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      The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort “Dresden Study on Parenting, Work, and Mental Health” (DREAM)

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          Abstract

          The Dresden Study on Parenting, Work, and Mental Health (“ DResdner Studie zu Elternschaft, Arbeit, und Mentaler Gesundheit”, DREAM) aims to prospectively investigate the relationship between parental work participation, role distribution, stress factors, and their effects on perinatal outcomes and long-term family mental and somatic health in a community sample targeting N = 4,000 individuals, i.e., 2,000 couples, expecting a child and residing in Dresden, Germany (interim sample of N = 1,410 participants, recruitment ongoing). Various questionnaires are completed at four measurement points from pregnancy to 2 years postpartum (prolongation into middle childhood planned). Applying a multi-method approach, long-term endocrinological data (analyses of hair cortisol concentrations and other endogenous hormones, “DREAM HAIR”) and qualitative interview data (regarding gender role attitudes and distribution of domestic work, child care, and paid employment; “DREAM TALK”) are obtained. In this study protocol, the theoretical background, methods, and preliminary results considering sociodemographic characteristics during pregnancy and birth-related factors at 8 weeks postpartum are presented. Additionally, there is a focus on our endocrinological sub-study DREAM HAIR. In this sub-study currently comprising N = 152 participants, i.e., 88 families (recruitment ongoing), we want to gain knowledge on the transgenerational processes of stress regulation and psychopathology in the whole family by analyzing hair cortisol concentrations in both parents and children during the course from pregnancy (or after birth regarding children) to at least 2 years postpartum. By comparing data of the community sample to a clinical sample of mothers with postpartum mental disorders, their children, and their partners during the period between admission and discharge from a mother-baby unit and post-treatment (“DREAM MBU”), the course of mothers' psychopathology, parent-infant interaction, and infant regulation disorders with special regard to long-term endocrine correlates will be examined. With previous studies neglecting the fathers or partners involved, a major advantage of DREAM is the use of a multi-method and multi-level approach by examining the whole family in a longitudinal design. Therefore, the DREAM study will contribute to a better understanding of the role of social, work, and stress factors for mental and somatic health and its long-term endocrine correlates in the natural course of becoming a family.

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          Missing data: our view of the state of the art.

          Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.
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            A Measure of Parenting Satisfaction and Efficacy

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              Hair cortisol as a biological marker of chronic stress: current status, future directions and unanswered questions.

              The detrimental effects of stress on human health are being increasingly recognized. There is a critical need for the establishment of a biomarker that accurately measures its intensity and course over time. Such a biomarker would allow monitoring of stress, increase understanding of its pathophysiology and may help identify appropriate and successful management strategies. Whereas saliva and urine cortisol capture real-time levels, hair cortisol analysis presents a complementary means of monitoring stress, capturing systemic cortisol exposure over longer periods of time. This novel approach for cortisol quantification is being increasingly used to identify the effects of stress in a variety of pathological situations, from chronic pain to acute myocardial infarctions. Because of its ability to provide a long-term, month-by-month measure of systemic cortisol exposure, hair cortisol analysis is becoming a useful tool, capable of answering clinical questions that could previously not be answered by other tests. In this paper we review the development, current status, limitations and outstanding questions regarding the use of hair cortisol as a biomarker of chronic stress. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                12 June 2019
                2019
                : 10
                : 1273
                Affiliations
                [1] 1Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden , Dresden, Germany
                [2] 2Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden , Dresden, Germany
                [3] 3Department of Gynecology and Obstetrics, Faculty of Medicine of the Technische Universität Dresden , Dresden, Germany
                [4] 4Department of Psychology, PROMENTA Research Center, University of Oslo , Oslo, Norway
                [5] 5Department of Child Health, Norwegian Institute of Public Health , Oslo, Norway
                Author notes

                Edited by: Beate Ditzen, Heidelberg University Hospital, Germany

                Reviewed by: Wendy Nilsen, OsloMet – Oslo Metropolitan University, Norway; Berta Rodrigues Maia, Catholic University of Portugal, Portugal

                *Correspondence: Susan Garthus-Niegel susan.garthus-niegel@ 123456uniklinikum-dresden.de

                This article was submitted to Health Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2019.01273
                6584823
                31263435
                a4b72cf0-04c2-4ea9-acef-2deef97df6cb
                Copyright © 2019 Kress, Steudte-Schmiedgen, Kopp, Förster, Altus, Schier, Wimberger, Kirschbaum, von Soest, Weidner, Junge-Hoffmeister and Garthus-Niegel.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 15 November 2018
                : 14 May 2019
                Page count
                Figures: 3, Tables: 6, Equations: 0, References: 218, Pages: 26, Words: 20231
                Funding
                Funded by: Deutsche Forschungsgemeinschaft 10.13039/501100001659
                Award ID: GA 2287/4-1
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                parental mental health,work participation,role distribution,peripartum stress,dream study,hair cortisol,multi-method approach,study protocol

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