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Watkins V, Kavanagh SA, Macdonald JA, Rasmussen B, Maindal HT, Hosking S, Wynter K. "I always felt like I wasn't supposed to be there". An international qualitative study of fathers' engagement in family healthcare during transition to fatherhood. Midwifery 2024; 130:103928. [PMID: 38290320 DOI: 10.1016/j.midw.2024.103928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father's perceptions and experiences of healthcare engagement during pregnancy and early infant care. DESIGN Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers' attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. SETTING AND PARTICIPANTS Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. FINDINGS Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers' feelings of confidence in their partner's autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. KEY CONCLUSIONS Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. IMPLICATIONS FOR PRACTICE Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family.
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Affiliation(s)
- Vanessa Watkins
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia.
| | - Shane A Kavanagh
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health; Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia; University of Melbourne, Department of Paediatrics, Melbourne, Australia
| | - Bodil Rasmussen
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark.; University of Southern Denmark, Faculty of Health Sciences and Steno Diabetes Center, Odense, Denmark; Aarhus University, Department of Public Health, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia; Aarhus University, Department of Public Health, Aarhus, Denmark; Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sarah Hosking
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia
| | - Karen Wynter
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; Monash University, Department of Psychiatry, School of Clinical Sciences, Clayton, Victoria, Australia
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Smith I, O'Dea G, Demmer DH, Youssef G, Craigie G, Francis LM, Coles L, D'Souza L, Cain K, Knight T, Olsson CA, Macdonald JA. Associations between unintended fatherhood and paternal mental health problems: A systematic review and meta-analysis. J Affect Disord 2023; 339:22-32. [PMID: 37393953 DOI: 10.1016/j.jad.2023.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months. METHODS We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists. RESULTS Of 2826 records identified, 23 studies (N = 8085 fathers), reporting 29 effects, were eligible for meta-analysis. Included studies assessed depression, anxiety, stress, parenting stress, post-traumatic stress disorder (PTSD), alcohol misuse and psychological distress. Pooled estimates, from random effects meta-analyses, for all mental health outcomes (k = 29; OR = 2.28) and depression only (k = 19; OR = 2.36), showed that the odds of reporting mental health difficulties were >2-fold higher in men reporting unintended births compared with those reporting intended births. However, there was no evidence of association with anxiety (k = 2) or stress (k = 2). Overall, mental health problems were greater in low-income countries. No differences were found across parity, timepoint of mental health assessment, or instruments used to measure mental health symptoms. LIMITATIONS Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies. CONCLUSIONS Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.
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Affiliation(s)
- Imogene Smith
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; The Cairnmillar Institute, East Hawthorn, Australia.
| | - Gypsy O'Dea
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - David Hilton Demmer
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Georgia Craigie
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Laetitia Coles
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Levita D'Souza
- Faculty of Education, Monash University, Clayton, Australia
| | - Kat Cain
- Library Client Services, Deakin University, Geelong, Australia
| | - Tess Knight
- The Cairnmillar Institute, East Hawthorn, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
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Liverpool S, Eisenstadt M, Mulligan Smith A, Kozhevnikova S. An App to Support Fathers' Mental Health and Well-Being: User-Centered Development Study. JMIR Form Res 2023; 7:e47968. [PMID: 37578834 PMCID: PMC10463090 DOI: 10.2196/47968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/30/2023] [Accepted: 06/22/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Numerous studies describe the popularity and usefulness of parenting programs. In particular, parenting programs are generally viewed as effective for supporting parents' mental well-being during key transition periods. However, the evidence base for fathers is limited owing to their lack of involvement in parenting programs and scarcity of tailored support. OBJECTIVE This paper aimed to describe the co-design process for a universal digital intervention for fathers (fatherli) and the outline of a logic model with its expected outcomes. METHODS Following established guidelines for co-designing and developing complex interventions, we conducted a nonsystematic review of the available literature to gather key information, developed market surveys to assess fathers' needs and interests, consulted with key stakeholders to obtain expert opinions, and engaged in a rapid iterative prototyping process with app developers. Each step was summarized, and the information was collated and integrated to inform a logic model and the features of the resulting intervention. RESULTS The steps in the co-design process confirmed a need for and interest in a digital intervention for fathers. In response to this finding, fatherli was developed, consisting of 5 key features: a discussion forum for anyone to post information about various topics (the forum), a socializing platform for fathers to create and engage with others in small groups about topics or points of shared interest (dad hub), a tool for fathers to find other fathers with shared interests or within the same geographic location (dad finder), a resource for fathers to access up-to-date information about topics that interest them (dad wiki), and a portal to book sessions with coaches who specialize in different topics (dad coaching space). The evidence-based logic model proposes that if fatherli is successfully implemented, important outcomes such as increased parental efficacy and mental health help-seeking behaviors may be observed. CONCLUSIONS We documented the co-design and development process of fatherli, which confirmed that it is possible to use input from end users and experts, integrated with theory and research evidence, to create suitable digital well-being interventions for fathers. In general, the key findings suggest that an app that facilitates connection, communication, and psychoeducation may appeal to fathers. Further studies will now focus on acceptability, feasibility, and effectiveness. Feedback gathered during pilot-testing will inform any further developments in the app to increase its applicability to fathers and its usability.
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Affiliation(s)
- Shaun Liverpool
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Mia Eisenstadt
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Aoife Mulligan Smith
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Sofia Kozhevnikova
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- School of Biosciences, University of Nottingham, Nottingham, United Kingdom
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Francis LM, Greenwood CJ, Enticott PG, Mansour KA, Smith I, Graeme LG, Olsson CA, Milgrom J, Skouteris H, Macdonald JA. Father trait anger and associations with father-infant bonding and caregiving: The mediating role of mentalizing. Fam Process 2023. [PMID: 37414415 DOI: 10.1111/famp.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023]
Abstract
Trait anger reflects a tendency to feel irritation, annoyance, and rage, and involves a narrowing of cognition and attention. This narrowed scope may impact the capacity to understand the mental states of oneself and others (mentalizing), which for fathers of infants may compromise bonding and caregiving involvement. Here, we investigated the extent to which mentalizing mediated the relationship between father trait anger and both father-infant bonding and father involvement in infant caregiving. Data were from 168 fathers (M = 30.04 years of age, SD = 1.36) of 190 infants (M = 7.58 months of age, SD = 5.06) in the longitudinal Men and Parenting Pathways (MAPP) study. We assessed fathers' preconception trait anger at Wave 1 and their mentalizing 2 years later at Wave 3. At Waves 3, 4, and/or 5, we assessed father-infant bonding and father involvement in infant caregiving when men had an infant younger than 18 months of age. Associations were examined using path analysis. Poorer mentalizing fully mediated the relationship between preconception trait anger and father-infant bonding (total score), but not involvement in infant caregiving. Further, poorer mentalizing fully mediated the relationships between trait anger and each component of the father-infant bond (i.e., patience and tolerance, affection and pride, and pleasure in interactions). Findings suggest that for men high on trait anger, targeted interventions that facilitate mentalizing capacities may help to develop a foundation for a strong father-infant bond. Interventions may be offered on becoming a father (perinatal), or prior to becoming a father (preconception) to prevent future bonding problems.
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Affiliation(s)
- Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Peter G Enticott
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kayla A Mansour
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Imogene Smith
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Liam G Graeme
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Warwick Business School, Warwick University, Coventry, UK
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Francis LM, Youssef GJ, Greenwood CJ, Enticott PG, Curtis A, Graeme LG, Mansour KA, Olsson CA, Skouteris H, Milgrom J, Williams J, Knight T, Macdonald JA. Father trait anger: Associations with father–infant bonding and subsequent parenting stress. Front Psychol 2023; 14:1114084. [PMID: 36968729 PMCID: PMC10036745 DOI: 10.3389/fpsyg.2023.1114084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionParent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father–infant bonding.MethodData were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father–infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent–child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father–infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome.ResultsPatience and tolerance was the only domain of father–infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent–child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress.DiscussionFather trait anger both directly and indirectly (through patience and tolerance in the father–infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father–infant bonding may benefit fathers and children.
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Affiliation(s)
- Lauren M. Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- *Correspondence: Lauren M. Francis,
| | - George J. Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Christopher J. Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Peter G. Enticott
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Ashlee Curtis
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liam G. Graeme
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Kayla A. Mansour
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Warwick Business School, Warwick University, Coventry, United Kingdom
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Heidelberg, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Social Development, Deakin University Faculty of Health, Burwood, VIC, Australia
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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Skilbeck L, Spanton C, Roylance I. Recognition and CBT for Paternal Perinatal Depression in Primary Care: A Case Report. Am J Mens Health 2023; 17:15579883231159955. [PMID: 36890730 PMCID: PMC9998414 DOI: 10.1177/15579883231159955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
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.
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Affiliation(s)
- Lilian Skilbeck
- Newham Talking Therapies, East London NHS Foundation Trust, Stratford, UK
| | | | - Ian Roylance
- Newham Talking Therapies, East London NHS Foundation Trust, Stratford, UK
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Davenport C, Lambie J, Owen C, Swami V. Fathers’ experiences of depression during the perinatal period: a qualitative systematic review. JBI Evid Synth 2022; 20:2244-2302. [DOI: 10.11124/jbies-21-00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVES To develop and validate a short form of the Male Depression Risk Scale (MDRS-22) for use in primary care, examining associations with prototypic depression symptoms, psychological distress and suicidality. DESIGN Cross-sectional study with 8-month follow-up. SETTING Community-based. PARTICIPANTS A community sample of younger (n=510; 18-64 years) and older (n=439; 65-93 years) men residing in Australia (M age=58.09 years, SD=17.77) participated in the study. A subset of respondents (n=159 younger men; n=169 older men) provided follow-up data approximately eight months later. PRIMARY AND SECONDARY OUTCOME MEASURES Quantitative data were obtained through a survey comprising a range of validated measures, including the MDRS-22, the Patient Health Questionnaire (PHQ-9) and the Kessler Psychological Distress Scale (K10). The MDRS-22 was refined using exploratory and confirmatory factor analysis in line with best practice guidelines. Analysis of variance and generalised linear models were conducted to explore relationships between variables. RESULTS The short-form MDRS consisted of seven items (MDRS-7) and captured all of the domains in the original tool. Participants with mixed symptoms (PHQ-9 ≥ 10 and MDRS-7 > 5) had significantly higher risk of mental illness (K10 ≥ 25) and current suicidality (PHQ-9 item 9 ≥ 1) than those with exclusively prototypic symptoms (PHQ-9 ≥ 10 and MDRS-7 ≤ 5). Furthermore, the MDRS-7 was shown to be effective at predicting elevated symptoms of depression at follow-up, after controlling for previous depression diagnosis. CONCLUSIONS Findings provide preliminary evidence of the potential utility of the MDRS-7 as a screening tool for externalised and male-type symptoms associated with major depression in men. Field trials of the MDRS-7 in primary care settings may facilitate identification of men at risk of suicide and psychological distress who do not meet cut-off scores for existing measures of major depression symptoms.
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Affiliation(s)
- Danielle Herreen
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ian Zajac
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia
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Rodrigues AL, Ericksen J, Watson B, Gemmill AW, Milgrom J. Interventions for Perinatal Depression and Anxiety in Fathers: A Mini-Review. Front Psychol 2022; 12:744921. [PMID: 35126228 PMCID: PMC8810528 DOI: 10.3389/fpsyg.2021.744921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men. Methods We drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both. Results Eleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms. Discussion There was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.
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Affiliation(s)
- Andre L. Rodrigues
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jennifer Ericksen
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Brittany Watson
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Alan W. Gemmill
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
- University of Melbourne School of Psychological Sciences, Parkville, VIC, Australia
- *Correspondence: Jeannette Milgrom
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Kornfield SL, White LK, Waller R, Njoroge W, Barzilay R, Chaiyachati BH, Himes MM, Rodriguez Y, Riis V, Simonette K, Elovitz MA, Gur RE. Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19. Health Aff (Millwood) 2021; 40:1566-1574. [PMID: 34606353 DOI: 10.1377/hlthaff.2021.00803] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acute stress during pregnancy can have adverse effects on maternal health and increase the risk for postpartum depression and impaired mother-infant bonding. The COVID-19 pandemic represents an acute environmental stressor during which it is possible to explore risk and resilience factors that contribute to postpartum outcomes. To investigate prenatal risk and resilience factors as predictors of postpartum depression and impaired mother-infant bonding, this study recruited a diverse cohort of 833 pregnant women from an urban medical center in Philadelphia, Pennsylvania, and assessed them once during pregnancy in the early phase of the COVID-19 pandemic (April-July 2020) and again at approximately twelve weeks postpartum. Adverse childhood experiences, prenatal depression and anxiety, and COVID-19-related distress predicted a greater likelihood of postpartum depression. Prenatal depression was the only unique predictor of impaired maternal-infant bonding after postpartum depression was controlled for. Women reporting greater emotion regulation, self-reliance, and nonhostile relationships had healthier postpartum outcomes. Policies to increase the number of nonspecialty providers providing perinatal mental health services as well as reimbursement for integrated care and access to mental health screening and care are needed to improve lifelong outcomes for women and their children.
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Affiliation(s)
- Sara L Kornfield
- Sara L. Kornfield is an assistant professor in the Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, in Philadelphia, Pennsylvania. Kornfield and Lauren K. White are co-first authors
| | - Lauren K White
- Lauren K. White is a research scientist in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. White and Sara L. Kornfield are co-first authors
| | - Rebecca Waller
- Rebecca Waller is an assistant professor in the Department of Psychology, University of Pennsylvania
| | - Wanjiku Njoroge
- Wanjiku Njoroge is an assistant professor in the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Ran Barzilay
- Ran Barzilay is an assistant professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Barbara H Chaiyachati
- Barbara H. Chaiyachati is an associate fellow in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Megan M Himes
- Megan M. Himes is a research assistant in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Yuheiry Rodriguez
- Yuheiry Rodriguez is a study coordinator in the Department of Psychology, University of Pennsylvania
| | - Valerie Riis
- Valerie Riis is the director of operations, Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Keri Simonette
- Keri Simonette is a clinical research coordinator at Jefferson Health, in Philadelphia, Pennsylania. She was a project manager with the Maternal Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, when this work was performed
| | - Michal A Elovitz
- Michal A. Elovitz is a professor in the Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Raquel E Gur
- Raquel E. Gur is a professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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11
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Biden EJ, Greenwood CJ, Macdonald JA, Spry EA, Letcher P, Hutchinson D, Youssef GJ, McIntosh JE, Olsson CA. Preparing for Future Adversities: Lessons From the COVID-19 Pandemic in Australia for Promoting Relational Resilience in Families. Front Psychiatry 2021; 12:717811. [PMID: 34421689 PMCID: PMC8371315 DOI: 10.3389/fpsyt.2021.717811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has placed considerable pressure on families, testing the quality of relationships and the strength of social support within and beyond the family network. However, little is known about the pre-pandemic factors that predict family relational resilience and social functioning during times of natural disaster or global crisis. Here we use data from one of Australia's longest running studies of social and emotional development to examine the nature and timing of possible relational and social support intervention aimed at preparing families for future adversities. Methods: Data were from the Australian Temperament Project Generation 3 (ATPG3) Study, a population representative three generation cohort study of families established in 1983. A subset of Generation 2 parents completed a COVID-19 specific survey in May-September 2020 (502 parents of 871 children; 60% mothers; 37-38 years). These participants had completed the Quality of Relationships Inventory to assess social support during young adulthood, at 23-24 years (2006) and 27-28 years (2010), before next generation conception. Participants had also completed the Maternity Social Support Scale 1 year postpartum for each child born across the ATPG3 assessment period (2012-2019). In 2020, during the height of the Australian lockdowns, participants rated the quality of their relationships with their partners, children and broader family and friends, in addition to social support within and extended beyond their family. Results: Pre-pandemic partner support was associated with partner relationship quality during the pandemic (β = 0.22). Pre-pandemic support from friends was associated with relationship quality with other family and friends during the pandemic (β = 0.12 - 0.18). Pre-pandemic support (from partner, family and friends) was consistently associated with social support within families during the pandemic (β = 0.11 - 0.21). Pre-pandemic support from friends was also associated with family support extended to others within their local community during the pandemic (β = 0.12 - 0.13). Conclusions: Strengthening supportive relationships during major life transitions, prior to the start of family life and in early parenthood, may have long-term and intergenerational benefits years into the future for both families and communities. This may promote resilience during future crises and other more normative stressful life events.
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Affiliation(s)
- Ebony J. Biden
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A. Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - George J. Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jennifer E. McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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12
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Macdonald JA, Francis LM, Skouteris H, Youssef GJ, Graeme LG, Williams J, Fletcher RJ, Knight T, Milgrom J, Di Manno L, Olsson CA, Greenwood CJ. Cohort profile: the Men and Parenting Pathways (MAPP) Study: a longitudinal Australian cohort study of men's mental health and well-being at the normative age for first-time fatherhood. BMJ Open 2021; 11:e047909. [PMID: 34315795 PMCID: PMC8317085 DOI: 10.1136/bmjopen-2020-047909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The Men and Parenting Pathways (MAPP) Study is a prospective investigation of men's mental health and well-being across the normative age for transitioning to fatherhood. This includes trajectories and outcomes for men who do and do not become fathers across five annual waves of the study. PARTICIPANTS Australian resident, English-speaking men aged 28-32 years at baseline were eligible. Recruitment was over a 2-year period (2015-2017) via social and traditional media and through engagement with study partners. Eight hundred and eighteen eligible men consented to participate. Of these, 664 men completed the first online survey of whom 608 consented to ongoing participation. Of the ongoing sample, 83% have participated in at least two of the first three annual online surveys. FINDINGS TO DATE Three waves of data collection are complete. The first longitudinal analysis of MAPP data, published in 2020, identified five profiles that characterise men's patterns of depressive symptom severity and presentations of anger. Profiles indicating pronounced anger and depressive symptoms were associated with fathers' lack of perceived social support, and problems with coparenting and bonding with infants. In a second study, MAPP data were combined with three other Australian cohorts in a meta-analysis of associations between fathers' self-reported sleep problems up to 3 years postpartum and symptoms of depression, anxiety and stress. Adjusted meta-analytic associations between paternal sleep and mental health risk ranged from 0.25 to 0.37. FUTURE PLANS MAPP is an ongoing cohort study. Waves 4 and 5 data will be ready for analyses at the end of 2021. Future investigations will include crossed-lagged and trajectory analyses that assess inter-relatedness and changing social networks, mental health, work and family life. A nested study of COVID-19 pandemic-related mental health and coping will add two further waves of data collection in a subsample of MAPP participants.
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Affiliation(s)
- Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, West Midlands, UK
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Liam G Graeme
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology-Hawthorn Campus, Hawthorn, Victoria, Australia
- School of Health and Social Development, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Richard J Fletcher
- Family Action Centre, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Tess Knight
- Cairnmillar Institute, Camberwell, Victoria, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Laura Di Manno
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
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13
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Macdonald JA, Greenwood CJ, Letcher P, Spry EA, Mansour K, McIntosh JE, Thomson KC, Deane C, Biden EJ, Edwards B, Hutchinson D, Cleary J, Toumbourou JW, Sanson AV, Olsson CA. Parent and Peer Attachments in Adolescence and Paternal Postpartum Mental Health: Findings From the ATP Generation 3 Study. Front Psychol 2021; 12:672174. [PMID: 34122266 PMCID: PMC8195233 DOI: 10.3389/fpsyg.2021.672174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/30/2021] [Indexed: 01/19/2023] Open
Abstract
Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood. Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum (N = 409 infant offspring) for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments. Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other. Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems.
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Affiliation(s)
- Jacqui A Macdonald
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J Greenwood
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Primrose Letcher
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A Spry
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Kayla Mansour
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Jennifer E McIntosh
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.,The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Kimberly C Thomson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, BC, Canada
| | - Camille Deane
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Ebony J Biden
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, Australian National University, Canberra, ACT, Australia
| | - Delyse Hutchinson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Joyce Cleary
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - John W Toumbourou
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Ann V Sanson
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Craig A Olsson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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14
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Livingston JD, Youssef GJ, Francis LM, Greenwood CJ, Olsson CA, Macdonald JA. Hidden in Plain Sight? Men's Coping Patterns and Psychological Distress Before and During the COVID-19 Pandemic. Front Psychiatry 2021; 12:772942. [PMID: 35069282 PMCID: PMC8766713 DOI: 10.3389/fpsyt.2021.772942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Individuals cope with stress using multiple strategies, yet studies of coping profiles are rare. We draw data from a longitudinal study of Australian men (n = 272; 30-37 years), assessed before (T1) and during (T2) a nation-wide COVID-19 lockdown. We aimed to: (1) identify men's multi-strategy coping profiles before and during the pandemic; (2) assess cross-sectional (T1-T1, T2-T2) and prospective (T1-T2) associations between profiles and symptoms of psychological distress (stress, anxiety, depression, and anger); and (3) examine relationships between coping profiles and appraisals of pandemic-related stressors and options for coping. In latent profile analyses of 14 coping strategies, three profiles emerged that were largely consistent across T1 and T2: (1) Relaxed Copers (low use of all strategies), (2) Approach Copers, and (3) Dual Copers (high avoidant and moderate-high approach-oriented strategies). Compared to Relaxed and Approach Copers, men who were Dual Copers had elevated psychological distress cross-sectionally before (T1) and during (T2) the pandemic, but not prospectively. Post hoc analyses suggested this was because many men changed coping profiles in the context of the pandemic. Men with stable (T1-T2) or new (T2 only) Dual Coping profiles experienced greater psychological distress and more negative appraisals of pandemic stressors and options for coping. In sum, at the sample level, the composition of men's coping profiles and associations with mental health risk were relatively stable over time and contexts; however, many men appeared to respond to pandemic conditions by changing coping profile groups, with mostly positive mental health outcomes. Of concern were men who adopted more avoidant strategies (e.g., denial, self-distraction, disengagement, substance use, and self-blame) under pandemic conditions. These Dual Coper men also engaged in commonly observable approach-oriented behaviours (e.g., planning, active coping, humour, seeking practical social support) that may mask their vulnerability to mental health risk. Our findings highlight the clinical importance of enquiring about escalating or frequent avoidant coping even in the presence of more active and interactive approach-oriented behaviours.
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Affiliation(s)
- Julianne D Livingston
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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