C.M.J.M. Vreeswijk

Long-term outcome in pyridoxine-dependent epilepsy.

Aim  The long‐term outcome of the Dutch pyridoxine‐dependent epilepsy cohort and correlations between patient characteristics and follow‐up data were retrospectively studied.

“Expectant Parents”: Study protocol of a longitudinal study concerning prenatal (risk) factors and postnatal infant development, parenting, and parent-infant relationships

BackgroundWhile the importance of the infant-parent relationship from the child’s perspective is acknowledged worldwide, there is still a lack of knowledge about predictors and long-term benefits or consequences of the quality of parent-infant relationships from the parent’s perspective. The purpose of this prospective study is to investigate the quality of parent-infant relationships from parents’ perspectives, both in the prenatal and postpartum period. This study therefore focuses on prenatal (risk) factors that may influence the quality of pre- and postnatal bonding, the transition to parenthood, and bonding as a process within families with young children. In contrast to most research concerning pregnancy and infant development, not only the roles and experiences of mothers during pregnancy and the first two years of infants’ lives are studied, but also those of fathers.Methods/designThe present study is a prospective longitudinal cohort study, in which pregnant women (N = 466) and their partners (N = 319) are followed from 15 weeks gestation until their child is 24 months old. During pregnancy, midwives register the presence of prenatal risk factors and provide obstetric information after the child’s birth. Parental characteristics are investigated using self-report questionnaires at 15, 26, and 36 weeks gestational age and at 4, 6, 12, and 24 months postpartum. At 26 weeks of pregnancy and at 6 months postpartum, parents are interviewed concerning their representations of the (unborn) child. At 6 months postpartum, the mother-child interaction is observed in several situations within the home setting. When children are 4, 6, 12, and 24 months old, parents also completed questionnaires concerning the child’s (social-emotional) development and the parent-child relationship. Additionally, at 12 months information about the child’s physical development and well-being during the first year of life is retrieved from National Health Care Centres.DiscussionThe results of this study may contribute to early identification of families at risk for adverse parent-infant relationships, infant development, or parenting. Thereby this study will be relevant for the development of policy, practice, and theory concerning infant mental health.

Effect of situation on mother-infant interaction.

Research has shown that the early parent-infant relationship is of critical importance for childrens developmental outcomes. While the effect of different settings on mother-infant interactive behavior is well studied, only few researchers systematically examined the effect of situational variables on mother-infant interaction. In the present study the effect of situational variables within the home setting on the quality of mother-infant interaction at 6 months was examined as well as the consistency in the quality of behaviors of mother and infant across these situations. During a home visit 292 mother-infant dyads were videotaped in three different situations (i.e., free play, face-to-face play, and diaper change). Interactive behaviors of mother and infant were assessed with the NICHD global ratings scales. Results showed substantial effects of situation on the interactive behavior of the mother-infant dyad. Despite the observed situational effects maternal sensitivity to non-distress, intrusiveness, stimulation of development, and positive regard and all five infant behavioral scales remained stable across the different situations. Insight into situational effects within the home setting on the quality of mother-infant interactive behavior may assist researchers to make well-informed decisions about measuring the parent-infant interaction in one or more specific situations.

Pictorial representation of attachment: measuring the parent-fetus relationship in expectant mothers and fathers.

BackgroundOver the past decades, attachment research has predominantly focused on the attachment relationship that infants develop with their parents or that adults had with their own parents. Far less is known about the development of feelings of attachment in parents towards their children. The present study examined a) whether a simple non-verbal (i.e., pictorial) measure of attachment (Pictorial Representation of Attachment Measure: PRAM) is a valid instrument to assess parental representations of the antenatal relationship with the fetus in expectant women and men and b) whether factors such as gender of the parent, parity, and age are systematically related to parental bonding during pregnancy.MethodsAt 26 weeks gestational age, 352 primi- or multiparous pregnant women and 268 partners from a community based sample filled in the PRAM and the M/PAAS (Maternal/Paternal Antenatal Attachment Scale, Condon, 1985/1993).ResultsResults show that the PRAM was significantly positively associated to a self-report questionnaire of antenatal attachment in both expectant mothers and fathers. Age and parity were both found significantly related to M/PAAS and PRAM scores.ConclusionsThe present findings provide support that the PRAM is as a valid, quick, and easy-to-administer instrument of parent-infant bonding. However, further research focusing on its capacity as a screening instrument (to identify parents with serious bonding problems) and its sensitivity to change (necessary for the use in evaluation of intervention studies) is needed, in order to prove its clinical value.

A longitudinal study on the maternal–fetal relationship and postnatal maternal sensitivity

Abstract Objective: The present study examined whether early signs of maternal sensitivity can be detected during pregnancy by focusing on the maternal–fetal relationship and postnatal maternal sensitivity. Background: Earlier research has identified maternal sensitive behaviour as an important factor for the quality of the mother–infant relationship and the child’s emotional and cognitive development later in life. Research on this topic has predominantly focused on the postnatal period and little is known about early predictors (i.e. during pregnancy) of maternal sensitivity. Methods: Participants were 273 women and their (unborn) infants. Mothers’ attitudes, thoughts and feelings towards the fetus were assessed by the Maternal Antenatal Attachment Scale at 26 weeks of gestation. At the infant’s age of 6 months, maternal sensitivity was assessed in three different situations (i.e. face-to-face play, caregiving and free play) using the NICHD global rating scales. Results: Mothers with a higher quality of the maternal–fetal relationship displayed more maternal sensitivity towards their 6-month-old infant in caregiving and free play situations, even when controlling for covariates such as parity, ethnicity, maternal education, maternal age and the postnatal mother–infant relationship. No associations were found in the face-to-face situation. Conclusion: This study shows that mothers who reported a higher quality of the maternal–fetal relationship were more sensitive while interacting with their infants during caregiving and free play, but not during face-to-face play.

Determinants of maternal fetal attachment in women from a community-based sample

Background Maternal fetal attachment (MFA) has been found to be an important predictor for the developing relationship between mother and child. During the last decades, research on determinants of MFA has yielded inconclusive and even contradictory results. Until now, a process model in which multiple determinants of MFA are studied concurrently has been lacking. The present study evaluates a process model (based on Belsky’s model of parenting) in which the specific contributions of parental, contextual, and expected child characteristics to MFA were examined. Methods Participants, 351 pregnant women from a community-based sample, completed questionnaires concerning their personality, attachment security, partner support, perceived stress, expected child temperament, and MFA at 26 weeks gestational age. Based on Belsky’s model, a set of competing structural equation models were formulated and evaluated with path analysis. Results MFA was found to be multiply determined by parental, contextual, and expected child characteristics. These factors explained 19% of the variance in MFA. Pregnant women who were more extrovert, conscientious and agreeable reported having higher levels of MFA. In contrast, those women who perceived more stress and expected having an infant with a dull temperament reported lower levels of MFA. Conclusion This study demonstrated that the theoretical framework of Belsky’s model is applicable for explaining variations in the quality of the mother–fetus relationship in the pregnancy period. More knowledge of the determinants of MFA could help to identify mothers at risk for developing suboptimal feelings of attachment.

Stability of fathers’ representations of their infants during the transition to parenthood

Studies investigating fathers’ roles in child development have focused on a range of different aspects. However, few studies have focused on the early father–infant relationship, which already emerges before the child is born. The aim of this study is to examine the concordance of fathers’ representations of their children during the transition to parenthood. The influences of demographic variables, psychological wellbeing, and personality on the stability of these representations are investigated. At 26 weeks gestational age and when infants were six months old, fathers (N = 243) completed questionnaires and the Working Model of the Child Interview during a home visit. A strong association was found between fathers’ prenatal and postnatal representations. First-time fathers more often had balanced representations than fathers who already had children. Furthermore, agreeable fathers were more likely to evolve from a non-balanced prenatal representation to a balanced postnatal representation.

Longitudinal Associations Between Parental Bonding, Parenting Stress, and Executive Functioning in Toddlerhood

Early executive functioning is an important predictor for future development of children’s cognitive skills and behavioral outcomes. Parenting behavior has proven to be a key environmental determinant of child executive functioning. However, the association of parental affect and cognitions directed to the child with child executive functioning has been understudied. Therefore, in the present study we examine the associations between parental bonding (i.e., the affective tie from parent to child), parenting stress, and child executive functioning. At 26 weeks of pregnancy, and at 6 months and 24 months postpartum the quality of the maternal (N = 335) and paternal (N = 261) bond with the infant was assessed. At 24 months, postnatal parenting stress and child executive functioning were measured by means of parent-report questionnaires. Results indicated that for both mothers and fathers feelings of bonding negatively predicted experienced parenting stress over time. In addition, for both parents a negative indirect effect of bonding on child executive functioning problems was found via experienced parenting stress. These findings indicate the importance of monitoring parents who experience a low level and quality of early parent-child bonding, as this makes them vulnerable to parenting stress, consequently putting their children at risk for developing executive functioning problems.