rural regions when offered. LaB was more likely to be used by families with migration background, with signs of depression or anxiety of parents, and with a child with perinatal adversities, and less likely when there was a need for expansion of this service. Conclusions: The increased use in rural areas could be due to the fact that there are long distances to few centralized services. Therefore, the outreach character of the LaB program is appreciated, especially among less mobile families.

Long-term effects of targeted prevention programmes for families with young children: A population-based study on parenting stress and children's negative emotionality.

BACKGROUND: Many prevention programmes for families focus parental adversities and adverse childhood experiences. Effects of such programmes are often examined in clinical trials; there is less research on effects under naturalistic conditions. The aim of this study was to examine the longitudinal association between parenting stress and child's negative emotionality, its modification through targeted prevention programmes, and to investigate the effects in the general population. METHODS: Data were taken from a sample of n = 903 families with infants (mean age: 13.3 months) who participated in a baseline study (T1) and a follow-up study (T2) 2 years later. The survey included parental self-report measurements on parenting stress and child's negative emotionality (T1 and T2 each) and targeted prevention programmes (T1 only). An autoregressive cross-lagged panel design was used to analyse the association of parenting stress and the child's negative emotionality, including use of targeted prevention programmes as moderator. We also tested if targeted prevention programmes can reduce parenting stress or child's negative emotionality using Propensity Score Matching (PSM). RESULTS: Parenting stress at T1 affected children's negative emotionality at T2, but children's negative emotionality at T1 did not affect parenting stress at T2. When targeted prevention was included as moderator, the correlation disappeared among programme users. With PSM, there was no direct effect on parenting stress or child's negative emotionality. But a subsample of parents with high parenting stress at T1 who used targeted prevention at T1 reported less child's negative emotionality problems at T2 than parents who scored high in parenting stress but did not receive targeted prevention at T1. CONCLUSION: Results suggest that the spillover from parenting stress to child's negative emotionality may be modified by prevention. Prevention programmes may help to build resources and have a direct positive effect on the child, especially for parents with high parenting stress.

Attachment goes to court: child protection and custody issues.

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child's need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration.

Child Abuse Potential in Young German Parents: Predictors, Associations with Self-reported Maltreatment and Intervention Use.

Since child maltreatment has highly negative effects on child adjustment, early identification of at-risk families is important. This study focuses on longitudinal risk factors for child maltreatment and associations between abuse risk and occurrence. It also examines whether abuse risk and involvement in early childhood intervention are associated. The sample comprises 197 German caregivers with children under 3 years of age. Data was collected in two waves. The Brief Child Abuse Potential Inventory assessed abuse risk. Socio-demographic, parent, child and family-related risk factors were measured using screening tools. The analysis revealed that parental characteristics (psychopathology, own maltreatment experiences etc.) were associated with concurrent abuse risk. Longitudinal changes in abuse risk were linked to caregiver education and child-related factors. Cumulative risk did not explain more variance than specific risk factors. Significant associations with caregiver-reported abuse were found, and data suggest that some burdened families cannot be reached by early childhood intervention.

Coparenting Problems and Parenting Behavior as Mediating Links Between Interparental Conflict and Toddlers' Adjustment Difficulties in Germany.

Objective: Interparental conflict has long been acknowledged as a major risk factor for the well-being of children. Empirical studies reveal clear associations between children's maladjustment and frequent destructive conflicts between their parents (van Eldik et al., 2020). Existing research suggests that interparental conflict spills over from the couple to the coparental relationship, undermining parents' skills to cooperate and their parenting competencies. This study addresses the effects of interparental conflict on the behavioral and emotional problems of toddlers. Methods: The analyses were based on longitudinal data from the German Family Panel pairfam. The sample comprised information on N = 828 anchor participants (59.9 % female) and their 3- to 5-year-old children. Results: As expected, the effects of interparental conflict on children's behavioral and emotional problems were mediated by coparenting problems and in part also by negative parenting. Further analyses comparing mothers and fathers revealed a stronger direct path of interparental conflict on coparenting for mothers. Conclusions: The findings provide support for the significance of the interparental relationship and coparenting quality for child development, even in this young age group, and point to the importance of early prevention.

A systemic perspective on children's emotional insecurity in relation to father: links to parenting, interparental conflict and children's social well-being.

Focusing on the father-child-relationship in a family systems perspective, this paper investigates longitudinal links of parenting, interparental conflict, and positive regard by both parents, to their emotional insecurity with father and mother. Furthermore, to clarify fathers' contribution to children's social development, aspects of the relationship to both parents are jointly considered. The sample was drawn from the German family panel pairfam and included 372 family triads with parents' and children's self-reports. Findings revealed consistent associations between interparental conflict and lack of positive regard and emotional insecurity, while parenting had no independent links with children's emotional insecurity or social adjustment. Controlling for the stability of child outcomes, interparental conflict predicted children's lower prosocial behavior and higher peer rejection. In addition, peer rejection was predicted by children's emotional insecurity with father. The findings are in line with the emotional security hypothesis and highlight the importance of the father-child-relationship for developing positive peer relationships.

[Children's Aggressive Behaviour and Therapeutic Interventions on the Parental Couple Level]. / Aggressives Verhalten von Kindern und Interventionen auf der elterlichen Paarebene.

Parents go to see child guidance counselling services for many different reasons. Behavioural problems or rather enraged or aggressive behaviour of children and adolescents towards their siblings or parents is a frequent issue in counselling practice. The current article takes a closer look at the range of problems around defiance, anger and aggression from a developmental and systemic point of view. The meaning of these negative affects within the family system is elaborated. Empirical studies show a clear connection between children's problem behaviour and frequent and destructive interparental conflict. So called spill-over-effects play a crucial role in explaining this connection. From a systemic perspective thus the child is seen as a symptom carrier, which shifts the focus of counselling on the interaction between parents as well. Consequently, family therapeutic sessions on the couple level are often indicated. Do parents succeed in constructively solving their conflicts, typically the aggressive behaviour of the children is reduced, too. On the basis of a compound single case such a process is illustrated.