The main objective of the present longitudinal study is to describe the progression of early adult-child interactions between the first and second years of life. Changes identified in interactions are described, focusing on both the qualitative aspects of maternal responses, as well as maternal response latency to the child\'s behavior using a microanalytical methodology that collected data on maternal and child behavior in real-time without losing sight of the temporal dimension.
This study examined 52 mother-child dyads from intact families that presented no psychological, social, or biological risk factors at 6, 12 and 18 months of age.
CITMI-R (early mother-child interaction coding system, revised edition) was used to assess early mother-infant interactions during free play sessions between mother and child the.
The results indicate that some components of maternal sensitivity improve as children progress towards the second year of life, detecting an increase in sensitive maternal behavior and a decrease in intrusive behavior in the evolutive observed period; moreover, regarding latency of maternal response, we observed that mothers of older children give more time for their children to explore, which stimulates autonomy. Finally, the implication of these results for intervention directed to optimizing early adult-child interactions are addressed.

Maternal sensitivity has been implicated in various aspects of child health and development, including overweight. However, long-term effects, the role of paternal sensitivity and the explanatory pathways are unclear. This study examined whether maternal sensitivity in early childhood is prospectively associated with adolescent body mass index and whether children\'s self-regulation mediates this relation. Data from 540 children and their mothers were available from a large cohort study in the Netherlands. Maternal sensitivity was assessed at child ages 1, 3, and at 4 years paternal sensitivity was also included. Children\'s self-regulation skills were observed at age 3, eating behaviour was assessed at 10 years, and child BMI was measured at 13 years. Longitudinal structural equation modelling was applied. The cross-sectional association between maternal sensitivity and child self-regulation was significant, while lower levels of self-regulation and higher levels of food responsiveness and restrained eating predicted a higher child BMI at 13 years. Furthermore, a direct association of paternal sensitivity at 4 years with BMI at 13 years was found, but only in girls. Maternal sensitivity was not directly associated with child BMI after adjusting for covariates. Our findings showed the importance of self-regulation in the early years for subsequent weight development. Nevertheless, as self-regulation could not explain the relationship between parenting and child weight, research should focus on the contribution of other contextual factors, such as feeding styles and the social environment, to this relationship.

BACKGROUND: Early childhood development is highly dependent on the sensitive care provided by caregivers, and interventions focused on supporting parents to improve their sensitivity have shown to be effective. The COVID-19 pandemic has had a significant impact on mental health, with pregnant women and mothers of infants being an especially vulnerable group and maternal sensitivity particularly affected. However, access to face-to-face interventions is restricted; thus, it is important to have remote interventions to support this group of mothers.
OBJECTIVE: The objective of this study is to evaluate the feasibility and acceptability of C@nnected, a group videoconferencing intervention to improve maternal sensitivity aimed at mother-infant dyads attending primary health care centers in vulnerable areas of Santiago, Chile.
METHODS: This is a randomized feasibility single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 3:2 allocation ratio (with more people allocated to the intervention arm). The intervention consists of 4 group videoconferencing sessions adapted from a face-to-face intervention with proven effectiveness. The control group will receive treatment as usual, along with educational brochures. The feasibility and acceptability of this study will be quantitatively and qualitatively assessed. Changes in clinical outcomes relating to maternal sensitivity, depressive symptoms, postpartum maternal attachment, and infant socioemotional development will also be evaluated.
RESULTS: We finished adapting the face-to-face intervention to the videoconferencing format in July 2021. The study began recruitment in August 2021, and enrollment is expected to end in August 2022, with final study results expected in December 2022.
CONCLUSIONS: This study will contribute evidence for the use of eHealth interventions to promote maternal sensitivity. It will also inform the design and implementation of a future randomized clinical trial.
BACKGROUND: ClinicalTrials.gov NCT04904861; https://clinicaltrials.gov/ct2/show/NCT04904861.
UNASSIGNED: DERR1-10.2196/35881.

UNASSIGNED: Childhood maltreatment (CM) is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.
UNASSIGNED: Mother-child dyads (N = 158) participated shortly after parturition (t 0), after 3 months (t 1), and 12 months later (t 2). Mothers\' CM experiences were assessed at t 0, attachment representation at t 1 and psychosocial risk and social support were assessed at t 1 and t 2. At t 2, dyads participated in the Strange Situation Procedure (SSP). Children\'s attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate (HR) and respiratory sinus arrhythmia (RSA) were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child\'s single nucleotide polymorphisms rs2254298 within the oxytocin receptor (OXTR) and rs2740210 of the oxytocin gene (OXT) were genotyped using DNA isolated from cord blood.
UNASSIGNED: Maternal CM experiences (CM+) were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children\'s HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.
UNASSIGNED: We replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk.

BACKGROUND: Although there is a large body of literature highlighting the behavioral effects of parenting interventions, studies on the neurocognitive mechanisms involved in such intervention effects remain scarce.
OBJECTIVE: The aim of the current study was to test whether changes in neural face processing (as reflected in N170 amplitudes) would act as a mediator in the association between the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and maternal sensitivity.
METHODS: A total of 66 mothers of whom a random 33% received the VIPP-SD and the others a \"dummy\" intervention participated in pre- and postintervention assessments. We recorded mothers\' electroencephalographic (EEG) activity in response to photographs of children\'s neutral, happy, and angry facial expressions. Maternal sensitivity was observed while mothers interacted with their offspring in a semi-structured play situation.
RESULTS: In contrast with our expectations, we did not find evidence for mediation of intervention effects on maternal sensitivity by the N170.
CONCLUSIONS: We discuss that parenting support programs may yield different effects on neurocognitive processes depending on the population and provide recommendations for future research. Our study underscores the importance of reporting null findings and preregistering studies in the field of neurocognitive research.

UNASSIGNED: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant-parent attachment classification at 12 months postpartum.
UNASSIGNED: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant-parent attachment was measured using the Strange Situation Procedure at 12 months.
UNASSIGNED: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample.
UNASSIGNED: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

BACKGROUND: Psychotherapy of mother-child dyads is an intervention which was developed to prevent maltreatment and negative children\'s development. There is a lack of good-quality research investigating psychotherapeutic interventions and social care for mothers at high-risk living in Mother-Child Facilities in Germany. The present randomized controlled pilot trial (RCT) aimed to evaluate the need for parent-infant psychotherapy (PIP) and to explore its impact on the mother-infant relationship. Primary feasibility objectives were recruitment and attrition, with potential efficacy defined as the secondary feasibility objective.
METHODS: This pilot RCT focused on (young) mothers with cumulative risk factors and their infants under 7 months of age living in Mother-Child Facilities. N=32 mother-child dyads were randomly allocated to PIP or Care as usual (CAU). Outcomes were assessed at baseline, 3 months, and 6 months of intervention. The primary potential efficacy outcome was maternal sensitivity. Secondary outcomes were maternal mental health problems, reflective functioning, parenting stress, personality organization, infant\'s development, and attachment.
RESULTS: At baseline, all mothers showed low levels of emotional availability, but results revealed improvements in sensitivity, mental health problems, stress, and depressive symptomatology favoring PIP after 6 months. Positive developments in maternal sensitivity, a healthy aspect of mother-child interaction, were only found in the PIP group. Overall attrition was high at 6 months. Some evidence of fewer depressive symptoms and lower maternal distress after 6 months of PIP-intervention exists that did not reach significance.
CONCLUSIONS: Findings revealed improvements in the mother\'s well-being for both groups, but PIP had a higher impact on the mother-child dyad. In sum, there is some evidence that PIP may represent an effective intervention offer besides the social and pedagogical support in these facilities, but further research is demanded.
BACKGROUND: DRKS00022485 (retrospectively registered).

The mother\'s attunement to her infant\'s emotional needs influences her use of touching behaviors during mother-infant interactions. Moreover, maternal touch appears to modulate infants\' physiological responses to affective touch. However, little is known about the impact of maternal sensitivity on infants\' touch processing at a brain level. This study explored the association between maternal sensitivity when infants (N = 24) were 7 months old and their patterns of cortical activation to touch at 12 months. Brain activation was measured using functional near-infrared spectroscopy. Changes in oxy-hemoglobin (HbO2) and deoxy-hemoglobin (HHb) concentrations were measured in the left somatosensory cortex and right temporal cortex while infants received two types of tactile stimulation-affective and discriminative touch. Results showed that a lower maternal sensitivity was associated with a higher HbO2 response for discriminative touch over the temporal region. Additionally, infants of less sensitive mothers tended to present a higher response in HbO2 for affective touch over the somatosensory region. These findings suggest that less sensitive interactions might result in a lower exposure to maternal touch, which can be further related to infants\' neural processing of touch.

A pilot randomized controlled trial (RCT) was conducted in El Salvador of an intervention (\'Thula Sana\') previously shown to enhance maternal sensitivity and infant security of attachment in a South African sample. In El Salvador, trained community workers delivered the intervention from late pregnancy to 6 months postpartum as part of a home-visiting programme. The sample comprised 64 pregnant adolescent women, aged 14-19 years, living in predominantly rural settings. They were randomised to receive either the intervention or normal care. Demographic information was collected at baseline and, immediately post-intervention, blind assessments were made of parental sensitivity and infant emotion regulation. The intervention was found to have a substantial positive impact on maternal sensitivity. Further, compared to control group, infants in the intervention group showed more regulated behaviour: in a social challenge task they showed more attempts to restore communication, and in a non-social challenge task they showed more social and goal-directed behaviour. This replication and extension of the South African findings in a small El Salvador sample shows promise and justifies the conduct of a large-scale RCT in a Central or South American context.
Un ensayo piloto controlado al azar se llevó a cabo en El Salvador sobre una intervención (‘Thula Sana’) que previamente había mostrado en un grupo muestra sudafricano el mejoramiento de la sensibilidad materna y la seguridad de la afectividad del infante. En El Salvador, trabajadores entrenados de la comunidad llevaron la intervención como parte de un programa de visitas a casa a partir de la última etapa del embarazo hasta seis meses después del parto. El grupo muestra estuvo compuesto por 64 mujeres adolescentes embarazadas, de entre 14 y 19 años, que vivían en áreas predominantemente rurales. Ellas fueron asignadas al azar para recibir o la intervención o el cuidado normal. Al inicio, se recogió la información demográfica e, inmediatamente después de la intervención, se llevaron a cabo evaluaciones ciegas sobre la sensibilidad de la progenitora y la regulación de la emoción del infante. Se determinó que la intervención tenía un impacto positivo considerable sobre la sensibilidad materna. Es más, comparados con el grupo de control, los infantes en el grupo de intervención mostraron una conducta más regulada: en una tarea de reto social mostraron más intentos de restaurar la comunicación, y en una tarea que no era de reto social, mostraron una conducta más sociable y enfocada en el objetivo. La reproducción y extensión de los resultados sudafricanos en un pequeño grupo muestra en el Salvador es prometedora y justifica que se lleve a cabo un ensayo controlado al azar (RCT) a mayor escala dentro de un contexto centro o suramericano.
The Impact of a Mother-Infant Intervention on Parenting and Infant Response to Challenge: a pilot randomized controlled trial with Adolescent Mothers in El Salvador Un essai randomisé contrôlé pilote a été fait au Salvador, d\'une intervention (‘Thuna Sana’) dont on avait précédemment démontré dans un échantillon Sud-Africain qu\'elle améliore la sensibilité maternelle et la sécurité de l\'attachement du nourrisson. Au Salvador des agents communautaires formés ont fourni l\'intervention de la fin de la grossesse à six mois postpartum, comme faisant partie d\'un programme de visite à domicile. L’échantillon a consisté en 64 adolescentes enceintes, âgées de 14 à 19 ans, vivant principalement en milieux ruraux. Elles ont été randomisées afin de recevoir soit l\'intention soit les soins normaux. Les renseignements démographiques ont été recueillis au début de l’étude et, immédiatement après l\'intervention des évaluations aveugles ont été faites de la sensibilité parentale et de la régulation de l’émotion du bébé. Nous avons trouvé que l\'intervention s\'est avérée avoir un impact positif important sur la sensibilité maternelle. De plus, comparés au groupe contrôle, les nourrissons du groupe d\'intervention ont fait preuve de plus de comportement régulé: lors d\'une tâche de défi sociale ils ont fait preuve de plus de tentatives pour restaurer la communication et durant une tâche de défi non-social ils ont fait preuve d\'un comportement plus social et plus orienté vers un but. Cette réplique et extension des résultats Sud-Africains dans un petit échantillon du Salvador est prometteur et justifier un essai randomisé contrôlé à large échelle dans un contexte Sud-Américain et en Amérique Centrale.
Der Einfluss einer Mutter-Kind-Intervention auf Elternkompetenzen und die kindliche Reaktion auf Herausforderung: Eine randomisierte kontrollierte Pilotstudie mit jugendlichen Müttern in El Salvador In El Salvador wurde eine randomisierte kontrollierte Pilotstudie mit einer Intervention („Thula Sana“) durchgeführt, bei der zuvor an einer südafrikanischen Stichprobe gezeigt werden konnte, dass sie sowohl mütterliche Sensibilität als auch kindliche Bindungssicherheit verbessert. Geschulte Sozialarbeiter:innen führten die Intervention von der späten Schwangerschaft bis sechs Monate nach der Geburt im Rahmen eines Hausbesuchsprogramms durch. Die Stichprobe umfasste 64 schwangere, jugendliche Frauen im Alter von 14 bis 19 Jahren, die in überwiegend ländlichen Regionen lebten. Sie wurden randomisiert entweder der Interventionsgruppe oder einer Kontrollgruppe zugeteilt, die die übliche Betreuung erhielt. Zu Studienbeginn wurden demografische Daten gesammelt und unmittelbar nach der Intervention wurden verblindet Beurteilungen der elterlichen Sensibilität und der kindlichen Emotionsregulation vorgenommen. Es wurde festgestellt, dass die Intervention einen signifikanten positiven Einfluss auf die mütterliche Sensibilität hat. Im Vergleich zur Kontrollgruppe zeigten Säuglinge in der Interventionsgruppe ein stärker reguliertes Verhalten: Bei einer Aufgabe mit sozialer Herausforderung zeigten sie mehr Versuche, die Kommunikation wiederherzustellen, und bei einer Aufgabe mit einer nicht-sozialen Herausforderung zeigten sie mehr soziales und zielgerichtetes Verhalten. Diese Replikation und Erweiterung der südafrikanischen Ergebnisse in einer kleinen salvadorianischen Stichprobe sind vielversprechend und können die Grundlage für groß angelegten RCT`s in mittel- oder südamerikanischen Kontexten darstellen.
母-子介入が養育と乳児の挑戦課題への反応に及ぼす影響:エルサルバドルの青年期の母親を対象にした予備的無作為化比較試験 すでに南アフリカの対象者に関して報告されている、母親の感受性と乳児の安定したアタッチメントを向上させるための介入“トゥラサナ”の予備的な無作為化比較試験がエルサルバドルで実施された。エルサルバドルでは、訓練を受けた自治体の職員が家庭訪問プログラムの一環として、妊娠後期から産後6か月まで介入を提供した。対象者は、主に農村部に住む14〜19歳の青年期の妊婦64名であった。対象者は、この介入もしくは通常のケアのいずれかを受けるように無作為に振分けられた。ベースラインとして人口統計学的情報が収集され、介入直後に、養育の感受性と乳児の感情調整について盲検評価が行われた。この介入は、母親の感受性に実質的な正の影響を与えることがわかった。さらに、介入群の乳児は対照群と比較して、より調整された行動を示した。すなわち、社会的挑戦課題ではコミュニケーションを回復するためにより多くの試みを示し、非社会的挑戦課題において、より社会的で目標志向的な行動を示した。エルサルバドルの小規模サンプルにおいて南アフリカでの実施知見の再現と拡張が見られたことは、中南米の状況における大規模なRCT (無作為化比較試験) の実施に見込みと正当性があることを示している。.
在萨尔瓦多进行了一项试验性的随机对照试验, 对先前在南非样本中开展的一种干预措施 (“Thula Sana”) 进行了研究, 以提高孕产妇依恋的敏感性和婴儿依恋的安全性。在萨尔瓦多, 作为家访计划的一部分, 经过培训的社区工作人员, 对孕产妇从妊娠晚期到产后六个月开展了干预措施。样本包括64名怀孕的青少年妇女, 年龄在14至19岁之间, 主要生活在农村地区。他们被随机分配为接受干预组或常规护理组。试验开始时收集了人口统计信息, 并在干预后立即对育儿敏感性和婴儿情绪调节进行盲测。研究发现, 这项干预措施对孕产妇的敏感性有很大的积极影响。此外, 与对照组相比, 干预组的婴儿表现出更为规范的行为:在社交挑战任务中, 他们表现出更多恢复沟通的尝试;在非社交挑战任务中, 他们表现出更多的社交和目标导向行为。在萨尔瓦多的一个小样本中复制和扩展了南非的研究结果, 这预示着试验的成功, 并证明了在中美洲或南美洲进行大规模RCT的合理性。.
تأثير تدخل تجريبي مع ثنائيات الأم والطفل على عملية الرعاية الوالدية واستجابة الرضع للتحدي: تجربة استطلاعية معشاة ذات شواهد مع الأمهات المراهقات في السلفادور أجريت تجربة استطلاعية معشاة ذات شواهد في السلفادور على التدخل التجريبي (Thula Sana) الذي سبق أن أظهر تأثيراً على عينة جنوب أفريقيا من حيث تعزيز حساسية الأمهات وأمان التعلق لدى الرضع. وفي السلفادور، قام العاملون المجتمعيون المدربون بالتدخل من مرحلة الحمل المتأخر إلى فترة ما بعد الولادة لمدة ستة أشهر كجزء من برنامج الزيارات المنزلية. واشتملت العينة على 64 من المراهقات الحوامل، اللاتي تتراوح أعمارهن بين 14 و 19 سنة، ويعشن في بيئات ريفية في الغالب. وتم توزيع العينة عشوائياً إلى مجموعة تجريبية تتلقى التدخل أو مجموعة ضابطة تتلقى الرعاية العادية. وتم جمع المعلومات الديمغرافية عند نقطة البداية، وأجريت، بعد التدخل مباشرة، تقييمات عمياء لحساسية الوالدين وتنظيم المشاعر عند الرضع. وتبين أن هذا التدخل له أثر إيجابي كبير على حساسية الأمهات. وعلاوة على ذلك، وبالمقارنة مع المجموعة الضابطة، أظهر الرضع في مجموعة التدخل سلوكاً أكثر تنظيماً: ففي مهمة التحدي الاجتماعي أظهروا المزيد من المحاولات لاستعادة التواصل، وفي مهمة التحدي غير الاجتماعي أظهروا سلوكاً اجتماعياً وموجهاً نحو الأهداف. وهذا التكرار والامتداد لنتائج جنوب أفريقيا في عينة صغيرة من السلفادور يدعم إجراء تجارب على نطاق واسع في مجتمعات أمريكا الوسطى أو الجنوبية.

The first years of life are a significant period for child development, when children are particularly sensitive and prone to crises. This early phase lays the foundation for healthy growth. Clinical assessment of psychological symptoms in early infancy and adequate treatment are both important in improving the diagnostic outcome and preventing later long-term developmental consequences. The most common psychological problems in the first 3 years of life are regulatory disorders. The aim of this trial is to investigate the efficacy of Parent-Infant Psychotherapy (PIP) for infants and young children (aged 0-36 months, diagnosed with at least one regulatory disorder) and their mothers, compared to care as usual (CAU).
In this open multicentre randomised controlled trial, 160 mother-infant dyads are randomised to receive PIP or CAU for 6 weeks of intervention in clinical or outpatient (including home treatment) settings. The primary outcome is the maternal sensitivity (sensitivity scale of the Emotional Availability Scales (EAS)) after 6 weeks. Secondary outcomes include assessment of interaction, mental health problems, attachment, development, psychological factors, treatment adherence, health care system utilisation, and costs, after 6 weeks and 12 months.
This study will evaluate whether a manualised focus-based short-term psychodynamic psychotherapeutic intervention in mother-child dyads improves the care situation for families of children diagnosed with regulatory disorders, and helps prevent long-term psychopathologies. Assessment of the intervention in different settings will support the development of more tailored interventions for affected infants and their mothers.
German Clinical Trial Register, ID: DRKS00017008 . Registered 03/20/2019.