Letourneau, Nicole LynAli, Elena2020-09-222020-09-222020-09-09Ali, E. (2020). Maternal Prenatal Anxiety, Attachment and Children’s Externalizing and Internalizing Behavioral Problems (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/112562Perinatal anxiety is common, and affects up to 15-20% of women during perinatal period (Abrar, Fairbrother, Smith, Skoll, & Albert, 2020). Regarded as a prenatal programming factor (Madigan et al., 2018), prenatal anxiety (PA) is associated with biological, cognitive, and behavioral development in offspring, increasing risk for later externalizing and internalizing problems and adult psychopathology (Finsaas et al., 2018; Vogel, Jackson, Barch, Tillman, & Luby, 2019). Child behavioral development is also influenced by the postpartum anxiety (Madigan et al., 2018; Vogel et al., 2019). Externalizing behaviors are more often observed in boys and internalizing behaviors are more often observed in girls (Martel, 2013). Maternal-child attachment is defined as an affectionate, mutually satisfying relationship between a child and a caregiver that is involved in making the child feel safe, secure, and protected (Bowlby, 1958). Maternal-child attachment may moderate the association between PA and externalizing and internalizing behavioral problems, and function differently for boys and girls. The first manuscript provides a review of women’s experiences with postpartum anxiety, showing that postpartum anxiety is common, and can have serious implications for the maternal-child relationship. The second manuscript consists of a concept analysis of parent-child attachment to advance the application of this concept in nursing practice. The third manuscript presents the results of testing associations between PA and children's behavioral problems, and the role of maternal-child attachment and child sex as moderators of this association. Maternal-child attachment security moderated the association between prenatal anxiety and children’s behavioral problems; however, the sex of the child did not. The final paper describes the sample from which the third paper was derived, the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort, highlighting findings on maternal and paternal mental health from pregnancy to three years postpartum. The dissertation concludes with recommendations for nursing research, policy, education and practice.engUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.attachment theory, secondary data analysis, regression analysis, maternal and child mental healthHuman DevelopmentMental HealthNursingdoctoral thesis10.11575/PRISM/38222