Paternal bonding is influenced by prenatal paternal depression and trait-anxiety.

BACKGROUND: Even though the development of an emotional bond to the child involves both parents, studies on the development of paternal bonding and the influencing factors are scarce. This pilot study examines the quality of paternal postnatal bonding in association with paternal depressive and anxiety symptoms before and after birth. Methods: Expecting parents (n = 81) were recruited from maternity services in Frankfurt, Germany. At recruitment and 3 months postpartum (pp) mothers and fathers completed an interview including sociodemographic and pregnancy data. Depressive and anxiety symptoms were screened using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. At 3-month pp, fathers also completed the Postpartum Bonding Questionnaire for the assessment of bonding difficulties. A total of 63 couples, from whom data were available for both time points, were included in the final study group. RESULTS: Depressive and anxiety symptoms before birth are the best predictors for the quality of paternal bonding pp (Total score R2 .402 p = .001; Impaired bonding R2 .299 p = .019; Rejection and Anger R2 .353 p = .005; Anxiety about care R2 .457 p = .000). Maternal depression and sociodemographic variables were not significantly associated. LIMITATIONS: High selected small study group. CONCLUSIONS: Paternal depressive and anxiety symptoms during pregnancy are highly predictive for the quality of bonding as well as for the presence of depressive and anxiety symptoms 3 month pp. It is necessary to identify these symptoms as soon as possible in order to prevent later negative impacts on parental mental health and on child developmental outcomes.

A pilot study of multilevel analysis of BDNF in paternal and maternal perinatal depression.

Depression in the perinatal period is common in mothers worldwide. Emerging research indicates that fathers are also at risk of developing perinatal depression. However, knowledge regarding biological risk factors and pathophysiological mechanisms of perinatal depression is still scarce, particularly in fathers. It has been suggested that the neurotrophin BDNF may play a role in maternal perinatal depression; however, there is currently no data regarding paternal perinatal depression. For this pilot study, 81 expecting parents were recruited and assessed at several time points. We screened for depression using EPDS and MADRS, investigated several psychosocial variables, and took blood samples for BDNF val66met genotyping, epigenetic, and protein analysis. Between pregnancy and 12 months postpartum (pp), we found that 3.7 to 15.7% of fathers screened positive for depression, and 9.6 to 24% of mothers, with at least a twofold increased prevalence in both parents using MADRS compared with EPDS. We also identified several psychosocial factors associated with perinatal depression in both parents. The data revealed a trend that lower BDNF levels correlated with maternal depressive symptoms at 3 months pp. In the fathers, no significant correlations between BDNF and perinatal depression were found. Pregnant women demonstrated lower BDNF methylation and BDNF protein expression compared with men; however, these were found to increase postpartum. Lastly, we identified correlations between depressive symptoms and psychosocial/neurobiological factors. The data suggest that BDNF may play a role in maternal perinatal depression, but not paternal.

Delivery room skin-to-skin contact for preterm infants-A randomized clinical trial.

AIM: To investigate the effects of 60 minutes delivery room skin-to-skin contact (DR-SSC) compared with 5 minutes visual contact (VC) on mother-child interaction (MCI), salivary cortisol, maternal depression, stress and bonding at 6 months corrected age. METHODS: A single-centre randomized controlled trial conducted in a German level III NICU. Eighty-eight preterm infants (25-32 weeks of gestational age) were randomized after initial stabilization to either 60 minutes DR-SSC or 5 minutes VC. Forty-five infants were allocated to DR-SSC, 43 to VC. RESULTS: Delivery room skin-to-skin contact dyads showed a higher quantity of maternal motoric (18 vs 15, P = .030), infant's vocal (7 vs 5, P = .044) and motoric (20 vs 15, P = .032) responses. Moreover, the combined score of maternal and infant responsive behaviour was higher (86 vs 71, P = .041) in DR-SSC dyads. DR-SSC mothers had lower risk of both, early postpartum depression (15% vs 45%, P = .003) and impaired bonding (Score 3 vs 5, P = .031). CONCLUSION: In addition to regular intermittent kangaroo mother care, DR-SSC promotes MCI and decreases risk of maternal depression and bonding problems. Thus, DR-SSC may have positive effects on preterm development.

Interacting effects of maternal responsiveness, infant regulatory problems and dopamine D4 receptor gene in the development of dysregulation during childhood: A longitudinal analysis.

Recent longitudinal studies have indicated that affective and behavioral dysregulation in childhood is associated with an increased risk for various negative outcomes in later life. However, few studies to date have examined early mechanisms preceding dysregulation during early childhood. Aim of this study was to elucidate early mechanisms relating to dysregulation in later life using data from an epidemiological cohort study on the long-term outcome of early risk factors from birth to adulthood. At age 3 months, mothers and infants were videotaped during a nursing and playing situation. Maternal responsiveness was evaluated by trained raters. Infant regulatory problems were assessed on the basis of a parent interview and direct observation by trained raters. At age 8 and 11 years, 290 children (139 males) were rated on the Child Behavior Checklist (CBCL). Additionally, participants were genotyped for the dopamine D4 receptor (DRD4) exon 3 VNTR polymorphism. A significant three-way interaction between maternal responsiveness, DRD4 genotype and infant regulatory problems was detected predicting the CBCL-dysregulation profile (CBCL-DP). Carriers of the DRD4 7r allele with regulatory problems at age 3 months showed significantly more behavior problems associated with the CBCL-DP during childhood when exposed to less maternal responsiveness. In contrast, no effect of maternal responsiveness was observed in DRD4 7r carriers without infant regulatory problems and in non-carriers of the DRD4 7r allele. This prospective longitudinal study extends earlier findings regarding the association of the CBCL-DP with early parenting and later psychopathology, introducing both DRD4 genotype and infant regulatory problems as important moderators.

Maternal stimulation in infancy predicts hypothalamic-pituitary-adrenal axis reactivity in young men.

Evidence from animal research has demonstrated the effect of early maternal care on the offspring's endocrine and behavioral stress response in adulthood. The present prospective study investigates, in humans, the long-term impact of maternal responsiveness and stimulation during early mother-child interaction on adrenocorticotropic hormone (ACTH) and cortisol response to a psychosocial laboratory stressor in adulthood. The data are from an epidemiological cohort study of the long-term outcome of early risk factors assessed at birth. At age 3 months, mothers and infants were videotaped during a 10-min standardized nursing and playing situation and evaluated by trained raters for maternal stimulation and infant and maternal responsiveness. At age 19 years, 270 participants (146 females, 124 males) completed the Trier Social Stress Test. The results indicated that less maternal stimulation during early interaction at age 3 months predicted diminished plasma ACTH and cortisol increase in response to acute psychosocial stress in male, but not female offspring. In contrast, maternal responsiveness was found to be unrelated to hypothalamic-pituitary-adrenal (HPA) reactivity. In accordance with the findings from animal research, the present study provides prospective evidence in humans of a long-term association between early maternal interaction behavior and the offspring's hormonal stress response in young adulthood, suggesting that poor maternal stimulation in early infancy may result in reduced HPA axis reactivity to an acute psychosocial stressor in males.

Quality of early mother-child interaction associated with depressive psychopathology in the offspring: a prospective study from infancy to adulthood.

Evidence from animal research has revealed that less maternal care results in disturbed emotionality in the offspring. In the present study, the long-term impact of maternal responsiveness and stimulation during early mother-child interaction on depressive psychopathology was examined until adulthood. Data are from an epidemiological cohort study of the long-term outcome of early risk factors assessed at birth. At age 3 months, mothers and infants were videotaped during a nursing and playing situation. Maternal responsiveness and stimulation as well as infant responsiveness were evaluated by trained raters. At age 19 years, 314 participants (145 males, 169 females) were characterized on measures of depression through interview and questionnaire. In addition, measures of depression and anxiety were available from assessments in childhood. Results indicated that less maternal stimulation during early interaction was associated with a higher risk of depression in the offspring until the age of 19 years. In addition, children of less stimulating mothers showed more depressive symptoms at age 19 years and displayed more anxiety and depressive symptoms between the ages of 4.5 and 15 years. In contrast, maternal responsiveness was unrelated to children's outcome. In accordance with findings from animal research, the present study provides first longitudinal evidence in humans of a continuous and long-term influence of early maternal interaction behavior on the offspring's psychological adjustment until adulthood. The results suggest that the amount of maternally initiated contact behavior in a very early developmental stage may be crucial for children's mental health, regardless of child and maternal responsiveness.

[Perinatal prevention network for mentally burdened and adolescent mothers]. / Perinatales Präventionsnetz für psychisch belastete und jugendliche Mütter.

Psychiatric disorder in pregnancy and after child birth as well as psychological distress are well known factors that put child wellbeing at risk. They are, however, often estimated as less frequent and less severe then they occur. Postpartum psychiatric disorder meets mothers of all social classes, they are highly stigmatized, therefore often disregarded and remain undetected. The affected mothers socially withdraw themselves due to feelings of shame, fear and guilt. They cut themselves off from psychiatric treatment and from support by child welfare institutions. The regional network "Hand in Hand" in the Rhine-Neckar-area consisting of psychiatrists, psychotherapists, gynaecologists, paediatricians, social workers and midwives uses and connects the resources available in public health and youth aid to support both the child wellbeing as well as the mental health of mothers. Our program begins by identifying risk factors for mothers' postpartum disorders and continues by increasing awareness with the previous named professional groups, so that they act promptly and offer treatment and support. The following paper describes our network activities emphasizing anti-stigma, instruction of professionals and intervention with affected families.

Perturbaciones psíquicas postparto: pueden los profesionales de la salud ayudar a prevenir efectos negativos a largo plazo / Post-partum psychic alterations: can health professionels help prevent long-term negative effects

La presencia de perturbaciones psíquicas en el embarazo y puerperio son frecuentes. En muchos casos suelen no ser detectadas y en consecuencia quedar sin tratamiento. Es frecuente observar madres que durante las primeras semanas postparto desarrollan un estado depresivo generalizado, el baby blues, que desaparece espontáneamente durante los días siguientes. Su prevalencia llega hasta el 80 por ciento. Trastornos de ansiedad y sintomatología de tipo obsesivo-compulsiva son otros cuadros psicopatológicos frecuentes. Sólo 1-2 de cada 1000 mujeres desarrollan psicosis puerperal. También puede encontrarse con frecuencia el suicidio o suicidio ampliado. La perturbación psíquica postparto diagnosticada con mayor frecuencia es la depresión. Estas patologías no difieren en su etiología ni en su desarrollo de los cuadros que se presentan en otro momento de la vida. Su característica distintiva son los síntomas, relacionados a la maternidad y al bebé y el nacimiento como evento desencadenador. Sus efectos pueden afectar a corto, mediano y largo plazo el desarrollo emocional y cognitivo de los niños. Debido a la baja especificidad de los factores de riesgo y a la estigmatización social es difícil establecer estrategias de prevención efectivas, por eso es fundamental la detección y tratamiento temprano. Muchas madres afectadas no consultan servicios de salud mental, pero sí recurren a otros profesionales de la salud por aparentes problemas de salud propios o del bebé. De ahí la importancia clave de los profesionales de salud en la detección y derivación a servicios adecuados para ayudarlas.

Father-infant interaction patterns as precursors of children's later externalizing behavior problems: a longitudinal study over 11 years.

AIM: This study examined the extent to which fathers' and infants' interaction behavior were related to children's externalizing behavior problems at age 8 and 11 years. METHODS: In a prospective longitudinal study of children at risk for later psychopathology, 72 fathers and their 3-month-old children were videotaped and evaluated during a standardized playing and nursing situation. Externalizing behavior problems at age 8 and 11 years were assessed using Achenbach's Child Behavior Checklist. RESULTS: In the high externalizing group, fathers were found to be less responsive and less sensitive (the latter only with respect to girls) during early interaction than fathers of the low externalizing group, while children were more positive with their fathers. Furthermore, low scores on the interaction pattern of "sensitive fathering/negative infant" and high scores on the "nonresponsive fathering or active infant" pattern were associated with more externalizing problems. CONCLUSION: These findings suggest that father and infant interaction behaviors during early infancy may predict later problem behaviors at school age, although the mechanisms underlying this relationship have yet to be identified.

[Father negativity in the interaction with toddlers as predictor of internalizing problems in girls and boys at school age]. / Väterliche Negativität in der Interaktion mit Zweijährigen als Prädiktor internalisierender Verhaltensprobleme von Mädchen und Jungen im Grundschulalter.

The aim of this study is to examine the association between observed fathers' negativity in the interaction with their toddlers and internalizing problems of girls and boys at school age. In a prospective study of children at risk (Mannheim Study of Risk Children), 88 father-child dyads at the child's age of 2 years were videotaped and rated with a macro- and microanalytic coding system. Behavior problems were assessed at the age of 8 years using the Teacher Report Form of Achenbach's rating scales. Results revealed that fathers were more emotionally negative with their sons than with their daughters. No further differences in the fathers' interactive behavior according to child gender were found. However, fathers whose daughters had more internalizing problems (as seen by the teachers) at age 8 years were more restrictive and showed more inadequate control and negative interactive styles. In contrast, no predictive value of father negativity was observed in boys.