Evaluation of Possums Sleep Intervention: A Pilot Feasibility Study : A Pilot Feasibility Study

The first year with a child is one of the most challenging times for mothers due to repeated awakenings typical for young infants. Research has shown that persistent fragmented sleep increases a mother’s risk for low overall well-being, which can challenge the mother-infant relationship. In an effort to improve sleep for both mother and infant, healthcare providers often recommend infant behavioral sleep interventions. The primary focus of this pilot study was to assess the feasibility of the Possums Sleep Intervention, a psychoeducational group workshop for women with infants between the ages of 0-6 months. A second goal of the study was to evaluate the potential of the Possums curriculum in improving maternal and infant sleep and self-reported mother-infant emotional availability. Participants were 24 mothers with their 0-6 month old infants assessed at the start of the study and again at the completion of the 4-week workshop. Results showed improvements in the perceived emotional availability in the mother-infant relationship; however, positive effects related to maternal or infant sleep were only on a trend level.Peer reviewe

“A window of opportunity” : Parenting and addiction in the context of pregnancy

Purpose of Review Maternal prenatal substance use presents a multilevel risk to child development and parenting. Although parenting interventions are increasingly integrated into substance use treatment, prenatal parenting processes have not received equal attention within these interventions. This article aims to synthesize the evidence on the specific prenatal risk factors affecting the development of early parenting of substance-using mothers, as well as interventions focusing on those factors. Recent Findings Both neurobiological and psychosocial risk factors affect the prenatal development of parenting in the context of maternal substance use. Maternal–fetal attachment, mentalization, self-regulation, and psychosocial risks are important in treatment and highly intertwined with abstinence. Although parenting interventions seem to be highly beneficial, most studies have not differentiated between pre- and postnatal interventions or described pregnancy-specific intervention elements. Summary Due to the salience of pregnancy in treating substance-using parents, interventions should begin prenatally and include pregnancy-specific parenting focus. Further research on prenatal interventions is warranted.Peer reviewe

Preschool children’s coping and caregiver support in families with maternal substance misuse : A qualitative study

Maternal substance misuse affects caregiving, which influences children’s coping skills. However, little is known about how children of mothers with substance misuse describe their coping in stressful situations. We studied coping and caregiver support among 29 children 4 years of age recruited from a children’s health clinic serving families with maternal substance misuse in Finland. Children completed a revised Attachment Story Completion Task that we examined with qualitative content analysis. We identified children’s experiences with coping in stressful situations with optimal and non-optimal caregiver support. Experiences with optimal caregiver support included (a) empathy, (b) solicitude, (c) intimacy, (d) reassurance, (e) being a role model, (f) concrete help, and (g) shared joy. Ones with non-optimal caregiver support included (a) punishment, (b) abandonment, (c) unresponsiveness, (d) physical aggression, (e) aggressive protection, and (f) parentification. Children’s strategies for coping without caregiver involvement were (a) magic, (b) avoidance, (c) inappropriate laughing, (d) self-reliance, or (e) a lack of strategy. Our findings highlight that preschool children of mothers with substance misuse employ various coping strategies in stressful situations that either include caregiver support or indicate non-optimal support. Children also tended to use maladaptive coping strategies when a caregiver was not involved. Understanding children’s coping with stress in families with maternal substance misuse is essential to supporting their socioemotional development and providing adequate interventions.publishedVersionPeer reviewe

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome : Comparing Results From Two Different RF Measures

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.Peer reviewe

Raskaudenaikainen huumeriippuvuus heijastuu äidin hyvinvointiin ja lapsen sosioemotionaaliseen kehitykseen

Vertaisarvioitu. English summary.Lähtökohdat : Tutkimus seurasi 51:tä avohoidon interventioita saavaa huumeriippuvaista äitiä ja 50 ¬normatiivista verrokkia loppuraskaudesta lapsen kouluikään. Tutkimme äidin huumeriippuvuuden lyhyt- ja pitkäaikaisvaikutuksia äidin ja lapsen hyvinvointiin ja lapsen kehitykseen. Menetelmät : Äidin mielenterveyttä tutkittiin kyselylomakkeilla, äiti-lapsivuorovaikutusta emotionaalisen saatavillaolon videomenetelmällä sekä lapsen kognitiivista ja sosioemotionaalista kehitystä äidin raportoimana ja psykologisin testein vauva- ja kouluiässä. Tulokset : Huumeriippuvaisilla äideillä oli enemmän masennus- ja ahdistusoireita varhaisvaiheissa ja enemmän vakavia päihde- ja mielenterveysongelmia lasten kouluiässä kuin verrokeilla. Heillä oli enemmän vuorovaikutusongelmia lapsen kanssa sekä vauva- että kouluiässä. Vuoden iässä lasten kehityksessä ei ollut eroja, mutta kouluiässä huumeryhmän lapsilla oli enemmän tarkkaavuus- ja mielenterveysoireita. Päätelmät : Varhaisen äitiyden tuki lisäsi äidin emotionaalista saatavuutta lapselleen, ja huumeiden käytön vaikutuksille altistuneiden lasten kehitys eteni hyvin ensimmäisen vuoden aikana. Se kuitenkin vaarantui kuormittavien kasvuolosuhteiden jatkuessa. Lasten psyykkistä kehitystä tulisi seurata ja tukea koko perhettä pitkäjänteisesti eri kehitysvaiheissa.Peer reviewe

Vauvojen huostaanotto kehityksellisenä ja tutkimusperustaisena kysymyksenä

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Dynamics of attachment and emotion regulation in daily life : uni- and bidirectional associations

Attachment theory proposes that the activation of the attachment system enacts emotion regulation (ER) to maintain security or cope with insecurity. However, the effects of ER on attachment states and their bidirectional influences remain poorly understood. In this ecological momentary assessment study, we examined the dynamics between attachment and ER. We hypothesised that attachment states and ER influence each other through time. Specifically, we hypothesised bidirectional short-term cycles between state attachment security and reappraisal, state attachment anxiety and rumination, and state attachment avoidance and suppression. We also tested how trait attachment is related to state attachment and ER. One hundred twenty-two participants (M-age = 26.4) completed the Experiences in Close Relationship-Revised and reported state attachment and ER seven times daily for seven days. The results were only partly consistent with our cycle hypotheses yet revealed a cycle between low state attachment security and rumination that was attenuated by reappraisal. Moreover, rumination and suppression predicted increased insecure states, and reappraisal predicted increased secure and insecure states. Finally, trait attachment showed associations with state attachment and ER. Our study suggests regulatory dynamics between attachment and ER and opens important questions about their functional relationship in maintaining attachment-related behavioural patterns and emotional well-being.Peer reviewe

Adolescent Attachment Profiles Are Associated With Mental Health and Risk-Taking Behavior

This person-oriented study aimed to identify adolescents’ hierarchical attachment profiles with parents and peers, and to analyze associations between the profiles and adolescent psychosocial adjustment. Participants were 449 Finnish 17–19-year-olds reporting their attachments to mother, father, best friend, and romantic partner and details on mental health (internalizing symptoms, inattention/hyperactivity, and anger control problems) and risk-taking behavior (substance use and sexual risk-taking). Attachment was measured with Experiences in Close Relationships – Relationship Structures (ECR-RS); internalizing, inattention/hyperactivity, and anger control problems with Self-Report of Personality — Adolescent (SRP—A) of the Behavior Assessment System for Children, third edition (BASC-3); substance use with the Consumption scale of the Alcohol Use Disorders Identification Test (AUDIT-C) and items from the Finnish School Health Promotion Study; and sexual risk-taking behavior with the Cognitive Appraisal of Risky Events (CARE). Latent profile analysis identified five attachment profiles: “All secure” (39%), “All insecure” (11%), “Parents insecure – Peers secure” (21%), “Parents secure – Friend insecure” (10%), and “Parents secure – Partner insecure” (19%). “All insecure” adolescents showed the highest and “All secure” adolescents the lowest levels of mental health problems and substance use. Further, parental attachment security seemed to specifically prevent substance use and anger control problems, while peer attachment security prevented internalizing problems. Our findings help both understand the organization of attachment hierarchies in adolescence and refine the role of specific attachment relationships in psychosocial adjustment, which can be important for clinical interventions in adolescence.Peer reviewe

Determinants of adolescent sleep : Early family environment, obstetric factors, and emotion regulation

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