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Effective reciprocal communication is a vital component in forming and maintaining social relationships. Peer social play may provide a particularly important context for communicative skill development, as sophisticated negotiation and exchange are required to coordinate play. We focus on connectedness, a property of conversation referring to the topical relation between speakers' turns, to understand how partners coordinate ideas to build a shared play experience. The present study uses a longitudinal secondary analysis approach to drive forward our understanding of the individual and shared influences that contribute to connectedness during peer social play. Using data from a three-wave, longitudinal study of children's play and social relationships during the first 3 years of school in the United Kingdom (https://osf.io/3p4q8/), we coded connectedness from transcripts of video observations of 148 children playing in pairs at wave three (mean age 6.79 years) and model individual differences in language ability, theory of mind, and emotion comprehension from all three waves as potential predictors of connectedness. Our results show substantial dyadic effects on connectedness, but individual differences in socio-cognitive measures were not significant predictors of connectedness. These findings indicate the importance of dyadic and partner effects in children's social interactions and implicate the dyad as an essential focus for future research.

This paper presents the findings of longitudinal research conducted in Ethiopia exploring the effects of COVID-19 school closures on children’s holistic learning, including their socio-emotional and academic learning. It draws on data from over 2,000 pupils captured in 2019 and 2021 to compare primary school children’s dropout and learning before and after school closures. The study adapts self-reporting scales used in similar contexts to measure grade 4–6 pupils’ social skills and numeracy. Findings highlight the risk of widening inequality regarding educational access and outcomes, related to pupils’ gender, age, wealth and location. They also highlight a decline in social skills following school closures and identify a positive and significant relationship between pupils’ social skills and numeracy over time. In conclusion, we recommend a need for education systems to promote children’s holistic learning, which is even more vital in the aftermath of the pandemic.

Effective reciprocal communication is a vital component in forming and maintaining social relationships. Peer social play may provide a particularly important context for communicative skill development, as sophisticated negotiation and exchange are required to coordinate play. We focus on connectedness, a property of conversation referring to the topical relation between speakers’ turns, to understand how partners coordinate ideas to build a shared play experience. The proposed study will use a longitudinal secondary analysis approach to drive forward our understanding of the individual and shared influences that contribute to connectedness during peer social play. Using data from a three-wave, longitudinal study of children’s play and social relationships during the first three years of school in the UK (https://osf.io/3p4q8/), we will code connectedness from transcripts of video observations of 152 children playing in pairs at wave three (mean age 6.79 years) and model individual differences in theory of mind, emotion comprehension, and language ability from all three waves as potential predictors of connectedness. Ultimately, we hope to provide a sound theoretical and empirical basis to underpin future work on play as a context for development and enhancement of communicative competences.

This project explores dyadic connectedness in children's play interactions with their peers, using secondary data from the ChiRPP study (https://osf.io/3p4q8/).

The first evaluation of the effect of Primeira Infancia Melhor (PIM), a large-scale Brazilian home-visiting program, on child development was published this year (Viegas da Silva et. al, 2022). This quasi-experimental study builds off of Viegas da Silva’s (2022) findings to 1) assess PIM’s effect on multiple positive (responsiveness, sensitivity, guidance) and negative (coerciveness) parenting practices and the parent-child relationship and 2) determine whether intervention effects are moderated by the time at which the families joined the intervention, during pregnancy vs. after birth.

This paper presents the findings of research undertaken in Ethiopia to examine the effects of COVID-19 school closures on children’s holistic learning, including both socio-emotional and academic learning. It draws on data collected in 2019 (prior to the pandemic) and 2021 (after schools reopened) to compare primary pupils’ learning before and after the school closures. In particular, the study adapts self-reporting scales that have been used in related contexts to measure Grade 3 and 6 children’s social skills, self-efficacy, emotional regulation, and mental health and wellbeing, along with literacy and numeracy. Lesson observations were also undertaken to explore teachers’ behaviours to foster socio-emotional learning (SEL) in the classroom. The findings advance current knowledge in several respects. First, they quantify the decline in Ethiopian pupils’ social skills over the period of the school closures. Second, they identify a significant and strong relationship between learners’ social skills and their numeracy, even after taking other factors into account. Third, they reveal a significant association between children’s social skills and their mental health and wellbeing, highlighting the importance of interpersonal interactions to safeguard children’s holistic welfare. The paper concludes by proposing a model for understanding the relationship between learners’ SEL and academic outcomes, and with recommendations for education planning and practice, in Ethiopia and elsewhere.

This paper explores methodological issues relating to research on children’s socio-emotional learning (SEL), mental health and wellbeing in low- and lower-middle-income countries. In particular, it examines the key considerations and challenges that researchers may face and provides practical guidance for generating reliable and valid data on SEL, mental health and wellbeing in diverse settings and different cultural contexts. In so doing, the paper draws on the experience of recent research undertaken in Ethiopia to illustrate some of the issues and how they were addressed. The present study extends earlier 2018-2019 RISE Ethiopia research, expanding its scope to consider further aspects of SEL, mental health and wellbeing in the particular context of COVID-19. In particular, the research highlights that the pandemic has brought to the fore the importance of assessing learning, and learning loss, beyond academic learning alone.

Objective. Paternal depressive disorder is associated with adverse effects on child development. One possible mechanism for this is through the effects of the disorder on parenting capacities. The link between paternal depression and father-infant interactions was investigated at three-months postpartum. Design. Major depressive disorder was assessed in N = 192 fathers using a structured clinical interview (SCID). Altogether, 54 fathers met criteria for depression, and 99 fathers were categorized as non-depressed. Observational assessments of face-to-face father-infant interactions were conducted in an infant-seat setting and a floor-mat setting. Associations between paternal depression and father-infant interactions were analyzed. Results. Paternal depression is associated with more withdrawn parental behavior in interactions on the floor-mat. There were few other differences in observed interaction between depressed and non-depressed fathers. Conclusions. Fathers with depression may be more withdrawn, displaying less verbal and behavioral stimulation during interactions with their young infants. They may initiate a pattern of parenting that remains compromised, potentially affecting their children's development.

Background: RCTs face issues with poor/slow recruitment needing extensions and extra funding. A Study within a trial (SWAT) is an embedded study that evaluates and tests ways of delivering trials to improve trial delivery. Participant Information Sheets may not be optimal for informing potential participants of trial demands. Effectiveness of alternative formats (e.g video clips) should be investigated. Aim: To evaluate the effectiveness of an information video clip in comparison to a standard participant information sheet on the rate of recruitment.

This is a brief study protocol of the study "A feasibility study and pilot RCT of a modified video-feedback parenting intervention forchildren in foster care with reactive attachment disorder" (ISRCTN18374094). The full version (version 6, 10/07/2019) can be provided upon request.

Importance: Paternal depression during the postnatal period has been associated with adverse child outcomes. Family environment has been reported as a pathway for risk transmission from fathers to children. The influence of paternal depression during the postnatal period on offspring depression remains to be clarified.Objective: To investigate the association between paternal depression in the postnatal period and offspring depression and explore potential mediating and moderating factors that influence any association between paternal and offspring depression.Design, Setting, and Participants: This prospective study of a UK community-based birth cohort (the Avon Longitudinal Study of Parents and Children) of parents and their adolescent offspring investigated associations between paternal depression during the postnatal period and offspring depression at age 18 years. We tested a hypothesized moderator (ie, sex) and conducted path analysis to examine hypothesized mediators (ie, depression in the other parent, couple conflict, and paternal involvement and emotional problems, conduct problems, and hyperactivity in offspring at age 3.5 years) of the associations between both paternal and maternal depression and offspring depression. Data collection for the Avon Longitudinal Study of Parents and Children began in 1991 and is ongoing. Data analysis for this study was conducted from June 2015 to September 2018.Exposures: Depression symptoms in fathers at 8 weeks after the birth of their children.Main Outcomes and Measures: Offspring depression symptoms at age 18 years, using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes.Results: A total of 3176 father-offspring pairs were analyzed; of the children, 1764 were girls (55.5%) and 1412 (44.5%) were boys. Paternal mean (SD) age at delivery was 29.6 (9.6) years. The offspring of fathers who had depression during the postnatal period were at increased risk of experiencing depression symptoms at age 18 years (β = 0.053 [95% CI, 0.02-0.09]). The association is mediated by maternal depression at 8 months after birth (β = 0.011 [95% CI, 0.0008-0.02]; 21% [0.011/0.053]) and conduct problems at 42 months after birth (β = 0.004; [95% CI , -0.00004 to 0.009]; 7.5% [0.004/0.053]). Couple conflict and paternal involvement do not mediate this association. The increased risk is seen in girls but not boys (interaction β = 0.095; P = .01).Conclusions and Relevance: The association between paternal depression in the postnatal period and depression in girls at age 18 years is partially explained by maternal depression. Couple conflict and paternal involvement were not found to play a role in the risk of transmission; this contrasts with the role that couple conflict was found to play in the risk of childhood behavior problems. Conduct problems in childhood appear to be a pathway for risk transmission between paternal depression and subsequent depression in offspring at age 18 years.

BACKGROUND: The quality of parenting is associated with a wide range of child and adult outcomes, and there is evidence to suggest that some aspects of parenting show patterns of intergenerational transmission. This study aimed to determine whether such intergenerational transmission occurs in mothers and fathers in a UK birth cohort. METHODS: The study sample consisted of 146 mothers and 146 fathers who were recruited from maternity wards in England and followed up for 24 months ['Generation 2' (G2)]. Perceptions of their own parenting [by 'Generation1' (G1)] were assessed from G2 parents at 12 months using the Parental Bonding Instrument (PBI). G2 parents were filmed interacting with their 'Generation 3' (G3) children at 24 months. RESULTS: We found that G1 mothers' 'affection' was associated with positive parenting behaviour in the G2 fathers ('positive responsiveness' β = 0.19, P = 0.04 and 'cognitive stimulation' β = 0.26, P < 0.01). G1 mothers' 'control' was associated with negative parenting behaviour in G2 mothers (decreased 'engagement' β = -0.19, P = 0.04), and negative parenting behaviour in G2 fathers (increased 'control' β = 0.18, P = 0.05). None of the G1 fathers' parenting variables were significantly associated with G2 parenting. CONCLUSIONS: There is evidence of intergenerational transmission of parenting behaviour in this highly educated UK cohort, with reported parenting of grandmothers associated with observed parenting in both mothers and fathers. No association was seen with reported parenting of grandfathers. This raises the possibility that parenting interventions may have benefits that are realised across generations.

Introduciton: Depression is a common mental health disorders during pregnancy, with important consequences for mothers and their children. Despite this, it goes undiagnosed and untreated in many women attending antenatal care. Smartphones could help support the prompt dentification of antenatal depression in this setting. In addition, these devices enable the implementation of ecological momentary assessment techniques, which could be used to assess how mood is experienced during pregnancy. With this study, we will assess the feasibility of using a bespoke mobile application running on participants’ own handsets for the longitudinal (6 months) monitoring of antenatal mood and screening of depression. Methods and analysis: We will use a randomised controlled study design to compare two types of assessment strategies: retrospective + momentary (consisting of the Edinburgh Postnatal Depression Scale plus 5 momentary and 2 contextual questions), and retrospective (consisting of the Edinburgh Postnatal Depression Scale only). We will assess the impact that these strategies have on participant adherence to a pre-specified sampling protocol, drop-out rates and timeliness of data completion. We will evaluate differences in acceptance of the technology through a short quantitative survey and open ended questions. We will also assess the potential effect that momentary assessments could have on retrospective data. We will attempt to identify any patterns in app usage through the analysis of log data. Ethics and dissemination: This study has been approved by the South East Coast – Surrey Research Ethics Committee. Our findings will be disseminated through academic peer-reviewed publications, conferences and discussion with peers. Registration details: This study has been registered in ClinicalTrials.gov under the identifier NCT02516982. STRENGTHS OF THIS STUDY: This study will explore: (i) the role of mobile technology as a medium to address some of the practical barriers preventing depression screening in antenatal settings; (ii) how mood and depression are experienced throughout pregnancy (using momentary, experiential and ecological data); and ( iii) two critical success factors for the successful deployment of mobile technology in pregnancy: user engagement and adherence to a proposed sampling protocol • This study will provide baseline information regard ing the appropriateness of a sampling protocol (in terms of its duration, intensity and frequency) for the monitoring of mood and screening of depression during the antenatal period • The technology used in this study has been specific ally designed and developed to fit within the clinical context and the local care path ways in which it will be deployed LIMITATIONS OF THIS STUDY: • This study focuses on mood and antenatal depression. It does not consider other common mental health disorders that occur during pr egnancy, or the presence of potential triggers or risk factors (for example, do mestic violence) • The mood-related momentary questions used in this study have not been validated • This study relies on self-report measures. Research is being conducted to explore how smartphone and app usage data could be used to unobtrusively identify low mood and depression in the general population

Additional file 1: Appendix 1. Interview schedule for participants. Appendix 2. Interview schedule for researchers.

Background Mobile devices may facilitate depression screening in the waiting area of antenatal clinics. This can present implementation challenges, of which we focused on survey layout and technology deployment. Methods We assessed the feasibility of using tablet computers to administer a socio-demographic survey, the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to 530 pregnant women attending National Health Service (NHS) antenatal clinics across England. We randomised participants to one of two layout versions of these surveys: (i) a scrolling layout where each survey was presented on a single screen; or (ii) a paging layout where only one question appeared on the screen at any given time. Results Overall, 85.10% of eligible pregnant women agreed to take part. Of these, 90.95% completed the study procedures. Approximately 23% of participants answered Yes to at least one Whooley question, and approximately 13% of them scored 10 points of more on the EPDS. We observed no association between survey layout and the responses given to the Whooley questions, the median EPDS scores, the number of participants at increased risk of self-harm, and the number of participants asking for technical assistance. However, we observed a difference in the number of participants at each EPDS scoring interval (p = 0.008), which provide an indication of a woman’s risk of depression. A scrolling layout resulted in faster completion times (median = 4 min 46 s) than a paging layout (median = 5 min 33 s) (p = 0.024). However, the clinical significance of this difference (47.5 s) is yet to be determined. Conclusions Tablet computers can be used for depression screening in the waiting area of antenatal clinics. This requires the careful consideration of clinical workflows, and technology-related issues such as connectivity and security. An association between survey layout and EPDS scoring intervals needs to be explored further to determine if it corresponds to a survey layout effect. Future research needs to evaluate the effect of this type of antenatal depression screening on clinical outcomes and clinic workflows. Trial registration This study was registered in ClinicalTrials.gov under the identifier NCT02516982 on 20 July 2015.

Edinburgh Postnatal Depression Scale. Description of data: a ten-item instrument used to screen for antenatal or postnatal depression in community and clinical settings. This instrument assesses feelings of guilt, sleep disturbance, anhedonia and thoughts of self-harm that have been present for the past 7 days. (DOCX 84 kb)

Whooley Questions. Description of data: two-item survey used to evaluate the presence of depressive mood and anhedonia over the past month. (DOCX 46 kb)

Spirit checklist. (DOCX 50 kb)

Whooley Questions. Description of data: two-item survey used to evaluate the presence of depressive mood and anhedonia over the past month. (DOCX 46 kb)

Edinburgh Postnatal Depression Scale. Description of data: a ten-item instrument used to screen for antenatal or postnatal depression in community and clinical settings. This instrument assesses feelings of guilt, sleep disturbance, anhedonia and thoughts of self-harm that have been present for the past 7 days. (DOCX 84 kb)

Socio-demographic survey. Description of data: eleven-question survey used to gather socio-demographic information from participants. (DOCX 66 kb)

SPIRIT Checklist. (PDF 130 kb)

Standard Operating Procedure where participant has elevanted levels of depressive symptoms. (PDF 386 kb)

Additional file 1. SPIRIT Checklist.

OBJECTIVE: Maternal antenatal anxiety is associated with an increased risk of behavioral disturbances in offspring. Recent work has suggested that the effect of maternal antenatal anxiety on infant temperament at 6 months is moderated by the serotonin transporter polymorphism 5-HTTLPR, with carriers of the short allele more susceptible to the adverse behavioral outcomes of maternal antenatal anxiety. These findings, however, are yet to be replicated and extended beyond infancy. The aim of the current study was to assess this same potential moderator (5-HTTLPR) in a large population-based cohort study, and to determine whether or not the effects persist into childhood and early adolescence. METHOD: Data from the Avon Longitudinal Study of Children and Parents (ALSPAC) cohort (N = 3,946) were used to assess whether the 5-HTTLPR genotype moderated the association between self-reported maternal antenatal anxiety (Crown Crisp Index) in pregnancy, and child temperament at 6 months (Infant Temperament Questionnaire), and also later behavioral and emotional problems on the Strengths and Difficulties Questionnaire from age 4 to 13 years. RESULTS: We found no evidence to suggest that the 5-HTTLPR polymorphism moderated the effects of maternal antenatal anxiety on infant temperament at 6 months or infant behavioral and emotional problems from childhood through to adolescence. CONCLUSION: Our results, based on a large prospective community sample that assessed children from infancy to early adolescence, provide a thorough test of, but no evidence for, a genetic moderation of the effects of maternal antenatal anxiety by 5-HTTLPR.

Additional file 1. SPIRIT Checklist.

BACKGROUND: Perinatal mental health problems affect up to one in five women worldwide. Mental health problems in the perinatal period are a particular challenge in low- and middle-income countries (LMICs) where they can be at least twice as frequent as in higher-income countries. It is thus of high priority to develop new low-cost, low-resource, non-stigmatising and culturally appropriate approaches to reduce symptoms of anxiety and depression perinatally, for the benefit of both mother and child. Music-centred approaches may be particularly useful in The Gambia since a range of musical practices that specifically engage pregnant women and new mothers already exist. METHODS: This protocol is for a study to examine the feasibility of undertaking a stepped wedge trial to test how a Community Health Intervention through Musical Engagement (CHIME) could be beneficial in alleviating perinatal mental distress in The Gambia. In this study, we plan to recruit 120 pregnant women (n = 60 intervention, n = 60 control) at four antenatal clinics over two 6-week stepped sequences. Women in the intervention will participate in weekly group-singing sessions, led by local Kanyeleng singing groups, for 6 weeks. The control group will receive standard care. We will assess symptoms of anxiety and depression using the Edinburgh Postnatal Depression Scale (EPDS) and the Self-Reporting Questionnaire (SRQ-20). The feasibility of the design will be assessed through recruitment, retention and attrition rates of participants, clinics' adherence to the schedule and completeness of data by site. Qualitative interviews and video and audio recordings will be used to evaluate the acceptability of the intervention. DISCUSSION: This feasibility trial will allow us to determine whether a larger trial with the same intervention and target group is feasible and acceptable in The Gambia. TRIAL REGISTRATION: Retrospectively registered (24/01/2019) with Pan African Clinical Trials Registry (PACTR): PACTR201901917619299.

Background: Perinatal mental health problems affect up to one in five women worldwide. Mental health problems in the perinatal period are a particular challenge in low- and middle-income countries (LMICs) where they can be at least twice as frequent as in higher-income countries. It is thus of high priority to develop new low-cost, low-resource, non-stigmatising and culturally appropriate approaches to reduce symptoms of anxiety and depression perinatally, for the benefit of both mother and child. Music-centred approaches may be particularly useful in The Gambia since a range of musical practices that specifically engage pregnant women and new mothers already exist. Methods: This protocol is for a study to examine the feasibility of undertaking a stepped wedge trial to test how a Community Health Intervention through Musical Engagement (CHIME) could be beneficial in alleviating perinatal mental distress in The Gambia. In this study, we plan to recruit 120 pregnant women (n = 60 intervention, n = 60 control) at four antenatal clinics over two 6-week stepped sequences. Women in the intervention will participate in weekly group-singing sessions, led by local Kanyeleng singing groups, for 6 weeks. The control group will receive standard care. We will assess symptoms of anxiety and depression using the Edinburgh Postnatal Depression Scale (EPDS) and the Self-Reporting Questionnaire (SRQ-20). The feasibility of the design will be assessed through recruitment, retention and attrition rates of participants, clinics' adherence to the schedule and completeness of data by site. Qualitative interviews and video and audio recordings will be used to evaluate the acceptability of the intervention. Discussion: This feasibility trial will allow us to determine whether a larger trial with the same intervention and target group is feasible and acceptable in The Gambia. Trial registration: Retrospectively registered (24/01/2019) with Pan African Clinical Trials Registry (PACTR): PACTR201901917619299.

BACKGROUND: Behaviour problems emerge early in childhood and place children at risk for later psychopathology. OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness of a parenting intervention to prevent enduring behaviour problems in young children. DESIGN: A pragmatic, assessor-blinded, multisite, two-arm, parallel-group randomised controlled trial. SETTING: Health visiting services in six NHS trusts in England. PARTICIPANTS: A total of 300 at-risk children aged 12-36 months and their parents/caregivers. INTERVENTIONS: Families were allocated in a 1 : 1 ratio to six sessions of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) plus usual care or usual care alone. MAIN OUTCOME MEASURES: The primary outcome was the Preschool Parental Account of Children's Symptoms, which is a structured interview of behaviour symptoms. Secondary outcomes included caregiver-reported total problems on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The intervention effect was estimated using linear regression. Health and social care service use was recorded using the Child and Adolescent Service Use Schedule and cost-effectiveness was explored using the Preschool Parental Account of Children's Symptoms. RESULTS: In total, 300 families were randomised: 151 to VIPP-SD plus usual care and 149 to usual care alone. Follow-up data were available for 286 (VIPP-SD, n = 140; usual care, n = 146) participants and 282 (VIPP-SD, n = 140; usual care, n = 142) participants at 5 and 24 months, respectively. At the post-treatment (primary outcome) follow-up, a group difference of 2.03 on Preschool Parental Account of Children's Symptoms (95% confidence interval 0.06 to 4.01; p = 0.04) indicated a positive treatment effect on behaviour problems (Cohen's d = 0.20, 95% confidence interval 0.01 to 0.40). The effect was strongest for children's conduct [1.61, 95% confidence interval 0.44 to 2.78; p = 0.007 (d = 0.30, 95% confidence interval 0.08 to 0.51)] versus attention deficit hyperactivity disorder symptoms [0.29, 95% confidence interval -1.06 to 1.65; p = 0.67 (d = 0.05, 95% confidence interval -0.17 to 0.27)]. The Child Behaviour Checklist [3.24, 95% confidence interval -0.06 to 6.54; p = 0.05 (d = 0.15, 95% confidence interval 0.00 to 0.31)] and the Strengths and Difficulties Questionnaire [0.93, 95% confidence interval -0.03 to 1.9; p = 0.06 (d = 0.18, 95% confidence interval -0.01 to 0.36)] demonstrated similar positive treatment effects to those found for the Preschool Parental Account of Children's Symptoms. At 24 months, the group difference on the Preschool Parental Account of Children's Symptoms was 1.73 [95% confidence interval -0.24 to 3.71; p = 0.08 (d = 0.17, 95% confidence interval -0.02 to 0.37)]; the effect remained strongest for conduct [1.07, 95% confidence interval -0.06 to 2.20; p = 0.06 (d = 0.20, 95% confidence interval -0.01 to 0.42)] versus attention deficit hyperactivity disorder symptoms [0.62, 95% confidence interval -0.60 to 1.84; p = 0.32 (d = 0.10, 95% confidence interval -0.10 to 0.30)], with little evidence of an effect on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The primary economic analysis showed better outcomes in the VIPP-SD group at 24 months, but also higher costs than the usual-care group (adjusted mean difference £1450, 95% confidence interval £619 to £2281). No treatment- or trial-related adverse events were reported. The probability of VIPP-SD being cost-effective compared with usual care at the 24-month follow-up increased as willingness to pay for improvements on the Preschool Parental Account of Children's Symptoms increased, with VIPP-SD having the higher probability of being cost-effective at willingness-to-pay values above £800 per 1-point improvement on the Preschool Parental Account of Children's Symptoms. LIMITATIONS: The proportion of participants with graduate-level qualifications was higher than among the general public. CONCLUSIONS: VIPP-SD is effective in reducing behaviour problems in young children when delivered by health visiting teams. Most of the effect of VIPP-SD appears to be retained over 24 months. However, we can be less certain about its value for money. TRIAL REGISTRATION: Current Controlled Trials ISRCTN58327365. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 29. See the NIHR Journals Library website for further project information.

BACKGROUND: Female fetuses are more vulnerable to high levels of maternal glucocorticoids. We examined whether exposure to prenatal maternal depression, a condition associated with high glucocorticoids, carries greater risk for depression at 12 and 18 years in girls. METHODS: Our sample comprised 7959 mothers and children from the Avon Longitudinal Study of Parents and Children following imputation for missing data. Maternal depression was assessed pre-and post-natally, and offspring depression at ages 12 and 18. We used logistic regression models to examine the relationship between exposure to prenatal and postnatal depression and offspring depression at 18 and 12 and interactions with gender. RESULTS: There was an interaction between prenatal depression and gender (P=0.027) and between postnatal depression and gender (P=0.027) for offspring depression at 18. Following adjustment in pre-natally depressed mothers, the odds ratio for offspring depression at 18 was 1.55 (95% c.i. 1.03-2.34) for girls and 0.54 (0.23-1.26) for boys. In post-natally depressed mothers, the odds ratio for offspring depression at 18 was 1.15 (0.70-1.89) in girls and 3.13 (1.52-6.45) in boys. However there was no evidence for interaction between prenatal or postnatal depression and gender (P=0.559 and 0.780 respectively) for offspring depression at 12. LIMITATIONS: As expected with this large cohort spanning over 18 years, there was loss-to-follow-up. CONCLUSIONS: This is the first evidence in humans that increased vulnerability of female fetuses to maternal stress responses during pregnancy persists into adolescence. One explanation for gender differences emerging later is more depressive symptomatology is attributed to heritable risk at 12, whereas biological processes involved in brain development at 18 may be influenced by foetal programming. If replicated, this study has potential to help understand intergenerational transmission of depression, a leading cause of morbidity worldwide.

The COVID‐19 pandemic and lockdown regulations introduced many changes to children's everyday lives, including play, creating a unique pandemic experience for children. For this qualitative study, 15 children (ages 3–10) participated in virtual interviews on play during the pandemic between August and October 2020. While children recognised changes to play, it had persisted despite restrictions—play itself was not on lockdown. Children showed that play remained valuable and was an expression of adaptability, confidence and positivity. These considerations can help us support children's childhoods during crises, as children are members of society with rights to voice their opinions on matters affecting their lives.

Funder: LEGO Foundation, This systematic review and meta-analysis considered evidence of guided play compared to direct instruction or free play to support children’s learning and development. Interventions from 39 studies were reviewed (published 1977-2020); 17 were included in meta-analysis (N total = 3,893; M childage = 1 – 8 years; M girls 49.8%; M ethnicity; White 41%, African American/Black 28%, Hispanic 19%). Guided play had a greater positive effect than direct instruction on early maths skills (g = 0.24), shape knowledge (g = 0.63) and task switching (g = 0.40); and than free play on spatial vocabulary (g = 0.93). Differences were not identified for other key outcomes. Narrative synthesis highlighted heterogeneity in conceptualisation and implementation of guided play across studies., LEGO Foundation

Background We investigated the acceptability and feasibility of a new brief intervention for maternal prenatal anxiety within maternity services in London and Exeter, UK. Methods One hundred fourteen pregnant individuals attending their 12-week scan at a prenatal clinic with elevated symptoms of anxiety (GAD-7 score of ≥7) were randomly assigned to either the ACORN intervention + Treatment as usual (TAU) (n = 57) or to usual care only (n = 57). The ACORN intervention consisted of 3 2-h group sessions, led by a midwife and psychological therapist, for pregnant individuals and their partners. The intervention included psychoeducation about anxiety, strategies for problem-sovling and tolerating uncertainty during pregnancy, including communicating about these with others, and mindfulness exercises. Results Engagement rates with ACORN met or exceeded those in primary care services in England. In the intervention arm, 77% (n = 44) of participants attended at least one session, 51% (n = 29) were adherent, defined as attending two or more sessions. Feedback was positive, and participants in the ACORN treatment group demonstrated evidence of a larger drop in their levels of anxiety than the participants in the TAU-only group (Cohen’s d = 0.42). Conclusion The ACORN intervention was acceptable to pregnant individuals and their partners and resulted in reductions in anxiety. With further evaluation in a larger-scale trial with child outcomes, there is significant potential for large scale public health benefit.

Paternal mental health is beginning to be recognized as an essential part of perinatal health. Historically, fathers were not recognized as being at risk for perinatal mental illnesses or relevant to maternal and infant health outcomes. The purpose of this paper is to provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. An international team of paternal perinatal mental health experts summarized the key findings of the field. Fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression and can impact their ability to support mothers. Paternal mental health is uniquely associated with child mental health and developmental outcomes starting from infancy and continuing through the child lifespan. Tailored screening approaches for paternal mental health are essential to support fathers early in the perinatal period, which would offset health risks for the family. Recommendations on paternal mental health are provided on four key areas to support father perinatal mental health: (1) intervention research, (2) clinical training, (3) national policy, and (4) the inclusion of fathers in the focus of the International Marce Society for Perinatal Mental Health.

Funder: National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London, Funder: LEGO Foundation, Background: Parental anxiety and depression have been associated with changes to parent–child interactions. Although play constitutes an important part of parent–child interactions and affords critical developmental opportunities, little is known regarding how parental anxiety and depression are related to parent–child play. This is an important knowledge gap because parents play a crucial role in children’s early play experience. The purpose of the current study was to examine whether levels of maternal anxiety and depression respectively predicted frequencies of pretend play in both mothers and their children, and whether mothers’ engagement in pretend play predicted child behaviour problems two years later. Methods: Pretend play in 60 mother-toddler dyads (Mage of child = 29.67 months, SD = 3.25, 41.7% girls) was assessed during home visits. Maternal anxiety and depression were assessed using self-report questionnaires. Children’s behaviour problems were rated by mothers at baseline and two years later. Hierarchical regression analyses examined concurrent associations between mother–child pretend play and maternal anxiety and depression at baseline, and longitudinal associations between baseline mother pretend play and child behavioural problems two years later. Results: Higher maternal anxiety predicted less pretend play in mothers and children (β = − .23, BCa 95% CI: [− .018, − .001]) and β = − .22, BCa 95% CI [− .014, − .001]). Higher maternal depression predicted less child pretend play (β = − .20, BCa 95% CI [− .012, − .001]). There was evidence (albeit weak) that more mother pretend play at baseline predicted fewer child behaviour problems two years later (β = − .18, BCa 95% CI [− 62.38, 11.69]), when baseline child behaviour problems and maternal anxiety were controlled for. Conclusions: Maternal anxiety and depression are associated with less pretend play during mother–child interaction. Mother’s pretend play might help reduce child behavioural problems risks, suggesting that play might be one mechanism by which maternal mental health influences children’s development.

This thesis aims to explore the role of temperamental emotionality in the development and early intervention of externalising behavioural problems (EBP). Given the evidence that early EBP has a lasting negative impact on adjustment outcomes, interventions are suggested to be offered as early as possible. Longitudinal research provides general support for temperamental emotionality as a risk factor for persistent early EBP and some evidence of its mediation between adverse parenting and EBP. However, it remains unclear whether temperamental emotionality should be targeted by parenting interventions to reduce early EBP. If temperamental emotionality can be measured accurately earlier and it leads to EBP, this may provide an earlier point of intervention. Study 1 examined measurement agreement between a caregiver-reported temperament questionnaire and an observational measure using parent-infant interactions as emotion elicitors. The findings of an absent or medium positive association between caregiver-reported and observed temperamental emotionality indicate that both measures capture different but somewhat overlapping components of temperamental emotionality. Study 2 and Study 3 were conducted with 300 toddlers at risk of behavioural difficulties and their parents, who were randomised to III receive Video feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) or treatment as usual. Study 2 found that decreases in caregiverreported negative emotionality, but not observed negative emotionality, were associated with decreases in EBP, Attention-Deficit/Hyperactivity Disorder symptoms and conduct problems. This supports negative emotionality as a general vulnerability across subtypes of early EBP. The finding of mediation of decreased negative emotionality between improved overreactive parenting and EBP indicates the importance of negative emotionality in coercive parent-child processes to early EBP. Study 3 experimentally tested whether negative emotionality could be a malleable target for VIPP-SD to reduce early EBP but found no evidence. Future research on how temperamental emotionality impacts parent-child transactional processes is worthwhile for innovating early intervention. Open Access

Background Studies of child development typically rely on the insights of adults to understand children’s behaviour. The value of integrating children’s own perspectives into these investigations has been more widely recognised in recent years. However, such opportunities are rarely extended to very young children, particularly in populations exhibiting challenging behaviours. This thesis contributes empirical evidence to this field by obtaining child-reported data in a large sample of three- and four-year-olds. Using a play-based story stem battery, children’s narrative representations and their relation to children’s behaviour, parental discipline, parental sensitivity, and a video-feedback parenting intervention are explored. Setting, Participants, and Main Measures This research was embedded in the Healthy Start, Happy Start study, a pragmatic randomised controlled trial. Participants were 300 children, who were 12-36 months old and exhibited elevated behaviour problems at screening, and their caregivers. Families were assessed at baseline, 5-month follow-up, and 24-month follow-up. In this thesis, key measures were child behaviour assessed at all time-points, parental sensitivity assessed at baseline and 5-month follow-up, and children’s narrative representations assessed at 24-month follow-up. Results Results from three studies are presented. The first, a cross-sectional study, revealed modest but consistent associations between constructs derived from children’s narratives and parent- and teacher-reported behaviour. The second and third studies were longitudinal and experimental in design. Behaviour problems in toddlerhood were associated with disruptive story themes at three- and four-years-old. Early parental sensitivity was associated with narrative coherence and observed behavioural dysregulation at three- and four-years-old. A video-feedback parenting intervention was found to have small to medium, positive effects on children’s behaviour problems, narrative coherence, and expression of prosocial themes. There was no evidence that improvements to parental sensitivity mediated these relationships. Conclusion This thesis contributes to our understanding of the influences of early behaviour and parent-child interactions on children’s development and highlights the feasibility and unique value of integrating young children’s own perspectives into such investigations. Open Access

Children will face many hidden negative effects from the new coronavirus- it's not too late to avert them, says Paul Ramchandani.

UNLABELLED: This paper reviews parenting programmes and their effectiveness with families of young children and highlights additional resources for primary care practitioners. Typically, 30% of GP consultations concern child behaviour problems and established behaviour problems can have lasting effects on children's life chances. These problems can be identified in infancy and toddlerhood.Parenting is a key risk factor in their development and maintenance, yet is also amenable to change. In this paper we consider six parenting programmes that are widely evaluated and/or available in the U.K. and their evidence base . These include two NICE recommended parenting programmes (Incredible Years and Triple P), which offer tiered and flexible parenting programmes; predominantly for parents of school-age children. We also review Parent-Infant Psychotherapy, which is typically for parents of younger children. Fourth is Family Nurse Partnership, an intensive programme to support young, first-time mothers. Finally we consider, video feedback programmes which use video to focus in detail on parents' interactions with their children, including Video Feedback to Promote Positive Parenting and Video Interactive Guidance. These interventions demonstrate the range of approaches which are being used to intervene early in children's lives to try to prevent the development of enduring behavioural problems. WHY THIS MATTERS TO ME: It is becoming increasingly clear that the origins of many mental health problems lie in childhood. Family factors, including the quality of care that parents provide for their children, can make a huge difference to children's early life pathways, for better or for worse. Understanding how best to intervene to support parents is a key challenge. In this article, we critically review the most widely used parenting programmes for parents of young children. It is imperative that we judge these early interventions to high standards so that we are offering children the best start in life. KEY MESSAGE: Parenting programmes offer a means to intercept behaviour problems in early childhood before they become established.

BackgroundLittle is known about the social and emotional well-being of children whose fathers have been deployed to the conflicts in Iraq/Afghanistan or who have post-traumatic stress disorder (PTSD).AimsTo examine the emotional and behavioural well-being of children whose fathers are or have been in the UK armed forces, in particular the effects of paternal deployment to the conflicts in Iraq or Afghanistan and paternal PTSD.MethodFathers who had taken part in a large tri-service cohort and had children aged 3–16 years were asked about the emotional and behavioural well-being of their child(ren) and assessed for symptoms of PTSD via online questionnaires and telephone interview.ResultsIn total, 621 (67%) fathers participated, providing data on 1044 children. Paternal deployment to Iraq or Afghanistan was not associated with childhood emotional and behavioural difficulties. Paternal probable PTSD were associated with child hyperactivity. This finding was limited to boys and those under 11 years of age.ConclusionsThis study showed that adverse childhood emotional and behavioural well-being was not associated with paternal deployment but was associated with paternal probable PTSD.Declaration of interestN.T.F. is a trustee of the Warrior Programme, a charity supporting ex-service personnel and their families. She is also a member of the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee of Combat Stress, a charity supporting ex-service personnel and their families, and President of the Royal Society of Medicine. S.W. is partially funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastle University.

Background National guidelines in the UK, United States of America, Canada, and Australia have recently stressed the importance of identifying and treating antenatal anxiety and depression. However, there is little research into the most effective and acceptable ways of helping women manage their symptoms of anxiety and stress during pregnancy. Research indicates the necessity to consider the unique needs and concerns of perinatal populations to ensure treatment engagement, highlighting the need to develop specialised treatments which could be integrated within routine antenatal healthcare services. This trial aims to develop a brief intervention for antenatal anxiety, with a focus on embedding the delivery of the treatment within routine antenatal care. Methods/Design This study is a two-phase feasibility trial. In phase 1 we will develop and pilot a brief intervention for antenatal anxiety, blended with group support, to be led by midwives. This intervention will draw on cognitive behavioural principles and wider learning from existing interventions that have been used to reduce anxiety in expectant mothers. The intervention will then be tested in a pilot randomised controlled trial in phase 2. The following outcomes will be assessed: (1) number of participants meeting eligibility criteria, (2) number of participants consenting to the study, (3) number of participants randomised, (4) number of sessions completed by those in the intervention arm, and (5) number of participants completing the post-intervention outcome measures. Secondary outcomes comprise: detailed feedback on acceptability, which will guide further development of the intervention; and outcome data on symptoms of maternal and paternal anxiety and depression, maternal quality of life, quality of couple relationship, mother-child bonding, infant temperament and infant sleep. Discussion The study will provide important data to inform the design of a future full-scale randomised controlled trial of a brief intervention for anxiety during pregnancy. This will include information on its acceptability and feasibility regarding implementation within current antenatal services, which will inform whether ultimately this provision could be rolled out widely in healthcare settings. Trial registration Current Controlled Trials ISRCTN95282830. Registered on 29 October 2014. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1274-8) contains supplementary material, which is available to authorized users.

The quality of father–child interactions has become a focus of increasing research in the field of child development. We examined the potential contribution of father–child interactions at both 3 months and 24 months to children's cognitive development at 24 months. Observational measures of father–child interactions at 3 and 24 months were used to assess the quality of fathers’ parenting (n = 192). At 24 months, the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development, Second Edition (N. Bayley, 1993) measured cognitive functioning. The association between interactions and cognitive development was examined using multiple linear regression analyses, adjusting for paternal age, education and depression, infant age, and maternal sensitivity. Children whose fathers displayed more withdrawn and depressive behaviors in father–infant interactions at 3 months scored lower on the MDI at 24 months. At 24 months, children whose fathers were more engaged and sensitive as well as those whose fathers were less controlling in their interactions scored higher on the MDI. These findings were independent of the effects of maternal sensitivity. Results indicate that father–child interactions, even from a very young age (i.e., 3 months) may influence children's cognitive development. They highlight the potential significance of interventions to promote positive parenting by fathers and policies that encourage fathers to spend more time with their young children.

Background Coparenting describes the relationship between two caregivers and the way they work together to provide care for a child. Research is increasingly demonstrating the importance of coparenting as a predictor of child and parent outcomes. However, less is known about the determinants of this relationship and whether it is a suitable target for intervention. Video-feedback interventions have been shown to be effective at improving parenting, but the effectiveness of these interventions in improving child outcomes has not been systematically explored. Aims 1. Chapter two is a meta-analysis investigating the effectiveness of video-feedback interventions in improving child socio-emotional development. 2. Chapter three is a longitudinal study exploring the contributions of early child temperament and parental depression on the development of mothers’ and fathers’ coparenting (N = 138). 3. Chapter four is a randomised controlled trial (RCT) of a video-feedback intervention (VIPP-Co), investigating whether the intervention improves coparenting, and whether these potential changes mediate the effectiveness of the intervention in improving child behaviour problems (N = 45). Results 1. The results of chapter two found mixed effects of video-feedback on child outcomes, with short-term effects seen for externalising behaviour (d = -0.20), child initiated interaction (d = 0.45 – 0.64) and one measure of attachment security (pOR = -0.58). No long-term effects were found. 2. The results of chapter three suggest that some families can compensate for an early difficult child temperament and parental depression, leading to more cooperative coparenting. 3. The trial in chapter four was underpowered to detect intervention effects, but showed a trend towards a possible effect of the intervention on fathers’ cooperation. Conclusions This thesis has shown that video-feedback is effective at improving some child-socio-emotional outcomes. It has contributed to our understanding of how the coparenting relationship is affected by early family characteristics. Some evidence was found to suggest that coparenting is an acceptable target for intervention. Open Access

BACKGROUND: Early childhood aggressive behaviour is a predictor of future violence. Therefore, identifying risk factors for children's aggressive behaviour is important in understanding underlying mechanisms. Maternal postpartum depression is a known risk factor. However, little research has focused on the influence of paternal behaviour on early childhood aggression and its interaction with maternal postpartum depression. METHODS: This study was performed in two cohorts: the Fathers Project, in the United Kingdom (n = 143) and the Generation R Study, in The Netherlands (n = 549). In both cohorts, we related paternal antisocial personality (ASP) traits and maternal postpartum depressive (PPD) symptoms to childhood aggressive behaviour at age two (Fathers Project) and age three (Generation R Study). We additionally tested whether the presence of paternal ASP traits increased the association between maternal PPD-symptoms and early childhood aggression. RESULTS: The association between paternal ASP traits and early childhood aggressive behaviour, corrected for maternal PPD-symptoms, was similar in magnitude between the cohorts (Fathers Project: standardized β = 0.12, p = 0.146; Generation R: β = 0.14, p = 0.001), although the association was not statistically significant in the Fathers Project. Strikingly, and in contrast to our expectations, there was evidence of a negative interaction between paternal ASP traits and maternal PPD-symptoms on childhood aggressive behaviour (Fathers Project: β = -0.20, p = 0.020; Generation R: β = -0.09, p = 0.043) in both studies. This meant that with higher levels of paternal ASP traits the association between maternal PPD-symptoms and childhood aggressive behaviour was less and vice versa. CONCLUSIONS: Our findings stress the importance of including both maternal and paternal psychopathology in future studies and interventions focusing on early childhood aggressive behaviour.

This article extends the research focusing on the early origins of psychopathology into the prenatal period, by exploring the association between maternal prenatal depression and offspring (fetal and infant) neurobehavior. The sample is recruited from a rural population in South India where women in the third trimester of pregnancy were assessed for depression and the heart rate responses of their fetuses to extrinsically applied vibroacoustic stimuli were studied. At 2 months postbirth, infant temperament and cortisol responsivity to immunization were assessed. The association between maternal prenatal depression and fetal responsivity to vibroacoustic stimulation, and infant responsivity to immunization, was U shaped with higher levels of responsivity noted in the offspring of mothers with very high and very low depression scores, and lower levels noted in the offspring of mothers with moderate depression scores. Maternal prenatal depression was not associated with infant temperament. The findings highlight the importance of environmental influences in the developmental origins of neurobehavior, suggesting that such differences, not evident at baseline, may emerge upon exposure to stressors. The study also emphasizes the need for further investigation in low- and middle-income contexts by providing preliminary evidence of the differing patterns of association observed between high- and low-income populations.

Background Depression in fathers in the postnatal period is associated with an increased risk of some adverse child developmental outcomes. One possible mechanism for the familial transmission of risk is through the negative effects of depression on parenting and the parent-child relationship. So far, evidence indicates that depressed fathers tend to be more withdrawn in their early interactions. However, the interaction dimensions studied to date may not be able to detect and accurately classify unique features of father-infant play – including physically stimulating and highly rousing episodes of play. Hence, in this matched design comparison study, we set out to examine, for the first time, links between diagnosed paternal depression in the postnatal period and playfulness in father-infant interactions. Methods Fathers and their infants were assessed when the infants were 3 months old. Paternal depression was diagnosed using a structured psychiatric interview. Currently depressed (n = 19) and non-depressed (n = 19) fathers were individually matched on age and education. Fathers were filmed playing with their children. Four dimensions were coded for paternal playfulness during free-play: physicality, playful excitation, tactile stimulation and active engagement. Results Depressed fathers, compared to non-depressed fathers, engaged in fewer episodes of playful excitation (mean scores: 0.71 vs.2.53, p = 0.005), less gentle touch (mean time: 38.57 vs. 53.37, p = 0.015) and less active engagement (mean scores: 2.29 vs 3.24, p = 0.044). When controlling for infant fretfulness, the findings remained largely unchanged. Limitations The sample size was small and the sample was limited to mostly white, well-educated fathers. Conclusions Playful paternal behaviours as early as 3 months differ between fathers with and without depression. These changes may help in understanding children’s risk in relation to paternal psychopathology and could be a target for future family interventions., Highlights • Playful behaviours at 3-months differ between depressed and non-depressed fathers. • Depressed fathers use less playful excitation, gentle touch and active engagement. • Coding measures focusing on fathers may accurately detect and classify playfulness. • Unique features of paternal play could be a target for future family interventions.

Summary Background Prenatal stress is associated with altered fetal and infant development. Previous studies have suggested that these effects may be mediated in part via altered functioning of placental enzymes and receptors involved in the HPA-axis, including the glucocorticoid receptor (NR3C1) and HSD11B2, the enzyme which metabolises cortisol. However, previous studies have not examined the potential ethnicity effects on these associations. This study aimed to characterise the association between maternal prenatal stress and placental genes expression and subsequently, any potential effect of maternal ethnicity. Method Pregnant women(n = 83) were recruited prior to elective caesarean section and assessed for trait anxiety, depression and life events. Placentas were collected and placental gene expression of NR3C1 and HSD11B2 were analysed. We examined associations between maternal prenatal stress and placental gene expression, and the tested for a possible moderating effect of maternal ethnicity(59.0% Caucasian;41.0% non-Caucasian:12.0% South Asian;6.0% African/African-American;14.4% Other;8.4% Mixed). Results Analyses demonstrated a trend in the association between both maternal trait anxiety and depression symptoms with placental gene expression of NR3C1(adj.β = 0.220,p = 0.067;adj.β = 0.212,p = 0.064 respectively). We found a significant interaction with maternal ethnicity(β = 0.249;p = 0.033). In Caucasian women only prenatal trait anxiety and depressive symptoms were associated with an increase in placental NR3C1 expression(adj.β = 0.389,p = 0.010;adj.β = 0.294;p = 0.047 respectively). Prenatal life events were associated with a down regulation of HSD11B2(adj.β = 0.381;p = 0.008), but only in Caucasians. Conclusion These results support previous findings of an association between maternal prenatal stress and the expression of placental genes associated with the HPA-axis, but only in Caucasians. These ethnic specific findings are novel and require replication in different populations.

BackgroundSymptoms of maternal postnatal depression are associated with an increased risk of adverse effects on child development. However, some children exposed to postnatal depression have outcomes similar to unexposed children, and can be referred to as resilient. This study aimed to determine the mechanisms of resilience in children exposed to depressive symptoms postnatally.MethodData are from a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Self-report questionnaire data were collected during pregnancy and the child's first 2 years regarding maternal views of parenting and her perception of the child. The Edinburgh Postnatal Depression Scale (EPDS) was completed postnatally at 8 months and the Strengths and Difficulties Questionnaire (SDQ) at age 11 years. Exposed children who scored above the median score of non-exposed children were defined as resilient. Structural equation modeling was used to investigate the development of resilience.ResultsFrom the core ALSPAC cohort, 1,009 children (6.9%) were exposed to maternal depression at 8 months postnatally. The SDQ total difficulties scores at 11 years of age indicated that 325 (32.2%) were resilient, 684 were non-resilient. Maternal positive feelings about parenting and child non-verbal communication at 15 months increased the likelihood of later resilience.ConclusionsIn this study, resilience was associated with two factors: the child's nonverbal communication at 15 months and by maternal positive feelings about parenting. Early intervention to support mother-child interaction and foster child development in women identified with postnatal depressive symptoms may benefit later child resilience.

Children of parents with psychiatric disorders are at increased risk of disorder themselves, as well as other developmental difficulties (Goodman & Gotlib, 1999; Murray & Cooper, 2003). Depression is the most significant of these parental disorders in terms of worldwide impact (Patel, 2007). Its potential impact on children has also been studied extensively. There is particular interest in maternal depression in the postnatal period because of specific associations with children's behavioural, social and psychiatric problems (Goodman, Brogan, Lynch, & Fielding, 1993; Halligan, Murray, Martins, & Cooper, 2007) and, in the developing world, effects on physical health as well as socio-emotional development (Rahman, Iqbal, Bunn, Lovel, & Harrington, 2004; Tomlinson, Cooper, & Murray, 2005). The mechanisms underlying these associations have, by and large, not been clearly disentangled because of the confounded nature of genetic and psychosocial risks (Goodman & Gotlib, 1999). Depression also affects men during the postnatal period and in later child-rearing years (Goodman, 2004), but the effects of paternal psychiatric disorder on children's development are under-studied (Kane & Garber, 2004), particularly during the early years of infant and early child development. In part this may be due to an underestimation of the impact of paternal influence on early child development (Cabrera, Tamis-LeMonda, Bradley, Hofferth, & Lamb, 2000; Lamb & Lewis, 2004), but it may also be because of the challenges of including men in child development research (Cassano, Adrian, Veits, & Zeman, 2006). Nevertheless, studies do demonstrate that psychiatric disorders affecting men in the perinatal period may predict disorder in their offspring. Specifically, depression in fathers in the postnatal period is associated with increased rates of subsequent behavioural problems in their children (Carro, Grant, Gotlib, & Compas, 1993; Ramchandani, Stein, Evans, & O'Connor, 2005; Ramchandani et al., 2008); associations appear stronger for boys, but this has not been confirmed. As in the case of maternal depression, there remains some uncertainty as to the mechanisms involved. In particular, the experience of exposure to an adverse psychosocial environment created by a depressed parent is typically confounded by exposure to genetic risk – a point repeatedly made by behavioural geneticists (Plomin, 1995). The aim of the current paper is to use a novel natural experiment that capitalises on a pre- postnatal design using fathers, to test the hypothesis that exposure to psychosocial factors can account for the link between paternal depression and children's behavioural problems.

Objective: Maternal antenatal anxiety is associated with an increased risk of behavioral disturbances in offspring. Recent work has suggested that the effect of maternal antenatal anxiety on infant temperament at 6 months is moderated by the serotonin transporter polymorphism 5-HTTLPR, with carriers of the short allele more susceptible to the adverse behavioral outcomes of maternal antenatal anxiety. These findings, however, are yet to be replicated and extended beyond infancy. The aim of the current study was to assess this same potential moderator (5-HTTLPR) in a large population-based cohort study, and to determine whether or not the effects persist into childhood and early adolescence. Method: Data from the Avon Longitudinal Study of Children and Parents (ALSPAC) cohort (N = 3,946) were used to assess whether the 5-HTTLPR genotype moderated the association between self-reported maternal antenatal anxiety (Crown Crisp Index) in pregnancy, and child temperament at 6 months (Infant Temperament Questionnaire), and also later behavioral and emotional problems on the Strengths and Difficulties Questionnaire from age 4 to 13 years. Results: We found no evidence to suggest that the 5-HTTLPR polymorphism moderated the effects of maternal antenatal anxiety on infant temperament at 6 months or infant behavioral and emotional problems from childhood through to adolescence. Conclusion: Our results, based on a large prospective community sample that assessed children from infancy to early adolescence, provide a thorough test of, but no evidence for, a genetic moderation of the effects of maternal antenatal anxiety by 5-HTTLPR. © 2013 American Academy of Child and Adolescent Psychiatry.