Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/S2237-60892012000300005
Trends in Psychiatry and Psychotherapy
Original Article

Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood

Relações problemáticas entre pais e criança em famílias com pai e mãe: prevalência e fatores de risco em um bairro brasileiro

Olga Garcia Falceto; Elsa R. J. Giugliani; Carmen Luiza C. Fernandes

Downloads: 0
Views: 490

Abstract

Introduction: Although the quality of parent-child relationships is known to be associated with the offspring's mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. Methods: During 1 year, all families (n = 230) from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire). Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. Results: Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. Conclusions: There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.

Keywords

Parent-infant problematic relationship, parenting, family relationship, child development, prevalence, relational problems

Resumo

Introdução: Embora seja consenso que a qualidade das relações pais-filho influencie a saúde mental da prole, pouco se sabe sobre a prevalência de relações problemáticas nessa esfera. Este estudo transversal teve como objetivo investigar a prevalência e os fatores de risco de diferentes tipos de relações entre pais e lactentes em um bairro brasileiro. Métodos: Durante 1 ano, todas as famílias (n = 230) residentes em uma comunidade urbana de Porto Alegre, sul do Brasil, com filhos de 4 meses de idade nascidos em hospitais públicos foram identificadas, e 148 foram investigadas em detalhe por dois terapeutas familiares. Este estudo descreve os dados dos 116 lactentes com famílias formadas por pai e mãe. Variáveis demográficas, obstétricas e relacionais foram coletadas através de questionários e escalas (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning e Self-Report Questionnaire). Razões de prevalência foram calculadas, e a regressão de Poisson com variância robusta foi utilizada para ajuste de covariáveis. Resultados: Quase 10% das mães e 12% dos pais mostraram pelo menos uma relação significativamente perturbada com seus lactentes de 4 meses de idade. Vínculo inadequado entre mãe e lactente coincidiu com evidências de transtorno mental paterno, uma rede social de apoio insatisfatória por parte da mãe e interrupção do aleitamento materno aos 4 meses. Relação problemática entre o pai e o lactente associou-se com relação disfuncional do casal e com baixo peso do lactente ao nascimento. Conclusões: Há uma alta prevalência de problemas nas relações precoces entre pais e filho, sugerindo a necessidade de intervenções do sistema de saúde. Problemas relacionais pais-filho são altamente prevalentes logo no início na vida do lactente e são mais associados a outros problemas relacionais do que a sobrecarga socioeconômica.

Palavras-chave

Relação problemática pais-filho, parentalidade, relações familiares, desenvolvimento infantil, prevalência, problemas relacionais

References

Phillips A. Winnicott: an introduction. Br J Psychiatry. 1989;155:612-8.

Ainsworth MD, Blehar MC, Waters E, Wall S. Patterns of attachment: a psychological study of the strange situation. 1978.

Ramos SP. What can we learn from psychoanalysis and prospective studies about chemically dependent patients?. Int J Psychoanal.. 2004;85:467-88.

Ramos SP. Crack, the father, psychiatrists and psychoanalysts. Rev Psiquiatr Rio G Sul.. 2008;30:99-100.

Newman K, Harrison L, Dashiff C, Davies S. Relationships between parenting styles and risk behaviors in adolescent health: an integrative literature review. Rev Lat Am Enfermagem. 2008;16:142-50.

Crockenberg S, Langrock A. The role of specific emotions in children's responses to interparental conflict: a test of the model. J Fam Psychol.. 2001;15:163-82.

Skovgaard AM, Olsen EM, Christiansen E, Houmann T, Landorph SL, Jørgensen T. Predictors (0-10 months) of psychopathology at age 11/2 years: a general population study in The Copenhagen Child Cohort CCC 2000. J Child Psychol Psychiatry. 2008;49:553-62.

Andresen PA, Telleen SL. The relationship between social support and maternal behaviors and attitudes: a meta-analytic review. Am J Community Psychol.. 1992;20:753-74.

Paulson JF, Dauber S, Leiferman JA. Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics. 2006;118:659-68.

Vandell DL, Hyde JS, Plant EA, Essex MJ. Fathers and "others" as infant-care providers: predictors of parents' emotional well-being. Merrill Palmer Q.. 1997;43:361-85.

Rogers SJ, White LK. Satisfaction with parenting: the role of marital happiness, family structure, and parents'gender. J Marriage Fam.. 1998;60:293-308.

Namba S, Tanaka K. Effects of support from and conflict with intimates on childcare stress: a longitudinal study. Jpn J Health Psychol.. 1999;12:37-47.

Feldman R. Parents'convergence on sharing and marital satisfaction, father involvement, and parent-child relationship at the transition to parenthood. Infant Behav Dev.. 2000;21:176-91.

Belsky J, Spanier GB, Rovine M. Stability and change in marriage across the transition to parenthood. J Marriage Fam.. 1983;45:567-77.

Coiro MJ, Emery RE. Do marriage problems affect fathering more than mothering?: A quantitative and qualitative review. Clin Child Fam Psychol Rev.. 1998;1:23-40.

Fox NA, Kimmerly NL, Schafer WD. Attachment to mother/attachment to father: a meta-analysis. Child Dev.. 1991;62:210-25.

Classificação diagnóstica: 0-3 - classificação diagnóstica de saúde mental e transtorno do desenvolvimento do bebê e da criança pequena. 1997.

Diagnostic and Statistical Manual of Mental Disorders. 2000.

Mari JS, William P. A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of São Paulo. Br J Psychiatry. 1986;148:23-6.

Aldous J, Mulligan GM. Father's child care and children's behavior problems. J Fam Issues. 2002;23:624-47.

Flouri E, Buchanan A. The role of father involvement in children's later mental health. J Adolesc.. 2003;26:63-78.

Wood BL, Lim J, Miller BD, Cheah P, Zwetsch T, Ramesh S. Testing the Biobehavioral Family Model in pediatric asthma: pathways of effect. Fam Process. 2008;47:21-40.

Bell BG, Belsky J. Parenting and children's cardiovascular functioning. Child Care Health Dev.. 2008;34:194-203.

Sikorski J, Renfrew MJ, Pindoria S, Wade A. Support for breastfeeding mothers. Cochrane Database Syst Rev.. 2002.

Falceto OG, Giugliani ERJ, Fernandes CL. Influence of parental mental health on early termination of breast-feeding: a case-control study. J Am Board Fam Pract.. 2004;17:173-83.

Falceto OG, Giugliani ERJ, Fernandes CL. Couples'relationships and breastfeeding: is there an association?. J Hum Lact.. 2004;20:46-55.

Gavin LE, Black MM, Minor S, Abel Y, Papas MA, Bentley ME. Young, disadvantaged fathers'involvement with their infants: an ecological perspective. J Adolesc Health.. 2002;31:266-76.

Feeley N, Gottlieb L, Zelkowitz P. Mothers and fathers of very low-birth weight infants: similarities and differences in the first year after birth. J Obstet Gynecol Neonatal Nurs.. 2007;36:558-67.

Areias MEG, Kumar R, Barros H, Figueiredo E. Comparative incidence of depression in women and men during pregnancy and after childbirth: validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers. Br J Psychiatry. 1996;169:30-5.

Matthey S, Barnett B, Ungerer J, Waters B. Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord.. 2000;60:75­‑85.

Bowlby J. Apego. 1984.

Matthey S, Barnett B. Parent-infant classes in the early postpartum period: need and participation by fathers and mothers. Infant Ment Health J.. 1999;20:278-90.

616b2f8ba95395380021f152 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections