Paediatrics (RCH) - Research Publications
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ItemNo Preview AvailableInfant and preschool attachment, continuity and relationship to caregiving sensitivity: findings from a new population-based Australian cohort(WILEY, 2024-01)BACKGROUND: Here, we report new prevalence and temporal stability data for child attachment and parental caregiving behaviour, from infancy (1 year) to preschool (4 years). METHODS: Attachment (SSP) and caregiving data (MBQS) were from observations of parents and their infants and preschoolers, who represent the third generation of participants within an Australian longitudinal cohort. RESULTS: At 1 year (n = 314 dyads) and at 4 years (n = 368 dyads), proportions assessed secure were 59% and 71%, respectively. Proportions assessed avoidant were 15% and 11%; ambivalent 9% and 6%, and disorganised 17% and 12%, at 1 and 4 years. Continuity of attachment pattern was highest for the infant secure group. Of dyads initially classified disorganised in infancy, 36% remained so at the preschool assessment. Attachment and caregiving continuities across the infancy-preschool period were highest for the stable secure attachment group and lowest for the stable insecure attachment group. Loss of secure attachment to mother by age 4 years correlated with decreased maternal caregiving sensitivity, and acquisition of secure status by age 4 was associated with increased maternal sensitivity. We found no difference in caregiving sensitivity scores for mothers and fathers for female and male preschool children. CONCLUSIONS: The contemporary infant and preschool attachment proportions we report here closely mirror the patterns of those reported in prior decades, with an inclination towards secure base relationships. Our findings alert practitioners anew to the responsiveness of early attachment status to change in caregiving responsiveness and support ongoing investment in early identification of disorganised attachment.
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ItemNo Preview AvailableContinuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium(CAMBRIDGE UNIV PRESS, 2023-04-08)Background This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. Methods Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. Results Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. Conclusions Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.
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ItemNo Preview AvailableMultilevel Impacts of the COVID-19 Pandemic: A Bioecological Systems Perspective of Parent and Child Experiences(SPRINGER, 2024-04)Abstract Background The coronavirus (COVID-19) pandemic and associated public health restrictions created unprecedented challenges for parents and their young dependent children. While psycho-social impacts of natural disasters on families are well studied, a typography of parent specific concerns in the COVID-19 context was yet to be articulated. Objective Using a bioecological systems framework, we adopted a mixed-methods research design to examine parents’ core concerns about the impacts of the pandemic on themselves and their children, testing for differences in concern foci of mothers compared with fathers. Method Data were drawn from the Australian Temperament Project Generation 3 (ATPG3) study, a prospective study of children born to a 40-year population-based cohort. During enforced COVID-19 lockdown restrictions between May to September 2020, ATPG3 parents (n = 516) were surveyed about their own and their children’s functioning in the context of the pandemic. Subject of qualitative content analysis, parents (n = 192) experiencing wellbeing concerns offered additional free-text responses about the nature of stress impacting themselves and their child/ren. Results Parents reported far-reaching impacts for themselves and their children across multiple bioecological systems. Core concerns were for emotional rather than physical health, specifically, for parents this was represented by increased levels of anxiety and stress, and for children, these impacts were notable from a developmental perspective. Greater frequency of parenting related concern was expressed by mothers in comparison to fathers. Conclusions Findings demonstrate the complex and interrelated nature of multi-systemic and gendered stressors impacting parents during the pandemic, and importantly point to modifiable risk factors which may inform early risk detection efforts.
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ItemNo Preview AvailableFactor structure of the Mini-Maternal Behavior Q-Sort and associations with infant attachment: Informing precision in research and intervention(WILEY, 2023-03)We examined the factor structure of parental sensitivity to infants as assessed by the Mini-Maternal Behavior Q-Sort (Mini-MBQS), a 25-item short-form of the original 90-item MBQS. We aimed to: (1) identify latent factors of the Mini-MBQS; and (2) validate each factor by testing associations with infant attachment classifications. Data on parent-infant dyads (n = 313; 222 mothers with 281 children, 29 fathers with 32 children) were drawn from a three-generation Australian cohort study. Exploratory Factor Analysis and Exploratory Structural Equation Modelling examined the structure of the Mini-MBQS. Two latent Mini-MBQS factors were identified, requiring 8 of 25 original items: (1) Attention and Responsiveness and (2) Contingency in Interactions. Infants with insecure attachment classifications had parents with lower sensitivity across both factors relative to infants classified secure. In particular, infants with resistant attachment classifications had parents with notably low Contingency in Interactions scores. Infants with disorganised attachment classifications had parents with the lowest relative sensitivity across both factors, and in these dyads Attention and Responsiveness scores were especially low. Results provide an empirically derived factor structure for the Mini-MBQS. Two subscales, each with significant infant attachment associations, may improve precision in clinical intervention and research translation.
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ItemNo Preview AvailableThe lived experience of stress for parents in the context of COVID-19-related disruption(WILEY, 2023-10)Abstract Objective This mixed methods study sought to explore the lived experience of stress for parents of young dependent children during COVID‐19 lockdowns in Australia. Background Public health restrictions implemented during the COVID‐19 pandemic disproportionately burdened parents as they balanced novel and competing role demands. Despite growing research on impacts to parent mental health, much less is known about parenting at the experiential level during this period. Method Data were derived from free‐text survey responses collected during 2020 in an Australian population cohort study and analyzed in a mixed methods approach focusing on descriptive phenomenology. Twenty‐eight parent accounts of either ‘extreme’ or ‘minimal’ stress experiences were subject to phenomenological analysis of the individual, interpersonal, and contextual factors associated with each stress category. Results Three themes defined ‘extreme’ stress experiences: inadequacy of resources to cope, perceived lack of control, and compounding stressors. Two themes characterized ‘minimal’ stress experiences: feeling well resourced to cope and the absence of significant disruption to everyday life. Conclusion Findings highlight three targets in particular: compounding stressors, family relationships, and gendered differences in parental stress. Implications Intervention efforts should focus on better resourcing parents experiencing accumulating stressors through provision of individual and relational support and by addressing the higher burden experienced by mothers compared with fathers across pandemic related lockdowns.
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ItemNo Preview AvailableParental history of positive development and child behavior in next generation offspring: A two-cohort prospective intergenerational study(WILEY, 2023-01)This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (βrange = .11-.16) and fewer behavior problems (βrange = -.09 to -.11). Promoting strengths may secure a healthy start to life.
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ItemNo Preview AvailableFrom adolescence to parenthood: a multi-decade study of preconception mental health problems and postpartum parent-infant bonds(SPRINGER HEIDELBERG, 2022-03)PURPOSE: To examine associations between anxiety and depressive symptoms across adolescence and young adulthood with subsequent maternal- and paternal-infant bonding at 1 year postpartum. METHODS: The data were from a prospective, intergenerational cohort study. Participants (381 mothers of 648 infants; 277 fathers of 421 infants) self-reported depression and anxiety at three adolescent waves (ages 13, 15 and 17 years) and three young adult waves (ages 19, 23 and 27 years). Subsequent parent-infant bonds with infants were reported at 1 year postpartum (parent age 29-35 years). Generalised estimating equations (GEE) separately assessed associations for mothers and fathers. RESULTS: Mean postpartum bonding scores were approximately half a standard deviation lower in parents with a history of persistent adolescent and young adult depressive symptoms (maternal βadj = - 0.45, 95% CI - 0.69, - 0.21; paternal βadj = - 0.55, 95% CI - 0.90, 0.20) or anxiety (maternal βadj = - 0.42, 95% CI - 0.66, - 0.18; paternal βadj = - 0.49, 95% CI - 0.95, 0.03). Associations were still mostly evident, but attenuated after further adjustment for postpartum mental health concurrent with measurement of bonding. CONCLUSIONS: Persistent symptoms of depression or anxiety spanning adolescence and young adulthood predict poorer emotional bonding with infants 1-year postbirth for both mothers and fathers.
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ItemNo Preview AvailableLife course psychosocial precursors of parent mental health resilience during the COVID-19 pandemic: A three-decade prospective cohort study(ELSEVIER, 2023-08-15)BACKGROUND: There has been widespread interest in the implications of COVID-19 containment measures on the mental health of parents. Most of this research has focused on risk. Much less is known about resilience; yet such studies are key to protecting populations during major crises. Here we map precursors of resilience using life course data spanning three decades. METHODS: The Australian Temperament Project commenced in 1983 and now follows three generations. Parents (N = 574, 59 % mothers) raising young children completed a COVID-19 specific module in the early (May-September 2020) and/or later (October-December, 2021) phases of the pandemic. Decades prior, parents had been assessed across a broad range of individual, relational and contextual risk and promotive factors during childhood (7-8 years to 11-12 years), adolescence (13-14 years to 17-18 years) and young adulthood (19-20 years to 27-28 years). Regressions examined the extent to which these factors predicted mental health resilience, operationalised as lower than expected anxiety and depressive symptoms during the pandemic relative to pre-pandemic symptoms. RESULTS: Parent mental health resilience during the COVID-19 pandemic was consistently predicted by several factors assessed decades before the pandemic. These included lower ratings of internalizing difficulties, less difficult temperament/personality traits and stressful life events, and higher ratings of relational health. LIMITATIONS: The study included 37-39-year-old Australian parents with children age between 1 and 10 years. DISCUSSION: Results identified psychosocial indicators across the early life course that, if replicated, could constitute targets for long-term investment to maximise mental health resilience during future pandemics and crises.
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ItemThe Australian Temperament Project Generation 3 study: a population-based multigenerational prospective cohort study of socioemotional health and development(BMJ PUBLISHING GROUP, 2022-09)PURPOSE: The Australian Temperament Project Generation 3 Study (ATPG3) was established to examine the extent to which offspring social and emotional development is shaped in the decades prior to conception, in parent and grandparent histories of psychosocial adjustment (eg, emotional regulation, relationship quality and prosociality) and maladjustment (eg, depressive symptoms, substance use and antisociality). PARTICIPANTS: The Australian Temperament Project (ATP) commenced in 1983 as a population representative survey of the social and emotional health of 2443 young Australians (Generation 2: 4-8 months old) and their parents (Generation 1). Since then, families have been followed from infancy to young adulthood (16 waves). Between 2012 and 2018, the cohort was screened biannually for pregnancies (Generation 3), with assessments conducted in the third trimester of pregnancy, and at 8 weeks and 1 year postpartum. FINDINGS TO DATE: A total of 1167 offspring (607 female) born to 703 Generation 2 parents (400 mothers) were recruited into the ATPG3 Study. Findings to date highlight: (1) strong continuities in depressive symptoms and substance use from adolescence through to becoming a parent; (2) a role for persistent preconception mental health problems in risk for parent-child bonding difficulties, as well as infant emotional reactivity and behaviour problems; (3) the importance of secure attachments in adolescence in reducing long-term risk for postpartum mental health problems; and (4) the protective nature of perceived social support, both preconception and postpartum, in strengthening relationship quality and social support during the COVID-19 pandemic. FUTURE PLANS: Assessments of ATPG3 families in preschool and middle childhood are currently funded and underway. We intend to maintain the offspring cohort through childhood, adolescence, young adulthood and into parenthood. Data will be used to map preconception determinants of emotional health, and enhance approaches to population monitoring and targeted intervention over the life course and across generations.
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ItemPreparing for Future Adversities: Lessons From the COVID-19 Pandemic in Australia for Promoting Relational Resilience in Families(FRONTIERS MEDIA SA, 2021-08-04)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.