Assessing the impact of a family nurse-led intervention on young mothers’ references to internal states

A mother's propensity to refer to internal states during mother–child interactions is important for her child's developing social understanding. However, adolescent mothers are less likely to reference internal states when interacting with their children. We investigated whether young mothers’ references to internal states are promoted by the Family Nurse Partnership (FNP) intervention, an intensive home-visiting programme designed to support adolescent mothers in England. We also investigated family, maternal, and child factors associated with young mothers’ references to inner states during interactions with their children. Adolescent mothers (n = 483, aged ≤ 19 years when recruited in pregnancy) and their children participated in an observational substudy of a randomized controlled trial investigating the impact of FNP compared to usual care. Mother–child dyads were video-recorded during free play, and mothers’ speech was coded for use of internal state language (references to cognitions, desires, emotions, intentions, preferences, physiology, and perception). We found no differences in mothers’ use of internal state language between the FNP and usual care groups. A sample-wide investigation identified that other features of mothers’ language and relationship status with the child's father were associated with internal state language use. Findings are discussed with reference to targeted interventions and implications for future research.     

Parent–child interaction: Does parental language matter?

Although parental language and behaviour have been widely investigated, few studies have examined their unique and interactive contribution to the parent–child relationship. The current study explores how parental behaviour (sensitivity and non‐intrusiveness) and the use of parental language (exploring and control languages) correlate with parent–child dyadic mutuality. Specifically, we investigated the following questions: (1) ‘Is parental language associated with parent–child dyadic mutuality above and beyond parental behaviour?’ (2) ‘Does parental language moderate the links between parental behaviour and the parent–child dyadic mutuality?’ (3) ‘Do these differences vary between mothers and fathers?’ The sample included 65 children (M_age = 1.97 years, SD = 0.86) and their parents. We observed parental behaviour, parent–child dyadic mutuality, and the type of parental language used during videotaped in‐home observations. The results indicated that parental language and behaviours are distinct components of the parent–child interaction. Parents who used higher levels of exploring language showed higher levels of parent–child dyadic mutuality, even when accounting for parental behaviour. Use of controlling language, however, was not found to be related to the parent–child dyadic mutuality. Different moderation models were found for mothers and fathers. These results highlight the need to distinguish parental language and behaviour when assessing their contribution to the parent–child relationship.     

Testing a Military Family Stress Model

The current study examines a military family stress model, evaluating associations between deployment‐related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (N = 293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (N = 253) and/or mothers had deployed (N = 45) to the recent conflicts in the Middle East. Multiple‐method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers’ and fathers’ PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers’ but not fathers’ PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment.     

Parental Perceived Control and Social Support: Linkages to Change in Parenting Behaviors During Early Adolescence

Prior studies have found that parents’ perceptions of control over their lives and their social support may both be important for parenting behaviors. Yet, few studies have examined their unique and interacting influence on parenting behaviors during early adolescence. This longitudinal study of rural parents in two‐parent families (N = 636) investigated (a) whether perceived control and social support when their youth were in sixth grade were independently or interactively associated with changes in parenting behaviors (discipline, standard setting) and parent–child warmth and hostility 6 months later and (b) if these linkages differed by parent gender. We also investigated the interactive links between perceived control, social support, and parenting. Specifically, we tested if parents’ perceived control moderated the linkages between social support and parenting and if these linkages differed by parent gender. Greater perceived control predicted more increases in parents’ consistent discipline and standard setting, whereas greater social support predicted increases in parent–child warmth and decreases in parent–child hostility. Parental perceived control moderated the effect of social support on parental warmth: For mothers only, social support was significantly linked to parent–child warmth only when mothers had low (but not high) perceived self‐control. The discussion focuses on reasons why perceived control and social support may have associations with different aspects of parenting and why these might differ for mothers and fathers.     

A Model‐Based Cluster Analysis of Maternal Emotion Regulation and Relations to Parenting Behavior

In a diverse community sample of mothers (N = 108) and their preschool‐aged children (M_age = 3.50 years), this study conducted person‐oriented analyses of maternal emotion regulation (ER) based on a multimethod assessment incorporating physiological, observational, and self‐report indicators. A model‐based cluster analysis was applied to five indicators of maternal ER: maternal self‐report, observed negative affect in a parent–child interaction, baseline respiratory sinus arrhythmia (RSA), and RSA suppression across two laboratory tasks. Model‐based cluster analyses revealed four maternal ER profiles, including a group of mothers with average ER functioning, characterized by socioeconomic advantage and more positive parenting behavior. A dysregulated cluster demonstrated the greatest challenges with parenting and dyadic interactions. Two clusters of intermediate dysregulation were also identified. Implications for assessment and applications to parenting interventions are discussed.     

Maternal Directiveness in Childhood Survivors of Acute Lymphoblastic Leukemia

Parental intrusiveness is associated with internalizing problems in healthy children. Given the unique demands that childhood cancer places on parents, it is important to determine whether intrusiveness operates differently in survivors of childhood cancer. The current study tested whether cancer survivorship moderates the relation between maternal directiveness—one aspect of intrusiveness—and children’s internalizing problems. Survivors (7–12 years old) of acute lymphoblastic leukemia (ALL) (n = 25) and their mothers, and healthy controls (n = 22) and their mothers engaged in parent–child interactions. Mothers completed a measure of children’s psychosocial adjustment, and observations of 10-min parent–child interactions were obtained. Cancer survivorship moderated the relation between directiveness and children’s withdrawn/depressed symptoms. Maternal directiveness was associated with increased withdrawn/depressed symptoms for children in the control group. This association was not significant for survivors of ALL. Findings suggest that childhood cancer may alter the context in which children experience maternal directiveness.     

Parent–child interactions during traditional and interactive media settings: A pilot randomized control study

Parent–child interactions are pivotal for children's socioemotional development, yet might suffer with increased attention to screen media, as research has suggested. In response, we hypothesized that parent–child play on a tablet computer, as representative of interactive media, would generate higher‐quality parent–child interactions than toy play or watching TV . We examined the emotional availability of mothers and their 2‐year‐old child during the previous three contexts using a randomized crossover design (n = 22) in a laboratory room. Among other results, mothers were more sensitive and structuring during joint gaming on a tablet than when engaged in toy play or watching TV . In addition, mothers were more hostile toward their children during play with traditional toys than during joint tablet gaming and television co‐viewing. Such findings provide new insights into the impact of new media on parent–child interactions, chiefly by demonstrating that interactive media devices such as tablets can afford growth‐enhancing parent–child interactions.     

Gender and age differences in parent–child emotion talk

This study examined gender differences in emotion word use during mother–child and father–child conversations. Sixty‐five Spanish mothers and fathers and their 4‐ (M = 53.50, SD = 3.54) and 6‐year‐old (M = 77.07, SD = 3.94) children participated in this study. Emotion talk was examined during a play‐related storytelling task and a reminiscence task (conversation about past experiences). Mothers mentioned a higher proportion of emotion words than did fathers. During the play‐related storytelling task, mothers of 4‐year‐old daughters mentioned a higher proportion of emotion words than did mothers of 4‐year‐old sons, whereas fathers of 4‐year‐old daughters directed a higher proportion of emotion words than did fathers of 4‐year‐old sons during the reminiscence task. No gender differences were found with parents of 6‐year‐old children. During the reminiscence task daughters mentioned more emotion words with their fathers than with their mothers. Finally, mothers' use of emotion talk was related to whether children used emotion talk in both tasks. Fathers' use of emotion talk was only related to children's emotion talk during the reminiscence task.     

Predictors of Parenting Stress for Abusive and Nonabusive Mothers

We examined a model of parenting stress for abusive mothers (n = 80) and nonabusive mothers (n = 86) using linear regression analyses. Predictors in the model included (a) the degree to which mothers were bothered by child misbehavior, (b) mothers’ general psychological functioning, and (c) observed child behavior during parent–child interactions. Whether abuse status moderated the relations between each predictor and parenting stress was also explored. Results indicated that mothers’ psychological functioning significantly predicted parenting stress; however, neither mothers’ intolerance for their children’s misbehavior nor observed child behavior were significant predictors of parenting stress in the regression model. A test of moderation revealed a significant interaction between parental intolerance and abuse status such that intolerance predicted parenting stress level only for abusive mothers. A comparison of correlations indicated that abusive mothers’ level of parenting stress was more closely related to their intolerance for child conduct problems than to the child’s behavior during play with their mothers. Findings are discussed in terms of implications for interventions to reduce parenting stress experienced by nonabusive and abusive mothers.     

Moderately dysphoric mothers behave more positively with their infants after completing the BDI

To determine whether mildly and moderately dysphoric adolescent mothers display infantized facial and vocal behaviors, 21 nondysphoric mothers and 32 dysphoric (16 mildly and 16 moderately/severely dysphoric) mothers were videotaped during face-to-face interactions with their 4-month-old infants. Mildly dysphoric mothers showed less positive facial expressions and less animated/exaggerated vocal expressions. The moderately/severely dysphoric mothers, however, did not differ from nondysphoric mothers in their display of facial and vocal behaviors. These mothers with higher Beck Depression Inventory (BDI) scores may have become concerned about their many symptoms affecting their interactions and tried to compensate for this during their interactions. A second study was conducted to determine whether completing the BDI before interactions positively affected the moderately/severely dysphoric mothers' behavior. Moderately/severely dysphoric mothers (N=24) and mildly dysphoric mothers (N=24) were given the Beck Depression Inventory either before or after their face-to-face interactions with their 4-month-old infants. Moderately/severely dysphoric mothers who were given the BDI before their interactions showed more positive behavior than mothers given the BDI after their interactions. © 1997 Michigan Association for Infant Mental Health     

Parental play styles and sibling interaction during a problem‐solving task

Associations between parental play styles and sibling interaction were investigated in 30 same‐sex preschool‐ and school‐aged sibling dyads (first‐borns were 4–9 years, M=6.6 years; second‐borns were 2–7 years, M=4.2 years), divided into older and younger sibling groups. Participants completed puzzles under three conditions: (a) siblings alone, (b) together with mother, and (c) together with father. Prosocial and agonistic sibling‐directed behaviors and positive and negative parent–child behaviors were coded. Siblings engaged in both more prosocial and agonistic interactions when alone than with either parent; there were no differences in sibling interactions in the mother versus father episodes. Paternal negative behavior was associated with sibling agonistic behavior when the children were alone, indicating second‐order effects, however, mother–child and sibling interactions were not significantly associated. Nevertheless, reciprocity in positive and negative behaviors directed by children to parents and vice versa was evident, demonstrating synchrony in patterns of exchanges. The findings underscore the necessity of studying both parents in order to understand more fully the dynamics involved in family relationships. Copyright © 1999 John Wiley & Sons, Ltd.     

Patterns of emotional availability between mothers and young children: Associations with risk factors for borderline personality disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low socio‐economic backgrounds: 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non‐intrusiveness, non‐hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over‐responsiveness and over‐involvement. Using person‐centred analyses, we identified four clusters: high functioning, low functioning, asynchronous (mothers above average on two of four dimensions and children below), and below average. Mothers in the low‐functioning cluster had lower income, less social support, more of the borderline feature of negative relationships, and more depression than did mothers in the high‐functioning cluster. The children in the low‐functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother–child relationship in their stories) than did children in the high‐functioning group. The asynchronous group included older girls who were over‐responsive and over‐involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Highlights

• This paper investigated how mother‐child emotional availability (warmth and closeness) relates to risk factors for borderline personality disorder, including mother‐child role reversal.
• In filmed mother‐child interactions, low emotional availability was associated with risk for borderline personality disorder and role reversal was more likely for older girls.
• Findings support the cumulative risk hypothesis and may inform interventions to improve mother‐child emotional availability to prevent the development of psychopathology.

     

Preterm behavior,maternal adjustment,and competencies in the newborn period: What influence do they have at 12 months postnatal age?

This article examines whether preterm newborns' behavior and their mother's adjustment to the premature birth and infant hospitalization have an influence on subsequent infant development and behavior, maternal adjustment, and mother–infant relationship. The behavioral competencies of 42 well, singleton preterm infants (mean gestational age=31 weeks) were assessed, as were their mothers' adjustment (depression and coping) and competencies (knowledge of child development). At 12 months of postnatal age, child competencies (development and behavior) were assessed, together with maternal adjustment (parenting stress and depression). Mother–infant interaction also was observed. Regression analyses indicated that in the newborn period, maternal positive reappraisal and a planful coping style, more knowledge of child development, and previous experience with baby‐sitting were associated with better infant development (p=.002), maternal adjustment (p=.012), and mother–child relationship (p=.002) at 12 months. Newborn infant muscle‐tone maturity was predictive of better motor quality at 12 months (p=.011), and being a firstborn infant who was more sleepy and drowsy was associated with subsequent higher maternal parenting stress (p=.007). Social and educational support groups combined with an approach that assists mothers to develop problem‐solving coping styles may have a beneficial influence on infant development.     

Parent Education for Migrant Mothers of Left‐Behind Children in China: A Pilot Randomized Controlled Trial

Although numerous studies have indicated the significance of parental support and parent–child communication in alleviating the adverse effects of parental departure on left‐behind children, researchers have rarely addressed the impact of parent education on migrant parents. On the basis of the results of a pilot randomized controlled trial, the study reported here involved examining the possible outcomes and feasibility of a parent education program for rural‐to‐urban migrant mothers of left‐behind children in China. Informed by an existential–narrative approach to parent education, the program was composed of six 2.5‐hour sessions. The sample included 56 migrant mothers recruited from a social service center in Shenzhen, China, who were randomly assigned to either the immediate group (n = 28, M = 34.82 years, SD = 4.12, aged 23–43) or the waitlist control group (n = 28, M = 34.68 years, SD = 4.53, aged 28–43). The hypotheses of the trial were twofold: that the program would positively affect participants’ parental identity and that it would improve mother–child relationships and parenting practices. The results revealed no significant difference in parental identity between the intervention group and the waitlist control group at the post‐test assessment after ruling out the effects of pretest survey scores. However, significant differences did emerge in parent–child relationships and parenting practices. Overall, the results corroborate the feasibility of examining the current program for migrant mothers in China in a full trial. The findings also offer insights into developing empirically supported parent education programs for migrant parents.     

Fathers' versus mothers' social referencing signals in relation to infant anxiety and avoidance: a visual cliff experiment

Infants use signals from others to guide their behavior when confronted with novel situations, a process called ‘social referencing’ (SR). Via SR, signs of parental anxiety can lead to infant anxiety. Little is known about differences in the effect of paternal and maternal SR signals on child anxiety. Using a visual cliff paradigm, we studied whether SR processes between fathers and their infants differed from mothers and their infants. Eighty‐one infants aged 10–15 months were randomly assigned to conduct the visual cliff task with their father (n = 41) or mother (n = 40). The infant was placed on the shallow side of the cliff and the parent, standing at the deep side, was instructed to encourage the infant to cross. Results showed that although mothers showed more intense facial expressions of encouragement than fathers, no differences occurred in how fast, and with how much anxiety, infants crossed the cliff with fathers and mothers. However, path analyses showed that paternal, but not maternal, expressed anxiety was positively associated with infant expressed anxiety and avoidance. For infants who participated with their mother, infants' anxious temperament was negatively associated with infant avoidance of the cliff. Infant anxious temperament moderated the link between paternal expressed anxiety and infant avoidance: the higher the level of infant anxious temperament the stronger the positive association between paternal expressed anxiety and infant's avoidance of the cliff. Lastly, parental encouragement was unrelated to infant expressed anxiety and avoidance. Our results suggest that SR processes between fathers and their infants differ from those between mothers and their infants.     

Co‐Occurring Trajectory of Mothers’ Substance Use and Psychological Control and Children's Behavior Problems: The Effects of a Family Systems Intervention

This study examined the effects of a family systems therapy (Ecologically‐Based Family Therapy [EBFT]) on the co‐occurring trajectory of mothers’ substance use and psychological control, and its association with children's problem behaviors. Participants included 183 mothers with a substance use disorder who had at least one biological child in their care. Mothers were randomly assigned to one of the three intervention conditions: EBFT—home, n = 62; EBFT—office, n = 61; or Women's Health Education, n = 60. Participants were assessed at baseline, 3, 6, 12, and 18 months post‐baseline. A dual‐trajectory class growth analysis identified three groups of mothers in regard to their change trajectories. The majority of the mothers exhibited a synchronous decrease in substance use and psychological control (n = 107). In all, 46 mothers exhibited a synchronous increase in substance use and psychological control. For the remaining 30 mothers, substance use and psychological control remained stable. Mothers in the family therapy condition were more likely to show reduced substance use and psychological control compared to mothers in the control condition. Moreover, children with mothers who showed decreased substance use and psychological control exhibited lower levels of problem behaviors compared to children with mothers showing increased substance use and psychological control. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in treating mothers’ substance use, improving parenting behaviors, and subsequently improving child behavioral outcomes.     

Externalizing behaviors and attachment disorganization in children of different‐sex separated parents: The protective role of joint physical custody

The aim of this study was to examine the relationship between externalizing behaviors and the quality of attachment representations in preschool children, and to determine if family type and custody arrangement had a moderating effect on this relationship. The participants were 33 girls and 31 boys (n = 64) aged between three and six years (M = 4.75; SD = 0.87 years) and their mothers. Among them, 36 came from “intact” families, 13 were living mainly with their mothers and 15 were in joint physical custody. Children’s attachment representations were assessed with the Attachment Story Completion Task (Bretherton, Ridgeway & Cassidy, 1990). Mothers reported on their child’s behavior problems using the Child Behavior Checklist (Achenbach & Rescorla, 2001) and on their alliance with the father using the Parenting Alliance Inventory (Abidin & Brunner, 1995). Although children’s externalizing behaviors were found to be associated with the disorganization of their attachment representations, this relationship was significantly weaker and was non‐significant for children in joint physical custody. Thus, the results of this pilot study suggest that joint custody may protect children of separated parents from the effects of attachment disorganization on externalizing behaviors.     

Parenting practices and their relevance to child behaviors in Canada and China

Liu, M. & Guo, F. (2010). Parenting practices and their relevance to child behaviors in Canada and China. Scandinavian Journal of Psychology, 51, 109–114. Recent studies have revealed that parents in different cultures endorse different child‐rearing practices. Studies in the West suggest that there is a cluster of behavioral characteristics in children that are linked with each type of parenting styles. Mixed results, however, were found in non‐Western countries. This study examined (1) parenting practices in Canadian and Chinese mothers, and (2) the relevance between parenting practices and child behaviors in Canada and China. Forty Canadian children (average age = 5.40) and 39 Chinese children (average age = 4.84) and their mothers participated in the study. Information on maternal authoritative and authoritarian behaviors and children’s behaviors, including coercive request, polite request, and assertiveness, was obtained from observations of mother‐child interactions in a laboratory situation. The results indicated that Chinese mothers were less authoritative and more authoritarian than Canadian mothers. Both cross‐cultural differences and similarities were found on the associations between maternal parenting practices and child behaviors.     

Sibling relationship quality in early adolescence: child and maternal perceptions and daily interactions

Correspondence between child and maternal perceptions of sibling relationship quality (standards, actual ratings, problems) and children's reports of daily interactions were assessed in 40 early adolescent children (M age=11.5 yrs) and their mothers (n=32). Children completed the Sibling Relationship Questionnaire (Furman & Buhrmester, 1985. Child Development, 56, 448–461) and Daily Checklist ratings of sibling interactions for 14 days. Mothers completed the Parental Expectations and Perceptions of Children's Sibling Relationship Questionnaire (Kramer & Baron, 1995. Family Relations, 44, 95–103). Overall, findings revealed correspondence between child perceptions of sibling warmth and maternal ratings of standards, actual ratings, and problems in sibling warmth but not conflict and rivalry. Maternal and child perceptions of sibling relationship qualities were positively associated with children's reports of ongoing interactions. Finally, regression analyses identified unique maternal and child correlates for both happy and prosocial daily interactions. Findings are discussed in light of recent research and theory on family dynamics. Copyright © 2010 John Wiley & Sons, Ltd.     

MOTHER–CHILD AND FATHER–CHILD PLAY INTERACTION: THE IMPORTANCE OF PARENTAL PLAYFULNESS AS A MODERATOR OF THE LINKS BETWEEN PARENTAL BEHAVIOR AND CHILD NEGATIVITY

Based on the premise that father–child play is an important context for children's development and that fathers “specialize” in play, similarities and differences in the role of playfulness in the father–child and mother–child relationship were examined. Participants in this study included 111 families (children's age: 1–3 years). Father–child and mother–child play interactions were videotaped and coded for parental playfulness, sensitivity, structuring, and nonintrusiveness as well as child negativity. Results indicated that mothers and fathers did not differ in playfulness and that mothers and fathers who were higher in playfulness had children with lower levels of negativity. However, playfulness differently moderated the links between parents’ and children's behaviors for mothers and fathers. A double‐risk pattern was found for mothers, such that the links between child negativity and maternal sensitivity, structuring, and nonintrusiveness were significant only for the subgroup of mothers with low levels of playfulness. When mothers had high levels of playfulness, these effects were negligible. For fathers, a double‐buffer pattern was revealed, indicating that the links between child negativity and paternal sensitivity and structuring were significant only for fathers with high levels of playfulness. When fathers had low levels of playfulness, these effects were negligible. These findings demonstrate the important role that parental playfulness has on parent–child interaction as well as the need to examine moderation patterns separately for fathers and mothers.