Publications by authors named "Rebecca Giallo"

97 Publications

Development and validation of a multidimensional, culturally and socially inclusive Child Resilience Questionnaire (parent/caregiver report) to measure factors that support resilience: a community-based participatory research and psychometric testing study in Australia.

BMJ Open 2022 06 20;12(6):e061129. Epub 2022 Jun 20.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Objective: Develop a comprehensive socially inclusive measure to assess child resilience factors.

Design: A socioecological model of resilience, community-based participatory research methods and two rounds of psychometric testing created the Child Resilience Questionnaire (parent/caregiver report, child report, school report). The parent/caregiver report (CRQ-P/C) is the focus of this paper.

Setting: Australia.

Participants: Culturally and socially diverse parents/caregivers of children aged 5-12 years completed the CRQ-P/C in the pilot (n=489) and validation study (n=1114). Recruitment via a large tertiary hospital's outpatient clinics, Aboriginal and refugee background communities (Aboriginal and bicultural researchers networks) and nested follow-up of mothers in a pregnancy cohort and a cohort of Aboriginal families.

Analysis: Exploratory and confirmatory factor analyses conducted to assess the structure and construct validity of CRQ-P/C subscales. Cronbach's alpha used to assess internal consistency of subscales. Criterion validity assessed with the Strengths and Difficulties Questionnaire (SDQ) parent report.

Results: Conceptually developed CRQ comprised 169 items in 19 subscales across five socioecological domains (self, family, friends, school and community). Two rounds of psychometric revision and community consultations created a CRQ-P/C with 43 items in 11 scales: self (positive self, positive future, managing emotions), family (connectedness, guidance, basic needs), school (teacher support, engagement, friends) and culture (connectedness, language). Excellent scale reliability (α=0.7-0.9), except scale (α=0.61) (where a highly endorsed item was retained for conceptual integrity). Criterion validity was supported: scales had low to moderate negative correlations with SDQ total difficulty score (R -0.2/-0.5. p<0.001); children with emotion/behavioural difficulties had lower CRQ-P/C scores (β=-14.5, 95% CI -17.5 to -11.6, adjusted for gender).

Conclusion: The CRQ-P/C is a new multidomain measure of factors supporting resilience in children. It has good psychometric properties and will have broad applications in clinical, educational and research settings. The tool also adds to the few culturally competent measures relevant to Aboriginal and refugee background communities.
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http://dx.doi.org/10.1136/bmjopen-2022-061129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9214413PMC
June 2022

Examining a rural Victorian community's knowledge and help seeking behaviour for family violence and the role of the local public health service.

Aust J Rural Health 2022 Jun 17. Epub 2022 Jun 17.

Department of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia.

Objective: The rates of family violence within some rural communities are higher than that of metropolitan areas. The extent to which these rural communities know about and access family violence support services is not well understood. Local health services often play a role in providing information and support for community members at risk of, or experiencing family violence. For a rural community in Victoria, the study aimed to: (a) determine community members' knowledge of family violence services, (b) explore community members' help seeking behaviour for family violence, (c) identify perceived barriers and enabling factors to accessing family violence services and (d) explore community members' expectations of, and preferences for, family violence support provided by local health services.

Design: A cross-sectional, anonymous, mixed-methods online survey.

Setting: A rural community in Victoria's Western District, Australia.

Participants: Ninety-nine residents, over 18 years of age.

Results: The majority of respondents had been exposed to family violence. There were varying knowledge levels of family violence support services as well as a number of barriers identified that directly impacted community members seeking help. There were clear expectations about the role of the local health service in family violence identification and response.

Conclusion: There are particular challenges for rural communities in providing support for family violence. Valuable insights can be gained from local communities about their knowledge of services and help seeking behaviours. Evidence generated by this study will inform future strategic planning for family violence services and the local health service.
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http://dx.doi.org/10.1111/ajr.12887DOI Listing
June 2022

Risk and Protective Factors Experienced by Fathers of Refugee Background during the Early Years of Parenting: A Qualitative Study.

Int J Environ Res Public Health 2022 06 6;19(11). Epub 2022 Jun 6.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne 3052, Australia.

Fathers of refugee background with young children can experience significant mental health difficulties, with the potential for intergenerational impacts. This study aimed to explore how fathers of refugee background experience risk and protective factors for their own health and wellbeing during the early years of parenting. Semi-structured interviews and one semi-structured focus group were conducted with fathers of refugee background, with young children (0-5 years), who had settled in Australia. Transcribed interviews were analysed using thematic analysis, informed by the socioecological model of health. A total of 21 fathers participated in the study. Risk factors experienced included: prior experiences of trauma, reduced access to family support in Australia, adjustments in parenting roles, and the challenges of learning a new language and securing employment. Fathers drew on a number of sources of strength, including a sense of joy from fatherhood and support from partners, families, and communities. While most fathers regularly accompanied their partners and children to healthcare appointments, they were rarely asked by healthcare professionals about their own needs. Our findings support the idea that there is a need for greater assistance for fathers, particularly for navigating issues arising from the settlement process. Healthcare services working with families of refugee background must adopt a father-inclusive, trauma-informed approach that is responsive to fathers' needs.
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http://dx.doi.org/10.3390/ijerph19116940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180233PMC
June 2022

Intimate Partner Violence and Child and Adolescent Cognitive Development: A Systematic Review.

Trauma Violence Abuse 2022 Jun 6:15248380221082081. Epub 2022 Jun 6.

34361Murdoch Children's Research Institute, Parkville, VIC, Australia.

Intimate partner violence (IPV) is a public health and human rights issue, with millions of children affected worldwide. While several reviews have explored the emotional-behavioural functioning of children exposed to IPV, this review aimed to examine the relationship between children's exposure to IPV and their cognitive development, and to identify associated factors such as aspects of parenting. The databases MEDLINE, PsycInfo, EMBASE, Family and Society Studies Worldwide, CINAHL, and ERIC were searched using key words related to IPV, such as domestic, family, partner, interparental, spousal, marital, violence, abuse, aggression, assault, combined with key words related to cognitive functioning, such as neuropsychological, executive, intelligence, learning, memory, and key words related to children and adolescents. A total of 38 studies met the criteria for review which included reporting an estimate of the relationship between IPV and cognition using direct assessments of cognitive functioning. Approximately 70% of studies found a relationship between IPV and poorer cognitive functioning, with general IQ the most frequently assessed domain of functioning, followed by verbal abilities and academic skills. Most studies assessed skills during early childhood, with fewer studies assessing children during middle childhood and adolescence. Results were consistent across cognitive domains and developmental stages. In terms of factors associated with IPV and cognition, a range of demographic, individual, and family factors were included, with several studies exploring mediating and moderating mechanisms. The findings suggest that IPV in childhood is associated with poorer cognitive skills across a range of domains. Implications for policy, practice and research are discussed.
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http://dx.doi.org/10.1177/15248380221082081DOI Listing
June 2022

The COVID-19 pandemic and Australian parents with young children at risk of interparental conflict.

J Reprod Infant Psychol 2022 Jun 1:1-15. Epub 2022 Jun 1.

Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, Australia.

Background: The COVID-19 pandemic has created many challenges for families across the world, with those who have recently had a baby particularly vulnerable to increased stress Study Aim: The current study aimed to explore the experiences of the COVID-19 pandemic of families who have recently had a baby in Melbourne, Australia.

Methods: Interviews were conducted with sixteen parents participating in a family-based intervention during early parenthood and seven clinicians who delivered the program.

Results: Parents and clinicians described impacts of the pandemic on parent and family functioning included mental health concerns, stress and irritability, feelings of isolation, and increased relationship tension. Parents discussed coping strategies used during the crisis, including activities with their family, connecting with others, trying to stay positive, and self-care activities such as spending time outdoors. Both parents and clinicians acknowledged the importance of mental health and parenting support during and following the pandemic, and for these services to be promoted and easily accessible.

Discussion: The study highlights the mental health and parenting support needs of families during times of crisis and emphasises the importance of early intervention for families exhibiting poor communication and relationship tension.
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http://dx.doi.org/10.1080/02646838.2022.2084055DOI Listing
June 2022

Inequalities in the distribution of COVID-19-related financial difficulties for Australian families with young children.

Child Care Health Dev 2022 Apr 3. Epub 2022 Apr 3.

Murdoch Children's Research Institute, Melbourne, Victoria.

Background: We examine (1) the frequency of financial difficulties in Australian families with young children (0-8 years) in the early and later phases of the pandemic; (2) the extent to which parents' pre-pandemic socio-economic disadvantage (SED) predicted financial difficulties; and (3) whether grandparent intergenerational SED further amplified this risk.

Method: Data: Australian Temperament Project (ATP; established 1983, N = 2443) and ATP Generation 3 study (ATPG3; established 2012; N = 702), of which 74% (N = 553) completed a COVID-specific module in the early (May-September 2020) and/or later (October-December 2021) phases of the pandemic.

Outcomes: Parent-reported loss of employment/reduced income, difficulty paying for essentials, and financial strain.

Exposures: Pre-pandemic parent and grandparent education and occupation.

Analysis: Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre-pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders.

Results: At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30-38; later: 32%, 95% CI = 28-36). Each standard deviation increase in the parents' pre-pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04-1.78). There was little evidence of an interaction between the SED of parents and grandparents.

Conclusions: Financial impacts related to the COVID-19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre-pandemic SED. Given the well-established relationship between disadvantage and child health and development, sustained and well-targeted government supports will be critical to minimizing adverse impacts in years to come.
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http://dx.doi.org/10.1111/cch.13010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111372PMC
April 2022

Patterns and predictors of depressive and anxiety symptoms in mothers affected by previous prenatal loss in the ALSPAC birth cohort.

J Affect Disord 2022 06 24;307:244-253. Epub 2022 Mar 24.

Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada. Electronic address:

Background: Studies investigating the patterns or predictors of psychological distress in expecting and postpartum mothers affected by previous prenatal loss, are limited. The study objectives were to explore longitudinal trajectory patterns of depressive and anxiety symptoms in mothers affected by previous prenatal loss from early in a subsequent pregnancy up to pre-adolescence, and to identify early factors predictive of elevated symptom trajectory patterns.

Methods: A total of 2854 mothers from the Avon Longitudinal Study of Parents and Children self-identified as having experienced a previous prenatal loss. A latent class analysis identified trajectory patterns of symptoms across 10 timepoints from 18-weeks' gestation up to 134-months postpartum, multivariate regression analysis identified predictors of elevated symptom trajectories, and hierarchical regression analysis determined predictive accuracy between predictors and elevated trajectory patterns.

Results: Three distinct longitudinal trajectory patterns of depressive and anxiety symptoms reflected low (54%), sub-clinical (34%), and clinical symptoms (12%). Key factors that predicted elevated symptom trajectory patterns better than increased symptom scores early in subsequent pregnancy include history of severe depression or other psychiatric problem, experiencing three or more stressful events from mid-pregnancy, inadequate social support, history of induced abortion, and history of abuse. Predictive accuracy of elevated trajectories was 0.542 (depression) and 0.432 (anxiety).

Limitations: Generalizability may be compromised by attrition, under-reporting, and recall bias.

Conclusion: Including factors predictive of long-term sub-clinical or clinical depressive and anxiety symptoms in early assessments will improve clinician's ability to identify mothers who may benefit from immediate and/or ongoing monitoring, and psychotherapeutic intervention after prenatal loss.
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http://dx.doi.org/10.1016/j.jad.2022.03.055DOI Listing
June 2022

Working out dads (WOD): a study protocol for a randomised controlled trial of a group-based peer support intervention for men experiencing mental health difficulties in early fatherhood.

BMC Psychiatry 2022 02 12;22(1):111. Epub 2022 Feb 12.

LaTrobe University, Bundoora, Australia.

Background: Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers' mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) - a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms.

Methods: This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation.

Discussion: This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated.

Trial Registration: The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042 ). Date of Registration: March 22nd, 2021.
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http://dx.doi.org/10.1186/s12888-022-03698-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8841057PMC
February 2022

Intimate partner violence during infancy and cognitive outcomes in middle childhood: Results from an Australian community-based mother and child cohort study.

Child Dev 2022 Jul 9;93(4):e396-e411. Epub 2022 Feb 9.

Murdoch Children's Research Institute, Parkville, Victoria, Australia.

The cognitive functioning of children who experience intimate partner violence (IPV) has received less attention than their emotional-behavioral outcomes. Drawing upon data from 615 (48.4% female) 10-year-old Australian-born children and their mothers (9.6% of mothers born in non-English speaking countries) participating in a community-based longitudinal study between 2004 and 2016, this study examined the associations between IPV in infancy and cognition in middle childhood (at age 10). Results showed that IPV in the first 12 months of life was associated with lower general cognitive ability and poorer executive attention but not working memory skills. IPV in middle childhood (in the 10th year postpartum) was not associated with cognition. This study provides evidence for the long-term impact of early life exposure to IPV on children's cognition, and points to the importance of early intervention to optimize development.
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http://dx.doi.org/10.1111/cdev.13736DOI Listing
July 2022

Using Participatory Methods to Engage Diverse Families in Research about Resilience in Middle Childhood.

J Health Care Poor Underserved 2021 ;32(4):1844-1871

Background: Resilience entails drawing on resources to navigate adversity; few measures exist to explore how children cope with adversity in varying cultural contexts.

Purpose: We aimed to develop a socially-inclusive measure of child resilience by (1) co-designing methods to engage diverse families, and (2) identifying resilience factors.

Methods: We used a community-based participatory research (CBPR) approach to recruit Aboriginal families, refugee families, and families from hospital outpatient clinics. To triangulate findings and codesign methods, we held discussion groups with 21 service providers. Codesigned group-based visual methods were employed in discussion groups with 97 parents and 106 children (5-12 years).

Findings: Participants identified culturally-meaningful resilience factors such as loving family, speaking their home language (for families of Non-English speaking backgrounds). We discuss differences and commonalities across participant groups.

Conclusion: Co-designing research that is both rigorous and inclusive is critical for gleaning culturally-meaningful data from diverse families.
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http://dx.doi.org/10.1353/hpu.2021.0170DOI Listing
December 2021

Providing therapeutic services to women and children who have experienced intimate partner violence during the COVID-19 pandemic: Challenges and learnings.

Child Abuse Negl 2022 Aug 15;130(Pt 1):105365. Epub 2021 Oct 15.

Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Australia; Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville 3052, Australia.

Background: In the face of the COVID-19 pandemic, many therapeutic services for children and their parents who had experienced intimate partner violence (IPV) were required to rapidly transition to telehealth.

Objective: The current study aims to explore parents' experiences of participating in a parent-child telehealth intervention during the COVID-19 pandemic. The study also aimed at exploring clinicians' experiences of delivering the service, including key strengths and challenges.

Participants And Setting: Participants were five mothers who took part in Berry Street's Restoring Childhood service during the COVID-19 pandemic in Melbourne, Australia, and 14 Restoring Childhood clinicians, delivering the service across metropolitan and regional sites.

Methods: Semi-structured qualitative interviews were conducted, and data were analysed using thematic analysis to determine key themes and sub-themes within the data.

Results: Parents identified several strengths and benefits of Restoring Childhood delivered via telehealth including improvements in parenting skills and confidence, parent-child relationships, and children's emotional-behavioural functioning. Both parents and clinicians noted the creativity utilised during the online approach, and the increased accessibly it offered for families. However, challenges to the telehealth approaches were also noted. Clinicians discussed important considerations for telehealth within this context including safety and confidentiality, technology challenges, and challenges working from home.

Conclusions: The current study highlights the promise of telehealth interventions for parents and children who have experienced IPV. It also poses several important considerations for the use of telehealth within this setting and emphasises the need for rigorous evaluations of telehealth services for children exposed to IPV.
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http://dx.doi.org/10.1016/j.chiabu.2021.105365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516655PMC
August 2022

A mixed-methods feasibility study of the Home Parenting Education and Support Program for families at risk of child maltreatment and recurrence in Australia.

Child Abuse Negl 2021 12 9;122:105356. Epub 2021 Oct 9.

Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia.

Background: Efforts to prevent child maltreatment and its recurrence in infancy and early childhood are critical to disrupting pathways to poor physical and mental health and interpersonal relationships across the life course. The Home Parenting Education and Support (HoPES) program is an intensive 8-week home-visiting intervention for families of infants and young children (0-4 years) receiving child protection services or welfare services.

Objective: The aims of this feasibility study were to: (a) explore parents' and clinicians' perceptions of the outcomes related to participation in HoPES, and (b) obtain preliminary data about potential intervention outcomes related to parent-child interactions, parent mental health, and parenting self-efficacy.

Participants And Setting: HoPES was delivered to 30 families by a child and family health service. Seven mothers and eight HoPES clinicians also participated in qualitative interviews.

Methods: A mixed-methods evaluation was conducted incorporating qualitative interviews and self-report pre-post intervention data was conducted.

Results: Interviews with mothers identified perceived benefits for parent mental health and wellbeing, parenting, and relationships with children. This was further supported by clinician interviews and by the analysis of pre-post assessment data which revealed moderate to large decreases in maternal stress (d = 0.35) and increases in parental self-efficacy (0.76).

Conclusions: The findings of this study have important implications for further development of HoPES, and the design of a rigorous evaluation in next stage of evaluation research.
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http://dx.doi.org/10.1016/j.chiabu.2021.105356DOI Listing
December 2021

Capturing the experiences of clinicians implementing a new brief intervention for parents and children who have experienced family violence in Australia.

Health Soc Care Community 2022 Sep 29;30(5):e1599-e1610. Epub 2021 Sep 29.

Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Family violence (FV) affects one in four families. While the evidence regarding therapeutic interventions for children and families who experience FV is expanding, little research has been conducted about clinicians' experiences of implementation. The current study aimed to capture the voices of clinicians delivering a brief dyadic intervention for women and their children after FV exposure. The Brief Relational Intervention and Screening (BRISC) is an evidence-informed intervention designed by Berry Street (Australia) for mothers and children with recent experiences of FV. Consisting of four sessions, BRISC was implemented across one regional and one metropolitan site. Thirteen BRISC clinicians participated in semi-structured interviews individually or in a focus group. Thematic analysis of transcripts was conducted using NVivo. Clinicians considered key strengths of BRISC to be related to the intervention principles, including the hopeful and relationship-focused approach, the intervention implementation such as the timing, structure and flexibility, as well as the systems and processes in place, such as intake and triage, supervision structure and their team environment. Challenges described by clinicians included aspects of delivery such as limited referral options and safety concerns, the nature of the program including the mechanics of delivery and specific role challenges such as vicarious trauma. Clinicians also shared suggestions for improvements for delivery, supervision and training. This study emphasises the importance of clinician perspectives when identifying factors that can promote the successful implementation of innovative interventions in real-world community settings.
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http://dx.doi.org/10.1111/hsc.13587DOI Listing
September 2022

The experience of the COVID-19 pandemic for families of infants involved with Child Protection Services for maltreatment concerns.

Health Soc Care Community 2022 Sep 25;30(5):1754-1762. Epub 2021 Aug 25.

Murdoch Children's Research Institute, Melbourne, Vic., Australia.

The COVID-19 pandemic and associated physical distancing restrictions have exacerbated social, economic and health disadvantage within our communities. With increases in mental health difficulties and family violence already being seen, there is concern that the risk of child maltreatment risk may also be increased. The current study aimed to explore the experience of the COVID-19 pandemic for families identified to be at risk of child maltreatment in Victoria, Australia. Understanding the experiences of the pandemic for families already at risk is essential in identifying how to best support vulnerable parents and young children during this challenging time. Interviews were conducted with 11 parents currently involved with Child Protection Services, and nine clinicians working within a child and family health services, supporting clients with child protection involvement. Parents and clinicians described a range of pandemic related stressors including employment and financial stress, worry about infection and changes to service access. In addition, parents with children in out of home care discussed decreased access to their children resulting from physical distancing restrictions. Parents and clinicians perceived the pandemic to be having a negative impact on parent mental health, parenting stress and isolation. Although parents raised minimal concerns about the impact of the pandemic on child well-being, clinicians expressed concerns about the rise in risk factors for child maltreatment. Parents discussed a range of coping strategies which they perceived to be helpful during the pandemic, and clinicians and parents described the need for additional mental health support and support to access basic needs. The study highlights the importance of ensuring at risk families have access to parenting and mental health support throughout the pandemic and the importance of ensuring children within at-risk families are sighted and their safety assessed.
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http://dx.doi.org/10.1111/hsc.13555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653246PMC
September 2022

The maternal health study: Study design update for a prospective cohort of first-time mothers and their firstborn children from birth to age ten.

Paediatr Perinat Epidemiol 2021 09 6;35(5):612-625. Epub 2021 May 6.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.

Background: Maternal health is critical to the health and well-being of children and families, but is rarely the primary focus of pregnancy and birth cohort studies. Globally, poor maternal health and the exposure of women and children to family violence contribute to the perpetuation and persistence of intergenerational health inequalities.

Objectives: The Maternal Health Study was designed to investigate the contribution of social and obstetric risk factors to common maternal physical and psychological morbidities. Over time, our focus has expanded to include mother-child pairs and investigation of intergenerational trauma and family violence.

Population: A total of 1507 first-time mothers were recruited in early pregnancy from six public hospitals in Melbourne, Australia, in 2003-2005.

Methods: Women completed questionnaires or telephone interviews in early pregnancy (≤24 weeks); at 32 weeks' gestation; at three, six, nine, 12 and 18 months postpartum; and at four and ten years. At ten years, women and children were invited to participate in face-to-face interviews, which included direct assessment of children's cognitive and language development. A wide range of obstetric, social and contextual factors have been measured, including exposure to intimate partner violence (IPV) (1-year, 4-year and 10-year follow-up).

Results: 1507 eligible women were recruited at a mean gestation of 15 weeks. At one year, four years and ten years postpartum, 90.0%, 73.1% and 63.2% of the original cohort took part in follow-up. One in three women in the study (34.5%) reported exposure to IPV in the first ten years of motherhood: 19% in the first 12 months postpartum, 20% in the year prior to four-year follow-up and 18.3% in the year prior to ten-year follow-up.

Conclusion: The study affords a unique opportunity to examine patterns of maternal and child health and health service use associated with exposure to IPV.
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http://dx.doi.org/10.1111/ppe.12757DOI Listing
September 2021

Intimate partner violence and child outcomes at age 10: a pregnancy cohort.

Arch Dis Child 2021 11 21;106(11):1066-1074. Epub 2021 Apr 21.

Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Objective: Assess the mental health, physical health, cognitive and language development of 10-year old children in families where mothers have reported intimate partner violence (IPV) compared with children with no reported IPV exposure.

Design: Prospective pregnancy cohort. Maternal report of IPV (Composite Abuse Scale) at 1, 4 and 10 years. Maternal and direct assessment of child mental health (probable psychiatric diagnosis, anxiety and emotional/behavioural difficulties), cognition (IQ and executive function), language (general, pragmatic and receptive) and physical health at 10 years.

Setting: A subsample of 615 mother-child dyads drawn from a pregnancy cohort of 1507 nulliparous women recruited from six public hospitals in Melbourne, Australia.

Results: Any IPV exposure from infancy to age 10 was associated with poorer child outcomes at age 10. Specifically, twice the odds of a probable psychiatric diagnosis, emotional/behavioural difficulties, impaired language skills (general and pragmatic), and having consulted a health professional about asthma or sleep problems. IPV exposure at age 10 associated with two to three times higher odds of all mental health outcomes, elevated blood pressure and sleep problems. Early life exposure alone (at 1 and/or 4 years) associated with three times higher odds of a general language problem and asthma at age 10.

Conclusion: The high prevalence of IPV and increased risk of poorer health and development among children exposed highlights the burden of ill health carried by children in families experiencing IPV. Fewer difficulties where exposure was limited to the early years builds the case for better identification, understanding and resourcing of effective early intervention.
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http://dx.doi.org/10.1136/archdischild-2020-320321DOI Listing
November 2021

Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort.

J Pediatr 2021 06 4;233:90-97.e2. Epub 2021 Feb 4.

Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia.

Objective: To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants.

Study Design: Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years.

Results: Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63).

Conclusions: Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.
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http://dx.doi.org/10.1016/j.jpeds.2021.02.002DOI Listing
June 2021

Trajectories of interparental conflict and children's emotional-behavioural functioning at 10-11 years: an Australian population-based study.

Eur Child Adolesc Psychiatry 2022 Apr 5;31(4):625-635. Epub 2021 Jan 5.

Judith Lumley Centre, La Trobe University, Bundoora, Australia.

Interparental conflict (IPC) has the potential to adversely affect children's social, emotional, and behavioural functioning. The overall objective of this study was to investigate the relationship between both the severity and chronicity of IPC across early and middle childhood and children's emotional-behavioural functioning at 10-11 years. Specifically, we aimed to: (1) identify distinct trajectories of IPC spanning 10-11 years since birth of the study child as reported by mothers, and (2) examine the emotional-behavioural functioning of children exposed to the identified IPC trajectories. Drawing from a nationally representative longitudinal study of Australian families (N = 4875), four distinct trajectories of IPC were identified: (1) consistently low exposure to IPC over time, (2) persistently elevated exposure to IPC, (3) increasing IPC exposure over time, and (4) decreasing IPC exposure over time. Children exposed to trajectories with high IPC at any point during the study period were reported by their mothers to be experiencing more emotional-behavioural difficulties than children exposed to low IPC over time. Based on teacher report, there were no differences in emotional-behavioural functioning of children exposed to the different patterns of IPC. Our findings reinforce that high parental conflict at any point in a child's life is a form of adversity that can have adverse consequences for their mental health, and that early interventions for parents and caregivers experiencing high IPC are critical.
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http://dx.doi.org/10.1007/s00787-020-01700-7DOI Listing
April 2022

Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: an Australian prospective cohort study of first-time mothers.

BMJ Open 2020 12 21;10(12):e040891. Epub 2020 Dec 21.

Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Objective: To investigate mental and physical health of mothers exposed to recent and early postpartum intimate partner violence (IPV) in the 10 years after having their first child.

Design: Prospective pregnancy cohort study.

Setting: Women were recruited at six metropolitan public maternity hospitals in Melbourne, Australia and followed up at 1, 4 and 10 years post partum.

Study Measures: Exposure to physical and/or emotional IPV was measured using the Composite Abuse Scale at 1, 4 and 10 years. At 10-year follow-up, mothers reported on physical and mental health, and functional health status.

Participants: 1507 first-time mothers enrolled at mean of 15 weeks' gestation.

Results: One in three women experienced IPV during the 10 years after having their first child. Women experiencing recent IPV (19.1%) reported worse physical and mental health than women not reporting IPV. Compared with women not reporting IPV, women experiencing recent IPV had higher odds of poor functional health status (Adj OR=4.5, 95% CI 3.2 to 6.3), back pain (Adj OR=2.0, 95% CI 1.4 to 2.9), incontinence (Adj OR=1.8, 95% CI 1.2 to 2.6), depressive symptoms (Adj OR=4.9, 95% CI 3.2 to 7.5), anxiety (Adj OR=5.1, 95% CI 3.0 to 8.6) and post-traumatic stress symptoms (Adj OR=7.2, 95% CI 4.6 to 11.1) at 10 years. Women with past IPV at 1 and/or 4 years (15.7% of the cohort) also had higher odds of physical and mental health problems. There was evidence of a gradient in health outcomes by recency of exposure to IPV.

Conclusions: Both recent and past exposure to IPV are associated with poor maternal physical and mental health 10 years after a first birth. Health services and advocacy organisations providing support to women need to be aware of the consistent relationship between IPV and a range of physical and mental health conditions, which may persist even after IPV appears to have ceased.
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http://dx.doi.org/10.1136/bmjopen-2020-040891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754634PMC
December 2020

Predictors of child resilience in a community-based cohort facing flood as natural disaster.

BMC Psychiatry 2020 11 19;20(1):543. Epub 2020 Nov 19.

Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.

Background: Natural disasters are unpredictable and uncontrollable events that usually induce significant level of stress and social disruption in afflicted individuals. The consequences are formidable, affecting lifetime health and economic prosperity. Among natural disasters, floods are the most common causes and tend to have the highest economic burden. The aim of this study was to examine factors associated with child resilience in the face of the natural disaster experienced by the city of Calgary, Alberta, Canada during its unprecedented flood of 2013.

Methods: The current study was conducted in a community-based cohort situated in the city of Calgary. The participants were recruited out of the All Our Families longitudinal cohort within the Cummings School of Medicine at the University of Calgary. Of the total 1711 people contacted, 469 people consented and completed questionnaire. Of those 469 who consented to be part of the study, 467 were eligible to be included for analysis. A flood impact questionnaire was delivered 6 months after the 2013 flood in families whose children were an average of 3 years old. Mother reported questionnaires were used to assess child resilience. The study included maternal data on a range of factors including socio-demographic, history of mental health, relationship with the partner and social support. Child related data were also incorporated into the study, and variables included delivery mode, child sex, and child age at the time of disaster.

Results: Child resilience was best predicted by mother's age and social support, and by child gender, the child's externalizing and internalizing behaviors and the Rothbart temperament scale: effortful control. Furthermore, this study revealed that children who were more exposed to the flood events, showed higher resilience compared to the children who were less or not exposed.

Conclusions: These findings highlight the risk and protective factors that predict child resilience and suggest that mother reported questionnaire are useful tools to assess child resilience amidst early life adversity.
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http://dx.doi.org/10.1186/s12888-020-02944-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678269PMC
November 2020

Children's language abilities at age 10 and exposure to intimate partner violence in early childhood: Results of an Australian prospective pregnancy cohort study.

Child Abuse Negl 2021 01 5;111:104794. Epub 2020 Nov 5.

Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia; La Trobe University, Bundoora, Australia.

Background: Approximately one in four children in Australia have mothers who experience intimate partner violence (IPV). These children are at risk of poor mental health. Less is known about their language outcomes, despite evidence that childhood adversity threatens neurodevelopment, and the home environment effects language development.

Objective: This study aimed to examine the relationship between early childhood IPV exposure and language outcomes (receptive vocabulary, general language, pragmatic language) at age 10, including the influence of maternal depressive symptoms.

Participants And Setting: Participants were 615 mothers and their first-born child participating in a prospective, community-based pregnancy cohort study in Melbourne.

Methods: Mothers reported their experience of IPV and depressive symptoms in the first and fourth year postpartum. At 10 years postpartum, children's receptive vocabulary was directly assessed and mothers reported on their child's general and pragmatic language skills.

Results: Exposure to IPV was related to scores indicating poorer abilities in receptive vocabulary (d=-0.26, p = .009), general language (d = 0.23, p = .047) and pragmatic language skills (d = 0.41, p < .001) at age 10. After adjusting for maternal depressive symptoms, evidence remained for the relationship with pragmatic language (d=-0.32, p = .006), and a trend for receptive vocabulary (d=-0.20, p = .052).

Conclusions: At a community-level, children whose mothers experienced IPV during the child's first four years had poorer language skills in middle childhood than children whose mothers did not experience IPV. This is important because poor child language skills are associated with adverse outcomes across the lifespan including academic under-achievement and mental health problems. Clinical implications are discussed.
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http://dx.doi.org/10.1016/j.chiabu.2020.104794DOI Listing
January 2021

Preservation and reunification for families of young children: case file review of a home-visiting program.

J Reprod Infant Psychol 2022 07 26;40(3):311-323. Epub 2020 Oct 26.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Australia.

Objective: The Home Parenting Education and Support (HoPES) programme is a new intensive 8-week home-visiting intervention supporting the preservation and reunification of families with young children (aged 0-4 years) receiving child protection services following child abuse and/or neglect in Australia. The aims of the study were to (a) describe families who had participated in HoPES, (b) describe the key education content and support activities of the programme, and (c) identify the enablers and challenges in implementing HoPES.

Background: Intensive home-based family preservation programs are designed to improve parenting skills, reduce specific abusive behaviours, and address child, parent and contextual risk factors for child maltreatment and its recurrence.

Methods: A casefile review and document analysis of 34 families who enrolled in HoPES was conducted.

Results: Families enrolled in HoPES were experiencing significant parent and child risk factors for child maltreatment and recurrence. Despite challenges in supporting families experiencing many complex social health issues and stressful life circumstances, there was evidence of intervention tailoring and use of strengths-based approaches to meet the needs of families.

Conclusion: This casefile review gathered rich evidence to inform further development of a trauma informed and culturally sensitive intervention to support family preservation and reunification, and to guide the next stage of evaluation research to generate a more robust level of evidence.
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http://dx.doi.org/10.1080/02646838.2020.1836335DOI Listing
July 2022

"We're in the background": Facilitators and barriers to fathers' engagement and participation in a health intervention during the early parenting period.

Health Promot J Austr 2021 Oct 28;32 Suppl 2:78-86. Epub 2020 Oct 28.

Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.

Issues Addressed: Little is known about the barriers and facilitators associated with engaging fathers in interventions targeting their physical and mental health. The current research therefore aimed to explore fathers' perceived barriers and facilitators to engagement and participation in a health intervention delivered during the early parenting period.

Methods: Eleven fathers of young children (0-4 years) were interviewed about their perceptions and experiences of facilitators and barriers to engaging and participating in an intervention (Working Out Dads) to target their mental and physical health. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis.

Results: Fathers identified a number of program-related and father-related facilitators and barriers which impacted their engagement and participation. Program-related facilitators included: accessibility of the program; father advocacy of the program; group fitness/exercise component; and having a father-specific program. Facilitating factors related to fathers included: making social connections; learning how to be a better dad/partner; and partner support and encouragement to attend. Program-related barriers included: travel; lack of awareness; and gender roles. While father-related barriers included: being time poor; sacrifices to family; and apprehension.

Conclusions: The current findings identified many areas that facilitate, encourage and motivate men to participate in interventions which support their mental and physical health during the early parenting period.

Relevance: Generating evidence on barriers and facilitators to health interventions is important to improving the current intervention along with informing the development of engaging and targeted health interventions for fathers in early parenthood.
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http://dx.doi.org/10.1002/hpja.432DOI Listing
October 2021

Intimate partner violence, maternal depression, and pathways to children's language ability at 10 years.

J Fam Psychol 2021 Feb 8;35(1):112-122. Epub 2020 Oct 8.

Murdoch Children's Research Institute.

Intimate partner violence (IPV) between parents is associated with poorer child language development. This study aimed to examine pathways from IPV and maternal depressive symptoms in children's 1st year to language skills at 10 years. Pathways were examined via IPV, maternal depressive symptoms, and maternal involvement in home learning activities (e.g., reading, storytelling) at age 4. A secondary aim was to examine whether these pathways differed by child gender. Data were drawn from 1,507 mothers and their firstborn children participating in a community-based prospective longitudinal study. At child age 1 and 4 years, mothers reported IPV using the Composite Abuse Scale (CAS) and completed a depression scale. At child age 10 years, mothers completed the Children's Communication Checklist (2nd edition) Short Form and 4 pragmatic subscales, and children completed a receptive vocabulary test. Results provided some evidence that maternal depressive symptoms at 4 years postpartum may be an important mechanism by which exposure to IPV and maternal depressive symptoms in the child's 1st year is associated with poorer language at age 10. These pathways remained evident after accounting for social disadvantage, number of siblings, and concurrent IPV exposure at 10 years. There was little evidence that the pathways were mediated by maternal involvement or differed by gender. Implications for speech pathology, health, and education professionals concern identifying and supporting the language needs of children in family contexts where IPV is present. Intervention strategies for families affected by IPV such as supporting maternal mental health and the mother-child relationship could be extended to support child language development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/fam0000804DOI Listing
February 2021

Facilitators to Engagement in a Mother-Child Therapeutic Intervention Following Intimate Partner Violence.

J Interpers Violence 2022 02 9;37(3-4):1796-1824. Epub 2020 Jun 9.

Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Intimate partner violence (IPV) affects more than one in four children worldwide. Despite the growing evidence base for interventions addressing children's IPV exposure, little is known about what assists families to engage with services. The current study sought to explore women's perceptions of barriers and facilitators to accessing an intervention for their children following IPV. A total of 16 mothers who had engaged in a community-based, dyadic intervention for children exposed to IPV participated in the study. The Brief Relational Intervention and Screening (BRISC) is an evidenced informed program designed by Berry Street (Australia). A pilot of the intervention was implemented across one metropolitan and one regional site. In-depth semi-structured interviews were conducted with 16 mothers who had completed BRISC. Transcripts were analyzed in NVivo using thematic analysis. Key facilitators to initial engagement included strong referral pathways, clear information about the program, and initial phone contact from the service. Difficulty trusting services were identified as a key barrier to initial engagement. Facilitators of continued engagement included flexibility in service delivery, consistent and direct communication between sessions, and the therapeutic approach. Key barriers to sustained intervention engagement included children's continued contact with their father, mothers' experiences of guilt and blame, and the need for additional support for mothers' own mental health. These findings highlight how service and clinician factors such as flexibility, therapeutic approaches, and communication can facilitate engagement for families affected by IPV. In addition, the study highlights the importance of including the voices of women in research to improve the acceptability of services for consumers.
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http://dx.doi.org/10.1177/0886260520926316DOI Listing
February 2022

Mental Health Trajectories of Fathers Following Very Preterm Birth: Associations With Parenting.

J Pediatr Psychol 2020 08;45(7):725-735

Murdoch Children's Research Institute.

Objective: Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers' depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors.

Methods: In total, 100 fathers of 125 infants born VPT (<30 weeks' gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant's birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months' corrected age. At 12 months' corrected age, fathers' parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers' depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers' parenting behaviors.

Results: For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories.

Conclusions: Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.
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http://dx.doi.org/10.1093/jpepsy/jsaa041DOI Listing
August 2020

Hair cortisol in mother-child dyads: examining the roles of maternal parenting and stress in the context of early childhood adversity.

Eur Child Adolesc Psychiatry 2021 Apr 22;30(4):563-577. Epub 2020 Apr 22.

Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.

Physiological stress is thought to be one way that early adversity may impact children's health. How this occurs may be related to parental factors such as mothers' own stress and parenting behaviour. Hair cortisol offers a novel method for examining long-term physiological stress in mother-child dyads. The current study used hair cortisol to examine the role that maternal physiological stress and parenting behaviours play in explaining any effects of adversity on young children's physiological stress. This cross-sectional study comprised 603 mother-child dyads at child age 2 years, recruited during pregnancy for their experience of adversity through an Australian nurse home visiting trial. Hair cortisol data were available for 438 participating mothers (73%) and 319 (53%) children. Confirmatory factor analysis was used to define composite exposures of economic (e.g. unemployment, financial hardship) and psychosocial (e.g. poor mental health, family violence) adversity, and positive maternal parenting behaviour (e.g. warm, responsive). Structural equation modelling examined maternal mediating pathways through which adversity was associated with children's physiological stress. Results of the structural model showed that higher maternal and child physiological stress (hair cortisol) were positively associated with one another. Parenting behaviour was not associated with children's physiological stress. There was no evidence of any mediating pathways by which economic or psychosocial adversity were associated with children's physiological stress. The independent association identified between maternal and child hair cortisol suggests that young children's physiological stress may not be determined by exogenous environmental exposures; endogenous genetic factors may play a greater role.
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http://dx.doi.org/10.1007/s00787-020-01537-0DOI Listing
April 2021

Infant sleep and child mental health: a longitudinal investigation.

Arch Dis Child 2020 07 9;105(7):655-660. Epub 2020 Mar 9.

Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.

Objective: To determine whether infants with severe persistent sleep problems are at increased risk of (1) meeting diagnostic criteria for a psychiatric disorder (age 10 years), and (2) having elevated symptoms of mental health difficulties (ages 4 and 10 years), in comparison with infants with settled sleep.

Design And Setting: Prospective longitudinal community cohort study-the Maternal Health Study. Mothers completed questionnaires/interviews at 15 weeks' gestation; 3, 6, 9 and 12 months post partum; and when their child turned 4 and 10 years old. Measures included parental report of infant night waking and sleep problems and child mental health (Strengths and Difficulties Questionnaire; Spence Children's Anxiety Scale; Development and Well-being Assessment).

Participants: 1460 mother-infant dyads.

Results: 283 (19.4%) infants had persistent severe sleep problems, 817 (56.0%) had moderate/fluctuating sleep problems and 360 (24.7%) infants were settled. Infants with persistent severe sleep problems were more likely to report emotional symptoms at age 4 (adjusted odds ratio (AOR)=2.70, 95% CI 1.21 to 6.05, p=0.02), and meet diagnostic criteria for an emotional disorder at age 10 (AOR=2.37, 95% CI 1.05 to 5.36, p=0.04). Infants with persistent severe sleep problems also had elevated symptoms of separation anxiety (AOR=2.44, 95% CI 1.35 to 4.41, p<0.01), fear of physical injury (AOR=2.14, 95% CI 1.09 to 4.18, p=0.03) and overall elevated anxiety (AOR=2.20, 95% CI 1.13 to 4.29, p=0.02) at age 10.

Conclusions: Infants with persistent severe sleep problems during the first postnatal year have an increased risk of anxiety problems and emotional disorders at age 10.
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http://dx.doi.org/10.1136/archdischild-2019-318014DOI Listing
July 2020

Maternal childhood abuse and children's emotional-behavioral difficulties: Intergenerational transmission via birth outcomes and psychosocial health.

J Fam Psychol 2020 Feb 19;34(1):112-121. Epub 2019 Dec 19.

Healthy Mothers Healthy Families Research Group.

Understanding the mechanisms and psychosocial pathways potentially underlying the association between maternal childhood abuse exposure and poor child health and wellbeing is important to inform opportunities for support and intervention early in the period of becoming a parent. The aim of the study was to investigate whether adverse birth outcomes and psychosocial health issues (maternal depressive symptoms, exposure to intimate partner violence in the first postnatal year) are potential mechanisms underlying the association between maternal childhood abuse and children's emotional-behavioral functioning at 10 years. Data were drawn from 1,507 first-time mothers and their 10-year-old children participating in the Maternal Health Study, a prospective study of women's health during pregnancy and after birth. One in four women reported that they had experienced physical or sexual abuse in childhood. Children whose mothers had experienced either of these types of childhood abuse had significantly higher emotional-behavioral difficulties than children whose mothers had not. Psychosocial health pathways via maternal depressive symptoms and exposure of mothers to intimate partner violence in the first 12 months postpartum, but not adverse birth outcomes, mediated the association between maternal childhood abuse and children's emotional-behavioral difficulties. These findings underscore the need to support mothers who have experienced childhood abuse and psychosocial health issues, both as a means of promoting maternal health and mitigating the potential intergenerational risks for children's emotional and behavioral health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/fam0000623DOI Listing
February 2020

Psychosocial factors associated with trajectories of maternal psychological distress over a 10-year period from the first year postpartum: An Australian population-based study.

J Affect Disord 2020 02 30;263:31-38. Epub 2019 Nov 30.

Intergenerational Health Group, Murdoch CHildren's Research Institute; Department of Paediatrics, The University of Melbourne, Australia. Electronic address:

Background: Maternal mental health problems contributes significantly to perinatal morbidities and extend beyond the perinatal period for some women. Drawing data from a population-based study this paper aimed to: 1) identify patterns of maternal psychological distress spanning ten years following the birth of a baby, and 2) identify psychosocial risk factors in the first postnatal year for trajectories of elevated psychological distress.

Methodology: A secondary analysis was conducted using data from 4875 mothers participating in the Longitudinal Study of Australian Children. The Kessler-6 assessed maternal psychological distress symptoms when the child was 0-12 months, 2-3 years, 4-5 years, 6-7 years, 8-9 years and 10-11 years. Longitudinal latent class analyses (LCA) was conducted to identify patterns of psychological distress. Latent class membership was assigned and used in subsequent regression analyses to identify predictors of each trajectory.

Results: LCA identified five distinct trajectories of maternal psychological distress symptoms over time. Predictors of trajectories with elevated symptoms reflected a pattern of social and economic disadvantage and psychosocial stress. The strongest predictors of elevated mental health symptoms were a history of depression [OR: 7.57(4.73-12.11)] and 3 or more stressful life events in the past year [OR: 3.38(2.02-5.65)].

Limitations: The assessment of maternal mental health and child health was based on brief self-report measures and mothers from lower socioeconomic and diverse cultural backgrounds were underrepresented.

Conclusions: These findings underscore the importance of early diagnosis and treatment of women at risk of mental health problems in the postnatal period and early years of parenting.
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http://dx.doi.org/10.1016/j.jad.2019.11.138DOI Listing
February 2020
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