Relationship functioning moderates the link between history of childhood maltreatment and depression during pregnancy.

Prenatal depression is a significant health issue associated with increased risk for poor mental and physical health outcomes among for both parents and their children. Having a history of childhood maltreatment is associated with increased risk for prenatal depression. Although research suggests that romantic relationship functioning likely plays a role in the links between childhood maltreatment and prenatal depression, it remains to be tested which aspects of relationship functioning modulate these associations. Using an actor-partner interdependence model framework (Kenny et al., 2006), the present study examined how specific aspects of romantic relationship functioning-relationship commitment, perceived partner support, constructive communication, and destructive conflict-moderated the links between mothers' and fathers' childhood maltreatment and depression during pregnancy. Participants included a subset of 1,135 low-income heterosexual couples (2,270 individuals) who enrolled in a randomized controlled trial of a relationship education program during pregnancy. Baseline, pretreatment data were used. Results indicated significant actor and partner effects of childhood maltreatment on prenatal depression. Further, these effects were moderated by specific indices of relationship functioning, such that the effect of one's own maltreatment on their prenatal depression was mitigated by high emotional support from partner and high constructive communication and was exacerbated by destructive conflict. Findings demonstrate that high relationship functioning can act as a protective factor, and low relationship functioning as a risk factor, in the link between one's own childhood maltreatment and their prenatal depression among both mothers and fathers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parent-Child Relationship Quality in the Family of Origin and Later Romantic Relationship Functioning: A Systematic Review.

A large and diverse literature has shown that parent-child relationship quality shapes development to affect later romantic relationship functioning. Guided by the developmental psychopathology framework, the current systematic review aimed to characterize the links between two major subtypes of parent-child relationship quality (parent-child attachment security and interaction quality) and several romantic relationship outcomes (i.e., adjustment, attachment security, aggression, and observed interaction quality), as well as to identify mechanisms accounting for these associations. We focused on studies that included both members of a couple/partnership for dyadic assessment of romantic relationship functioning, to more accurately and fully capture both partners' perspectives. A total of 40 articles met inclusion criteria, most of which sampled early/emerging adult couples between the ages of 18 and 26 years. Findings suggest that parent-child attachment security and interaction quality have similar associations with dyadic romantic relationship functioning, with the strongest evidence of effects on romantic relationship adjustment and observed interactions between romantic partners. Many studies found gender differences in effects, as well as cascading effects across development and over the course of a relationship. We argue that it is important for future studies to explore effects of one partner's parent-child relationship quality history on the other partner's romantic relationship adjustment and behavior, and to evaluate the extent to which parent-child attachment security mediates associations between parent-child interaction quality and romantic relationship functioning.

Se ha demostrado en publicaciones completas y variadas que la calidad de la relación entre padres e hijos determina el desarrollo de una manera que influye en el funcionamiento posterior de las relaciones amorosas. Guiado por el marco de la psicopatología evolutiva, el presente análisis sistemático tuvo como finalidad caracterizar los vínculos entre dos grandes subtipos de calidad de la relación entre padres e hijos (seguridad en el apego entre padres e hijos y calidad de la interacción) y varias consecuencias en las relaciones amorosas (p. ej.: adaptación, seguridad en el apego, agresión y calidad de la interacción observada), así como identificar los mecanismos que dan cuenta de estas asociaciones. Nos centramos en estudios que incluyeron tanto a integrantes de una pareja/asociación para la evaluación diádica del funcionamiento de las relaciones amorosas con el fin de captar más precisa y completamente las perspectivas de ambos integrantes de la pareja. Cuarenta artículos en total cumplieron con los criterios de inclusión, la mayoría de los cuales usaron como muestras a parejas de adultos emergentes de entre 18 y 26 años. Los resultados indican que la seguridad en el apego entre padres e hijos y la calidad de la interacción tienen asociaciones similares con el funcionamiento diádico de las relaciones amorosas, y que los indicios más claros de los efectos están en la adaptación de las relaciones amorosas y las interacciones observadas entre los integrantes de la relación amorosa. En muchos estudios se hallaron diferencias de género en los efectos, así como efectos dominó a lo largo del desarrollo y durante el transcurso de una relación. Sostenemos que es importante para estudios futuros analizar los efectos del historial de la calidad de la relación entre padres e hijos de uno de los integrantes de la pareja en la adaptación a la relación amorosa y la conducta del otro integrante de la pareja, y evaluar hasta qué punto la seguridad en el apego entre padres e hijos actúa como mediadora de las asociaciones entre la calidad de la interacción entre padres e hijos y el funcionamiento de la relación amorosa.

Telehealth adaptation of perinatal mental health mother-infant group programming for the COVID-19 pandemic.

The COVID-19 pandemic and ensuing isolation stressed pregnant and postpartum women and their families pervasively. This necessitated addressing young families' mental health needs while protecting both patients and providers from COVID-19 exposure. Our experience of rapidly adapting Pregnancy, Maternal Postpartum Peer Support, and Mother-Infant Postpartum Group interventions to high-quality telehealth modalities elucidates benefits and challenges of mother-infant dyadic treatment amidst the pandemic. This study compares 2019 in-person and 2020 telehealth services during the period from mid-March through mid-December in each year. Initial program Warmline contacts were similar across years despite pandemic-related restrictions, with 2020 program contacts surpassing the 147 unique patient outreaches during the commensurate 2019 period. Pregnancy Group enrollment remained consistent. Maternal Postpartum Peer Support Group participation increased with transition to telehealth with 27 individuals with over 100 group-based visits in 2020. Twenty-five mother-infant Postpartum pairs initially enrolled in the 12-week multicomponent Mother-Infant Therapy Group (M-ITG) during 2019 in-person services, and 16 completed the program (36% non-completion rate). During 2020 telehealth, 15 of 18 mother-infant pairs completed the program (17% non-completion rate); a greater than 50% reduction in non-completion. We further compare pre-/post-pandemic onset M-ITG participant demographics, enrollment, and Edinburgh Postnatal Depression Scale (EPDS) scores.

La pandemia COVID-19 y el consecuente aislamiento estresó a mujeres embarazadas y en postparto y a sus familias de manera generalizada. Esto requirió abordar asuntos de salud mental de familias jóvenes mientras que se protegía tanto a pacientes como proveedores de estar expuestos al COVID-19. Nuestra experiencia de adaptar rápidamente el Embarazo, el Apoyo entre Iguales al Postparto Materno y las intervenciones de grupo Madre-Infante en Postparto, a modalidades de telesalud de alta calidad, esclarece beneficios y retos del tratamiento a la díada madre-infante en medio de la pandemia. El estudio compara el servicio presencial en 2019 y de telesalud en 2020 durante el período de mitad de marzo a mitad de diciembre en cada año. Los contactos iniciales de programas de apoyo emocional telefónico con alguien en igual circunstancia (Warmline) fueron similares a lo largo de los dos años a pesar de las restricciones de la pandemia, con más contactos de programas de 2020 que las específicas 147 actividades de contacto a pacientes durante el período similar en 2019. La inscripción en grupos de embarazo se mantuvo consistente. La participación en grupos de Apoyo entre Iguales al Postparto Materno aumentó con la transición a la telesalud, con 27 individuos y más de 100 visitas con base en el grupo en 2020. Veinticinco pares de Madre-Infante en Postparto se inscribieron al inicio en el Grupo de Terapia Madre-Infante de 12 semanas y múltiples componentes (M-ITG) durante los servicios en persona de 2019 y 16 completaron el programa (36% tasa de incompletos). Durante la telesalud del 2020, 15 de los 18 pares de madre-infante completaron el programa (17% tasa de incompletos); una reducción de más del 50% en incompletos. Además, comparamos, antes y después de la pandemia, datos demográficos, inscripción y puntajes en la Escala de Edimburgo de Depresión Postnatal de participantes que iniciaron el M-ITG.

La pandémie du COVID-19 et l'isolation qui s'en est suivie a stressé les femmes enceintes et postpartum et leurs familles de façon générale. Il a donc fallu prendre en compte les besoins de santé mentale des jeunes familles tout en protégeant à la fois les patients et les praticiens de toute exposition au COVID-19. Notre expérience d'adaptation rapide du Soutien Maternel par Pair à la Grossesse et Postpartum ainsi que des interventions de groupe Postpartum Mère-Bébé en modalités de télésanté de haute qualité illustrent les bénéfices et les défis du traitement dyadique mère-bébé en pleine pandémie. Cette étude compare l'année 2019 en personne et les services de télésanté de 2020 durant la période de la mi-mars jusqu'à la mi-décembre de chaque année. Les contacts du programme initial Warmline ont été les mêmes au fil de ces deux années en dépit des restrictions liées à la pandémie, avec des contacts du programme de 2020 surpassant la communication à 147 patients uniques durant la même période de 2019. Le groupe de grossesse enregistré est demeuré constant. La participation de groupe de Soutien par Pair Postpartum a augmenté avec la transition à la télésanté avec 27 individus avec plus de 100 visites basées sur le groupe en 2020. Vingt-cinq paires Postpartum Mère-Bébé se sont initialement inscrites dans le Groupe de Thérapie Mère-Bébé de 12 semaines à plusieurs composants (M-ITG) durant les services en personne de 2019 et 16 ont terminé le programme (36% de taux d'inachèvement). Durant la télésanté 2020, 15 des 18 paires mère-bébé ont complété le programme (17% de taux d'inachèvement); un taux de réduction de 50% plus grand pour l'inachèvement). Nous comparons par ailleurs les données démographiques des participants M-ITG avant et après le début de la pandémie, les inscriptions et les scores de l'Echelle de Dépression Postnatale d'Edinbourg.

Supporting Romantic Relationships During COVID-19 Using Virtual Couple Therapy.

The novel coronavirus disease pandemic (COVID-19) has profoundly impacted people's lives, resulting in economic turmoil, death and suffering, and drastic changes to everyday life. The adjustment and strain of such challenges can spill over into couples' relationship processes, including how partners spend time together, talk to one another, and manage conflict. Drawing from our experiences conducting virtual couple therapy (VCT) in a university-based training clinic and community-based clinic, as well as themes from an informal survey of 29 couple therapy clinicians, the current paper discusses the unique challenges that couples face in therapy during COVID-19. Such challenges include renegotiating quality time together, navigating less personal space and time alone, experiencing individual anxiety and stress prompted by the pandemic, and increases in conflict. We discuss our clinical recommendations for addressing these challenges for couples and utilize clinical case examples to illustrate our points. Despite these challenges, we also comment on several positive aspects of COVID-19 on couple relationships. Guided by these considerations and recommendations, our observations suggest that clinicians can effectively support couples' growth and progress using VCT during COVID-19.

Learning helplessness in the family: Maternal agency and the intergenerational transmission of depressive symptoms.

Children of mothers with elevated depressive symptoms may observe and learn a maladaptive cognitive style, including low perceptions of agency, that is, low perceived control over their emotions and circumstances. In turn, children may face increased cognitive vulnerability to depressive symptoms; however, this mediational model has yet to be tested. Using a longitudinal design and testing our hypotheses within a community sample, we investigated the mediating role of maternal agency in the associations between maternal depressive symptoms and child behavioral helplessness and depressive symptoms one and a half years later (M = 18.58 months, SD = 6.91 months). A diverse sample of school-age children (N = 137, 57.4% female, Mage = 9.74 years, SDage = 1.51 years) and their mothers (N = 122) reported on their depressive symptoms at Time 1. A subsample of children and mothers returned to report on depressive symptoms at Time 2 (N = 68 dyads; 49 with complete data prior to multiple imputation). Maternal agency was coded from narrative responses to the Parent Development Interview-Revised for Parents of School-aged Children (Slade et al., 2009), completed at Time 1. Child behavioral helplessness was indicated by low strategy use at the end of a challenging puzzle task at Time 2. Results revealed that lower maternal agency predicted higher child depressive symptoms at Time 2 and mediated the associations between higher maternal depressive symptoms at Time 1 and higher child behavioral helplessness and depressive symptoms at Time 2. Implications for clinical intervention and future investigations are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Opening windows of opportunities: Evidence for interventions to prevent or treat depression in pregnant women being associated with changes in offspring's developmental trajectories of psychopathology risk.

Although animal models and correlational studies support a model of fetal programming as a mechanism in the transmission of risk for psychopathology from parents to children, the experimental studies that are required to empirically test the model with the human prenatal dyad are scarce. With a systematic review and meta-analysis of the literature, we critically examined the evidence regarding the neurobiological and behavioral changes in infants as a function of randomized clinical trials to prevent or reduce maternal depression during pregnancy, treating randomized clinical trials as experiments testing the fetal programming model. Based on 25 articles that met inclusion criteria, we found support for interventions designed to change maternal prenatal mood being associated with changes in offspring functioning, but with a very small effect size. Effect sizes ranged broadly, and were higher for younger children. The findings enhance understanding of putative mechanisms in the transmission of risk from women's prenatal depression to infants' vulnerabilities to, and early signs of, the development of psychopathology. We note limitations of the literature and suggest solutions to advance understanding of how preventing or treating depression in pregnant women might disrupt the transmission of risk to the infants.

Attachment avoidance, but not anxiety, minimizes the joys of caregiving.

Perhaps unlike other social roles that people may hold, caring for children offers opportunities for both immense joy and incredible frustration. Yet what predicts how parents will feel during caregiving experiences? In the current study, we examined parents' (N = 152) positive emotion, negative emotion, and felt meaning during caregiving using the Day Reconstruction Method. In addition, we tested attachment anxiety and avoidance as predictors of parents' emotion during caregiving relative to their other daily experiences. We found that attachment avoidance was associated with elevated negative emotion and reduced positive emotion and meaning in life across the entire day, whereas attachment anxiety was associated with elevated negative emotion and marginally greater meaning in life, but not positive emotion, across the entire day. Furthermore, caregiving was associated with greater positive emotion and meaning, but not negative emotion, compared to parents' other daily activities. Finally, attachment avoidance, but not anxiety, was associated with lower levels of positive emotion, negative emotion, and felt meaning during caregiving compared to other daily activities. These findings are consistent with other evidence that attachment avoidance is associated with deactivation of emotion in close relationships and suggest that attachment avoidance minimizes the joys of parenting.

EXAMINING PARENTS' ROMANTIC ATTACHMENT STYLES AND DEPRESSIVE AND ANXIETY SYMPTOMS AS PREDICTORS OF CAREGIVING EXPERIENCES.

Evidence has suggested that parental romantic attachment style and depressive and anxiety symptoms are related to experiences of caregiving (Creswell, Apetroaia, Murray, & Cooper, 2013; Jones, Cassidy, & Shaver, 2014; Lovejoy, Graczyk, O'Hare, & Neuman, 2000), but more research is necessary to clarify the nature of these relations, particularly in the context of attachment-salient events such as reunions. In a cross-sectional study of 150 parents of children ages 1 to 3 years, we assessed participants' attachment styles (self-reported anxiety and avoidance) and depressive and anxiety symptoms. Participants generated a narrative describing their most recent reunion with their child, which we coded for caregiving outcomes of negative emotion and secure base script content. Attachment style and depressive and anxiety symptoms separately predicted each caregiving outcome. Depressive and anxiety symptoms mediated the associations between attachment style and caregiving outcomes. These results suggest that parental attachment insecurity and depressive and anxiety symptoms contribute to negative emotion and reduced secure base script content. Further, depressive and anxiety symptomatology partially accounts for the relation between attachment insecurity and caregiving outcomes, suggesting that parental mental health is a critical point for intervention.