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Maternal mindfulness during pregnancy and infant socio-emotional development and temperament: The mediating role of maternal anxiety
... Recent work suggests that greater prenatal maternal mindfulness is associated with greater excitability and motor activity in newborns (M = 3.80 days after birth; Ostlund et al., 2021). With respect to outcomes in later infancy, research from one prospective study (n = 190) conducted in the Netherlands suggests that greater maternal mindfulness during pregnancy predicts lower parent-reported negative social-emotional behavior in offspring at 4-months (Braeken et al., 2017) and lower negative affectivity at 10-months (van den Heuvel et al., 2015). Both of these published manuscripts (Braeken et al., 2017;van den Heuvel et al., 2015), which were drawn from the same study sample, provided initial evidence for the relation between prenatal mindfulness and infant socioemotional outcomes. ...
... With respect to outcomes in later infancy, research from one prospective study (n = 190) conducted in the Netherlands suggests that greater maternal mindfulness during pregnancy predicts lower parent-reported negative social-emotional behavior in offspring at 4-months (Braeken et al., 2017) and lower negative affectivity at 10-months (van den Heuvel et al., 2015). Both of these published manuscripts (Braeken et al., 2017;van den Heuvel et al., 2015), which were drawn from the same study sample, provided initial evidence for the relation between prenatal mindfulness and infant socioemotional outcomes. However, these data came from a relatively homogenous sample (i.e., highly educated, high income, Dutch). ...
... For example, maternal prenatal stress and psychopathology predict poorer executive functioning and greater fear in female compared to male infants (Nolvi et al., 2018(Nolvi et al., , 2019. Maternal prenatal mindfulness also indirectly predicted poorer infant self-regulation for male compared to female infants (van den Heuvel et al., 2015). Given heterogeneity in the nature of sex differences by prenatal exposure and offspring outcome, no a priori hypotheses were formed. ...
Objectives
The present study tested the unique contributions of prenatal maternal mindfulness to infant emerging effortful control and negative affect at 6 months postnatal. Exploratory analyses evaluated the role of individual facets of mindfulness in predicting infant outcomes.
Method
The sample consisted of 178 individuals. Participants completed self-report measures of mindfulness during pregnancy (M = 16.91 gestational weeks; SD = 4.37) and postnatally (M = 6.54 months after birth; SD = 2.12). At 6 months postpartum, participants also reported on their infants' (55% female) emerging effortful control and negative affect using the Infant Behavior Questionnaire.
Results
Greater prenatal maternal mindfulness was associated with higher infant emerging effortful control (β = 0.40, p < 0.001) and lower negative affect (β = -0.16, p = 0.04). These relations remained statistically significant when controlling for postnatal mindfulness. The prenatal describing (β = 0.21, p = 0.02) and nonreacting (β = 0.28, p = 0.01) subscales of mindfulness were statistically significant predictors of emerging effortful control after controlling for postnatal mindfulness subscales. None of the subscales were significant predictors of infant negative affect after controlling for postnatal mindfulness.
Conclusions
Maternal prenatal mindfulness predicted both infant emerging effortful control and negative affect. Individual facets of prenatal mindfulness demonstrated unique patterns of association with infant emerging effortful control, suggesting that aspects of mindfulness may be promotive factors to consider in future interventions. These findings highlight that mindfulness during pregnancy is linked to improved infant self-regulation and reduced emotional reactivity.
Preregistration
This study is not preregistered.
... Moreover, mindfulness interventions have been demonstrated to reduce stress, anxiety, depression, and negative affect during pregnancy (Beddoe et al., 2009;Dunn et al., 2012;Vieten & Astin, 2008), continuing into the postnatal phase (Dunn et al., 2012). Concerning child development, mothers' prenatal mindfulness capacities were negatively related to infant self-regulation problems (Van den Heuvel et al., 2015) and negative social-emotional behavior (Braeken et al., 2017), and this association was mediated by maternal anxiety assessed during pregnancy (Van den Heuvel et al., 2015). Finally, children of parents that reported more dispositional mindfulness in early childhood displayed fewer internalizing and externalizing behavior problems (Parent et al., 2016), as well as fewer symptoms of anxiety and depression (Bird et al., 2021). ...
... Moreover, mindfulness interventions have been demonstrated to reduce stress, anxiety, depression, and negative affect during pregnancy (Beddoe et al., 2009;Dunn et al., 2012;Vieten & Astin, 2008), continuing into the postnatal phase (Dunn et al., 2012). Concerning child development, mothers' prenatal mindfulness capacities were negatively related to infant self-regulation problems (Van den Heuvel et al., 2015) and negative social-emotional behavior (Braeken et al., 2017), and this association was mediated by maternal anxiety assessed during pregnancy (Van den Heuvel et al., 2015). Finally, children of parents that reported more dispositional mindfulness in early childhood displayed fewer internalizing and externalizing behavior problems (Parent et al., 2016), as well as fewer symptoms of anxiety and depression (Bird et al., 2021). ...
... In line with the hypotheses, better non-reacting skills in mothers during pregnancy were associated with more socialemotional capacities in children at 2 years of age. These findings were in line with earlier research that associated more maternal mindfulness during pregnancy with less infant selfregulation problems (Van den Heuvel et al., 2015) and negative social-emotional behavior (Braeken et al., 2017). The association between non-reacting and child social-emotional behavior in the current study was, against expectation, not mediated by pregnancy distress or postnatal symptoms of anxiety or depression. ...
Objectives
During the perinatal period, women are exposed to major changes, holding possible adverse effects on psychological well-being and child development. An effective way of coping with these challenges and adjustments could be mindfulness. The current study examined associations of mindfulness facets during pregnancy with toddler’s social-emotional development and behavior problems, as well as potentially mediating effects of maternal mental health.
Method
A total of 167 women completed questionnaires during pregnancy, the postpartum period, and 2 and 3 years after childbirth, assessing dispositional mindfulness, pregnancy distress, symptoms of anxiety and depression, child social-emotional development, and child behavior problems.
Results
There was a positive association between maternal non-reacting mindfulness skills and child social-emotional development at 2 years of age, regardless of mothers’ perinatal mental health, whereas other mindfulness facets were unrelated. Pregnancy distress mediated the association between maternal non-judging skills during pregnancy and child externalizing problem behavior, but no other mediating effects were found.
Conclusions
Non-reacting skills in mothers during pregnancy may have favorable implications for child social-emotional development. Due to the relatively high number of tests that were conducted, the mediating effect of pregnancy distress must be interpreted with caution.
... Therefore, trait mindfulness may strengthen breastfeeding self-efficacy and breastfeeding attitude. Moreover, trait mindfulness has been negatively associated with depression and anxiety in general ( Brown and Ryan, 2003 ;Cash and Whittingham, 2010 ) and with psychological distress during pregnancy ( Truijens et al., 2016 ;van den Heuvel et al., 2015 ). Antenatal depressive symptoms and pregnancy-related anxiety have in turn been inversely related to antenatal breastfeeding intention ( Fairlie et al., 2009 ;Insaf et al., 2011 ). ...
... At 22 weeks of pregnancy, women completed the Dutch version of the 12-item Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) to assess trait mindfulness during pregnancy ( Truijens et al., 2016 ). This measure was derived from the short form of the Five Facet Mindfulness Questionnaire (FFMQ) ( Baer et al., 2006 ;Bohlmeijer et al., 2011 ) and consists of three subscales. ...
... (non-judging) and .81 (non-reacting) ( Truijens et al., 2016 ). In the current study the Cronbach's alpha's per subscale were .86, ...
Objective
: Breastfeeding has been associated with many health benefits for both infant and mother. Trait mindfulness during pregnancy may have a beneficial impact on breastfeeding intention. The current study aimed to examine whether trait mindfulness during pregnancy was associated with antenatal breastfeeding intention.
Design, setting and participants
: The current study is part of a large prospective population-based cohort study among pregnant women in the south of the Netherlands.
Measurements
: A subsample of participants completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy and a question on their breastfeeding intention at 32 weeks of pregnancy (N=790). Moreover, the Edinburgh Depression Scale and Tilburg Pregnancy Distress scale were completed at 32 weeks of pregnancy to assess levels of distress.
Findings
: Univariate analyses showed that women with breastfeeding intention during pregnancy had significantly higher scores on the mindfulness facet non-reacting (p <.001, medium effect size) and significantly lower scores on acting with awareness (p =.035, small effect size). A subsequent multiple logistic regression analysis showed that only non-reacting remained significantly associated with antenatal breastfeeding intention (OR =1.09, 95% CI [1.03, 1.15], p =.001), after controlling for confounders. Women who eventually initiated breastfeeding had significantly higher non-reacting scores (p <.001, small to medium effect size).
Key conclusions
: The mindfulness facet non-reacting was found to be associated with antenatal breastfeeding intention. More research is needed to confirm our results, since the current study is one of the first assessing the possible relation of trait mindfulness during pregnancy and breastfeeding intention.
Implications for practice
: Mindfulness-based programs during pregnancy could be helpful in improving non-reacting in pregnant women, which may enhance breastfeeding intention and ultimately the initiation of breastfeeding.
... A more mindful mother may influence her child's neural and behavioral development beginning in utero. Pregnant women who are more mindful report less emotional distress and show less change in sympathetic and parasympathetic activity across gestation, supporting self-regulation across the prenatal period van den Heuvel et al., 2015b). These regulatory benefits are then thought to be transmitted to the offspring. ...
... It is possible that mindfulness during pregnancy may modulate sympathetic activation, which subsequently facilitates uteroplacental blood flow. Prenatal mindfulness has also been related to less infant self-regulation problems via reductions in prenatal anxiety (van den Heuvel et al., 2015b). Pregnant women who report less prenatal anxiety show a smaller increase in cortisol across gestation, suggesting that fetuses of these women may be buffered from prolonged exposure to elevated cortisol (Kane et al., 2014;Moisiadis & Matthews, 2014). ...
... Pregnant women who report less prenatal anxiety show a smaller increase in cortisol across gestation, suggesting that fetuses of these women may be buffered from prolonged exposure to elevated cortisol (Kane et al., 2014;Moisiadis & Matthews, 2014). Taking into consideration these findings, and the fact that more mindful mothers report less emotion dysregulation, anxiety, and emotional distress prenatally van den Heuvel et al., 2015b), it follows that mindfulness may influence fetal development through a biosocial cascade involving reductions in emotional distress and, subsequently, changes in intrauterine catecholaminergic or neuroendocrine concentrations. ...
Newborn neurobehavioral competencies portend a young child's abilities to modulate their arousal and attention in response to dynamic environmental cues. Although evidence suggests prenatal contributions to newborn neurobehavioral differences, no study to date has examined wellness‐promoting traits, such as a pregnant woman's mindfulness, in this association. We examined whether a mother's mindfulness while pregnant related to neurobehavioral outcomes in her neonate, as well as whether maternal mindfulness moderated the link between prenatal maternal emotion dysregulation and newborn neurobehavior. Mothers (N = 162) reported on their mindfulness and emotion dysregulation while pregnant. Newborn arousal and attention were assessed at least 24 h after birth (M = 3.8 days, SD = 8.3) using the NICU Network Neurobehavioral Scale (NNNS). Highly mindful pregnant women reported lower levels of emotion dysregulation. Newborns of highly mindful mothers exhibited higher levels of arousal (e.g., excitability, motor activity) but did not differ in regards to attention at birth. Maternal emotion dysregulation while pregnant was associated with blunted newborn attention, but only among mothers who were less mindful. Our findings suggest that a mother's mindfulness while pregnant may influence her fetus’ neurobehavioral development in ways that are evident at birth.
... Seventeen articles investigated the association between prenatal mental health disorders of mothers and the temperament of infants longitudinally, nine focused on antenatal depression or anxiety in pregnancy (41,(50)(51)(52)(53)(54)(55)(56)(57), five investigated prenatal stress (18,48,49,58,59), and one investigated eating disorders (60) and another investigated mindfulness (61). First, maternal antenatal depression and anxiety were assessed using the Structured Clinical Interview for the DSM (SCID) or parent-administered questionnaire. ...
... Raikonnen et al. (49) reported that 'fear' in infants was higher for mothers who experienced severe stressful events prenatally than those who had not. One paper found a positive factor of infant temperament (61). Van den Heuvel et al. (61) found that mothers who were more mindful tended to score lower on self-regulation problems. ...
... One paper found a positive factor of infant temperament (61). Van den Heuvel et al. (61) found that mothers who were more mindful tended to score lower on self-regulation problems. Regarding eating disorders, infants of mothers who were diagnosed with an eating disorder such as Anorexia Nervosa (AN), Bulimia Nervosa (BN), Eating Disorder Not Otherwise Specified (EDNOS) and/or Binge Eating Disorder (BED), scored higher on 'fussiness' than the un-exposed group (60). ...
Background: Temperament involves individual variations in behavioural tendencies of emotional responses and reactions to stimuli after birth. Because ‘foetal programming' is a strong hypothesis in developing temperament, prenatal and intrapartum factors may be significant determinants of infant temperament. This systematic literature review aims to elucidate the evidence of prenatal and intrapartum predictors, including genetic, biological, environmental, socio-demographic, psychological, and obstetric factors of parents and their child.
Methods: Relevant articles were searched using MEDLINE, PubMed, and SCOPUS. The inclusion criteria were (a) original research article, (b) written in English, (c) assessed the temperament of infants 12 months old or younger as an outcome variable, and (d) investigated prenatal and intrapartum factorial variables of infant temperament. Following the PRISMA guideline, the articles found in the three databases were screened and selected according to the inclusion and exclusion criteria before the final review.
Results: Finally, 35 articles were reviewed. This systematic review identified a variety of prenatal and intrapartum factors that were significantly associated with infant temperament: (1) genetic and biological factors: certain genotypes, maternal cortisol and ACTH, and CRHs, (2) environmental factors: substance use such as tobacco, alcohol, and illegal drugs, (3) socio-demographic factor: lower-income, (4) psychological factors: depression or anxiety, eating disorders, personality types of mothers, and domestic violence, and (5) obstetric factors: foetal growth (birth weight), hypertension in mothers, nausea (emesis), and preterm birth.
Conclusion: The findings support gene-environment interaction and biological mechanisms for developing infant temperament, suggesting the importance of ensuring a safe and comfortable environment for pregnant mothers, unborn infants, and families during pregnancy and delivery.
... The minimum and maximum scores vary between 17 and 119. The scale has demonstrated high content validity, and its reliability was confirmed with a Cronbach's α coefficient of .76. (Van den Bergh, 1990;Williams et al., 2021). In Iran, Karamoozian et al. (2017) confirmed the validity of the questionnaire by confirmatory factor analysis and reported a good correlation of this questionnaire with the Beck Anxiety Inventory (Beck et al., 1988; r = 0.74). ...
... The findings of this research offer supporting evidence regarding the impact of a mindfulness and spiritual health training package on pregnancy anxiety and maternal-fetal attachment. This pattern of results aligns with previous literature (van den Heuvel et al., 2015;Azizi et al., 2017;Shahoei et al., 2019;Heydarpour et al., 2020), which demonstrated the positive effects of MBSR, prayer, or reading the Quran and religious coping in reducing pregnancy anxiety. It is important to note that in previous studies conducted within the context of Iranian culture, despite the significant role of spirituality in this culture and the inherent connection between spirituality and mindfulness, investigations primarily focused on the distinct effects of mindfulness-based training and religious training on the anxiety levels of pregnant women. ...
Many people consider pregnancy as one of the most important events in the life of any woman, which has important effects on the mental state of the mother and her fetus. Therefore, this study was conducted to evaluate the effect of mindfulness and spiritual health training of pregnant women on pregnancy anxiety and maternal-fetal attachment in Iranian culture. This is an experimental study with a pretest–posttest design and a control group. The population of the present study included all pregnant women of Arak from 2020 to 2021, from whom 48 women in 20–32 weeks of gestation were selected by convenience sampling and randomly assigned to experimental and control groups. The participants completed the Pregnancy Anxiety Questionnaire and the Maternal-Fetal Attachment Scale. The educational intervention group received mindfulness and spiritual health training through eight 90- to 120-min sessions on WhatsApp messenger over 8 weeks as well as routine pregnancy care, and the control group received only routine pregnancy care. At the end of the sessions, the posttest was completed by both experimental and control groups. Multivariate analyses of covariance results showed that mindfulness and spiritual health training significantly decreased pregnancy anxiety in the experimental group (p < .05) and significantly increased maternal-fetal attachment in this group relative to the control group (p < .05). According to the findings of the present study, providing mindfulness and spiritual health training to pregnant women can help improve the quality of pregnancy by increasing maternal-fetal attachment and decreasing pregnancy anxiety.
... Support programs during pregnancy, such as mindfulness-based therapies, have shown positive outcomes, primarily in reducing parental stress, anxiety, and depression [3,[36][37][38]. Antenatal maternal mindfulness has been associated with better self-regulation and lower levels of negative affect in 10-month-old infants [39]. Associations between maternal mindfulness and response to infant stress with reduced reactivity have been identified [40,41]. ...
... Furthermore, correlational longitudinal investigations spanning pregnancy and early childhood have provided evidence of the benefits of prenatal support programs on two generations [42]. In addition, higher levels of mother's self-reported use of mindfulness during pregnancy were found to be associated with maternal report of lower levels of infant self-regulation issues and negative affectivity [39]. ...
This feasibility study sought to investigate the impact of an online 9-session Prenatal Mindfulness Relationship-Based (PMRB) group treatment program upon maternal mental health (depression, anxiety, and stress), interoception, and mother-infant relationship during pregnancy and post-partum. The study was designed in two parts 1) a quantitative examination of pre, post-treatment and 10-12 weeks post-partum measures targeting 13 pregnant women from a non-clinical population and 2) a qualitative exploration of the same pregnant women’s experiences of the PMRB program reported during the sessions, including their birth stories. Responses to an open-ended question about how the program had supported them during pregnancy, labor/birth and the first post-partum trimester were summarised using thematic analysis. Women (N = 36) were recruited to the non-randomised feasibility study and 13 were allocated to the PMRB program. Women were excluded due to the online recruitment timeframe, missing baseline gestational age and unavailability for the proposed time. All the allocated women completed the program during pregnancy and the baseline and post-treatment surveys. There were 12 women who completed the post-partum follow-up. Only one participant was lost to the follow up for unknown reasons. Results revealed an improvement in mindfulness, depression, interoception and mother-infant relationship post-treatment and at postpartum follow-up. The qualitative analysis led to the identification of 16 themes, which were organized in four categories describing the experience of participants. Findings provide preliminary support for the feasibility of the PMRB program to improve maternal mindfulness, interoception, mental wellbeing and mother-infant relationship during pregnancy and post-partum. The qualitative evaluation suggested the PMRB program may help women cope with emotional challenges and be more connected to their bodies and infant. The program may also help women become more aware of their unborn infant as a sentient being and the influence of their health and mental wellbeing on the infant development and health. Furthermore, it may be a facilitator of the mother-infant relationship during pregnancy and post-partum, promoting infant’s healthy development.
... On the basis of a medium intervention effect (Cohen d=0. 50), an estimated total sample size of 128 was needed to achieve 80% power and 2-sided P<.05. Considering a 20% attrition rate, 160 participants were included in the study. ...
... One possible explanation is that the ripple effect may be completely direct or may involve other indirect pathways. Van den Heuvel et al [50] found that maternal mindfulness during pregnancy can directly affect infants' self-regulation ability. In addition, mindfulness interventions might affect maternal parenting. ...
Background
Maternal psychological distress during pregnancy is associated with unfavorable outcomes in infants. Mindfulness-based interventions (MBIs) can effectively alleviate psychological distress, but there are often barriers to the access of face-to-face interventions.
Objective
This study aimed to investigate the effectiveness of a digital guided self-help (GSH) MBI (GSH-MBI) in reducing maternal psychological distress and improving infant neuropsychological performance.
Methods
This was a randomized controlled trial. We recruited 160 women who were 12 to 20 weeks pregnant and exhibited psychological distress. We randomized them into a digital GSH-MBI group and a control group (usual perinatal care). The digital GSH-MBI consisted of a 6-week intervention through a WeChat mini program, with a daily reminder sent to the participants by a research assistant via WeChat. The primary outcomes consisted of maternal psychological distress, including depression, anxiety, and pregnancy-related anxiety symptoms, which were assessed at 6 time points from baseline to 6 months post partum (only pregnancy-related anxiety symptoms were assessed 3 times during pregnancy). The secondary outcomes were infant neuropsychological outcomes, including temperament and developmental behaviors, which were assessed at 6 weeks and 6 months post partum.
Results
Compared with the control group, the digital GSH-MBI group showed a significant reduction in depression, anxiety, and pregnancy-related anxiety symptoms. In addition, the scores of the digital GSH-MBI group were lower than those of the control group for the 3 types of infant temperament at 6 weeks post partum, including quality of mood, distractibility, and adaptability.
Conclusions
Digital GSH-MBIs are effective in alleviating psychological distress among pregnant women and protecting infant outcomes.
Trial Registration
Chinese Clinical Trial Register ChiCTR2000040717; https://www.chictr.org.cn/showproj.aspx?proj=65376
... First, real-time changes in fetal heart rate, heart rate variability, and motor activity have been observed in response to experimental inductions of maternal relaxation and stress (39). In addition, correlational approaches have found that higher levels of mother's self-reported use of mindfulness during pregnancy are associated with maternal report of lower levels of infant self-regulation problems and negative affectivity (40). Thus, it seems likely that infant stress physiology and temperament are associated with maternal prenatal mood and behavior. ...
... More importantly, the results shift the focus from the role of poor maternal health in this programming to the role of improving wellness during pregnancy to optimize health outcomes for children. Current behavioral findings are consistent with prior correlational work on prenatal stress and infant behavior (16,18,57), and a prior finding that mothers' self-reported use of mindfulness during pregnancy is associated with maternal report of lower levels of infant self-regulation problems and negative affectivity (40). Furthermore, a previous randomized controlled trial using a meditation intervention during pregnancy found that infants of treatment group mothers received higher maternal-report ratings of approach behaviors and positive affect, compared with infants of control group mothers (58). ...
Objective:
Maternal health and wellness during pregnancy are associated with long-term health outcomes in children. The current study examined whether infants of women who participated in a mindfulness-based intervention during pregnancy that reduced levels of stress and depression, increased physical activity, and improved glucose tolerance differed on biobehavioral markers of psychopathological and physical health risk compared with infants of women who did not.
Methods:
Participants were 135 mother-infant dyads drawn from a racially and ethnically diverse, low-income sample experiencing high stress. The women participated in an intervention trial during pregnancy that involved assignment to either mindfulness-based intervention or treatment-as-usual (TAU). Infants of women from both groups were assessed at 6 months of age on sympathetic (preejection period), parasympathetic (respiratory sinus arrhythmia), and observed behavioral (negativity and object engagement) reactivity and regulation during the still face paradigm. Linear mixed-effects and generalized linear mixed-effects models were used to examine treatment group differences in infant outcomes.
Results:
Relative to those in the intervention group, infants in the TAU group showed a delay in sympathetic activation and subsequent recovery across the still face paradigm. In addition, infants in the intervention group engaged in higher proportions of self-regulatory behavior during the paradigm, compared with the TAU group. No significant effect of intervention was found for parasympathetic response or for behavioral negativity during the still face paradigm.
Conclusions:
Findings provide evidence that maternal participation in a short-term, group mindfulness-based intervention during pregnancy is associated with the early development of salutary profiles of biobehavioral reactivity and regulation in their infants. Because these systems are relevant for psychopathology and physical health, prenatal behavioral interventions may benefit two generations.
... Furthermore, the low rates of maternal depression could also explain why the children in our sample did not show high scores for problems of social-emotional development-a finding that is at odds with previous reports in the literature that the children of adolescent mothers have more significant behavioral problems, lower levels of social performance and poorer well-being (Hofferth & Reid, 2002;Levine, Pollack & Comfort, 2001). Despite this, our results are similar to the findings of Van den Heuvel et al. (2015), who demonstrated that the presence of maternal anxiety could be a mediating factor between maternal mindfulness, which is associated with optimism and feelings of competence, and self-regulation problems in infants. In light of the previous studies presented here, the importance of the selfconfidence of mothers as caregivers of their children has relevant implications for their emotional well-being and their children's development. ...
... The present study used a cross-sectional design, which clearly limited our ability to draw causal inferences regarding the relationships between the variables. However, the proposed models were supported by previous research and by current theory, and all the relationships estimated between the mothers' self-efficacy and well-being, and children's social development have also been demonstrated by longitudinal studies (e.g., Huang et al., 2014;Lawrence et al., 2020;Van den Heuvel et al., 2015;Vance et al., 2020). Other studies of these relationships have also applied cross-sectional designs (e.g., Azmoude, Jafarnejade & Mazlom, 2015; Puspasari, Nur Rachmawati & Budiati, 2018;Tan et al., 2020). ...
Background
Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children’s social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children’s social-emotional development; and (c) describe the effects of maternal self-efficacy on children’s social-emotional development, mediated by maternal well-being.
Methods
A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers’ anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children’s social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships.
Results
A bivariate analysis showed that maternal self-efficacy was negatively related to the mother’s anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children’s self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children’s self-regulation.
Conclusions
The results confirm the importance of adolescent mothers’ emotional well-being and maternal self- efficacy with respect to their children’s social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother’s role in the development of her children.
... Parents who are able to be aware, accepting, and responsive to their baby's needs either through an inherent capacity for or a cultivated practice of mindfulness will foster higher-quality parent-child relationships and be better able to avoid automatic patterns of maladaptive parenting behavior (Duncan et al., 2009;Fernandes et al., 2021), thus promoting secure attachment relationships (Siegel & Hartzell, 2003). In turn, infants of more mindful mothers show benefits in social-emotional development (Braeken et al., 2017;Van den Heuvel, Donkers, et al., 2015;Van den Heuvel, Johannes, et al., 2015), neurocognitive functioning (Van den Heuvel, Donkers, et al., 2015;Van den Heuvel, Johannes, et al., 2015), and neuroendocrine stress regulation (Laurent et al., 2017). Given these cascading effects on family well-being, it is critical to determine which child-bearers are likely to have limited capacity to be present in the face of challenges. ...
... Parents who are able to be aware, accepting, and responsive to their baby's needs either through an inherent capacity for or a cultivated practice of mindfulness will foster higher-quality parent-child relationships and be better able to avoid automatic patterns of maladaptive parenting behavior (Duncan et al., 2009;Fernandes et al., 2021), thus promoting secure attachment relationships (Siegel & Hartzell, 2003). In turn, infants of more mindful mothers show benefits in social-emotional development (Braeken et al., 2017;Van den Heuvel, Donkers, et al., 2015;Van den Heuvel, Johannes, et al., 2015), neurocognitive functioning (Van den Heuvel, Donkers, et al., 2015;Van den Heuvel, Johannes, et al., 2015), and neuroendocrine stress regulation (Laurent et al., 2017). Given these cascading effects on family well-being, it is critical to determine which child-bearers are likely to have limited capacity to be present in the face of challenges. ...
Objectives
The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness—a protective factor for child-bearers—may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic.Methods
Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses.ResultsTests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b = − 0.72, SE = 0.08, p < .001) on psychological symptoms (R2 = .21–.34; F[2, 197] = 51.13–52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R2 = .41, F[3, 195] = 45.08, p < .001).Conclusions
Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.
... Connecting to body, breath, and baby was another important theme emerging from the data. In a qualitative study investigating elements of yoga classes, such as mindfulness, to reduce depressive symptoms, women reported that they were able to get more in touch with their bodies and that they learned how to be present in their body and listen to it (Uebelacker et al., 2017). Because a core ability fostered by mindfulness practice is drawing attention to the present moment, it may enable women to reflect on the messages that their bodies and developing babies are sending them. ...
Background
Pregnancy and the postpartum period are times of significant transition for women, with changes in maternal physical and mental health. The formation of a relationship between a mother and her baby is vital and has been recognised as laying the foundation for later child development. There is considerable evidence that this early relationship is influenced by a woman’s well-being during pregnancy and in the early post-partum period. Mindfulness-based programs have previously revealed positive outcomes, primarily in reducing maternal stress, anxiety, and depression. However, there remains a need for considering the influence of mindfulness on the mother-baby relationship and embodiment during pregnancy and the first trimester post-partum. This study aimed to conduct an in-depth exploration of pregnant women’s experiences of a nine-session prenatal mindfulness relationship-based (PMRB) program to support its feasibility.
Methods
Information about pregnant women’s (n = 13) experiences of the PMRB program was collected through online interviews during the sessions, including their birth stories. Responses to an open-ended question about how the program had supported them during pregnancy, labour/birth, and the first post-partum trimester were summarised using thematic analysis.
Results
Sixteen themes were identified and organised in four categories: (1) expectations and motivations (healthy pregnancy and mental health, non-medicalised birth, contribution to the field); (2) experiences of the PMRB program (positive experiences, shared experience, engagement with mindfulness practices, pain, stress, and anxiety relief); (3) changes attributed to the PMRB program (a new way of responding to stressors, trusting the process, connecting to body, breath, and unborn baby, awareness of the unborn baby as a sentient being); (4) changes attributed to the mindfulness practice (increased mindfulness/self-awareness, stop look listen, embracing the moment, acceptance).
Conclusions
The evaluation suggested the PMRB program may help women cope with pain and emotional challenges and be more connected to their bodies and infant. The program may also help women become more aware of their unborn baby as a sentient being and the influence of their health and mental well-being on the baby development and health. Furthermore, the program may facilitate the mother-baby relationship during pregnancy, post-partum, and breastfeeding.
Preregistration
The trial has been successfully registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) following ethical approval from Bond University Human Research Ethics Committee (BUHREC—Application AS03534, approved 20 December 2022) and allocated the Australian clinical trials registration number (ACTRN): ACTRN12623000679684.
... These findings highlight the importance of promoting mindfulness, especially in parents at risk for depression or poor prenatal bonding. Antenatal maternal mindfulness has been associated with better selfregulation and lower levels of negative affect in 10-month-old infants (van den Heuvel et al., 2015). Studies identified associations between maternal mindfulness and response to infant stress with reduced reactivity, which indicates more responsive and attuned parenting behavior (Waters, 2016;Pickard et al., 2017). ...
This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent–child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.
... Approximately 14% to 54% of women are reported to experience anxiety symptoms during pregnancy within a low-risk, healthy, well-educated, and employed pregnant cohort [12]. Moreover, antenatal depression affects around 10-15% of pregnant individuals, with a significant number of women being affected by subsyndromal depressive symptoms, which are frequently overlooked [96][97][98]. Clinical evidence shows a chronic elevation of maternal glucocorticoids under stressful or depressive maternal conditions, accompanied by increased levels of pro-inflammatory cytokines associated with the increased risk of preterm birth (PTB) and neurodevelopmental pathologies [34]. Two prospective studies observed an association between antenatal maternal depression and alterations in neonatal microstructure of the right amygdala [10] and a decrease in cortical thickness [11]. ...
During intrauterine life, external stimuli including maternal nutrition, lifestyle, socioeconomic conditions, anxiety, stress, and air pollution can significantly impact fetal development. The human brain structures begin to form in the early weeks of gestation and continue to grow and mature throughout pregnancy. This review aims to assess, based on the latest research, the impact of environmental factors on fetal and neonatal brain development, showing that oxidative stress and inflammation are implied as a common factor for most of the stressors. Environmental insults can induce a maternal inflammatory state and modify nutrient supply to the fetus, possibly through epigenetic mechanisms, leading to significant consequences for brain morphogenesis and neurological outcomes. These risk factors are often synergic and mutually reinforcing. Fetal growth restriction and preterm birth represent paradigms of intrauterine reduced nutrient supply and inflammation, respectively. These mechanisms can lead to an increase in free radicals and, consequently, oxidative stress, with well-known adverse effects on the offspring’s neurodevelopment. Therefore, a healthy intrauterine environment is a critical factor in supporting normal fetal brain development. Hence, healthcare professionals and clinicians should implement effective interventions to prevent and reduce modifiable risk factors associated with an increased inflammatory state and decreased nutrient supply during pregnancy.
... In addition, women who were classified as non-judgmentally aware scored lowest in symptoms of depression and anxiety, followed by women who were classified as moderate in mindfulness. Although we are not aware of previous studies on mindfulness profiles in pregnant women, these results are consistent with studies that have found that higher scores on facets, such as acting with awareness and nonreacting, are associated with fewer symptoms and greater wellbeing in pregnant women (van den Heuvel et al., 2015;Hulsbosch et al., 2021;Mennitto et al., 2021). Therefore, these results highlight the importance of cultivating these facets during pregnancy to increment wellbeing. ...
Introduction
Pregnancy is a time of major transition that can be stressful for women. Dispositional mindfulness may protect individuals when they face stress. Recent studies have adopted a person-centered approach to examine the role of mindfulness by identifying subtypes of individuals based on their scores in five mindfulness facets. Latent profile analysis was used to identify different mindfulness profiles in a sample of pregnant women, and we explored the relationships between these profiles, depression and anxiety symptoms, and whether dyadic adjustment mediated these relationships.
Method
A total of 535 women aged 18–45 years in their 26th week of pregnancy completed questionnaires regarding mindfulness, dyadic satisfaction and cohesion, and depression and anxiety symptoms.
Results
Three profiles were identified: (1) low mindfulness (53.8%), (2) moderate mindfulness (34.3%), and (3) non-judgmentally aware (11.9%). The most adaptive profile was the non-judgmentally aware profile. Compared to the low mindfulness profile, the non-judgmentally aware profile and the moderate mindfulness profile were related to fewer symptoms of depression and anxiety, and these relationships were partly mediated by dyadic satisfaction.
Discussion
These results suggest that analyzing each pregnant woman’s mindfulness profile can improve the prevention of and interventions for anxiety and depression.
... A negative relationship has been found between maternal mindfulness and infant social-emotional problems (Braeken et al., 2017). As the level of mindfulness in parenting increases, the parent's negative criticism of him/herself (Moreira & Canavarro, 2018) and the level of anxiety decreases (van den Heuvel et al., 2015). The flexibility and sensitivity that mindfulness brings to parenting contributes to the child's well-being (Duncan et al., 2009). ...
The purpose of this study is to investigate the relationship between children's social skills in early childhood, mindfulness in parenting, and mindfulness in marriage. The research was conducted based on the correlational survey model. The participants are 279 parents with children aged 3-7 years. The instruments that used for data collection were the Preschool and Kindergarten Behavior Scale (PKBS-2), Mindfulness in Marriage Scale (MMS), Mindfulness in Parenting Questionnaire (MPQ) and Personal Information Form. Independent samples t-test, correlation analysis, and multiple linear regression analysis were used to analyze the data. The results show that mindfulness in marriage and mindfulness in parenting have a positive and significant relationship with social skills in early childhood. According to the results of the regression analysis, mindfulness in marriage and mindfulness in parenting are significant predictors of children’s social skills. The regression model has explained 27% of social skills. The research findings were discussed in light of the literature.
... This lack of awareness of the present moment could then exacerbate anxiety symptoms, including a preoccupation with future events and may explain the significant negative association between mindfulness and anxiety. The negative relation between mindfulness and anxiety is consistent with prior work (Corthorn & Milicic, 2016;Van den Heuvel et al., 2015) but may also be due, in part, to shared method variance. It could also be that mindfulness is simply not a meaningful moderator of the PCS-anxiety link. ...
Guided by the Family Stress Model for minority families, the present study examined the potential buffering effect of resting respiratory sinus arrythmia (RRSA), cognitive reappraisal, and mindfulness on the association between political climate stress (PCS) and anxiety symptoms in a sample of Latina and Black mothers. Participants were 100 mothers living in the southeastern United States. Mothers reported on PCS, cognitive reappraisal, mindfulness, and symptoms of anxiety. RRSA were measured during a resting task. Moderation analyses tested the influence of these three factors (RRSA, cognitive reappraisal, mindfulness) on the relation between PCS and anxiety. Results showed that the relation between PCS and anxiety symptoms was strongest at low levels of RRSA and cognitive reappraisal. At high levels of these two factors, there was no association between PCS and anxiety symptoms. Mothers with high levels of RRSA and cognitive reappraisal may be able to interact with and evaluate environmental stimuli in such a way that allows for adaptive adjustment, buffering against the negative impact of PCS. RRSA and cognitive reappraisal may be important targets of interventions designed to address the rising rates of anxiety symptoms in Latina and Black mothers.
... Moreover, maternal prenatal distress has been linked to markedly higher rates of psychiatric conditions (e.g., ADHD, anxiety, depression) in offspring (Monk et al., 2019;O'Donnell & Meaney, 2017;Van Den Bergh et al., 2018;Van den Bergh et al., 2020). Prenatal anxiety has been linked to poorer infant self-regulation, which can set the stage for later emotional/behavioral difficulties (van den Heuvel et al., 2015), and one study reported children and adolescents whose mothers experienced high levels of anxiety during pregnancy were over twice as likely to have a probable mental disorder (O'Donnell et al., 2014). ...
Critical congenital heart disease (CHD) presents a lasting threat to quality of life through its adverse impact on neurodevelopmental and psychosocial outcomes. As recognition of this threat has increased, so too has an appreciation for the role of pediatric neuropsychologists in supporting families affected by CHD. But there is more to offer these families than traditional neuropsychological services, which tend to focus on secondary/tertiary forms of prevention. Now that many children with CHD are diagnosed prenatally, it may be possible to begin mitigating CHD-related risks and promoting positive outcomes earlier than ever before. Through primary prevention-oriented fetal neuropsychological consultation, as well as close collaboration with allied specialists, pediatric neuropsychology has an opportunity to re-envision its typical borders and more familiar practice models; to forge early and enduring partnerships with families; and to help promote the best possible neurodevelopmental trajectories, beginning before children are even born. In this conceptual review, we survey and integrate evidence from developmental science, developmental origins of health and disease, maternal-fetal medicine, and cardiac neurodevelopmental literatures, along with current practice norms, arriving ultimately at two central conclusions: 1) there is an important role to fill on multidisciplinary teams for the pediatric neuropsychologist in fetal cardiac care and 2) role expansion (e.g., through valuing broader-based training, flexing more generalist skills) can likely improve neuropsychological outcomes earlier than has been standard for pediatric neuropsychologists. Such a reimagining of our practice may be considered primary prevention neuropsychology. Implications for care in various settings and pragmatic barriers to implementation are discussed.
... An association between heightened maternal antenatal stress and increased negative emotionality (NE) in female infants was reported in at least three studies (Braithwaite et al., 2017a(Braithwaite et al., , 2017bSandman et al., 2013). However, the opposite pattern with disaster-related maternal antenatal stress being associated with increased irritability only in 6-month-old boys (Simcock et al., 2017) was also found, as well as no significant effects of sex in the association between prenatal anxiety and infant negative affectivity at 9-14 months ( Van den Heuvel et al., 2015). Furthermore, preliminary evidence indicates that antenatal adverse experiences have sex-specific epigenetic effects on a number of target genes. ...
Maternal antenatal anxiety is an emerging risk factor for child emotional development. Both sex and epigenetic mechanisms, such as DNA methylation, may contribute to the embedding of maternal distress into emotional outcomes. Here, we investigated sex-dependent patterns in the association between antenatal maternal trait anxiety, methylation of the brain-derived neurotrophic factor gene (BDNF DNAm), and infant negative emotionality (NE). Mother-infant dyads (N = 276) were recruited at delivery. Maternal trait anxiety, as a marker of antenatal chronic stress exposure, was assessed soon after delivery using the Stait-Trait Anxiety Inventory (STAI-Y). Infants' BDNF DNAm at birth was assessed in 11 CpG sites in buccal cells whereas infants' NE was assessed at 3 (N = 225) and 6 months (N = 189) using the Infant Behavior Questionnaire-Revised (IBQ-R). Hierarchical linear analyses showed that higher maternal antenatal anxiety was associated with greater 6-month-olds' NE. Furthermore, maternal antenatal anxiety predicted greater infants' BDNF DNAm in five CpG sites in males but not in females. Higher methylation at these sites was associated with greater 3-to-6-month NE increase, independently of infants' sex. Maternal antenatal anxiety emerged as a risk factor for infant's NE. BDNF DNAm might mediate this effect in males. These results may inform the development of strategies to promote mothers and infants' emotional well-being.
... Socio-emotional development is a complex process that involves the interaction of maturation factors and the child's environment. Some studies reported an association between maternal distress during pregnancy and postpartum and poorer socio-emotional development [75,153,154]. Further, a small study of mother-infant dyads [143] used diffusion tensor imaging (DTI) pointed out the association between the internalizing domain of behavior and neonatal insula variation in infants whose mothers had prenatal distress. ...
Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child’s psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.
... The total ASQ-SE II score is often used to assess social-emotional risk. However, previous research has also tested the relationship between its sub-dimensions and other variables (Van, Johannes, Henrichs, & Van, 2015;Thomas-Stonell, Robertson, Oddson, & Rosenbaum, 2016;Shen, Xu, & Liu, 2021). Therefore, we also summed the item scores of each behavioral area according to the ASQ: SE-2 User's Guide Book to represent children's problems in self-regulation (9 items), compliance (2 items), adaptive functioning (7 items), autonomy (3 items), affect (4 items), social communication (4 items), and interaction with people (6 items), which were used as dependent variables in the linear regressions. ...
Many studies have shown a relationship between preschool-aged children’s digital media use and their cognitive and physical development. However, the relationship between preschoolers’ digital media exposure and social-emotional development is under-researched both in and outside of China. The current study explores associations between both the amount and content of digital media, as well as parental mediation and other demographic variables, and Chinese preschoolers’ risk of social-emotional delay. Nine hundred and forty-four parents of preschoolers aged 42 to 72 months completed the Ages and Stages Questionnaire: Social-Emotional II (ASQ: SE II) and a media diary. Results indicate that time spent on digital media is positively associated with preschool-aged children’s risk of social-emotional delay, particularly for children from affluent families. Children were less likely to be at risk with increased restrictive mediation while more likely to be at risk when parental co-use increased. We did not find a relationship between digital content type and social-emotional development, which may due to our focus on the interactive conditions of the content rather than the social-emotional lessons in the content. The present study suggests possible predictors of preschoolers’ social-emotional delay related to digital media usage and parental mediation.
... Higher maternal mindfulness of women at 22-week gestation significantly predicted a normal, as opposed to low, neonatal birth weight [23]. Van den Heuvel and colleagues [24,25] showed that maternal mindfulness was negatively correlated with maternal anxiety during pregnancy, and positively associated with fewer infant self-regulation problems, a less difficult temperament, and greater control in infants at ten months old. In a randomized controlled trial examining the efficacy of MBI among pregnant women, Chan [26,27] found mothers in the MBI group to have lower levels of the "stress hormone" salivary cortisol in the evening, and the infants at five months old had easier temperaments as well as improved positive appraisal. ...
Background
Psychological distress is a common occurrence among women during the perinatal period. Maternal psychological distress (MPS) can also have a negative influence on neonatal outcomes such as infant health, child development or mother-child interaction. Hence, interventions to improve mental wellbeing during this period are vital. Mindfulness based intervention (MBI) has been found to be effective in reducing psychological distress. Delivery of MBI via the internet, making it accessible and inexpensive, is showing a promising positive effect in reducing psychological distress. A randomized control trial with sufficient power is required to confirm its positive effect among pregnant women. The positive effects of MBI have been found to be associated with heart rate variability (HRV) biofeedback; however, the efficacy of MBI on HRV has been rarely studied among pregnant women. Also, the potential association of HRV with MBI and psychological wellbeing needs further examination. This research aims to test the effectiveness of guided mobile-based perinatal mindfulness intervention (GMBPMI) among pregnant women experiencing psychological distress during the pre- and post-natal period, as well as examining the efficacy of GMBPMI on HRV.
Method
This study is a randomized controlled trial that follows a parallel design. Consenting pregnant women in their second trimester (between 12th and 20th week gestation) will be randomly assigned to an intervention group (GMBPMI) or a control group (psychoeducation). The intended sample size is 198, with 99 participants in each group. Three levels of outcomes will be measured at baseline, post intervention in both the intervention and control groups, and at 36-week gestation and five-week postpartum. The primary outcomes include maternal psychological stress, mindfulness and positive appraisal HRV. Secondary outcomes are psychological and physical wellbeing. Tertiary outcomes include obstetric and neonatal outcomes, and social support. Analyses will follow an intention-to-treat method and repeated measures MANOVA will be conducted to compare changes in primary and secondary outcomes. A series of mixed-effects models will be fitted to assess the mediation effects.
Discussion
This trial expects to increase understanding of GMBPMI on HRV and psychological wellbeing for pregnant women, with extended support in both pre-and post-natal periods. The study could also potentially provide evidence for delivery of cost-effective and accessible services to pregnant women.
Trial registration
ClinicalTrials.gov: NCT04876014, registered on 30 March 2021. Protocol Version 1.0., 10 May 2021.
... To our knowledge, this study is the first to investigate associations between positive maternal mental health during pregnancy and mental and behavioral disorders in children. Hence, it adds novel information to the preliminary evidence suggesting that positive maternal mental health during pregnancy carries beneficial effects on child psychological development and on the risk of psychiatric symptoms (Braeken et al., 2017;DiPietro et al., 2006;van den Heuvel et al., 2015;Phua et al., 2017). Our study broadens this perspective to the more severe end on the continuum of psychiatric symptoms, namely, to diagnosed mental and behavioral disorders, and extends the follow-up beyond toddlerhood into childhood and early adolescence. ...
Background
The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health.
Methods
Among 3,378 mother–child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children’s mental and behavioral disorder diagnoses as well, from birth until 8.4−12.8 (Median = 10.2, Interquartile Range 9.7−10.8) years of age.
Results
A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 − 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 − 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55−0.86]. These associations were independent of covariates.
Conclusions
Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.
... Recent research suggests that maternal mindfulness during pregnancy may have positive effects on temperament and infant development. Specifically, this association may be mediated by reduced anxiety symptoms in pregnant women who score high on mindfulness [35]. However, the specific effects of a structured mindfulness intervention on temperamental dimensions of primary school children are not known and we set out to explore the possible effects of mindfulness on children's temperament. ...
Mindfulness is a mental state that can be achieved through meditation. So far, studies have shown that practicing mindfulness on a consistent and regular basis can improve attentional functions and emotional well-being. Mindfulness has recently begun to be used in the field of child development. The goal of this study is to assess if a mindfulness program may help primary school students in reducing anxiety and depression while also improving their temperamental characteristics. This multi-arm pre-post study included 41 subjects recruited in the fifth year of two primary school classes. Participants were randomly assigned to the experimental and control groups. The experimental group, but not the control group, underwent an eight-week mindfulness training. Every week, the program included 60-min group sessions. QUIT (Italian Questionnaires of Temperament) and TAD (Test for Anxiety and Depression in Childhood and Adolescence) were used to assess temperament, and anxiety and depression, respectively. Both groups were administered both instruments before and after mindfulness intervention. The mindfulness program lowered anxiety levels and was effective in changing temperament dimensions: there was an increase in social orientation (SO), positive emotionality (PE), and attention (AT), as well as a decrease in inhibition to novelty (IN) and negative emotionality. Path analysis revealed that AT may promote the improvement of both SO and IN. Similarly, PE may be promoted by the decrease of IN. Clinical implications are discussed.
... Conversely, the positive correlation between mother's anxiety trait and an inquiry behavior detected for older children may reflect a better self-regulation and a less emotional dependence on the mother. In this regard, it has been observed that mild levels of maternal anxiety, like those observed in this study, are related to a greater development of some cognitive skills, particularly motor and visual skills (Keim et al., 2011, van den Heuvel et al., 2015. ...
... This is an important population to work with both because this is a population with considerable need, and because meta-analysis indicates associations between maternal prenatal stress and child outcomes are strongest in high-risk groups [95]. It is known that there are specific traits, such as internal locus of control, social skills, exercise, maternal mindfulness, optimism, and ego development that predict more resilient outcomes [96][97][98][99]. For example, Christianson and colleagues showed that exercise mitigates the expression of stressor-induced anxiety; [100] Young and colleagues showed that responses to stress are attenuated by strong male bonds in wild macaques; [101] and Wellman and colleagues showed individual differences in the effects of stress on REM in Wistar rats and suggest that sleep may be an important biomarker of stress resilience and vulnerability [102]. ...
Studies reporting significant associations between maternal prenatal stress and child outcomes are frequently confounded by correlates of prenatal stress that influence the postnatal rearing environment. The major objective of this study is to identify whether maternal prenatal stress is associated with variation in human brain functional connectivity prior to birth. We utilized fetal fMRI in 118 fetuses [48 female; mean age 32.9 weeks (SD = 3.87)] to evaluate this association and further addressed whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Community detection was used to empirically define networks and enrichment was used to isolate differential within- or between-network connectivity effects. Significance for χ2 enrichment was determined by randomly permuting the subject pairing of fetal brain connectivity and maternal stress values 10,000 times. Mixtures modelling was used to test whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Increased maternal prenatal negative affect/stress was associated with alterations in fetal frontoparietal, striatal, and temporoparietal connectivity (β = 0.82, p < 0.001). Follow-up analysis demonstrated that these associations were stronger in women with better health behaviors, more positive interpersonal support, and lower overall stress (β = 0.16, p = 0.02). Additionally, magnitude of stress-related differences in neural connectivity was marginally correlated with younger gestational age at delivery (β = −0.18, p = 0.05). This is the first evidence that negative affect/stress during pregnancy is reflected in functional network differences in the human brain in utero, and also provides information about how positive interpersonal and health behaviors could mitigate prenatal brain programming.
... In their model, the practice of mindfulness promotes effective parenting behaviors such as correctly discerning the child's cues, the sense of parenting self-efficacy, the appreciation of the child's traits, and responsiveness to the child's needs and emotions. Interestingly, higher levels of mindfulness in pregnant women (as assessed in self-reports) have been associated with positive infant outcomes, including less negative affectivity and self-regulation problems (van Den Heuvel et al., 2015), and with more adaptive autonomic nervous system changes and better social-emotional development . Higher levels of mindfulness in expectant parents also seem to buffer the effects of depression on prenatal bonding (Hicks et al., 2018). ...
Objective
Maternal stress and depression in pregnancy and early parenting are associated with decreased maternal sensitivity and infant social-emotional development impairments. This randomized controlled trial explored if a Mindfulness-Based Childbirth and Parenting Program (MBCP) is more beneficial than a Lamaze program for infant’s social-emotional development. Infant social-emotional development was also explored in the light of maternal psychological states.
Methods
Pregnant women at risk of perinatal stress and depression were included and randomized to either MBCP or Lamaze. The Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) regarding infant social-emotional development was filled out by the mothers (n = 88) 3 months postpartum. Data on mode of delivery, skin-to-skin care, and breastfeeding rates was collected from medical records and self-report questionnaires. The women also filled out self-report questionnaires: Perceived Stress Scale, Edinburgh Postpartum Depression Scale, Positive States of Mind, and Five Facets of Mindfulness Questionnaire, at baseline, postintervention, and 3 months postpartum.
Results
There was a significant difference in score on the infants’ social-emotional development, suggesting that infants in the MBCP-study arm showed better social-emotional development compared with infants in the Lamaze-study arm ( p = .049 d = .407). At 3 months postpartum, 9% in the MBCP-arm compared with 29% in the Lamaze-arm (p = .02) scored above the EPDS cutoff 11/12. Furthermore, maternal positive states of mind at 3 months postpartum influenced the variance of ASQ:SE.
Conclusion
The study shows positive effects of MBCP influencing the mother-infant dyad, suggesting that the increase in maternal psychological well-being supports positive infant social-emotional development.
Trial Registration
NCT02441595
... Although behavioral outcomes have not been typically framed as temperament per se, but rather discussed in terms of stress reactivity, susceptibility to anxiety, or impulsivity, these characteristics are consistent with the overarching theoretical framework defining temperament as early appearing individual differences in reactivity and regulation, which are constitutionally based and subject to influences of environmental factors and maturation [7]. In human research, a preponderance of evidence suggests associations between prenatal stress exposure and high levels of largely overlapping temperament attributes associated with expressions of negative emotions [8][9][10][11][12][13][14]. Early manifestations of temperament are not only important as key components of social-emotional development, but are also significant as markers of risk for later symptoms of psychopathology [15,16]. ...
Objective
Exposure to stress in pregnancy has been shown to affect fetal development with short- and long-term physiological and behavioral consequences for the offspring. Although social support is known to lower perceived stress, no prior study has investigated the buffering role of social support in the context of prenatal stress effects on infant temperament. The aim of this study was to examine interactive effects of prenatal stress and social support on several dimensions of infant temperament at 9 months postpartum.
Study design
A total of 272 mothers completed the Perceived Stress Scale and the Perceived Social Support Scale in the 3rd trimester of pregnancy. Infant temperament was assessed by mothers at 9 months postpartum using the Infant Characteristics Questionnaire. Linear regression models were performed to assess the effects of perceived stress, social support, and their interaction on infant temperament.
Results
Prenatal stress interacted with social support, such that prenatal stress increased infant unpredictability when social support was low (below -0.4 SD).
Conclusions
Prenatal stress was found to be a risk factor for infant temperamental unpredictability when combined with low social support perceived by the mother during pregnancy. Support of others, not previously examined in this context, can reduce the impact of prenatal stress.
... It is worth noting that these perspectives are not mutually exclusive or incompatible. Overwhelmingly, the current narrative in the literature on predictors of infant NA is dominated by the fetal programming hypothesis, which posits that maternal antenatal symptoms affect infant neurodevelopment, affect and behavior via in-utero exposure to stress hormones, immune-inflammatory processes, or microbiota (Chan, Nugent, & Bale, 2017;Glover, 2011;Van den Bergh et al., 2017). Accordingly, most prospective studies of parental internalizing symptoms and infant NA focus on maternal exposure during pregnancy (Davis et al., 2004;Gustafsson et al., 2018;Henrichs et al., 2009;Nolvi et al., 2016;Rouse & Goodman, 2014). ...
This study aims to explore the long-term physical, neurological, social and emotional development outcomes of the offspring born to patients with systemic lupus erythematosus (SLE), and to provide insights that can assist pediatricians in enhancing the long-term prognosis of these children. We conducted a cross-sectional study on the offspring of SLE patients who had undergone pregnancy and were admitted to our obstetrics department between January 1, 2016 and September 30, 2021. The control group consisted of offspring born to mothers without connective tissue disease, and was matched 1:1 based on age (birth date ± 1 month) with the offspring of SLE patients. Physical development, including measurements of weight and height (length), was assessed. The Ages and Stages Questionnaires, Third Edition (ASQ-3) was utilized to evaluate development in five domains: communication, gross motor, fine motor, problem solving, and personal-social. The Ages and Stages Questionnaires: Social-Emotional (ASQ: SE) was used to assess social-emotional development. Weight, height (length), BMI (body mass index), and ASQ-3 domain scores at different ages and for both genders were standardized into Z-scores for comparison. In the SLE group, the offspring demonstrated higher BMI Z-scores, higher rates of obesity, and increased probabilities of abnormal social-emotional development screening. In addition, their problem solving domain Z-scores were lower as compared to the control group. All of these differences were statistically significant. It is recommended that SLE patients should pay close attention to sensible feeding practices after the birth of their offspring to prevent the occurrence of obesity. Furthermore, there should be an emphasis on strengthening monitoring and intervention efforts to enhance the problem solving abilities and social-emotional development of the offspring. By implementing these measures, the overall long-term developmental outcomes of children born to SLE patients can be improved.
Objectives
Two key parental reflective capacities—mindful parenting (MP) and parental reflective functioning (PRF) — have been shown to promote healthy parent-child relationships through parents’ increased sensitivity and responsiveness to their children’s needs in spite of parenting stressors. Despite the theoretical overlap between these two constructs, researchers have continued to examine them independently. Therefore, the purpose of this scoping review was to review the overlapping and distinctive outcomes and correlates in the empirical MP and PRF literatures.
Method
A comprehensive literature search across the MP and PRF literature for studies published from 2005 through early 2020 (pre-COVID-19 pandemic) was conducted.
Results
A review of 301 articles (n = 180 MP and n = 121 PRF) revealed overlapping study outcomes and correlates, including improvement in parent and child well-being, parenting behaviors, and attachment. Both MP and PRF literatures suggest MP and PRF are amenable to intervention-induced changes, although mostly documented in White mothers, which results may not be generalizable to diverse populations.
Conclusions
Researchers should consider the impact MP and PRF have on positive family relationships. Results suggest that scholars should consider investigating and intervening on MP and PRF simultaneously. Specifically, results identified MP and PRF convergent associations and perhaps synergistic impacts on positive parenting behaviors. Limitations and future directions are discussed.
Preregistration
This review was not preregistered.
Purpose
This study is the first to directly investigate the mechanistic role of maternal bonding toward her infant in the early intergenerational pathway of risk from maternal anxiety to infant fearfulness.
Methods
Mothers (N = 216; Mage=32.78) reported on their anxiety and bonding at four time-points between pregnancy and ten-months postpartum. At four and ten-months postpartum, infant temperamental precursors of anxiety were assessed through maternal report and observation.
Results
Cross-lagged longitudinal path modeling indicated a significant link between prenatal maternal anxiety and infant temperamental fearful withdrawal at 10-months postpartum (R² = 0.117), which was fully explained by decreased maternal bonding at one-month postpartum and increased infant temperamental negative reactivity at 4-months postpartum.
Conclusion
Results support the need to foster maternal bonding in preventive perinatal care, particularly in the context of maternal anxiety.
Long-term impact from prenatal noise exposure in birds should raise general concern
The impact of prenatal maternal mental health on offspring socioemotional development is substantial and enduring. Existing literature primarily focuses on the effects of psychological distress during pregnancy, emphasizing adverse child outcomes. Recent studies, however, highlight the unique impact of positive maternal mental health on child outcomes. To elucidate the differential associations of maternal psychological distress and positive mental health during pregnancy with child outcomes, we conducted a systematic literature search and random-effects meta-analyses on studies investigating the associations of prenatal maternal mental health with child socioemotional development. Our analyses, comprising 74 studies with 321,966 mother-child dyads across 21 countries, revealed significant associations of prenatal psychological distress with both adverse and positive child socioemotional outcomes. Notably, the effect sizes for the association of psychological distress with positive child outcomes were smaller compared to adverse outcomes. Positive prenatal mental health, on the other hand, was significantly associated with positive socioemotional outcomes but not adverse outcomes. This meta-analysis highlights the independence of negative and positive prenatal mental health constructs and their distinct relationships with child socioemotional development. The findings underscore the importance of considering the positive spectrum of maternal mental health and developmental outcomes to enhance our understanding of prenatal influences on child development.
Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335227 , identifier CRD42022335227.
Nosečnost je za ženske občutljivo obdobje, ki ga spremljajo pomembne fiziološke in psihološke spremembe, tako na čustveni kot biološki, hormonski ravni. Anksioznost je v obdobju tako velikih sprememb do neke mere normalen in prilagoditven odgovor na situacijo, vendar pa nekatere nosečnice izkusijo visoko raven anksioznosti, ki doseže stopnjo klinično pomembne motnje. Anksiozne motnje, ki se v peripartalnem obdobju najpogosteje pojavljajo, so generalizirana anksiozna motnja, panična motnja, fobije, obsesivno kompulzivna motnja in posttravmatska stresna motnja. Pretekla anamneza razpoloženjskih in/ali anksioznih motenj je med najmočnejšimi napovedovalci razvoja peripartalne anksioznosti. Kljub temu, da raziskovalno zanimanje za anksiozne motnje v peripartalnem obdobju narašča in vemo več o značilnostih in diagnostiki, pa so dokazi o klinični obravnavi – tako farmakološki kot nefarmakološki - še vedno omejeni. Tveganje in korist uvedbe farmakološkega zdravljenja vedno individualno pretehtamo. Prepoznava in obravnava anksioznosti med nosečnostjo sta bistvenega pomena in delujeta kot preventiva psihiatričnim motnjam po porodu. Poporodna anksioznost matere lahko tudi pomembno ovira proces navezovanja matere in otroka, kar ima posredno tudi vpliv na razvoj otroka. Pri nosečnicah, ki pa so v psihiatrično obravnavo že vključene zaradi obravnavane duševne motnje, pa je sledenje, podpora in dobro interdisciplinarno sodelovanje lečečega psihiatra in ginekološke službe nujno potrebno.
This study aimed to systematically review the measures used to assess infant self‐regulation during the first 12 months of life. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement protocol. From 235 selected papers, 79 provided information on behavioural and physiological measures to assess infant self‐regulation during the first 12 months of life. Thirty‐six behavioural (30 observational and 6 parent‐report) and five physiological different measures were identified. Studies with a longitudinal design, comprising larger samples, and aiming to assess infant self‐regulation later in infancy, mostly used behavioural measures than physiological measures. Studies comprising lower samples and aiming to assess infant self‐regulation earlier in infancy, mostly used observational than parent‐reported measures. Studies targeting younger infants used physiological measures and studies targeting older infants used behavioural measures, with observational measures used with younger infants and parental‐reported measures used with older infants during the first year of life. When measuring self‐regulation is important to consider infant's age, to fit the measurement procedures with the self‐regulation development level.
The aim of present study was to explore the possible mediating roles of parenting stress and authoritative parenting style in the relations between maternal mindfulness and children’s social skills among Chinese preschool children. Participants were N = 294 mothers (Mage =34.14 years; SD = 3.79; Range = 25–48 years) and 24 preschool teachers. Upon obtaining consent, mothers completed self-report measures of their dispositional mindfulness, parenting stress and authoritative parenting style. Teachers evaluated each child’s social skills. Among the results, maternal mindfulness was positively associated with children’s social skills. Moreover, bootstrapping revealed a significant indirect effect of maternal mindfulness on children’s social skills via parenting stress and authoritative parenting style. Specifically, maternal mindfulness was related to a low level of parenting stress, which in turn, predicted more authoritative parenting style, and lower level of children’s social skills. This study sheds light on the role of parenting stress and authoritative parenting style in the relationship between maternal mindfulness and children’s social skills.
Background and purpose
Mindfulness-based intervention (MBI) has been suggested as a method to alleviate mental health difficulties during the perinatal period. However, few studies have examined its use in improving maternal role adaptation. This study aimed to investigate the effectiveness of mindfulness in maternal role adaptation among first-time mothers.
Materials and methods
This randomized controlled trial study was performed on 40 first-time mothers who were randomly assigned into experimental (n = 20) and control (n = 20) groups. Research instruments included a demographic questionnaire and a validated Maternal Role Adaptation Questionnaire (MRAQ). In addition to receiving routine care, mothers in the experimental group attended eight 90-min sessions of mindfulness-based intervention. The control group, however, received only routine care. Both groups completed MRAQ before intervention, and immediately, one month, and two months after it.
Results
After intervention, there was a significant increase in the mean scores of MRAQ and its seven domains in the experimental group at all three follow-up intervals (P < 0.001). These domains included “support and strengthening of the couples’ relationships”, “hardship and dissatisfaction”, “mother-infant attachment”, “stress and anxiety”, “emotional growth”, “functionality” and “social adaptation development”.
Conclusion
The intervention implemented in this study could be effective in promoting maternal role adaptation.
Background:
Maternal psychological stress during pregnancy, including stress resulting from disasters and trauma, has been linked to temperamental difficulties in offspring. Although heightened cortisol concentrations are often hypothesized as an underlying mechanism, evidence supporting this mechanism is not consistent, potentially because of methodological issues and low stress in the population.
Aim:
To address these issues, this preregistered study investigated the following associations between: 1) prenatal psychological stress and hair cortisol, as a biomarker for chronic stress, during the COVID-19 outbreak (i.e., as a major worldwide psychological stressor), and 2) maternal hair cortisol during the COVID-19 outbreak and later infant temperamental negative affectivity and orienting/regulation. Additionally, we explored whether associations were different for women with low versus high socioeconomic status (SES; maternal education and annual household income) and at different stages of pregnancy.
Method:
Pregnant women (N = 100) filled out online questionnaires during the first COVID-19 lockdown. Six months later, when most mothers were still pregnant or had just given birth, maternal hair samples were collected during home visits. When infants were six months old, mothers reported on their infant's temperament.
Results:
Although hierarchical regression analyses revealed no associations between prenatal COVID-19 psychological stress and hair cortisol during the COVID-19 outbreak, SES proved to be a moderator in this association. Only pregnant women with higher levels of SES, not lower levels, showed a positive association between work-related and social support-related COVID-19 worries and hair cortisol. Finally, prenatal hair cortisol was not associated with later infant temperamental negative affectivity and orienting/regulation.
Conclusion:
Although the COVID-19 outbreak proved to be a major psychological stressor worldwide, the physiological impact of the crisis might be different for pregnant women with higher SES as compared to lower SES.
Mindfulness has been defined as the concentration of non-judgmental attention along with accepting the experience occurring in the present. Previous studies have shown that mindfulness decreases pregnant women’s anxiety. This study examined the relationship between mindfulness facets, cognitive flexibility components, and death anxiety in third-trimester pregnant women in Kerman in 2021. Two hundred fifty-six pregnant women completed the FFMQ, CFI, and DASS questionnaires. Path analysis of responses showed that describing, non-judging, and non-reactivity facets of mindfulness, positively predict alternative component of cognitive flexibility and describing facet of mindfulness positively predicts control component of cognitive flexibility. In this analysis, only the direct effect of describing facet of mindfulness on death anxiety was significant and its indirect effect was applied by control component of cognitive flexibility. Thus, these findings supported previous studies on the importance of mindfulness in pregnant women to increase cognitive flexibility and thus reduce their death anxiety. Therefore, if mindfulness training for pregnant women is implemented by emphasizing the importance of describing their experiences and increasing their control over their own situation, significant results can be expected in this area.
Mindfulness-based programs and techniques have become some of the most examined and validated prevention/intervention approaches. With the rising movement on holistic education, they are increasingly being used in schools around the world, including in Singapore, to support the development of socio-emotional competencies and cognitive, emotional, and behavioral self-regulation in students. These skills underlie the “21st Century Competencies” regarded to be important for children to survive and thrive in a fast-changing world. This chapter begins with an introduction to mindfulness and how it can be cultivated in young children. This is followed by a discussion of how mindfulness-based practices can foster self-regulation and socio-emotional competencies underlying 21st century skills and how mindfulness in teachers/teaching and parents/parenting can also influence child outcomes. The chapter concludes with a section on recommendations and implications for policy and practice, including a brief discussion of mindfulness in the local school settings and the need for future studies examining systems-level approaches involving teachers and parents.KeywordsEarly childhoodMindfulness21st century skillsSocio-emotional competenciesSelf-regulationTeachingParenting
Objectives
Maternal prenatal depression and anxiety have far-reaching consequences including disruptions to mother-infant bonding and possible impacts on the mother’s perceptions of her infant’s temperament. Emerging evidence suggests that dispositional mindful awareness may attenuate the effects of maternal anxiety and depressive symptoms in the perinatal period, from conception through to 1 year postpartum. This prospective study aimed to assess whether dispositional mindful awareness moderates the influence of prenatal anxiety and depressive symptoms on maternal perceptions of infant temperament and mother-infant bonding.
Methods
Across the perinatal period, 149 mothers completed two online surveys assessing: during pregnancy—dispositional mindful awareness, depression, anxiety; and at 3–6 months postpartum—maternal perceptions of infant temperament and the developing mother-infant bond.
Results
Analyses indicated that greater dispositional mindful awareness was negatively associated with prenatal depression and anxiety, and positively associated with the quality of mother-infant bonding, but not perceptions of infant temperament. Mindful awareness moderated the relationship between depressive symptoms and mother-infant bonding. For mothers with lower mindful awareness, the inverse association between depressive symptoms and mother-infant bonding remained strong, yet for mothers with higher mindful awareness, the adverse impact of depressive symptoms on mother-infant bonding was attenuated.
Conclusions
These results highlight the potential importance of developing higher levels of mindful awareness as a protective factor during pregnancy, and particularly for helping mitigate the adverse impact of maternal depression on the mother-infant bonding process.
In recent years the practice of prenatal yoga and mindfulness has progressively grown due to the possible benefits, and few risks, for mother and fetus associated with this practice. The objective of this chapter is to provide up-to-date information on the numerous benefits of yoga and mindfulness practice throughout the gestational process, preventing and relieving the typical discomforts of pregnancy and childbirth preparation; likewise, yoga and mindfulness practice increases the serenity and overall emotional wellbeing of the pregnant woman. This chapter also describes the most recommended asanas as the pregnant woman’s body changes along with the benefits they provide for the gestational process. Furthermore, it also addresses, even if more briefly, the beneficial effects of these practices for the childbirth process as well as for the postpartum. It must be emphasized that these practices should be guided by competent professionals with specific certification that allows them to work with this very special population. The vast information described here should be seen as a description of benefits related to the practice and not as a manual that can be followed by the pregnant woman on her own or by a professional that does not possess the adequate training.
Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent–infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent–infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent–child relationship.
Although mindfulness in parenting has been recognized as important for some time, there is a dearth of measurement tools, especially for caregivers of infants. Two studies were conducted: (1) developing and providing an initial psychometric evaluation of the Mindful Parenting in Infancy Scale (MPIS) and (2) reproducing initial findings with an independent sample of infants and caregivers. In Study 1, 37 caregivers of infants (3–12 months of age) responded to MPIS, providing indicators of parenting stress and infant temperament. Study 2 caregivers (N = 57) responded to identical measures, with infant electroencephalogram (EEG) recorded during the Still Face Procedure, along with a baseline condition. Study 1 results indicated good internal consistency, with Study 2 providing additional support for reliability. Correlations with parenting stress markers were also significant across both investigations, indicative of greater stress with lower levels of mindfulness. A number of correlations with temperament scores were also significant, and in the hypothesized direction, across both studies. Importantly, the MPIS score was predictive of infant frontal EEG asymmetry in a path model examined in the context of Study 2. Thus, the present investigation provides support for MPIS as a promising brief measurement tool based on results obtained with two independent samples.
We examined whether Research Domain Criteria (RDoC)-informed measures of prenatal stress predicted newborn neurobehavior and whether these effects differed by newborn sex. Multilevel, prenatal markers of prenatal stress were obtained from 162 pregnant women. Markers of the Negative Valence System included physiological functioning (respiratory sinus arrhythmia [RSA] and electrodermal [EDA] reactivity to a speech task, hair cortisol), self-reported stress (state anxiety, pregnancy-specific anxiety, daily stress, childhood trauma, economic hardship, and family resources), and interviewer-rated stress (episodic stress, chronic stress). Markers of the Arousal/Regulatory System included physiological functioning (baseline RSA, RSA, and EDA responses to infant cries) and self-reported affect intensity, urgency, emotion regulation strategies, and dispositional mindfulness. Newborns’ arousal and attention were assessed via the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. Path analyses showed that high maternal episodic and daily stress, low economic hardship, few emotion regulation strategies, and high baseline RSA predicted female newborns’ low attention; maternal mindfulness predicted female newborns’ high arousal. As for male newborns, high episodic stress predicted low arousal, and high pregnancy-specific anxiety predicted high attention. Findings suggest that RDoC-informed markers of prenatal stress could aid detection of variance in newborn neurobehavioral outcomes within hours after birth. Implications for intergenerational transmission of risk for psychopathology are discussed.
Maternal anxiety during pregnancy has been consistently shown to negatively affect offspring neurodevelopmental outcomes.
However, little is known about the impact of positive maternal traits/states during pregnancy on the offspring. The present
study was aimed at investigating the effects of the mother’s mindfulness and anxiety during pregnancy on the infant’s neurocognitive
functioning at 9 months of age. Mothers reported mindfulness using the Freiburg Mindfulness Inventory and anxiety using the
Symptom Checklist (SCL-90) at ±20.7 weeks of gestation. Event-related brain potentials (ERPs) were measured from 79 infants
in an auditory oddball paradigm designed to measure auditory attention—a key aspect of early neurocognitive functioning. For
the ERP responses elicited by standard sounds, higher maternal mindfulness was associated with lower N250 amplitudes (P < 0.01, η2 = 0.097), whereas higher maternal anxiety was associated with higher N250 amplitudes (P < 0.05, η2 = 0.057). Maternal mindfulness was also positively associated with the P150 amplitudes (P < 0.01, η2 = 0.130). These results suggest that infants prenatally exposed to higher levels of maternal mindfulness devote fewer attentional
resources to frequently occurring irrelevant sounds. The results show that positive traits and experiences of the mother during
pregnancy may also affect the unborn child. Emphasizing the beneficial effects of a positive psychological state during pregnancy
may promote healthy behavior in pregnant women.
This randomised controlled pilot trial tested a six-week mindfulness-based intervention in a sample of pregnant women experiencing high levels of perceived stress and pregnancy anxiety. Forty-seven women enrolled between 10 and 25 weeks gestation were randomly assigned to either a series of weekly Mindful Awareness Practices classes (n = 24) with home practice or to a reading control condition (n = 23). Hierarchical linear models of between-group differences in change over time demonstrated that participants in the mindfulness intervention experienced larger decreases from pre-to post-intervention in pregnancy-specific anxiety and pregnancy-related anxiety (PRA) than participants in the reading control condition. However, these effects were not sustained through follow-up at six weeks post-intervention. Participants in both groups experienced increased mindfulness, as well as decreased perceived stress and state anxiety over the course of the intervention and follow-up periods. This study is one of the first randomised controlled pilot trials of a mindfulness meditation intervention during pregnancy and provides some evidence that mindfulness training during pregnancy may effectively reduce PRA and worry. We discuss some of the dilemmas in pursuing this translational strategy and offer suggestions for researchers interested in conducting mind-body interventions during pregnancy.
Mindfulness may be conceptualised as a dispositional trait which differs across individuals. Previous
research has independently identified both attachment security and emotion regulation abilities as correlates
of dispositional attachment. We investigated the relationship between the three concepts in a
sample of 192 participants who had previously had no mindfulness training. Participants completed
the Five Factor Mindfulness Questionnaire (FFMQ), the Experiences in Close Relationships Scale-Revised
(ECR-R) and the Difficulties in Emotion Regulation Scale (DERS) online. Exploratory factor analysis
revealed a 2-factor solution accounting for 52% of the variance across scores on these measures. The first
factor accounted for 36% of the variance and loaded highly on emotion regulation and mindfulness subscales.
The second factor accounted for 16% of the variance and loaded highly on emotion regulation,
attachment and mindfulness subscales. We called the first factor ‘conscious awareness of emotional
states’ and the second factor ‘metacognition of emotional states’. The results confirmed that both emotional
regulation abilities and attachment security were related to dispositional mindfulness.
The aim of this study was to investigate whether maternal anxiety that is temporary or chronic during the pre- and postnatal period predicts infant temperament. Mothers of 2997 infants in a population-based birth cohort reported levels of pregnancy-specific anxiety (Pregnancy Outcome Questionnaire) and general anxiety symptoms (Brief Symptom Inventory) prenatal and at 6 months postnatal. Temperament characteristics were assessed by maternal report using the Infant Behavior Questionnaire—Revised when the infants were 6 months of age. Maternal pregnancy-specific and general anxiety during the pre- and postnatal period were all independently associated with perceived infant temperamental difficulties. Chronically high maternal anxiety predicted the highest perceived infant activity level and negative affectivity. These findings show that different forms of maternal anxiety during both the pre- and postnatal period are independently related to perceived temperamental problems in infancy. They also emphasize the significance of chronic maternal anxiety for infant mental health. Copyright © 2009 John Wiley & Sons, Ltd.
This chapter defines and gives a brief history of temperament research, describing recent advances in our understanding of temperament structure, developmental stability and change, and the degree to which later developing self-regulative processes (fear and effortful control) moderate earlier developing emotional and behavioral reactivity. Measurement issues are discussed and neural models of temperament described. The genetics of temperament and the relation of temperament to the development of personality, adjustment, and psychopathology are reviewed. Finally, directions for future study are proposed.
Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well.
The aim of this prospective study was to investigate whether selective serotonin reuptake inhibitors (SSRIs) utilized by pregnant women influence fetal neurobehavioral development. In this observational study we investigated developmental milestones of fetal behavior during the pregnancy of women with psychiatric disorders who took SSRIs throughout gestation (medicated group; n=96) or who had discontinued medication early in gestation or before conception (unmedicated group; n=37). Healthy unexposed fetuses of women without mental disorders comprised the control group (n=130). Ultrasonographic observations of fetal behavior were made three times in pregnancy (T1-T3). Effects of SSRIs were studied over a wide range of dosages (low, standard, or high) and for different drug types. Fetuses exposed to standard or high SSRI dosages compared with control, unmedicated, or low-medicated fetuses showed significantly increased motor activity at the beginning (T1) and end of the second trimester (T2). They particularly exhibited disrupted emergence of non-rapid eye movement (non-REM; quiet) sleep during the third trimester, characterized by continual bodily activity and, thus, poor inhibitory motor control during this sleep state near term (T3). The SSRI effects on the fetus were dose related, but independent of SSRI type. The results demonstrate changes in fetal neurobehavioral development associated with standard and high SSRI dosages that are observable throughout gestation. A first-choice SSRI type was not apparent. Bodily activity at high rate during non-REM sleep in SSRI-exposed fetuses is an abnormal phenomenon, but its significance for postnatal development is unclear.
We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples. MBCP is designed to promote family health and well-being through the practice of mindfulness during pregnancy, childbirth, and early parenting. Quantitative results from the current study include statistically significant increases in mindfulness and positive affect, and decreases in pregnancy anxiety, depression, and negative affect from pre- to post-test (p < .05). Effect sizes for changes in key hypothesized intervention mediators were large (d > .70), suggesting that MBCP is achieving its intended effects on maternal well-being during pregnancy. Qualitative reports from participants expand upon the quantitative findings, with the majority of participants reporting perceived benefits of using mindfulness practices during the perinatal period and early parenting. Our future research will involve conducting a randomized controlled trial of MBCP to test effects on psychophysiological stress mechanisms and to examine effects on birth outcomes, family relationship quality, and child development outcomes.
The aim of the study was to examine the impact of anxiety in the postnatal year on maternal contribution to mother-infant interaction. Participants were 32 mothers with high anxiety and 32 mothers with low anxiety, when their infants were aged 10-14 months. Mother-infant interaction was videotaped during a standardized play situation and coded blind to group status. High trait anxiety mothers showed less sensitive responsivity (p<.05) and reduced emotional tone (p<.05) during interaction. When participants scoring high in depressive symptomatology were removed for a subgroup analysis, the same pattern of results was obtained, suggesting that the observed differences in mother-infant interaction were due to group differences in anxiety.
Exposure to hostile conditions results in a series of coordinated responses aimed at enhancing the probability of survival. The activation of the hypothalamo-pituitary-adrenocortical (HPA) axis plays a pivotal role in the stress response. While the short-term activation of the HPA axis allows adaptive responses to the challenge, in the long run this can be devastating for the organism. In particular, life events occurring during the perinatal period have strong long-term effects on the behavioral and neuroendocrine response to stressors. In male and female rats exposed to prenatal restraint stress (PRS), these effects include a long-lasting hyperactivation of the HPA response associated with an altered circadian rhythm of corticosterone secretion. Furthermore, male animals exhibit sleep disturbances. In males, these HPA dysfunctions have been reported in infant, young, adult and aged animals, thus suggesting a permanent effect of early stress. Interestingly, after exposure to an intense inescapable footshock, female PRS rats durably exhibit a blunted corticosterone secretion response to stress. In male PRS rats exposed to an alcohol challenge, the HPA axis is similarly hyporesponsive. Rats exposed to PRS also show behavioral disturbances. Both male and female PRS rats show high anxiety levels and depression-like behavior during adulthood, although some studies suggest that female PRS rats present low anxiety levels. With ageing, male and female PRS rats exhibit memory impairments in hippocampus-dependent tasks, while female PRS rats improve their memory performance during adulthood. The gender effect on behavior seems to be related to a reduction in hippocampal plasticity in male PRS rats, and an increase in female PRS rats. Despite the permanent imprinting induced by early stress, the dysfunctions observed after PRS can be reversed by environmental or pharmacological strategies such as environmental enrichment or antidepressive and neurotrophic treatments. Mechanisms underlying the effects of PRS on the offspring remain largely unknown. However, previous studies have demonstrated that maternal glucocorticoids during pregnancy play an important role in the HPA disturbances reported in male offspring. Finally, gestational stress has long-lasting effects on the HPA axis and on behavior in the dams. Alterations in maternal behavior could thus also make a strong contribution to the long-term effects of PRS, through epigenetic mechanisms.
Results are presented from a recent study within the Australian Temperament Project (ATP), in which a group of children with significant behaviour problems, and a comparison group, were selected from the sample at 11–12 years and home-visited, with assessments of clinical diagnoses, intelligence, school achievement and social competence, and a variety of family functioning indices. Approximately half the behaviour problem group received at least one diagnosis. Twice as many boys as girls were diagnosed. Rates of comorbidity were high but, generally, within—rather than between—the broadband internalising or externalising spectra. Concurrent family functioning measures discriminated between groups, but not as strongly as intrinsic child measures, and the particular family variables that best discriminated between groups showed sex differences. High stability of behaviour problems from earlier years was evident, and the behaviour problem group differed from the comparison group on measures of temperament, behaviour, and context from early childhood; both findings reinforce the need for early intervention.The implications of these and other findings from the ATP, particularly the need for early intervention, are discussed.
Many studies have examined effects of prenatal stress on pregnancy and fetal development, especially on prematurity and birthweight, and more recently long-term effects on child behavioral and emotional development. These studies are reviewed and their limitations are discussed with regard to definitions (including the concepts of stress and anxiety), stress measurements, samples, and control for confounds such as depression. It appears necessary to assess individual stress reactivity prospectively and separately at each trimester of pregnancy, to discriminate chronic from acute stress, and to take into consideration moderator variables such as past life events, sociocultural factors, predictability, social support and coping strategies. Furthermore, it might be useful to examine simultaneously, during but also after pregnancy, stress, anxiety and depression in order to understand better their relationships and to evaluate their specific effects on pregnancy and child development. Finally, further research could benefit from an integrated psychological and biological approach studying together subjective perceived stress and objective physiological stress responses in pregnant women, and their effects on fetal and child development as well as on mother-infant interactions.
A content analysis of 2 years of Psychological Science articles reveals inconsistencies in how researchers make inferences about indirect effects when conducting a statistical mediation analysis. In this study, we examined the frequency with which popularly used tests disagree, whether the method an investigator uses makes a difference in the conclusion he or she will reach, and whether there is a most trustworthy test that can be recommended to balance practical and performance considerations. We found that tests agree much more frequently than they disagree, but disagreements are more common when an indirect effect exists than when it does not. We recommend the bias-corrected bootstrap confidence interval as the most trustworthy test if power is of utmost concern, although it can be slightly liberal in some circumstances. Investigators concerned about Type I errors should choose the Monte Carlo confidence interval or the distribution-of-the-product approach, which rarely disagree. The percentile bootstrap confidence interval is a good compromise test.
ANTENATAL MATERNAL ANXIETY IS ASSOCIATED WITH
ALTERED COGNITIVE CONTROL IN FIVE-YEAR-OLD
CHILDREN
E. M. Loomans,12 O. van der Stelt,1 M. van Eijsden,2 R. J. B. J. Gemke,3
T. Vrijkotte,4 and B. R. H. M. Van den Bergh1
1Department of Psychology, Tilburg University, the Netherlands
2Department of Epidemiology, Documentation and Health Promotion,
Public Health Service, Amsterdam, the Netherlands
3Department of Paediatrics, EMGO institute,
Institute of Cardiovascular Research VU, VU University Medical
Centre, Amsterdam, the Netherlands
4Department of Social Medicine, Academic Medical Centre,
University of Amsterdam, Amsterdam, the Netherlands
e.m.loomans@uvt.nl
The current study prospectively examined the relation between maternal anxiety during pregnancy and children’s cognitive functioning at age five. Participants (N =922) were mothers and their children participating in the Amsterdam Born Children and their Development study. Antenatal maternal
anxiety wasmeasured using the State-Trait Anxiety Inventory (STAI) around the 16th week of pregnancy. Children’s neurocognitive functioning was examined using two reaction time (RT) tasks; one simple and one complex, differing in the amount of cognitive load (low vs. high). Regression analyses
were performed in thewhole sample (STAI score,M=36.0, SD=9.5) and in the highly anxious subsample (STAI score >90th percentile, M=54.7, SD=5.7) controlling for: gender, birth weight corrected for gestational age, parity,maternal education, maternal smoking, maternal alcohol consumption and postnatal anxiety. In the whole sample antenatal anxiety was positively related to children’s intra-individual variability in RT in the simple task. Subsample analyses showed that high levels of antenatal anxiety were positively associated with mean RT and intra-individual variability in RT in the complex task.Asignificant interaction was found between anxiety and the child’s gender on the intra-individual variability in RT in both tasks. All pvalues
<.05. Our study provided evidence that high levels of maternal anxiety during pregnancy specifically affect offsprings performance on tasks high in cognitive load. In boys, high levels of antenatal anxiety were also related to intra-individual variability in RT in conditions low in cognitive load.
Research focusing on the prenatal mother–child relationship has begun to create a body of scientific knowledge. The aim of our article is to bring a selective overview of research on scales to measure the mother–foetus relationship (MFR). First, we describe the construction and available information on psychometric properties of three frequently used scales – the Maternal Foetal Attachment Scale (MFAS), Maternal Antenatal Attachment Scale (MAAS), Prenatal Attachment Inventory (PAI), and some other scales. Second, we review empirical research using these scales (a) to study some of the supposed effects of the MFR on the health behaviour of the mother and the well‐being of the child, and (b) to examine factors that influence the prenatal maternal–foetal relationship. We focus this review on a description of research with MFR scales that are relevant for clinical obstetrics, gynaecology and reproductive psychology. Some suggestions for further research are made.
Studied the effect of maternal emotions during the pregnancy in 30 of 70 nulliparous women (age 18–30 yrs) with varying levels of anxiety. Emotions were studied during each pregnancy trimester and in the 1st, 10th, and 28th wk after birth, using the State-Trait Anxiety Inventory. During pregnancy Ss were tested for a number of variables, including social support, coping abilities, personality, and pregnancy anxiety, in addition to the administration of the Maternal–Fetal Attachment Scale. After birth, Ss answered questionnaires on the birth experience and the behavior of the neonates. Maternal emotions had a small but significant effect on occurrence and duration of fetal motor activity. Fetuses of women with high anxiety tended to be more active than fetuses of women with low anxiety. The prenatal influence was reflected in neonatal behavior. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
: The Individuals with Disabilities Education Act (IDEA) requires states to engage in child-find efforts to identify infants and toddlers at risk for social-emotional problems. Parent-completed rating scales can be an efficient and cost-effective method for identifying young children in need of further assessment for social-emotional problems. This article discusses the importance of screening children in this domain and the benefits of using parent-completed questionnaires in the screening process. Six screening tools that rely on parent report, including three experimental tools, are reviewed. Additionally, challenges to screening for social-emotional disorders are discussed, and cautions for practitioners are suggested.
(C)1998Aspen Publishers, Inc.
The early identification of social and emotional problems in infants, toddlers, and young children is critical for improving developmental outcomes. The Ages and Stages Questionnaires: Social-Emotional, a newly-developed screening tool, is described in this article. Questionnaires span the 3- to 63-month period with 8 separate assessment intervals. Research findings, including data on 3014 questionnaires, are reported. Internal consistency was generally high, with an overall alpha of 0.82. Test-retest reliability between parents’ classifications was 0.94. Sensitivity ranged from 0.75 to 0.89 with 0.82 overall sensitivity; specificity ranged from 0.82 to 0.96 with 0.92 overall specificity. Parents reported easy understanding and high satisfaction with the questionnaires.
The reliability and validity of the Infant Behavior Questionnaire-Revised was examined in a sample of 6-month-old infants and their parents. One hundred and fifteen mothers and 79 fathers completed the IBQ-R and a measure of depression and 98 infants participated in a laboratory assessment of temperament. Internal consistency reliability was adequate for all 14 IBQ-R subscales for both mothers and fathers and inter-rater reliability of mother and father reports was demonstrated for 11 of 14 subscales. Convergent validity was established between observed fear and mother reported fear and father reported approach. Parent depression and infant gender were examined as moderators of the concordance between parent reported and observed temperament. As predicted, concordance was higher when parents reported low versus high symptoms of depression. Infant gender did not alter concordance.
There is an ongoing discussion about the definition of mindfulness including the question whether mindfulness is a one-dimensional or multidimensional construct. Research on the Freiburg mindfulness inventory (FMI) has also reflected this debate. We have investigated the psychometric properties of the FMI-14-item in an online convenience sample of n = 244 individuals (150 female; mean age 28.7 (SD = 8.76)) with (n = 75) and without (n = 169) regular meditative training). A simplified version of the beck depression inventory (BDI-V) and the trait subscale of the state-trait-anxiety-inventory (STAI-T) were used for determining criterion validity. A one-dimensional (α = .83) and an alternative two-dimensional solution (αF1 = .77; αF2 = .69) of the FMI-14 were tested with a confirmatory factor analysis and yielded suboptimal fit indices. An exploratory analysis resulted in a reduced 8-item version of the two-dimensional solution with better fit indices, but low internal consistency (αF1 = .71; αF2 = .64). The factors could be identified as “Presence” (F1) and “Acceptance” (F2). Further investigation revealed that the substantial negative relationship between mindfulness and anxiety and depression is completely due to the “Acceptance” factor of mindfulness. This suggests that there may be heuristic value in the two-factorial solution, although for practical purposes it seems sufficient to assess mindfulness as one-dimensional construct.
This study describes a revision of a widely used parent-report measure of infant temperament, the Infant Behavior Questionnaire (IBQ; Rothbart, 1981). A rationally derived instrument was developed that included nine new scales and minor modifications of the seven scales of the IBQ. Parents of 360 infants, equally distributed over three age groups: 3–6 months; 6–9 months; and 9–12 months of age, participated. Conceptual and item analyses provided support for 14 of the 16 proposed scales, demonstrating satisfactory internal consistency. Inter-rater reliability was evaluated, with evidence of moderate agreement between primary and secondary caregivers. Monomethod discriminant validity was demonstrated through an examination of correlations among the Infant Behavior Questionnaire—Revised (IBQ-R) scale scores. Results of the factor analytic procedure were consistent with three broad dimensions of Surgency/Extraversion, Negative Affectivity, and Orienting/Regulation. Developmental and gender differences were also noted for a number of the IBQ-R scales. Specifically, older infants received higher scores on Approach, Vocal Reactivity, High Intensity Pleasure, Activity, Perceptual Sensitivity, Distress to Limitations, and Fear, whereas younger infants’ scores were higher for Low Intensity Pleasure, Cuddliness/Affiliation, and Duration of Orienting. Male infants obtained higher scores on Activity and High Intensity Pleasure, and female infants were rated higher on the Fear scale.
Mindfulness, a concept originally derived from Buddhist psychology, is essential for some well-known clinical interventions. Therefore an instrument for measuring mindfulness is useful. We report here on two studies constructing and validating the Freiburg Mindfulness Inventory (FMI) including a short form. A preliminary questionnaire was constructed through expert interviews and extensive literature analysis and tested in 115 subjects attending mindfulness meditation retreats. This psychometrically sound 30-item scale with an internal consistency of Cronbach alpha = .93 was able to significantly demonstrate the increase in mindfulness after the retreat and to discriminate between experienced and novice meditators. In a second study we broadened the scope of the concept to 86 subjects without meditation experience, 117 subjects with clinical problems, and 54 participants from retreats. Reducing the scale to a short form with 14 items resulted in a semantically robust and psychometrically stable (alpha = .86) form. Correlation with other relevant constructs (self-awareness, dissociation, global severity index, meditation experience in years) was significant in the medium to low range of correlations and lends construct validity to the scale. Principal Component Analysis suggests one common factor. This short scale is sensitive to change and can be used also with subjects without previous meditation experience.
The Developmental Origins of Health and Disease (DOHaD) hypothesis studies the short- and long-term consequences of the conditions of the developmental environment for phenotypic variations in health and disease. Central to this hypothesis is the idea of interdependence of developmental influences, genes, and environment. Developmental programming effects are mediated by alterations in fundamental life functions, and the most enduring effects seem to occur if the main regulatory instances of the organ - the (epi)genome and the brain - are affected. Some new insights in the role of chromatin, in cellular development and differentiation, and neural plasticity from the field of epigenetics are introduced, followed by a section on epigenetics and brain development. It is proposed to extend the DOHaD hypothesis into the 'Developmental Origins of Behaviour, Health, and Disease' (DOBHaD) concept. Pregnancy and the early postnatal period are times of both great opportunity and considerable risk, and their influence can extend over a lifetime. The DOBHaD hypothesis opens fundamental new perspectives on preventing diseases and disorders.
Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to pregnant women, but knowledge about their unintended effects on child health is scarce.
To examine the effects of maternal SSRI use during pregnancy on fetal growth and birth outcomes.
The study was embedded in the Generation R Study, a prospective population-based study from fetal life onward.
Seven thousand six hundred ninety-six pregnant women were included. Selective serotonin reuptake inhibitor use was assessed by questionnaires in each trimester and verified by pharmacy records. Using depressive symptom scores from the Brief Symptom Inventory, 7027 pregnant mothers (91.3%) had no or low depressive symptoms, 570 pregnant mothers (7.4%) had clinically relevant depressive symptoms and used no SSRIs, and 99 pregnant mothers (1.3%) used SSRIs.
Fetal ultrasonography was performed in each trimester. We determined fetal body and head growth with repeated assessments of body and head size. The birth outcomes studied were preterm birth, small for gestational age, and low birth weight.
Fetuses from mothers with prenatal depressive symptoms showed reduced body growth (β=-4.4 g/wk; 95% CI: -6.3 to -2.4; P<.001) and head growth (β=-0.08 mm/wk; 95% CI: -0.14 to -0.03; P=.003). Mothers using SSRIs during pregnancy had fewer depressive symptoms than mothers in the clinical symptom range. Prenatal SSRI use was not associated with reduced body growth but was associated with reduced fetal head growth (β=-0.18 mm/wk; 95% CI: -0.32 to -0.07; P=.003). The SSRI-exposed children were at higher risk for preterm birth (odds ratio=2.14; 95% CI: 1.08 to 4.25; P=.03).
Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.
Maternal stress during pregnancy has been repeatedly associated with problematic child development. According to the fetal programming hypothesis adverse experiences during pregnancy increase maternal cortisol, which is then assumed to exert a negative effect on fetal development. Recent studies in non-pregnant women report significant associations between positive emotionality and low cortisol levels. We tested in a sample of 60 pregnant women whether both negative and positive life events independently predicted third-trimester baseline awakening cortisol levels. While the effect of negative life events proved unrelated positive life events significantly predicted lower cortisol levels. These findings suggest that positive experiences are of relevance regarding maternal morning cortisol levels in pregnancy reflecting a resource with potentially beneficial effects for the mother and the developing fetus. It might be promising for psychological intervention programs to focus on increasing positive experiences of the expecting mother rather than exclusively trying to reduce maternal stress during pregnancy.
This longitudinal prospective study examined the relation between maternal anxiety during pregnancy and specific aspects of children's cognitive functioning at age five. Antenatal maternal state-anxiety was measured around the 16th week of pregnancy. Children's neurocognitive functioning was examined using a simple reaction time (RT) task, and a choice RT task. Multiple regression analyses in the total sample (N = 922) showed that antenatal anxiety was positively related to children's intra-individual variability in RT in the simple task. In a subsample (n = 100) of women with state-anxiety scores above the 90th percentile, antenatal anxiety was positively associated with mean RT and intra-individual variability in RT in the incompatible trials of the choice RT task. In addition, in this subsample of highly anxious mothers we found a significant positive association in boys but not in girls, between prenatal maternal anxiety and intra-individual variability in RT in the simple task.
Within the past few decades, there has been a surge of interest in the investigation of mindfulness as a psychological construct and as a form of clinical intervention. This article reviews the empirical literature on the effects of mindfulness on psychological health. We begin with a discussion of the construct of mindfulness, differences between Buddhist and Western psychological conceptualizations of mindfulness, and how mindfulness has been integrated into Western medicine and psychology, before reviewing three areas of empirical research: cross-sectional, correlational research on the associations between mindfulness and various indicators of psychological health; intervention research on the effects of mindfulness-oriented interventions on psychological health; and laboratory-based, experimental research on the immediate effects of mindfulness inductions on emotional and behavioral functioning. We conclude that mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation. The review ends with a discussion on mechanisms of change of mindfulness interventions and suggested directions for future research.
Animal studies have shown sex differences in the impact of prenatal maternal stress on the offspring. The aim of this prospective case-control study was to assess the effect of prenatal depression on newborn and 1-year-old infant characteristics as related to gender, controlling for confounding variables.
We screened 205 pregnant women from April 2004 to November 2006 for depressive symptoms. Inclusion in the prenatal depression group (n = 34) was based on meeting DSM-IV criteria for major depressive episode. We excluded postnatal depression from the control group (n = 79) by routine screening at 2 and 6 months. Newborn and 1-year-old infant characteristics were evaluated with the Neonatal Behavioral Assessment Scale (NBAS) and the Infant-Toddler Social and Emotional Assessment, respectively.
Despite our use of numerous exclusion criteria (eg, at-risk pregnancy, preterm delivery), prenatal depression highly correlated with anxiety and stress scores. Male newborns of mothers with prenatal depression had lower scores than controls on the motor skills and regulation of states NBAS clusters (P = .03 and P = .026, respectively). At 1 year, infants of prenatally depressed mothers presented higher scores on generalized anxiety (P = .002), particularly in males (P = .009); activity/impulsivity (P = .042); and sleep problems (P = .023) than controls.
As in animal studies, depression during pregnancy may affect infant development in a way that is related to gender. Early gender differences observed to be associated with depression, stress, and anxiety during pregnancy may be a key to understanding the higher prevalence in males of child psychiatric disorders.
This review of recent research on prenatal depression suggests that it is a strong predictor of postpartum depression and is more common than postpartum depression. Prenatal depression has been associated with excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, and later in development attentional, emotional and behavioral problems have been noted during childhood and adolescence, as well as chronic illnesses in adulthood. Several variables have confounded the effects of prenatal depression including comorbid anxiety and anger as well as stressful life events. Potential mediating variables are low prenatal maternal dopamine and serotonin levels and elevated cortisol and norepinephrine. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies also suggest the heritability of developmental problems for the children of prenatally depressed mothers, including ADHD and antisocial behavior. Multivariate, longitudinal research is needed to disentangle these confounding and mediating variables.
The consequences of prenatal maternal stress for development were examined in 125 full-term infants at 3, 6, and 12 months of age. Maternal cortisol and psychological state were evaluated 5 times during pregnancy. Exposure to elevated concentrations of cortisol early in gestation was associated with a slower rate of development over the 1st year and lower mental development scores at 12 months. Elevated levels of maternal cortisol late in gestation, however, were associated with accelerated cognitive development and higher scores at 12 months. Elevated levels of maternal pregnancy-specific anxiety early in pregnancy were independently associated with lower 12-month mental development scores. These data suggest that maternal cortisol and pregnancy-specific anxiety have programming influences on the developing fetus.
This article provides researchers with a guide to properly construe and conduct analyses of conditional indirect effects, commonly known as moderated mediation effects. We disentangle conflicting definitions of moderated mediation and describe approaches for estimating and testing a variety of hypotheses involving conditional indirect effects. We introduce standard errors for hypothesis testing and construction of confidence intervals in large samples but advocate that researchers use bootstrapping whenever possible. We also describe methods for probing significant conditional indirect effects by employing direct extensions of the simple slopes method and Johnson-Neyman technique for probing significant interactions. Finally, we provide an SPSS macro to facilitate the implementation of the recommended asymptotic and bootstrapping methods. We illustrate the application of these methods with an example drawn from the Michigan Study of Adolescent Life Transitions, showing that the indirect effect of intrinsic student interest on mathematics performance through teacher perceptions of talent is moderated by student math self-concept.
Hypotheses involving mediation are common in the behavioral sciences. Mediation exists when a predictor affects a dependent variable indirectly through at least one intervening variable, or mediator. Methods to assess mediation involving multiple simultaneous mediators have received little attention in the methodological literature despite a clear need. We provide an overview of simple and multiple mediation and explore three approaches that can be used to investigate indirect processes, as well as methods for contrasting two or more mediators within a single model. We present an illustrative example, assessing and contrasting potential mediators of the relationship between the helpfulness of socialization agents and job satisfaction. We also provide SAS and SPSS macros, as well as Mplus and LISREL syntax, to facilitate the use of these methods in applications.
Mickey, R. M. (Dept of Mathematics and Statistics, U. of Vermont, Burlington, VT 05405) and S. Greenland. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989;129:125–37.
Much controversy exists regarding proper methods for the selection of variables in confounder control. Many authors condemn any use of significance testing, some encourage such testing, and others propose a mixed approach. This paper presents the results of a Monte Carlo simulation of several confounder selection criteria, including change-in-estimate and collapsibility test criteria. The methods are compared with respect to their Impact on Inferences regarding the study factor's effect, as measured by test size and power, bias, mean-squared error, and confidence Interval coverage rates. In situations in which the best decision (of whether or not to adjust) is not always obvious, the change-in-estimate criterion tends to be superior, though significance testing methods can perform acceptably If their significance levels are set much higher than conventional levels (to values of 0.20 or more).
Research on the prevalence, course, and correlates of behavior problems in preschool children was examined. Prospective epidemiological studies and follow-up studies of clinical/high risk samples indicate that serious externalizing problems identified early often persist. Negative, inconsistent parental behavior and high levels of family adversity are associated with the emergence of problems in early childhood and predict their persistence to school age. Studies are examined from a developmental perspective and integrated with research on optimal parent-child relationships. The severity of initial problems and family context are related to different developmental outcomes.
To describe the mental and emotional well-being of children born at different birth weights assessed at school age and to identify neonatal, intervening health, and sociodemographic and environmental factors associated with mental and emotional well-being.
To address this issue, we used a prospective cohort study involving two previously studied cohorts, which were recontacted at 8 to 10 years of age to provide a multisite sample of 247 children weighing 1000 g or less at birth, 364 weighing 1001 to 1500 g, 724 weighing 1501 to 2500 g, and 533 weighing more than 2500 g. Maternal reports were obtained on three standardized measures of mental and emotional well-being (the Rand General Well-being Scale, the Behavior Problem Index, and the Harter Scale of Child Competence) and on intervening health, sociodemographic, and environmental variables. Neonatal variables were derived from records at birth. Statistical techniques included analysis of variance and ordinary least squares multiple regression.
Lower birth weight children did not differ on the General Well-being Scale but were more likely to have behavior problems and to be considered less competent. Other important correlates of mental and emotional well-being included childhood illness, maternal mental health, home environment score, and exposure to household cigarette smoking.
Although lower birth weight children have poorer mental and emotional well-being, a substantial portion of this adverse outcome reflects modifiable environmental factors.
4-month-old infants were specifically selected for patterns of affective and motoric reactivity that were hypothesized to be associated with later inhibited and uninhibited behavior. Infants were classified as high on motor activity and negative affect, high on motor activity and positive affect, or low on motor activity and affect. Brain electrical activity was assessed in these infants at 9 months of age, and behavior toward novelty was observed at 14 months of age. Infants who were high on motor activity and negative affect exhibited greater right frontal EEG activation at 9 months of age and inhibited behavior at 14 months of age. Infants classified as high motor/high positive at 4 months of age exhibited uninhibited behavior at 14 months of age. No relations were found between frontal asymmetry at 9 months of age and inhibited behavior at 14 months of age. However, greater activation in both the left and right frontal hemispheres was associated with higher inhibition scores at 14 months of age. These findings are discussed in terms of the role that affective and physiological reactivity may play in the development of social behavior during toddlerhood.
Animal experiments have convincingly demonstrated that prenatal maternal stress affects pregnancy outcome and results in early programming of brain functions with permanent changes in neuroendocrine regulation and behaviour in offspring.
To evaluate the existing evidence of comparable effects of prenatal stress on human pregnancy and child development.
Data sources used included a computerized literature search of PUBMED (1966-2001); Psychlit (1987-2001); and manual search of bibliographies of pertinent articles.
Recent well-controlled human studies indicate that pregnant women with high stress and anxiety levels are at increased risk for spontaneous abortion and preterm labour and for having a malformed or growth-retarded baby (reduced head circumference in particular). Evidence of long-term functional disorders after prenatal exposure to stress is limited, but retrospective studies and two prospective studies support the possibility of such effects. A comprehensive model of putative interrelationships between maternal, placental, and fetal factors is presented.
Apart from the well-known negative effects of biomedical risks, maternal psychological factors may significantly contribute to pregnancy complications and unfavourable development of the (unborn) child. These problems might be reduced by specific stress reduction in high anxious pregnant women, although much more research is needed.
To examine the hypothesis that the effects of postnatal depression on children's behavioral/emotional problems are explained by antenatal maternal mood.
The current study investigated this hypothesis in the Avon Longitudinal Study of Parents and Children, a prospective, community-based study that has followed a cohort of women since pregnancy (n = 7,144) who delivered their baby between April 1, 1991, and December 31, 1992. Self-report measures of maternal anxiety and depression were assessed at repeated intervals in pregnancy and the postnatal period. Children's behavioral/emotional problems were assessed by parent report at age 4 years.
After controlling for smoking, alcohol use, birth weight for gestational age, maternal age, child sex, and socioeconomic status, postnatal depression at 8 weeks (OR = 2.27 [1.55-3.31]) and 8 months (OR = 1.68 [1.12-2.54]) was associated with children's behavioral/emotional problems. Subsequent analyses that included antenatal maternal mood indicated that antenatal anxiety in late pregnancy and not antenatal depression was also independently associated with behavioral/emotional problems at age 4 (OR = 1.72 [1.14-2.59]); 8 week postnatal depression remained a significant predictor after antenatal maternal mood was statistically controlled for (OR = 1.56 [1.04-2.32]).
Antenatal anxiety and postnatal depression represent separate risks for behavioral/emotional problems in children and act in an additive manner.
To assess whether links exist between maternal trait anxiety (STAI), perceived life event (LE) stress and depression (Edinburgh scale) and infant temperament.
Women in the third trimester of pregnancy returned psychological self-report questionnaires; infant temperament was evaluated at 4 and 6 months by maternal and paternal report, while depression (concurrent Edinburgh scale) was also assessed at four and six months. As data were returned inconsistently at 4 and 6 months, we combined these two time points for simplicity of reporting and optimisation of numbers.
Univariate logistic regressions on 970 subjects indicated that the pregnancy STAI (>40) scores were associated with 2.56- and 1.57-fold increases (maternal and paternal, respectively), in the odds of "difficult" infant temperament at 4 or 6 months. Concurrent Edinburgh scores (OR of 3.06 and 2.64 for maternal reports, respectively) were also predictive of infant temperament. Age, education, income, marital status, obstetric complications, infant gender and prematurity were not predictive of infant temperament. In stepwise multiple logistic regression analyses, the antenatal trait STAI (odds ratio 1.96) significantly predicted maternal reports of "difficult" temperament at 4 or 6 months independent of both antenatal and postnatal depression scores. There were similar trends for paternal reports of "difficult" temperament but these were not significant. Antenatal depression and perceived LE stress were not predictive of temperament. Finally, women (N=14) reporting domestic violence (DV) in pregnancy had highly significant increased Edinburgh and STAI scores.
Maternal trait anxiety was predictive of "difficult" infant temperament, independent of "concurrent" depression and key sociodemographic and obstetric risk factors. These findings, while needing replication using objective measures of infant temperament, suggest that antenatal psychological interventions aimed at minimising anxiety may optimize infant temperament outcomes. There may be some benefit in shaping specific interventions to women reporting specific risk factors such as DV or past abuse.
Accumulating evidence indicates that prenatal maternal and fetal processes can have a lasting influence on infant and child development. Results from animal models indicate that prenatal exposure to maternal stress and stress hormones has lasting consequences for development of the offspring. Few prospective studies of human pregnancy have examined the consequences of prenatal exposure to stress and stress hormones.
In this study the effects of prenatal maternal psychosocial (anxiety, depression, and perceived stress) and endocrine (cortisol) indicators of stress on infant temperament were examined in a sample of 247 full-term infants. Maternal salivary cortisol and psychological state were evaluated at 18-20, 24-26, and 30-32 weeks of gestation and at 2 months postpartum. Infant temperament was assessed with a measure of negative reactivity (the fear subscale of the Infant Temperament Questionnaire) at 2 months of age.
Elevated maternal cortisol at 30-32 weeks of gestation, but not earlier in pregnancy, was significantly associated with greater maternal report of infant negative reactivity. Prenatal maternal anxiety and depression additionally predicted infant temperament. The associations between maternal cortisol and maternal depression remained after controlling for postnatal maternal psychological state.
These data suggest that prenatal exposure to maternal stress has consequences for the development of infant temperament.
There is evidence that stress and emotional problems during pregnancy are related to adverse health outcomes of the child at birth and in later life. The aim of this study was to determine the association between stress and emotional problems during pregnancy and excessive infant crying.
From an initial sample of 8266 pregnant women, a follow-up sample of 4976 women and their 3- to 6-month-old babies was examined. Depressive symptoms, pregnancy related anxiety, parenting stress, and job strain during pregnancy were all univariately and multivariately associated with excessive infant crying (adjusted odds ratios between 1.69 and 2.23).
Women with three or four of these antenatal risks were more likely to have an infant who cries excessively than women with no antenatal risks (adjusted odds ratio of 4.89).
In conclusion, stress and emotional problems during pregnancy increase the chances of having an excessively crying baby. Women with multiple antenatal risk factors are at particular risk.
Antenatal anxiety predicts child behavioral/ emotional problems independently of postnatal depression
- O' Connor
- T G Heron
- J Glover
O'Connor TG, Heron J, Glover V. Antenatal anxiety predicts child behavioral/
emotional problems independently of postnatal depression. J Am Acad Child
Adolesc Psychiatry 2002;41(12):1470-7.
Behavioral and physiological antecedents of inhibited and uninhibited behavior
- Calkins