Expressed emotion as an assessment of family environment with mothers and fathers of 1-year-old children.

Background: High levels of expressed emotion (EE) in parents have been found to put children at risk for emotional and behavioural problems. However, the majority of existing studies have focused on mothers of school-aged children and adolescents rather than younger children, and have only rarely included fathers. Methods: The present study examined the reliability of EE in mothers and fathers of 1-year old children. It also investigated whether depression and marital problems in the postnatal period predicted EE toward the child at 12 months. EE was assessed with the Preschool Five Minute Speech Sample in 163 families. Results: The rater-interrater and code-recode reliability was high for most EE dimensions. Mothers and fathers were found to display quite similar EE scores. Regression analyses showed that depression and couple relationship significantly predicted EE in mothers, but not fathers. Conclusions: The findings suggest that EE provides a reliable and useful assessment of the family environment in families of young children. © 2012 John Wiley & Sons Ltd

No moderating effect of 5-HTTLPR on associations between antenatal anxiety and infant behavior.

OBJECTIVE: Maternal antenatal anxiety is associated with an increased risk of behavioral disturbances in offspring. Recent work has suggested that the effect of maternal antenatal anxiety on infant temperament at 6 months is moderated by the serotonin transporter polymorphism 5-HTTLPR, with carriers of the short allele more susceptible to the adverse behavioral outcomes of maternal antenatal anxiety. These findings, however, are yet to be replicated and extended beyond infancy. The aim of the current study was to assess this same potential moderator (5-HTTLPR) in a large population-based cohort study, and to determine whether or not the effects persist into childhood and early adolescence. METHOD: Data from the Avon Longitudinal Study of Children and Parents (ALSPAC) cohort (N = 3,946) were used to assess whether the 5-HTTLPR genotype moderated the association between self-reported maternal antenatal anxiety (Crown Crisp Index) in pregnancy, and child temperament at 6 months (Infant Temperament Questionnaire), and also later behavioral and emotional problems on the Strengths and Difficulties Questionnaire from age 4 to 13 years. RESULTS: We found no evidence to suggest that the 5-HTTLPR polymorphism moderated the effects of maternal antenatal anxiety on infant temperament at 6 months or infant behavioral and emotional problems from childhood through to adolescence. CONCLUSION: Our results, based on a large prospective community sample that assessed children from infancy to early adolescence, provide a thorough test of, but no evidence for, a genetic moderation of the effects of maternal antenatal anxiety by 5-HTTLPR

Parenting and HIV

With the widespread use of antiretroviral therapy and successful prevention of mother-to-child transmission the development of HIV-negative children with HIV-positive parents has become an important focus. There is considerable evidence that children’s developmental risk is heightened because a parental HIV-diagnosis is associated with a range of potential problems such as depression, stigma and financial difficulties. Up to a third of children in sub-Saharan Africa (SSA) are cared for by an HIV-positive parent or caregiver. We review the mechanisms by which HIV affects parenting including its negative effects on parental responsiveness in the early years of parenting and parental avoidant coping styles and parenting deficits in the later years. We describe low-cost parenting interventions suited for low resourced HIV endemic settings

Parenting and HIV

With the widespread use of antiretroviral therapy and successful prevention of mother-to-child transmission the development of HIV-negative children with HIV-positive parents has become an important focus. There is considerable evidence that children’s developmental risk is heightened because a parental HIV-diagnosis is associated with a range of potential problems such as depression, stigma and financial difficulties. Up to a third of children in sub-Saharan Africa (SSA) are cared for by an HIV-positive parent or caregiver. We review the mechanisms by which HIV affects parenting including its negative effects on parental responsiveness in the early years of parenting and parental avoidant coping styles and parenting deficits in the later years. We describe low-cost parenting interventions suited for low resourced HIV endemic settings

Psychometric properties of the Generalized Anxiety Disorder Questionnaire - IV (GAD-Q-IV) in postpartum mothers

Generalized Anxiety Disorder (GAD) is a mental disorder where the main feature is persistent and impairing worry. GAD symptoms are common for women during the postpartum period and GAD prevalence rates have been reported as higher in postpartum mothers than in the general population. Currently, little psychometric evidence exists for a screening measure to detect the possible presence of diagnosable GAD for postpartum women. The purpose of this investigation was to gather psychometric information for the Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) with a sample of postpartum mothers. Factor analyses were conducted to determine the factor structure of the GAD-Q-IV in postpartum women. Receiver operating characteristic (ROC) analysis was used to determine a range of potential GAD-Q-IV cut-off scores for detecting the likely presence of GAD in postpartum women. Results from this study provided evidence to justify a one-factor structure for GAD-Q-IV responses from postpartum women, which demonstrated structural, metric, and scalar invariance over time. Findings from these analyses provided evidence of incremental validity as there was a significant increase in predicting GAD diagnoses when GAD-Q-IV responses were used compared to another measure of postpartum depression. Lastly, using ROC analysis, a range of GAD-Q-IV cut-off scores was determined that can be applied to screen for the likely presence or absence of GAD in postpartum women. The evidence presented in this study suggests that the GAD-Q-IV could be a viable screening measure used to identify the likely presence of GAD in postpartum women so that further evaluations and treatments can be recommended

Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study

Background: Surveillance of antenatal depression in low and middle-income countries (LMIC) is still limited. Identification of women at high risk of antenatal depression is urgently needed to plan appropriate interventions. The aim of the present study was to identify predictors and correlates of antenatal depression among Brazilian women. Methods: All women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date between 1 January and 31 December 2015, were invited to take part in the study. Eligible pregnant women were recruited from health services. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more defined antenatal depression. Outcomes: Information on antenatal depression was available for 4130 women. Mean and median EPDS scores were 7.6 (SD 5) and 7, respectively. The prevalence of antenatal depression was 16% (95%CI 14.9-17.1). After adjustment for potential confounders, low maternal education, older age, non-white skin color, not living with a partner, unplanned pregnancy, alcohol consumption during pregnancy, higher number of children and a history of depression were found to be associated with antenatal depression. Interpretation: Antenatal depression prevalence is higher among Brazilian women than women from high-income countries but similar to other LMIC populations. Our study identifies relevant predictors and correlates that may be considered potential targets to plan intervention strategies for disease management in the context of a middle-income country

Paternal depression: an examination of its links with father, child and family functioning in the postnatal period

Background: Maternal depression is common and is known to affect both maternal and child health. One of the mechanisms by which maternal depression exerts its effects on child health is through an increased rate of parental disharmony. Fathers also experience depression, but the impact of this on family functioning has been less studied. The aim of this study was to investigate the association between paternal depressive disorder and family and child functioning, in the first 3 months of a child's life. Methods: A controlled study comparing individual and familial outcomes in fathers with (n = 54) and without diagnosed depressive disorder (n = 99). Parental couple functioning and child temperament were assessed by both paternal and maternal report. Results: Depression in fathers is associated with an increased risk of disharmony in partner relationships, reported by both fathers and their partners, controlling for maternal depression. Few differences in infant's reported temperament were found in the early postnatal period. Conclusion: These findings emphasize the importance of considering the potential for men, as well as women, to experience depression in the postnatal period. Paternal symptoms hold the potential to impact upon fathers, their partners, and their children

Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study

Background: Surveillance of antenatal depression in low and middle-income countries (LMIC) is still limited. Identification of women at high risk of antenatal depression is urgently needed to plan appropriate interventions. The aim of the present study was to identify predictors and correlates of antenatal depression among Brazilian women. Methods: All women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date between 1 January and 31 December 2015, were invited to take part in the study. Eligible pregnant women were recruited from health services. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more defined antenatal depression. Outcomes: Information on antenatal depression was available for 4130 women. Mean and median EPDS scores were 7.6 (SD 5) and 7, respectively. The prevalence of antenatal depression was 16% (95%CI 14.9-17.1). After adjustment for potential confounders, low maternal education, older age, non-white skin color, not living with a partner, unplanned pregnancy, alcohol consumption during pregnancy, higher number of children and a history of depression were found to be associated with antenatal depression. Interpretation: Antenatal depression prevalence is higher among Brazilian women than women from high-income countries but similar to other LMIC populations. Our study identifies relevant predictors and correlates that may be considered potential targets to plan intervention strategies for disease management in the context of a middle-income country

Paternal depression: an examination of its links with father, child and family functioning in the postnatal period

Background: Maternal depression is common and is known to affect both maternal and child health. One of the mechanisms by which maternal depression exerts its effects on child health is through an increased rate of parental disharmony. Fathers also experience depression, but the impact of this on family functioning has been less studied. The aim of this study was to investigate the association between paternal depressive disorder and family and child functioning, in the first 3 months of a child's life. Methods: A controlled study comparing individual and familial outcomes in fathers with (n = 54) and without diagnosed depressive disorder (n = 99). Parental couple functioning and child temperament were assessed by both paternal and maternal report. Results: Depression in fathers is associated with an increased risk of disharmony in partner relationships, reported by both fathers and their partners, controlling for maternal depression. Few differences in infant's reported temperament were found in the early postnatal period. Conclusion: These findings emphasize the importance of considering the potential for men, as well as women, to experience depression in the postnatal period. Paternal symptoms hold the potential to impact upon fathers, their partners, and their children