Evaluating the efficacy of Circle of Security-Parenting as an addition to care-as-usual in families affected by maternal postpartum depression and/or infant social withdrawal: A randomized controlled trial.

The Circle of Security - Parenting (COSP™) is a psychoeducational intervention aiming at fostering secure child-parent attachment relationships. In a randomized controlled trial, we investigate the effect of COSP™ as an adjunct to care-as-usual compared to only care-as-usual for at-risk families. Mothers and their 2-12-month-old infants were randomized into COSP™ +care-as-usual ( = 197) for at-risk families in Copenhagen or only care-as-usual ( = 100).

Validating the parental reflective functioning questionnaire - infant version using a rasch model.

Parental reflective functioning is the parent's ability to reflect on the psychological processes in their child and in themselves as a parent. Recently, an infant version of the Parental Reflective Functioning Questionnaire, PRFQ-I, has been developed and validated using confirmatory factor analyses. The present study aims to validate the PRFQ-I using a Rasch model in a sample of 531 Danish mothers at risk of depression and their infants aged 2-11 months.

Proposing a two-stage screening approach to distinguish between transient and enduring postnatal depressive symptoms: A prospective cohort study.

Background: Screening for perinatal depression using the Edinburgh Postnatal Depression Scale (EPDS) improves detection and increases health service utilization. However, previous studies with antenatal samples indicate that positive screenings might reflect transient distress that resolves without intervention, raising concerns about over-pathologizing typical postnatal responses and inefficiencies in referral practices. Therefore, distinguishing between transient and enduring depressive symptoms for appropriate referrals to secondary services is crucial, highlighting the need for a refined screening practice.

Links among maternal antenatal attachment, postnatal depressive symptoms and infant crying: a prospective cohort study.

Purpose: This study investigated whether maternal antenatal attachment (MAA) in the third trimester was associated with self-reported problematic infant crying at eight weeks postnatally and explored links with postnatal depressive symptoms.

Methods: A prospective cohort study was conducted with 1287 pregnant participants in Danish general practice. MAA was measured using the Maternal Antenatal Attachment Scale (MAAS) in the third trimester.

Mentalizing Care: Adult Attachment and Structural Factors as Predictors of Representational Mind-Mindedness in Early Child-Care Professionals.

Out-of-home childcare is increasingly essential in many children's lives, significantly impacting their wellbeing and development. Central to high-quality care is the concept of caregiver mind-mindedness (MM), the ability to recognize a child as a unique psychological individual with thoughts, feelings, intentions etc., as this capacity is linked with more optimal responsiveness to children's needs.

Influence of introducing a story stem in an interactive play context on maternal and their four-year-old children's use of mental state language.

Maternal and child mental state language is associated with improved socioemotional and cognitive child development. This study examined if introducing a story stem (a narrative playing out socioemotional conflicts) in a play situation facilitated maternal and child mental state language compared to a free-play (baseline) situation, and if mothers and children with low baseline mental state language profited more from the story stem situation. Participants were 101 four-year-old children and their mothers.

Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness.

Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N = 142), with symptoms of postpartum depression, and their 1-11-month-old infants.

The significance of parental mentalizing for four-year-old children's solitary pretend play.

Background: Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play).

I'm with you, baby: Using parental embodied mentalizing in a pilot study to capture change following the circle of security parenting intervention.

Supported by a large body of work demonstrating the impact of infant attachment representations on subsequent development, numerous therapeutic programs have been developed to promote secure attachment, with increasing focus on parental mentalizing. Nonetheless, empirical evidence supporting their effectiveness has yet to be fully established. The current pilot study (N = 24) was designed to evaluate whether and to what extent parents' shifts in parental mentalizing following a brief attachment-based group intervention, namely circle of security parenting (COSP; Cooper, Hoffman & Powell, 2009) can be captured using the parental embodied mentalizing instrument (PEM; Shai & Belsky, 2017).

Four-year-old children's pretend play complexity during free play and story stem play and associations with maternal sensitivity.

Theory and research have linked pretend play in early childhood with the development of language and theory of mind. In 102 mother-child dyads at 4.5 years, we examined whether (1) introducing a story stem (a play narrative with socioemotional dilemmas) in a mother-child play context increases pretend play complexity compared with mother-child free play; and (2) maternal sensitivity is associated with pretend play complexity.

The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health.

The parents' capacity to reflect upon the psychological processes in their child, termed parental reflective functioning (PRF) can be impaired by parental mental health problems. The present study aimed to investigate the factor structure of an infant version of the Parental Reflective Functioning Questionnaire (PRFQ-I) in a low-risk sample of 259 Danish fathers of 1-11-month-old infants to investigate measurement invariance of the PRFQ-I between fathers and mothers; and to examine the association between PRF and paternal depressive symptoms, psychological distress, and parenting stress. Confirmatory factor analysis supported a three-factor model of the PRFQ-I.

Promoting interactive skills and mind-mindedness among early childcare professionals: study protocol for a randomized wait-list controlled trial comparing the Circle of Security approach with care as usual in center-based childcare (the SECURE project).

Background: In countries where the majority of young children are enrolled in professional childcare, the childcare setting constitutes an important part of children's caregiving environment. Research consistently shows that particularly the quality of the daily interactions and relationship between young children and their professional caregivers have long-term effects on a range of developmental child outcomes. Therefore, professional caregivers' capacity for establishing high quality interactions with the children in their care is an important target of intervention.

Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort.

Infant social withdrawal is a risk factor for non-optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2-3, 4-7 and 8-12 months postpartum.

Protocol for a randomized controlled trial comparing the Circle of Security-parenting (COS-P) with treatment as usual in child mental health services.

Background: The quality of a child's attachment to its primary caregiver plays an important role for its long-term socioemotional development. While 'secure' attachment is associated with better outcomes, 'insecure' attachment is associated with a higher risk of externalizing and internalizing symptoms. Children referred to mental health services show much higher rates of insecure attachment than the general population, yet the parent-child relationship is rarely in treatment focus.

The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms.

Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes.

Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety?

Background: Anxiety in the ante- and postnatal period is prevalent, often co-occurs with depression, and can have adverse consequences for the infant. Therefore, perinatal mental health screening programs should not only focus on depression but also on detecting anxiety. However, in many already implemented perinatal screening programs, adding extra screening instruments is not feasible.

Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology.

Parental reflective functioning (PRF) refers to the parent's capacity to envision mental states in the infant and in themselves as a parent, and to link such underlying mental process with behavior, which is important for parenting sensitivity and child socio-emotional development. Current findings have linked maternal postpartum depression to impaired reflective skills, imposing a risk on the developing mother-infant relationship, but findings are mixed, and studies have generally used extensive methods for investigating PRF. The present study examined the factor structure and measurement invariance of the Danish version of the 18-item self-report Parental Reflective Functioning Questionnaire (PRFQ) in a sample of mothers with and without diagnosed postpartum depression.

How to screen for social withdrawal in primary care: An evaluation of the alarm distress baby scale using item response theory.

Background: Early identification of infants at-risk is imperative for proper referral to intervention programs. The Alarm Distress Baby Scale (ADBB) is an eight-item observer-rated screening tool detecting social withdrawal in infants. Previously, a shortened five-item version of the scale (m-ADBB) has been proposed.

What factors are most important for the development of the maternal-fetal relationship? A prospective study among pregnant women in Danish general practice.

Background: Development of the maternal antenatal attachment (MAA) constitutes an important aspect of the transition into motherhood. Early identification of women at risk of developing a poor MAA provides possibilities for preventive interventions targeting maternal mental health and the emerging mother-infant relationship. In this study, we investigate the relative importance of an extensive set of psychosocial, pregnancy-related, and physiological factors measured in the first trimester of pregnancy for MAA measured in third trimester.

Associations of maternal sensitivity and embodied mentalizing with infant-mother attachment security at one year in depressed and non-depressed dyads.

Parental Embodied Mentalizing (PEM) captures the parent's capacity to extrapolate the child's mental states from movement and respond on a nonverbal level. Little is known about PEM's relation to other established measures of parent-child interactive behavior, such as maternal sensitivity and attachment. This is investigated in a sample of four months old infants and mothers with ( = 27) and without a diagnosis of postpartum depression ( = 44).

Maternal-fetal bonding among pregnant women at psychosocial risk: The roles of adult attachment style, prenatal parental reflective functioning, and depressive symptoms.

Pregnancy offers a unique period for initiating preventive parenting interventions. Disturbances in maternal-fetal bonding may indicate suboptimal parenting and a need for intervention. However, more knowledge is needed on the development of maternal-fetal bonding among at-risk groups.

Associations Between Maternal Postpartum Depression, Infant Social Behavior With a Stranger, and Infant Cognitive Development.

Maternal postpartum depression (PPD) has been found to be related to infant social withdrawal during mother-infant interaction, and this may spill over on infant interactive behavior in other social contexts and impact infant psychosocial development. We investigated whether PPD was associated with infant social withdrawal during interaction with a tester in a psychological test situation and whether infant social withdrawal in the test situation mediated the association between PPD and infant cognitive scores reported in a previous study. Participants were 28 PPD dyads and 41 control dyads.

Maternal postpartum depression is a risk factor for infant emotional variability at 4 months.

Maternal postpartum depression (PPD) is a risk for disruption of mother-infant interaction. Infants of depressed mothers have been found to display less positive, more negative, and neutral affect. Other studies have found that infants of mothers with PPD inhibit both positive and negative affect.

Motor activity and spatial proximity: Relationships to infant emotions and maternal postpartum depression.

The ability to express emotions is a protective factor for infant development. Despite the multimodal nature of emotion expression, research has mainly focused on facial expressions of emotions. The present study examined motor activity and spatial proximity in relation to positive and negative infant facial expressions and maternal postpartum depression during face-to-face interactions at four months.

Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression.

Background: The Edinburgh Postnatal Depression Scale (EPDS) is widely used in many countries to screen women for depression in the perinatal period. However, across studies the psychometric properties and cutoff scores of the EPDS have varied considerably; potentially due to different depression criteria and diagnostic systems being used. Therefore, we validated the Danish EPDS against a depression diagnosis according to both DSM-5 and ICD-10.