Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related... Show moreMental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents’ behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission. Show less
Zeegers, M.A.; Potharst, E.S.; Veringa-Skiba, I.K.; Aktar, E.; Goris, M.; Bögels, S.M.; Colonnesi, C. 2019
Studies on the effectiveness of mindful parenting interventions predominantly focused on self-report measures of parenting, whereas observational assessments of change are lacking. The present... Show moreStudies on the effectiveness of mindful parenting interventions predominantly focused on self-report measures of parenting, whereas observational assessments of change are lacking. The present study examined whether the Mindful with your baby/toddler training leads to observed changes in maternal behavior and mother-child interaction quality. Mindful with your baby/toddler is a 8- or 9-week mindful parenting training for clinically referred mothers of young children (aged 0-48 months), who experience parental stress, mother-child interaction problems, and/or whose children experience regulation problems. The study involved a quasi-experimental non-random design including a sample of 50 mothers who were diagnosed with a mood disorder (n = 21, 42%), an anxiety disorder (n = 7, 14%), post-traumatic stress disorder (n = 6, 12%), or other disorder (n = 7, 14%). Mothers completed a parental stress questionnaire and participated in home observations with their babies (n = 36) or toddlers (n = 14) during a waitlist, pretest, and posttest assessment. Maternal sensitivity, acceptance, and mind-mindedness were coded from free-play interactions and dyadic synchrony was coded from face-to-face interactions. Sensitivity and acceptance were coded with the Ainsworth's maternal sensitivity scales. Mind-mindedness was assessed by calculating frequency and proportions of appropriate and nonattuned mind-related comments. Dyadic synchrony was operationalized by co-occurrences of gazes and positive facial expressions and maternal and child responsiveness in vocal interaction within the dyad. Coders were blind to the measurement moment. From waitlist to pretest, no significant improvements were observed. At posttest, mothers reported less parenting stress, and were observed to show more accepting behavior and make less nonattuned comments than at pretest, and children showed higher levels of responsiveness. The outcomes suggest that the Mindful with your baby/toddler training affects not only maternal stress, but also maternal behavior, particularly (over)reactive parenting behaviors, which resulted in more acceptance, better attunement to child's mental world, and more "space" for children to respond to their mothers during interactions. Mindful with your baby/toddler may be a suitable intervention for mothers of young children with (a combination of) maternal psychopathology, parental stress, and problems in the parent-child interaction and child regulation problems. Show less
The sense of touch develops in utero and enables parent-child communication from the earliest moments of life. Research shows that parental touch (e.g., licking and grooming in rats, skin-to-skin... Show moreThe sense of touch develops in utero and enables parent-child communication from the earliest moments of life. Research shows that parental touch (e.g., licking and grooming in rats, skin-to-skin care in humans) has organizing effects on the offspring's stress system. Little is known, however, about the psychological effects of parental touch. Building on findings from ethology and psychology, we propose that parental touch-even as subtle as a touch on the shoulder-tells children that their environment is safe for exploration, thus reducing their social vigilance. We tested this hypothesis in late childhood (ages 8-10) and early adolescence (ages 11-14) in 138 parent-child dyads. Parents were randomly assigned to touch or not touch their child briefly and gently on the shoulder, right below the deltoid. Parental touch lowered children's implicit attention to social threat. While parental touch lowered trust among socially non-anxious children, it raised trust among those who needed it the most: socially anxious children. The effects were observed only in late childhood, suggesting that parental touch loses its safety-signaling meaning upon the transition to adolescence. Our findings underscore the power of parental touch in childhood, especially for children who suffer from social anxiety. Show less
Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations... Show moreEarlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in chil‐dren at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety. Show less
Aktar, E.; Majdandžić, M.; De Vente, W.; Bögels, S.M. 2017
This study investigated the link between (a) parents’ social trait and state anxiety and (b) children’s fear and avoidance in social referencing situations in a longitudinal design and considered... Show moreThis study investigated the link between (a) parents’ social trait and state anxiety and (b) children’s fear and avoidance in social referencing situations in a longitudinal design and considered the modulating role of child temperament in these links. Children were confronted with a stranger and a robot, separately with their father and mother at 1 (N = 122), at 2.5 (N = 117), and at 4.5 (N = 111) years of age. Behavioral inhibition (BI) was separately observed at 1 and 2.5 years. Parents’ social anxiety disorder (SAD) severity was assessed via interviews prenatally and at 4.5 years. More expressed anxiety by parents at 4.5 years was not significantly linked to more fear or avoidance at 4.5 years. High BI children were more avoidant at 4.5 years if their parents expressed more anxiety at 2.5 years, and they were more fearful if the parents had more severe forms of lifetime SAD. More severe lifetime forms of SAD were also related to more pronounced increases in child fear and avoidance over time, whereas parents’ expressions of anxiety predicted more pronounced increases in avoidance only from 2.5 to 4.5 years. High BI toddlers of parents with higher state and trait anxiety become more avoidant of novelty as preschoolers, illustrating the importance of considering child temperamental dispositions in the links between child and parent anxiety. Moreover, children of parents with more trait and state anxiety showed more pronounced increases in fear and avoidance over time, highlighting the importance of early interventions targeting parents’ SAD. Show less
Many mothers experience difficulties after the birth of a baby. Mindful parenting may have benefits for mothers and babies, because it can help mothers regulate stress, and be more attentive... Show moreMany mothers experience difficulties after the birth of a baby. Mindful parenting may have benefits for mothers and babies, because it can help mothers regulate stress, and be more attentive towards themselves and their babies, which may have positive effects on their responsivity. This study examined the effectiveness of Mindful with your baby, an 8-week mindful parenting group training for mothers with their babies. The presence of the babies provides on-the-spot practicing opportunities and facilitates generalization of what is learned. Forty-four mothers with their babies (0–18 months), who were referred to a mental health clinic because of elevated stress or mental health problems of the mother, infant (regulation) problems, or mother-infant interaction problems, participated in 10 groups, each comprising of three to six mother-baby dyads. Questionnaires were administered at pretest, posttest, 8-week follow-up, and 1-year follow-up. Dropout rate was 7%. At posttest, 8-week follow-up, and 1-year follow-up, a significant improvement was seen in mindfulness, self-compassion, mindful parenting, (medium to large effects), as well as in well-being, psychopathology, parental confidence, responsivity, and hostility (small to large effects). Parental stress and parental affection only improved at the first and second follow-ups, respectively (small to medium effects), and maternal attention and rejection did not change. The infants improved in their positive affectivity (medium effect) but not in other aspects of their temperament. Mindful with your baby is a promising intervention for mothers with babies who are referred to mental health care because of elevated stress or mental health problems, infant (regulation) problems, or mother-infant interaction problems. Show less
Generalized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD.... Show moreGeneralized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD. First, we address child acquisition of a generalized pattern of fearful/anxious and avoidant responding to potential threat from parents via verbal information and via modeling. Next, we address how parenting behaviors may contribute to maintenance of fearful/anxious and avoidant reactions in children. Finally, we consider intergenerational transmission of worries as a way of coping with experiential avoidance of strong negative emotions and with intolerance of uncertainty. We conclude that parents with GAD may bias their children's processing of potential threats in the environment by conveying the message that the world is not safe, that uncertainty is intolerable, that strong emotions should be avoided, and that worry helps to cope with uncertainty, thereby transmitting cognitive styles that characterize GAD. Our review highlights the need for research on specific pathways for parent-to-child transmission of GAD. Show less
Aktar, E.; Mandell, D.J.; De Vente, W.; Majdandzic, M.; Raijmakers, M.E.J.; Bögels, S.M. 2016
Between 10 and 14 months, infants gain the ability to learn about unfamiliar stimuli by observing others’ emotional reactions to those stimuli, so called social referencing (SR). Joint processing... Show moreBetween 10 and 14 months, infants gain the ability to learn about unfamiliar stimuli by observing others’ emotional reactions to those stimuli, so called social referencing (SR). Joint processing of emotion and head/gaze direction is essential for SR. This study tested emotion and head/gaze direction effects on infants’ attention via pupillometry in the period following the emergence of SR. Pupil responses of 14-to-17-month-old infants (N = 57) were measured during computerized presentations of unfamiliar objects alone, before-and-after being paired with emotional (happy, sad, fearful vs. neutral) faces gazing towards (vs. away) from objects. Additionally, the associations of infants’ temperament, and parents’ negative affect/depression/anxiety with infants’ pupil responses were explored. Both mothers and fathers of participating infants completed questionnaires about their negative affect, depression and anxiety symptoms and their infants’ negative temperament. Infants allocated more attention (larger pupils) to negative vs. neutral faces when the faces were presented alone, while they allocated less attention to objects paired with emotional vs. neutral faces independent of head/gaze direction. Sad (but not fearful) temperament predicted more attention to emotional faces. Infants’ sad temperament moderated the associations of mothers’ depression (but not anxiety) with infants’ attention to objects. Maternal depression predicted more attention to objects paired with emotional expressions in infants low in sad temperament, while it predicted less attention in infants high in sad temperament. Fathers’ depression (but not anxiety) predicted more attention to objects paired with emotional expressions independent of infants’ temperament. We conclude that infants’ own temperamental dispositions for sadness, and their exposure to mothers’ and fathers’ depressed moods may influence infants’ attention to emotion-object associations in social learning contexts. Show less
Aktar, E.; Majdandžić, M.; De Vente, W.; Bögels, S.M. 2013
Background: Anxiety runs in families. Observational learning of anxious behavior from parents with anxiety disorders plays an important role in the intergenerational transmission of anxiety. We... Show moreBackground: Anxiety runs in families. Observational learning of anxious behavior from parents with anxiety disorders plays an important role in the intergenerational transmission of anxiety. We investigated the link between parental anxiety (parental lifetime anxiety disorders and expressed parental anxiety) and toddler fear/avoidance during social referencing (SR) situations. Method: Toddlers (N = 117) participated with both parents (with lifetime social anxiety disorder, other nonsocial anxiety disorders, lifetime comorbid social and other anxiety disorders, or without anxiety disorders) in a longitudinal study. Behavioral inhibition (BI) was measured at 12 months via observational tasks. At 30 months, children were confronted with a stranger and a remote-control robot in SR situations, separately with each parent. Children’s fear and avoidance, and parents’ expressions of anxiety, encouragement, and overcontrol were observed. Results: Toddlers of parents with lifetime social anxiety disorder (alone and comorbid with other anxiety disorders) showed more fear/avoidance in SR situations than toddlers of parents without anxiety disorders, while the effect of other anxiety disorders alone was not significant. Although expressed parental anxiety at 30 months in SR situations did not significantly predict toddlers’ fear/avoidance, higher levels of expressed anxiety at 12 months in SR situations by parents with comorbid social and other anxiety disorders predicted higher levels of fear/avoidance. BI at 12 months predicted toddlers’ fear/avoidance only with mothers, but not with fathers. Conclusions: Parental lifetime social anxiety disorders may be a stronger predictor of children’s fear/avoidance than parents’ expressions of anxiety in SR situations in toddlerhood. End of infancy may be a sensitive time for learning of anxiety from parents with comorbid lifetime social and nonsocial anxiety disorders in SR situations. Fathers are as important as mothers in the transmission of anxiety via SR. Furthermore, children may act relatively free of their early temperament in SR situations with fathers. Show less
Aktar, E.; Majdandžić, M.; Vente, W. de; Bögels, S.M. 2012
Background: Anxiety aggregates in families. Environmental factors, such as modelling of anxious behaviours, are assumed to play a causal role in the development of child anxiety. We investigated... Show moreBackground: Anxiety aggregates in families. Environmental factors, such as modelling of anxious behaviours, are assumed to play a causal role in the development of child anxiety. We investigated the predictive value of paternal and maternal anxiety (lifetime anxiety disorders and expressed parental anxiety) on infants’ fear and avoidance during encounters with social and nonsocial novel stimuli in a social referencing (SR) paradigm.Methods: A total of 122 12-month-old infants participated in this study separately with their fathers and mothers (parents with lifetime: social anxiety disorders [n = 47], other types of anxiety disorders [n = 33], comorbid social and other types of anxiety disorders [n = 52] and without anxiety disorders [n = 112]). Infants were confronted with a stranger and a mechanical dinosaur as novel stimuli in two SR situations. Infants’ avoidance as well as fear and parents’ expressed anxiety were observed. Infants’ behavioural inhibition (BI) was separately observed in structured tasks. Results: Parental lifetime anxiety disorders did not significantly predict infant fear or avoidance. Expressed parental anxiety interacted with BI to significantly predict infant avoidance, revealing a positive association between expressed parental anxiety and infant avoidance among infants with moderate-to-high BI. The association between infant avoidance and expressed parental anxiety was not significantly different for mothers and fathers, pointing to an equally important role of fathers at this young age. Infant fear was significantly predicted by infant BI, but not by expressed parental anxiety. Conclusions: Infants with a temperamental disposition for anxiety (BI) may learn from both paternal and maternal anxious signals and become avoidant towards novelty when their parents express anxiety. This link between expressed parental anxiety and infant avoidance for moderate-to-high BI children, that seems to hold across contexts and to be independent of lifetime parental anxiety disorders, may be a mechanism explaining early intergenerational transmission of anxiety. Show less
Majdandžić, M.; Vente, W. de; Feinberg, M.E.; Aktar, E.; Bögels, S.M. 2011
Research into anxiety has largely ignored the dynamics of family systems in anxiety development. Coparenting refers to the quality of coordination between individuals responsible for the... Show moreResearch into anxiety has largely ignored the dynamics of family systems in anxiety development. Coparenting refers to the quality of coordination between individuals responsible for the upbringing of children and links different subsystems within the family, such as the child, the marital relationship, and the parents. This review discusses the potential mechanisms and empirical findings regarding the bidirectional relations of parent and child anxiety with coparenting. The majority of studies point to bidirectional associations between greater coparenting difficulties and higher levels of anxiety. For example, the few available studies suggest that paternal and perhaps maternal anxiety is linked to lower coparental support. Also, research supports the existence of inverse links between coparenting quality and child anxiety. A child’s reactive temperament appears to have adverse effects on particularly coparenting of fathers. A conceptual model is proposed that integrates the role of parental and child anxiety, parenting, and coparenting, to guide future research and the development of clinical interventions. Future research should distinguish between fathers’ and mothers’ coparenting behaviors, include parental anxiety, and investigate the coparental relationship longitudinally. Clinicians should be aware of the reciprocal relations between child anxiety and coparenting quality, and families presenting for treatment who report child (or parent) anxiety should be assessed for difficulties in coparenting. Clinical approaches to bolster coparenting quality are called for. Show less
