The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child’s sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants’ regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.

Background: Postpartum maternal mental health problems affect the development of mother-child interaction and of children’s attachment security. Focus-based brief parent-infant psychotherapy (PIP-f) was developed to support parents ‘mentalize’ their child’s affective states and promote a healthy parent-child relationship and child development. Efficacy of PIP-f was evaluated against care-as-usual (CAU) in a randomized controlled trial within the SKKIPPI project. Method: N = 120 mothers diagnosed with an ICD-10 psychopathological disorder and their infants under one year were randomly assigned to PIP-f ( n = 57) or CAU ( n = 63). Primary outcome was maternal sensitivity in mother-child interaction after 6 weeks of intervention. Secondary outcomes include maternal and child psychopathological symptoms, child development, parenting stress, emotional availability, parental reflective functioning and child attachment after 6 weeks and 12 months. Results: PIP-f was not superior to CAU in maternal sensitivity ( b = 0.129, 95%CI [-0.161, 0.418], p = 0.378) at post-intervention, nor in maternal symptoms ( b =-0.702, [-2.603, 1.198], p = 0.463) or child symptoms of regulatory disorder ( b = 1.079, [-2.344, 4.502], p = 0.531). Attachment security assessed at 12 months did not differ between intervention groups (OR = 2.0, [0.64, 6.33], p = 0.226). Moderator analyses suggest that emotional availability and parental reflective functioning improve up to 12 months for more severe cases. Conclusion: Differences between PIP-f and CAU were smaller than expected, but PIP-f seemed to reduce symptoms of mental health problems. Some evidence exists that mothers with higher symptom burden benefit from PIP-f. High dropout rates and initially high emotional availability prevent generalizability. Trial registration : The trial was registered in the German Register for Clinical Studies (DRKS00016353) on January 16, 2019.

Background/Objectives: Early childhood psychopathology has a profoundly negative impact on various areas of psychosocial functioning. Psychopathology and child development are closely linked and influenced by a range of factors, such as socioeconomic status and pre- and postnatal risks. This cross-sectional study aims to gain a deeper understanding of child development in children with early psychopathology and to derive implications for the diagnosis and treatment of the youngest children. Methods: This cross-sectional study examines the developmental status of children aged 0 to 5 years with early psychopathology (EPP) in comparison to gender- and age-matched healthy controls (HC). A newly self-developed objective, semi-structured, symptom-based interview was administered in each subgroup by trained research assistants. This interview is based on the DC: 0–5 classification system. The ET 6-6-R was used as a standardized developmental test, covering the developmental areas of gross and fine motor skills, cognition, language development, and socioemotional development. Demographic characteristics, including maternal education and household income, were considered as potential confounders. Results: Children with early pathology elicited a lower total developmental quotient than healthy controls. HC demonstrated a better performance in fine motor skills, language development, and socioemotional development than their counterparts with EPP. HC showed better gross motor skills as well, but statistical significance was p = 0.08. After controlling for maternal education, overall development and socioemotional development were found to be lower in the EPP group than in the HC group. Conclusions: These findings highlight the need to identify psychopathology and associated developmental deficits early in childhood which might allow more targeted treatments, enhancing developmental opportunities for affected children.

Zusammenfassung: Theoretischer Hintergrund: Traumatische Erlebnisse in der Kindheit sind ein Risikofaktor für postpartale Depressionen. Die Symptomatik kann sich auf die Interaktion mit dem Baby und auch auf die kindliche Entwicklung auswirken. Bisher gibt es wenige Interventionsprogramme, die sich spezifisch an depressive Mütter mit aversiven Kindheitserfahrungen richten. Fragestellung: Die vorliegende Studie untersucht, ob postpartal depressive Mütter mit aversiven Kindheitserfahrungen mehr Symptombelastung zeigen, mehr Stress in der Elternrolle erleben und in der feinfühligen Interaktion mit ihren Babys besonderen Herausforderungen gegenüberstehen. Weiterhin wird die Wirksamkeit einer multimodalen Behandlung in einer Mutter-Kind-Tagesklinik betrachtet. Methode: Die Stichprobe besteht aus 49 postpartal psychisch erkrankten Müttern, die gemeinsam mit ihren Babys tagesklinisch behandelt wurden und 34 Müttern einer gesunden Kontrollgruppe. Anhand des Childhood Trauma Questionnaire wurden aversive Kindheitserfahrungen erfasst. Die Edinburgh Postnatal Depression Scale sowie das Eltern-Belastungs-Inventar dienten der Erhebung der mütterlichen Belastung. Mütterliche Feinfühligkeit wurde mittels Videobeobachtung erhoben. Während des Klinikaufenthalts erhielten die Mütter eine multimodale Behandlung und nahmen kurz vor Entlassung an einem zweiten Erhebungszeitpunkt teil. Ergebnisse: Postpartal depressive Mütter mit und ohne aversive Kindheitserfahrungen berichteten deutlich mehr Symptom- und Stressbelastung als Mütter einer gesunden Kontrollgruppe. Dabei wiesen die Mütter mit aversiven Kindheitserfahrungen eine ausgeprägtere depressive Symptomatik auf als jene ohne. Zudem zeigen sie am meisten den negativen Affekt in der Interaktion mit ihrem Kind. Am Ende der Therapie berichteten sowohl die Mütter mit als auch ohne aversive Kindheitserfahrungen eine deutlich reduzierte Belastung und nähern sich im negativen Affekt im Verlauf zwischen den Gruppen an. Diskussion und Schlussfolgerung: Aversive Kindheitserlebnisse haben einen verstärkenden Effekt auf die Postpartale Depression hinsichtlich der Symptomatik. Dies zeigt sich auch am stärkeren negativen Affekt während der Interaktion mit dem Kind. Dennoch genesen die betroffenen Mütter genauso gut durch einer multimodalen, tagesklinischen Behandlung wie Mütter ohne aversive Kindheitserfahrungen. Ein langfristiges Ziel ist es, durch adäquate Behandlungsansätze, die auch feinfühliges Elternverhalten fördern eine transgenerationale Weitergabe von aversiven Kindheitserfahrungen zu unterbrechen.