Larissa G. Duncan

Objectives: The Interpersonal Mindfulness in Parenting (IM-P) scale is a self-report questionnaire validated and adapted in several countries. This study aimed to assess the psychometric properties and factor structure of the Italian version (IM-P-IT) across three different samples of Italian parents of preschool-aged children. Method: In Study 1, 867 parents completed the IM-P-IT. In Studies 2 and 3, 561 and 928 parents filled out the IM-P-IT and self-reported questionnaires examining parental behaviors and stress. Result: The exploratory factor analysis in Study 1 identified a 22-item version of the IM-P-IT with a five-factor structure: (1) Listening with Full Attention, (2) Self-Regulation in the Parenting Relationship, (3) Emotional Awareness and Compassion for the Child, (4) Emotional Non-Reactivity in Parenting, and (5) Non-Judgmental Acceptance in Parenting. The five-factor model was confirmed in Study 2 (CFI = 0.93; RMSEA = 0.05; SRMR = 0.05) and Study 3 (CFI = 0.91; RMSEA = 0.06; SRMR = 0.06) through confirmatory factor analysis. Good internal consistency was observed (Study 1, α = 0.88; Study 2, α = 0.89; Study 3, α = 0.89). In Studies 2 and 3, convergent validity was demonstrated, as interpersonal mindfulness in parenting positively correlated with positive parenting behaviors (e.g., sensitivity, consistency, engagement in activities) and negatively correlated with negative parenting behaviors (e.g., over-reactivity) and parenting stress. Conclusions: The three validation studies confirmed the reliability and validity of the Italian version of the Interpersonal Mindfulness in Parenting scale, providing a valuable tool for assessing mindful parenting in Italy for research and clinical purposes.

Objectives: Two key parental reflective capacities—mindful parenting (MP) and parental reflective functioning (PRF) — have been shown to promote healthy parent-child relationships through parents’ increased sensitivity and responsiveness to their children’s needs in spite of parenting stressors. Despite the theoretical overlap between these two constructs, researchers have continued to examine them independently. Therefore, the purpose of this scoping review was to review the overlapping and distinctive outcomes and correlates in the empirical MP and PRF literatures. Method: A comprehensive literature search across the MP and PRF literature for studies published from 2005 through early 2020 (pre-COVID-19 pandemic) was conducted. Results: A review of 301 articles (n = 180 MP and n = 121 PRF) revealed overlapping study outcomes and correlates, including improvement in parent and child well-being, parenting behaviors, and attachment. Both MP and PRF literatures suggest MP and PRF are amenable to intervention-induced changes, although mostly documented in White mothers, which results may not be generalizable to diverse populations. Conclusions: Researchers should consider the impact MP and PRF have on positive family relationships. Results suggest that scholars should consider investigating and intervening on MP and PRF simultaneously. Specifically, results identified MP and PRF convergent associations and perhaps synergistic impacts on positive parenting behaviors. Limitations and future directions are discussed. Preregistration: This review was not preregistered.

Objectives: Prenatal mindfulness programs can improve mental health, yet access to and cultural and linguistic relevance of existing programs in the United States are limited for people who do not speak English and/or face major life stressors such as migration, housing instability, limited income, and racism. In response, mindfulness skills training drawn from Mindfulness-Based Childbirth and Parenting (MBCP) was integrated into Medicaid-covered CenteringPregnancy (CP) group prenatal healthcare, delivered in Spanish and English by certified nurse-midwives and community co-leaders, and tested in a pragmatic pilot trial. Method: A provider survey of 17 CP clinics informed development of the enhanced program. Next, it was tested with 49 pregnant people who chose CP prenatal care. All of the sample identified as women; 4% as LGBTQ + ; 90% as Black, Indigenous, and People of Color (65% as Latina/e/x); 10% as White; and 63% as Spanish-speaking. Groups were allocated 1:1 to CenteringPregnancy or CenteringPregnancy with Mindfulness Skills (CP +). Results: Intent-to-treat analysis of self-report interview data indicated CP + yielded lower postpartum depression (the a priori primary study outcome) with a large effect size (Cohen’s d = 0.80) and a trend toward lower postpartum anxiety (Cohen’s d = 0.59) compared to CP. Hypothesized effects on mindfulness, positive/negative affect, and perceived stress were only partially supported at post-birth follow-up. Satisfaction with care was high across conditions. Conclusions: Augmenting group prenatal healthcare with mindfulness training in Spanish and English appears feasible, did not reduce satisfaction with care, and may have additional mental health benefits. Key questions remain about structural supports for perinatal well-being. Preregistration: This trial was registered with ClinicalTrials.gov (NCT01646463).

Background: The perinatal period is a time of immense change, which can be a period of stress and vulnerability for mental health difficulties. Mindfulness-based interventions have shown promise for reducing distress, but further research is needed to identify long-term effects and moderators of mindfulness training in the perinatal period. Methods: The current study used data from a pilot randomized control trial (RCT) comparing a condensed mindfulness-based childbirth preparation program—the Mind in Labor (MIL)—to treatment as usual (TAU) to examine whether prenatal mindfulness training results in lower distress across the perinatal period, and whether the degree of benefit depends on child-bearers’ initial levels of risk (i.e., depression and anxiety symptoms) and protective (i.e., mindfulness) characteristics. Child-bearers (N = 30) in their third trimester were randomized to MIL or TAU and completed assessments of distress—perceived stress, anxiety, and depressive symptoms—at pre-intervention, post-intervention, six-weeks post-birth, and one-year postpartum. Results: Multilevel modeling of distress trajectories revealed greater decreases from pre-intervention to 12-months postpartum for those in MIL compared to TAU, especially among child-bearers who were higher in anxiety and/or lower in dispositional mindfulness at baseline. Conclusions: The current study offers preliminary evidence for durable perinatal mental health benefits following a brief mindfulness-based program and suggests further investigation of these effects in larger samples is warranted. Trial registration: The ClinicalTrials.gov identifier for the study is: NCT02327559. The study was retrospectively registered on June 23, 2014.

Background: Pregnancy and the postpartum period are times of great change for women and their partners, often bringing substantial challenges and stress. Approximately 10%–20% of women suffer from mood disorders such as depression in the perinatal period. There are risks involved in using psychopharmacological interventions to treat perinatal depression. Mindfulness and compassion-based educational programs could be efficacious and cost-effective options for the prevention and treatment of perinatal mood disorders. The aim of this study is to assess the efficacy of an adapted Mindfulness-Based Childbirth and Parenting (MBCP) program that includes compassion training for pregnant women in primary care (PC) settings in the Spanish National Health System to decrease perinatal depression. Methods: A multicenter randomized controlled trial (RCT) will be conducted. Participants will be pregnant women (n = 122) and their partners who wish to participate. They will be enrolled and assessed in PC settings and randomly assigned to either: (1) an adapted MBCP educational program tailored to the Spanish National Health System + treatment as usual (TAU); or (2) TAU only. The main outcome to be assessed will be depression, evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Secondary outcomes will include self-reported measures of perceived stress, affects, mindfulness, self-compassion, maternal self-efficacy, and use of health and social services. Patients will be assessed at four timepoints: baseline; post-treatment; and at three and six months after childbirth. Intention-to-treat and per-protocol analyses will be carried out using linear regression mixed models. Effect sizes will be estimated using Cohen’s d. Discussion: Perinatal depression is a significant health problem. An effective and low-cost childbirth education program that incorporates mindfulness and compassion practices may be a beneficial preventive complementary healthcare modality for expectant women and their partners. This study will be the first multicenter RCT in Spanish PC settings using adapted MBCP and compassion practices to reduce symptoms of depression during pregnancy and the postpartum period. Trial registration: ClinicalTrials.gov, NCT03247491. Registered on 31 July 2017.

Pregnancy is a time of high risk for excessive weight gain, leading to health-related consequences for mothers and offspring. Theory-based obesity interventions that target proposed mechanisms of biobehavioral change are needed, in addition to simply providing nutritional and weight gain directives. Mindfulness training is hypothesized to reduce stress and non-homeostatic eating behaviors – or eating for reasons other than hunger or caloric need. We developed a mindfulness-based intervention for high-risk, low-income overweight pregnant women over a series of iterative waves using the Obesity-Related Behavioral Intervention Trials (ORBIT) model of intervention development, and tested its effects on stress and eating behaviors. Overweight pregnant women (n = 110) in their second trimester were enrolled in an 8-week group intervention. Feasibility, acceptability, and facilitator fidelity were assessed, as well as stress, depression and eating behaviors before and after the intervention. We also examined whether pre-to-post intervention changes in outcomes of well-being and eating behaviors were associated with changes in proposed mechanisms of mindfulness, acceptance, and emotion regulation. Participants attended a mean of 5.7 sessions (median = 7) out of 8 sessions total, and facilitator fidelity was very good. Of the women who completed class evaluations, at least half reported that each of the three class components (mindful breathing, mindful eating, and mindful movement) were “very useful,” and that they used them on most days at least once a day or more. Women improved in reported levels of mindfulness, acceptance, and emotion regulation, and these increases were correlated with reductions in stress, depression, and overeating. These findings suggest that in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy. ClinicalTrials.gov NCT01307683 , March 8, 2011.

Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education. This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the Mind in Labor (MIL): Working with Pain in Childbirth, based on Mindfulness-Based Childbirth and Parenting (MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected. In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women’s childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls. This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum depression symptoms. There is also some indication that MIL participants may use mindfulness coping in lieu of systemic opioid pain medication. A large-scale RCT that captures real-time pain perceptions during labor and length of labor is warranted to provide a more definitive test of these effects. The ClinicalTrials.gov identifier for the PEARLS study is: NCT02327559 . The study was retrospectively registered on June 23, 2014.