Non-alcoholic fatty liver disease (NAFLD) is an increasingly common condition, strongly associated with the metabolic syndrome, that can lead to progressive hepatic fibrosis, cirrhosis and hepatic ...failure. Subtle inter-patient genetic variation and environmental factors combine to determine variation in disease progression. A common non-synonymous polymorphism in TM6SF2 (rs58542926 c.449 C>T, p.Glu167Lys) was recently associated with increased hepatic triglyceride content, but whether this variant promotes clinically relevant hepatic fibrosis is unknown. Here we confirm that TM6SF2 minor allele carriage is associated with NAFLD and is causally related to a previously reported chromosome 19 GWAS signal that was ascribed to the gene NCAN. Furthermore, using two histologically characterized cohorts encompassing steatosis, steatohepatitis, fibrosis and cirrhosis (combined n=1,074), we demonstrate a new association, independent of potential confounding factors (age, BMI, type 2 diabetes mellitus and PNPLA3 rs738409 genotype), with advanced hepatic fibrosis/cirrhosis. These findings establish new and important clinical relevance to TM6SF2 in NAFLD.
Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and ...emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play). Based on the assumption that child solitary pretend play reflects the child's 'baseline' pretend play ability, in this study, we investigated children's pretend play at its peak, i.e., during the preschool age, without the facilitation of another player. The overall objective was to investigate if parental mentalizing increases pretend play complexity in children.
The sample consisted 99 Danish mothers and their 4-year-old children. Employing a cross-sectional design, we hypothesized that parental mental state language, as an indicator of 'online' mentalizing during interaction with the child, is a mechanism through which 'offline' mentalizing, measured as parental reflective functioning, is associated with child solitary pretend play. Child pretend play complexity was observed and coded with an adapted version of the 12-Step Play Scale. Maternal offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire, and maternal online mentalizing was assessed by coding the mothers' mental state language during interaction with the child using a modified version of the mind-mindedness coding scheme.
While there was no direct effect of maternal offline reflective functioning on child pretend play, online mental state language mediated the link between offline maternal reflective functioning and child pretend play.
These results provide support for the theoretically assumed link between parental mentalizing and children's capacity for pretend play. Furthermore, our study contributes to the literature on parental mentalization, suggesting that parental mentalizing facilitates child development only if the parent can translate this ability into 'mentalizing in action'.
Many parents use social media to seek knowledge about child development and parenting, but parents are an understudied population in social media research. In this study, we use a mixed-methods ...approach to examine mothers' experience of following three different types of Instagram profiles: InstaParents, i.e. influencers sharing their personal experiences with parenthood, professional profiles disseminating knowledge about parenting and child development, and a university-based profile disseminating knowledge about child socioemotional development. The participants were 270 mothers with children aged 0–6 years, who completed an online questionnaire regarding their experience and use of Instagram. Generalized Estimating Equations were used to examine associations between mothers' social comparison orientation and their experience of following the different types of profiles. Content analysis of mothers' responses to open-ended questions was used to examine how mothers were negatively affected and supported by the different profiles. Results showed that mothers with higher levels of social comparison orientation were more negatively affected by following all three types of profiles, but also more supported by following InstaParents. The content analysis suggested that mothers were negatively affected by InstaParents by making upward comparisons and supported by making horizontal comparisons. Mothers were supported by professional profiles, including the university-based profile, by improved knowledge, but these profiles could also lead to a decreased sense of parenting competence. Results inform professionals in relation to how to support mothers through content on Instagram and how to talk to mothers about their digital use and well-being.
•Social comparison orientation and mothers' experiences of Instagram were examined.•Mothers' experiences of different types of Instagram profiles were examined.•Mothers were supported by professional profiles by improved knowledge.•Mothers were supported by InstaParents by an experience of a community.•Instagram profiles could also lead to a decreased sense of parenting competence.
Infant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, ...i.e. the caregiver's ability to notice and interpret the child's behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant's behavioral cues. This study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants' behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors' register. Trial registrationhttps://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019--Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416
During early childhood, play develops through levels of sensory exploration and manipulation, to functional activities and during the second year of life to the level of pretend and symbolic play. ...However, little is known about the factors contributing to individual variations in the development of play. The present study investigated associations between maternal sensitivity and play conditions with different ways of engaging and participating and children’s development of pretend play. Participants were 64 primiparous mothers and their 30-months-old children. Sensitivity was assessed using the Coding Interactive Behavior (CIB) coding system, and children’s play was coded using the 12 Step Play Scale. Analyses showed no significant associations between sensitivity and children’s play development but a play condition introducing a story stem was associated with a higher developmental play level and longer duration of pretend play compared to free interactive play. The findings suggest that the use of a story stem may promote pretend play in interactive settings with the mother.
•Play behavior of 30-months-old children with their mothers was investigated across four conditions.•Developmental play level increased in a story stem compared to free play condition.•Duration of pretend play also increased in a story stem play condition.•Maternal sensitivity was not associated with child play.•Findings highlight how introducing a story stem may help promote play development.
Parental Embodied Mentalizing (PEM) captures the parent's capacity to extrapolate the child's mental states from movement and respond on a nonverbal level. Little is known about PEM's relation to ...other established measures of parent-child interactive behavior, such as maternal sensitivity and attachment. This is investigated in a sample of four months old infants and mothers with (n = 27) and without a diagnosis of postpartum depression (n = 44). Video-recorded infant-mother interactions were coded independently using PEM and Coding Interactive Behavior. Attachment was assessed at 13 months using the Strange Situation Procedure. Sensitivity and PEM was positively associated, but only sensitivity predicted attachment security and only the nonclinical group. This indicates that PEM and sensitivity are moderately related as well as capturing different aspects of infant-mother interactions. The study confirms previous findings of sensitivity predicting attachment in nonclinical groups. More research is required to further understand predictors of attachment in clinical samples.
The quality of parent-child interaction has consistently been associated with child psychosocial outcomes. Postnatal depression (PND) and anxiety (PNA) can have an adverse effect on the parent-child ...interaction. The Coding Interactive Behaviour (CIB) measure has frequently been used to assess parent-infant interaction quality; however, few have investigated the construct validity. The purpose of this study is to: (1) compare two theoretical models and one data-driven model for best fit and to test the best fitting one for measurement invariance among mothers with and without PND, and (2) compare effects of PND and PNA on the mother-infant interactions. The sample consisted of mothers with PND (
n
= 236) and a subclinical sample of mothers with elevated symptoms of PND but did not meet criteria for a diagnosis (
n
= 183) and their infants (aged ≤ 6 months). PND was assessed with a diagnostic interview and PNA using a self-report measure. Confirmatory factor analyses showed that the data-driven model, consisting of the composites ‘Maternal Sensitivity’, ‘Child Engagement’, ‘Maternal Social Withdrawal’, and ‘Maternal Controlling Behaviour’, reached the best fit and showed measurement invariance with regard to PND. Factorial ANOVAs showed no effects of PND and PNA on the composites. The study is the first to investigate and find measurement invariance in the CIB, providing evidence of construct validity. The importance of investigating the factor structure of an instrument liable to change due to contextual factors is discussed.
Highlights
Investigating the factor structure of observational tools has important implications for research and theory.
Using CIB, we compare two theoretically and one data driven model to establish construct validity.
The best fitting model consists of maternal sensitivity, social withdrawal, controlling behaviour and child engagement.
Measurement invariance is established with regard to postnatal depression.
Neither postnatal depression nor anxiety are found to be associated with mother-infant interaction quality.
•The mean amount of screen time in infants aged 2–11 months was 6−17 min a day.•Technoference in mother-infant interactions happened, on average, 5–6 times a day.•Maternal educational level was ...negatively related to infant screen time.
This study aimed to examine longitudinal developmental patterns in the daily amounts of screen time and technoference in infants aged 2, 4, 7, and 11 months and to examine associations with maternal sociodemographic factors across all age groups.
The results showed that the amount of screen time varied between 6 and 17 min a day, while interruptions in mother-infant interactions due to maternal use of digital technology occurred between 5 and 6 times a day. There was a significant increase in infant screen time from 2 to 4 months, from 4–7 months, and from 7–11 months, and in technoference from 2 to 4 months and from 4–7 months. Maternal age and household income were not associated with infant screen time, but maternal educational level was negatively associated with infant screen time throughout the first year. No associations were found between technoference and maternal age, maternal educational level, or household income.
Future research focusing on infant screen time and technoference should aim at including samples that reflect the general population, include measures of screen time and technoference that do not rely on parental report, and include measures of the effects of early infant screen time and technoference on later development.
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