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ID
Source
Brief title
Health condition
Increased parental stress and child disruptive behavior
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary outcome variables in this study are:
- parental sensitivity, observational (emotional availability scales)
- parenting practices, questionnaire (CECPAQ)
- parental self-efficacy, questionnaire (MaaP)
- parenting stress, questionnaires (OBVL-k).
Each measurement will be administered at the three time points (pre-intervention, pos-intervention, and follow-up).
Secondary outcome
Secondary outcome variables in this study are:
- methylation of child’s stress system/stress related genes, measured with saliva sample (Oragene DNA Genotek)
- Child stress response functioning, measured with polar belt for assessing heart-rate variability + cortisol reactivity and diurnal cortisol rhythms, measured with saliva samples
- child temperament and internalizing and externalizing behavior, questionnaires (CBQ + CBCL)
Methylation measurements will be conducted twice, at pretest and follow-up. Measurements for child stress response functioning, and temperament and problem behavior, will administered at three time points (pre-intervention, post-intervention, and follow-up).
Background summary
Dysfunctional parenting in early childhood constitutes a major risk factor for the development of irritability and disruptive behavior, and for the development of broader physical and mental health problems. Studies suggest that dysfunction in the epigenetic regulation of the stress response is an important mediator in the association between parental caregiving and the functioning of children’s stress response system and disruptive behavior. Specifically, insensitive parental care, and also a lack of warmth and harsh and/or inconsequent discipline, has been linked to differential methylation of stress system/stress related genes in offspring. Moreover, these differences in methylation have been associated with a dysfunctional physiological stress response and, in turn, increased rates of stress-related disorders. However, previous findings on these associations should be considered preliminary, as they are based on small retrospective correlational studies. The causal chain from parenting to subsequent stress system functioning and disruptive behavior through DNA methylation has yet to be established in humans. Furthermore, it remains unclear whether this causal chain can be broken, with a proven effective parenting intervention. The current project addresses these gaps in our knowledge through the implementation of a RCT of a preventive parenting intervention (VIPP-SD) aimed at increasing sensitive parenting in families at-risk for dysfunctional parenting. By increasing sensitive parenting, we aim to revert differential methylation of stress related genes, leading to improved stress system functioning in young children and, in turn, a reduction in disruptive behavior.
Study objective
The primary aim of this study is to examine whether a parenting intervention that increases sensitive parenting improves children’s stress system functioning and reduces disruptive behavior, and to examine whether these improvements are causally mediated by alterations in DNA methylation at stress related genes Core hypotheses are:
1. The VIPP-SD parenting intervention leads to improved parenting (more positivity and warmth; higher parental self-efficacy; less parenting stress; more sensitive and consequent disciplining by parents).
2. The VIPP-SD parenting intervention leads to alterations in DNA methylation at stress system/stress related genes.
3. Improved parenting leads to improvements in children’s stress response and reduced child disruptive behavior.
4. Improvements in children’s stress response and reduced child disruptive behavior are induced by alterations in DNA methylation at stress system/stress related genes.
Study design
Pre-intervention assessment
Post-intervention assessment
Follow-up assessment, at 6 months after completion intervention
Intervention
Experimental group: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD)
Control intervention group: semi-structured interviews via phone calls
Inclusion criteria
Children aged 12-16 months old, screened within the Sarphati Amsterdam cohort (https://www.sarphaticohort.nl/) using the OBVL (Opvoedingsbelasting Vragenlijst). A 75th percentile cut-off on the OBVL will be used to select parents that may be potentially at-risk for having increased levels of parenting stress and for the development of dysfunctional parenting behavior. Primary caregivers will be included.
Exclusion criteria
Not mastering the Dutch language and a (mental) health condition in the parent and/or child that does not allow an effective and safe participation in the home assessments.
Design
Recruitment
IPD sharing statement
Followed up by the following (possibly more current) registration
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In other registers
| Register | ID |
|---|---|
| NTR-new | NL9104 |
| Other | Ethics Committee – University of Amsterdam : 2019-CDE-10160 |