Paternal Mental Health: Why Is It Relevant?

The Impact of Social Support: Fathers' Depressive Symptoms and Parenting Stress

Parental depressive symptoms are positively correlated with levels of parenting stress. Greater parenting stress predicts negative outcomes for both parents and children, and worse family functioning. Social support is a key protective factor against depressive symptoms; however, minimal research has examined the relationship between social support, paternal depressive symptoms, and parenting stress among fathers. Seventy-nine fathers of children, aged 2-6 years old, completed an online survey. Mediation analyses, using Hayes' PROCESS macro, determined significant indirect effects of social support on parenting stress through paternal depressive symptoms. Our findings elucidate the need for social support from family, friends, and significant others to improve depressive symptomology and parenting stress among fathers. We encourage fathers to seek support from friends, family, and their partners, to benefit their mental health and the family unit. Clinicians working with fathers should be aware of the possibility of co-occurring problems related to these factors.

Prenatal Care of Parents Who Continued Pregnancies With Down Syndrome, 2003-2022

Parents of children with Down syndrome have historically reported poor experiences receiving a prenatal diagnosis. In a 2003 survey, mothers reported that their physicians pitied them, emphasized negative aspects of Down syndrome, and encouraged them to terminate the pregnancy. This study assesses whether parents' perceptions have since improved. Community-based organizations that had distributed the original 2003 survey distributed a similar survey to parents who have had a child with Down syndrome since 2003. Compared to the 2003 survey, parents continued to report dissatisfaction with their prenatal medical care (N = 60). Though subgroups became likelier to view their testing experience positively, parents' experiences worsened on certain metrics. Most parents reported dissatisfaction when providers conveyed pity or attempted to influence their decision-making about the pregnancy. Interventions to date have failed to improve parents' perceptions of their prenatal medical support, urging new strategies to improve parents' care.

Paternal perinatal mental health support: fathers' perspectives on barriers, facilitators, and preferences

The perinatal period is a time of increased vulnerability to psychological distress. Paternal mental wellbeing is linked to both maternal and child wellbeing. Paternal mental health problems are common in the perinatal period. Men, however, report a lack of therapeutic support. This study focused on the experiences of fathers with poor mental health during the perinatal period, who had a biological child under the age of two and a half, and explored their perceptions of barriers and facilitators to, and preferred sources of, mental health support. Semi-structured interviews were undertaken with eight participants and an experiential thematic analysis conducted. Three main themes were identified; "Fathers are not the priority (sub-themes of "Deprioritised", "Masculinity"), "The perinatal period is unique" (sub-themes of "Needing to be prepared", "Stretched resources", "Disconnection from partner") and "Dad specific support" (sub-themes of "Someone to speak to", "Actively offered"). These themes identified barriers of exclusion by, and lack of information from, services, prioritisation of the mother and baby, stigma, masculine norms, and emotional, financial, and time pressure. Facilitators identified included healthcare professionals focusing on the father's mental health and providing signposting, and fathers receiving support from their partner. Participants valued opportunities for greater social connection but their preferred mental health provision was one-to-one, personalised support that was actively offered and targeted specifically at fathers. This study highlights the universal need for greater awareness of paternal mental health in the perinatal services and the necessity for accessible, appropriate, and timely support.

Longitudinal associations of depressive symptoms in father-mother-child triads: A cross-lagged panel network analysis

BACKGROUND

The current study aimed to test symptom-level associations underlying the concordance of depressive symptoms in father-mother-child triads. We used network analysis to examine central and bridge symptoms in the contemporaneous depressive network of triads and additionally assessed prospective relationships in temporal depressive networks.

METHODS

We included 881 father-mother-child triads with children aged 10 to 14 years from the China Family Panel Studies. Depressive symptoms were assessed by the short version of the Center for Epidemiologic Studies Depression Scale (CESD) across three different time points from 2012 to 2018. Contemporaneous and temporal networks (2012 → 2016 and 2016 → 2018) were estimated to examine the cross-sectional and longitudinal relationships between symptoms.

RESULTS

Within the contemporaneous network, "feeling depressed" was the most central symptom. Parental "could not get going" was identified as the bridge symptom across almost all cross-sectional networks. In the temporal network (2012 → 2016), fathers' symptoms were likely to influence mothers' symptoms. Over time (2016 → 2018), offspring symptoms (such as "could not get going") began to affect their parents. Certain symptoms were more influential than others: for instance, fathers' "could not get going" significantly predicted mothers' "bad life" and feeling that "everything was an effort" in 2016. Fathers' "could not get going" in 2016 significantly predicted children's "bad life" and "lack of happiness" in 2018.

LIMITATIONS

A self-reported scale other than clinical diagnosis was used to assess depressive symptoms.

CONCLUSIONS

The current study demonstrates that family members mutually influence each other in specific depressive symptoms. Therefore, family-based treatments that combat depression in youth should also involve both parents and target core depressive symptoms to disrupt the cycle of depression within the family context.

First-Time Father's Risk Factors of Paternal Perinatal Psychological Distress: A Scoping Review

Fathers can experience psychological distress during the paternal perinatal period. The effects of paternal perinatal psychological distress (PPPD) are multileveled. Little research is available about PPPD in first-time fathers. The purpose of this review is to explore the literature on risk factors contributing to PPPD in first-time fathers. The Arksey & O'Malley framework was used to guide this scoping review. The Population, Concept, and Context (PCC) framework was used for answering the review question "What evidence is available about factors contributing to PPPD in first-time fathers?" Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO, and PubMed) were used to retrieve relevant, full-text, English references from January 01, 2020, to January 04, 2023. A data extraction tool was developed to identify risk factors assessed in the included studies. The Socio-Ecological Model (SEM) was used for analyzing the extracted data according to the four socio-ecological levels, i.e., individual, relationship, community, and societal. A total of 18 references reporting on 16 studies were included in the review. Fifty-six tools were used for assessing the risk factors contributing to PPPD in first-time fathers. Limited understanding was established about risk factors because tools lacked gender sensitivity. Risk factors aligned with 12 domains (e.g., psychological, relationship, social, and physical). Most domains corresponded with the individual level of SEM. Only two domains corresponded with the societal level of SEM. The literature indicates there are few studies about PPPD experienced by first-time fathers. This scoping review adds to the literature on the mental health care gaps for this population. Further research on measuring PPPD may improve individual and family functioning during the perinatal period.

Paternal Depression and Anxiety During the COVID-19 Pandemic

The COVID-19 pandemic significantly impacted the lives of families worldwide. Findings suggest a substantial impact of the COVID-19 pandemic on maternal mental health. Yet, much less is known about the impact of COVID-19 on paternal mental health. This study describes depression and anxiety and risk and protective factors among fathers of young children largely residing in Canada during the COVID-19 pandemic. Fathers (N = 70) of children 0 to 8 years old self-reported depression (EPDS, CESD, CESD-R) and anxiety (PASS, GAD-7) symptoms, while mothers (N = 236) provided reports of paternal depressive symptoms using the EPDS-P. Fathers evidenced clinically significant depression (37.1%) and anxiety (22.9%). Linear regression models with significant bivariate correlates indicated that depressive symptoms were associated with a mental health history and experiencing recent stressful events in the past month, while anxiety symptoms were related to mental health history over and above other correlates. Mother-reported paternal depression was prevalent (61.9%) and associated with lower mother-reported marital quality and higher maternal depressive symptoms. Of the fathers reporting clinically significant mental health concerns, less than one-third reported accessing mental health services. Paternal depression and anxiety symptoms were elevated during the pandemic, when compared to pre-pandemic comparisons. The risk and protective factors for paternal depression and anxiety included mental health history, recent stressful events, maternal marital quality, and maternal depressive symptoms. Longitudinal studies evaluating the persistent impact of the COVID-19 pandemic on paternal mental health are needed to inform continued efforts to repair the pandemic's impact on family wellbeing.

A Group Parenting Intervention for Male Postpartum Depression: A Cluster Randomized Clinical Trial

Importance

Male postpartum depression is prevalent across populations; however, there is limited evidence on strategies to address it, particularly in low-income settings.

Objective

To evaluate the effectiveness of Learning Through Play Plus Dads (LTP + Dads), a nonspecialist-delivered psychosocial intervention, in improving symptoms of male postpartum depression compared to treatment as usual.

Design, Setting, and Participants

This cluster randomized clinical trial was conducted in Karachi, Pakistan, between June 2018 and November 2019. Assessors were blind to treatment allocation. Participants were recruited from 2 large towns in the city of Karachi via basic health units. Fathers aged 18 years and older with a DSM-5 diagnosis of major depressive episode and a child younger than 30 months were recruited. Of 1582 fathers approached, 1527 were screened and 357 were randomized in a 1:1 ratio to either the intervention or treatment as usual; 328 were included in the final analysis. Data were analyzed from April to June 2022.

Interventions

LTP + Dads is a manualized intervention combining parenting skills training, play therapy, and cognitive behavior therapy. The intervention was delivered by community health workers via 12 group sessions over 4 months.

Main Outcomes and Measures

The primary outcome was change in 17-item Hamilton Depression Rating Scale score at 4 months. Secondary outcomes included anxiety symptoms; parenting stress; intimate partner violence; functioning; quality of life; and child social, emotional, and physical health outcomes. Assessments were completed at baseline and 4 and 6 months postrandomization.

Results

Of the 357 fathers included (mean [SD] age, 31.44 [7.24] years), 171 were randomized to the intervention and 186 to treatment as usual. Participants randomized to the intervention demonstrated significantly greater improvements in depression (group difference ratio [GDR], 0.66; 95% CI, 0.47 to 0.91; P < .001), anxiety (GDR, 0.62; 95% CI, 0.48 to 0.81; P < .001), parenting stress (GDR, -12.5; 95% CI, -19.1 to -6.0; P < .001), intimate partner violence (GDR, 0.89; 95% CI, 0.80 to 1.00; P = .05), disability (GDR, 0.77; 95% CI, 0.61 to 0.97; P = .03), and health-related quality of life (GDR, 12.7; 95% CI, 0.17 to 0.34; P < .001) at 4 months. The difference in depression and parenting stress was sustained at 6 months. Children of fathers randomized to the parenting intervention had significantly greater improvements in social-emotional development scores (mean difference, -20.8; 95% CI, -28.8 to -12.9; P < .001) at 6 months.

Conclusions and Relevance

The psychosocial parenting intervention in this study has the potential to improve paternal mental health and child development in Pakistan. Further studies in other populations and with longer follow-up are warranted.

Trial Registration

ClinicalTrials.gov Identifier: NCT03564847.

Perceptions, Attitudes, and Experiences Regarding Mental Health Care Among Young Black Men

Mental health service research has insufficiently examined young Black men's (YBM; ages 18-25) mental health care consumption patterns, obscuring their unmet mental health needs. Concurrently, the literature indicates YBM face unmet service needs that impede their ability to address numerous negative social determinants of health (e.g., high adverse childhood experiences, low socioeconomic status, etc.). Because preventing or treating mental health issues at or near onset can dramatically improve outcomes, this study utilizes thematic analysis to elucidate the factors most consequential to YBM's experiences as mental health service consumers. Eight YBM (Mage = 21.1 years) were purposively recruited to participate in semi-structured interviews to discuss attitudes regarding mental health care and cultural attitudes, gender-based attitudes, structural racism, and transition to adulthood. Of the eight participants, five had active health insurance, six had received mental health services before age 18 years, and three were currently receiving mental health services. Participants were attuned to their mental health needs and rejected stigmatizing attitudes about mental illness. Most participants reported hesitation about taking psychiatric medications. Participants had limited resources and encountered structural barriers to accessing mental health services. Most participants did not perceive racism as a source of mental distress. Culturally informed, consumer-oriented research is critical to tailoring and strengthening YBM's mental health care. Future research should employ a population health approach to promote YBM's mental health service uptake in adulthood.

The impact of paternal mental illness on child development: an umbrella review of systematic reviews and meta-analyses

Whilst there is growing evidence highlighting the importance of paternal mental illness (PMI) on child development, this relationship still remains under-studied and often over-looked. Considering the increasingly active role of fathers in their children's upbringing, a comprehensive overview of the impact of PMI on child development is overdue. This study aimed to combine and synthesise currently available evidence on the relationship between PMI and multiple domains of child development. Narrative synthesis of systematic reviews and meta-analyses on the relationship between PMI and child development (mental health and social, emotional, language, cognitive or adaptive behaviour), published between 1980 to December 2021, was conducted in line with PRISMA 2020 guidelines. Review quality was assessed based on AMSTAR-2 criteria and respective study confidence was interpreted in line with GRADE scoring. All relevant meta-analytic effect sizes were converted to odds ratios (OR) and grouped using a random effects model. Grouped meta-analyses saw PMI to have a significant, detrimental effect on all studied domains of child development [OR: 1.54; 95% CI (1.36-1.74)]. Subgroup analyses saw PMI affecting both internalising [OR: 1.62; 95% CI (1.27-2.08)] and externalising [OR: 1.63; 95% CI (1.28-2.08)] child behaviours to a similar extent. However, included reviews were of poor methodological quality, demonstrating either low or critically low confidence. These results show a consistent and influential effect of PMI on child development. The relationship between fathers' mental illness and child development warrants further investigation, as current research is limited in scope, particularly regarding cognitive domains of child development and non-affective PMI diagnoses.

Exploring paternal postpartum depression and contributing factors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Paternal postpartum depression (PPD) is a significant yet often neglected mental health issue affecting fathers during the postpartum period. While maternal postpartum depression is extensively studied, the psychological challenges faced by new fathers, particularly in resource-limited settings like Ethiopia, receive considerably less attention. Paternal postpartum depression not only impacts fathers' well-being but also affects the health and development of their children and their relationships with partners. Understanding the prevalence of paternal postpartum depression and its underlying causes in Ethiopia is essential for developing effective healthcare policies and tailored support programs for new fathers. The goal of this meta-analysis and systematic review is to compile the information currently available regarding the prevalence of and contributing factors to postpartum depression in Ethiopian fathers.

METHODS

This study adhered to the PRISMA guidelines and focused on research from Ethiopia. A comprehensive search was performed across multiple databases, including Google, Google Scholar, PubMed, Web of Science, and Medline. Data were systematically collected using a structured checklist and analyzed with STATA version 11. To assess heterogeneity, the Cochrane Q test and I² statistic were applied. Publication bias was also checked using Egger's regression analysis, a funnel plot, and Begg's test.

RESULTS

Five studies with a total of 2,055 participants were included in the meta-analysis. The pooled prevalence of paternal postpartum depression in Ethiopia was 20.86% (95% CI: 16.43-25.29). Significant factors associated with paternal postpartum depression included low family income (OR = 3.04, 95% CI: 1.46-6.32), substance use (OR = 2.96, 95% CI: 1.63-5.37), poor social support (OR = 4.28, 95% CI: 2.53-7.23), unplanned pregnancy (OR = 3.42, 95% CI: 2.24-5.24), and infant sleep problems (OR = 4.78, 95% CI: 2.35-9.73). Heterogeneity was high (I² = 97.9%, P < 0.05). A subgroup analysis was conducted to better understand the variations among the primary studies.

CONCLUSION

The study reveals a significant prevalence of paternal postpartum depression in Ethiopia, highlighting key risk factors such as low family income, substance use, poor social support, unplanned pregnancies, and infant sleep difficulties. These findings emphasize the need for routine depression screening for fathers, improved social support programs, education on infant sleep management, and further research to develop targeted prevention and treatment strategies.

The importance of perinatal non-birthing parents' mental health and involvement for family health

Perinatal mental health research typically focuses on the birthing parent's experiences and their influence on birth/child outcomes, while not considering non-birthing parents in similar depth. Non-birthing parents are also at increased risk for mental illness during the perinatal period, and non-birthing parents' health and involvement affect the health of birthing people, fetuses, and newborns, necessitating greater understanding of non-birthing parents' contributions to family functioning. This review examines perinatal mental health disorders in non-birthing parents, their relationship quality with the birthing parent, and how the non-birthing parent's mental health and involvement affects the health outcomes of the birthing parent and the child. Recommendations are provided for healthcare professionals who work with perinatal patients and their families to engage non-birthing parents, learn about non-birthing parent health, and facilitate connections to care. By doing so, professionals working with perinatal patients can optimize health outcomes for their patients and the family as a whole.

Long-term effects of unintended pregnancy on children: Findings from the Dutch prospective birth-cohort Amsterdam born children and their development study

Several studies investigated short-term risks of children born from unintended pregnancies, however evidence about long-term risks is lacking. We aimed to examine whether children born from unintended pregnancies experience psychosocial problems up into adolescence. This study is based on the longitudinal birth cohort study 'Amsterdam Born Children and their Development' (n = 7784). Unintended pregnancy was measured as a multidimensional construct, based on self-reports on the extent of pregnancy mistiming ('This pregnancy happened too soon'), unwantedness ('I did not want to be pregnant (anymore)') and unhappiness ('I am happy to be pregnant'; recoded). Further, children's psychosocial problems were measured with the Strengths and Difficulties Questionnaire, at 5-6, 11-12 and 15-16 years old. Multiple over-time associations between unintended pregnancy and children's psychosocial problems were analysed using Structural Equation Modelling, while controlling for confounders. Results showed that pregnancy mistiming was a significant predictor of internalizing (β = 0.10, p < 0.001) and externalizing problems (β = 0.07, p = 0.006) and unwanted pregnancy of internalizing problems (β = 0.13, p < 0.001) at 5-6 years. These associations were substantially mediated by maternal mental health and poorer maternal bonding. Associations were no longer present at 11-12 and 15-16 years. Thus, we conclude that children born from unintended pregnancies experience more psychosocial problems at 5-6 years, but no longer at 11-12 and 15-16 years. Unintended pregnancies often coincide with maternal mental health problems and socioeconomic factors. Most importantly, the associations between unintended pregnancy and children's psychosocial problems are influenced by maternal mental health and poorer bonding. Therefore it is important to improve maternal mental health and bonding for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy per se.

Paternal Postpartum Depression and Associated Factors Among Partners of Women Who Gave Birth in Seka Town, Southwest Ethiopia

Despite epidemiologic studies demonstrating the increased incidence of paternal postpartum depression, their emotional health is overlooked throughout their partner's pregnancy and postpartum period as postpartum depression has been traditionally construed as a disease of women. Traditional masculinity norms also result in a lack of recognition and barriers to the treatment of depression in men. This study is aimed to determine the prevalence and factors of paternal postpartum depression among fathers whose wives gave birth. A community-based cross-sectional study was conducted from July 7 to 17, 2023. The 288 sample size was estimated using a single population proportion formula and selected by random sampling technique. The data were exported from Kobo Toolbox and analyzed using SPSS version 26. Candidate variables were identified in bivariate at p < .25 for the multivariate analysis. A p < .05 and adjusted odds ratio (AOR) were used to determine the significance. A total of 280 partners participated making a 97.22% response rate. Paternal postpartum depression was 19.6%(95% confidence interval [CI] = [15.4%, 24.3%]). It was significantly associated with history of depression (AOR = 4.4, 95% CI = [1.7, 10.9]), unplanned pregnancy (AOR = 4.7, 95% CI = [1.9, 11.3]), alcohol consumption (AOR: 3.0, 95% CI = [1.3, 7.4]), infant sleeping problem (AOR: 3.0, 95% CI = [1.1, 8.9]), and mode of delivery (AOR: 3.0, 95% CI = [1.3, 7.6]). This study concluded that paternal postpartum depression was high. The researchers recommended the inclusion of men's mental health services like screening into women's postnatal health care.

Parents of children with Down syndrome reflect on their postnatal diagnoses, 2003-2022

A 2003 survey revealed the scope of mothers' dissatisfaction with their postnatal support following a diagnosis of Down syndrome (DS). Substantial proportions of mothers reported that providers conveyed diagnoses with pity, emphasized negative aspects of DS, and neglected to provide adequate materials explaining DS. This study follows up on the 2003 survey by assessing whether parents' experiences have improved. Four DS nonprofit organizations, which participated in the original study, distributed a mixed-methods survey to families who have had children with DS between 2003 and 2022. Quantitative analysis assessed correlations among responses and differences between the 2003 and 2022 survey groups. Open-ended responses were qualitatively analyzed. Compared to the 2003 findings, parents' perceptions of their postnatal care have not improved (N = 89). Parents are increasingly likely to report that their providers pitied them, omitted positive aspects of DS, and provided insufficient materials describing DS. Substantial proportions of parents reported fear (77%) and anxiety (79%), only 24% described receiving adequate explanatory materials, and parents were 45% likelier to report that physicians discussed negative aspects of DS than positive aspects. Qualitatively, substantial numbers of parents recounted insensitive conduct by providers. These results suggest that despite interventions, parents' experiences of postnatal diagnoses of DS have not improved over time. Certain provider behaviors-such as describing positive aspects of DS and providing comprehensive explanatory materials-can reduce fear and anxiety, pointing to directions for reform.

Relationship between personality traits and postpartum depression in Pakistani fathers

The previous studies have found an association between Big Five personality traits and postpartum depression in women. The present study aimed to find out an association between Big Five personality traits and postpartum depression in a sample of Pakistani fathers. A total of 400 Pakistani fathers who had birth of a child in the past 1 month to 1 year period and had been living with their married partners were recruited purposively by using Google Form based survey from the major cities of Pakistan. The Urdu translated versions of Big Five Personality Inventory (BFI) and Edinburgh Postnatal Depression Scale (EPDS) were used as the main outcome measures to assess the relationship between personality traits and postpartum depression. The results found a significant negative and moderate association between Big Five personality traits and paternal postpartum depression except openness which had a weak association and neuroticism which had a positive and moderate association with PPPD (r(398) = .45). The multiple linear regression analysis found that Big Five personality traits significantly predicted paternal postpartum depression (F(5, 394) = 53.33, p = .001) except openness (B = .007, p = .98). The analysis of variance (ANOVA) found significant differences in paternal postpartum depression for age of father (F(2, 397) = 6.65, p = .001, ηp2 = .03), spouse age (F(2, 393) = 5.97, p = .003, ηp2 = .02), employment type (F(2, 395) = 9.69, p = .001, ηp2 = .04) and time spent at home (F(2, 397) = 6.23, p = .002, ηp2 = .03) while there were found no significant differences for education (F(2, 397) = 1.29, p = .27, ηp2 = .006), marital duration (F(2, 397) = 2.17, p = .11, ηp2 = .01), and birth number of recent child (F(2, 397) = 1.48, p = .22, ηp2 = .007). The study concluded that Big Five personality traits are significantly correlated with and predict paternal postpartum depression except openness which did not predict paternal postpartum depression. The occurrence of paternal postpartum depression varied significantly for age of father, age of spouse, type of employment and time spent at home.

Caregiver and parent-child relationship during COVID-19: The mediator role of anxiety and life satisfaction

AIM

This research was conducted to evaluate the mediation effect of anxiety and life satisfaction on the relationship between Care burden and Parent Child Relationship in Turkish parents during the COVID-19 epidemic.

METHODS

The research was carried out with parents (221 women and 219 men) who have children between the ages of 6-18 living in Turkey. Data were collected in June-July 2021 using the demographic data form, "Care Burden Scale," "Pervasive Anxiety Disorder-7 Test," "Satisfaction with Life Scale," and "Parent Child Relationship Scale." Path analysis was used to analyse the relationships. In this study, structural equation modelling (SEM) was used to examine the path analysis.

RESULTS

It was found that the burden of care and anxiety of the parents and the parent-child conflict relationship were positively correlated and negatively correlated with the life satisfaction and parent-child closeness relationship (p < 0.05). Path model analyses revealed that the burden of care had a direct effect on anxiety and life satisfaction, and an indirect effect on the parent-child relationship, respectively.

CONCLUSIONS

It shows that parents' perceptions of how the COVID-19 pandemic is affecting their mental health have implications for parent and child well-being, with stronger relationships for low-income families. Anxiety and life satisfaction had a mediating effect between care burden and parent-child relationship. Given the demonstrable impact of COVID-19 on the parent-child relationship, this study may guide the planning of coping strategies and programmes focused on mental health.

Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian-Ukrainian War Outbreaks

The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one's relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian-Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents' opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance.

Perinatal Mental Health: Father Inclusion At The Local, State, And National Levels

Fathers occupy a dual role in the realm of perinatal mental health: partner and parent. In fathers' role as partners, their support for mothers during pregnancy and postpartum is associated with improved maternal mental health. In their role as parents, fathers themselves are vulnerable to perinatal mood and anxiety disorder. This article aims to advance awareness of paternal perinatal mental health issues and impacts on families. We first review the evidence on paternal perinatal mental health. This evidence includes the critical role played by fathers in maternal perinatal mental health, the prevalence of paternal perinatal mood and anxiety disorder, the impact of paternal mental health on child and family well-being, and screening and treatment approaches. Next, we offer recommendations for more inclusive approaches at the local, state, and national levels aimed at improving parental mental health and health outcomes for fathers, mothers, and babies.

The effects of flavonoid supplementation on the mental health of postpartum parents

Introduction

During the postpartum period, parents face psychological challenges and consequently, changes in mood and associated mood disorders have become increasingly prevalent in the 6-months following birth. Dietary flavonoids have been found to benefit mood and are therefore an appealing non-pharmacological option for potentially treating mood disorders in the postpartum. The aim of this study was to investigate whether a two-week dietary flavonoid intervention would improve mothers' and fathers' mental health in the immediate 6-month postpartum period.

Method

The study employed a randomised, parallel groups, controlled design to explore the effects of a flavonoid intervention vs. control group on several outcomes, including mood (PANAS), postpartum depression (EPDS), postpartum anxiety (PSAS-RSF-C) and quality of life (WHOQOL). Sixty participants (mothers n = 40, fathers n = 20) in the 6-month post-partum period were randomised to either a "flavonoid" or "control" condition. The flavonoid group were asked to add two flavonoid-rich foods (approximate flavonoid intake 218 mg/day) into their daily diet whilst controls (n = 23) were asked to continue with their usual diet for two-weeks (ClinicalTrials.gov (NCT04990622).

Results

Significant effects were found in the flavonoid group where mothers reported higher positive affect and lower postpartum depression after the two-week intervention relative to baseline. This finding is especially relevant as a clinical reduction in postpartum depression scores in the flavonoid group by an average 2.6 scoring points was observed, which equated to a reduction from "possible depression" at baseline to "little or no depression" at 2-weeks, which was not observed in the control group. Fathers' data was not analysed due to non-compliance with the intervention.

Discussion

This study provides evidence for the benefits of a dietary flavonoid intervention for mood and mental health in new mothers, supporting the utility of non-pharmacological, self-administrable changes to the diet for improving positive mood outcomes and reducing symptoms of postpartum depression in mothers during an especially challenging time. Further research for the effect of dietary interventions on paternal mental health is needed.

Clinical Trial Registration

ClinicalTrials.gov, identifier NCT04990622.

Paternal postnatal depression and parenting behaviours in the first year of life

BACKGROUND

Paternal postnatal depression (PPD) symptomology has been positively associated with poorer outcomes for children. One mechanism by which PPD is thought to influence child outcomes is through parenting. The current study investigated the association between paternal postnatal depressive symptoms and parenting behaviours.

METHOD

Fathers (N = 213) with an infant (mean age = 7 months, 46% female) between 2 and 12 months old were recruited through community and social media advertisements, as well as a paid survey recruitment website. Fathers completed a questionnaire on their symptoms of PPD and how they care for and raise their child (parental warmth, irritability, engagement in enrichment, play and safety behaviours).

RESULTS

Fathers experiencing greater levels of PPD symptomatology self-reported higher irritability, lower warmth and fewer safe parenting behaviours but did not report lower enrichment or play with their infants.

CONCLUSION

Overall, findings suggest that PPD symptomology may impact negatively on aspects of fathers' parenting behaviours. Further research using larger and more diverse samples is needed to assess the generalisability of these findings.

Longitudinal associations between paternal mental health and child behavior and cognition in middle childhood

Introduction

Paternal mental health has been associated with adverse consequences on offspring psychosocial development, and family environmental factors may partly explain those associations. To clarify this, we need comprehensive prospective studies, particularly in middle-childhood when the child enters school and is expected to make use of behavioral and cognitive skills as part of their interactions and learning.

Method

Using data from a sub-sample of the prospective 3D birth cohort study comprised of mother-father-child triads, and a follow-up of the parents and the children at 6-8 years of age (n = 61; 36 boys, 25 girls), we examined whether paternal anxious and depressive symptoms measured during the pregnancy period (i.e., prenatally) or concurrently when the child was assessed at 6-8 years old were associated with children's cognition/behavior.

Results

In contrast to our hypotheses, we found that greater prenatal paternal depressive symptoms predicted fewer child behavioral difficulties; and that greater concurrent childhood paternal depression or anxiety symptoms were associated with higher child full-scale IQ, controlling for the equivalent maternal mental health assessment and parental education. Father parenting perception did not mediate these associations, nor were they moderated by maternal mental health at the concurrent assessment, or paternal ratings of marital relationship quality.

Discussion

These findings suggest that higher symptoms of paternal mental health symptoms are associated with fewer child behavioral difficulties and higher cognitive performance in middle childhood. Potential clinical implications and future research directions are discussed.

An intergenerational examination of retrospective and current depression patterns among Black families

BACKGROUND

There is limited information regarding the intergenerational transmission of mental health among three generations (i.e., grandparents, parents, and children) of Black families. Given that intergenerational and kinship ties are integral in Black families, this study explores the context that might contribute to the generational transmission of mental health among Black families.

METHODS

The present study examined the retrospective family history of mental health among fathers and mothers, current reports of their depression, and their children's internalizing and depressive symptoms among a sample of 2530 Black families from the Future of Families and Child Wellbeing Study using waves 4 to 6. All analyses were conducted using STATA 15.1.

RESULTS

Focal children's maternal and paternal grandparents' history of mental health was associated with higher odds of depression in their mothers and fathers; in addition, child-internalizing symptoms were associated with a report of depression in maternal grandparents in waves 4 and 5. Children of mothers who were depressed had higher internalizing scores in waves 4, 5, and 6.

LIMITATIONS

This descriptive study did not account for how parenting might also be protective against childhood internalizing behaviors. A retrospective account may not fully encapsulate a complete understanding of mental health patterns.

CONCLUSIONS

In treating the mental and behavioral health of Black families, it is essential to focus on multiple generations of family health, given that family history is the strongest predictor of the youth's onset of depression. The utility of these findings in understanding psychological distress and strengths among Black families is discussed.

Non-birthing mothers' experiences of perinatal anxiety and depression: Understanding the perspectives of the non-birthing mothers in female same-sex parented families

OBJECTIVE

Partners of birthing mothers can themselves experience perinatal mental health (PMH) difficulties. Despite birth rates increasing amongst LGBTQIA+ communities and the significant impact of PMH difficulties, this area is under-researched. This study aimed to examine the experiences of perinatal depression and anxiety of non-birthing mothers in female same-sex parented families.

DESIGN

Interpretative Phenomenological Analysis (IPA) was used to explore the experiences of non-birthing mothers who self-identified as having experienced perinatal anxiety and/or depression.

SETTING AND PARTICIPANTS

Sevenparticipants were recruited from online and local voluntary and support networks for LGBTQIA+ communities and for PMH. Interviews were in-person, online or via telephone.

MEASUREMENTS AND FINDINGS

Six themes were generated. Distress was characterised by feelings of "Failure and Inadequacy in Role" (i.e., parent, partner and individual) and "Powerlessness and Intolerable Uncertainty" in their parenting journey. These feelings were reciprocally influenced by perceptions of the "Legitimacy of (Di)stress as a Non-birthing Parent", which impacted help-seeking. Stressors that contributed to these experiences were: "Parenting Without" a parental role template, social recognition and safety, and parental connectedness; and "Changed Relationship Dynamics" with their partner. Finally,participants spoke about "Moving Forward" in their lives.

KEY CONCLUSIONS

Some findings are consistent with the literature on paternal mental health, including parents' emphasis on protecting their family and experiencing services as focusing on the birthing parent. Others appeared distinct or amplified for LGBTQIA+ parents, including the lack of a defined and socially recognised role; stigma concerning both mental health and homophobia; exclusion from heteronormative healthcare systems; and the importance placed on biological connectedness.

IMPLICATIONS FOR PRACTICE

Culturally competent care is needed to tackle minority stress and recognise diverse family forms.

Paternal Perinatal Experiences during the COVID-19 Pandemic: A Framework Analysis of the Reddit Forum Predaddit

During the COVID-19 pandemic, new parents were disproportionately affected by public health restrictions changing service accessibility and increasing stressors. However, minimal research has examined pandemic-related stressors and experiences of perinatal fathers in naturalistic anonymous settings. An important and novel way parents seek connection and information is through online forums, which increased during COVID-19. The current study qualitatively analyzed the experiences of perinatal fathers from September to December 2020 through the Framework Analytic Approach to identify unmet support needs during COVID-19 using the online forum predaddit on reddit. Five main themes in the thematic framework included forum use, COVID-19, psychosocial distress, family functioning, and child health and development, each with related subthemes. Findings highlight the utility of predaddit as a source of information for, and interactions of, fathers to inform mental health services. Overall, fathers used the forum to engage with other fathers during a time of social isolation and for support during the transition to parenthood. This manuscript highlights the unmet support needs of fathers during the perinatal period and the importance of including fathers in perinatal care, implementing routine perinatal mood screening for both parents, and developing programs to support fathers during this transition to promote family wellbeing.

Recognition and CBT for Paternal Perinatal Depression in Primary Care: A Case Report

Perinatal depression is prevalent in primary care in the United Kingdom. The recent NHS agenda implemented specialist perinatal mental health services to improve women's access to evidence-based care. Although there is ample research on maternal perinatal depression, paternal perinatal depression remains overlooked. Fatherhood can have a positive long-term protective impact on men's health. However, a proportion of fathers also experience perinatal depression which often correlates with maternal depression. Research reports that paternal perinatal depression is a highly prevalent public health concern. As there are no current specific guidelines for screening for paternal perinatal depression, it is often unrecognized, misdiagnosed, or untreated in primary care. This is concerning as research reports a positive correlation between paternal perinatal depression with maternal perinatal depression and overall family well-being. This study illustrates the successful recognition and treatment of a paternal perinatal depression case in a primary care service. The client was a 22-year-old White male living with a partner who was 6 months pregnant. He attended primary care with symptoms consistent with paternal perinatal depression as indicated by his interview and specified clinical measures. The client attended 12 sessions of cognitive behavioral therapy, conducted weekly over a period of 4 months. At the end of treatment, he no longer portrayed symptoms of depression. This was maintained at 3-month follow-up. This study highlights the importance of screening for paternal perinatal depression in primary care. It could benefit clinicians and researchers who may wish to better recognize and treat this clinical presentation.

Impact of the COVID-19 pandemic on expectant and new parents' experience of pregnancy, childbirth, breast feeding, parental responsiveness and sensitivity, and bonding and attunement in high-income countries: a systematic review of the evidence

OBJECTIVES

To review the evidence on how pregnancy, birth experience, breast feeding, parental responsiveness and sensitivity, and bonding and attunement were impacted by COVID-19.

METHODS

We searched eight literature databases and websites of relevant UK-based organisations. The review focused on evidence during pregnancy and the early years (0-5 years). Studies of any study design published in English from 1 March 2020 to 15 March 2021 and conducted in high-income countries were included. Screening and data extraction were undertaken in duplicate. Evidence was synthesised using a narrative approach. Study quality of included studies was assessed using the Mixed Methods Appraisal Tool.

RESULTS

The search yielded 9776 publications, of which 26 met our inclusion criteria. Significant knowledge gaps on how COVID-19 affected pregnancy and breast feeding limited healthcare providers' ability to provide consistent evidence-based information and care at the start of the pandemic. There was an enduring sense of loss about loved ones being restricted from taking part in key moments. Parents were concerned about the limitations of virtual healthcare provision. Some parents reported more opportunities for responsive breast feeding and improved parent-infant bonding due to reduced social and work pressures. Women from minoritised ethnic groups were less likely to continue breast feeding and attributed this to a lack of face-to-face support.

CONCLUSIONS

The evidence suggests that new and expectant families have been both negatively and positively impacted by the COVID-19 pandemic and the resulting restrictions. The impacts on parents' opportunities to bond with their young children and to be attuned to their needs were felt unequally. It is important that emergency response policies consider the mother and the partner as a family unit when making changes to the delivery of maternal and child health and care services, so as to mitigate the impact on the family and existing health inequalities.

PROSPERO REGISTRATION NUMBER

CRD42021236769.

Illuminating the origins of the intergenerational transmission of psychopathology with a novel genetically informed design

Although it is well known that parental depression is transmitted within families across generations, the etiology of this transmission remains unclear. Our goal was to develop a novel study design capable of explicitly examining the etiologic sources of intergenerational transmission. We specifically leveraged naturally-occurring variations in genetic relatedness between parents and their adolescent children in the 720 families participating in the Nonshared Environment in Adolescent Development (NEAD) study, 58.5% of which included a rearing stepparent (nearly always a stepfather). Results pointed squarely to the environmental transmission of psychopathology between fathers and children. Paternal depression was associated with adolescent depression and adolescent behavior problems (i.e., antisocial behavior, headstrong behavior, and attention problems) regardless of whether or not fathers and their children were genetically related. Moreover, these associations persisted to a subset of "blended" families in which the father was biologically related to one participating child but not to the other, and appeared to be mediated via father-child conflict. Such findings are not only fully consistent with the environmental transmission of psychopathology across generations, but also add to extant evidence that parent-child conflict is a robust and at least partially environmental predictor of adolescent psychopathology.

An Assessment of Pediatric Residency Applicant Perceptions of "Fit" During the Virtual Interview Era

PURPOSE

Residency recruitment events and interviews are widely considered an integral component of the residency match experience. Due to the COVID-19 pandemic, residency recruitment and interviewing throughout the 2020-2021 academic year were performed virtually, which created challenges for applicants' ability to discern "fit" to a program. Given this change, it is reasonable to suspect that applicants would be less able to discern program fit. Therefore, this study evaluated how virtual interviews impacted pediatric residency applicants' ability to assess factors contributing to fit and subsequently how applicants assessed their self-perceived fit to their top-ranked programs.

METHODS

An online, anonymous survey was distributed to all residency applicants who applied to any specialty at our large academic institution. The survey utilized a 5-point Likert-type scale to evaluate qualities of fit as well as the applicants' self-perceived ability to assess these qualities through a virtual platform.

RESULTS

1,840 surveys were distributed, of which 473 residency applicants responded (25.7% response rate). Among these responses, 81 were pediatric applicants (27.6%). Factors deemed most important in determining fit included how well the residents get along with one another (98.8%), how much the program appeared to care about its trainees (97.5%), and how satisfied residents were with their program (97.5%). Qualities deemed most difficult for applicants to discern included the quality of facilities (18.6%), patient diversity (29.4%), and how well the residents got along with one another (30.2%). When compared to all other residency applicants, pediatric applicants placed more value on whether a program was family-friendly (p = 0.015), the quality of the facilities (p = 0.009), and the on-call system (p = 0.038).

CONCLUSION

This study highlights factors that influence pediatric applicants' perception of fit into a program. Unfortunately, many factors deemed most important for pediatric applicants were also among the most difficult to assess virtually. These include resident camaraderie, whether a program cares about its residents, and overall resident satisfaction. Taken together, these findings and the recommendations presented should be considered by all residency program leaders to ensure the successful recruitment of a pediatric residency class.

Examining the Relationship between Paternal Mental Health and Informal Support Networks: Reflections on the Impact of the COVID-19 Pandemic

Paternal mental health remains an under-researched area in the UK. Consequently, father-focused formal and informal support provisions fail to address the complex emotional and psychological wellbeing needs of fathers. Drawing on data from twenty semi-structured interviews with fathers in the York area, this study seeks to better understand how access to and participation in informal support networks is influenced by gendered perceptions and the impact hegemonic perceptions of masculinity have on fathers' access to support prior and during the COVID-19 pandemic. The findings demonstrate that fathers internalise stereotypical masculine tropes, such as stoicism, which prevent them from actively seeking support. While fathers value informal support network, they generally struggle to engage in mental health talks. The COVID-19 lockdown exacerbated fathers' struggles to access informal support or prioritise their mental health. Fathers felt the pandemic presented a unique challenge that only people that became parents at the time understood. This meant that fathers could not rely on their parents or other parents who did not have similar experiences of the COVID-19 pandemic. This paper aims at challenging structural and cultural barriers that inhibit fathers' participation in informal support networks, and to promote more meaningful, supportive engagement with peer groups.

PROTOCOL: The support needs of families living with parental mental illness: A qualitative systematic review

This is the protocol for a Campbell systematic review. The objectives are as follows: To review existing qualitative research on the experiences of families living with parental mental illness from the perspective of (i) children, (ii) parents who have a mental illness) and (ii) the well parent. To synthesise qualitative evidence on the experience of living with parental mental illness and the experience of and attitude towards services from the perspective of (i) children, (ii) parents who have a mental illness and (ii) the well parent in order to develop the understanding of the needs of families and the implications for service provision.

Male partners’ experiences of early pregnancy ultrasound scans in Soweto, South Africa: The Healthy Pregnancy, Healthy Baby randomised trial

Background. Despite international evidence highlighting the benefits of male partners attending antenatal visits, including pregnancy ultrasound scans, it is unusual for South African (SA) men to attend such visits, and little is known about their experiences if they do. Objectives. To explore the experiences and antenatal attachment among male partners who attend early pregnancy ultrasound examinations in Soweto, SA. Methods. Pregnant women attending ultrasound examinations were invited to bring their partners with them. Both completed individual questionnaires, including the antenatal attachment scale. The results are based on a descriptive analysis of 102 mother-partner pairs. Results. The mean age of partners was 35 years. Only 32% of men were living with their pregnant partner. Before the ultrasound scan, 64% of men reported feeling very anxious, while 54% also felt anxious after the procedure. The ultrasound examination had a positive effect on men and their thoughts regarding their developing baby, with 30% stating that they were ready or excited to be a father. Twenty-eight percent believed their relationship with the mother was stronger as a result of participating in antenatal care. Conclusions. We found that prenatal ultrasound scans had a positive effect on male partners and their thoughts about the pregnancy, their forthcoming child and their relationship with and support for their partner. Health services in SA should accommodate partners/ fathers and encourage them to attend antenatal care, including pregnancy ultrasound scans. Interventions are needed to encourage more men to be involved – from conception – potentially addressing individual, familial, societal and structural barriers to involvement of the father in long-term maternal and child care.

Paternal depression and attachment levels of first-time fathers in Turkey

PURPOSE

Paternal depression and inadequate attachment experienced in the postpartum period may be associated with future emotional and behavioural problems of children. This study aimed to investigate the paternal depression and attachment levels of first-time fathers.

DESIGN AND METHODS

The sample of this descriptive study consisted of 175 fathers with 3-6 months old babies whose wives applied to the polyclinic for check-up.

FINDINGS

When the cut-off point of the scale was evaluated at 13 and above in this study, the risk of depression was found to be 14.2%. The level of attachment decreases as fathers' risk of depression increases (p < 0.05).

PRACTICE IMPLICATIONS

There is a risk of depression in fathers in the postpartum period. The level of attachment decreases as fathers' risk of depression increases.

Inventory of Father Involvement and Fathers’ Perceptions of Family Life

Abstract Cross-cultural comparisons of father involvement and related issues are still scarce, as are consolidated measures for its assessment. We examined relationships among father involvement and family-related variables, in Brazil, and then compared these results with findings from other countries. In total, 200 fathers with children aged 5 to 10 completed the Brazilian version of the Inventory of Father Involvement (IFI-BR), and measures of stress, marital satisfaction, parent-child relationship, children’s social skills and their behavior problems. Correlations among these variables were between .32 and .58, providing new evidence of validity for the IFI-BR. When comparing Brazilian results with correlations observed in other countries, the majority did not differ in magnitude, indicating that father involvement systematically influences the fathers’ well-being, family relationships, and their children’s socioemotional development, in different countries. In addition to the psychometric evidence for the IFI-BR, these results also indicate the potential for using the IFI in different cultures.

Prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period

BACKGROUND

The changes experienced during the transition to first-time or subsequent fatherhood are mainly positive; however, fathers can also experience adverse mental health outcomes such as stress, anxiety, and depression. The aim of this study was to investigate the prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period.

METHODS

A quantitative, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising of the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale.

RESULTS

A total of 336 fathers were included in the study. The prevalence rates were 41.1% (n = 138) for moderate/high stress symptoms, 20.8% (n = 70) for state anxiety symptoms, 25.9% (n = 87) for trait anxiety symptoms, and 13.4% (n = 45) for depression symptoms. In the multivariable analysis, several factors were associated with increased stress, anxiety, and depression symptoms including being a subsequent father (p = 0.009), not living in a house (p = 0.009), having a history of adverse mental health (p = 0.008), and having a partner with a history of anxiety (p = 0.040).

CONCLUSION

The findings suggest that fathers are at risk of adverse mental health in the early postnatal period which is a pivotal time for fathers in terms of bonding with their infant and redefining their relationship with their partner.

Recent Neuroscience Advances in Human Parenting

The transition to parenthood entails brain adaptations to the demands of caring for a newborn. This chapter reviews recent neuroscience findings on human parenting, focusing on neuroimaging studies. First, we describe the brain circuits underlying human maternal behavior, which comprise ancient subcortical circuits and more sophisticated cortical regions. Then, we present the short-term and long-term functional and structural brain adaptations that characterize the transition to motherhood, discuss the long-term effects of parenthood on the brain, and propose several underlying neural mechanisms. We also review neuroimaging findings in biological fathers and alloparents (such as other relatives or adoptive parents), who engage in parenting without directly experiencing pregnancy or childbirth. Finally, we describe perinatal mental illnesses and discuss the neural responses associated with such disorders. To date, studies indicate that parenthood is a period of enhanced brain plasticity within brain areas critical for cognitive and social processing and that both parenting experience and gestational-related factors can prime such plasticity.

Development of a Supportive Parenting App to Improve Parent and Infant Outcomes in the Perinatal Period: Development Study

Background

The transition to parenthood can be challenging, and parents are vulnerable to psychological disorders during the perinatal period. This may have adverse long-term consequences on a child’s development. Given the rise in technology and parents’ preferences for mobile health apps, a supportive mobile health intervention is optimal. However, there is a lack of a theoretical framework and technology-based perinatal educational intervention for couples with healthy infants.

Objective

The aim of this study is to describe the Supportive Parenting App (SPA) development procedure and highlight the challenges and lessons learned.

Methods

The SPA development procedure was guided by the information systems research framework, which emphasizes a nonlinear, iterative, and user-centered process involving 3 research cycles—the relevance cycle, design cycle, and rigor cycle. Treatment fidelity was ensured, and team cohesiveness was maintained using strategies from the Tuckman model of team development.

Results

In the relevance cycle, end-user requirements were identified through focus groups and interviews. In the rigor cycle, the user engagement pyramid and well-established theories (social cognitive theory proposed by Bandura and attachment theory proposed by Bowlby) were used to inform and justify the features of the artifact. In the design cycle, the admin portal was developed using Microsoft Visual Studio 2017, whereas the SPA, which ran on both iOS and Android, was developed using hybrid development tools. The SPA featured knowledge-based content, informational videos and audio clips, a discussion forum, chat groups, and a frequently asked questions and expert advice section. The intervention underwent iterative testing by a small group of new parents and research team members. Qualitative feedback was obtained for further app enhancements before official implementation. Testing revealed user and technological issues, such as web browser and app incompatibility, a lack of notifications for both administrators and users, and limited search engine capability.

Conclusions

The information systems research framework documented the technical details of the SPA but did not take into consideration the interpersonal and real-life challenges. Ineffective communication between the health care research team and the app developers, limited resources, and the COVID-19 pandemic were the main challenges faced during content development. Quick adaptability, team cohesion, and hindsight budgeting are crucial for intervention development. Although the effectiveness of the SPA in improving parental and infant outcomes is currently unknown, this detailed intervention development study highlights the key aspects that need to be considered for future app development.

Family dynamics. An exploration of parental sensitivity and depressive symptoms among mothers and fathers of toddlers

In studies of maternal sensitivity, the influence of mothers’ depressive symptomatology has been consistently highlighted. Additionally, the relevance of both maternal and paternal sensitive responses to children’s development has been recognized. However, literature regarding the dynamics of the mother-father-toddler triad is scarce. This is particularly true when understanding how parental sensitivity may be bidirectionally shaped by both parents’ (i.e., mothers’ and fathers’ depressive symptomatology) and children’s characteristics (i.e., age). Hence, the present study aims to describe and analyse the associations between parental depression, paternal sensitivity and children’s socioemotional difficulties and age with mothers’ sensitive responses to highlight the appropriateness of considering fathers’ depressive symptoms and sensitivity to better understand the impact of maternal depressive symptomatology on mothers’ sensitivity. The participants included 80 Chilean mother-father-child triads in which all children were between 1 and 3 years of age and presented some degree of socioemotional difficulty. The results reveal no differences in maternal and paternal sensitivity or higher depressive symptomatology in mothers than in fathers. Additionally, while mothers’ depression was significantly associated with their sensitivity, this was not the case for fathers. Paternal depressive symptomatology was associated with the mother’s depression. Finally, paternal sensitivity emerged as a mediator between maternal depressive symptoms and sensitivity. This result calls attention to the use of paternal variables to understand how maternal depression impacts mothers’ sensitivity and to thus develop appropriate interventions that expand the scope of such impacts from the dyad to the triad.

Prevalence and predictors of parental depressive episodes: Results from a 15-year longitudinal study

BACKGROUND

Depression affects approximately 7.5 million parents in the United States each year. Parental depression has detrimental consequences for both the parent and the parent-child relationship. The purpose of this study was to: (1) understand the prevalence of parental depressive episodes longitudinally, (2) identify the risk and protective factors for parental depressive episodes, and (3) compare the risk and protective factors for depressive episodes among mothers and fathers.

METHODS

We used six waves of the Fragile Families and Child Wellbeing Study to descriptively examine parental depression over a period of 15 years. We used logistic and fixed effects regressions to assess the association between a number of demographic, health and parenting variables and maternal and paternal depression.

RESULTS

Our sample was primarily Black (48%) and Hispanic/Latino (27%). Fathers had a slightly lower prevalence of depression compared to mothers at all waves (approximately 13% averaged across waves for fathers, compared to 18% for mothers). Factors negatively correlated with depression among mothers and fathers included: social support, employment, and better-perceived health. Factors positively associated with depression for mothers and fathers were substance misuse and having a parent with a history of depression, anxiety, or drug misuse.

LIMITATIONS

Our study was unable to identify causal relationships and the directionality of the relationship between depression and other variables of interest.

CONCLUSIONS

We found that parental depression is prevalent in a sample of predominantly racially minoritized parents. Addressing comorbidities and increasing social support access may help manage parental depression and ensure a healthy child development.

Parents' Self-Reported Psychological Impacts of COVID-19: Associations With Parental Burnout, Child Behavior, and Income

OBJECTIVE

The current study investigates associations between parents' perceived coronavirus disease 2019 (COVID-19) psychological impacts and experiences of parental burnout, children's behaviors, and income.

METHODS

Data were collected during an online survey of parents' (N = 1000) pandemic experiences in April 2020. Parents (M = 36.5 years old, SD = 6.0; 82.1% White) with at least one child 12 years or younger reported on measures of mental health, perceived COVID-19 impacts, parental burnout, and perceived increases in children's stress and positive behaviors.

RESULTS

Path model analyses revealed that parents who perceived increased psychological impacts from COVID-19 reported higher levels of parental burnout, greater increases in children's stress behaviors, and less positive behavior in children. Additionally, there were significant indirect effects of parental burnout on the link between COVID-19 psychological impacts and children's behaviors. Finally, family income moderated associations between psychological impacts and children's stress behaviors, such that the association was stronger for families with lower income.

CONCLUSIONS

These results suggest parents' perceptions of how the COVID-19 pandemic has impacted their mental health has implications for parent and child well-being, with stronger associations for low-income families. Given the potential for spillover effects between parents and children, promoting family well-being through practice and policy initiatives is crucial, including providing financial and caregiving relief for parents, and mental and behavioral health support for families.

Expanding the international conversation with fathers' mental health: toward an era of inclusion in perinatal research and practice

Paternal mental health is beginning to be recognized as an essential part of perinatal health. Historically, fathers were not recognized as being at risk for perinatal mental illnesses or relevant to maternal and infant health outcomes. The purpose of this paper is to provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. An international team of paternal perinatal mental health experts summarized the key findings of the field. Fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression and can impact their ability to support mothers. Paternal mental health is uniquely associated with child mental health and developmental outcomes starting from infancy and continuing through the child lifespan. Tailored screening approaches for paternal mental health are essential to support fathers early in the perinatal period, which would offset health risks for the family. Recommendations on paternal mental health are provided on four key areas to support father perinatal mental health: (1) intervention research, (2) clinical training, (3) national policy, and (4) the inclusion of fathers in the focus of the International Marcé Society for Perinatal Mental Health.

What about the babies? A critical review of infants' and toddlers' absence in homelessness scholarship

Rates of family homelessness continue to reach unprecedented levels. As many as two million young children experience family homelessness each year, with an estimated one in 10 younger than one year old. Yet, despite their high prevalence, a dearth of studies have specifically investigated infants' and toddlers' experiences of homelessness. Overall, the available literature suggests homeless infants and toddlers experience increased risk to physical health, development, and well-being at an individual- and family-level. This presents a severely limited understanding of homeless infants' and toddlers' experiences, with substantial gaps remaining. This review documents the scant existing literature on infant and toddler development within the context of homelessness at both the individual and family-system levels, and proposes next steps for research, practice, and policy.

Mental Health of Parents and Primary Caregivers by Sex and Associated Child Health Indicators

Poor mental health among parents or primary caregivers is associated with poor mental and physical health in children; however, research often excludes the mental health of male caregivers including fathers. This analysis examines associations between caregiver mental health by caregiver sex and child health indicators (i.e., child's general health; child's history of diagnosed mental, behavioral, or developmental disorders (MBDDs)). Using parent-reported data on 97,728 US children aged 0-17 years from the National Survey of Children's Health (2016-2018), we estimated nationally representative, weighted proportions of children with parents or primary caregivers with poor mental health by caregiver sex, prevalence ratios (PR), and 95% confidence intervals (CI) for child health indicators by caregiver mental health and sex. Nationally, 7.2% of children had at least one caregiver with poor mental health; 2.8% had any male caregiver; and 5.1% had any female caregiver with poor mental health. Compared to children with all male caregivers with good mental health, children with any male caregiver with poor mental health were more likely to have poor general health (PR: 4.9, CI: 3.0-8.0) and have ≥1 diagnosed MBDDs (PR: 1.9, CI: 1.7-2.1); this remained significant when controlling for caregiver and household characteristics. Findings were similar when comparing children with any female caregiver with poor mental health to children with all female caregivers with good mental health. Our findings support previously published recommendations that promoting mental health among all types of caregivers by addressing gaps in research on fathers and male caregivers may further promote child health and wellness.

Fathers' Experience of Perinatal Obsessive-Compulsive Symptoms: A Systematic Literature Review

Perinatal Obsessive-Compulsive Disorder (pOCD) refers to the onset/exacerbation of Obsessive-Compulsive Disorder (OCD) during the perinatal period. This disorder has been studied in mothers, with limited research conducted on fathers. The aim of the current study was to conduct the first systematic review of research investigating the experience of pOCD in fathers. A systematic review was conducted via electronic searches of Scopus, ProQuest, APA PsychNet, PubMed, and EBSCOhost. There were 523 articles identified and screened for eligibility, resulting in six eligible studies included in the final review. All studies reported the presence of subclinical obsessive-compulsive symptoms in fathers during the perinatal period, with the prevalence comparable to mothers. Compared to mothers, however, fathers were found to report less intrusion-related distress. Two studies reported a correlation between dysfunctional beliefs, negative appraisal of intrusions, and pOCD symptoms. Common categories of obsessive thoughts and compulsions experienced by fathers were also identified. Fathers appear susceptible to pOCD, which is consistent with the Cognitive-Behavioral Theory of OCD. Future research is recommended, therefore, to investigate clinical prevalence and severity of pOCD in fathers, particularly relative to mothers, and further investigate the role of dysfunctional beliefs in the development of pOCD.

Parenting and Child Development: A Relational Health Perspective

A child's development is embedded within a complex system of relationships. Among the many relationships that influence children's growth and development, perhaps the most influential is the one that exists between parent and child. Recognition of the critical importance of early parent-child relationship quality for children's socioemotional, cognitive, neurobiological, and health outcomes has contributed to a shift in efforts to identify relational determinants of child outcomes. Recent efforts to extend models of relational health to the field of child development highlight the role that parent, child, and contextual factors play in supporting the development and maintenance of healthy parent-child relationships. This review presents a parent-child relational health perspective on development, with an emphasis on socioemotional outcomes in early childhood, along with brief attention to obesity and eating behavior as a relationally informed health outcome. Also emphasized here is the parent-health care provider relationship as a context for supporting healthy outcomes within families as well as screening and intervention efforts to support optimal relational health within families, with the goal of improving mental and physical health within our communities.

Relationship between parents' mental disorders and socioeconomic status and offspring's psychopathology: A cross-sectional study

Mental disorders (MD) are one of the main causes of the disease burden worldwide. Associations between socioeconomic status (SES) and presence of MD in parents have been related with increased odds of MD in offspring. However, there is a lack of population-based research in this field. The aim of the present study was to examine together the relationship between the presence of MD in children, and the SES and presence of MD in their parents, in a whole of population data. A gender approach was undertaken aiming to discern how these variables influence children's mental health when related with the father and the mother. Using administrative individual data from the National Health System, a retrospective cross-sectional study was conducted. The entire children population aged 6 to 15 resident in Catalonia in 2017 was examined. A logistic regression model was performed. Low SES was associated with increased odds of children's MD. Offspring of a parent with MD were at more risk of presenting MD than offspring of parents without these problems. Although these associations were consistent for both boys and girls when looking at the father's or mother's SES and MDs, the mother's SES and MDs showed a higher association with the offspring's MDs than the father's. Lowest associations, found for boys when looking at the father's SES and MDs, were: OR of 1.21, 95%CI 1.16 to 1.27 for lowest SES, and OR of 1.66, 95%CI 1.61 to 1.70 for parental MDs. Children's familiar environment, which includes SES and mental health of parents, plays an important role in their mental health. Socially constructed gender roles interfere with SES and parent's MD. These findings support the relevance of examining MD and its risk factors within a gender approach.

The link between parental psychological control, depressive symptoms and epigenetic changes in the glucocorticoid receptor gene (NR3C1)

AIMS

This paper examines the relationship between parental Psychological Control (PC) and depressive symptoms in adolescents and assesses whether this relationship was mediated by DNA methylation, focusing on the glucocorticoid receptor gene (NR3C1), which plays a crucial role in HPA-axis functioning and is linked to environmental stress and depression. This is among the very few studies that looked at the relation between DNA methylation, environmental stress and depression in family trios.

METHODS

The study cohort consisted of 250 families: father, mother and a biologically related adolescent (adolescents (48.9% boys), mean age: 15.14, SD= 1.9; mean age mothers: 45.83, SD= 4.2; mean age fathers: 47.77, SD= 4.7). Depressive symptoms and PC were measured in adolescents and in both parents. DNA methylation levels in NR3C1 were examined in all participants.

RESULTS

Depressive symptoms in adolescents were predicted by PC of both mothers and fathers. Moreover, maternal depressive symptoms were associated with maternal PC, and fathers' depressive symptoms and PC. In fathers, only the level of their self-reported PC was associated with their depressive symptoms. There was no relation between adolescents' DNA methylation and depressive symptoms or the level of parental PC. Yet, there was a significant association between maternal depressive symptoms and maternal epigenetic patterns in NR3C1.

CONCLUSIONS

These findings highlight the need for more research in order to better understand the biological and contextual mechanisms through which parenting and parental emotional well-being is related to the development of psychopathology.

Early life risk and resiliency factors and their influences on developmental outcomes and disease pathways: a rapid evidence review of systematic reviews and meta-analyses

The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure-outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.