the generation r study behavioral and cognitive research in a prospective cohort study from fetal...
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The Generation R Study Behavioral and cognitive research in a prospective cohort study from fetal life
onwardsNicole Lucassen
Child and Adolescent Psychiatry, Sophia Children’s Hospital, Erasmus MC, www.generationr.nl
Generation R study (Rotterdam, the Netherlands)
Prospective cohort design From early fetal life Recruited from midwifery practices and hospitals Urban, multi-ethnic population 9.778 mothers and their unborn child 65.8% of their partners participated
Design Generation R
Generation R
Prospective cohort study from fetal life until
young adulthood. Primary research areas:
1) Behavioral and cognitive development
2) Growth and physical development
3) Diseases in childhood
4) Health(care) for pregnant women and children
Ethnicity Generation R children
Based on classification according to the CBS, 2004. Missing: 12%
Dutch, other European
58%
Others9%Cape Verdian
4%
Dutch Antilles4%
Turkish9%
Moroccan7%
Surinamese8%
Detailed measures in the Focus Cohort Homogeneous group: both parents and
grandparents are born in the Netherlands Children born between Feb, 2003 – Aug, 2005 1.232 families; 64,9% of fathers participated
Design Generation R:Focus Cohort
Data collection flowchart
12 weeks 20 weeks 30 weeks birth 2 months 6 months 12/14 months 18 months 24 months 3 yrs 4yrs
Fetal Ultrasound
Additional UltrasoundMeasures
Psychiatric Interview
Question naire 7
Question naire 10
Question naire 11
Questionaire 6
Neuromotor assessmentHome observation
Research Center visit 1e.g. Brain ultrasound
Research Center visit 2Neuromotor assessment
Research Center visit 3e.g. Strange Situation
Research Center visit 5e.g. Executive Functioning
Fetal UltrasoundBlood
Fetal UltrasoundUrine
Questionnaire 12
Questionnaire 14
FatherQuestionnaire
Assessments in Generation R Cohort
Questionnaire 1
Question naire 3
Question naire 4
Cord bloodBirth weightComplications
FatherQuestionnaire
Home Visit father-child interaction, discipline
GenerationR @ age 5 Research center visit
Observational research Generation R Focus Cohort
14 months lab visit: parent-infant attachment, psychophysiological
measurements (blood sampling, cortisol)
(primary caregiver requested to participate: 760 mothers, 115 fathers)
3 year lab visit: parent-child interaction, parental disciplinary strategies,
child’s compliance, emotion recognition, moral development
(primary caregiver requested to participate: 753 mothers, 107 fathers)
4 year home visit: father-child interaction, parental disciplinary
strategies, child’s compliance, cognitive development, moral development,
mother-child interaction
(752 families)
“Does the father matter?”
The influence of paternal psychopathology and father-child interaction on behavior problems in
preschool children
Family systems theory
Family systems theory describes the family as a
network of interconnected relationships in which the
whole is greater than the sum of its parts.
Accordingly, understanding a particular individual
within the family is not fully possible without
considering the network of relationships in which
that individual is embedded.
Family systems theory
Examples:
• Parental depression
• Parental sensitivity
Family systems theory: example depression
Parental depression: lack of research on the role of
one parent’s depression in the other parent’s
depression
Family systems theory: example depression
• Paternal depression magnifies children’s risk for developing psychopathology when co-occurring with maternal depression (e.g. Marchand & Hock, 1998)
• Nondepressed fathers are not a buffer for the
effects of maternal depression, even if fathers spend high amounts of time interacting with their
children (Mezulis et al., 2004)
Family systems theory: example sensitivity
Sensitivity is defined as the ability to respond
appropriately and promptly to the signals of the
infant
(Ainsworth, Blehar, Waters, & Wall, 1978)
Family systems theory: example sensitivity
Volling et al. (2002): no consistency in mothers’ and fathers’ sensitivity
• Mothers are more sensitive with their infants than fathers
Family systems theory: example sensitivity
Braungart-Rieker et al. (1999): modest to moderate
correlations in sensitivity to their infants.
Possible explanations:
• Parents hold same value systems with regard to responding sensitively
• One parent models sensitive caregiving to the other parent
(Fox et al., 1991)
My research questions
• Is paternal psychopathology related to behavior problems in young children?
• Does negative father-child interaction increase the risk of behavioral problems in the child?
• Can positive father-child interaction or paternal non-depression moderate the effect of maternal psychopathology on behavioral problems in children?
• What factors predict fathers’ sensitivity and what is the association between fathers’ sensitivity and mothers’ sensitivity at the age of four?
Method
• Generation R Focus Cohort
• Information folder at age of 4 years
• Appointment home visit when child is
4 years; 2 months
• The main focus is on participation of father!
• In case of divorce/split-up: biological father as well as stepfather is recruited
Information folder for participants
15 students conducting the home visits
Response rate
• Home visits performed: 752
September 2007 – December 2009
• Response rate: 76% of all eligible participants at the start
• Top 3 reasons not to participate: 1. Not interested; 2. No time; 3. Moved outside the country / inaccessible
4-year home visit: overview of 10 tasks
Task 1 & 2: father-child interaction
Task 3 & 4: father-child interaction/parenting
Task 5 & 8: development of conscience
Task 6: development of working memory
Task 7: development of sustained attention
Task 9 & 10: mother-child interaction
Total duration of home visit: 1,5 hours
Parent-child interaction
Teaching Tasks:
Tasks that require interaction between child
and parent in a problem solving task
(Erickson, Sroufe & Egeland, 1985)
Parent-child interaction: Etch-a-Sketch
Parent-child interaction: Etch-a-Sketch
Parent-child interaction: Tower building
Parent-child interaction: Tower building
Parental sensitivity
Supportive Presence reflects the extent to which
the parent expresses positive regard and emotional
and instructional support of the child
Intrusiveness refers to the degree to which the
parent lacks respect for the child’s autonomy
Parent-child interaction (Etch a Sketch)
Insert scene: father-child interaction
Paternal sensitivity: Supportive Presence
1. Father completely fails to be supportive to the child, either being aloof and unavailable or being hostile toward the child
2. Father provides very little emotional support to the child
3. Father gives some support, but it is sporadic and poorly timed to the child’s needs
4. This father does a respectable job of being available when his child needs support
5. Father provides good support, reassurance and confidence in the child’s ability, but he falters in this at times when the child especially could use more support
6. Father establishes himself as supportive and encouraging toward the child but has some lapses
7. Father skillfully provides support throughout the session
Parental sensitivity: Intrusiveness
1. The father allows the child sufficient time to explore and examine the environment, tools and parts
2. The father generally intervenes appropriately but he may show subtle signs of being intrusive
3. The father allows some time for exploration but steps in before the child seems to require help a few times
4. There is a feeling of some intrusiveness that is easily or clearly picked up by the coders, but it is not pervasive
5. There are clear signs that the father does not respect the child’s needs and interests
6. There are clear incidents of intrusiveness through out the session
7. This father is highly intrusive. His agenda clearly has precedence over the child’s wishes
Parent-child interaction (Etch a Sketch)
Insert scene: mother-child interaction
Paternal sensitivity: Supportive Presence
1. Mother completely fails to be supportive to the child, either being aloof and unavailable or being hostile toward the child
2. Mother provides very little emotional support to the child
3. Mother gives some support, but it is sporadic and poorly timed to the child’s needs
4. This mother does a respectable job of being available when her child needs support
5. Mother provides good support, reassurance and confidence in the child’s ability, but she falters in this at times when the child especially could use more support
6. Mother establishes herself as supportive and encouraging toward the child but has some lapses
7. Mother skillfully provides support throughout the session
Parental sensitivity: Intrusiveness
1. The mother allows the child sufficient time to explore and examine the environment, tools and parts
2. The mother generally intervenes appropriately but she may show subtle signs of being intrusive
3. The mother allows some time for exploration but steps in before the child seems to require help a few times
4. There is a feeling of some intrusiveness that is easily or clearly picked up by the coders, but it is not pervasive
5. There are clear signs that the mother does not respect the child’s needs and interests
6. There are clear incidents of intrusiveness through out the session
7. This mother is highly intrusive. Her agenda clearly has precedence over the child’s wishes
With special thanks to all the participants of the
Generation R study and to my supervisors:
Mijke P. van den Berg
Henning Tiemeier
Frank C. Verhulst
Marinus H. van IJzendoorn (Leiden University)
Marian J. Bakermans-Kranenburg (Leiden University)