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IntroductionParenthood can be experienced as a pleasant but challenging period for parents, possibly accompanied by parenting stress. Early parenthood in particular is a vulnerable period as many parents experience biological and psychosocial changes related to new parenthood. Previous studies have shown that parenting stress is related to child behavior problems, but few studies have investigated the transactional relations across time between parenting stress and child internalizing and externalizing outcomes separately, examining within-person changes. The first aim of this study was to examine the transactional within-person associations of parenting stress and child internalizing and externalizing behavior problems across childhood from age 9 months to 9 years. As a second aim, we examined parenting as a possible underlying mechanism of the transactional associations by testing whether parental warmth and hostility mediate within-person associations of parenting stress and child behavior across time.MethodData were analyzed from the Growing Up in Ireland longitudinal child cohort study including 7,208 caregiver-child dyads at wave 1 (child’s age 9 months), who were followed at child’s age three (wave 2), five (wave 3), and 9 years (wave 5). Primary caregiver’s and child’s age and gender, household income, occupational status, educational status, partner status, and cultural background were covariates assessed at all waves. Data were analyzed using a random intercept cross-lagged panel model (CLPM) in R-lavaan.ResultsBidirectional relations between parenting stress and child behavior were found for both internalizing and externalizing behavior from age 5 to 9, but not for earlier time points.DiscussionOur results did not indicate mediating effects of parental warmth or parental hostility in the associations between parenting stress and child behavior problems. Therefore, we conclude that parenting stress and child internalizing as well as parenting stress and child externalizing behaviors have transactional associations from child’s age 5 to 9 years. Future research examining transactional associations of parenting stress and child behaviors should investigate possible other mediations taking a within-person approach by utilizing the RI-CLPM.

The Adult Attachment Interview (AAI) is a widely used measure in developmental science that assesses adults’ current states of mind regarding early attachment-related experiences with their primary caregivers. The standard system for coding the AAI recommends classifying individuals categorically as having an autonomous, dismissing, preoccupied, or unresolved attachment state of mind. However, previous factor and taxometric analyses suggest that: (a) adults’ attachment states of mind are captured by two weakly correlated factors reflecting adults’ dismissing and preoccupied states of mind and (b) individual differences on these factors are continuously rather than categorically distributed. The current study revisited these suggestions about the latent structure of AAI scales by leveraging individual participant data from 40 studies (N = 3,218), with a particular focus on the controversial observation from prior factor analytic work that indicators of preoccupied states of mind and indicators of unresolved states of mind about loss and trauma loaded on a common factor. Confirmatory factor analyses indicated that: (a) a 2-factor model with weakly correlated dismissing and preoccupied factors and (b) a 3-factor model that further distinguished unresolved from preoccupied states of mind were both compatible with the data. The preoccupied and unresolved factors in the 3-factor model were highly correlated. Taxometric analyses suggested that individual differences in dismissing, preoccupied, and unresolved states of mind were more consistent with a continuous than a categorical model. The importance of additional tests of predictive validity of the various models is emphasized.

This systematic review and meta-analysis aimed to determine mean estimates of prevalence rates for fulfilling all diagnostic criteria of posttraumatic stress disorder (PTSD) or at least showing significant levels of posttraumatic stress (PTSS) in relation to the traumatic event of childbirth. For the first time, both mothers and fathers were included in the synthesis. Studies were identified through systematic database search and manual searches, irrespective of language. Meta-analyses of 154 studies (N = 54,711) applied a random-effects model to four data sets, resulting in pooled prevalence rates of 4.7% for PTSD and 12.3% for PTSS in mothers. Lower rates of 1.2% for PTSD and 1.3% for PTSS were found among fathers. Subgroup analyses showed elevated rates in targeted samples (those with a potential risk status) most distinctly for maternal PTSS. The significant amount of heterogeneity between studies could not be explained to a satisfactory degree through meta-regression. Given the substantial percentage of affected parents, the adoption of adequate prevention and intervention strategies is needed. As this field of research is evolving, attention should be broadened to the whole family system, which may directly and indirectly be affected by birth-related PTSD. Further studies on paternal PTSD/PTSS are particularly warranted.

Environmental exposures are increasingly investigated as possible drivers of health behaviours and disease outcomes. So-called exposome studies that aim to identify and better understand the effects of exposures on behaviours and disease risk across the life course require high-quality environmental exposure data. The Netherlands has a great variety of environmental data available, including high spatial and often temporal resolution information on urban infrastructure, physico-chemical exposures, presence and availability of community services, and others. Until recently, these environmental data were scattered and measured at varying spatial scales, impeding linkage to individual-level (cohort) data as they were not operationalised as personal exposures, that is, the exposure to a certain environmental characteristic specific for a person. Within the Geoscience and hEalth Cohort COnsortium (GECCO) and with support of the Global Geo Health Data Center (GGHDC), a platform has been set up in The Netherlands where environmental variables are centralised, operationalised as personal exposures, and used to enrich 23 cohort studies and provided to researchers upon request. We here present and detail a series of personal exposure data sets that are available within GECCO to date, covering personal exposures of all residents of The Netherlands (currently about 17 M) over the full land surface of the country, and discuss challenges and opportunities for its use now and in the near future.

Environmental exposures are increasingly investigated as possible drivers of health behaviours and disease outcomes. So-called exposome studies that aim to identify and better understand the effects of exposures on behaviours and disease risk across the life course require high-quality environmental exposure data. The Netherlands has a great variety of environmental data available, including high spatial and often temporal resolution information on urban infrastructure, physico-chemical exposures, presence and availability of community services, and others. Until recently, these environmental data were scattered and measured at varying spatial scales, impeding linkage to individual-level (cohort) data as they were not operationalised as personal exposures, that is, the exposure to a certain environmental characteristic specific for a person. Within the Geoscience and hEalth Cohort COnsortium (GECCO) and with support of the Global Geo Health Data Center (GGHDC), a platform has been set up in The Netherlands where environmental variables are centralised, operationalised as personal exposures, and used to enrich 23 cohort studies and provided to researchers upon request. We here present and detail a series of personal exposure data sets that are available within GECCO to date, covering personal exposures of all residents of The Netherlands (currently about 17 M) over the full land surface of the country, and discuss challenges and opportunities for its use now and in the near future.

The aim of the study was to examine parenting self-efficacy in relation to depressive and anxiety symptoms during pregnancy. Five hundred thirty-three first-time pregnant women completed questionnaires at 12, 22, and 32 weeks of pregnancy that measure parenting self-efficacy, anxiety, and depressive symptoms. Parenting self-efficacy increased slightly but significantly over the course of pregnancy. Higher levels of depressive symptoms as well as state and trait anxiety symptoms were related to lower expectations of parenting self-efficacy at all time points, but only anxiety symptoms uniquely predicted parenting self-efficacy. Higher levels of anxiety symptoms in the first trimester predicted less positive change in parenting self-efficacy over the course of pregnancy, but depressive symptoms did not when anxiety levels were taken into account. The findings highlight the role of antenatal anxiety symptoms as a predictor of suboptimal preparation for the parenting role in first-time-expecting mothers. Possible explanations and implications for clinical practice are briefly discussed. © 2013 Michigan Association for Infant Mental Health.

Maternal mental health problems are linked to negative parenting and child outcomes. However, evidence for mechanisms that may explain the undermining influence of psychological problems is less well specified and the influence of possible moderators is relatively unexplored. (Dix & Meunier, 2009). This symposium brings into the discussion intervention as well as longitudinal studies focusing on processes at the cognitive, affective and behavioral level, which may explain the adverse effects of mental health problems in the perinatal period and help to evaluate and select pre- and postnatal intervention targets which are most critical for adaptation to parenthood. The first presentation will report results from three studies (involving over 300 mother-infant dyads) to comment on links among maternal state of mind with respect to attachment, adult separation anxiety, childhood parenting experiences, postnatal psychological distress, parenting confidence and early infant behavior. Results identified attachment and separation anxiety issues as important mechanisms in the development of postnatal difficulties. The second presentation focuses on the impact of anxiety and depression on the development of parental self-efficacy and the moderating role of marital and social support. As part of a longitudinal study, 296 primiparous expecting women were followed from pregnancy (12, 22, 32 weeks) to 3 months postpartum. Controlled for concurrent levelsof PSE, state anxiety symptoms (12 weeks) were uniquely associated with prenatal PSE at 32 weeks of pregnancy. Prenatal depressive symptoms were no longer significant when anxiety was taken into account. The association between state anxiety symptoms (32 weeks) and postnatal PSE was mediated by prenatal PSE (32 weeks). Marital and social support showed a compensating effect on postnatal PSE. The third presentation focuses on the role of violated expectations in mediating the effects of parental mental health, marital quality and birth experience on parent-child relationship. The findings are based on a sample of 745 couples, followed from pregnancy to 12 months postpartum, half having conceived via infertility treatment. The effect of marital and mental health problems on parent-child relationship was partly mediated via negatively violated expectations. The role of negative prenatalexpectations was also crucial, whereas former infertility had little impact. The fourth presentation presents results from a postnatal intervention (Mom Power) aimed at engaging high-risk families, specifically, low-income mothers with a history of childhood abuse. The intervention addressed potential mediators and moderators in five core domains: attachment-based parenting education, enhancing social support, connecting families to care, practicing self-care skills, and supporting child-parent interaction. Evaluation results on 100 families demonstrated improved parent mental health, and enhanced maternal representations of their children.

OBJECTIVE: This symposium explores the construct of maternal resolution of grief in infants with varying medical conditions, and highlights implications for intervention. We will demonstrate how maternal resolution of grief was explored in mothers of infants with prematurity and cerebral palsy, using the Reaction to Diagnosis Interview. Findings will be used to highlight potential opportunities to address maternal resolution of grief in a clinical intervention with dyads at risk. PAPER 1: Maternal Resolution of Grief Regarding Preterm Birth, Implications for Attachment Security: Prachi Shah, Melissa Clements, Julie Poehlmann. This study explored the association between maternal unresolved grief regarding preterm birth, quality of parent-child interactions, and infant-mother attachment security, and assessed 74 preterm infants a larger longitudinal study of high-risk infants. The association of maternal resolution of grief regarding preterm birth, and quality of infant-mother attachment was assessed using a relative risk ratio and multipleregression models. Maternal resolved grief regarding prematurity was associated with attachment security at 16 months after controlling for covariates (adjusted OR 2.94); maternal grief resolution and interaction quality were both independent predictors of attachment security. Results suggest that future research should explore screening for maternal grief resolution following preterm birth in pediatric practice.PAPER 2: Reactions to Diagnosis of Cerebral Palsy: Patterns of Resolution Across Development: Carlo Schuengel, Ingrid C.M. Rentinck, Marjolein Ketelaar, Jules Becher.This study explored the patterns of adaptation of parents to their children’s diagnosis of cerebral palsy (CP). The Reaction to Diagnosis Interview was given to 255 parents of infants, school age children, and teenagers with CP. In a subsample of 38 parents of infants, the interview was repeated after 1 year. A significant shift was observed from more cognition-focused patterns of resolution to strategies focused on addressing the needs related to the disabilities. Disability severity played a minor role. Results suggest that patterns of adaptation to their child’s diagnosis of CP may guide clinical interventions to parents with problematic grief resolution.PAPER 3 : Incorporating Reactions to Diagnosis With Couples with a Prenatal Diagnosis of a Congenital Malformation. Margot Hankel, Mirjam Oosterman, Christine Brouwer-Dudok de Wit, Carlo Schuengel. Individual differences exist in parents’ reactions to a diagnosis of a congenital malformation or disability in theirchild. Increasingly, couples receive such diagnoses prenatally. Prenatal interventions focused on the couple’s selfawareness about their reaction to diagnosis, while providing strategies towards resolution may assist in their adaptation to caring for their infant. This paper describes how the Reaction to Diagnosis Interview may be used as an intervention tool, to highlight representational diversity and change, foster coherence in emerging working models of their relationship with the infant, and to strengthen marital support. Case notes on first participants in an ongoing trial will illustrate the benefits and challenges of this approach.

Expectation of competence in parenting infants, or parenting self-efficacy (PSE), is an elusive concept both for parents and professionals. High PSE may have different consequences for infant development depending on the basis of PSE (e.g., actual experience vs. persuasion). High PSE may also not be maintained when actual parenting starts. Experimental studies, intervention studies, and longitudinal studies starting during pregnancy are yielding novel findings on PSE, which serve as input for a discussion that should deepen understanding of PSE and increase the utility of the concept for practice. The first presentation tests robustness of PSE in two ways. The first approach is based on a computerized task in which prenatal PSE was challenged among 179 pregnant women by manipulating success in regulating the baby. The second approach followed first-time mothers (intended N=1000) across alltrimesters of pregnancy and during the first year to examine patterns of change in PSE in relation to infant temperament. Analyses of the experimental data demonstrated that PSE decreased in response to regulation difficulty. The longitudinal data (preliminary n = 138) indicated that PSE on average increased across pregnancy and first year, but not for mothers of more irritable babies. Is there a common mechanism involved? The second presentation focuses on the course of PSE from pregnancy to 9 months postpartum in 180 new mothers and fathers,and the role that coparenting support plays in initial levels of PSE and change in PSE over time. Expectant parents completed a survey regarding task-specific PSE during the third trimester of pregnancy, and again 3 months and 9 months after their infant’s birth. At 3 months and 9 months postpartum, new parents completed a survey aboutcoparenting. Preliminary SEM analyses of associations between PSE and coparenting support over time indicate that for fathers, increases in PSE from 3 to 9 months postpartum were precipitated by greater perceived coparenting support, but a similar effect was not observed for mothers. The third presentation focuses on PSE and early persistent infant behavior disturbance (i.e., excessive crying, sleeping and feeding difficulties in the first year postpartum). The study included 80 first-time mothers participating in a residential parent-infant intervention with an unsettled infant. Results show clear associations between infant behavior and PSE, and support the effectiveness of the intervention with respect to both variables. Associations between PSE and various maternal variables including depression and anxiety, attachment security and perceived parenting during childhood will also bereported and discussed. Professor Bryanne Barnett will relate in her discussion to links with perinatal mental health, to open up the discussion with the symposium participants about including PSE in building resilience in at-risk families.

This study focused on attachment of foster children by examining factors associated with attachment relationships of children raised from birth by the same parents. The sample included 61 children between 26 to 88 months of age and their foster caregivers. Attachment security and caregiver sensitivity were coded on the basis of, respectively, a home-observation (Attachment Q-Set) and a laboratory procedure (Three boxes). Other measures included caregiver reports of child externalizing and internalizing behavior problems and symptoms of attachment disorder, including inhibited and disinhibited attachment as well as secure base distortions. For a subsample of children, teacher ratings of behavior problems also were available. Foster parent sensitivity was positively associated with attachment security, but only if symptoms of disordered attachment were partialled out. Symptoms of inhibited and disinhibited attachment as well as secure base distortions were positively related to parent reports of externalizing and internalizing behavior problems whereas attachment security was negatively related to teacher reports of externalizing behavior problems. Attachment theoretical tenets appeared valid with foster parent-child relationships, except for children with symptoms of attachment disorder. © 2008 Michigan Association for Infant Mental Health.

Young infants need their caregivers to help them regulate their affect. When the caregiver does this successfully, infants gradually learn to regulate their affect themselves. However, regulating the affect of the infant is challenging for new parents; they have to learn which methods are effective from the signals the baby emits. To interpret these signals, caregivers have to be in control of their own emotions as well, which might be more difficult if an infant is hard to soothe, since research has shown that exposure to infant cries leads to strong physiological arousal (Donovan & Leavitt, 1989). The current study investigated with a simulated cry response task whether perceptions of a crying infant and physiological reactions were influenced by difficulty of regulating the infant’s affect. We were alsointerested in whether this had an effect on the response latency and the amount and consistency of the caregiver’s responses. This study has been executed with first-time pregnant women, because we expected them to be able to relate to this task more than any other group of non-parent adults, while their responses were not colored by previous parenting experiences. 179 women (age 18-40 years) who were pregnant with their first child participated at 22 weeks of pregnancy in a computerized cry response task involving audio taped baby cries. They listened to 2x10 baby cries during which they could choose one of four responses (feeding, distracting, changing the diaper or picking up the infant) to terminate the cry. The first series of cries simulated an easy to regulate infant (soothing success rate 80%, short cry duration); the second series represented a difficult to regulate infant (soothing successrate 20%, longer cry duration). After each series, the women filled out four questions regarding their perception of the cries. Physiological reactivity was measured using the VU-AMS (De Geus & Van Doornen, 1996), an ambulatory device that records ECG and ICG, allowing calculation of indicators of sympathetic (PEP; pre-ejectionperiod) and parasympathetic nervous system activity (RSA: respiratory sinus arrhythmia). The cries of the difficult infant were perceived as more urgent, stressful, unpleasant and piercing (pstress) was related to faster (p