Marjo Flykt

Prenatal Expectations in Transition to Parenthood: Former Infertility and Family Dynamic Considerations

Prenatal expectations are important for the future parent-child relationship. The authors examined how maternal and paternal prenatal expectations of the relationship with the child predicted 1st-year parenting stress and whether these expectations were violated over the transition to parenthood. They further examined how former infertility affected these associations. The participants were 745 Finnish couples, 367 having undergone a successful assisted reproductive treatment and 378 conceiving spontaneously. Couples completed a questionnaire of family representations during pregnancy and when the child was 2 and 12 months old and Abidins Parenting Stress Index at 2 and 12 months postpartum. The hypothesis of moderately high expectations predicting the lowest level of parenting stress was substantiated only concerning paternal expectations of own autonomy with the child. Generally, however, negative expectations of own and spouses relationship with the child were linearly associated with higher parenting stress. Postnatal representations were more positive or equal to expectations, except for negative violation occurring in maternal expectation of the father-child relationship, especially among normative mothers. The results are discussed in relation to family dynamic considerations and special features of formerly infertile couples.

Maternal Pre- and Postnatal Mental Health Trajectories and Child Mental Health and Development: Prospective Study in a Normative and Formerly Infertile Sample.

Pregnancy and early motherhood involve uncertainty and change, which can evoke mental health problems. We identified maternal mental health trajectories in pre- and postnatal period, and examined their association with later child mental health and development. Finnish mothers reported psychological distress (General Health Questionnaire [GHQ-36]) and depressive (Beck Depression Inventory [BDI-13]) symptoms in pregnancy (T1; N = 788) and two months (T2; N = 657) and 12 months (T3; N = 545) postpartum. Both parents accounted their child’s mental health (Behavior Assessment System for Children [BASC]) and social (Social Skills Rating System [SSRS], Child Behavior Scale [CBS]) and cognitive development (Five to Fifteen [FTF]) when the child was 7–8 years old (T4; N = 485). We identified five trajectories depicting unique timing and course of maternal mental health from pregnancy into 1 year of mothering: Stable low levels of mental health symptoms (75%) and prenatal (6%), early postpartum (9%) and late postpartum (6%) mental health problems. The fifth trajectory, heterogeneous high levels of mental health problems (4%) was an unclassified post hoc class, combining mothers with chronic high or highly variable mental health profiles. Results show some trajectory-related timing effects on children’s mental health and cognitive development. The trajectories of early postpartum and heterogeneous high levels of mental health problems predicted higher level of internalizing symptoms as compared to stable low-levels trajectory. The heterogeneous high-levels trajectory predicted higher levels of problems in executive functions than the stable low and late postpartum trajectories, and in memory tasks than children in other trajectories. We discuss the timing and course of maternal mental health from the viewpoint of infant and child development.

What explains violated expectations of parent-child relationship in transition to parenthood?

Parent-child relationship is created already in prenatal fantasies and expectations of the child-to-be. Negative violation of these expectations after the child is born is known to be harmful for the parent-child relationship. Yet, research is scarce about the medical and psychological factors contributing to violated expectations (VE). This study models the role of parent-, delivery- and infant-related underlying mechanisms for VE. It further compares parents with assisted reproductive treatment (ART) and spontaneous conception (SC), and primi- and multiparous couples. The couples (n = 743) separately filled in questionnaires concerning their prenatal expectations (T1) and 2 months postnatal representations (T2) of intimacy and autonomy in the relationship with their child, measured with Subjective Family Picture Test. A negative or positive discrepancy indicated violated expectations. The parent-related (mental health and marital quality), delivery-related (maternal and paternal birth experience, unplanned Caesarean, and amount of analgesia) and infant-related (infant health problems, difficult infant characteristics, and parental worry) factors were assessed at T2. Results show that among mothers, the associations were mostly indirect and mediated via mental health problems. Among fathers, the associations were direct, marital problems most crucially predicting VE. ART fathers were less susceptible to VE resulting from infant-related problems than SC fathers, but more susceptible to VE resulting from delivery problems. Delivery- and infant-related factors also predicted VE differently among primi- and multiparous mothers. Considering factors that contribute to VE is important when working with couples in transition to parenthood.

Intercepting the intergenerational cycle of maternal trauma and loss through mother-infant psychotherapy: a case study using attachment-derived methods.

Some mothers who have recently lost a significant attachment figure may become mentally incoherent and sporadically even enter a trancelike, dissociative state. Such states of mind have been shown to predict infant attachment disorganization. Infants born close to the time of a parental loss are at a greater risk for intergenerational trauma. A background of maternal substance abuse is also known to increase such risk. We illustrate by way of a case study how a mother–infant group psychotherapy programme aimed at substance-abusing mothers may help to prevent the transmission of mother’s unresolved trauma to the infant. Another goal was to discuss how attachment-derived methods (namely, Adult Attachment Interview, Strange Situation Procedure and the Emotional Availability Scales) may aid in understanding the effects of the intervention.

Paternal mental health trajectory classes and early fathering experiences Prospective study on a normative and formerly infertile sample

A father’s mental health is important for family well-being, but research is scarce on paternal symptoms during the transition to fatherhood. This study identified fathers’ latent mental health trajectory classes from the pre- to postnatal period and examined their associations with early fathering experiences. It further analysed, whether a family’s infertility history was associated with mental health trajectory classes and moderated their effects on fathering experiences. Finnish fathers (N = 773) reported psychological distress (General Health Questionnaire; GHQ-36) and depressive symptoms (Beck Depression Inventory; BDI-13) in pregnancy (T1), and at 2 months (T2) and 12 months (T3) postpartum. They further reported their fathering experience (Parenting Stress Index; PSI-36) at T2 and T3. Results revealed five paternal mental health trajectory classes, differing in timing and course of symptoms across the pre- and postpartum: stable low (79%) and moderate increasing (9%) levels of symptoms, and prenatal (5%), early fatherhood (3%) and heterogeneous high levels of (4%) problems. The trajectory classes were associated with fathering experiences within parental, interactive and child domains, across the child’s first year. The stable low levels of symptoms-class showed the most positive experiences and the heterogeneous high levels of problems-class the most negative ones; mental health problems in the early fatherhood-class reported negative fathering experience, but only when the child was 2 months old. A family’s infertility history neither showed any significant association with trajectory classes nor moderated their impact on early fathering, supporting the growing evidence that infertility treatments do not place an additional burden on early fatherhood.

Birth experience of women conceiving with assisted reproduction: a prospective multicenter study

To determine how infertility and subsequent assisted reproductive treatment (ART) affect a womans childbirth experience.

From Early Family Systems to Internalizing Symptoms : The Role of Emotion Regulation and Peer Relations

Research has demonstrated the importance of early family characteristics, such as the quality of caregiving, on children’s later mental health. Information is, however, needed about the role of more holistic family systems and specific child-related socioemotional mechanisms. In this study, we conceptualize families as dynamic family system types, consisting of both marital and parenting trajectories over the transition to parenthood. First, we examine how early family system types predict children’s anxiety, depression, peer exclusion, and emotion regulation. Second, we test whether couples’ infertility history and other family related contextual factors moderate the effects of family system types on child outcomes. Third, we test whether children’s emotion regulation and peer exclusion mediate the effects of family system types on anxiety and depression. The participants were 452 families representing cohesive, distant, authoritative, enmeshed, and discrepant family types, identified on the basis of relationship autonomy and intimacy from pregnancy to the child’s age of 2 and 12 months. Children’s anxiety, depression, emotion regulation, and peer exclusion were assessed at the age of 7–8 years. Structural equation modeling showed that distant, enmeshed, and discrepant families similarly predicted children’s heightened anxiety and depression. Infertility history, parental education, and parity moderated the associations between certain family system types and child outcomes. Finally, emotion regulation, but not peer exclusion, was a common mediating mechanism between distant and enmeshed families and children’s depression. The results emphasize the importance of early family environments on children’s emotion regulation development and internalizing psychopathology.

Attachment representations among substance-abusing women in transition to motherhood: implications for prenatal emotions and mother–infant interaction

ABSTRACT We studied how attachment representations contribute to central components of transition to motherhood, prenatal emotion processing (EP) and emotional availability (EA) of mother–infant interaction, and whether there are group specific differences. Participants were 51 treatment-enrolled substance-abusing (SA) mothers and their infants and 50 non-using comparison dyads with obstetric risk. Mother’s attachment representations (AAI) and EP were assessed prenatally and EA when infants were four months. Results showed that autonomous attachment only had a buffering effect on prenatal EP among comparisons. All SA mothers showed more dysfunctional EP than comparisons and, contrary to comparisons, autonomous SA mothers reported more negative cognitive appraisals and less meta-evaluation of emotions than dismissing SA mothers. Preoccupied SA mothers showed high negative cognitive appraisals, suggesting under-regulation of emotions. Attachment representations were not associated with EA in either group; rather, SA status contributed to global risk in the relationship. Surprisingly, autonomous SA mothers showed a tendency towards intrusiveness. We propose that obstetric risk among comparisons and adverse relational experiences among almost all SA mothers might override the protective role of mother’s autonomous representations for dyadic interaction. We conclude that prenatal emotional turbulence and high interaction risk of all SA mothers calls for holistic treatment for the dyad.

Fear and experience of childbirth among women who conceived with donated oocytes: a prospective cohort study

The aim of this study was to compare the level of fear of childbirth, pregnancy‐related anxiety and experience of childbirth in women who conceived with donated oocytes (OD), with that in women with in vitro fertilization/intra‐cytoplasmic sperm injection (IVF/ICSI) and spontaneous conception (SC).

Early Family Relationships Predict Children’s Emotion Regulation and Defense Mechanisms

Early family relationships have been suggested to influence the development of children’s affect regulation, involving both emotion regulation and defense mechanisms. However, we lack research on the specific family predictors for these two forms of affect regulation, which have been conceptualized to differ in their functions and accessibility to consciousness. Accordingly, we examine how the (a) quality and (b) timing of family relationships during infancy predict child’s later emotion regulation and defense mechanisms. Parents (N = 703) reported autonomy and intimacy in marital and parenting relationships at the child’s ages of 2 and 12 months, and the child’s use of emotion regulation and immature and neurotic defenses at 7 to 8 years. As hypothesized, the results showed that functional early family relationships predicted children’s efficient emotion regulation, whereas dysfunctional relationships predicted reliance on defense mechanisms in middle childhood. Further, results showed a timing effect for neurotic defenses, partially confirming our hypothesis of early infancy being an especially important period for the development of defense mechanisms. The findings are discussed from the viewpoints of attachment and family dynamics, emotional self-awareness, and sense of security.