MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS

We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide‐ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers’ CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers’ higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war‐exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems.     

IMPACT OF JOINT ATTENTION ON SOCIAL‐COMMUNICATION SKILLS IN INTERNATIONALLY ADOPTED CHILDREN

Internationally adopted (IA) children have often experienced early adversity and are at risk for long‐term deficiencies in multiple developmental domains. This study examined the association between IA children's joint attention (JA) soon after arrival and later cognitive, communicative, and socioemotional competency 6 months’ postadoption. We expected a child's initial JA would positively predict later cognitive, communication, and social ability. IA children (n = 63) adopted from Eastern Europe were seen soon after their arrival into the United States to assess their JA. Their socioemotional competency, social communication, and cognitive abilities were measured at a follow‐up session 6 months’ postadoption. We found that higher order JA was positively associated with measures of social relatedness. Furthermore, individual hierarchical regressions of each measure of JA (higher order JA, initiating JA, responding to JA, and initiating behavior requests [BR]) considered with age‐at‐adoption showed that each measure was an independent and positive predictor of Mullen outcomes in the receptive and expressive language domains. These results suggest that JA may be a sensitive predictor of subsequent functioning in the social, communicative, and cognitive domains. Thus, assessing JA soon after arrival has the potential to identify at‐risk IA children, and interventions targeting JA may support those children in overcoming the negative impacts of early adversity.     

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.     

THE MAGIC OF PLAY: LOW‐INCOME MOTHERS’ AND FATHERS’ PLAYFULNESS AND CHILDREN'S EMOTION REGULATION AND VOCABULARY SKILLS

Using data from a diverse sample of low‐income families who participated in the Early Head Start Research Evaluation Project (n = 73), we explored the association between mothers’ and fathers’ playfulness with toddlers, toddler's affect during play, and children's language and emotion regulation at prekindergarten. There were two main findings. First, fathers’ playfulness in toddlerhood was associated with children's vocabulary skills in prekindergarten whereas mothers’ playfulness was related to children's emotion regulation. Cross‐parental effects were found only for mothers. The association between mothers’ playfulness and children's vocabulary and emotion regulation was strengthened when fathers engaged in more pretend play and when children were affectively positive during the play. These findings show that playfulness is an important source of variation in the vocabulary and emotion regulation of children growing up in low‐income families. They also point to domain‐specific ways that mothers and fathers promote children's regulatory and vocabulary skills, and highlight the importance of children's positive engagement in play.     

THE WORLDWIDE BURDEN OF INFANT MENTAL AND EMOTIONAL DISORDER: REPORT OF THE TASK FORCE OF THE WORLD ASSOCIATION FOR INFANT MENTAL HEALTH

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth –3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015 ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.     

2型糖尿病大血管病变机理和糖尿病治疗

2型糖尿病大血管病变与代谢综合征密切相关.现代医学认为两者的根本原因是胰岛素抵抗,导致糖耐量下降,血脂紊乱,高胰岛素血症,高血压和高凝状态等.从系统论的观点阐述了代谢综合征的相互关系和2型糖尿病大血管病变发病机理,并进一步从该观点阐明2型糖尿病的防治策略.     

A socio-emotional relational framework for infidelity: the relational justice approach

Current clinical models for addressing infidelity tend not to make social context issues a central focus; yet, societal gender and power structures, such as female responsibility for relationships and limited male vulnerability, affect the etiology of affairs and create power imbalances in intimate relationships. How therapists respond to these societal influences may either limit or enhance the mutual healing of both persons in the relationship. Thus attention to these societal processes is an ethical issue. This paper presents one perspective, the Relational Justice Approach, for working with infidelity. It places gender, power, and culture at the center of intervention in couple therapy, and includes three stages: (1) creating an equitable foundation for healing, (2) placing the infidelity in a societal context, and (3) practicing mutuality. Each stage is illustrated with case examples and contrasted with current practice regarding infidelity.