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Psychoneuroendocrinology Dec 2019In fathers testosterone levels are suggested to decrease in the context of caregiving, but results seem inconsistent. In a meta-analysis including 50 study outcomes with... (Meta-Analysis)
Meta-Analysis
In fathers testosterone levels are suggested to decrease in the context of caregiving, but results seem inconsistent. In a meta-analysis including 50 study outcomes with N = 7,080 male participants we distinguished three domains of research, relating testosterone levels to parental status (Hedges' g = 0.22, 95% CI: 0.09 to 0.35; N = 4,150), parenting quality (Hedges' g = 0.14, 95% CI: 0.03 to 0.24; N = 2,164), and reactivity after exposure to child stimuli (Hedges' g = 0.19, 95% CI: -0.03 to 0.42; N = 766). The sets of study outcomes on reactivity and on parenting quality were both homogeneous. Parental status and (higher) parenting quality were related to lower levels of testosterone, but according to conventional criteria combined effect sizes were small. Moderators did not significantly modify combined effect sizes. Results suggest that publication bias might have inflated the meta-analytic results, and the large effects of pioneering but small and underpowered studies in the domains of males' parental status and parenting quality have not been consistently replicated. Large studies with sufficient statistical power to detect small testosterone effects and, in particular, the moderating effects of the interplay with other endocrine systems and with contextual determinants are required.
Topics: Child; Child Care; Father-Child Relations; Fathers; Female; Humans; Male; Paternal Behavior; Testosterone
PubMed: 31541914
DOI: 10.1016/j.psyneuen.2019.104435 -
Midwifery Sep 2019fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for...
BACKGROUND
fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period.
PURPOSE
the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety.
DESIGN
Systematic review.
METHODS
A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures.
FINDINGS
Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner' anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers' mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention.
KEY CONCLUSION
Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships.
Topics: Adult; Anxiety; Fathers; Humans; Male; Paternal Behavior; Perinatal Care; Prevalence; Psychometrics
PubMed: 31176080
DOI: 10.1016/j.midw.2019.05.013 -
The Lancet. Psychiatry Jun 2019Adverse in-utero and perinatal conditions might contribute to an increased suicide risk throughout the lifespan; however, existing evidence is sparse and contradictory.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Adverse in-utero and perinatal conditions might contribute to an increased suicide risk throughout the lifespan; however, existing evidence is sparse and contradictory. We aimed to investigate in-utero and perinatal exposures associated with suicide, suicide attempt, and suicidal ideation.
METHODS
We did a systematic review and meta-analysis and searched MEDLINE, Embase, and PsycINFO from inception to Jan 24, 2019, for population-based prospective studies that investigated the association between in-utero and perinatal factors and suicide, suicide attempt, and suicidal ideation. Only papers published in English in peer-reviewed journals were considered. Two researchers independently extracted formal information (eg, country, year, duration of follow-up) and number of cases and non-cases exposed and non-exposed to each risk factor. We calculated pooled odds ratios (ORs) with 95% CIs using random-effects models and used meta-regression to investigate heterogeneity. This study was registered with PROSPERO, number CRD42018091205.
FINDINGS
We identified 42 eligible studies; they had a low risk of bias (median quality score 9/9 [IQR 8-9]). Family or parental characteristics, such as high birth order (eg, for fourth-born or later-born vs first-born, pooled OR 1·51 [95% CIs 1·21-1·88]), teenage mothers (1·80 [1·52-2·14]), single mothers (1·57 [1·31-1·89]); indices of socioeconomic position, such as low maternal (1·36 [1·28-1·46]) and paternal (1·38 [1·27-1·51]) education; and fetal growth (eg, low birthweight 1·30 [1·09-1·55] and small for gestational age 1·18 [1·00-1·40]) were associated with higher suicide risk. Father's age, low gestational age, obstetric characteristics (eg, caesarean section), and condition or exposure during pregnancy (eg, maternal smoking or hypertensive disease) were not associated with higher suicide risk. Similar patterns of associations were observed for suicide attempt and suicidal ideation; however, these results were based on a lower number of studies. In meta-regression, differences in length of follow-up explained most between-study heterogeneity (inital I ranged from 0 to 79·5).
INTERPRETATION
These findings suggest that prenatal and perinatal characteristics are associated with increased suicide risk during the life course, supporting the developmental origin of health and diseases hypothesis for suicide. The low number of studies for some risk factors, especially for suicide attempt and ideation, leaves gaps in knowledge that need to be addressed. The mechanisms underlying the reported associations and their causal nature still remain unclear.
FUNDING
Horizon 2020 (EU).
Topics: Child; Child Care; Female; Humans; Maternal Behavior; Perinatal Care; Pregnancy; Prospective Studies; Risk Factors; Suicide; Suicide Prevention
PubMed: 31029623
DOI: 10.1016/S2215-0366(19)30077-X -
Journal of Advanced Nursing Jan 2019The aim of this study was to evaluate the efficacy of interventions to support coparenting, how partners relate to and support one another as parents, on paternal...
AIMS
The aim of this study was to evaluate the efficacy of interventions to support coparenting, how partners relate to and support one another as parents, on paternal outcomes.
BACKGROUND
Despite societal shifts in gender roles leading to fathers' increasing involvement in parenting and growing recognition of the need for couples-based parenting interventions, fathers have been underrepresented in parenting research.
DESIGN
Systematic review.
DATA SOURCES
Medline, Embase, Healthstar, and PsycInfo.
REVIEW METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify peer-reviewed articles published up to 2016 that evaluated the effectiveness of coparenting interventions for expectant fathers or fathers of children <18 years. Study quality was assessed using Cochrane risk of bias criteria for Effective Practice and Organisation of Care reviews; Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to summarize quality of the evidence. The primary outcome was coparenting behaviour among men.
RESULTS
We identified 16 randomized controlled trials that evaluated 14 coparenting interventions. Nine interventions targeted partners in the perinatal period; five targeted parents of children. All but one involved face-to-face contact, but this varied in duration and intensity. Of the 12 trials that examined coparenting outcomes, eight reported an effect on at least one measure of paternal coparenting behaviour. The quality of the evidence was at a low level.
CONCLUSION
Success was moderate, supporting the need for future research to explore the use of additional approaches to increase efficacy, including technology-based interventions, to improve uptake among men.
Topics: Adult; Cooperative Behavior; Fathers; Female; Humans; Male; Middle Aged; Mothers; Parent-Child Relations; Parenting; Paternal Behavior
PubMed: 30066488
DOI: 10.1111/jan.13815 -
Epidemiologic Reviews Jun 2018Mass incarceration has profoundly restructured the life courses of not only marginalized adult men for whom this event is now so prevalent but also their families. We...
Mass incarceration has profoundly restructured the life courses of not only marginalized adult men for whom this event is now so prevalent but also their families. We examined research published from 2000 to 2017 on the consequences of parental incarceration for child health in the United States. In addition to focusing on specific health outcomes, we also considered broader indicators of child well-being because there has been little research on the association between parental incarceration and objectively measured child health outcomes. Our findings support 4 conclusions. First, paternal incarceration is negatively associated-possibly causally so-with a range of child health and well-being indicators. Second, although some research has suggested a negative association between maternal incarceration and child health, the evidence on this front is mixed. Third, although the evidence for average effects of paternal incarceration on child health and well-being is strong, research has also suggested that some key factors moderate the association between paternal incarceration and child health and well-being. Finally, because of the unequal concentration of parental incarceration and the negative consequences this event has for children, mass incarceration has increased both intracountry inequality in child health in the United States and intercountry inequality in child health between the United States and other developed democracies. In light of these important findings, investment in data infrastructure-with emphasis on data sets that include reliable measures of parental incarceration and child health and data sets that facilitate causal inferences-is needed to understand the child health effects of parental incarceration.
Topics: Adult; Child; Child Behavior; Child Health; Health Status Disparities; Humans; Maternal Deprivation; Mental Health; Paternal Deprivation; Prisoners; Risk Factors; United States
PubMed: 29635444
DOI: 10.1093/epirev/mxx013 -
PloS One 2018Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low-... (Review)
Review
BACKGROUND
Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low- and middle-income countries. Previous reviews have identified male involvement as a promising intervention, but with a complex evidence base and limited direct evidence of effectiveness for mortality and morbidity outcomes.
OBJECTIVE
To determine the effect of interventions to engage men during pregnancy, childbirth and infancy on mortality and morbidity, as well as effects on mechanisms by which male involvement is hypothesised to influence mortality and morbidity outcomes: home care practices, care-seeking, and couple relationships.
METHODS
Using a comprehensive, highly sensitive mapping of maternal health intervention studies conducted in low- and middle-income countries between 2000 and 2012, we identified interventions that have engaged men to improve maternal and newborn health. Primary outcomes were care-seeking for essential services, mortality and morbidity, and home care practices. Secondary outcomes relating to couple relationships were extracted from included studies.
RESULTS
Thirteen studies from nine countries were included. Interventions to engage men were associated with improved antenatal care attendance, skilled birth attendance, facility birth, postpartum care, birth and complications preparedness and maternal nutrition. The impact of interventions on mortality, morbidity and breastfeeding was less clear. Included interventions improved male partner support for women and increased couple communication and joint decision-making, with ambiguous effects on women's autonomy.
CONCLUSION
Interventions to engage men in maternal and newborn health can increase care-seeking, improve home care practices, and support more equitable couple communication and decision-making for maternal and newborn health. These findings support engaging men as a health promotion strategy, although evidence gaps remain around effects on mortality and morbidity. Findings also indicate that interventions to increase male involvement should be carefully designed and implemented to mitigate potential harmful effects on couple relationship dynamics.
Topics: Adult; Child; Community Health Services; Father-Child Relations; Fathers; Female; Health Promotion; Humans; Infant; Infant Health; Infant Mortality; Infant, Newborn; Male; Maternal Health Services; Morbidity; Parturition; Paternal Behavior; Patient Acceptance of Health Care; Poverty; Pregnancy; Prenatal Care
PubMed: 29370258
DOI: 10.1371/journal.pone.0191620 -
Midwifery Dec 2017despite the evidence that fatherhood has a long-term positive and protective effect on men's health, there is also evidence that fatherhood in the perinatal period can... (Review)
Review
BACKGROUND
despite the evidence that fatherhood has a long-term positive and protective effect on men's health, there is also evidence that fatherhood in the perinatal period can be complex and demanding. Due to the potential increase in stressors in the perinatal period, there is reason to hypothesise that it is a time of increased stress for fathers. However, it is not clear how significant a problem stress is for fathers during this stage of life. This is in part, due to the fact that the available research has not been systematically reviewed.
PURPOSE
the purpose of this systematic review was to critically appraise the empirical evidence that examined stress in fathers in the perinatal period.
DESIGN
systematic review.
METHODS
a systematic review protocol was developed and registered with PROSPERO (Reference number: CRD42016035821). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collections were searched to identify studies that met the inclusion criteria. Studies that researched fathers in the perinatal period were included if stress was the principal focus of the research, if stress was in the title and/or aim of the study or if stress was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures.
FINDINGS
eighteen studies met the inclusion criteria. The findings indicate that fathers experience stress in the perinatal period, particularly at the time of birth. Stress levels were found to increase from the antenatal period to the time of birth, with a decrease in stress levels from the time of birth to the later postnatal period. There are a number of factors that contribute to stress in fathers in the perinatal period and these included negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth and feelings of incompetence related to infant care. The review found that stress has a negative impact on fathers, with higher stress levels contributing to mental health issues such as anxiety, depression, psychological distress and fatigue.
KEY CONCLUSION
during the perinatal period fathers experience stress and face unique stressors that can impact negatively on their health and social relationships.
Topics: Delivery, Obstetric; Fathers; Female; Humans; Male; Paternal Behavior; Perinatal Care; Pregnancy; Stress, Psychological
PubMed: 28992554
DOI: 10.1016/j.midw.2017.09.016 -
Journal of Behavioral Addictions Sep 2017Background and aims Familial influences are known to affect the likelihood of an adolescent becoming a problem gamer. This systematic review examined some of the key... (Review)
Review
Background and aims Familial influences are known to affect the likelihood of an adolescent becoming a problem gamer. This systematic review examined some of the key findings in empirical research on family factors related to adolescent problem gaming. Methods A total of 14 studies in the past decade were evaluated. Family-related variables included: (a) parent status (e.g., socioeconomic status and mental health), (b) parent-child relationship (e.g., warmth, conflict, and abuse), (c) parental influence on gaming (e.g., supervision of gaming, modeling, and attitudes toward gaming), and (d) family environment (e.g., household composition). Results The majority of studies have focused on parent-child relationships, reporting that poorer quality relationships are associated with increased severity of problem gaming. The paternal relationship may be protective against problem gaming; therefore, prevention programs should leverage the support of cooperative fathers. Discussion The intergenerational effects of problem gaming require further attention, in light of adult gamers raising their children in a gaming-centric environment. Research has been limited by a reliance on adolescent self-report to understand family dynamics, without gathering corroborating information from parents and other family members. The very high rates of problem gaming (>10%) reported in general population samples raise concerns about the validity of current screening tools. Conclusions Interventions for adolescents may be more effective in some cases if they can address familial influences on problem gaming with the active co-participation of parents, rather than enrolling vulnerable adolescents in individual-based training or temporarily isolating adolescents from the family system.
Topics: Adolescent; Behavior, Addictive; Family; Humans; Parent-Child Relations; Social Environment; Video Games
PubMed: 28762279
DOI: 10.1556/2006.6.2017.035 -
Journal of Pediatric Psychology Jul 2017To conduct a systematic review of the interrelationships between children's coping responses, children's coping outcomes, and parent variables during needle-related... (Review)
Review
Systematic Review: A Systematic Review of the Interrelationships Among Children's Coping Responses, Children's Coping Outcomes, and Parent Cognitive-Affective, Behavioral, and Contextual Variables in the Needle-Related Procedures Context.
To conduct a systematic review of the interrelationships between children's coping responses, children's coping outcomes, and parent variables during needle-related procedures. A systematic literature search was conducted. It was required that the study examined a painful needle-related procedure in children from 3 to 12 years of age, and included a children's coping response, a children's coping outcome, and a parent variable. In all, 6,081 articles were retrieved to review against inclusion criteria. Twenty studies were included. Parent coping-promoting behaviors and distress-promoting behaviors enacted in combination are the most consistent predictors of optimal children's coping responses, and less optimal children's coping outcomes, respectively. Additional key findings are presented. Children's coping with needle-related procedures is a complex process involving a variety of different dimensions that interact in unison. Parents play an important role in this process. Future researchers are encouraged to disentangle coping responses from coping outcomes when exploring this dynamic process.
Topics: Adaptation, Psychological; Affect; Child; Child Behavior; Child, Preschool; Cognition; Humans; Maternal Behavior; Needles; Pain; Parent-Child Relations; Parents; Paternal Behavior; Psychology, Child
PubMed: 28340190
DOI: 10.1093/jpepsy/jsx054 -
Journal of Affective Disorders Jan 2016Men's experiences of anxiety within the perinatal period can adversely impact themselves, their partner and infant. However, we know little about the prevalence and... (Review)
Review
BACKGROUND
Men's experiences of anxiety within the perinatal period can adversely impact themselves, their partner and infant. However, we know little about the prevalence and course of men's anxiety across the perinatal period. The current review is one of the first to systematically review the published literature.
METHODS
Five databases (PubMed, PsycINFO, Cochrane, SCOPUS, and Web of Science) were searched to identify relevant papers published prior to April 2015. The literature search identified articles with data for expectant fathers (prenatal period) and/or fathers of an infant aged between 0 and 1 (postnatal period). The following data were extracted: (a) anxiety disorder prevalence (diagnostic clinical interviews), (b) 'high' anxiety symptom prevalence (above thresholds/cut-points on anxiety symptom scales) and (c) mean anxiety levels (anxiety symptom scales). Initially, 537 unique papers were identified. Subsequently, 43 papers met criteria for inclusion in the review.
RESULTS
Prevalence rates for 'any' anxiety disorder (as defined by either diagnostic clinical interviews or above cut-points on symptom scales) ranged between 4.1% and 16.0% during the prenatal period and 2.4-18.0% during the postnatal period. The data reviewed suggest the course of anxiety across the perinatal period is fairly stable with potential decreases postpartum.
LIMITATIONS
Wide variation in study measurement and methodology makes synthesis of individual findings difficult. Anxiety is highly comorbid with depression, and thus measures of mixed anxiety/depression might better capture the overall burden of mental illness.
CONCLUSIONS
Anxiety disorders are common for men during the perinatal period. Both partners should be included in discussions and interventions focused on obstetric care and parent mental health during the perinatal period.
Topics: Adjustment Disorders; Adult; Anxiety; Anxiety Disorders; Comorbidity; Depressive Disorder; Fathers; Female; Humans; Infant; Male; Paternal Behavior; Postpartum Period; Pregnancy; Prevalence
PubMed: 26590515
DOI: 10.1016/j.jad.2015.09.063