Stefan Kurbatfinski

Background: Maternal depressive symptoms have been associated with adverse child and family outcomes, including child behavioural problems, suboptimal parenting quality, and increased child screen time. However, the developmental pathways linking these factors remain poorly understood. The first model of this study examined whether children’s behavioural problems mediated associations between maternal depressive symptoms and later parenting quality (i.e., nurturant, hostile, consistent). The second model then investigated whether these pathways extended to preschool children’s screen time during the pre-bedtime period. Methods: Longitudinal data from the APrON Study (N = 373 dyads) were analyzed. A mean score for maternal depressive symptoms (EPDS) was derived using data collected across pregnancy and 3, 6, and 12 months postpartum. At age 3 years, child behaviour was assessed using the Child Behavior Checklist. At 5 years, parenting quality was measured using the Parenting Scale, and children’s screen time (frequency of use before bedtime) was assessed using a single maternal-reported item developed by the APrON team. Parallel and parallel serial mediation models were estimated using structural equation modeling. Findings: Maternal depressive symptoms were indirectly associated with more hostile parenting through children’s externalizing problems (p < 0.01, 95% CI [0.02, 0.11]) and directly associated with less nurturant parenting (p = 0.02, 95% CI [−0.19, −0.02]). Results from the parallel serial mediation model indicated that maternal depressive symptoms were indirectly associated with greater child screen time via children’s externalizing problems (p = 0.02, 95% CI [0.01, 0.06]). Significance: These findings suggest that children’s externalizing problems may represent a plausible pathway linking maternal depressive symptoms with later maternal hostile parenting and preschool children’s screen time.

Background: The COVID-19 pandemic increased stress experienced by children through individual-, family-, and community-level factors, with potential sex-specific impacts on behavioural outcomes. Children’s resilience may buffer these effects. This exploratory study investigated associations between COVID-19 stress and children’s internalising, externalising, and overall behavioural symptoms, and whether child resilience and sex assigned at birth moderated these associations. Methods: Data (N = 68) came from the longitudinal COVID-19 Impact Study of the Canadian APrON pregnancy cohort of mothers and their children followed for more than 9 years. COVID-19 stress, combining individual-, family-, and community-level stressors, was reported by mothers (mean age = 42.37, SD = 3.72) and their children (53% female; mean age = 10.21 years, SD = 0.43) across three timepoints (October–December 2020; February–May 2021; June–August 2021). Children’s behavioural problems and self-reported resilience were assessed between April and September 2022. Results: COVID-19 stress was not significantly associated with children’s behavioural problems. Moderated-moderation suggested that the association between COVID-19 stress and children’s internalising (T-score estimate = −2.38, 95% CI [−4.08, −0.68]), externalising (T-score estimate = −3.21, 95% CI [−5.09, −1.33]), and overall (T-score estimate = −2.79, 95% CI [−4.45, −1.12]) symptoms may vary by child resilience and child sex assigned at birth. Among females, COVID-19 stress appeared to be associated with more behavioural problems at lower levels of resilience and fewer problems at higher levels of resilience. Significance: The association between COVID-19 stress and children’s behavioural symptoms across children’s resilience levels may vary based on sex assigned at birth, with effects suggested among females. Null findings may reflect the modest sample size and limited statistical power.

Background: Children of mothers exposed to adverse childhood experiences (ACEs) may be at increased risk of sleep disruptions, such as night waking, due to potential suboptimal caregiving or living conditions. Mothers’ ACEs are also associated with maternal depressive symptoms, which in turn are associated with children’s screen time and sleep disruptions, revealing relevant, but unexplored, mediation pathways. This Canadian study investigated if mothers’ ACEs were associated with their 5-year-old children’s sleep disruptions (1) directly and (2) indirectly through independent or serial mediation via maternal depressive symptoms and/or children’s screen time. Methods: Data (n = 622; maternal mean age 32.3 years, 88.4% white) came from the longitudinal APrON Study. ACEs were measured 1 year postpartum. Mother’s depressive symptoms were measured across prenatal and postnatal timepoints. Children’s evening screen time (i.e., number of days in a week children engaged in one hour of screen time before bedtime) and sleep disruptions (number of days in a week their child wakes up multiple times) were measured at 5 years postpartum using adapted scales (52.9% male). PROCESS was used to assess for mediation. Results: Mothers’ ACEs had an indirect effect on their children’s sleep disruptions through mothers’ mean depressive symptoms (effect = 0.018, 95% CI [0.006, 0.034]), but not through children’s screen time. No other effects (i.e., direct, total) were observed. Conclusions: Although replication studies are warranted, this novel study reveals that the effects of maternal ACEs on children’s sleep disruptions may operate indirectly with effects potentiated through maternal depressive symptoms, thus serving as a target for intervention.

Sexual and gender minorities (SGM) experience inequitable health outcomes due to oppressive social forces (e.g., homophobia, transphobia). For SGM experiencing intimate partner violence and abuse (IPV), help-seeking is challenged by concomitant navigation of the abusive partner and discriminatory forces toward SGM. Mental health providers are an important source of support who can provide SGM experiencing IPV with the tools and resources they need to manage or leave abusive relationships. This systematic review synthesized existing literature on the help-seeking experiences of SGM in North America who experienced IPV and accessed mental health supports. This secondary review (#CRD42020139639) from a larger study used meta-aggregative methods to identify main findings. The authors searched peer-reviewed literature from MEDLINE, Embase, PsycInfo, Scopus, CINAHL, Genderwatch, and Social Science Abstracts and assessed validity using the Joanna-Briggs Institute Checklists. Four synthesized findings were identified from studies ( N = 34) conducted in the United States ( n = 29) and Canada ( n = 5): (a) components of SGM-affirming spaces, (b) characteristics of mental health provision, (c) healing journey process, and (d) community awareness and familiarity with services. Mental health providers (not including couples’ counselors) were identified as positive forms of support for SGM experiencing IPV, providing opportunities for self-development and skills to manage or leave abusive relationships. SGM-affirming spaces (e.g., use of inclusive language) increased SGM comfort in IPV discussions with mental health providers. Training and acknowledgment of SGM-specific IPV, along with client-provider rapport, further underlie effective mental health supports. Increased education and outreach would promote improved access to mental health supports.

Background: Mothers’ insecure adult attachment pattern (i.e., dismissive, preoccupied) has been proposed to positively mediate the associations between mothers’ adverse childhood experiences (ACEs) and their preschool children’s sex-specific behavioral problems. However, findings remain mixed with few focusing on a total score ranging from secure to insecure. Therefore, the aim of this study was to novelly employ the Revised-Experiences in Close Relationships (ECR-R) questionnaire to explore if (1) mothers’ adult attachment pattern measured continuously from secure to insecure mediates the relationship between maternal ACEs and children’s internalizing and externalizing behaviors and (2) child sex-assigned-at-birth moderated the effects. Methods: Data ( n = 636) derived from the prospective APrON Study (participants recruited during early pregnancy). Maternal ACEs were measured at child age 1, while children’s behavioral problems and mothers’ adult attachment pattern at child age 5. Findings: Positive, indirect effects on children’s internalizing (*bootstrap 95% CI [0.10, 0.58]) and externalizing (*[0.11, 0.62]) problems were supported. Post-hoc, a positive, indirect effect through preoccupied adult attachment pattern on their children’s internalizing problems was supported (*[0.04, 0.47]), but the effect did not differ from that of dismissive adult attachment pattern (*[−0.45, 0.15]). No moderation was observed ( p > 0.05). Significance: This study is the first to employ the ECR-R to measure mothers’ adult attachment pattern continuously from secure to insecure. Findings suggest that (1) adult attachment pattern measured continuously mediates the association between mothers’ ACEs and their preschool children’s behavioral problems and (2) preoccupied adult attachment pattern behaviors may play a stronger role than those of dismissive.

Introduction: Mental health conditions include disorders, diseases, problems, and/or symptoms that affect an individual’s emotions, thoughts, and/or behaviors, such as anxiety, depression, and substance use disorders. When describing the etiology of mental health conditions, various factors are often considered, including genetic, biomedical, social, and environmental. Therefore, the theoretical framework through which mental health conditions are discussed is important to consider, as it directly affects the conceptualization and treatment of mental health conditions. This narrative review synthesized the existing literature on different theoretical frameworks that can be used to understand the etiology of mental health conditions. Methods: This review employed a pragmatic, narrative approach to literature synthesis. Google Scholar was searched using variations of the terms “theory”, “mental health”, “etiology”, and “resilience” to locate the relevant peer-reviewed literature. The identified literature was further mined for additional important evidence sources. Results: Six theoretical frameworks were identified and discussed, including (1) attachment theory, (2) intersectionality theory, (3) intergenerational theory, (4) queer theory, (5) social cognitive theory, and (6) resilience theory. Strengths and weaknesses of each theoretical framework are identified. Conclusions: Although overlap exists among these theories, the different theoretical frameworks influence the conceptualization and treatment of mental health conditions. This has important implications since perceptions about the etiology and treatment of mental health conditions can be influenced by the theoretical perspective that one adopts. Some theoretical frameworks focus predominantly on psychosocial versus biological mechanisms, or vice versa, alluding to the need for interdisciplinary collaboration to best understand the etiology and treatment of mental health conditions.