Do early father-infant interactions predict the onset of externalising behaviours in young children? Findings from a longitudinal cohort study.

BACKGROUND: Factors related to parents and parenting capacities are important predictors of the development of behavioural problems in children. Recently, there has been an increasing research focus in this field on the earliest years of life, however, relatively few studies have addressed the role of fathers, despite this appearing to be particularly pertinent to child behavioural development. This study aimed to examine whether father-infant interactions at age 3 months independently predicted child behavioural problems at 1 year of age. METHOD: A sample of 192 families was recruited from two maternity units in the United Kingdom. Father-infant interactions were assessed in the family home and coded using the global rating scales. Child behaviour problems were assessed by maternal report. Hierarchical and logistic regression analyses were used to examine associations between father-infant interaction and the development of behavioural problems. RESULTS: Disengaged and remote interactions between fathers and their infants were found to predict externalising behavioural problems at the age of 1 year. The children of the most disengaged fathers had an increased risk of developing early externalising behavioural problems [disengaged (nonintrusive) interactions--adjusted odds ratio 5.33 (95% confidence interval; 1.39, 20.40): remote interactions adj. OR 3.32 (0.92, 12.05)]. CONCLUSIONS: Disengaged interactions of fathers with their infants, as early as the third month of life, predict early behavioural problems in children. These interactions may be critical factors to address, from a very early age in the child's life, and offer a potential opportunity for preventive intervention

Documentary Analysis within a Realist Evaluation: recommendations from a study of Sexual Assault Referral Centres

Realist approaches are increasingly used in studies of complex health interventions/evaluations to understand how programmes work, for whom, and under what circumstances. Mixed-method data sources can be used to generate, refine and test realist programme theories, which explore causal links about the contexts that affect the mechanisms of an intervention and lead to the production of different outcomes. The realist approach provides a framework for a detailed understanding of how a programme functions, aiding with the implementation, refinement or adaptation of interventions.Documentary analysis provides an overview of the theoretical and practical functioning of a service and the ways it is structured to provide interventions. Data is often collected early in the evaluation and can include service specifications, organisational policies and procedures and routine audit data. This paper describes a two-stage process of documentary analysis, where data extraction forms and journey maps are used to explore how Sexual Assault Referral Centres (SARCs) in England respond to the mental health and substance use needs of users. Using documentary analysis as part of a sequential data collection process can be valuable in informing subsequent data sources (e.g. qualitative interview schedules can be used to further test and refine theories from a documentary analysis). Considerations for researchers in applying documentary analysis include the value of keeping initial searches broad, to capture documents from a range of sources; the need for clarity about the prioritisation of data sources in the selection process; the benefit in establishing a standardised extraction form that incorporates the wider context within which the intervention functions; taking steps to ensure face validity and transferability during interpretation of data sources; the benefits of transforming information from the data extraction form into a visual journey map

Intergenerational transmission of parenting: findings from a UK longitudinal study.

BACKGROUND: The quality of parenting is associated with a wide range of child and adult outcomes, and there is evidence to suggest that some aspects of parenting show patterns of intergenerational transmission. This study aimed to determine whether such intergenerational transmission occurs in mothers and fathers in a UK birth cohort. METHODS: The study sample consisted of 146 mothers and 146 fathers who were recruited from maternity wards in England and followed up for 24 months ['Generation 2' (G2)]. Perceptions of their own parenting [by 'Generation1' (G1)] were assessed from G2 parents at 12 months using the Parental Bonding Instrument (PBI). G2 parents were filmed interacting with their 'Generation 3' (G3) children at 24 months. RESULTS: We found that G1 mothers' 'affection' was associated with positive parenting behaviour in the G2 fathers ('positive responsiveness' β = 0.19, P = 0.04 and 'cognitive stimulation' β = 0.26, P < 0.01). G1 mothers' 'control' was associated with negative parenting behaviour in G2 mothers (decreased 'engagement' β = -0.19, P = 0.04), and negative parenting behaviour in G2 fathers (increased 'control' β = 0.18, P = 0.05). None of the G1 fathers' parenting variables were significantly associated with G2 parenting. CONCLUSIONS: There is evidence of intergenerational transmission of parenting behaviour in this highly educated UK cohort, with reported parenting of grandmothers associated with observed parenting in both mothers and fathers. No association was seen with reported parenting of grandfathers. This raises the possibility that parenting interventions may have benefits that are realised across generations

Father-child interactions at 3 months and 24 months: contributions to children's cognitive development at 24 months

The quality of father-child interactions has become a focus of increasing research in the field of child development. We examined the potential contribution of father-child interactions at both 3 months and 24 months to children's cognitive development at 24 months. Observational measures of father-child interactions at 3 and 24 months were used to assess the quality of fathers' parenting (n = 192). At 24 months, the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development, Second Edition (N. Bayley, ) measured cognitive functioning. The association between interactions and cognitive development was examined using multiple linear regression analyses, adjusting for paternal age, education and depression, infant age, and maternal sensitivity. Children whose fathers displayed more withdrawn and depressive behaviors in father-infant interactions at 3 months scored lower on the MDI at 24 months. At 24 months, children whose fathers were more engaged and sensitive as well as those whose fathers were less controlling in their interactions scored higher on the MDI. These findings were independent of the effects of maternal sensitivity. Results indicate that father-child interactions, even from a very young age (i.e., 3 months) may influence children's cognitive development. They highlight the potential significance of interventions to promote positive parenting by fathers and policies that encourage fathers to spend more time with their young children.This research was supported by Wellcome Trust Clinical Research Fellowship No. 078434 to P.G.R

For Baby’s Sake: Intervention Development and Evaluation Design of a Whole-Family Perinatal Intervention to Break the Cycle of Domestic Abuse

For Baby’s Sake is an innovative whole-family intervention that works with parents from pregnancy to two years postpartum to break cycles of domestic abuse and improve outcomes for children. The programme launched in 2015 across two community settings in England, with an independent evaluation led by King’s College London. This paper aims to (1) summarise the process of developing For Baby’s Sake and how it has been embedded within two different settings and (2) describe the evaluation design using early data to illustrate successes and challenges. The programme was developed following a review of the evidence and extensive stakeholder engagement. Three experts co-designed the content in partnership with the Stefanou Foundation and the programme delivery teams have been integrated into two local authorities. The evaluation uses mixed methods to assess abuse victimisation/perpetration, mental health, parenting and child outcomes, alongside service user experiences of early engagement. Forty individuals (27 women and 13 men) have been recruited to the evaluation. Early findings suggest that parents value the novel approach of For Baby’s Sake and their relationships with practitioners. Data on parents’ mental health and childhood adversities supports the decision to create a trauma-informed intervention. Interventions for domestic abuse are necessary to improve health and behaviour outcomes for families and prevent intergenerational transmission of abuse and developmental trauma. For Baby’s Sake addresses limitations of existing interventions, through its trauma-informed, attachment-based, whole-family approach. Early data from the evaluation suggests that the programme is reaching its intended audience and that service users appreciate the supportive approach

Mental health service responses to human trafficking:A qualitative study of professionals' experiences of providing care

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Group cognitive behaviour therapy combining early intervention with an exclusive focus on single medication-resistant delusional beliefs:A service evaluation

AbstractCognitive behaviour therapy (CBT) is now the psychological treatment of choice for psychosis but meta-analyses indicate a low effect size on delusions, so further innovations are clearly needed, and group CBT for psychosis (GCBTp) is an under-researched area. This study aimed to service-evaluate the feasibility, satisfaction, safety, and effectiveness of a CBT group specifically targeting medication-resistant single delusions in early psychosis patients (EI-GCBTp). Three separate EI-GCBTp groups were run resulting in a total of 11 medication-resistant early psychosis patients. A within-subjects design tested for group change across two time points: pre-baseline (4 weeks before treatment) to baseline (session 1 of treatment) and sessions 1–8 (the treatment period). Thirteen delusion dimensions were measured from three psychosis-specific questionnaires: The Psychotic Symptom Rating Scale (PSYRATS), Characteristics of Delusion Rating Scale, and the Belief Rating Scale. At least three patients attended each group, satisfaction scores were high, and no harm to patients was identified. With reference to effectiveness, the pre-baseline period showed virtually no change. In contrast, across the EI-GCBTp treatment period, the PSYRATS total demonstrated a statistically significant decrease in delusional severity (p &lt; 0.01), a 31% symptom reduction, and a large effect size (Cohen's d = 1.2, 95% confidence interval = −2.53 to 0.05), statistically significant across four delusion dimensions. EI-GCBTp appears feasible, acceptable, safe, and preliminary uncontrolled effectiveness results suggest merit for larger-scale more rigorous testing of this treatment format for possible dimensional improvements of persistent delusions.</jats:p