Maternal Parenting Stress in the Face of Early Regulatory Disorders in Infancy: A Machine Learning Approach to Identify What Matters Most

Abstract

Objective: Early regulatory disorders (ERD) in infancy are typically associated with high parenting stress (PS). Theoretical and empirical literature suggests a wide range of factors that may contribute to PS related to ERD. The aim of this study was to identify key predictors of maternal PS within a large predictor data set in a sample of N = 135 mothers of infants diagnosed with ERD.Methods: We used machine learning to identify relevant predictors. Maternal PS was assessed with the Parenting Stress Index. The multivariate dataset assessed cross-sectionally consisted of 464 self-reported and clinically rated variables covering mother-reported psychological distress, maternal self-efficacy, parental reflective functioning, socio-demographics, each parent's history of illness, recent significant life events, former miscarriage/abortion, pregnancy, obstetric history, infants' medical history, development, and social environment. Variables were drawn from behavioral diaries on regulatory symptoms and parental co-regulative behavior as well as a clinical interview which was utilized to diagnose ERD and to assess clinically rated regulatory symptoms, quality of parent–infant relationship, organic/biological and psychosocial risks, and social–emotional functioning.Results: The final prediction model identified 11 important variables summing up to the areas maternal self-efficacy, psychological distress (particularly depression and anger-hostility), infant regulatory symptoms (particularly duration of fussing/crying), and age-appropriate physical development. The RMSE (i.e., prediction accuracy) of the final model applied to the test set was 21.72 (R2 = 0.58).Conclusions: This study suggests that among behavioral, environmental, developmental, parent–infant relationship, and mental health variables, a mother's higher self-efficacy, psychological distress symptoms particularly depression and anger symptoms, symptoms in the child particularly fussing/crying symptoms, and age-inappropriate physical development are associated with higher maternal PS. With these factors identified, clinicians may more efficiently assess a mother's PS related to ERD in a low-risk help-seeking sample.

The impact of crying, sleeping, and eating problems in infants on childhood behavioral outcomes: A meta-analysis

“…The underlying reasons that might explain the association between RPs and behavioral problems during childhood cannot be explained by our analysis. From a relational perspective, due to the complex early interplay between parents and infants in the development of self-regulation, one can differentiate behavioral, environmental, developmental, interactional, and mental health variables on the parental and infant side which might contribute to ongoing behavioral problems later on (4,7,70).…”

“…Besides the challenges that cause distress in parents of an infant with primary self-regulatory deficits, there are several parental factors that may promote RPs, affect the parentinfant interaction, and need further attention in future studies. Among them, parental mental health, particularly maternal depression, hostility and anxiety, parental mentalization, and the quality of parenting behavior are central (4,7,23,70). If parents are less able to co-regulate and compensate an infant´s difficultness, or cannot read the infant's signals and react in a prompt and sensitive way to it due to their own impairment, there might be an elevated risk for persistent RPs and later behavioral or attentional problems (4,70,84,85).…”

“…Among them, parental mental health, particularly maternal depression, hostility and anxiety, parental mentalization, and the quality of parenting behavior are central (4,7,23,70). If parents are less able to co-regulate and compensate an infant´s difficultness, or cannot read the infant's signals and react in a prompt and sensitive way to it due to their own impairment, there might be an elevated risk for persistent RPs and later behavioral or attentional problems (4,70,84,85).…”

Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum

“…Regulatory problems (RPs) such as excessive infant crying, sleeping or eating problems show the strongest prevalence rates in young infants up to 18 months (Skovgaard et al, 2007;Lyons-Ruth et al, 2017;Georg et al, 2021). Infant self-regulation as one of the fundamental developmental tasks during the first years is, besides maturation processes, strongly associated with co-regulation capacities of the primary caregivers, embedded in a mutual, dyadic interaction (Berger et al, 2007;Tronick and Beeghly, 2011;Beeghly et al, 2016).…”

“…Infant self-regulation as one of the fundamental developmental tasks during the first years is, besides maturation processes, strongly associated with co-regulation capacities of the primary caregivers, embedded in a mutual, dyadic interaction (Berger et al, 2007;Tronick and Beeghly, 2011;Beeghly et al, 2016). Thus, clinical features of RPs comprise a complex interplay between parental, infant and interactional factors such as infant behavioral problems in at least one developmental area, caregiver overload syndrome, and dysfunctional interaction patterns in dealing with infant problems ("symptom trias"; Cierpka, 2015;Georg et al, 2021).…”