Parents who have experienced childhood maltreatment may develop posttraumatic stress (PTS) symptoms and display disrupted parenting behavior, particularly in situations of revictimization through intimate partner violence (IPV). This study investigated (1) the relation between parental childhood maltreatment, PTS symptoms, and disrupted parenting, and (2) whether PTS symptoms mediate the relation between childhood maltreatment and disrupted parenting. A culturally diverse sample of IPV-exposed mothers participated (N = 52; Mage = 30.6 years) and their children (Mage = 2.8 years; range = 7.5 months-7.0 years), residing in Dutch women's shelters. Multiple Bayesian regression analyses were carried out, and prior probability distributions (priors) were used, informed by a systematic literature search. Results showed a positive association between childhood maltreatment and PTS symptoms but not between these variables and the overall construct of disrupted parenting. No meaningful mediation was found. Exploratory analyses showed some inconclusive evidence for mediation of PTS symptoms in the associations between'childhood maltreatment on the one hand and role/boundary confusion and fearful/disoriented parenting behavior on the other hand. The findings highlight the relevance of childhood maltreatment in the experience of PTS symptoms. Furthermore, they underscore the need for treatment focused on trauma and parenting in families exposed to IPV. Clinical trial registration: Ethical approval was given by the Medical Research Ethics Committee Leiden The Hague Delft (MREC LDD, protocol number NL74114.058.20) and the study was pre-registered in the Open Science Framework (DOI: 10.17605/OSF.IO/9EW7P).
The Circle of Security-Parenting program (COS-P) is a widely disseminated attachment and mentalization-informed parenting intervention. Outcome studies, however, have yielded mixed results and its effectiveness for parents from different demographic groups is largely unknown. This study examined the outcomes of COS-P and explored parent demographics (mother/father status and education). Participants were 117 parents who attended COS-P at an Australian Early Parenting Center. The Composite Caregiving Questionnaire (CCQ) assessed caregiving representations (self-efficacy regarding emotion/affection and empathy/understanding, hostility, caregiving helplessness, and parental reflective functioning). Outcomes were analyzed using a mixed model repeated measures design. Results revealed significant post-intervention improvement on all CCQ domains, with some demographic differences. Fathers reported a greater rate of improvement in parental self-efficacy regarding empathy and understanding compared to mothers, after starting from a lower level. There were no differences in any outcomes between parents who were university-educated and those who were not. Findings provide further evidence that COS-P improves caregiving representations, but there may be some differences for mothers and fathers.
Caregivers play a critical role in early child development, yet adverse experiences such as trauma or mental health difficulties can compromise caregiving. Minding the Baby (MTB) is a home-visiting intervention supporting vulnerable families from pregnancy to the child's second birthday. This study explored parents' experiences to understand engagement and barriers to participation. Within a Danish MTB trial, 31 semi-structured telephone interviews were conducted with parents who completed, discontinued, or declined MTB. Data were analyzed thematically. Eight themes were identified: (1) Validation and Support in Early Parenthood, (2) Community Mobilization, (3) Divergent Perspectives within Couples, (4) Therapeutic Alliance and Home Visitors' Skills, (5) Intervention as Time Consuming or Confusing, (6) Fear of Surveillance, (7) Not Identifying with the Target Group, and (8) When MTB Is Not Enough. Most parents valued parenting confidence-building, relational support, and flexible delivery. Barriers included mistrust, surveillance concerns, scheduling constraints (especially for fathers), perceptions of not belonging to the target group due to feeling "too well-functioning", associated stigma, and limits of program scope. Parents found MTB broadly acceptable and supportive, highlighting the importance of transparent communication, flexible scheduling, and father engagement. Findings offer insights for recruitment, tailoring, and implementation of home-visiting programs.
Parental mind-mindedness (MM), the tendency of parents to interpret and comment on their child's internal mental states, is a critical factor in caregiving and child development, particularly in vulnerable or atypical developmental populations. This scoping review synthesizes research on MM in parents of atypically developing children, examining group differences compared to typically developing populations, links between parental MM and well-being, and connections between MM and broader parenting skills. The database search identified twelve studies published between 2012 and 2026. Findings across studies are mixed: while some report no significant MM differences, others show that parents of neurodivergent children more often use negative or symptomatic descriptors, suggesting challenges in recognizing internal states. Positive MM appears associated with aspects of parental well-being, particularly lower parenting stress or distress, although findings for anxiety and depression are more mixed. However, maternal anxiety and child behavior outcomes show a complex interplay, with MM potentially moderating negative effects. The review also explores intervention studies that target MM to enhance parental functioning and child development. In conclusion, MM emerges as a meaningful construct for understanding and supporting parenting in atypical and at-risk developmental contexts, warranting further research on its role in early intervention and parent-child outcomes.
Infant and Early Childhood Mental Health Consultation (IECMHC) is a capacity-building, prevention-focused service that supports early childhood professionals and families in promoting young children's social-emotional development. This conceptual analysis addressed the research question: How can IECMHC programs systematically and efficiently measure fidelity using existing documentation systems? The study examined data from a large, government-sponsored IECMHC program in a mid-Atlantic U.S. metropolitan region, involving 17 consultants (50% Black or African American, 36% other racial minority) serving 102 early childhood education centers with mostly racial minority staff and families. Through an iterative process with program leadership, 15 fidelity metrics were developed and operationalized at the programmatic, classroom, and child-specific levels using consultants' electronic documentation. The resulting fidelity database enables programs to assess consultant adherence to core consultation activities, identify areas for quality improvement, and facilitate reflective supervision. This approach offers a practical, replicable strategy for other IECMHC programs to adopt or adapt to enhance implementation fidelity and, ultimately, the equity, quality and effectiveness of mental health consultation services for infants, young children, and their caregivers.
This study explored how a history of childhood maltreatment shapes the transition to parenthood, with a focus on how partners jointly negotiate this adjustment within the couple relationship. Using Interpretative Phenomenological Analysis (IPA), in-depth semi-structured interviews were conducted with 11 heterosexual couples (22 individuals) living in the United States, in which at least one partner reported a history of childhood maltreatment. Interviews were analyzed for emergent themes related to adjustment to parenthood, relational functioning, and dyadic support processes. Four overarching dyadic themes emerged: (1) relational meaning-making of childhood maltreatment, (2) relational challenges activated by maltreatment history, (3) dyadic support as co-regulation for maltreatment-related vulnerability, and (4) couples' resilient and intentional orientation toward family life. Findings suggest that supportive romantic partnerships may function as a relational context through which parenting-related self-doubt is negotiated, emotional safety is fostered, and caregiving approaches distinct from participants' own childhood experiences are collaboratively constructed. These insights have implications for dyadic interventions during the transition to parenthood that aim to support reflective parenting and relational resilience.
Paternal mental health (PMH) has been shown to associate with child development as early as infancy. However, the moderating effects of certain contextual factors remain poorly understood. Using data from the French SEPAGES cohort, an outcome-wide analytic approach was used to investigate the relationship between PMH during pregnancy (n = 166), 0-12 months postnatally (n = 117), and 12-24 months postnatally (n = 207) with child socioemotional, behavioral and cognitive outcomes at two and three years. Mother's mental health, child sex and parent's professional class were then tested as potential moderators. Findings revealed no significant associations between paternal depression or anxiety with any measure of child development. However, mother's professional class and maternal prenatal depression moderated the association between paternal anxiety and several areas of child development, with children of lower maternal professional classes showing poorer cognitive outcomes but improved social perception when exposed to paternal anxiety. Children exposed to paternal anxiety showed worse working memory outcomes and future-oriented tasks and organization when also exposed to maternal depression. While our findings contrast with current research, showing no relationship between PMH and child development, they highlight the importance of considering family socioeconomic position when studying the relationship between PMH and child development.
This study explored whether the strength of parent-home visitor working alliances might alter the benefits of Recipe 4 Success, a highly structured food-based curriculum designed to promote parents' sensitive scaffolding, responsive food parenting practices, toddlers' self-regulation, and healthy eating habits. This study included 242 parents and their toddlers residing in the United States, most of whom were living in poverty (37% white, 25% Black, 19% Latiné, 17% Multiracial, and 2% Asian; median income = $1555 per month). Families were randomly assigned to Recipe 4 Success or usual practice home visits within home visitor caseload. Home visitors tended to rate their working alliance as very strong versus less strong. Within-group regression equations revealed that, among families with a less strong working alliance, Recipe 4 Success was more effective than usual practice home visits in improving parents' sensitive scaffolding, responsive food parenting practices, and toddlers' self-regulation. In contrast, among families who had a strong working alliance, Recipe 4 Success was more effective than usual practice home visits in changing toddlers' healthy eating habits, including reducing body mass index for toddlers with overweight/obesity. These findings highlight how families with varying strengths of working alliances may benefit differently from highly structured evidence-based curricula.
The parenting experience of parents of children with disabilities is unique, encompassing both positive and challenging aspects. Parental mentalization (PM), the ability of parents to interpret and understand their children's inner world, has been identified as a crucial factor benefiting both parents and their children. However, the literature on PM in parents of children with disabilities would benefit from greater organization. This scoping review aims to address this gap by examining the existing research on PM in this population. The study was conducted in accordance with the PRISMA-ScR guidelines. The review included studies retrieved from five databases: PsycNet, PubMed, MEDLINE, ProQuest, and EBSCO. Studies were eligible for inclusion if they were peer-reviewed, published in English, and examined the PM abilities of parents of children with developmental disabilities. A total of 27 studies were identified, coded, and analyzed to generate key themes, including: (1) comparison of PM between groups, (2) associations between PM and demographic characteristics, (3) PM-focused interventions, and (4) variables associated with PM. The discussion highlights gaps in the current literature, offers recommendations for future research, and provides practical implications for supporting the PM of parents of children with disabilities.
Sex chromosome trisomies (SCTs) are genetic conditions caused by the presence of an additional sex chromosome. While recent studies have focused on analyzing the early competencies of children with SCTs, relatively few have investigated aspects of parent-child interaction. No studies have yet examined how parents support the development of children with SCTs. This study aims to (1) identify differences in supportive parenting behaviors between mothers of children with SCTs and mothers of typically developing (TD) children, and (2) observe these behaviors longitudinally at 8 months (T1) and 24 months (T2). Participants included 36 Italian mother-child dyads (19 with SCTs and 17 TD). At both T1 and T2, ten-minute semi-structured play interactions were video-recorded and coded using PICCOLO. At 8 months, mothers in the SCT group demonstrated fewer responsive and teaching behaviors than mothers in the TD group, and exhibited fewer encouraging behaviors at 24 months. However, longitudinally, the same mothers exhibited significantly more responsive and teaching behaviors at T2 than at T1. In conclusion, while awareness of their children's condition, or differences in children's behavior, may affect how mothers interact with their children with SCTs, these mothers also exhibit parenting skills that could benefit from targeted interventions to support their children, who are more likely to exhibit developmental delays.
Evolutionary-based theories of parenting, such as activation relationship theory, suggest that fathers may be more likely than mothers to engage in activation parenting, that is, interactions designed to stimulate and challenge children within acceptable limits. However, available evidence is mixed in identifying differences between mothers and fathers in activation parenting. Using two meta-analyses, we examined 1) mean differences and 2) associations in activation parenting exhibited by partnered mothers and fathers. The meta-analyses included 40 studies (38 unique samples, 76.3% collected in North America) with a total of 3,607 fathers and 3,707 mothers, and their children (M = 41.4 months; range = 3 months to 19.9 years). Most parents were white and from a mid-high socioeconomic status. The first meta-analysis showed that fathers displayed higher activation parenting than mothers, with a small effect size: g = .27, 95% CI [.17, .37], p < .001. Differences were larger in studies examining rough-and-tumble play. A strong correlation between partnered parents' activation parenting levels emerged in the second meta-analysis: r = .33, 95% CI [.19, .45], p < .001. These results highlight the importance of continuing research on activation parenting across diverse types of parents.
A person's state of mind with respect to attachment, measured by the Adult Attachment Interview (AAI), represents how the individual perceives, accesses, and processes attachment-related content. One's state of mind with respect to attachment is thought to guide behavior in relationships, including caregiving relationships, and thus may have important implications for parents' engagement in parenting interventions. Relational savoring (RS) is a brief attachment-based intervention that has been shown to increase mothers' parenting sensitivity, feelings of closeness to their child, and positive emotion. However, it remains unknown how mothers with different attachment profiles respond to this intervention. In the current illustrative multiple case study, we examine how three mothers (Mage = 31.0 years, SDage = 1.0) of young children in the United States classified with different states of mind with respect to attachment respond to RS. First, we provide samples of mothers' AAI discourse to illustrate their states of mind with respect to attachment. Next, we analyze their responses during RS sessions using a qualitative approach. Results demonstrate differences in mothers' attachment-related discourse, capacity for reflection, and change processes during the intervention that varied by attachment profile. We discuss the implications of these findings for RS and other parenting interventions.
Early cardiac surgery for congenital heart disease (CHD) may have enduring effects on the parent-child emotional connection and a child's capacity for regulation. This study explored emotional availability in parent-child interaction following early cardiac surgery in relation to emotional and behavioral regulation in children and identified early predictors. Participants were 23 preschool-aged children with CHD and their parents from a longitudinal cohort assessed at infancy (post-surgery) and preschool age in Australia. Dyadic interaction was assessed using the Emotional Availability Scales (EA), and parents reported on child's emotional and behavioral regulation. Predictors included infant social-emotional functioning, parental attachment feelings and traumatic stress, hospitalization length, timing of diagnosis and duration of contact at birth. Over 50% of dyads demonstrated emotional availability, however 30% were classified as complicated and 12% detached. Greater parental sensitivity was associated with less externalizing behavior. Longer hospitalization was associated with lower child involvement and greater parental intrusiveness. Contact at birth was associated with greater emotional availability and more optimal parental structuring at preschool. Findings highlight the enduring impact of early medical adversity on emotional availability in CHD and illuminate effects on both child and parent. Future research should explore targeted interventions that buffer relational disruptions in medically vulnerable dyads.
This qualitative study investigated parental views on an extended home visit program by public health nurses (PHNs) using focus groups and individual interviews with first-time parents in Oslo, Norway. Participant responses to semi-structured questions were analysed using the recursive process for thematic analysis. Findings revealed a significant demand for enhanced support mechanisms. Through trust-building experiences during home visits, parents overcame initial scepticism rooted in vulnerability and fear of judgement. Participants emphasized the need for increased support during pregnancy and postnatal periods, addressing emotional concerns and the need of encouragement. Home visits were perceived as praxis-oriented, focusing on strengths and resources, and more informal than Child Health Clinic consultations. The accessibility of nurses and direct contact via mobile phones enhanced service quality and trust. Home visits targeting all new families mitigated stigmatization and ensured high utilization when delivered with proportionate universalism. Participating families endorsed integrating a universal home visit program into the Norwegian Child Health Clinic services. Key elements and principles were delineated, leading to a blueprint for future integration, emphasizing relational continuity and tailored support.
Infant temperamental negative affect (NA) poses transdiagnostic risk for psychopathology. Risk often operates indirectly through caregiving, as high NA infants tend to elicit intrusive parental responses. The present study examined whether maternal mind-mindedness (MM), moderates the longitudinal indirect pathway from infant NA, through concurrent maternal intrusive behavior, to child internalizing/externalizing symptoms at 5.5 years. Eighty-eight mother-infant dyads participated (55.7% male, all White, 70.2% middle-high socioeconomic status). Infant NA, maternal intrusiveness, and representational and interactional measures of MM were observed at 4 months. Mothers reported child symptoms at 5.5 years. Representational MM moderated the indirect pathway from infant NA to child symptoms through maternal intrusiveness. At low MM, infant-NA was significantly associated with increased maternal intrusiveness and subsequent risk for externalizing symptoms. At high MM, infant-NA was significantly associated with lower maternal intrusiveness and subsequent reduced externalizing symptoms, thereby creating a developmental advantage for high-NA infants relative to their low-NA counterparts. Findings underscore maternal representational MM as a protective buffer against NA-related risk. Methodological considerations are discussed regarding the employment of interactional versus representational measures of MM. Clinical implications of MM are discussed as a promising target for early interventions, particularly in the context of high-NA infants.
Parent-infant relationships are the foundation of child development. Ready to Relate (R2R) is a novel flexible intervention to enhance parent knowledge and awareness related to healthy parent-infant relationships including brain development, infant cues, and sensitive, responsive and attuned parenting. It is highly visual and designed to be accessible across cultures and language levels. This study explored parent and practitioner perspectives on the acceptability and impacts of R2R and used workshops to coproduce a logic model. Thematic analysis of semi-structured interviews with practitioners (N = 14) and parents (N = 18) in Bradford, UK, found that R2R was perceived to have positive outcomes for infants, parents, practitioners, and on others in the wider system. Potential mechanisms through which R2R promotes conversations about parent-infant relationships and facilitates positive change were identified and documented in the logic model. The relational parent-practitioner context was highlighted as critical for ensuring positive impacts and preventing unintended negative consequences. This study suggests that R2R may offer application in multiple delivery contexts and may generate positive impacts for parents and infants from diverse backgrounds. The logic model will guide further research to systematically evaluate outcomes from this promising intervention and support clinical application.
Infants engage with their world through a complex system of relationships, a reality that becomes especially salient in the neonatal intensive care unit (NICU), where infants encounter numerous healthcare professionals. Secure connections between infants and caregivers are critical to psychological, emotional, and physical development, yet little research has examined how infants experience their relationships with healthcare professionals in NICU. This qualitative phenomenological study, conducted in an Australian NICU, explored the infant's experience of connection and relationship-building with their healthcare professionals. Term-born infants, their parents, and members of their healthcare teams were purposively sampled. Data were generated through participant observation and semi-structured interviews, providing rich insight into the infant's relational world. Thematic analysis identified three themes: (1) the complexity of infant-clinician relational dynamics; (2) the infant within the relational space; and (3) barriers and challenges within the infant-clinician relationship. Findings highlight the complexity and fragility of infant-clinician relationships, which were frequently centred on physical survival, sometimes limiting attention to the infant's emotional safety and early relational health. These results highlight the importance of recognising infants as relational beings and calls for neonatal practice to prioritise developmentally supportive and emotionally attuned caregiving.
Although paternal post-partum depression (PPD) significantly impacts the mental wellbeing of fathers and their families, there are many barriers to fathers being assessed and supported for PPD. Given mothers are positioned both close to fathers and healthcare services, we employed mixed-methods to investigate mothers' potential role in facilitating fathers' recognition of and help-seeking for PPD. In Study 1, 189 mothers in Australia (M age = 35.0, 78.9% Australian-European) completed an online survey assessing mothers' levels of mental health literacy regarding paternal PPD. Results showed that 86.8% of mothers correctly recognized paternal PPD, 84.7% recommended professional help options, and almost all mothers were either likely or very likely to recommend professional help-seeking. In Study 2, 15 Australian mothers (M age = 37.4, 93.3% Australian-European) participated in qualitative interviews to explore mothers' willingness and capacity to facilitate fathers' recognition of and support for paternal PPD. Findings suggested that mothers' capacity and willingness to adopt this facilitative role may be undermined by poor-quality partner relationships, the all-encompassing experience of early motherhood, and stigma regarding men's mental health; however, certain health care practices could target such barriers. Together, these findings have important implications for policy and practice regarding paternal PPD and family support.
Infant and Early Childhood Mental Health Consultation (IECMHC) is a preventative intervention that is theorized to mediate its impacts through the consultative stance, described as a consultant's "way of being" in relationship. However, limited tools are available to measure the elements of the consultative stance or the degree to which consultants and supervisors assess its implementation. This study describes the conceptualization, development, and piloting of a set of tools in the United States measuring the consultative stance for use by consultants and supervisors, the Consultative Stance Learning and Measurement tools (CSLM). The CSLM includes the Consultant Self Reflection (CSR) and the Supervisor Survey (SS). Seventy-six consultants and 28 supervisors completed the tools at least once, with 48 consultants completing the tool at three timepoints. A confirmatory factor analysis (CFA) tested the theorized latent structure of the tool, providing good support for the CSR and moderate support for the SS. Over time, consultants and supervisors increasingly aligned in their perceptions of consultant implementation of the consultative stance, though consultants rated their implementation lower than supervisors. The tools advance the field's capacity to measure the impact of IECMHC and provide targeted information for ongoing reflective supervision and training, as consultants develop their practice.
Reflective supervision (RS) is a central component of Infant and Early Childhood Mental Health Consultation (IECMHC), providing mental health consultants (MHCs) with space to slow down, reflect on practice, and cultivate professional growth. This exploratory qualitative study examined how MHCs build the capacity and skills needed to develop an equity stance through RS. Sixteen mostly white and Hispanic MHCs from a Southwestern IECMHC program participated in individual interviews about their supervisory relationships and experiences addressing equity issues. Data were analyzed inductively to identify patterns and generate an emerging framework grounded in participants' experiences. We identified a developmental and relational process in which supervisors' behaviors gradually built trust and connection, cultivating safety as the foundation for reflective and equity-focused dialogue. Two interconnected themes captured this progression: (1) supervisors' behaviors that cultivate safety and foster equity dialogue, and (2) consultants' experiences of felt safety that support their willingness and vulnerability to engage in, or withhold from, equity dialogue. These findings align with relational-developmental and parallel process models of RS, extending existing literature by illustrating how intentional, equity-centered supervision supports consultants' capacity to engage in reflection and promote equitable outcomes for diverse children and families.
