Poster #51 - Primary care giver mental health and child development in Bhutan

• In Event: Poster Session 11

Abstract

Recent work demonstrates that primary caregiver mental health (PCMH) impacts infants and children’s cognitive development. Poor PCMH is associated with fewer high-quality interactions, more negative emptions, and negative parental styles such as harsh punishments (Peltonen, 2022). This relation has been demonstrated for families from various communities and for children of diverse ages. For example, both gaze following (Astor et al., 2020) and attention regulation (Juvrud, 2021; Tu, 2021) is associated with depression and social anxiety among primary caregivers in Swedish samples. Similarly, the ability to process emotional facial expressions is lower in Syrian refugee children (6-18 years; living in Turkish communities) who’s primary care giver (mothers) suffers from PTS symptoms due to war related traumatic experiences.
This association is not identical across cultures. Bhutanese infants display a similar tendency to follow gaze as Swedish infants but this ability is not associated with PCMH (Astor, in press). This finding led to the formation of the cultural mitigation hypothesis, suggesting that culture-specific risk and protective factors impact if/how PCMH impacts child development. Highly collectivistic cultures might offer protection in numbers. That more peoples are present and support the child, especially when mothers suffer from poor mental health, might provide enrichment and stability in a way that is not always present in more individualistic societies. Other local protective factors can be religious believes/practices, community level support (also known as collective efficacy), lack of poverty, and education.
The current study takes a closer look at the cognitive development (SON-R, non-verbal test) of 3-5-year-old children in 504 Bhutanese families. Primary care givers are also interviewed for about 1 hour, with focus on PCMH, local risk and protective factors. Local staff interviewed primary caregivers and tested children’s cognitive development in four regions of Western Bhutan during the spring of 2022.
We demonstrate that the number of negative emotions experienced by the primary caregiver in the last two weeks (PCNE), primary caregiver socio-economic status (SES), spiritual values, and sense of belonging to the community (social efficacy), together with the child’s age and sex predict child development (SON-R), see Table 1. The frequency of religious practices did not contribute significantly to the model. The full model is significant F(6) = 8.79, p < .001, R2 = .107. No interaction effects were observed. Follow-up analysis demonstrate that these effects are most pronounced for families of Lhotshampa origin (Hindu) living primarily in the southern parts of Bhutan (n=152) and less prominent for majority culture Buddhist families of Ngalop (n=117) or Tshangla (n=136) origin primarily from Eastern and Westerns Bhutan. In the former group all the effects described in Table 1 continue to impact child development. In the latter (Buddhist) groups only the frequency of religious practices impacted cognitive development of children, with more religious activities being associated with better child development (p<.008). Consistent with prior work with infants (Astor, in press), PCMH in Bhutanese majority culture Buddhist families does not appear to impact their children to the same extent seen in other cultural contexts within or outside Bhutan.

Authors

• Gustaf Gredebäck, Uppsala universitet
  Presenting Author

• Nidup Dorji, Khesar Gyalpo University of Medical Sciences of Bhutan

• Pär Nyström, Uppsala universitet

• Umay Sen, Uppsala universitet

• Wangchuk Wangchuk, Khesar Gyalpo University of Medical Sciences of Bhutan,