Paternal history of depression or anxiety disorder and infant-father attachment

Anxiety among fathers during the prenatal and postpartum period: a meta-analysis

INTRODUCTION

The purpose of this review was to determine the prevalence of anxiety among fathers during the perinatal (pre- and post-natal) period.

METHODS

A systematic search was conducted to identify studies published between 1995-2020. One hundred and seventy-two of the records met inclusion criteria and full texts were screened for eligibility. The authors followed PRISMA guidelines to extract the data.

RESULTS

A total of 23 studies, representing 40,124 participants, are included in this meta-analysis. The overall random effects estimate of paternal perinatal anxiety was 10.69% (95% confidence interval (CI): 8.14 - 13.91%). Rates of paternal perinatal anxiety demonstrated significant heterogeneity that was large in magnitude (Q = 304,494, p < .001, I² = 99.93 and τ² = .5381). Study quality rating did not appear to moderate rates of paternal perinatal anxiety (low: 10.74%; 95% CI: 6.56-17.11%; high: 10.65%; 95% CI: 6.02- 18.15%).

DISCUSSION

Paternal perinatal anxiety rates in this meta-analysis are considerably higher than the global WHO regional prevalence rates for anxiety among men suggesting the transition into parenthood may place men at greater risk for anxiety.

The Applicability and Performance of Tools Used to Assess the Father-Offspring Relationship in Relation to Parental Psychopathology and Offspring Outcomes

Introduction: Father-infant interactions are important for optimal offspring outcomes. Moreover, paternal perinatal psychopathology is associated with psychological and developmental disturbances in the offspring, and this risk may increase when both parents are unwell. While, the father-offspring relationship is a plausible mechanism of risk transmission, there is presently no "gold standard" tool for assessing the father-offspring relationship. Therefore, we systematically searched and reviewed the application and performance of tools used to assess the father-offspring relationship from pregnancy to 24-months postnatal. Methods: Four electronic databases (including MEDLINE, PsycINFO, Maternity and Infant Care Database, and CINAHL) were searched. Selected articles included evidence of father-offspring relationship assessment in relation to parental perinatal psychopathology and/or offspring outcomes. Data was extracted and synthesized according to the following: (i) evidence supporting the performance of tools in terms of their psychometric properties when applied in the context of fathers, (ii) tool specific characteristics, and (iii) study specific methodological aspects in which the tool was embedded. Results: Of the 30,500 records eligible for screening, 38 unique tools used to assess the father-offspring relationship were identified, from 61 studies. Ten tools were employed in the context of paternal psychopathology, three in the context of maternal psychopathology, and seven in the context of both maternal and paternal psychopathology, while nine tools were applied in the context of offspring outcomes only. The remaining nine tools were used in the context of both parental psychopathology (i.e., paternal, and/or maternal psychopathology) and offspring outcomes. Evidence supporting the psychometric robustness of the extracted observational, self-report and interview-based tools was generally limited. Most tools were originally developed in maternal samples-with few tools demonstrating evidence of content validation specific to fathers. Furthermore, various elements influencing tool performance were recognized-including variation in tool characteristics (e.g., relationship dimensions assessed, assessment mode, and scoring formats) and study specific methodological aspects, (e.g., setting and study design, sample characteristics, timing and nature of parental psychopathology, and offspring outcomes). Conclusion: Given the strengths and limitations of each mode of assessment, future studies may benefit from a multimethod approach to assessing the father-offspring relationship, which may provide a more accurate assessment than one method alone.

Is one secure attachment enough? Infant cortisol reactivity and the security of infant-mother and infant-father attachments at the end of the first year

Attachment security is theorized to shape stress reactivity, but extant work has failed to find consistent links between attachment security to mothers and infant cortisol reactivity. We examined family configurations of infant-mother and infant-father attachment security in relation to infant cortisol reactivity. One-year old infants (N = 180) participated in the Strange Situation with mothers and fathers in two counterbalanced lab visits, one month apart (12 and 13 months). Infants with secure attachments only to their fathers and not their mothers had higher cortisol levels than infants with a secure attachment to mother and also exhibited a blunted cortisol response (high at baseline and then a decrease after stress). Results suggest that a secure attachment to father may not be enough to reduce infant stress reactivity when the infant-mother attachment is insecure, and future research is needed to uncover the family dynamics that underlie different family configurations of attachment security.