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11 October 2022

Paternal stress associated with children's emotional and behavioural problems at age two

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London with the Finnish Institute for Health and Welfare and others has found an association between fathers who experience too much stress in the months following the birth of their child, and the child’s subsequent development of emotional and behavioural problems at age two.


The research, published in the Journal of Child Psychology, Psychiatry and Allied Disciplines, suggests that new fathers should be assessed for stress during the perinatal period as it presents an opportunity for early intervention to help prevent future difficulties for both father and child.

The study used data from the Finnish CHILD-SLEEP birth cohort. 901 fathers and 939 mothers completed questionnaires on stress, anxiety and depression during pregnancy and three stages in the postpartum period, with a final survey taking place at 24 months.

The new fathers were asked a number of questions about their levels of stress, including how often they felt that they were unable to control important things in their life, and how confident they felt handling personal problems. Their stress levels were scored on a 20-point scale, with those scoring 10 or more being considered as experiencing “high” levels of stress. Participants were also asked to report on their child’s emotional and behavioural problems at 24 months.

Overall, around 7% of participating fathers experienced high stress at the first three stages measured in the perinatal period. This then rose to 10% at two years postpartum.

Researchers identified the strongest association between paternal stress at three months postpartum and childhood emotional and behavioural problems at age two, even when accounting for other factors like maternal stress, anxiety and depression. Paternal stress was more strongly associated with childhood outcomes than paternal depression or anxiety.

Our study found that paternal stress makes a unique contribution to child outcomes, particularly during the early postpartum months. Nonetheless, men may be reluctant to seek help or express their needs during this time and may feel excluded from the maternal focus of perinatal services. Explicit effort may be required to engage fathers in discussions about the types of support they may need to manage stress and wellbeing and help prevent future difficulties for their children at what might be a sensitive stage of development.

Dr Fiona Challacombe, Clinical Psychologist at King’s IoPPN and South London and Maudsley NHS Foundation Trust and lead author of the study

Dr Challacombe continued by saying: “Future research needs to focus on understanding the mechanisms by which this effect may be acting - whether it is paternal behaviours or the impact on maternal behaviours. This will help design the right interventions for fathers. The rise in paternal stress at two years indicates that this does not dissipate over time - returning to work, chronic sleep difficulties and behavioural difficulties becoming more apparent may all contribute.”

The study was a collaboration between King’s College London, the Finnish Institute for Health and Welfare, University of Helsinki, University of Tampere and Pirkanmaa Hospital District. It was funded by the Academy of Finland, the Signe and Ane Gyllenberg Foundation, Yrjö Jahnsson Foundation, Foundation for Pediatric Research, Finnish Cultural Foundation, Tampere University Hospital and Arvo and Lea Ylppö Foundation. Dr Fiona Challacombe is funded by an NIHR Clinical Fellowship.

Paternal perinatal stress is associated with children’s emotional problems at two years’ (Fiona Challacombe, Johanna Pietikäinen, Olli Kiviruusu, Outi Saarenpää-Heikkilä, Tiina Paunio, E. Juulia Paavonen) was published in the Journal of Child Psychology, Psychiatry and Allied Disciplines (DOI: 10.1111/jcpp.13695).

For more information, please contact Patrick O’Brien (Senior Media Officer).

In this story

Fiona Challacombe

NIHR Clinical Lecturer