Relationship focused mother-infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning.

We report on two preliminary evaluations of a group intervention, targeting vulnerable infants and their mothers within the first 6-months postpartum. The Mother-Baby Nurture® program aims to strengthen the developing infant-mother attachment relationship by increasing maternal mentalizing. These studies were undertaken with pre-post evaluations with the mothers of infants under 10-months of age. The mother-infant dyads participated in ten 2-h group sessions. Study one (N = 69 dyads) included self-reported maternal depression, anxiety, and parenting confidence. In study two (N = 27 dyads), parenting stress and reflective functioning were measured by self-report, and reflective functioning coded on the 5 min speech sample (completed by N = 22). Results from study one confirmed a decrease in depression (p < .001, d = .79) and anxiety (p < .001, d = .72) symptoms, and an increase in mothers' scores for parenting confidence (p < .001, d = -.98). Results from Study Two demonstrated a significant decrease in parenting stress (p < .001, d = .94) and significant improvement in measures of self-report reflective functioning (p = .007, .024; d = .56, .61). These findings are preliminary yet promising indications that this program could be effective in alleviating parenting stress, depression, and anxiety, and improving mother's reflective functioning and parenting confidence. Further research is needed, with a control group and long-term follow-up assessments.

Reportamos sobre dos evaluaciones preliminares de un grupo de intervención, con enfoque en infantes vulnerables y sus madres dentro de los primeros seis meses después del parto. El programa Naturaleza Mamá-Bebé® se propone fortalecer el desarrollo de la relación afectiva infante-madre por medio de incrementar el proceso de mentalización materna. Estos estudios se llevaron a cabo con evaluaciones anteriores y posteriores con las madres de infantes menores de 10 meses de edad. Las díadas madre-infante participaron en diez sesiones de grupo de 2 horas. El Estudio Uno (N=69 díadas) incluyó la auto reportada depresión materna, la ansiedad y la confianza en la crianza. En el Estudio Dos (N=27 díadas) se midieron el estrés de crianza y el funcionamiento con reflexión por medio de auto reportes, y el funcionamiento con reflexión se codificó en base a la Muestra de Cinco Minutos de Charla Oral (completada por N=22). Los resultados del Estudio Uno confirmaron una disminución en los síntomas de depresión (p<.001, d=0.79) y ansiedad (p<.001, d=0.72) y un aumento en los puntajes de las madres en cuanto a confianza en la crianza (p<.001, d=-0.98). Los resultados del Estudio Dos demostraron una significativa disminución en el estrés de crianza (p<.001, d = 0.94) y un significativo mejoramiento en las medidas de funcionamiento con reflexión auto reportadas (p=.007, .024; d=0.56, 0.61). Estos resultados son preliminares, pero aun así indicaciones prometedoras de que este programa pudiera ser eficaz para aliviar el estrés de crianza, la depresión y la ansiedad, y mejorar el funcionamiento con reflexión y confianza en la crianza de la madre. Se necesita una mayor investigación, con un grupo de control y medidas de evaluación a largo plazo.

Nous présentons deux évaluations préliminaires d'un groupe d'intervention ciblant des nourrissons vulnérables et leurs mères durant les six premiers mois postpartum. Le programme Mother-Baby Nurture® a pour but de renforcer la relation d'attachement infant-mère qui se développe en augmentant la mentalisation maternelle. Ces études ont été faites avec des évaluations pré-post avec les mères de nourrissons de 10 mois. Les dyades mère-bébé ont participé à dix séances de groupes, de heures chacune. La première étude (N=69 dyades) a inclus une dépression maternelle, de l'anxiété et la confiance de parentage, toutes auto-rapportées. Dans la deuxième étude (N=27 dyades), le stress de parentage et le fonctionnement de réflexion ont été mesurés par auto-déclaration, et le fonctionnement de réflexion a été codé à partir du de l'échantillon Five-Minute Speech Sample (complété par N=22). Les résultats de la première étude ont confirmé une décroissance de la dépression (p<,001, d=0,79) et des symptômes d'anxiété (p<,001, d=0,72) et une augmentation des scores des mères pour ce qui concerne la confiance de parentage (p<,001, d=-0,98). Les résultats de la deuxième étude ont révélé une décroissance importante du stress de parentage (p<,001, d = 0,94) et une amélioration importante dans les mesures de fonctionnement de réflexion auto-rapporté (p=,007, ,024; d=0,56, 0,61). Ces résultats sont préliminaires mais cependant ils s'avèrent présenter des indications prometteuses que ce programme pourrait être efficaces pour soulager et atténuer le stress de parentage, la dépression et l'anxiété, et améliorer le fonctionnement de réflexion des mères ainsi que leur confiance de parentage. De plus amples recherches sont nécessaires, avec un groupe de contrôle et des évaluations de suivi à long terme.

How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years.

BACKGROUND: Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS: Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS: Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS: This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS: A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.

Association between pregnant women's experience of stress and partners' fly-in-fly-out work.

BACKGROUND: It is relatively common in Western Australia for men to commute long distances and work away from home for extended periods of time, often referred to as fly-in-fly-out work. Women are particularly susceptible to the effects of stress during pregnancy, and the absence of a partner due to working away could be an additional risk to their wellbeing. While there is little published fly-in-fly-out literature, there is evidence that working non-standard hours, more generally, has a negative impact on health and well-being of workers and their families. AIM: To determine if there is an association between pregnant women's report of stress and their partners working fly-in-fly-out, and if so, is there is a differential impact that is dependent on family socioeconomic status. METHODS: Data from a Western Australian pregnancy cohort study were analysed (n=394 families). Couples completed self-report ratings of anxiety, depression, stress, family functioning, and stressful life events. Comparisons were made between three groups: fly-in-fly-out workers, non-fly-in-fly-out regular schedule workers, and non-fly-in-fly-out irregular schedule workers. RESULTS: After controlling for a range of variables, women's stress was significantly associated (p<.05) with their partners working fly-in-fly-out. Neither women's education, partners' occupation nor an interaction between partners' fly-in-fly-out work and partners' occupation were significantly associated with women's stress. CONCLUSION: There is some evidence that the pregnant partners of fly-in-fly-out workers perceive their lives to be more stressful than women whose partner works non-fly-in-fly-out regular schedules.

PATERNAL AND MATERNAL REFLECTIVE FUNCTIONING IN THE WESTERN AUSTRALIAN PEEL CHILD HEALTH STUDY.

While past research on the care of infants has been mostly with mothers, in recent times there has been a renewed attention to the father-infant relationship. This study examined differences between mother and father parental reflective functioning (PRF) or parental mentalizing; that is, the parental capacity to reason about their own and their children's behaviors by taking into consideration intentional mental states. Data were collected from 120 couples with a 1-year-old child who were participants in the West Australian Peel Child Health Study. Parental mentalizing was assessed using the Parental Reflective Functioning Questionnaire (PRFQ; Luyten, Mayes, Nijssens, & Fonagy, ). Results showed that mother and father mentalizing with their children was independent and that mothers scored slightly higher levels of mentalizing than did fathers. Paternal mentalizing was weakly associated with family income and father education, and was more strongly associated with family functioning than with maternal mentalizing. Implications for theorizing on PRF and fatherhood more generally are discussed.