Perinatal mental health (PMH) difficulties are prevalent and often accompanied by parent-infant relationship difficulties. National Health Service community PMH services (PMHS) support birthing parents (typically mothers) experiencing moderate-to-severe and complex mental health difficulties. While PMHS primarily address maternal mental health, treatment can include interventions targeting parent-infant relationships. The Circle of Security-Parenting (COS-P) programme is widely used within PMHS in England and offers a potential solution to the evidence gaps for interventions that: i) target both parental mental health and parent-infant relationship quality; (ii) are transdiagnostic; and iii) delivered in groups. This study evaluates the acceptability of COS-P, an attachment-informed, group intervention delivered in PMHS in ten 90-min sessions, predominantly online. This qualitative study analysed the perspectives of parents (COS-P recipients) and practitioners (COS-P providers) in the intervention arm of a wider randomised controlled trial. Data collection involved interviews (58 parents, 7 practitioners) and focus groups (6 practitioners). Reflexive thematic analysis was conducted by a team including co-researchers with lived experience and interdisciplinary academics and practitioners. Four themes were constructed: (1) ‘Flamingos’, capturing the power of the group in normalising and validating demands relating to motherhood and PMH; (2) ‘Practise Babies’, highlighting the universal necessity and benefit of practising relationship skills, without expectations of perfection and with opportunities for repair; (3) ‘the Dark Things’, describing the emotional intensity for parents and practitioners arising from current and past relationships, occasionally necessitating extra support; and (4) ‘the Ripples’, illustrating shifts in understanding and compassion that may extend beyond the parent-infant relationship and interact with other interventions. These themes encompass both positive and negative experiences for parents and practitioners, as well as practical considerations for implementing COS-P within PMHS. Although COS-P is positively regarded by many parents and practitioners in PMHS, attention to individual and service-specific factors remains crucial. Findings underscore the importance of trauma-informed approaches, particularly regarding intervention timing, sequencing, and ensuring personal agency in treatment decisions. Moreover, the effective facilitation of parent-infant psychological group interventions demands significant skill and resource allocation before, during, and outside sessions, impacting workforce planning, practitioner training, and supervision. ISRCTN18308962. Registered 18/02/2022.

OBJECTIVES:The Circle of Security-Parenting (COS-P) group intervention has demonstrated efficacy in reducing maternal perinatal mental health difficulty (PMHD) symptoms in some contexts. The Circle of Security Intervention (COSI) study, a multisite, individually randomised, single-blind, parallel-arm controlled trial, was conducted in England to assess the clinical effectiveness of COS-P in reducing perinatal psychopathology, parenting and infant development, as well as its acceptability among the National Health Service (NHS) participants and staff. The main aim of this work is to estimate the cost-utility of COS-P plus treatment as usual (TAU) relative to TAU among mothers and birthing parents receiving NHS perinatal mental health services (PMHS) in England. DESIGN:A within-trial economic evaluation was performed comparing COS-P plus TAU with TAU alone, using data from the COSI trial, which employed a 2:1 randomisation ratio. Analyses were conducted from both NHS and personal social services (PSS) and societal perspectives. A 12-month time horizon was used, consistent with the final trial follow-up. SETTING:Secondary care NHS perinatal health services across multiple centres in England. PARTICIPANTS:A total of 371 mothers and birthing parents with PMHD were randomised and had complete economic outcome data; 248 received COS-P plus TAU and 123 received TAU alone. Participants were eligible if they were receiving NHS PMHS; exclusion criteria were defined in the trial protocol. INTERVENTIONS:Participants in the intervention arm received the COS-P group programme in addition to TAU. The control group received TAU alone. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary economic outcome was quality-adjusted life years (QALYs) over 12 months, derived from the 5-level EuroQol five-dimensional (EQ-5D-5L) questionnaire - responses. Costs were estimated from NHS and PSS as well as societal perspectives, including healthcare utilisation and productivity losses due to work absence. RESULTS:Compared with TAU, COS-P was associated with higher costs from both NHS and PSS (£180.58; 95% CI -£1075 to £1436) and societal (£72.94; 95% CI -£1473 to £1619) perspectives. COS-P was marginally less effective in terms of QALYs (-0.01; 95% CI -0.06 to 0.05). Probabilistic sensitivity analyses indicated substantial uncertainty around cost and effectiveness estimates. CONCLUSIONS:On average, COS-P was associated with higher costs and did not demonstrate improvements in health-related quality of life compared with TAU alone. Given the uncertainty surrounding the estimates, further research is warranted to explore potential longer term economic and clinical impacts of COS-P in perinatal mental health settings. TRIAL REGISTRATION NUMBER:SRCTN18308962.

Objective All children in England should receive a health review at 2-2 1/2 years, with the Ages and Stages Questionnaire third edition (ASQ-3) used to collect public health surveillance data on child development. However, practitioners also value tools that assess individual children's development-consistent with ASQ-3's original purpose. Concerns about licensing costs and barriers to digitalisation have prompted interest in alternative tools to the ASQ-3 in England. Design To inform policy, we conducted a rapid scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify tools that can measure or assess early child development. Data sources Searched PubMed, PsycINFO and Web of Science from January 2012 to November 2022, with targeted search update November 2024.Eligibility criteria We included English-language studies published after January 2012 that described or evaluated tools in English which could measure or assess early child development in children <5 years across five domains: motor, cognitive, communicative, social and emotional. Data extraction We extracted key features and reliability, validity, sensitivity and specificity of tools which could feasibly be implemented at the 2-2<1/2>-year review (eg, including multiple age versions and <30 min to use). We used Quality Assessment of Diagnostic Accuracy Studies-I to assess risk of bias. Results We identified 112 unique publications describing 34 tools; six met our feasibility criteria for the 2-2<1/2>-year review (reported in 53 studies). Only ASQ-3 and CREDI offer domain-specific scoring-a government priority. ASQ-3 moderately detects mild delays and performs better for severe delays in at-risk groups. Caregiver Reported Early Development Instruments (CREDI) was designed for public health surveillance, and we do not yet know how it performs for individual assessment. Conclusions ASQ-3 and CREDI are most promising for use at the 2-2 1/2 -year review. However, we lack UK-based validation and norming studies, even for ASQ-3. Ultimately, careful implementation and integration into existing systems will determine a tool's value for identifying developmental needs, supporting families and producing high quality data for public health surveillance.

Abstract Background: Rates of mental health problems in adolescents have increased in the last decade, prompting urgent calls for effective, scalable preventative interventions. To determine whether a novel, group-based, transdiagnostic indicated prevention programme (Building Resilience through Socioemotional Training; ReSET), delivered through existing school mental health provision, improves mental health and wellbeing in at-risk adolescents. Methods: Two-arm cluster randomised controlled superiority trial (1:1) evaluating ReSET plus usual care versus usual care only, with outcomes assessed immediately post-intervention and at 12-month follow-up. Adolescents aged 12–14 identified through whole-school screening as scoring in the top 25th percentile for overall psychopathology symptoms, in schools selected to over-represent high-need communities (≥30% free school meals eligibility). ReSET is an 8-session group -based intervention that targets two key mechanisms implicated in risk for psychopathology in adolescents – social functioning and emotional processing. Pre-registered co-primary outcomes were overall self-reported psychopathology (SDQ) and wellbeing (WEMWBS), assessed immediately post-intervention and at 12-month follow-up. Results: Of 4,005 adolescents screened, 1465 met eligibility, 727 consented and 560 were enrolled. There was no evidence of intervention effects on either co-primary outcome immediately post-intervention. At 12-month follow-up, there was evidence of improvement in overall psychopathology (adjusted mean difference −1.36, 97.5% CI −2.23 to −0.50, p=0.0004; SMD=0.25, 95% CI 0.11 to 0.42). Secondary outcomes showed a consistent pattern: no effects immediately post-intervention, but significant benefits for anxiety, depression, general psychopathology, and internalising symptoms at 12-month follow-up. No effects on externalising symptoms were observed at either timepoint. Conclusions: The delayed emergence of benefit is consistent with a skills-based prevention model in which adolescents acquire skills that support resilient functioning when facing subsequent emotional and interpersonal challenges. These findings suggest that transdiagnostic interventions targeting socioemotional processes have the potential to prevent common adolescent mental health problems, though replication and longer-term evaluation are needed.

Public engagement is an important mechanism for ensuring that the voices of the public are integrated into study design and data use. However, engaging with the public around data use and data privacy can be challenging, due to the complex and specialist nature of the topic. Building on previous work (Raybould, IJPDS 2025), this paper showcases the findings and outputs from a range of public engagement work carried out for Generation New Era, a new UK-wide birth cohort study, funded by the Economic and Social Research Council. A key aim for Generation New Era is to build public trust through clear communication about benefits and data safeguards and use the Five Safes Framework to help shape these communications. To help develop and test these communications, we are carrying out in-depth public engagement work to test the main study's privacy information and explanations of data use, security and privacy with members of the public, to better understand lay interpretations of technical language and to further improve how we communicate these. We are working with a specialist public dialogue team at Verian carry out testing of these materials using small in-person focus groups with a diverse group of parents from across the UK in late 2025. We also plan to use specialist public panels on data use (e.g. ADR-UK) in all four UK nations as part of this work, to review the more technical aspects of the privacy information.

Caregiver sensitivity is the extent to which a caregiver notices a child's signal, interprets it correctly, and responds quickly and appropriately. Although originally introduced to developmental science as the key antecedent of attachment security, decades since its conception, hundreds of studies have been conducted examining the predictive significance of caregiver sensitivity to a broad range of developmental outcomes. The literature on caregiver sensitivity and related constructs (e.g., warmth, responsivity, negative parenting) has grown exponentially and is now the focus of several meta-analyses. We conducted an umbrella review - a systematic review of reviews - to examine the extent to which caregiver sensitivity and related constructs are associated with child attachment, socioemotional, and cognitive outcomes. Searches in EMBASE, PsycINFO, and Medline and yielded 2,157 abstracts. Studies were included if they were a meta-analysis of caregiver sensitivity or a related construct, focused on children's developmental outcomes, were available in English, French, or Spanish, and were published between 2010 and 2024. Conducted and reported in accordance with PRISMA guidelines, 17 meta-analyses were identified. Using the metaumbrella package in R, we conducted quantitative analyses which demonstrated that caregiver sensitivity was moderately associated with attachment security (r = .25, k = 253, n = 37,444), cognition (r = .23, k = 44, n = 6,777), language skills (r = .26, k = 54, n = 11,136), and weakly associated with socioemotional problems (r = -.07, k = 135, n = 33,305). Narrative analysis of other meta-analyses on caregiver warmth, responsivity, positive and negative parenting, and child outcomes also showed associations in the expected direction. Our findings demonstrate the critical importance of caregiver sensitivity on children's socioemotional and cognitive development, supporting caregiver sensitivity as an important target for early childhood prevention and intervention programs.

Important breakthroughs in understanding the role of attachment for social functioning and wellbeing have always gone hand in hand with the construction of new measurement paradigms. In her 1986 book on five methods of assessment, Mary Main concluded that experiences and representations of attachment shape general, stable, and coherent categories of mental organization. The rules for classifying these categories were derived from data drawn from new, experimentally controlled measures. Taking inspiration from Main's approach, the current paper argues that a data-driven approach that leverages advances in naturalistic recording and computation may go further and also deliver a detailed understanding of how and when patterns of attachment behavior are formed during the first year of life. This paper describes how tools for long-term, fine-grained, multimodal recording can be embedded in daily family life and combined with high-throughput processing and supervised machine learning. Predictive models of dynamic interactions between features of infants' and caregivers' behaviors can be explored and interpreted to arrive at testable theory. By casting theory in the form of agent-based models, we can iteratively rebuild Bowlby's original conceptualization of behavioral control systems for attachment and caregiving, which provided the starting point of Main's empirical forays. We describe the theoretical gaps in current attachment research as well as the opportunities for multidisciplinary research that could be addressed by an approach that builds on Main's abductive logic.

Caregiver sensitivity is the extent to which a caregiver notices a child's signal, interprets it correctly, and responds quickly and appropriately. Although originally introduced to developmental science as the key antecedent of attachment security, decades since its conception, hundreds of studies have been conducted examining the predictive significance of caregiver sensitivity to a broad range of developmental outcomes. The literature on caregiver sensitivity and related constructs (e.g., warmth, responsivity, negative parenting) has grown exponentially and is now the focus of several meta-analyses. We conducted an umbrella review – a systematic review of reviews – to examine the extent to which caregiver sensitivity and related constructs are associated with child attachment, socioemotional, and cognitive outcomes. Searches in EMBASE, PsycINFO, and Medline and yielded 2,157 abstracts. Studies were included if they were a meta-analysis of caregiver sensitivity or a related construct, focused on children's developmental outcomes, were available in English, French, or Spanish, and were published between 2010 and 2024. Conducted and reported in accordance with PRISMA guidelines, 17 meta-analyses were identified. Using the metaumbrella package in R , we conducted quantitative analyses which demonstrated that caregiver sensitivity was moderately associated with attachment security ( r  = .25, k  = 253, n  = 37,444), cognition ( r  = .23, k  = 44, n  = 6,777), language skills ( r  = .26, k  = 54, n  = 11,136), and weakly associated with socioemotional problems ( r  = −.07, k  = 135, n  = 33,305). Narrative analysis of other meta-analyses on caregiver warmth, responsivity, positive and negative parenting, and child outcomes also showed associations in the expected direction. Our findings demonstrate the critical importance of caregiver sensitivity on children's socioemotional and cognitive development, supporting caregiver sensitivity as an important target for early childhood prevention and intervention programs.

Adverse childhood experiences (ACEs) are well-established risk factors for adult depression. Indicators of socioeconomic status (SES, i.e. income, education, and employment) are likely mechanisms linking ACEs to depression. However, research has yet to meta-analytically test the mediating role of SES in the ACEs-depression association. We examined the associations between childhood ACEs and adult depression and SES indicators by synthesizing available literature into three random-effects meta-analytic structural equation models (MASEMs). From systematic searches in PsycINFO, Embase, CINHAL, and MEDLINE, we identified 105 samples representing 755,306 adults. Included studies reported effect sizes between ACEs, depression, and ≥1 SES indicator in adult populations. To test the mediating role of SES, separate MASEMs were tested for adult income (k = 56, n = 414,020), education (k = 87, n = 557,483), and employment (k = 21, n = 260,550). Adult income and education partially mediated the childhood ACEs-to-adult depression association. Higher ACE scores were associated with lower income and decreased educational attainment, which then predicted higher depression severity. Indirect effects were small but significant (income = 0.01 [0.006, 0.02]; education = 0.003 [0.0004, 0.007]). No variables moderated these indirect effects. Employment did not mediate the association between ACEs and depression. Our research provides context for understanding how SES indicators differentially mediate the pathway from ACEs to depression across populations. Although potentially limited by study reporting and assumptions in MASEM models, this research highlights the need to address socioeconomic disparities, particularly in income and education, within mental health strategies that target the lasting impacts of childhood adversity.

OBJECTIVE:All children in England should receive a health review at 2-2½ years, with the Ages and Stages Questionnaire third edition (ASQ-3) used to collect public health surveillance data on child development. However, practitioners also value tools that assess individual children's development-consistent with ASQ-3's original purpose. Concerns about licensing costs and barriers to digitalisation have prompted interest in alternative tools to the ASQ-3 in England. DESIGN:To inform policy, we conducted a rapid scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify tools that can measure or assess early child development. DATA SOURCES:Searched PubMed, PsycINFO and Web of Science from January 2012 to November 2022, with targeted search update November 2024. ELIGIBILITY CRITERIA:We included English-language studies published after January 2012 that described or evaluated tools in English which could measure or assess early child development in children <5 years across five domains: motor, cognitive, communicative, social and emotional. DATA EXTRACTION:We extracted key features and reliability, validity, sensitivity and specificity of tools which could feasibly be implemented at the 2-2½-year review (eg, including multiple age versions and <30 min to use). We used Quality Assessment of Diagnostic Accuracy Studies-I to assess risk of bias. RESULTS:We identified 112 unique publications describing 34 tools; six met our feasibility criteria for the 2-2½-year review (reported in 53 studies). Only ASQ-3 and CREDI offer domain-specific scoring-a government priority. ASQ-3 moderately detects mild delays and performs better for severe delays in at-risk groups. Caregiver Reported Early Development Instruments (CREDI) was designed for public health surveillance, and we do not yet know how it performs for individual assessment. CONCLUSIONS:ASQ-3 and CREDI are most promising for use at the 2-2½-year review. However, we lack UK-based validation and norming studies, even for ASQ-3. Ultimately, careful implementation and integration into existing systems will determine a tool's value for identifying developmental needs, supporting families and producing high quality data for public health surveillance.

BACKGROUND:Genetic differences are robustly associated with educational outcomes, but how they become linked is poorly understood. A plausible hypothesis, yet to be thoroughly empirically tested, is that the school environment mediates the association. METHODS:Using structural equation models, we tested whether the student-teacher relationship at age 5 (teacher-reported Student-Teacher Relationship Scale) mediated the association between children's education-linked genetic propensities (PGSedu) and mother-rated reading and math performance at ages 6-8. We performed these analyses in 63,032 children from the Norwegian Mother, Father and Child Cohort Study, a longitudinal, population-based, pregnancy cohort. RESULTS:Higher PGSedu were significantly associated with lower student-teacher conflict (β = -0.08, p < .001) and positive teacher responses (β = 0.07, p = .001), but not student-teacher closeness (β = 0.01, p = .616). Associations between PGSedu and educational performance were significantly partially mediated via conflict (β = 0.01, p < .001) and positive teacher responses (β = 0.01, p = .019) but not closeness (β = 1 × 10-3, p = .619). CONCLUSIONS:Student-teacher conflict and positive teacher responses may be mechanisms involved in the cascade of pathways linking children's genetics to their educational outcomes.

This paper reports on Adult Attachment Interviews (AAIs) obtained from a low-risk sample of 51 pregnant women expecting their first child who were interviewed again when the child was five years of age. This is the first report of test-retest results that extends over five years that includes the transition to motherhood. Results suggest significant levels of continuity at the level of AAI classifications with three-way stability being 90% and two-way stability being 88%. When change was observed, it was more likely to be a move toward rather than away from security. At the level of dimensional scores, significant changes indicated a softening stance with higher coherence ratings, lower idealization scores, and less insistence on an inability to recall. This move toward a significantly more balanced state of mind regarding attachment was most evident among those mothers who maintained or became autonomous-secure.

Despite the recognized need for early interventions to prevent maltreatment and family separation in families involved with child protection services (CPS), evidence for children aged 0 to 5 years remains scarce and inconclusive. This systematic review and meta-analysis aimed to evaluate the effectiveness of psychosocial interventions delivered to these families in reducing the risk of harm, improving parenting quality, and supporting parental functioning. The review included families with children aged 0 to 5 years engaged with CPS and deemed at risk of entering the care system. A systematic search of databases (e.g., PubMed, CINAHL, PsychINFO) was conducted for randomized controlled trials (RCTs) from 1990 to 2024. Eligible studies were assessed for risk of bias using the Revised Cochrane Risk-of-Bias Tool. Meta-analyses used random effects models to estimate standardized mean differences (SMD) or odds ratios (OR). Narrative synthesis was provided for outcomes not appropriate to include in meta-analyses. Fifteen RCTs (n = 2,232 families) were included. Interventions did not demonstrate consistent effects on reducing subsequent maltreatment, as measured by official records (OR = 0.88, 95% CI [0.75, 1.02]) or parent-reported risk of harm (SMD = -0.07, [-0.25, 0.11]). However, significant improvements were observed in parental sensitivity (SMD = 0.53, [0.30, 0.76]), attachment organization (OR = 2.17, [1.64, 2.87]), and parental functioning (SMD = -0.21, [-0.36, -0.06]). In conclusion, psychosocial interventions show promise in improving parenting among edge-of-care families but lack consistent evidence for reducing maltreatment risk. Future research should prioritize larger trials with standardized outcome measures to strengthen this evidence base.

Introduction One in six women experience postnatal depression globally. Treatment is often unavailable, which increasing risks of long-term depression among mothers and poorer developmental outcomes for their children. This protocol outlines the first within-trial economic evaluation to inform policymakers about the value for money of culturally adapted group interpersonal therapy (group-IPT) to improve child cognitive development and postnatal depression outcomes. Methods We will conduct a full economic evaluation of group-IPT within the Supporting Mothers’ Mental Health with Interpersonal Therapy (SUMMIT) trial. SUMMIT is an individually randomised, controlled superiority trial in Kenya and Lebanon. The economic evaluation will adopt a societal perspective, comprising provider and patient perspectives. This will be based on an intention-to-treat analysis, over a 52-week time horizon in line with trial follow-up. The cost and cost-effectiveness of group-IPT will be compared with high-quality standard care in the control arm. Costs and outcomes will be analysed to estimate an incremental cost-effectiveness ratio (ICER) based on child cognitive development, the primary trial outcome. We will also estimate ICERs for statistically significant secondary trial outcomes, which include maternal depression and quality of life. Two-way sensitivity analyses will vary cost drivers and outcomes within confidence bounds to investigate uncertainty. To inform policymakers on affordability, we will estimate the cost of group-IPT at scale relative to available public resources. We will also investigate how group-IPT outcomes are distributed across socioeconomic groups and whether participating mothers experience financial hardship due to care-seeking. Ethics and dissemination The SUMMIT trial and economic evaluation received ethical approval from University College London’s Research Ethics Committee in the United Kingdom (23699/001), Saint Joseph University Secretariat of the University Ethics Centre in Lebanon (CEHDF 1854) and Kenyatta National Hospital and the University of Nairobi in Kenya (KNH/ERC/Mod&SAE/425). Economic evaluation results will be disseminated to various local and international stakeholders via peer-reviewed journal publications, policy briefs, conferences and workshops. Trial registration number The ISRCTN Registry: ISRCTN15154316. Registered on 27 September 2023: https://doi.org/10.1186/ISRCTN15154316

Research is needed to elucidate the underlying mechanisms that link adverse childhood experiences (ACEs) and internalizing symptomatology in women. In the present study, we conducted a systematic review to assess whether intimate partner violence (IPV) mediated the association between ACEs and internalizing symptomatology in women. We utilized a novel statistical technique-meta-analytic structural equation modelling (MASEM)-to examine the path model by amalgamating effect sizes across all studies, thereby combining both meta-analytic and structural equation modelling approaches. A total of 25 studies (N = 30,737 women) were included in the MASEM. The average age of female participants was 30.4 years. Results indicated that IPV partially mediated the association between ACEs and internalizing symptomatology, explaining 16 % of the total effect. Tested moderators included sociodemographic factors (age, SES, single status, and minority status) and methodological factors, including IPV characteristics (IPV category and IPV timeline), psychopathology assessment method, and the number of ACEs items measured. None of the tested moderators significantly influenced the indirect pathway. Findings suggest that IPV is an important risk factor in explaining why ACEs are associated with internalizing symptomatology in women.

Attentional control is key to the development of executive functions. Previous studies have indicated that individual differences in attentional control behaviour may be stable from 6 months. Here, we analyse electroencephalogram data collected from 59 6-month-olds to gain insights into the neural processes underlying attentional control in infancy. Firstly, we examine the neural activity preceding distinct looking behaviours in a task designed to elicit attentional control. Secondly, we test whether those neural markers show predictive associations to behavioural measures of attentional control (Freeze-Frame task) and executive function (A-not-B task) in the same infants at 9 months. Whilst our data do not show evidence that 6-9Hz power is implicated in attentional control at 6 months, or that the P1 ERP component plays a role in our attentional control task, we do find evidence that corroborates and extends research linking 3-6Hz power to attentional control. At the group level, frontal 3-6Hz power recorded whilst looking to a central target prior to the onset of a peripheral distractor was greater during trials where infants subsequently looked to the distractor, compared with trials where they did not look. Higher 3-6Hz power in trials where the infant did not look to a peripheral distractor was predictive of less distractibility at 9 months, and higher 3Hz power in trials where infants did look to the distractor strengthened the predictive association from 6-month EEG to 9-month behaviour. We suggest that 3-6Hz activity may be sensitive to multiple processes, such as anticipatory attention, and the ability to maintain attention on a target.

Oxytocin (OT) plays pivotal roles in stress regulation, mother-infant bonding, and breastfeeding, all of which are adversely impacted by postnatal depression (PND). In a double-blind, randomized controlled trial, we assessed endogenous OT concentrations first in the breast milk of new mothers at baseline, and second following the administration of exogenous OT compared to a placebo delivered via a nasal spray. METHOD:Participants were mothers (N = 62, aged 23-42 years) and their infants (aged 3-9 months). Each mother underwent screening for PND symptoms using the Edinburgh Postnatal Depression Scale (EPDS). N = 26 mothers scored above the cut-off point (≥9) on the EPDS, and N = 36 mothers scored below. Breast milk samples, collected during breastfeeding, were assayed for OT content. RESULTS:Baseline endogenous OT concentration in breast milk was not associated with maternal low mood. Exogenous OT administration was associated with a significant increase in breast milk OT, but with reduced effect in mothers experiencing symptoms of PND compared to control mothers. CONCLUSIONS:Future studies should test if breast milk OT exhibits a protective role against the developmental disadvantages of maternal PND on children. The current findings may reflect a possible disruption of the interaction between the central and peripheral OT pathways during breastfeeding in mothers experiencing symptoms of PND. These insights shed new light on the potential biological mechanisms involved in the transference of mental health vulnerabilities from mothers to infants.

BACKGROUND:It has long been hypothesized that increasing heritability with age of cognitive and educational performance is partly attributable to evocative gene-environment correlation. However, this hypothesis has not been widely tested. METHODS:We addressed this gap by examining whether children's education polygenic scores (PGSedu) were associated with maternal self-reported positive and literacy-focused parenting when children were 5 years old, and if evoked parenting differences mediated genetic effects on children's educational outcomes (mother-reported at 6-8 years of age), while controlling for parental PGSedu. We also investigated whether maternal reports of children's language at 5 years old were associated with parenting and mediated genetic effects on educational performance. These questions were addressed in a sample of 83,627 parent-offspring trios from the Norwegian Mother, Father and Child Cohort Study, a longitudinal population-based pregnancy cohort. RESULTS:Children's PGSedu were significantly associated with maternal literacy-focused (β = .03, 95% CI [0.01, 0.05], p = .021) but not positive parenting (β = 0.01, 95% CI [-0.02, 0.05], p = .410), and literacy-focused parenting significantly mediated the effects of children's PGSedu on their educational performance (β = 0.01, 95% CI [1 × 10-3, 0.01], p = .023). Children's language was associated with maternal parenting and mediated the effects of children's PGSedu on their educational performance (β = 0.01, 95% CI [3 × 10-3, 0.02], p = .002). CONCLUSIONS:These findings support our hypotheses and suggest early language and parenting may be mechanisms implicated in the pathways from children's genetics to their educational outcomes.

Public engagement is an important mechanism for ensuring that the voices of the public are integrated into study design and data use. The commissioning of a new UK-wide birth cohort study by the UKRI Economic and Social Research Council (ESRC), the Early Life Cohort Feasibility Study (ELC-FS), necessitated renewed dialogue with the public about the acceptability of conducting a large-scale study of this kind. The ELC-FS recruited several thousand children in their first year of life, using an administrative data sampling frame, an `opt-out' recruitment approach, and embedded linkages to education, health and social care administrative data. The study faced many complexities and challenges to achieve this: the sampling frame had not been used for this purpose before, required negotiation with different data holders in the four UK nations, and the study needed to ensure transparency around how participants' administrative and survey data would be used. Conducting public engagement projects with parents of young children prior to the study's fieldwork was essential to understanding more about the public acceptability of data use in ELC-FS. Evidence from these projects was used to support negotiations with data holders, as well as in guiding best practice for informing participants about their data use and data linkage. This paper summarises the evidence from these public engagement projects relating to data transparency and enacting participant choice and control of the use of their data in the study. We describe how this evidence was implemented in three key study design areas: sampling and recruitment, the collection and use of survey data, and seeking participant consent to link administrative records to individual-level survey data. We also present evidence from the study's fieldwork about participants' acceptability of the survey design and transparency around data use, from recruitment to data collection and processing.

ImportanceExposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability.ObjectiveTo meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates.Design, Setting, and ParticipantsStudies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024.Main Outcomes and MeasuresACEs.ResultsThe mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90).ConclusionsIn this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.