Feasibility of an Online Acute Stressor in Preschool Children of Mothers with Depression.

Maternal depression is a risk factor for future mental health problems in offspring, with stress-system function as a candidate vulnerability factor. Here we present initial validation of an online matching-task (MT) paradigm in young children exposed to maternal depression (N = 40), a first in stressor-paradigm research for this age group. Investigations of stress-system reactivity that can be conducted online are an innovative assessment approach, accelerated by the COVID-19 pandemic. Results indicate high feasibility, with a >75% data collection success rate across measures, similar-to or better-than in-person success rates in young children. Overall, the online MT elicited significant heart rate but not cortisol reactivity. Individual differences in child mental health symptoms were a moderator of reactivity to the stressor such that children with lower, but not higher, behavioral problems exhibited the typical pattern of cortisol reactivity to the online MT. Results are aligned with allostatic load models, which suggest downregulation of stress-system reactivity as a result of experiencing adversity and mental health vulnerability. Consistent with in-person research, this suggests that an early phenotype for the emergence of behavior problems may be linked to altered stress-system reactivity. Results hold potential clinical implications for intervention development and the future of online stress-system research. Trial Registration: Clinical Trial Registration: NCT04639557; (Building Regulation in Dual Generations-Telehealth Model [BRIDGE]).

The Building Regulation in Dual-Generations Program (BRIDGE): A Mixed-Methods Feasibility Pilot of a Parenting Program for Depressed Mothers of Preschoolers, Matched with Dialectical Behavior Therapy Skills.

Early exposure to maternal depression is a key risk factor for child mental illness (MI), but there are limited programs that interrupt intergenerational transmission. The BRIDGE "Building Regulation in Dual Generations" Program treats maternal MI using Dialectical Behavior Therapy Skills with a paired curriculum that promotes non-reactive and emotionally validating parenting designed to improve child mental health and ultimately prevent MI. The pilot feasibility trial (n = 28 dyads) included mothers and their preschool-aged children. The 20-week program was completed in a group-based format using mixed methods questionnaires and interviews. Results indicate high feasibility and acceptability (86% retention). Consistent improvements were seen across program targets and outcomes including maternal depression (d = 1.02) and child mental health (d = 1.08), with clinically significant symptom reductions for 85% of clients. Mothers with higher adversity exhibited greater reductions in parenting stress. Qualitative results highlighted efficacy in promoting positive parent-child relationships, rewarding parenting experiences, competence, and child development. Evidence suggests high feasibility and accessibility for BRIDGE in addressing intergenerational mental health needs. There was strong satisfaction with the program material and efficacy across key outcomes. BRIDGE holds promise for offering a transdiagnostic approach to preventing child MI in families of at-risk preschool aged children.

Family Factors Associated with Hands-On Play and Screen Time During the COVID-19 Pandemic.

Background: Parent-child interactions are crucial for child development. The COVID-19 pandemic has negatively affected mental health and increased parenting challenges impacting parent-child functioning. Objective: This study examined parent factors related to more and less enriching child activities during the pandemic through Bronfenbrenner's Ecological Systems framework. Methods: A convenience sample of parents (N = 708), primarily mothers (n = 610; 87.4%) aged 35.59 years old (SD = 5.59; range = 21-72), with children ages 2-8 years completed an online questionnaire between April 14-June 1, 2020. Participants mostly resided in Canada, had an income of > $100,000, and identified as White (82.4%). Parent-child activities were measured as total weekly time and combined time across activities within two categories: hands-on play and screen time. Bivariate correlations informed blockwise linear regression models. Results: For families with childcare needs, parental anxiety was associated with higher total hands-on play, combined hands-on play, and combined screen time. Families without childcare needs indicated parenting stress was associated with lower total hands-on play and combined hands-on play, and higher supervised screen time. Family structure and indices of socioeconomic status were also predictive of activities across childcare needs and child ages. Conclusions: To promote high-quality parent-child interactions and positive developmental outcomes during the pandemic, childcare needs and parent wellbeing should be supported, while evidence-based guidelines for child screen time should be further researched in this context.

Stress system reactivity moderates the association between cumulative risk and children's externalizing symptoms.

This study examined children's stress system reactivity via the autonomic nervous system (ANS) and hypothalamic pituitary adrenal axis (HPAA) during an acute stressor as moderators of predicted relations between cumulative risk (CR) and mental health symptoms in a sociodemographically diverse sample of young children (n = 58). We employed a reliable stressor paradigm to allow assessment of individual differences in respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), indexing ANS reactivity, and salivary cortisol, indexing HPAA reactivity. Children's behaviours were assessed using the Child Behaviour Checklist (CBCL). Cumulative risk was indexed by eight parent-reported sociodemographic and psychosocial risk factors. There was a significant main effect of CR on externalizing but not internalizing behaviours. Significant moderations emerged showing that among children with high CR, less RSA withdrawal during the acute stressor and less cortisol recovery following the stressor were associated with to greater externalizing behaviours. Among children with low CR, RSA and cortisol recovery were unrelated to internalizing or externalizing symptoms. Cortisol and PEP reactivity were not significant moderators. Results highlight the relevance of stress system function for understanding differential susceptibility to the early emergence of externalizing symptoms, linked to cumulative risk exposure.