Lecture 6 - Promoting parent-child health

How does the quality of parent-infant interaction influence brain development?

Higher quality maternal behaviour during mother-infant interactions at 5 months predicts higher EEG power up to 24 months of age (Bernier et al., 2016). Higher maternal Accessibility/availability and greater maternal positivity during mother-infant interactions at 1 year of age were found to be predictive of smaller right amygdala volume and smaller bilateral hippocampal volumes at 10 years (Bernier et al., 2019).

Describe the effect of family interventions on parents:

About 70% of adults with a mental disorder are parents and 1 in 5 childrenslives with a parent with psychopathology. However, there is a lack of evidence-based tailored interventions for parents. Most interventions aimed specifically at parenting practises are not designed to accommodate adult psychopathology. There are only a few models of integrated services that attend to both parents' and children's mental health.

How does an infant behavioural and physiological profile affect the quality of mother-infant interaction?

Associations between infants' behavioural and physiological profiles (neurobehavioral organisations, social withdrawal behaviour, and endocrine reactivity to stress) and quality of mother-infant interactions. Extroverted infants had higher neurological organisation, showed lower social withdrawal, and expressed more positive interactive behaviours. Under-aroused infants had lower reactivity to stress and their mothers were the more sensitive, happy and with more energy. Withdrawn infants had lower neurobehavioral organisation, higher response to stress and poor performance in interactions. Their mothers expressed less optimal behaviours and more depressive symptoms.

What results in disrupted interactions?

Caregiver's mental health - Social support, work status, socioeconomic and marital status. Caregiver's behaviours - Caregiver's expectations/representations of the infants and/or the relationships, E.g., Infants perceived as more difficult receive less responsive mothering. Combination of child and caregivers characteristics - Biological factors E.g., Preterm birth. Infant characteristics E.g., Temperament - Infant characteristics influence the way an infant takes part in interactions. E.g., More difficult infants show less responsive behaviour during an interaction with their mother.

Describe the effect of depressive symptoms on maternal responsivity:

Depressed mothers have longer latencies in terms of maternal responsivity towards the infant indicating a lack of synchrony during interactions. (Cohn et al., 1990). Depressive symptoms in the first 4 months postpartum are predictive of bonding impairments in the first 14 months of life (Moehler et al., 2006). Depressive symptoms at 6 months are associated with both lower maternal structuring and decreased infant involvement in interaction observed at 8 months (Hakanen et al., 2019).

What is health promotion?

Health promotion is any event, process or activity that facilitates the protection or improvement of the health status of individuals, groups, communities or populations. The objective is to prolong life and to improve quality of life that is to prevent or reduce the effects of impaired physical and/or mental health in those individuals who are directly (E.g., Patients) or indirectly (E.g., Carers) affected. While early models focused primarily on disease preventions (as influenced by the biomedical model), ,ore recently models are influenced by the biopsychosocial model, which takes into account the psychological and social determinants of health. I.e., Creating favourable social conditions. Coordinating with people from all walks of life. Reducing inequalities and ensuring equal opportunities.

Describe the mother-child dyadic synchrony:

Mother-child dyadic synchrony during interaction plays an important mediating role between maternal sensitivity and infant-mother attachment, and is critical for the development of infants' ability to regulate their internal states. Synchronized positive affect is essential for the development of self-regulation (Feldman, 2003;2007).

Describe the intergenerational transmission of psychopathology:

The extent of risk for the development of psychopathology in offspring of parents with psychopathology. This is also the extent to which those risks are specific to parental psychopathology or to related risks (E.g., Marital conflict). Having a parent with psychopathology is associated with offspring risk of psychopathology, but there is limited evidence that parent and child will have the same disorder. Parent psychopathology -> Biological transmission/Parenting quality stressors -> Children wellbeing/Risk of psychopathology. Parenthood as a protective factor for adult psychopathology. Integrated Treatments targeting simultaneously parents and children; effective at improving the symptoms of both mothers and their children and at improving parenting quality. Preventive Interventions decrease the risk of onset of new disorders in offspring by 40%.

What is parental mind-mindedness?

This is the caregiver's tendency to attribute mental states to their young children (emotions, preferences, motives and goals) and to interpret behaviour as resulting from these mental states (Meins, 1997). Mind-minded parents are more likely to act as if infants' vocalisations are an attempt to communicate; engage in appropriate talk with their infant commenting on what the infant may be feeling/thinking.

What is maternal sensitivity?

This is the mothers ability to perceive and accurately interpret the signals and communications implicit in infant behaviour and given the understanding, to respond to them appropriately and promptly. (Ainsworth et al., 1971). Attachment theory (e.g., Ainsworth et al., 1978) has traditionally focused on the construct of maternal sensitivity as a main precursor of child secure attachment.