The current study examined trajectories of maternal and paternal depression in the year following the birth of an infant sibling, and relations with family risk factors and firstborn children's internalizing and externalizing behavior problems. Latent class growth analysis was conducted on 231 families in a longitudinal investigation (prebirth and 1, 4, 8, and 12 months postbirth) and revealed four classes of families: both mother and father low in depressive symptoms (40.7%); mother high–father low (25.1%); father high–mother low (24.7%), and both mother and father high (9.5%). Families with both mothers and fathers high on depressive symptoms were higher on marital negativity, parenting stress, and children's internalizing and externalizing problems, and lower on marital positivity and parental efficacy than other classes. Children, parents, and marital relationships were more problematic in families with fathers higher on depressive symptoms than in families in which mothers were higher, indicating the significant role of paternal support for firstborn children undergoing the transition to siblinghood. Maternal and paternal depression covaried with an accumulation of family risks over time, no doubt increasing the likelihood of children's problematic adjustment after the birth of their infant sibling.
This column describes the establishment of the Michigan Child Collaborative Care (MC3), a statewide telepsychiatry consultation program that provides support to primary care providers (PCPs) in meeting the mental health needs of youths and perinatal women. The MC3 program provides cost-effective, timely, remote consultation to primary care providers in an effort to address the lack of access and scarcity of resources in child, adolescent, and perinatal psychiatry. Data from 10,445 service requests are summarized.Common diagnoses included attention-deficit hyperactivity disorder, mood disorders, anxiety disorders, and autistic spectrum disorders, with many cases (58%) deemed moderate to severe. Co-occurring psychological trauma was suspected in 9% of service requests. Partnerships, stakeholder roles, PCP engagement, and workflow integration are highlighted as keys to the program's success.
Attachment security is theorized to shape stress reactivity, but extant work has failed to find consistent links between attachment security to mothers and infant cortisol reactivity. We examined family configurations of infant-mother and infant-father attachment security in relation to infant cortisol reactivity. One-year old infants (N = 180) participated in the Strange Situation with mothers and fathers in two counterbalanced lab visits, one month apart (12 and 13 months). Infants with secure attachments only to their fathers and not their mothers had higher cortisol levels than infants with a secure attachment to mother and also exhibited a blunted cortisol 1 K u o e t a l . i n A t t a c h m e n t & H u m a n D e v e l o p m e n t 2 1 ( 2 0 1 9 ) 2 response (high at baseline and then a decrease after stress). Results suggest that a secure attachment to father may not be enough to reduce infant stress reactivity when the infant-mother attachment is insecure, and future research is needed to uncover the family dynamics that underlie different family configurations of attachment security.
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