Paediatrics (RCH) - Research Publications

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    Adverse experiences in early intimate relationships and next-generation infant-mother attachment: findings from the ATP Generation 3 Study
    Opie, J ; Mcintosh, J ; Olsson, CM ; Greenwood, CJ ; Letcher, P ; Tan, E ; Opie, JE ; Booth, A ; Mcintosh, J ; Olsson, CA (WILEY, 2023-12)
    Abstract Chronic insecurities that emerge from adverse experiences in early intimate partner relationships in adolescence and emerging adulthood can have profound impacts on mental health and well‐being. Less clear is the extent to which these experiences for parents impact subsequent relationships within and across generations. We examine the extent to which secure, dismissing, pre‐occupied, and fearful intimate partner relationships in adolescence and emerging adulthood, well before becoming a parent, are associated with next‐generation patterns of attachment between mothers and infant offspring. Data were drawn from a nested study of infant–mother attachment (n = 220) within the Australian Temperament Project Generation 3 Study (N = 1167, est. 1983). Intimate partner relationships in adolescence and young adulthood were assessed by self‐report at 23–24 years of age. Over a decade later, infant–mother attachment security was assessed at 12 months post‐partum. Young adult intimate partner relationships defined by high levels of fearful, pre‐occupied, and dismissing attachment styles were reported in 11%, 17%, and 38% of young mothers, respectively. Increases in fear of intimacy in relationships were associated with an increase in the odds, by around 50%, of infant–mother insecure attachments (vs secure; OR = 1.56, 95% CI = 1.07, 2.28) and disorganised attachments (vs organised; OR = 1.49, 95% CI = 1.00, 2.22). A mother's self‐reported history of fear of intimacy within young adult relationships predicts later insecure and disorganised mother–infant attachments. Guidance and greater support for young people navigating their earliest intimate relationships may not only prevent adverse relational experiences at the time but also on becoming a parent. Findings have relevance for family and infant mental health therapies. Translating these findings into supported conversations may help prevent infant–mother attachment difficulties, or later repair them, through validation of the lingering effects of early fear of intimacy and empowerment of parents to prevent next‐generation infant experiences of distrust.
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    Adolescent School Belonging and Mental Health Outcomes in Young Adulthood: Findings from a Multi-wave Prospective Cohort Study
    Allen, K-A ; Greenwood, CJ ; Berger, E ; Patlamazoglou, L ; Reupert, A ; Wurf, G ; May, F ; O'Connor, M ; Sanson, A ; Olsson, CA ; Letcher, P (SPRINGER, 2024-03)
    Abstract School belonging, sometimes referred to as school belonging or school connectedness, involves dimensions like positive affect towards school, relationships with teachers, and feeling socially valued. Previous research points to immediate benefits for students’ mental health and wellbeing; however, evidence on the potential long-term benefits of school belonging for mental health—once young people leave the school setting—is limited. This study used data on 1568 adults from the Australian Temperament Project (ATP), a 16-wave longitudinal study which has tracked participants since infancy. The short form of the Australian Council for Educational Research (ACER) School Life Questionnaire was used to assess secondary school belonging at age 15–16 years whilst young adult mental health symptoms were evaluated using the Depression, Anxiety and Stress Scales (DASS-21) at 19–20, 23–24, and 27–28 years. Generalised Estimating Equation models were used to examine the link between secondary school belonging and mental health symptoms in young adulthood. Results showed that higher levels of all aspects of school belonging were associated with lower mental health symptoms across young adulthood (β range − 0.05 to − 0.20). Associations were similar by gender. These findings underscore the importance of adolescent school belonging and in particular school status in reference to feeling socially valued, as a long-term protective factor that can mitigate against later depression, anxiety, and stress.
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    Is Neighborhood Nature an Ecological Precursor of Parenting Practices, Infant-Parent Bonding, and Infant Socioemotional Function?
    Mygind, L ; Greenwood, C ; Letcher, P ; Mavoa, S ; Lycett, K ; Wang, Y ; Flensborg-Madsen, T ; Bentsen, P ; Macdonald, JA ; Thomson, K ; Hutchinson, D ; Olsson, CA ; Enticott, PG (SAGE PUBLICATIONS INC, 2023-05)
    Nurturing relationships are crucial for adaptive child development. The objectives of the study were to investigate whether nature availability was associated with early nurturing parenting practices, mother-infant bonding, and infant socioemotional function. Data were from the Australian Temperament Project ( n = 809 infants to 515 parents residing in Victoria, Australia) and were linked cross-sectionally to residential greenness (i.e., Normalized Difference in Vegetation Index). There were no observable associations between residential greenness within a 1,600 m network radius and parenting practices, mother-infant bonding, or infant socioemotional function. The findings were largely corroborated by sensitivity analyses (i.e., NDVI within 100, 250, 500, and 1,000 m and distance to park). Shorter distances to a park were associated with less hostile parenting. More residential greenness (1,000 and 1,600 m) was associated with stronger father-infant bonding and more hostile parenting amongst the most stressed parents in exploratory analyses. Residential greenness might be a socioecological precursor for father-infant bonding.
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    Infant and preschool attachment, continuity and relationship to caregiving sensitivity: findings from a new population-based Australian cohort
    Mcintosh, JE ; Opie, J ; Greenwood, CJ ; Booth, A ; Tan, E ; Painter, F ; Messer, M ; Macdonald, JA ; Letcher, P ; Olsson, CA (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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    Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium
    Thomson, KC ; Greenwood, CJ ; Letcher, P ; Spry, EA ; Macdonald, JA ; McAnally, HM ; Hines, LA ; Youssef, GJ ; McIntosh, JE ; Hutchinson, D ; Hancox, RJ ; Patton, GC ; Olsson, CA (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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    Multilevel Impacts of the COVID-19 Pandemic: A Bioecological Systems Perspective of Parent and Child Experiences
    Painter, FL ; Booth, AT ; Letcher, P ; Olsson, CA ; McIntosh, JE (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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    Illicit Substance Use and Harm in Young Adulthood: the Role of Substance Use in Close Relationships and Individual Social Skills
    Greenwood, CJ ; Letcher, P ; Macdonald, JA ; Hutchinson, DM ; Youssef, GJ ; Toumbourou, JW ; Spry, E ; Sanson, A ; Cleary, J ; Olsson, CA (Springer Science and Business Media LLC, 2023-01-01)
    Abstract To examine illicit substance use across young adulthood and explore the extent to which social skills moderate the relationship between use and harm. 1,404 (761 women) from the Australian Temperament Project (est. 1983) participated across young adulthood (age 19–20, 23–24, and 27–28 years). Measures included self-reported illicit substance use/harm and social skills (i.e., assertion, empathy, responsibility, and self-control). The number and type of illicit substances used changed across young adulthood. Greater illicit substance use was associated with peer (OR = 4.96) and partner use (OR = 3.60). Moderation analyses suggested the risk relationship between the number of illicit substances used and harm was lower in those with high levels of assertion/self-control (ORassertion = 2.34, ORself-control = 2.60) compared to low levels (ORassertion = 4.43, ORself-control = 3.72). Evidence based programmes designed to strengthen individual social skills for young adults may play a role in protecting against the adverse effects of illicit substance use.
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    Factor structure of the Mini-Maternal Behavior Q-Sort and associations with infant attachment: Informing precision in research and intervention
    Booth, AT ; Greenwood, CJ ; Youssef, GJ ; McIntosh, JE ; Nguyen, T ; Letcher, P ; Edwards, B ; Hutchinson, DM ; Sanson, A ; Olsson, CA ; Macdonald, JA (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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    The lived experience of stress for parents in the context of COVID-19-related disruption
    Painter, FL ; Booth, AT ; Letcher, P ; Olsson, CA ; McIntosh, JE (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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    Parental history of positive development and child behavior in next generation offspring: A two-cohort prospective intergenerational study
    Letcher, P ; Greenwood, CJ ; McAnally, H ; Belsky, J ; Macdonald, JA ; Spry, EA ; Thomson, KC ; O'Connor, M ; Sligo, J ; Youssef, G ; McIntosh, JE ; Iosua, E ; Hutchinson, D ; Cleary, J ; Sanson, A ; Patton, GC ; Hancox, RJ ; Olsson, CA (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.