The association between sensory processing and stress in the adult population: A systematic review.

There is emerging empirical evidence indicating that differences in self-reported sensory processing may be associated with differences in levels of stress in the adult populations. Understanding how sensory processing relates to stress is of clinical relevance, given the well-established impact of stress on physical health, mental health and well-being. Although several studies have examined the association between sensory processing and stress in adult populations, no published reviews have systematically summarised and synthesised these findings. We aimed to fill this gap by conducting a systematic review to synthesise the available evidence examining the association between self-reported sensory processing and self-reported measures of stress in the adult population. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-S) checklist. Twenty studies were included in the final review. Quality assessment was conducted with the Mixed Methods Appraisal Tool. Overall, the evidence is strong for an association between differences in sensory processing and self-reported stress in adults. This association was found across a range of populations and measures of stress, in cross-sectional studies. The most commonly used measure of sensory processing was the Highly Sensitive Person Scale, which was consistently moderately associated with a range of measures of stress. The quality of the included studies was generally good, with most meeting four or five out of five criteria. Longitudinal studies are lacking. There is strong evidence for a cross-sectional association between sensory processing and stress in an adult population. Further research, in particular longitudinal studies and studies including clinical populations, would be of benefit in order to establish causality.

A smartphone app effectively facilitates mothers' mind-mindedness: A randomized controlled trial.

The efficacy of a smartphone app intervention (BabyMind©) in facilitating mind-mindedness was investigated in a randomized controlled trial, assigning mothers and their 6-month-olds (N = 152; 72 girls, 146 White) to intervention or active control conditions. Mothers who had received the BabyMind© app intervention scored higher for appropriate (d = .61, 95% CI .28, .94) and lower for non-attuned (d = -.55, 95% CI -.92, -.18) mind-related comments at follow-up (age 12 months), compared with their control group counterparts. Adjusting for missing data did not alter this pattern of findings. Mothers' baseline parental reflective functioning did not moderate these relations. Results are discussed in terms of the benefits of early intervention and exploring the efficacy of the app in more diverse populations.

Early psychosocial risk factors and postnatal parental reflective functioning.

Psychosocial factors have been found to relate to parental reflective functioning (PRF), a parent's ability to mentalize about themselves and their child. Relations between maternal psychosocial risk factors and PRF were investigated in a community sample. A sample of mothers (n = 146) was assessed for risk factors when infants were 6 months, infant temperament was assessed using an observational measure, and PRF was assessed with the Parent Development Interview-Revised (PDI). PRF was measured again with the Parental Reflective Functioning Questionnaire (PRFQ) when children were 4 years (n = 105) and 5 years (n = 92), with an additional sample of mothers (n = 48) tested at these two timepoints. Results showed that in infancy, total maternal psychosocial risk related to lower PDI-PRF; regression analyses highlighted low socioeconomic status, unplanned pregnancy, and low maternal anxiety as independent predictors of lower PDI-PRF. PDI-PRF scores at 6 months did not relate to PRFQ scores, but PRFQ subscales showed stability over time from age 4-5. Results are discussed with regard to the impact of maternal psychosocial risk and infant temperament on PRF and the stability and concordance of PRF measures.

Mental Health Professionals' Experiences of Adapting Mental Health Interventions for Autistic Adults: A Systematic Review and Thematic Synthesis.

Autistic adults experience high rates of metal health difficulties and face significant barriers to accessing appropriate mental health care. Empirical research and recent professional guidelines emphasise the importance of modifying standard mental health interventions to best meet the needs of autistic adults. This systematic review explored mental health professionals' experiences of adapting mental health interventions for autistic adults. A systematic search was conducted on CINAHL, PsychINFO, PubMed, Scopus, and Web of Science in July 2022. The findings from 13 identified studies were synthesised using thematic synthesis. Three major analytical themes were generated, the unique experience of adapting interventions for autistic clients, factors which facilitate successful adaptations, and challenges to adapting interventions. Each theme contained a number of subsequent sub-themes. Professionals view the process of adapting interventions to be a highly individualised process. A range of personal traits, professional experiences, and systemic, service-based issues were identified in facilitating or challenging this individualised process. Further research regarding adaptations with different intervention models and increased supportive resources are required to enable professionals to successfully adapt interventions for autistic adult clients.

Alexithymia and intolerance of uncertainty predict somatic symptoms in autistic and non-autistic adults.

LAY ABSTRACT: Autistic people have more physical health problems than non-autistic people. We were interested in whether autistic people experience more discomfort in their bodies than non-autistic people and whether certain psychological traits contribute to that. A survey was completed online by older adolescents and adults, 51 of whom were autistic, 32 of whom thought they might be autistic but were not diagnosed and 119 who were not autistic. They completed measures of somatic symptoms (daily experience of pain, discomfort, dizziness), alexithymia (difficulty identifying and expressing feelings), interoception (how much people are aware of their bodies) and intolerance of uncertainty (how people handle doubt or uncertainty), and reported any physical or mental health conditions. We found that the autistic participants had more physical and mental health conditions than the non-autistic participants, but even when we took account of this, they experienced higher levels of somatic symptoms. We looked at which psychological factors influenced levels of somatic symptoms across the whole sample, and found that alexithymia, intolerance of uncertainty, having physical health problems, being female and the number of mental health conditions predicted somatic symptoms, while interoception and autism diagnosis did not. The findings suggest that people may be more likely to experience physical discomfort if they are female, and have difficulty identifying and expressing feeling and difficulty tolerating doubt. As these psychological factors are more prominent in autism, we think this is important for physical and mental health providers to know about, so that these psychological factors can be considered when assessing and treating autistic people.

Explaining the relation between early mind-mindedness and children's mentalizing abilities: The development of an observational preschool assessment.

The aim of this research was to develop a new observation-based measure for assessing caregivers' mind-mindedness in the preschool years and investigate whether this measure could explain the link between mothers' early appropriate mind-related comments and children's later mentalizing abilities. The new measure was developed using a sample of mothers and 44-month-olds (N = 171), characterizing mind-mindedness in terms of (a) solicited child involvement, (b) adaptive communication, and (c) internal state talk. These indices were positively related to established assessments of mind-mindedness at 8, 44, and 61 months. Positive associations were also observed with children's later mentalizing abilities. The new measure of mind-mindedness did not, however, mediate the relation between mind-mindedness in the first year of life and children's mentalizing abilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Access to and Quality of Healthcare for Pregnant and Postpartum Women During the COVID-19 Pandemic.

Introduction: During the COVID-19 pandemic, obstetric care has adopted new precautions to ensure services can be maintained for pregnant women. The aim of this study was to describe access to and quality of obstetric care for pregnant and postpartum women during the COVID-19 pandemic and to identify factors that predict quality of care at this time. Methods: Between May 3 and June 28, 2020, we recruited women who were pregnant or within the first 6 months after delivery to participate in an online survey. This included questions on access to obstetric healthcare (type and place of health care provider, changes to obstetric appointments/services, appointment preferences) and the Quality of Prenatal Care Questionnaire (QPCQ). Results: Of the 917 eligible women, 612 (67%) were pregnant and 305 (33%) were in the first 6 months after delivery. Sixty-two percent (n = 571) reported that COVID-19 had affected their healthcare; appointments were rearranged, canceled or occurred via virtual means for 29% (n = 166), 29% (n = 167), and 31% (n = 175) of women, respectively. The majority preferred to physically attend appointments (74%; n = 676) and perceived the accompaniment of birth partners as important (77%; n = 471). Sixty-two percent (n = 380) were permitted a birth partner at delivery, 18% (n = 111) were unsure of the rules while 4% (n = 26) were not permitted accompaniment. During pregnancy, QPCQ was negatively associated with disruption to obstetric services including exclusion or uncertainty regarding birth partner permissions [F (7, 433) = 11.5, p < 0.001, R 2 = 0.16] while QPCQ was negatively associated with inadequate breastfeeding support postpartum [F (1, 147) = 12.05, p = 0.001, R 2 = 0.08]. Conclusion: Pregnant and postpartum have experienced disruption in their access to obstetric healthcare. Perceived quality of obstetric care was negatively influenced by cancellation of appointment(s), suspension of services and exclusion of birth partners at delivery. During this time, continuity of care can be fulfilled via virtual and/or phone appointments and women should receive clear guidance on changes to services including birth partner permissions to attend delivery.

Mind-Mindedness and Stress in Parents of Children with Developmental Disorders.

Relations between mind-mindedness (assessed using the describe-your-child interview) and stress were investigated in parents of children with developmental disorders (ADHD, n = 51, ASD, n = 23, Down's Syndrome, n = 38, and 22q11.2 Deletion Syndrome, 22q11.2DS, n = 32) and typically-developing children (n = 89). Mind-mindedness did not differ across diagnostic groups, and mind-mindedness predicted parenting stress across groups. Parenting stress was lowest in the typically-developing and Down's Syndrome groups. Across all groups, mind-minded and positive descriptions predicted lower parenting stress, and negative descriptions predicted higher stress. In the developmental disorder groups, describing the children with reference to their disorder was negatively correlated with mind-mindedness. Results are discussed with regard to interventions for families where children have developmental disorders.

Mind-mindedness versus mentalistic interpretations of behavior: Is mind-mindedness a relational construct?

Mind-mindedness is a measure of the tendency to represent significant others in internal state terms and is central to supportive parent-infant relationships. The two studies reported here explored whether mind-mindedness generalizes to representations of unknown individuals, using a novel task that assessed individual differences in adults' tendency to interpret others' behavior with reference to their internal states: the Unknown Mother-Infant Interaction Task (UMIIT). We compared UMIIT performance with measures of mind-mindedness from (a) adults' descriptions of close friends and partners (Study 1, N = 96) and (b) mothers' appropriate versus nonattuned comments on their infants' internal states (Study 2, N = 56). In line with the proposal that mind-mindedness is a relational construct, UMIIT performance was unrelated to mind-mindedness in both studies.

La consciente mentalidad es una medida que tiende a representar a quienes nos son importantes en términos de un estado interno y es esencial para las relaciones de mucho apoyo entre progenitores e infantes. Los dos estudios que se reportan aquí exploraron si la mentalidad consciente generaliza al punto de representar a individuos desconocidos, usando una novedosa tarea que evalúa las diferencias individuales en la tendencia de los adultos a interpretar la conducta de otros en función de sus estados mentales: El Trabajo de la Interacción Madre Desconocida-Infante (UMIIT). Comparamos la actuación de UMIIT con las medidas de mentalidad consciente de (a) descripciones de adultos sobre amigos cercanos y parejas (Estudio 1, N = 96), y (b) los comentarios apropiados de las madres versus sus no armonizados comentarios con respecto a los estados internos de sus infantes (Estudio 2, N = 56). Alineado con la propuesta de que la mentalidad consciente es un concepto de la relación, la actuación de UMIIT no estuvo relacionada con la mentalidad consciente en ninguno de los estudios.

L'esprit-qualité mentale (en anglais mind-mindedness) est une mesure de la tendance à représenter les personnes qui nous sont chères en des termes d'état interne. Elle est centrale aux relations parent-enfant positives. Les deux études dont on fait état ici ont exploré si l'esprit-qualité mentale généralise les représentations d'individus inconnus, en utilisant une tâche nouvelle qui a évalué les différences individuelles dans la tendance des adultes à interpréter le comportement des autres en référence à leurs états internes: la Tâche de Mère Inconnue-Interaction du Nourrisson (UMIIT en anglais, soit Unknown Mother-Infant Interaction Task). Nous avons comparé la performance UMIIT aux mesures de l'esprit-qualité mentale de (a) descriptions d'adultes de leurs amis proches et de leurs partenaires (Etude 1, N = 96) et (b) de commentaires appropriés par rapport à pas trop appropriés des mères sur les états internes de leurs nourrissons (Etude 2, N = 56). Conformément à la proposition selon laquelle l'esprit-qualité mentale est une construction relationnelle, la performance de l'UMIIT n'était pas liée à l'esprit-qualité mentale dans les deux études.

Translation and preliminary validation of a Korean version of the parental reflective functioning questionnaire.

This study aimed to explore the factor structure, reliability, and validity of a Korean translation of the Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. A convenience sample of 163 Korean parents completed the K-PRFQ. Exploratory factor analysis showed three factors mapped on to the original PRFQ factors, but items from the original prementalizing modes subscale clustered into two additional factors. Data from a subsample (n = 67) showed that the certainty about mental states and interest and curiosity in mental states subscales correlated positively with more optimal self-reported parenting. We discuss the validity of using the PRFQ in collectivistic cultures.

Este estudio se propuso explorar la estructura de factores, la confiabilidad y la validez de una traducción al coreano del Cuestionario de Funcionamiento de Reflexión del Progenitor (PRFO; Luyten, Mayes, Nijssens y Fonagy, 2017). El PRFQ consiste en tres escalas: Modos de Pre-mentalización, la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales. Un conveniente grupo muestra de 163 progenitores coreanos completó el K-PRFQ. Los exploratorios análisis de factores mostraron tres factores identificados dentro de los factores del PRFQ original, sin embargo, temas de la sub-escala original de Modos de Pre-mentalización se agruparon en dos factores adicionales. Los datos provenientes de un sub-grupo muestra (n = 67) mostraron que la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales se correlacionaron positivamente con una auto-reportada más óptima crianza. Discutimos la validez de usar el PRFQ en culturas colectivistas.

Cette étude s'est donné pour but d'explorer le facteur structure, fiabilité et validité d'une traduction coréenne du Questionnaire de Fonctionnement Réflexif Parental (PRFQ; Luyten, Mayes, Nijssens, & Fonagy, 2017). Le PRFQ consiste en trois sous-échelles: Modes pré-mentalisation, Certitude sur les états mentaux, et Intérêt et curiosité dans les états mentaux. Un échantillon de convenance de 163 parents coréens a rempli le K-PRFQ. Une analyse exploratoire de facteur a montré trois facteurs mappés sur les facteurs d'origine du PRFQl, mais des aspects de la sous-échelle des modes de pré-mentalisation se sont regroupés en deux facteurs de plus. Les données d'un sous-échantillon (n = 67) ont montré que la Certitude sur les états mentaux et les sous-échelles d'Intérêt et la curiosité dans les états mentaux étaient en corrélation positive avec un parentage auto-rapporté optimal. Nous avons discuté la validité de l'utilisation du PRFQ dans les cultures collectivistes.

Proof of concept of a smartphone app to support delivery of an intervention to facilitate mothers' mind-mindedness.

The present study reports on the first evaluation of a parenting intervention utilizing a smartphone app, BabyMind. The intervention aimed to facilitate mothers' mind-mindedness-attunement to their infants' internal states. Mothers in the intervention group (n = 90) used the BabyMind app from their infants' births and were followed up at age 6 months (n = 66). Mothers in the control group (n = 151) were recruited when their infants were age 6 months and had never used the BabyMind app. Mind-mindedness when interacting with their infants was significantly higher in intervention group mothers than in control group mothers. The intervention was equally effective in facilitating mind-mindedness in young and older mothers. These findings are discussed in terms of the potential for interventions utilizing smartphone apps to improve parenting and children's developmental outcome in vulnerable and hard-to-reach groups.

Predisposing Factors for Elevated Restricted and Repetitive Behavior in Typically Developing Toddlers.

Little is known about the relation between levels of restricted and repetitive behavior (RRB) in infants and parent factors. The present study investigated maternal and psychosocial factors (depressive symptoms, socio-economic status, social support) and mother-infant engagement factors (mind-mindedness, sensitivity, and infant-mother attachment security) as predictors of children's RRB at age 26 months in a sample of 206 mothers and children. Maternal depressive symptoms predicted levels of sensory and motor repetitive behavior and rigid, routinized, and ritualistic repetitive behavior. Lower socioeconomic status also predicted independent variance in children's sensory and motor repetitive behavior. The relations between maternal depressive symptoms and both types of RRB were not mediated through observational measures of maternal sensitivity or mind-mindedness at 8 months, or attachment security at 15 months. The results are discussed in terms of whether stress regulation, self-stimulation, and genetic susceptibility can help explain the observed link between maternal depressive symptoms and RRB in the child.

How does restricted and repetitive behavior relate to language and cognition in typical development?

Relations between restricted and repetitive behavior at age 26 months and children's concurrent (N = 203) and later (n = 161) social cognition and language development were investigated. Restricted and repetitive behavior was assessed using two scales: sensory and motor repetitive behaviors and rigidity/routines/restricted interests. Language was assessed at ages 26 and 51 months; social cognition was assessed at ages 26 (symbolic play) and 51 and 61 months (theory of mind). Sensory and motor repetitive behavior was negatively related to children's (a) language performance at 26 and 51 months, (b) instructed symbolic play at 26 months, and (c) theory of mind performance at 51 and 61 months. Path analyses showed that children's sensory and motor repetitive behavior at age 26 months was related to lower receptive verbal ability and theory of mind at 51 months, which led to lower theory of mind at 61 months. Rigidity/routines/restricted interests at 26 months were unrelated to concurrent and later social cognition and language. These results are discussed in terms of the pathways via which sensory and motor repetitive behavior might impact negatively on development.

The relationship development assessment - research version: preliminary validation of a clinical tool and coding schemes to measure parent-child interaction in autism.

The aim of this project was to replicate and extend findings from two recent studies on parent-child relatedness in autism (Beurkens, Hobson, & Hobson, 2013; Hobson, Tarver, Beurkens, & Hobson, 2013, under review) by adapting an observational assessment and coding schemes of parent-child relatedness for the clinical context and examining their validity and reliability. The coding schemes focussed on three aspects of relatedness: joint attentional focus (Adamson, Bakeman, & Deckner, 2004), the capacity to co-regulate an interaction and the capacity to share emotional experiences. The participants were 40 children (20 with autism, 20 without autism) aged 6-14, and their parents. Parent-child dyads took part in the observational assessment and were coded on these schemes. Comparisons were made with standardised measures of autism severity (Autism Diagnostic Observation Schedule, ADOS: Lord, Rutter, DiLavore, & Risi, 2001; Social Responsiveness Scale, SRS: Constantino & Gruber, 2005), relationship quality (Parent Child Relationship Inventory, PCRI: Gerard, 1994) and quality of parent-child interaction (Dyadic Coding Scales, DCS: Humber & Moss, 2005). Inter-rater reliability was very good and, as predicted, codes both diverged from the measure of parent-child relationship and converged with a separate measure of parent-child interaction quality. A detailed profile review revealed nuanced areas of group and individual differences which may be specific to verbally-able school-age children. The results support the utility of the Relationship Development Assessment - Research Version for clinical practice.