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Background The global health crisis caused by the COVID-19 pandemic has led to an increase in situations of risk of child abuse and neglect. Objective The objective of this study was to examine whether the Attachment Video-feedback Intervention (AVI) program can improve protective factors (decrease parental stress and household chaos, increase parent-child emotional availability and parental reflective functioning) that may diminish child maltreatment in a group of families at risk for child abuse and neglect during the COVID-19 pandemic. Participants and setting The sample consisted of 41 children aged between 0 and 5 years (Mage = 35.36 months, SD = 14.65; 85.4 % boys) and their parents (Mage = 35.44, SD = 6.04; 75.6 % mothers). Methods The study design incorporated two randomized groups (Intervention group: AVI; Control group: treatment as usual) with pre- and post-test evaluations. Results In comparison to the control group, parents and children exposed to the AVI showed increases in emotional availability. Parents in the AVI group also presented increases in certainty regarding their child's mental states and reported lower levels of household chaos compared to those of the control group. Conclusions The AVI program is a valuable intervention for increasing protective factors in families at risk of child abuse and neglect in times of crisis. This research was funded by a grant from the Basque Government (IT1450-22). Financial support was also given by the Canada Research Chairs program to Chantal Cyr.

Chronic relational trauma can lead to the formation of pervasively unintegrated attachment representations in adulthood, referred to as Hostile-Helpless (HH) states of mind. Individuals with this type of attachment disorganization evidence conflicting evaluations of caregivers and have difficulty reflecting on their traumatic childhood experiences. This scoping review is the first to systematically integrate the results of all empirical studies on HH states of mind in an effort to highlight the scientific and clinical contributions of the concept and guide future research. Following Arksey and O'Malley's (2005) Methodological Framework, cross-reference keywords were searched in three databases (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). In total, 19 studies met inclusion criteria and were included in the synthesis. Results suggest that prevalence rates of HH states of mind increase as a function of adults' psychosocial risk status. Findings also reveal that the long-term consequences of early trauma are greater in the presence of a HH state of mind, whereas the absence of a HH state of mind acts as a protective factor against the intergenerational transmission of maladaptation. Finally, results support the discriminant validity of the HH classification against other forms of attachment disorganization in adulthood. Research gaps and future research directions are discussed.El trauma crónico de la relación puede llevar a la formación de representaciones de afectividad profundamente desintegradas en la edad adulta, conocidas como estados mentales Hostiles-Sin Ayuda. Los individuos con este tipo de afectividad desorganizada demuestran evaluaciones conflictivas de quienes les cuidan y tienen dificultades para reflexionar acerca de sus experiencias traumáticas de niñez. Este estudio de alcance comprensivo es el primero en integrar sistemáticamente los resultados de todos los estudios empíricos acerca de los estados mentales Hostiles-Sin Ayuda como un esfuerzo para subrayar las contribuciones científicas y clínicas del concepto y guiar la investigación futura. Siguiendo el Marco de Trabajo Metodológico de Arksey y O'Malley's (2005), se investigaron palabras claves con enlaces de referencia en tres bases de datos (PsycArticles, Colección de Psicología y Ciencias del Comportamiento, ProQuest). En total, 19 estudios reunieron los criterios de inclusión y se les incluyó en la síntesis. Los resultados indican que los puntajes prevalentes de los estados mentales Hostiles-Sin Ayuda aumentan como una función del riesgo sicosocial de los adultos. Los resultados también revelan que las consecuencias a largo plazo del trauma temprano son mayores en presencia de un estado mental Hostil-Sin Ayuda, mientras que la ausencia de un estado mental Hostil-Sin Ayuda actúa como un factor de protección contra la transmisión intergeneracional de mal adaptación. Finalmente, los resultados apoyan la validez discriminante de la clasificación Hostil-Sin Ayuda contra otras formas de desorganización de la afectividad en la edad adulta. Se discuten los vacíos y el futuro de la investigación.Le trauma relationnel chronique peut mener à la formation de représentations de l'attachement non intégré omniprésent à l’âge adulte, auquel on fait référence en tant qu’états d'esprit Hostile-Impuissant. Les individus avec de type de désorganisation d'attachement font état d’évaluations contradictoires des personnes prenant soin d'eux et ont des difficultés à réfléchir à leurs expériences traumatiques durant l'enfance. Ce passage en revue est le premier à systématiquement intégrer les résultats de toutes les études empiriques sur les états d'esprit Hostile-Impuissant pour essayer de mettre en évidence les contributions scientifiques et cliniques du concept et guider les recherches futures. En suivant la structure méthodologique de Arksey et O'Malley (2005) les mots clés de référence croisée ont fait l'objet d'une recherche dans trois bases de données (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). Au total 19 études ont rempli les critères d'inclusion et ont été inclues dans la synthèse. Les résultats suggèrent que les taux de prévalence d’états d'esprit Hostile-Impuissant augmentent en tant que fonction du statut de risque psychologique des adultes. Les résultats révèlent aussi que les conséquences à long terme du trauma précoce sont plus grandes en présence d'un état d'esprit Hostile-Impuissant, alors que l'absence d’état d'esprit hostile-Impuissance agit en tant que facteur protecteur contre la transmission intergénérationnel de mal-adaptation. Enfin, les résultats soutiennent la validité discriminante de la classification Hostile-Impuissant par rapport à d'autres formes de désorganisation de l'attachement à l’âge adulte. Les écarts dans les recherches et des directions futures de recherches sont discutés.Feindselig-hilflose Gemütszustände: Ein Überblick über Risikofaktoren, Korrelate und Folgen Chronische Beziehungstraumata können im Erwachsenenalter zur Bildung von durchgängig unintegrierten Bindungsrepräsentationen führen, die als feindselig-hilflose Gemütszustände (Hostile-Helpless states of mind) bezeichnet werden. Personen mit dieser Art von Bindungsstörung weisen widersprüchliche Bewertungen von Bezugspersonen auf und haben Schwierigkeiten, über ihre traumatischen Kindheitserfahrungen zu reflektieren. Diese Übersichtsarbeit ist die erste, die die Ergebnisse aller empirischen Studien über feindselig-hilflose Gemütszustände systematisch zusammenfasst, um die wissenschaftlichen und klinischen Beiträge des Konzepts hervorzuheben und richtungsweisend für künftige Forschung zu sein. In Anlehnung an den methodischen Rahmen von Arksey und O'Malley (2005) wurden Querverweis-Schlüsselwörter in drei Datenbanken (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest) durchsucht. Insgesamt erfüllten 19 Studien die Einschlusskriterien und wurden in die Synthese aufgenommen. Die Ergebnisse deuten darauf hin, dass die Prävalenzraten feindselig-hilfloser Gemütszustände in Abhängigkeit vom psychosozialen Risikostatus im Erwachsenenalter zunehmen. Die Ergebnisse zeigen auch, dass die langfristigen Folgen früher Traumata bei Vorliegen eines feindselig-hilflosen Gemütszustands schwerer sind, während das Fehlen eines feindselig-hilflosen Gemütszustands als Schutzfaktor gegen die intergenerationale Weitergabe von Fehlanpassungen wirkt. Schließlich unterstützen die Ergebnisse die diskriminante Validität der Feindselig-Hilflos-Klassifikation gegenüber anderen Formen der Bindungsdesorganisation im Erwachsenenalter. Forschungslücken und zukünftige Forschungsrichtungen werden diskutiert.無力/敵対的な心性 (Hostile-Helpless States of Mind) :リスク因子、相関、結果に関するスコーピングレビュー 要旨 慢性的な関係性トラウマは、大人になってから、無力/敵対的な心性Hostile-Helpless States of Mindと呼ばれる、広範に統合されていない愛着形成につながる可能性がある。このような無秩序な愛着型をもつ成人は、養育者に対する評価が相反し、トラウマとなった幼少期の経験を振り返ることが困難であると証明されている。このスコーピングレビューは、無力/敵対的な心性に関するすべての経験的研究の結果を系統的に統合し、この概念の科学的および臨床的な貢献を明らかにし、今後の研究の指針とすることを目的とした初めてのものである。Arksey and O'Malley (2005) の方法論的枠組みに従い、3つのデータベース (PsycArticles、Psychology and Behavioral Sciences Collection、ProQuest) で相互参照キーワードを検索した。その結果、19の研究が対象基準を満たし、統合に含まれることになった。結果は、無力/敵対的な心性の有病率は、成人の心理社会的リスク状態の関数として増加することを示唆している。また、早期トラウマの長期的影響は、無力/敵対的な心性がある場合に大きく、一方、無力/敵対的な心性がない場合は、リスクの世代間伝達に対する防御因子として作用することが明らかになった。最後に、成人の他の愛着障害と無力/敵対的な心性分類の識別妥当性を支持する結果が得られた。研究ギャップと今後の研究の方向性について議論する。.慢性关系创伤可导致成年期普遍的不协调依恋表现的形成, 称为“敌对无助”心理状态。具有这种类型的依恋紊乱的个体, 对看护者的评价是相互矛盾的, 并且很难反思他们的创伤性童年经历。本范围综述第一次系统地整合了所有关于“敌对无助”心理状态的实证研究结果, 以突出这一概念的科学和临床贡献, 并指导未来的研究。按照Arksey和O'Malley (2005) 的“方法论框架”, 在三个数据库 (PsycArticles、Psychology and Behavioral Sciences Collection、ProQuest) 中搜索了交叉引用关键词。总共有19项研究符合纳入标准并被纳入综合研究。结果表明, “敌对无助”心理状态的患病率随着成年人的社会心理风险状况而增加。研究结果还表明, 当存在“敌对无助”心理状态时, 早期创伤的长期后果更大, 而没有“敌对无助”心理状态则可作为一种保护因素, 防止适应不良的代际传递。最后, 研究结果支持“敌对无助”分类对成年期其他形式依恋紊乱的区分效度。本文还讨论了研究的空白和未来的研究方向。.الحالات العقلية المعادية-العاجزة : استقصاء منهجي لعوامل المخاطرة والارتباطات والعواقب يمكن أن تؤدي الصدمة العلائقية المزمنة إلى تكوين تمثيلات تعلق غير متكاملة في مرحلة البلوغ ، ويشار إليها على أنها حالات عقلية معادية - عاجزة. الأفراد الذين يعانون من هذا النوع من عدم تنظيم التعلق يُقدمون تقييمات متضاربة لمقدمي الرعاية ويواجهون صعوبة في التعليق على تجارب طفولتهم المؤلمة. هذه المراجعة المنهجية هي الأولى التي تدمج بشكل منهجي نتائج جميع الدراسات التجريبية على الحالات الذهنية المعادية العاجزة في محاولة لتسليط الضوء على المساهمات العلمية والاكلينيكية للمفهوم وتوجيه البحث المستقبلي. ووفقاً لإطار Arksey and O'Malley (2005) المنهجي ، تم البحث عن الكلمات الرئيسية المرجعية في ثلاث قواعد بيانات (PsycArticles ، مجموعة علم النفس والعلوم السلوكية ، ProQuest). في المجموع ، حققت 19 دراسة معايير الاشتمال وتم تضمينها في التحليل. تشير النتائج إلى أن معدلات انتشار الحالات الذهنية المعادية العاجزة تزداد بالارتباط مع حالة الخطر النفسي والاجتماعي للبالغين. تكشف النتائج أيضًا أن العواقب طويلة المدى للصدمة المبكرة تكون أكبر في وجود حالة ذهنية معادية عاجزة ، في حين أن غياب الحالة الذهنية المعادية العاجزة يعمل كعامل وقائي ضد انتقال سوء التكيف بين الأجيال. أخيرًا ، تدعم النتائج الصلاحية التمييزية لتصنيف "معاد-عاجز" بالمقارنة مع الأشكال الأخرى من عدم تنظيم التعلق في مرحلة البلوغ. تناقش الدراسة الفجوات البحثية واتجاهات البحث المستقبلية.

The purpose of this study was to examine, in a sample of residential care children, the moderating role of cognitive flexibility in the association between maltreatment and emotion regulation competencies. The sample included 69 children aged 8 to 12 and their group home educator as their primary caretaker. Educators completed questionnaires evaluating child emotion regulation competencies and cognitive flexibility. Child history of maltreatment and sociodemographic data were collected on the basis of the children’s child protective services files. Moderation analyses showed that the effect of child maltreatment on emotion regulation was only present for children with high levels of cognitive flexibility, such that the less children experienced severe maltreatment, the more they showed emotion regulation competencies. Children with low cognitive flexibility displayed lower levels of emotion regulation regardless of their maltreatment history. These results suggest that focusing on cognitive flexibility when intervening with children in residential care could help strengthen their emotion regulation competencies, which may prevent further maladaptive behaviors.

Studies describing the link between infant sleeping arrangements and postpartum maternal depressive symptoms have led to inconsistent findings. However, expectations regarding these sleeping arrangements were rarely taken into consideration. Furthermore, very few studies on pediatric sleep have included fathers. Therefore, the aims of this study were (1) to compare maternal and paternal attitudes regarding co-sleeping arrangements and (2) to explore the associations among sleeping arrangements, the discrepancy between expected and actual sleeping arrangements, and depressive symptoms, in mothers and fathers. General attitudes about co-sleeping, sleeping arrangements and the discrepancy between expected and actual sleeping arrangements were assessed using the Sleep Practices Questionnaire (SPQ) in 92 parents (41 couples and 10 parents who participated alone in the study) of 6-month-old infants. Parental depressive symptoms were measured with the Center for Epidemiologic Studies-Depression Scale (CES-D). Within the same couple, mothers were generally more supportive than fathers of a co-sleeping arrangement (p p

Les donnees de la litterature indiquent une augmentation du nombre d’enfants pris en charge par l’aide sociale tous placements confondus. Les enfants places sont exposes a un risque eleve de problemes de sante mentale a court, moyen et long terme. Ainsi, des recherches sont necessaires pour identifier les facteurs qui pourraient etre cibles au cours du placement pour ameliorer la sante mentale de cette population vulnerable. Cette revue systematique vise a apporter une meilleure comprehension des facteurs de risque et de protection a la sante mentale associes aux differentes modalites de placement. Nous avons effectue une recherche dans trois bases de donnees : MEDLINE, Psychology and Behavioral Sciences et PsycINFO. Les criteres d’inclusion dans la revue etaient des echantillons d’enfants et d’anciens places ; et les etudes concernant specifiquement les resultats lies a la sante mentale, avec les modalites de placement (type de placement, nombre de placements, rupture du placement, placement avec la fratrie, contact avec les parents biologiques, relation avec le parent d’accueil), comme variables predictives/independantes.L’echantillon final comprenait 36 etudes, a partir desquelles nous avons identifie 27 facteurs de risque et de protection associes a la sante mentale des enfants et des anciens places. Nous avons determine certains facteurs lies au placement qui predisaient moins de problemes de sante mentale (placement avec les proches, âge precoce de placement et qualite de la relation avec le parent d’accueil) et d’autres associes a un risque accru (rupture de placement, placement en institution, âge tardif de placement). Certains aspects du placement restent peu explores, comme l’effet du contact avec les parents biologiques ou avec la fratrie.

Objective There are substantial inter-individual differences in infants’ longest consecutive sleep duration. However, intra-individual differences are rarely considered. The present study aimed to describe night-to-night variability in achieving 6 or 8 h of consolidated sleep over a 13-night period in 6-month-old infants. Methods Forty-four typically developing infants were part of the study (22 girls). When infants were 6 months old, mothers were asked to complete an infant sleep diary over 13 nights to measure the longest period of uninterrupted sleep each night. Two criteria were used to determine if infants were sleeping through the night: 6 and 8 h of uninterrupted sleep. Results On average, mothers reported that their infant slept 6 h consecutively for about 5 nights out of 13. Nine infants (20.5%) never slept 6 h consecutively, three (6.8%) met the criterion every night, but most infants (n = 32; 72.7%) showed high variability between the nights. Mothers reported that their infant slept 8 h consecutively for about 3 nights out of 13. Half of the infants (50.0%) never slept 8 h consecutively, one infant (2.3%) slept 8 h consecutively every night, and twenty-one infants (47.7%) showed high variability. Conclusions These findings expand current knowledge by showing that there is not only high inter-individual variability, but also high intra-individual variability in infant sleep consolidation. Parents and clinicians should be aware that occasional sleeping through the night does not necessarily indicate a consolidation of this behavior.

Two parenting capacity assessment (PCA) protocols, with a short parent-child intervention embedded in each protocol, evaluated the potential for enhanced parenting to orient child placement decision. Parents ( n = 69), with substantiated reports of maltreatment by child protective services, and their children (0–6) were randomly assigned to one of two PCAs with either the Attachment Video-feedback (PCA-AVI) or a psychoeducational intervention (PCA-PI) as the embedded intervention component. The PCA-AVI group showed the highest increases in parent-child interaction quality at post-test. Also, at PCA completion, evaluators’ conclusions about the parents’ capacity to care for both PCA groups were associated with parent-child interactive improvements at post-test, the court’s placement decision at post-test, and child placement one year later. However, only conclusions drawn by PCA-AVI evaluators were predictive of child re-reports of maltreatment in the year following PCA. PCAs, relying on short attachment interventions to assess the potential for enhanced parenting, are promising tools to orient child placement decisions.

Contexte : Les etudes recentes ont contribue a distinguer les comportements de desinhibition du contact social (CDCS) du concept d’attachement. Certains auteurs, en s’appuyant sur de rares etudes qui ont observe une correlation entre les CDCS et l’attachement insecure chez de jeunes enfants, soutiennent qu’il pourrait tout de meme exister une association entre les deux, notamment lors de la constitution des premiers liens avec la mere. A ce jour, tres peu d’etudes ont examine cette association chez des enfants vivant avec leur mere biologique et aucune aupres d’enfants issus d’un echantillon pedopsychiatrique. Objectif : Le but de cette etude exploratoire est d’examiner s’il existe un lien entre l’attachement mere-enfant de type insecure et la presence de CDCS chez des enfants consultant en service de pedopsychiatrie. Methode : Vingt-neuf enfants (âges entre 23 et 71 mois) et leur mere ont participe a l’etude. Les CDCS et l’attachement mere-enfant ont ete examines lors d’une procedure de separations et de reunions avec la presence d’une etrangere. Resultats : Plus les scores de CDCS sont eleves chez les enfants, plus leurs comportements d’attachement sont de type desorganise/controlant et moins ils presentent des comportements d’attachement de type secure. Conclusion : Ces resultats sont en accord avec ceux d’etudes anterieures qui avaient montre l’existence d’un lien significatif entre l’attachement mere-enfant de type insecure et la presence de CDCS chez de jeunes enfants vivant dans des milieux a risque psychosocial eleve.

Resume But de l’etude Cette etude a pour objectif d’evaluer le lien entre des indices de fonctionnement psychologique maternel et la qualite de l’attachement de l’enfant a sa mere, dans un echantillon clinique pedopsychiatrique. Methode Vingt-neuf enfants (âges entre 23 et 71 mois) consultant en service de pedopsychiatrie et leur mere ont participe a l’etude. L’attachement mere-enfant a ete examine avec la Situation Etrange ou la procedure de Separation-Reunion, selon l’âge de l’enfant. Les symptomatologies depressive et anxieuse des meres et le stress maternel ont ete evalues a l’aide de questionnaires auto-administres. Resultats La depression maternelle est marginalement correlee a l’attachement evitant alors que l’anxiete maternelle l’est de facon significative. Plus le niveau de stress ressenti par la mere dans l’exercice de son role parental est eleve, plus l’attachement de l’enfant est desorganise et moins il tend a etre secure. Plus le niveau de stress maternel lie aux difficultes de l’enfant est eleve, plus l’attachement mere-enfant tend a etre ambivalent. Conclusion Ces resultats soulignent l’interet de poursuivre la recherche sur les liens possibles entre des determinants psychologiques maternels et l’attachement mere-enfant aupres de populations d’enfants consultant en pedopsychiatrie.

Background An upsurge in psychological distress was documented in pregnant women during the COVID-19 pandemic. We investigated with a longitudinal design whether prenatal and postnatal maternal distress during the COVID-19 pandemic was associated with lower infant socioemotional development. Methods Pregnant women (N = 468, Mage = 30,00, 97.6% White) were recruited during the first COVID-19 mandatory lockdown in Quebec, Canada, from April 2nd to April 13th 2020 and were re-contacted at two months postpartum to complete self-reported measures of general (i.e. not specifically related to the COVID-19 pandemic) anxio-depressive symptoms and infant development. Structural equation modeling analyses were performed using maximum likelihood parameter estimation. Results Higher maternal prenatal distress significantly contributed to poorer infant socioemotional development. A mediation model showed that postnatal distress significantly mediated the association between prenatal distress and infant socioemotional development, whereas the direct effect of prenatal distress was no longer significant. Prenatal and postnatal maternal distress accounted for 13.7% of the variance in infant socioemotional development. Conclusion Our results call for special means of clinical surveillance in mothers and for innovative (online) interventions aiming to support maternal mental health during pregnancy and after delivery.

Approximately 7% of Americans and 13% of Canadians older than 25 years old use cannabis,1,2 suggesting that millions of parents across North America are users. We hypothesize that parental cannabis use may affect children in two ways: by increasing personal exposure to the substance (eg, in utero exposure) and through its impact on parenting (Figure 1). Regarding direct exposure, scientific evidence suggests that using cannabis during pregnancy is unsafe and may lead to complications at birth, such as preterm delivery, lower birth weight, lower Apgar scores, and decreased fetal growth.3 In addition, in one study, offspring of parents consuming cannabis were more likely to use cannabis themselves in adolescence,4 which was found, in a systematic review, to be associated with higher odds of depression, suicidal behavior, and psychotic illness.5 Paradoxically, we believe that our field is not well informed by scientific research about the effects of parental cannabis use on parenting and offspring development at early developmental periods when the child is highly sensitive to the types of parental behaviors identified at the bottom of Figure 1. Such a gap in our knowledge is of definite concern for public health and child psychiatry, particularly considering that parents and professionals have access to very conflictual information on this issue. To support our standpoint that the important gaps in our knowledge about the issue of parental cannabis use open the door for highly diverse opinions regarding the harmfulness of parental cannabis use, we reviewed the portrayal of parental cannabis use provided by three sources: the scientific literature, media (online media, print news, and print media), and publications of government and other public agencies (more information on the search strategy is provided in Supplement 1, available online).

Despite evidence of some intergenerational continuity of maltreatment, a notable proportion of parents maltreated in childhood do not perpetuate the cycle of maltreatment. The aim of this study was to identify factors that would distinguish mother–child dyads where intergenerational continuity was present from dyads characterized by intergenerational discontinuity. The sample included 193 children and their mothers, drawn from two populations: 74 maltreated children recruited through Child Protection Services and 119 nonmaltreated children recruited among low-income families. Factors investigated included maternal childhood maltreatment, psychological functioning, and family ecology. Compared to maltreated mothers who broke the cycle of maltreatment, those who perpetuated the cycle were more likely to have experienced childhood physical neglect and multitype maltreatment, and to experience sociodemographic risk, intimate partner violence, and lack of family support. Compared to nonmaltreated mothers who maintained a nonmaltreating child-rearing environment: (a) maltreated mothers who broke the cycle were more likely to experience residential instability and lack of family support, and (b) nonmaltreated mothers whose child was maltreated were more likely to experience sociodemographic risk and lack of family support. Maternal psychological functioning did not discriminate maltreatment groups. Lending empirical support to a diathesis-stress model of poor parenting, these findings suggest that family-ecology related stress, but not maternal psychological difficulties, may create additional burden that will precipitate the risk of maltreatment intergenerational continuity.

STUDY OBJECTIVES: To investigate whether the interaction between infant negative affectivity and maternal depressive symptoms is associated with the degree to which mothers perceive infant sleep to be problematic at 6 months postpartum, independent of infant sleep and sociodemographic factors. METHODS: Infant negative affectivity and maternal depressive symptoms were assessed in a sample of 59 mother–infant dyads at 6 months postpartum using standardized measures. Mothers reported the degree to which they perceived their infant’s sleep to be problematic via an item composite of the Sleep Practices Questionnaire. Nocturnal infant sleep variables (duration, number of awakenings) were retrieved from a 2-week infant sleep diary (maternal report). RESULTS: There was a significant interaction between infant negative affectivity and maternal depressive symptoms in predicting mothers’ perceived extent of infant sleep problems. Simple slope analysis showed that high levels of depression were related to higher maternal perception of infant sleep problem scores only among mothers of infants with high levels of negative affectivity. Moreover, infant negative affectivity and maternal depressive symptoms positively predicted perception scores after adjustment for infant sleep, maternal age, and parity (P < .05). CONCLUSIONS: The current study provides evidence that high levels of maternal depression combined with high levels of infant negative affectivity may contribute to mothers’ perceptions of infant sleep problems, independent of infant sleep duration and awakenings. These findings highlight the importance for pediatricians and other health professionals to consider infant temperament in conjunction with mothers’ depressive symptoms when addressing mothers’ concerns about infant sleep problems. CITATION: Burdayron R, Butler BP, Béliveau M-J, Dubois-Comtois K, Pennestri M-H. Perception of infant sleep problems: the role of negative affectivity and maternal depression. J Clin Sleep Med. 2021;17(6):1279–1285.

Background While fathers are at risk of developing poorer sleep and depressive symptoms in the postpartum period, they represent an understudied population in the literature. The present study aimed to explore the association between sleep and postpartum depressive symptoms in fathers using subjective and objective sleep measures. Methods Fifty-four fathers reporting no history of depression took part in this cross-sectional study. At 6 months postpartum, paternal sleep was assessed for 2 weeks utilizing a self-report daily sleep diary, a self-report perceived sleep quality rating, and actigraphy. In the same period, depressive symptoms in fathers were assessed with the Center for Epidemiologic Studies–Depression Scale (CES-D). Results Regression analyses showed that paternal subjective sleep variables captured by the sleep diary (total nocturnal sleep time and number of night awakenings) were not related to postpartum depressive symptoms. However, self-reported perceived sleep quality was significantly associated with postpartum depressive symptom severity in fathers independently of demographic variables related to depression. Alternatively, the objective sleep variables (total nocturnal sleep time, number of night awakenings, sleep efficiency, and wake after sleep onset), measured by actigraphy, did not demonstrate a significant relationship with paternal depression scores. Conclusions These findings highlight the importance of perceived sleep quality, along with better understanding its association with postpartum depressive symptoms. Implementing a multi-measure approach enabled us to expand our knowledge about how different facets of sleep relate to postpartum depression, specifically in fathers. The results have important implications for the development of clinical interventions targeting paternal sleep and mood in the postpartum period., Highlights • Examining the link between sleep and postpartum depression in fathers. • A multi-measure approach using subjective and objective sleep indices. • Lower perceived sleep quality is linked to postpartum depressive symptoms in fathers. • Sleep variables captured by actigraphy were not associated with paternal depression.

This study examines, in low-income families, whether fathers' distress is associated with behavioral problems in preschool children and if the quality of father-child interactions mediates this association. Participants were 81 children between the ages of 3 and 5 years and their parents who were receiving social welfare. Quality of father-child interactions was assessed during a free-play situation and a toy cleanup task, fathers' parenting stress and psychological distress were self-reported, and children's behavior problems were assessed by both parents. Results showed that the quality of father-child interactions during free play, but not during cleanup, partially mediated the link between father distress and child internalizing and externalizing behavior problems. Our findings point to the role of the father-child relationship in the intergenerational transmission of risk in the preschool period. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In adults, higher anxiety level related to COVID-19 has been associated with having a pre-existing medical or mental health condition and poor sleep quality. However, no study yet has looked at these links in children. The present study’s main aim was to assess family changes associated with child and parent fears and concerns about COVID-19. We conducted a cross-sectional study among 144 families with children aged 9–12 years during the COVID-19 lockdown period. Families came from Quebec, Canada, and the survey was done in the early stages of the lockdown (April–May 2020). A phone-based survey assessed parent and child COVID-19-related fears and concerns, family-related changes and health issues. Results showed the more fears parents have about COVID-19, the more fears their child also has. Moreover, changes in family sleep habits were associated with parental and child fears and concerns about COVID-19. Reduced access to health services was associated with parental concerns about COVID-19. If another lockdown was to be put in place in the future, it would be important to inform families on the importance of sleep schedules and to maintain or increase health appointments when possible.

Children in foster care are more likely to exhibit emotional, behavioral, social, and developmental problems. Accordingly, foster families should provide them with a safe family environment that promotes their development. Therefore, to ensure that foster families adequately meet children's needs, it is crucial for youth protection services to properly assess prospective foster family applicants. However, the specific assessment methods are understudied. This study aims to capture the experiences of caseworkers and the challenges they face in assessing and selecting potential foster caregivers, as well as their needs for support to perform the assessments. Focus groups were held in child protection services agencies in the province of Quebec (Canada). Three group interviews with a total of 15 caseworkers were transcribed and subjected to content analysis using NVivo 11. The caseworkers identified nine most important dimensions for assessing prospective foster families, notably motivation and engagement. Differences in the assessment process between caseworkers were observed, particularly for the type of foster family assessed. The caseworkers reported certain common needs for assessment training, primarily in interview techniques and the handling of multicultural issues. They also complained of lack of time allocated for clinical support during assessments. The results call for collaborative efforts between researchers and practitioners to provide appropriate training and tools to support the assessment process.

Background Little attention has been given to intergenerational transmission of risk, mainly whether caregivers’ history of childhood maltreatment is linked to behavioral symptoms in their children and which protective/risk factors are involved in this transmission process. Objective This study examined if parental Hostile/Helpless (H/H) state of mind with respect to attachment moderated the association between parental childhood trauma and behavior problems in maltreated children. Participants and setting The sample included 61 parents and their children victims or at very high risk of maltreatment, aged between 1 and 6 years old. Method Parents retrospectively reported their childhood trauma and completed a measure of their children’s behavior problems. Independent observers assessed H/H attachment representations. Results Among parents with H/H states of mind, more severe traumatic childhood experiences were associated with more externalizing and internalizing behavior problems in their children. Among non-H/H parents, associations between parental childhood trauma and child behavior problems were not significant. Conclusions In the context of trauma, this study suggests that the absence of a H/H state of mind in parents (i.e., the presence of an organized attachment state of mind) is a protective factor for child adjustment. H/H mental representations of self and attachment experiences as targets of intervention for parents with histories of maltreatment may help reduce the transmission of risk in maltreating families.

Objectives Mental health professionals who work with children face various challenges, requiring them to consider factors that aim to promote healthy adaptation in their clients. There is a growing body of literature showing that child attachment pattern, as well as mentalizing ability in both children and their parents, are related to various indicators of well-being including mental health. However, studies assessing these constructs in clinical samples are sparse. Method Forty-nine children (2-6 years of age) and their parents were recruited through the Clinique spécialisée 0-5 ans of the Hôpital en santé mentale Albert-Prévost (HSMAP). A two-hour laboratory visit was carried out where parents and children completed individual and parent-child dyad tasks and filled out questionnaires. Various dimensions of parent and child functioning were assessed including the mother-child attachment relationship and parents' mentalization ability. Results Preliminary results indicated that child attachment pattern was related to children's behavioral and executive functioning as well as parents' psychiatric symptoms and parenting-related stress. Moreover, parents in our sample had lower levels of mentalizing abilities than those found in normative samples. Parents' mentalizing ability was related to the presence of psychiatric symptoms, parenting-related stress, and a history stressful life events. Conclusion These results highlight the need for mental health professionals working in a child psychiatric clinic to consider the child's attachment pattern and the mentalization ability of children and their parents, throughout the assessment process and subsequent implementation of interventions. In the last section of the manuscript, we present different ways we have integrated these concepts into our clinical work with children and parents referred to HSMAP.

Sleep disruption and deprivation are highly prevalent among parents of an infant. However, most postpartum sleep studies focus solely on mothers, and few studies have investigated whether sleep differs between first-time and experienced parents. The present study aimed to determine whether self-reported sleep duration and quality differ between first-time and experienced mothers and fathers during the postpartum period. A total of 111 parents (54 couples and three single mothers) of 6-month-old infants completed a 2-week sleep diary to evaluate measures of sleep duration, sleep continuity, and sleep quality. An analysis of covariance model was used to compare the sleep variables of first-time to experienced parents. Breastfeeding frequency, infant sleep location, depression, education, and work status were used as co-variables. First-time mothers reported a longer consecutive nocturnal sleep duration (mean [SEM] 297.34 [17.15] versus 246.01 [14.79] min, p < .05), fewer nocturnal awakenings (mean [SEM] 1.57 [0.20] versus 2.12 [0.17], p < .05), and rated their sleep quality higher (mean [SEM] score 7.07 [0.36] versus 5.97 [0.30], p < .05) than experienced mothers, while total nocturnal sleep duration did not differ. There were no differences in subjective sleep measures between first-time and experienced fathers. The present study indicates that experienced mothers reported more fragmented sleep and perceived having worse sleep quality than first-time mothers, but that paternal sleep did not differ as a function of parental experience. These findings have clinical implications for healthcare professionals working with families of various configurations and sizes.

Objective: To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown. Method: Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed. Results: Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness. Conclusion: Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.

Background Recent evidence suggests that offspring of mothers having been exposed to childhood abuse and neglect (CA&N) are at increased risk of developmental problems and that boys are more affected by maternal CA&N than girls. Since impairments in reflective functioning (RF) have been associated with maternal CA&N and offspring development, RF could represent a key mechanism in these intergenerational risk trajectories. Objective This study evaluated mediating (RF) and moderating (child sex) mechanisms in the association between maternal CA&N and child development. Participants and setting In a longitudinal setting, 111 mothers completed measures during pregnancy and between 11 and 36 months postpartum. Methods CA&N and impairments in RF were assessed during pregnancy and offspring development was measured during the longitudinal follow-up using the Ages and Stages Questionnaires (ASQ-3). Child development was operationalized in two ways: using the global score at the ASQ-3 and using a dichotomous score of accumulation of delays across domains of development. Results Structural equation modeling indicated that RF mediated the association between maternal CA&N and offspring development. Child sex moderated the association between CA&N and the clustering of developmental problems (Wald = 5.88, p = 0.02), with boys being particularly likely to accumulate developmental delays when their mother experienced CA&N (RR = 2.62). Accumulation of developmental problems was associated with impairments in maternal RF in girls and with maternal exposure to CA&N in boys. Conclusions Results provide novel insights on the role of mentalization and child sex in the association between maternal CA&N and child development.

Children from high-risk environments are more likely to experience problems in development. Many difficulties are linked to early experiences in the context of the emerging attachment relationship. Over the past 20 years, our group has collaborated with government agencies to develop and implement an attachment-based video-feedback intervention strategy (AVI) that targets parental sensitivity and attachment. This case study presents the manner in which a young mother and her 6-month-old son experienced AVI. The study shows how the absence of maternal sensitivity and responsiveness to infant signals, difficulties in helping the child regulate affect, and problems in autonomy support are addressed via eight semi-structured mentoring visits. Discussion focuses on how AVI may be a helpful addition to primary prevention programs.

Introduction Studies suggest that feeling pressure about parenting practices is related to higher levels of stress. However, little is known about the pressure mothers feel about infant sleep-related parenting practices. This is surprising, considering that mothers are often exposed to contradictory information about infant sleep. This exploratory study aimed to 1) identify the proportion of mothers of 6-month-old infants who report feeling pressure about their sleep-related parenting practices and 2) assess the relationships between demographic factors and perceived pressure, and between parenting practices and perceived pressure. Methods Fifty-four mothers of 6-month-old infants completed a demographic questionnaire and the Sleep Practices Questionnaire (SPQ). Mothers were asked, “Have you ever felt pressure about your parenting choices and practices related to your child’s sleep?”. Responses ranged from never to always. Linear regressions were conducted to assess the concurrent associations between demographic factors (maternal age, maternal education, parity) and perceived pressure, and between sleep-related parenting practices (feeding method, frequency of bed-sharing, picking up or not picking up the infant when he/she cries at night) and perceived pressure. Results Analyses revealed that 5.6% of mothers reported feeling pressure constantly, 20.4% reported feeling pressure quite often, 46.3% reported feeling pressure sometimes, and about a quarter (27.7%) reported feeling pressure rarely or never. Lower maternal education and breastfeeding were associated with feeling more pressure about sleep-related parenting practices (p < .05). Furthermore, mothers reporting that they (or their partner) pick up their infant when he/she cries at night were more likely to report feeling pressure (p < .01). Maternal age, parity, and frequency of bed-sharing were not associated with feeling pressure (p > .05). Conclusion The majority of mothers (72.3%) in our sample reported feeling pressure about their sleep-related parenting practices at least sometimes, suggesting that this experience is quite common. Lower maternal education, breastfeeding, and picking up the infant to comfort him/her during the night were associated with higher perceived pressure. Future studies should examine feelings of pressure about sleep-related parenting practices in larger samples of mothers and investigate whether fathers share similar concerns. Moreover, identifying the potential sources of these feelings would represent an interesting clinical avenue. Support (if any) SSHRC, FRQS

Introduction The influence of birth order has been investigated in many areas of child development, but few studies have examined its relationship with infant sleep; those that have yield contradictory findings. Moreover, nocturnal parental practices may differ depending on the number of children, but these characteristics are rarely studied. This study aimed to compare nocturnal parental practices and sleep patterns of first-born to non-first-born 6-month-olds. Methods The mothers of fifty-two 6-month-olds completed a 14-day sleep diary to record their infant’s sleep. The following variables were averaged: total nocturnal sleep duration (in minutes), longest consecutive sleep duration (without interruption; in minutes) and number of nocturnal awakenings. Independent t-tests were used to compare each sleep variable between first-borns (n = 21) and non-first-borns (2nd, 3rd or 4th born, n = 31). Chi-square tests were used to compare parental sleep practices (breastfeeding frequency and infant sleep location) between first-borns and non-first-borns. Results First-borns had a longer consecutive nocturnal sleep duration (417.83 ± 142.42 vs. 310.08 ± 118.23; p < .01) and fewer nocturnal awakenings (1.69 ± 1.07 vs. 2.57 ± 1.09; p < .01) than non-first-borns. However, first-born and non-first-born infants did not differ in terms of total nocturnal sleep duration (p > .05). Breastfeeding frequency and sleep location differed as a function of birth order: 57.9% of first-born infants were exclusively breastfed, compared to 89.7% of non-firstborn infants (χ2 (1, N = 52) = 6.56; p < .05). Furthermore, 20.0% of first-borns slept in the parents’ room, compared to 56.7% of non-first-borns (χ2 (1, N = 50) = 6.62; p < .05). Conclusion First-born infants had longer periods of consecutive sleep and fewer nocturnal awakenings than non-first-borns; however, birth order was not associated with maternal reports of total nocturnal sleep duration. These results suggest that non-first-borns have more fragmented sleep. Moreover, sleep-related practices also differed between mothers of first-born and non-first-born infants. A study conducted in a larger sample and using objective sleep measures could clarify whether these different sleep patterns reflect specific nocturnal parental sleep-related practices, or if the presence of other children in the home play a role in infant sleep consolidation. Support (if any) SSHRC, FRQS

This meta-analysis aims at comparing mental health problems of children in foster care to those living with their biological parents while taking in consideration different protective and risk factors. Across 41 studies with a total of 72 independent effect sizes, a significant but small effect size was found between foster care placement and psychopathology (d = 0.19). Children in foster care showed higher levels of psychopathology compared to those from community samples or matched/at-risk samples. They were as likely to show mental health problems as maltreated children living with their biological parents or children from clinical samples. Results showed that foster children’s mental health problems also varied as a function of type of placement and study methodological characteristics. Being placed in kinship care, longer stay in the same foster home and fewer placement disruptions, all acted as protective factors limiting mental health problems of children in foster care.

Using a sample of 41 infants and toddlers (21 interventions, 20 controls) who were neglected or at serious risk for neglect, this randomized clinical trial examined the efficacy of a parent–child attachment-based video-feedback intervention on parental sensitivity, parental stress, and child mental/psychomotor development. Results showed that following the 8-week intervention, scores for maternal sensitivity and child mental and psychomotor development were higher in the intervention group than in the control group. The intervention appears to have no effect on self-reports of stress. All parents report lower levels of stress postintervention; however, when defensive responding is not considered (i.e., extremely low score of parental stress), parents in the control group report somewhat lower scores, raising questions as to the significance of this finding. Considering the small nature of our sample, replication of the present results is needed. Nevertheless, the present findings contribute to the burgeoning literature suggesting that the early attachment relationship provides an important context that influences developmental outcome in different spheres and raises questions as to how such intervention strategies may or may not affect the subjective experience of parenting.

Introduction Research on the link between sleep quality and depression in the postpartum period has focused primarily on mothers. Although fathers also experience poorer postpartum sleep and are at risk of developing depressive symptoms, they remain understudied. To date, the limited research focusing on paternal sleep and depression has relied on subjective measures of sleep, without objective verification. The current study implemented a multi-measure approach using subjective and objective indices to explore the relationship between sleep and depressive symptoms in fathers at 6 months postpartum. Methods Fifty-four healthy fathers participated in this cross-sectional study. Paternal sleep was assessed for 2 weeks utilizing: 1) a self-report daily sleep diary, 2) a self-report perceived sleep quality rating, and 3) actigraphy. Subjective indices via the sleep diary measured participants’ perception of their total nocturnal sleep duration and total number of awakenings (self-reported sleep duration and fragmentation). Perceived sleep quality ratings measured participants’ perceptions of how well they thought they slept. Objective sleep variables measured through actigraphy included: total nocturnal sleep duration, number of awakenings, sleep efficiency, and wake after sleep onset (WASO). Paternal depressive symptoms were assessed with the Center for Epidemiologic Studies – Depression Scale (CES-D). Results Regression analyses showed that subjective sleep variables (measured by the sleep diary) and objective sleep variables (measured by actigraphy) did not significantly predict postpartum depressive symptoms in fathers (p > .05). However, self-reported perceived sleep quality significantly predicted postpartum depressive symptom severity in fathers (R2 = .172, p = .034). Conclusion These findings advance our understanding of the link between sleep and depression in fathers. The results highlight the important role of fathers’ perceptions of sleep quality, rather than the actual quality or quantity of their sleep (measured through the sleep diary or actigraphy), in the development of postpartum depressive symptoms. The multi-measure approach to sleep implemented in this study expanded our knowledge about how different facets of sleep relate to depression. These findings have important implications for the development of clinical interventions targeting paternal sleep and mood in the months following childbirth. Support (if any) Social-Science and Humanities Research Council (SSHRC) and Fonds de recherche du Québec – Santé (FRQS)

This study examined parent-child relationship variables (child attachment, parental sensitivity, and prior parenting experience) and child behavior problems in parents and their international adopted children with a cleft lip and palate (CLP+; n = 29) and without a CLP- (n = 55). First, results do not show any group differences on child attachment (secure attachment CLP+ = 69%, CLP- = 59%), or on externalizing problems, but fewer internalizing problems were found for CLP children. Second, mothers of CLP children, although they have more prior parenting experiences, are less sensitive than mothers of children without a CLP. Parents with prior parenting experience or higher sensitivity are more likely to have a child with a secure attachment, but sensitivity, prior parenting experiences and attachment are not significantly associated with behavior problems. Finally, children with both a CLP and an insecure attachment show more externalizing problems and tend to have less sensitive mothers.

Introduction Certain temperament characteristics in infants have been shown to be associated with infant sleep patterns. However, other sleep-related practices, such as co-sleeping and breastfeeding, are also known to be associated with sleep in infancy and are not always taken into account in studies assessing the association between temperament and sleep. Thus, this study aims to examine the associations between infant temperament and sleep parameters at six months of age, while controlling for co-sleeping and breastfeeding practices. Methods Mother-infant dyads (n=60) were recruited in the metropolitan Montreal area and consented to participate in the study. Infant sleep was reported by mothers at six months of age (±1 month) using sleep diaries (two-week period). Total nocturnal and longest consecutive sleep duration were retrieved from the diaries and averaged through the two-week period. Temperament was measured with the Infant Behaviour Questionnaire-Revised (IBQ-R). Sleep-related parental practices (co-sleeping and breastfeeding) were measured using the Sleep Practices Questionnaire (SPQ). Multiple regression analyses were conducted to determine the degree to which the temperament composite negative affectivity predicted total nocturnal and longest consecutive sleep duration while controlling for breastfeeding and co-sleeping practices. Results Regression analyses revealed significant regression models for total nocturnal (F(3,44)=6.25, p=.001, R2=.30), and longest consecutive sleep duration (F(3,44)=6.26, p=.001, R2=.30). Greater infant negative affectivity predicted shorter nocturnal sleep duration (β;;=-0.28, p=.034) and shorter longest consecutive sleep duration (β;;=-0.34, p=.010) after adjusting for breastfeeding and co-sleeping practices. Conclusion Findings suggest infants with greater negative affectivity sleep for fewer hours during the night and have shorter periods of consecutive sleep, even when sleep-related parental practices are considered. These results provide further support for the relationship between infant temperament and sleep at six months of age. Future research should investigate the relationship between infant temperament and sleep using paternal report in addition to maternal report. Support SSHRC

Objective To investigate in a sample of low-income families whether the quality of parent-child interactions mediated the association between coparenting and child sleep, and if this association was moderated by parents' anxiety. Method In sum, 81 two-parent families with a preschool child (aged 3 to 5 years) and receiving social security benefits were recruited. Mothers and fathers completed questionnaires assessing coparenting, parental anxiety, and child sleep duration and sleep problems. Quality of mother-child and father-child interactions was evaluated by independent observers from videotaped free play sequences in the home environment. Results Results showed that preschoolers' sleep duration was unrelated to paternal factors but associated with maternal factors. Specifically, coparenting predicted children's sleep duration through its effect on the quality of mother-child interactions, but only for dyads in which mothers were clinically anxious. Preschoolers' sleep problems were related to coparenting, quality of mother-child and father-child interactions, and mothers' but not fathers' anxiety. Conclusion The current results suggest that both parents play a complementary role in children's sleep. Likewise, different pathways and interactions were found in relation to sleep duration and problems, emphasizing the complexity of the links between family factors and sleep processes. Overall, this study helps to clarify some of the associations between parental characteristics and preschoolers' sleep within a sample of low-income families.

Children from high-risk environments are more likely to experience problems in development. Many difficulties are linked to early experiences in the context of the emerging attachment relationship. Over the past 20 years, our group has collaborated with government agencies to develop and implement an attachment-based video-feedback intervention strategy (AVI) that targets parental sensitivity and attachment. This case study presents the manner in which a young mother and her 6-month-old son experienced AVI. The study shows how the absence of maternal sensitivity and responsiveness to infant signals, difficulties in helping the child regulate affect, and problems in autonomy support are addressed via eight semi-structured mentoring visits. Discussion focuses on how AVI may be a helpful addition to primary prevention programs.

La fonction reflexive (FR) designe la capacite a percevoir et interpreter son propre comportement et celui d’autrui au regard d’etats mentaux. Cette derniere a ete identifiee comme une variable qui, lorsqu’elle fait defaut, peut contribuer au developpement de difficultes d’adaptation ou de psychopathologies chez l’enfant. Comme cette fonction se developpe dans le contexte de la relation parent-enfant et que son developpement depend entre autres de la FR du parent, la presente etude vise a documenter la FR parentale (FRP) de treize parents (10 meres et 3 peres) d’enfants consultant en pedopsychiatrie. Une entrevue semi-structuree, le Parent Development Interview-Revised (PDI-R), a ete utilisee et analysee selon le systeme de cotation de la FR (Slade, et al., 2005) pour mesurer le niveau de la FRP des parents et selon le systeme de cotation du PDI (Henderson, Steele et Hillman, 2007) pour evaluer l’experience affective parentale en fonction de divers aspects de la relation parent-enfant. Les resultats font ressortir une FRP inferieure a celle attendue au sein de la population generale et mettent en lumiere des differences entre les parents presentant les cotes de FRP les plus eleves et les plus faibles ainsi qu’entre les meres et les peres.