Marjukka Pajulo

Substance abusing mothers in residential treatment with their babies: Postnatal psychiatric symptomatology and its association with mother - child relationship and later need for child protection actions

Background: A residential treatment model has been developed in Finland, which is specifically designed for substance abusing pregnant and parenting women, and has its focus on supporting both maternal abstinence from substances and mother–baby relationship. Aims: Among mother–baby pairs in this residential treatment, to explore amount and type of maternal postnatal psychiatric symptoms, relationship with the baby, and their association with later need for child substitution care placements. Methods: Participants were 34 mother–baby pairs from three units during pre- to postnatal period. Methods included self-report questionnaires for substance abuse and background data (pregnancy and perinatal period), experienced difficulties with the baby (1 month postnatally); maternal psychiatric symptoms (Brief Symptom Inventory, Edinburgh Pre–postnatal Depression Screen, Inventory of Interpersonal Problems; (pregnancy and 3 months) postnatally; videotaped mother–child interaction measure (Care Index for infants and toddlers) and standardized test of child development (Bayley Scales of Infant Development) (4 months postnatally); questionnaire for follow-up information (2 years of childs age). Results: Mothers showed high levels of different types of psychiatric symptomatology. Maternal interaction with the baby was on average weak, as 53% were within the high-risk range regarding sensitivity. Experiencing more difficulties in early care-giving of the baby was associated with higher amount of postnatal psychiatric symptomatology. Specific psychiatric symptoms were associated with later need for child substitution care. Conclusions: In designing treatment and follow-up of these mother–baby pairs, careful attention should be paid to pre- and perinatal identification and type of maternal psychiatric symptoms, and mothers’ expressions of subjectively experienced difficulties in early care-giving of the baby.

Maternal postnatal psychiatric symptoms and infant temperament affect early mother-infant bonding

Postnatal mother-infant bonding refers to the early emotional bond between mothers and infants. Although some factors, such as maternal mental health, especially postnatal depression, have been considered in relation to mother-infant bonding, few studies have investigated the role of infant temperament traits in early bonding. In this study, the effects of maternal postnatal depressive and anxiety symptoms and infant temperament traits on mother-infant bonding were examined using both mother and father reports of infant temperament. Data for this study came from the first phase of the FinnBrain Birth Cohort Study (n=102, father reports n=62). After controlling for maternal symptoms of depression and anxiety, mother-reported infant positive emotionality, measured by infant smiling was related to better mother-infant bonding. In contrast, infant negative emotionality, measured by infant distress to limitations was related to lower quality of bonding. In regards to father-report infant temperament, only infant distress to limitations (i.e., frustration/anger) was associated with lower quality of mother-infant bonding. These findings underline the importance of infant temperament as one factor contributing to early parent-infant relationships, and counseling parents in understanding and caring for infants with different temperament traits.

Cohort Profile: The FinnBrain Birth Cohort Study (FinnBrain)

Turun yliopiston FinnBrain syntymäkohorttitutkimus perustettiin tutkimaan erityisesti raskaudenaikaisten olosuhteiden ja perimän yhteyksiä lapsen aivojen kehitykseen ja terveyteen. Julkaistussa artikkelissa kuvataan tutkimuksen asetelma ja aineisto sekä keskeisimmät tutkimuskysymykset. Julkaisusarja on tarkoitettu erityisesti isojen kohorttitutkimusten kuvaamiseen. Artikkelissa kuvataan FinnBrain-aineisto: lasta odottavat äidit (n=3808), heidän puolisonsa (n=2623) ja tulevat lapsensa (n=3837;mukaan lukien 29 kaksosparia), jotka rekrytoitiin raskausviikolla 12 Lounais-Suomessa joulukuun 2011 ja huhtikuun 2015 välillä. Lisäksi kuvataan raskausajan arviointiin kuuluivat kyselylomakkeet (raskausviikot 14, 24, 24) sekä verinäytteet äidiltä ja isältä (raskausviikko 24) seerumin ja DNA:n analysoimiseksi. Lapsen syntymän jälkeen tutkittavia seurataan kyselylomakkeilla 3-36 kuukauden välein. Lisäksi nk. Fokuskohortissa verrataan raskaudenaikaista stressiä raportoineiden äitien lapsia ja heidän verrokkejaan käyttämällä esimerkiksi aivokuvantamista ja lapsen kehityksen neuropsykologisen toiminnan arviointia. Muissa alatutkimuksissa tutkitaan esimerkiksi hiuskortisolipitoisuuden merkitystä biomarkkerina, äidinmaidon ravintoaineja hormonipitoisuuksia sekä arvioidaan vanhempien neuropsykologisia toimintoja. Kaikkia osatutkimuksia ei ollut mahdollisuutta kuvata artikkelin puitteissa, vaan julkaisussa keskityttiin yleiskuvaan raskausaikana sekä ensimmäisen puolen vuoden aikana lapsen syntymän jälkeen.

Exploring parental mentalization in postnatal phase with a self-report questionnaire (PRFQ): Factor structure, gender differences and association with sociodemographic factors. The Finn Brain Birth Cohort Study

The objective was to explore the preliminary functioning of a self-report questionnaire designed to assess parental reflective functioning (PRFQ, Luyten et al., 2009, unpublished manual) during early postnatal phase and with a large population-based sample. Parental reflective functioning (PRF) refers to parental capacity to focus on experience and feelings, within self, in the child and underlying observed reactions. Individual differences in PRF reportedly affect child attachment and socio-emotional development. Cost-effective tools to assess key areas of early parenting are needed for both research and clinical purposes. The factor structure of a 36-item version suitable for early postnatal phase was explored using population-based data from the Finn Brain Birth Cohort Study (425 mothers and 237 fathers). Exploratory and confirmatory factor analysis resulted in a 14-item version comprising four factors capturing relevant aspects of early PRF. The factor structure was further tested with separate participants from the cohort (1030 mothers and 422 fathers). Mothers tended to score higher than fathers in PRF. Among mothers, parity, age, and financial situation were associated with postnatal mentalization. Level of education was associated with postnatal mentalization in both genders. The 14-item PRFQ-Fi has potential to serve as a new screening tool for very early parenting.