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Biaggi A, Hazelgrove K, Waites F, Bind RH, Lawrence AJ, Fuste M, Conroy S, Howard LM, Mehta MA, Miele M, Seneviratne G, Pawlby S, Pariante CM, Dazzan P. Mother-infant interaction and infant development in women at risk of postpartum psychosis with and without a postpartum relapse. Psychol Med 2024; 54:823-834. [PMID: 37706314 DOI: 10.1017/s0033291723002568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND This study aimed to investigate mother-infant interaction and infant development in women at-risk of postpartum psychosis (PP), with and without a postpartum relapse. METHODS 103 women (and their offspring) were included, 43 at-risk-of-PP because of a diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 60 with no current/previous mental illness or family history of PP. Of the at-risk women, 18 developed a psychiatric relapse within 4 weeks after delivery (AR-unwell), while 25 remained symptom-free (AR-well). Mother-infant interaction was assessed using the CARE-Index at 8 weeks' and 12 months' postpartum and infant development using the Bayley-III at 12 months' postpartum. RESULTS Women at-risk-of-PP as a group, regardless of whether they developed a psychiatric relapse within 4 weeks after delivery, had less synchronous mother-infant interactions and had infants with less optimal cognitive, language, motor and socio-emotional development than healthy controls. In particular, boys of at-risk women had the lowest scores in cognitive, language and motor development and in mother-infant interaction, while girls of the at-risk women had the lowest scores in socio-emotional development. The synchrony in the dyad predicted infant cognitive and language development. There was no evidence for a difference in mother-infant interaction nor in infant development between the AR-unwell and AR-well groups. CONCLUSIONS These results suggest that, while there is a lack of evidence that an early postpartum relapse in women at-risk-of-PP could represent a risk for the infant per se, maternal risk for PP may be associated with less optimal mother-infant interaction and infant development.
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Affiliation(s)
- Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Montserrat Fuste
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Perinatal Parent-Infant Mental Health Service, Goodmayes Hospital, North East London Foundation Trust, London, IG3 8XD, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Mitul A Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, SE5 8AF, UK
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, W2 1PF, UK
| | - Gertrude Seneviratne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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2
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Pazzagli C, Buratta L, Coletti E, Mazzeschi C. Mother-to-infant bonding mediates the effects of depressive and anxious postpartum symptoms on parenting stress. J Psychosom Obstet Gynaecol 2023; 44:2264487. [PMID: 37837341 DOI: 10.1080/0167482x.2023.2264487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/24/2023] [Indexed: 10/16/2023] Open
Abstract
A number of studies have suggested close associations between maternal postpartum mental health (depressive and anxious symptoms), mother-infant bonding, and parenting stress. However, the relationship between maternal bonding and parenting stresshas hardly been explored in published literature. This cross-sectional study explored whether maternal bonding could mediate the effect of postpartum maternal mental health on parenting stress. This study assessed maternal bonding (MPAS), depressive and anxious symptoms (EPDS; STAI), and parenting stress (PSI) at 3 months postpartum in a community sample of 105 women (M (SD) = 32.60 (4.18) years old). Spearman's correlation analyses showed moderate to high correlations between these factors. The three mediation models run showed that mother's MPAS partially mitigates the effects of EPDS (b = 0.71; SE = 0.217; 95% CI = 0.290/1.136) and STAI State (b = 0.39; SE = 0.113; 95% CI = 0.178/0.625) on PSI, and totally mediated the relationship between STAI Trait and PSI (b = 0.59; SE = 0.155; 95% CI = 0.303/0.912). Maternal bonding resulted to be a relevant factor in the association between maternal mental health and parenting stress. This highlights the importance of interventions focusing on mother-infant relationship to reduce parenting stress and prevent developmental difficulties in children.
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Affiliation(s)
- Chiara Pazzagli
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Elena Coletti
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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3
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Weiss SJ, Goodman SH, Kidd SA, Owen MT, Simeonova DI, Kim CY, Cooper B, Rosenblum KL, Muzik M. Unique Characteristics of Women and Infants Moderate the Association between Depression and Mother-Infant Interaction. J Clin Med 2023; 12:5503. [PMID: 37685568 PMCID: PMC10487744 DOI: 10.3390/jcm12175503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Research has shown mixed results regarding the association between women's postpartum depression and mother-infant interactions, suggesting that a woman's unique experience and context may moderate how depression shapes these interactions. We examined the extent to which a woman's comorbid anxiety, her exposure to adversity, and infant characteristics moderate the relationship between depressive symptoms of women and interactions with their infants at 6 (n = 647) and 12 months (n = 346) postpartum. The methods included standardized coding of mother-infant interactions and structural regression modeling. The results at 6 months of infant age indicated that infant male sex and infant negative affectivity were risk factors for mothers' depression being associated with less optimal interactions. At 12 months of infant age, two moderators appeared to buffer the influence of depression: a woman's history of trauma and infant preterm birth (≤37 weeks gestation). The results reinforce the salience of infant characteristics in the relationship between maternal depression and mother-infant interactions. The findings also suggest that experiences of trauma may offer opportunities for psychological growth that foster constructive management of depression's potential effect on mother-infant interactions. Further research is needed to clarify the underlying processes and mechanisms that explain the influence of these moderators. The ultimate goals are to reduce the risk of suboptimal interactions and reinforce healthy dyadic relations.
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Affiliation(s)
- Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, CA 94143, USA;
| | | | - Sharon A. Kidd
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA;
| | - Margaret Tresch Owen
- Department of Psychology, University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Christine Youngwon Kim
- Department of Human Development and Family Studies, Pennsylvania State University, Hershey, PA 17033, USA;
| | - Bruce Cooper
- Department of Community Health Systems, University of California, San Francisco, CA 94143, USA;
| | - Katherine L. Rosenblum
- Departments of Psychiatry and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; (K.L.R.); (M.M.)
| | - Maria Muzik
- Departments of Psychiatry and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; (K.L.R.); (M.M.)
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4
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Della Vedova AM, Santoniccolo F, Sechi C, Trombetta T. Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother-Baby Interactions at Three Months Post-Partum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4253. [PMID: 36901263 PMCID: PMC10002080 DOI: 10.3390/ijerph20054253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.
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Affiliation(s)
- Anna Maria Della Vedova
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | | | - Cristina Sechi
- Department of Pedagogy, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09126 Cagliari, Italy
| | - Tommaso Trombetta
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, Italy
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5
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Xie EB, Freeman M, Penner-Goeke L, Reynolds K, Lebel C, Giesbrecht GF, Rioux C, MacKinnon A, Sauer-Zavala S, Roos LE, Tomfohr-Madsen L. Building Emotional Awareness and Mental Health (BEAM): an open-pilot and feasibility study of a digital mental health and parenting intervention for mothers of infants. Pilot Feasibility Stud 2023; 9:27. [PMID: 36800982 PMCID: PMC9938356 DOI: 10.1186/s40814-023-01245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Maternal mental health concerns and parenting stress in the first few years following childbirth are common and pose significant risks to maternal and child well-being. The COVID-19 pandemic has led to increases in maternal depression and anxiety and has presented unique parenting stressors. Although early intervention is crucial, there are significant barriers to accessing care. METHODS To inform a larger randomized controlled trial, the current open-pilot trial investigated initial evidence for the feasibility, acceptability, and efficacy of a newly developed online group therapy and app-based mental health and parenting program (BEAM) for mothers of infants. Forty-six mothers 18 years or older with clinically elevated depression scores, with an infant aged 6-17 months old, and who lived in Manitoba or Alberta were enrolled in the 10-week program (starting in July 2021) and completed self-report surveys. RESULTS The majority of participants engaged in each of the program components at least once and participants indicated relatively high levels of app satisfaction, ease of use, and usefulness. However, there was a high level of attrition (46%). Paired-sample t-tests indicated significant pre- to post-intervention change in maternal depression, anxiety, and parenting stress, and in child internalizing, but not externalizing symptoms. Effect sizes were in the medium to high range, with the largest effect size observed for depressive symptoms (Cohen's d = .93). DISCUSSION This study shows moderate levels of feasibility and strong preliminary efficacy of the BEAM program. Limitations to program design and delivery are being addressed for testing in adequately powered follow-up trials of the BEAM program for mothers of infants. TRIAL REGISTRATION NCT04772677 . Registered on February 26 2021.
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Affiliation(s)
- E. Bailin Xie
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada
| | - Makayla Freeman
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
| | - Lara Penner-Goeke
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Kristin Reynolds
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Catherine Lebel
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada
| | - Gerald F. Giesbrecht
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Charlie Rioux
- grid.266900.b0000 0004 0447 0018Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Anna MacKinnon
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322CHU Sainte-Justine Research Center, Montréal, QC Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Department of Psychology, University of Kentucky, Lexington, KY USA
| | - Leslie E. Roos
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada ,grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Winnipeg, MB Canada
| | - Lianne Tomfohr-Madsen
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
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6
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Federica G, Renata T, Marzilli E. Parental Postnatal Depression in the Time of the COVID-19 Pandemic: A Systematic Review of Its Effects on the Parent-Child Relationship and the Child's Developmental Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2018. [PMID: 36767385 PMCID: PMC9915850 DOI: 10.3390/ijerph20032018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
The international literature has shown that maternal and paternal postnatal depression (PND) is one of the most common mental illnesses in the perinatal period, with significant consequences for parent-infant relationships and infant development. The COVID-19 pandemic has increased the rates of prevalence of PND, exacerbating the mental health risk for new families. This systematic review aims to examine the effect of maternal and paternal PND on parent-infant relationships and children's development in the first 36 months after childbirth during the COVID-19 outbreak. Eligible studies were identified using the following databases: Medline, CINAHL, SCOPUS, PsycINFO, PsycARTICLES, ScienceDirect, and Web of Science. Of the 1252 studies considered, 10 studies met the inclusion criteria. Results showed that maternal PND significantly affected the quality of the early mother-infant relationship and the infant's motor, self-regulation, and socio-emotional development. In addition, the detrimental impact of maternal PND on the quality of early mother-infant relationships seems to become stronger as COVID-19 concerns increase. No studies included fathers. These findings strengthened the importance of planning targeted prevention and treatment strategies to prevent PND and its short- and long-term consequences, especially in the case of stressful and traumatic events. They also suggested the urgent need for further exploration of fathers.
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Affiliation(s)
- Genova Federica
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy
| | - Tambelli Renata
- Department of Dynamic, Clinical & Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Eleonora Marzilli
- Department of Dynamic, Clinical & Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Aylward P, Sved Williams A. Holistic community-based group parenting programs for mothers with maternal mental health issues help address a growing public health need for a diversity of vulnerable mothers, children and families: Findings from an action research study. Front Glob Womens Health 2023; 3:1039527. [PMID: 36733300 PMCID: PMC9887053 DOI: 10.3389/fgwh.2022.1039527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background Maternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1-36 months. The program seeks to nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses that impinge upon their parenting. This study presents the evaluation of the program and its effectiveness. Methods Action research approach for continuous monitoring and program improvement engaging Acorn program staff in evaluation data collection and interpretation of pre and post self-completion measures and standardized observations. Additional data was collected through a telephone interview of attending mothers 6-8 months after program completion to address sustainable impacts on parenting and wellbeing. Results The program engaged 353 diverse vulnerable mothers with their children. Many had profound overlapping mental health issues including borderline personality disorder (BPD) and depression. The quality of the parent-child interaction, parental confidence, competence and enjoyment were enhanced; mothers' wellbeing, ability to cope and lasting social supports were augmented. This occurred for a number of "most vulnerable" subgroups including single mothers, mothers with BPD, mothers from non-English speaking households and those with lower levels of education or household income. Mothers reported sustained improvements in their wellbeing, parenting, social and family lives, and feeling closer to their child as a result of participating in the program. Conclusions Given the high prevalence of maternal mental health issues and substantial potential negative consequences for mothers and offspring, the Acorn parenting program offers an effective means of addressing this pressing public health issue potentially helping large numbers of vulnerable mothers and their children. This has additional gravitas in the shadow of COVID-19 due to expanded numbers of those experiencing greater parental stress, isolation and mental illness.
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Affiliation(s)
- Paul Aylward
- Action Research Partnerships, Adelaide, SA, Australia,Torrens University Australia, Public Health, Equity and Human Flourishing, Adelaide, SA, Australia,Correspondence: Paul Aylward ;
| | - Anne Sved Williams
- Department of Psychiatry, Women’s and Children’s Health Network, SA, Australia,Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
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8
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Dadhwal V, Sagar R, Choudhary V, Kant S, Perumal V, Misra P, Bhattacharya D. A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community. Indian J Psychol Med 2022; 44:567-574. [PMID: 36339693 PMCID: PMC9615458 DOI: 10.1177/02537176211072690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA. METHODS Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences. RESULTS MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52). CONCLUSION This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
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Affiliation(s)
- Vatsla Dadhwal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajesh Sagar
- Dept. of Psychiatry, All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Vandana Choudhary
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Shashi Kant
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vanamail Perumal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Puneet Misra
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Debabani Bhattacharya
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
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9
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Bradshaw H, Riddle JN, Salimgaraev R, Zhaunova L, Payne JL. Risk factors associated with postpartum depressive symptoms: A multinational study. J Affect Disord 2022; 301:345-351. [PMID: 34979186 DOI: 10.1016/j.jad.2021.12.121] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the association between maternal age, parity, gestational number (singleton vs twin), newborn gender and self-reported postpartum depressive symptoms (PDS) in a large multinational sample using survey data from a digital telephone application. METHODS Women using the Flo app answered a survey (available in 10 languages) from January 2018 to April 2020. A survey question asking about emotional state was used to determine the presence of PDS. Chi-squared statistics were used to compare groups. A weighted mean prevalence was calculated based upon the socioeconomic status and reproductive population of each country in 2020. RESULTS Over a million women from 138 countries participated. Of all respondents, 9.4% endorsed PDS. The weighted mean prevalence of PDS was 11%. We found that PDS decreased with advancing age. First-time mothers reported higher rates of PDS. Twin births were associated with a higher symptom burden than singleton births and mothers of twins in the oldest age group reported the greatest burden. We did not find a clinically significant difference in rates of PDS between mothers of singleton girls and boys. CONCLUSIONS To our knowledge, this study is the first to examine risk factors for postpartum symptoms using the same survey across a large international population. These results can further research and clinical aims to identify and treat maternal depression more effectively. LIMITATIONS Data was aggregated, thereby limiting analysis of individual associations. The survey was self-report and not diagnostic for postpartum depression. Generalizability of risks of postpartum depression should be approached with caution.
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Affiliation(s)
- Helen Bradshaw
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA
| | - Julia N Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA
| | - Rodion Salimgaraev
- Flo Health, Inc. 1013 Centre Road, Suite 403-B, Wilmington, DE, 19805, USA
| | - Liudmila Zhaunova
- Flo Health, Inc. 1013 Centre Road, Suite 403-B, Wilmington, DE, 19805, USA
| | - Jennifer L Payne
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA; Department of Psychiatry and Neurobehavioral Sciences, Reproductive Pschiatry Research Program, PO Box 800548, Charlottesville, VA 22908.
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10
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Peak JM, Ingram V, Urbanoski K, Milligan K. Specifying the Relations among PTSD Symptom Clusters and Parenting Stress in Mothers Engaged in Substance Use Treatment. Subst Use Misuse 2022; 57:1552-1562. [PMID: 35819030 DOI: 10.1080/10826084.2022.2096236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Parenting stress is often heightened in mothers receiving treatment for substance use. Experiences of trauma are commonly seen in this population, which may give rise to Posttraumatic Stress Disorder (PTSD) symptoms, including intrusion, avoidance, negative cognition and mood, and affective arousal. While past research has demonstrated a significant relation between PTSD symptoms and parenting stress, no studies have examined the relative contributions of these symptoms to parenting stress in mothers engaged in substance use treatment. METHODS Seventy-four mothers attending outpatient substance use treatment who were parenting children aged 0-3 years completed measures of parenting stress, PTSD, substance use, and depression symptoms. RESULTS A canonical correlation analysis indicated two canonical variates accounting for significant variance between PTSD symptom clusters and parenting stress measures. The first canonical variate, primarily reflecting depressive and PTSD cognition and mood symptoms, was predominantly related to the parental distress aspect of parenting stress (40%). The second canonical variate, primarily reflecting intrusion and avoidance PTSD symptoms, was associated with increased parental perceptions of their child as difficult (10%). CONCLUSION Future research directions and clinical implications of these results are discussed for designing parenting interventions with mothers attending substance use treatment who present with PTSD symptoms.
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Affiliation(s)
- Julia Marie Peak
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Victoria Ingram
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Karen Urbanoski
- Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Karen Milligan
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
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Muzard A, Olhaberry M, Immel N, Moran-Kneer J. Family dynamics. An exploration of parental sensitivity and depressive symptoms among mothers and fathers of toddlers. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2021; 24:551. [PMID: 35047427 PMCID: PMC8715268 DOI: 10.4081/ripppo.2021.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/27/2021] [Indexed: 12/03/2022]
Abstract
In studies of maternal sensitivity, the influence of mothers’ depressive symptomatology has been consistently highlighted. Additionally, the relevance of both maternal and paternal sensitive responses to children’s development has been recognized. However, literature regarding the dynamics of the mother-father-toddler triad is scarce. This is particularly true when understanding how parental sensitivity may be bidirectionally shaped by both parents’ (i.e., mothers’ and fathers’ depressive symptomatology) and children’s characteristics (i.e., age). Hence, the present study aims to describe and analyse the associations between parental depression, paternal sensitivity and children’s socioemotional difficulties and age with mothers’ sensitive responses to highlight the appropriateness of considering fathers’ depressive symptoms and sensitivity to better understand the impact of maternal depressive symptomatology on mothers’ sensitivity. The participants included 80 Chilean mother-father-child triads in which all children were between 1 and 3 years of age and presented some degree of socioemotional difficulty. The results reveal no differences in maternal and paternal sensitivity or higher depressive symptomatology in mothers than in fathers. Additionally, while mothers’ depression was significantly associated with their sensitivity, this was not the case for fathers. Paternal depressive symptomatology was associated with the mother’s depression. Finally, paternal sensitivity emerged as a mediator between maternal depressive symptoms and sensitivity. This result calls attention to the use of paternal variables to understand how maternal depression impacts mothers’ sensitivity and to thus develop appropriate interventions that expand the scope of such impacts from the dyad to the triad.
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Nonnenmacher N, Müller M, Taczkowski J, Zietlow AL, Sodian B, Reck C. Theory of Mind in Pre-school Aged Children: Influence of Maternal Depression and Infants' Self-Comforting Behavior. Front Psychol 2021; 12:741786. [PMID: 34899482 PMCID: PMC8651535 DOI: 10.3389/fpsyg.2021.741786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
A milestone of child development is theory of mind (ToM): the ability to attribute mental states, especially beliefs and desires, to other persons and to understand that their behavior is guided by mental states. The learning process about the mental world also takes place in social communication and interaction, beginning in infancy. Infancy is assumed to be a sensitive period for the development of social skills through interaction. Due to limited self-regulatory skills, infants depend on sensitive behavior of their caregivers to regulate affective states and physiological arousal, and in turn, mutually regulated affects allow the infant to gradually acquire the capability to self-regulate negative affective states. Effective and adequate affect regulation is an important prerequisite for environmental interaction and thus for the development of socio-emotional skills. The present study investigated the relation of self-regulatory abilities in infancy and later ToM in pre-school aged children of clinically depressed mothers and healthy controls. The sample comprised of N = 55 mother-child dyads, n = 22 diagnosed with postpartum or lifetime depression according to DSM-IV and n = 33 healthy controls. Mother-infant-interaction was videotaped during the Face-to-Face Still-Face paradigm. At 3 and 42 months postpartum mothers were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to evaluate maternal psychopathological status according to DSM-IV. At the age of M = 4.0 years, children's ToM abilities were assessed using content-false-belief and location-false-belief tasks. The results of this study show that contrary to our hypotheses, maternal depression did not impair the development of children's ToM-abilities per se. Rather, an interaction effect highlights the role of infant's self-comforting behavior during mother-infant interaction in infancy (3 months postpartum) for ToM-development at pre-school age assessed with the Maxi-task; this association was distinct for female in comparison to male children. The results of this longitudinal study shed light on the discussion, how maternal depression influences child development and point in the direction that self-comforting behaviors in infancy can also be seen as a resource.
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Affiliation(s)
- Nora Nonnenmacher
- Center for Psychosocial Medicine, Heidelberg University Hospital, Institute of Medical Psychology, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilians University Munich, Munich, Germany
| | - Joana Taczkowski
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna-Lena Zietlow
- Center for Psychosocial Medicine, Heidelberg University Hospital, Institute of Medical Psychology, Heidelberg, Germany.,School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Beate Sodian
- Department of Psychology, Ludwig Maximilians University Munich, Munich, Germany
| | - Corinna Reck
- Department of Psychology, Ludwig Maximilians University Munich, Munich, Germany
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Madsen EB, Smith-Nielsen J, Egmose I, Lange T, Vaever MS. The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms. Scand J Psychol 2021; 63:47-54. [PMID: 34743339 DOI: 10.1111/sjop.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes. In a cross-sectional study using a sample of mothers of 2-10 month-old infants (N = 367) we first examined depressive symptoms as a mediator, and then, the indirect effect of adult attachment through depressive symptoms between childhood adversity and parenting stress. Results showed that the effect of childhood adversity on parenting stress was mediated by an indirect pathway through depressive symptoms alone, and an indirect pathway of adult attachment through depressive symptoms. The indirect effect of adult attachment through depressive symptoms was found to be stronger than the indirect effect of depressive symptoms alone, supporting the hypothesis that adult attachment insecurity together with depressive symptoms are particularly important risk factors to be considered in this relationship. Results suggest that childhood adversity is a risk factor for parenting stress, and not a determinant of later parenting stress per se. Instead, mediators in this association, adult attachment, and depressive symptoms, were identified as potential targets of intervention to prevent negative effects of childhood adversity on parenting stress. A limitation of the study lies in its cross-sectional design. Future studies should examine these associations longitudinally to allow for interpretation of causality.
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Affiliation(s)
- Eva Back Madsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Sun K, Mulvaney MK. Intergenerational Support in Chinese Immigrant Families: The Influences of Grandparent Support, Cultural Values, and Orientations on Parenting Stress. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2021. [DOI: 10.1080/15350770.2021.1930622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kai Sun
- New York University Shanghai, Shanghai, China
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15
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Camisasca E, Di Blasio P, Milani L, Miragoli S. Postpartum depressive symptoms as a linking mechanism between maternal sleep and parenting stress: the conditional indirect effect by social support. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1824675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Elena Camisasca
- Psychology, Università Telematica eCampus, Novedrate, Italy
- C.R.I.d.e.e., Psychology Department, Catholic University of the Sacred Heart, Milano, Italy
| | - Paola Di Blasio
- C.R.I.d.e.e., Psychology Department, Catholic University of the Sacred Heart, Milano, Italy
| | - Luca Milani
- C.R.I.d.e.e., Psychology Department, Catholic University of the Sacred Heart, Milano, Italy
| | - Sarah Miragoli
- C.R.I.d.e.e., Psychology Department, Catholic University of the Sacred Heart, Milano, Italy
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Preterm birth and maternal sensitivity: Findings from a non-western country. Infant Behav Dev 2020; 61:101476. [PMID: 32771832 DOI: 10.1016/j.infbeh.2020.101476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/06/2020] [Accepted: 07/29/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Although there are several studies on maternal sensitivity of preterm-born children conducted in Western countries, the factors affecting the sensitivity of mothers of preterm infants have not been investigated outside the Western context. OBJECTIVES This study aimed to compare maternal sensitivity of preterm children at 18 months of corrected age with their healthy term-born peers and explore the factors associated with maternal sensitivity in a middle-income non-Western country. Moreover, the associations of maternal sensitivity with socio-demographic factors, maternal depression, and social-emotional competency and behavior problems of infants were investigated. METHODS In total, 70 (40 preterm-born and 30 term-born) mother-child dyads participated in this study. An observation-based measurement tool, Maternal Sensitivity Scale, was used to assess maternal sensitivity. Social-emotional competency and behavior problems of infants were evaluated via The Turkish version of the Brief Infant-Toddler Social Emotional Assessment. Maternal depressive symptoms were assessed via the Beck Depression Inventory. In addition, a demographic information form was filled out by the mothers. RESULTS Maternal sensitivity scores of preterm infants were significantly lower compared to term infants. Depressive symptoms scores and employment status of mothers, socio-economic status (SES), gestational age, breastfeeding duration, and behavior problems of children were the factors related to maternal sensitivity scores. In hierarchical regression analysis, SES and gestational age were the strongest predictors of maternal sensitivity. After controlling SES and gestational age, maternal depressive symptoms scores negatively predicted maternal sensitivity scores. CONCLUSION This study pointed out the factors associated with the maternal sensitivity of preterm infants outside the Western context. Interventions to improve sensitive parenting behaviors of preterm infants are needed, especially in socio-economically disadvantaged groups.
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Kokkinaki T, Vasdekis V, Devouche E. Maternal and paternal infant-directed speech to girls and boys: An exploratory study. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2019. [DOI: 10.1080/17405629.2019.1646123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Theano Kokkinaki
- Laboratory of Applied Psychology, Department of Psychology, University of Crete, Rethymno, Greece
| | | | - Emmanuel Devouche
- Laboratoire de Psychopathologie et Processus de Santé, Paris Descartes University, Paris, France
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B T Dau ALBT, Callinan LS, Smith MV. An examination of the impact of maternal fetal attachment, postpartum depressive symptoms and parenting stress on maternal sensitivity. Infant Behav Dev 2019; 54:99-107. [PMID: 30658270 DOI: 10.1016/j.infbeh.2019.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 10/30/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
The current study aimed to examine the impact of maternal depression, maternal fetal attachment (MFA) and parenting stress on maternal sensitivity, intrusiveness and positive regard for the child with a sample of 36 low-income, mothers-infant dyads that were followed from pregnancy through the first year postpartum. Maternal depression and parenting stress were expected to have a negative impact on maternal sensitivity, intrusiveness and positive regard, while high MFA was hypothesized to have a positive impact on these three outcomes. Our data provide partial support for our hypotheses. Findings from this study add to the literature by examining the stability of the maternal prenatal and postpartum bond with her infant as well as by looking at the impact of parenting stress on maternal behaviors and processes that may lead to later attachment security differences, such as maternal sensitivity and responsiveness.
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Affiliation(s)
| | - Laura S Callinan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Megan V Smith
- Child Study Center, Yale School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States.
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Bernard K, Nissim G, Vaccaro S, Harris JL, Lindhiem O. Association between maternal depression and maternal sensitivity from birth to 12 months: a meta-analysis. Attach Hum Dev 2018; 20:578-599. [PMID: 29374991 DOI: 10.1080/14616734.2018.1430839] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Maternal sensitivity plays a central role in shaping children's development across a number of domains, and may be disrupted by depression. The current meta-analysis quantified the magnitude of the association between depression and maternal sensitivity, defined broadly as timely, contingent, and appropriate responding to infants' cues, from birth to 12 months. Across k = 48 studies and n = 4,934 mother-infant dyads, the aggregate effect size between depression and maternal sensitivity was r = -.16, p < .0001, indicating that mothers with higher depression levels were less sensitive than mothers with lower depression levels. Studies that compared a depressed group with a nondepressed/control group had larger effect sizes (r = -.35, p < .0001) than studies that examined depression within a single sample of either unselected cases or clinical-only cases (r = -.11, p < .001), suggesting that clinical levels of depression may pose a particular threat to sensitive parenting. Clinical implications (e.g. screening, prevention) are discussed.
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Affiliation(s)
- Kristin Bernard
- a Department of Psychology , Stony Brook University , Stony Brook , NY, USA
| | - Galia Nissim
- a Department of Psychology , Stony Brook University , Stony Brook , NY, USA
| | - Suzanne Vaccaro
- a Department of Psychology , Stony Brook University , Stony Brook , NY, USA
| | - Jordan L Harris
- b Western Psychiatric Institute and Clinic , University of Pittsburgh Medical Center, PA, USA
| | - Oliver Lindhiem
- c Department of Psychiatry , University of Pittsburgh School of Medicine , PA , USA
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20
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Neri E, Agostini F, Baldoni F, Facondini E, Biasini A, Monti F. Preterm infant development, maternal distress and sensitivity: The influence of severity of birth weight. Early Hum Dev 2017; 106-107:19-24. [PMID: 28189798 DOI: 10.1016/j.earlhumdev.2017.01.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/04/2016] [Accepted: 01/31/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the influence of the severity of prematurity based on birth weight on maternal distress and sensitivity and on infant development. METHODS Sixty-eight mothers and their preterm babies (30 babies classified into Extremely-Low-Birth Weight-ELBW and 38 into Very-Low-Birth Weight-VLBW) were assessed at 9months of infant corrected age, using: Griffiths Scales for infant development, CARE-Index for maternal sensitivity during 5-minute of mother-infant interaction, and Parenting Stress Index-Short Form (PSI-SF) for maternal distress. Sixty-six healthy full-term infants (FT) and their mothers were assessed with the same procedure. RESULTS ELBW, VLBW and FT groups showed similar levels at CARE-Index and PSI-SF. Nevertheless, considering infant development as outcome, a significant interaction between birth weight and maternal distress emerged, with higher Hearing & Language mean quotients in association with Non-Distressed mothers, but only in VLBW infants, compared to FT ones. Also the interaction between birth weight and maternal sensitivity influenced infant development: higher quotients (Eye-hand coordination, Hearing & Language, Locomotor) were significantly associated with sensitive mothers but only in ELBW infants. CONCLUSION The severity of prematurity, in interaction with the degree of maternal distress and sensitivity, influenced the level of infant development. PRACTICAL IMPLICATIONS Taken together, these results suggest the relevance of considering severity of prematurity and maternal variables in order to implement appropriate interventions for supporting parenting role after a preterm birth and promoting an adequate infant development.
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Affiliation(s)
- Erica Neri
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy.
| | - Francesca Agostini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Franco Baldoni
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Elisa Facondini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Augusto Biasini
- Pediatric and Neonatal Intensive Care Unit, Bufalini Hospital, Viale Ghirotti 286, 47521 Cesena, Italy
| | - Fiorella Monti
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
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Guyard A, Michelsen SI, Arnaud C, Fauconnier J. Family adaptation to cerebral palsy in adolescents: A European multicenter study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:138-150. [PMID: 28087202 PMCID: PMC5667745 DOI: 10.1016/j.ridd.2016.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/19/2016] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND AIM Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model. MATERIALS AND METHODS 286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations. RESULTS 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. CONCLUSIONS Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed. WHAT THIS PAPER ADDS Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and financial support as non significant protective factors.
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Affiliation(s)
- Audrey Guyard
- UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France.
| | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1399 Copenhagen, Denmark.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, 31000 Toulouse, France.
| | - Jerome Fauconnier
- UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France.
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Rigby J, Conroy S, Miele-Norton M, Pawlby S, Happé F. Theory of mind as a predictor of maternal sensitivity in women with severe mental illness. Psychol Med 2016; 46:1853-1863. [PMID: 26979486 DOI: 10.1017/s0033291716000337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research has shown that maternal mental illness can affect mother-infant interactions with implications for infant outcomes. Severe and chronic mental illness (SMI), particularly schizophrenia, is associated with the greatest risk. Schizophrenia is also associated with impairments in attribution of mental states, 'theory of mind' (ToM). Recent attachment research has suggested that maternal mentalizing skills are strongly associated with attachment outcome in infants. To date, no research has explored the relationship between ToM and maternal sensitivity in mothers with SMI using standard tests of ToM. The present study was designed as an exploratory study in order to investigate this. METHOD A total of 40 women with SMI in the postpartum period were administered a battery of ToM tasks and general neuropsychological tasks. The women were also filmed in an unstructured play session with their infants, which was coded for maternal sensitivity using the Crittenden CARE-Index. RESULTS One ToM task, the Frith-Happé Animations, predicted maternal sensitivity across all diagnoses. There was also an effect of diagnosis, with lower sensitivity observed in women with schizophrenia. ToM impairments did not fully explain the effect of diagnosis on sensitivity. Mothers of girls were rated as being more sensitive than mothers of boys. CONCLUSIONS The results suggest that ToM is a significant predictor of maternal sensitivity across all mental health diagnoses, extending the results of studies focusing on healthy populations. Clinical interventions emphasizing the importance of understanding the perspective of the infant may enhance maternal sensitivity.
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Affiliation(s)
- J Rigby
- South London and Maudsley NHS Foundation Trust,London,UK
| | - S Conroy
- King's College London, Institute of Psychiatry,Psychology and Neuroscience,London,UK
| | | | - S Pawlby
- King's College London, Institute of Psychiatry,Psychology and Neuroscience,London,UK
| | - F Happé
- King's College London, Institute of Psychiatry, Psychology and Neuroscience,MRC Social, Genetic and Developmental Psychiatry Centre,London,UK
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Vismara L, Rollè L, Agostini F, Sechi C, Fenaroli V, Molgora S, Neri E, Prino LE, Odorisio F, Trovato A, Polizzi C, Brustia P, Lucarelli L, Monti F, Saita E, Tambelli R. Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study. Front Psychol 2016; 7:938. [PMID: 27445906 DOI: 10.3389/fpsyg.2016.00938/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/07/2016] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers' and mothers' postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child's birth; and 2) to explore how each parent's parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. METHOD The sample included 362 parents (181 couples; mothers' M Age = 35.03, SD = 4.7; fathers' M Age = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State-Trait Anxiety Inventory. RESULTS The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent's own levels of anxiety and parenting stress and by the presence of depression in his/her partner. DISCUSSION This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents.
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Affiliation(s)
- Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari Cagliari, Italy
| | - Luca Rollè
- Department of Psychology, University of Torino Torino, Italy
| | | | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari Cagliari, Italy
| | - Valentina Fenaroli
- Department of Psychology, University Cattolica del Sacro Cuore Milano, Italy
| | - Sara Molgora
- Department of Psychology, University Cattolica del Sacro Cuore Milano, Italy
| | - Erica Neri
- Faculty of Psychology, University of Bologna Bologna, Italy
| | - Laura E Prino
- Department of Psychology, University of Torino Torino, Italy
| | - Flaminia Odorisio
- Department of Psychology, University Cattolica del Sacro Cuore Milano, Italy
| | - Annamaria Trovato
- Department of Dynamic and Clinical Psychology, Sapienza University of Roma Roma, Italy
| | - Concetta Polizzi
- Department of Psychological, Educational and Training Sciences, University of Palermo Palermo, Italy
| | - Piera Brustia
- Department of Psychology, University of Torino Torino, Italy
| | - Loredana Lucarelli
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari Cagliari, Italy
| | - Fiorella Monti
- Faculty of Psychology, University of Bologna Bologna, Italy
| | - Emanuela Saita
- Department of Psychology, University Cattolica del Sacro Cuore Milano, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Roma Roma, Italy
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Vismara L, Rollè L, Agostini F, Sechi C, Fenaroli V, Molgora S, Neri E, Prino LE, Odorisio F, Trovato A, Polizzi C, Brustia P, Lucarelli L, Monti F, Saita E, Tambelli R. Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study. Front Psychol 2016; 7:938. [PMID: 27445906 PMCID: PMC4919353 DOI: 10.3389/fpsyg.2016.00938] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/07/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers' and mothers' postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child's birth; and 2) to explore how each parent's parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. METHOD The sample included 362 parents (181 couples; mothers' M Age = 35.03, SD = 4.7; fathers' M Age = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State-Trait Anxiety Inventory. RESULTS The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent's own levels of anxiety and parenting stress and by the presence of depression in his/her partner. DISCUSSION This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents.
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Affiliation(s)
- Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of CagliariCagliari, Italy
| | - Luca Rollè
- Department of Psychology, University of TorinoTorino, Italy
| | | | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of CagliariCagliari, Italy
| | - Valentina Fenaroli
- Department of Psychology, University Cattolica del Sacro CuoreMilano, Italy
| | - Sara Molgora
- Department of Psychology, University Cattolica del Sacro CuoreMilano, Italy
| | - Erica Neri
- Faculty of Psychology, University of BolognaBologna, Italy
| | - Laura E. Prino
- Department of Psychology, University of TorinoTorino, Italy
| | - Flaminia Odorisio
- Department of Psychology, University Cattolica del Sacro CuoreMilano, Italy
| | - Annamaria Trovato
- Department of Dynamic and Clinical Psychology, Sapienza University of RomaRoma, Italy
| | - Concetta Polizzi
- Department of Psychological, Educational and Training Sciences, University of PalermoPalermo, Italy
| | - Piera Brustia
- Department of Psychology, University of TorinoTorino, Italy
| | - Loredana Lucarelli
- Department of Pedagogy, Psychology, Philosophy, University of CagliariCagliari, Italy
| | - Fiorella Monti
- Faculty of Psychology, University of BolognaBologna, Italy
| | - Emanuela Saita
- Department of Psychology, University Cattolica del Sacro CuoreMilano, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of RomaRoma, Italy
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Reck C, Zietlow AL, Müller M, Dubber S. Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding. Arch Womens Ment Health 2016; 19:473-82. [PMID: 26592705 DOI: 10.1007/s00737-015-0590-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/15/2015] [Indexed: 11/30/2022]
Abstract
Research investigating maternal bonding and parenting stress in the course of postpartum depression is lacking. Aim of the study was to investigate the development and potential mediation of both constructs in the course of postpartum depression. n = 31 mothers with postpartum depression according to DSM-IV and n = 32 healthy controls completed the German version of the Postpartum Bonding Questionnaire and the Parenting Stress Index at two measuring times: acute depression (T1) and remission (T2). At T1, the clinical group reported lower bonding and higher parenting stress. Bonding was found to partially mediate the link between maternal diagnosis and parenting stress. Furthermore, the clinical group reported lower bonding and higher parenting stress averaged over both measurement times. However, at T2, the clinical group still differed from the controls even though they improved in bonding and reported less parenting stress. A significant increase of bonding was also observed in the control group. Maternal bonding seems to buffer the negative impact of postpartum depression on parenting stress. The results emphasize the need for interventions focusing on maternal bonding and mother-infant interaction in order to prevent impairment of the mother-child relationship.
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Affiliation(s)
- C Reck
- Department of Psychology, Ludwig-Maximilians-University München, Leopoldstr. 13, 80802, Munich, Germany.
| | - A-L Zietlow
- Center for Psychosocial Medicine, Heidelberg University Hospital, Voßstr. 2, 69115, Heidelberg, Germany
| | - M Müller
- Department of Psychology, Ludwig-Maximilians-University München, Leopoldstr. 13, 80802, Munich, Germany
| | - S Dubber
- Center for Psychosocial Medicine, Heidelberg University Hospital, Voßstr. 2, 69115, Heidelberg, Germany
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Frühe Hilfen und kindliche kognitive Entwicklung: Eine längsschnittliche Pilotuntersuchung psychosozial belasteter Mutter-Kind-Paare in der frühen Kindheit. Prax Kinderpsychol Kinderpsychiatr 2016; 65:340-53. [DOI: 10.13109/prkk.2016.65.5.340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Szaniecki E, Barnes J. Measurement Issues: Measures of infant mental health. Child Adolesc Ment Health 2016; 21:64-74. [PMID: 32680360 DOI: 10.1111/camh.12105] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emotional and behavioural problems emerging in very young children can represent a challenge to the child and family and warrant early identification and appropriate support or intervention. Diagnostic systems are being developed that allow for specific difficulties to be identified and this review summarizes them. SCOPE This evidenced based review describes the psychometric properties and potential for use in clinical practice of a range of instruments and methods that are available to identify infant mental health difficulties, and which may be suitable for use in primary care settings, including observations, questionnaires and checklists. FINDINGS AND CONCLUSION While debate continues about whether infant mental health problems can or should be identified, the use of standardized tools may help clinicians to compare observations of infants so that those emerging as atypical can receive additional attention, reflecting a more targeted approach to primary care services.
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Affiliation(s)
| | - Jacqueline Barnes
- Institute for the Study of Children, Families and Social Issues, Birkbeck, University of London, London, UK
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Riva Crugnola C, Ierardi E, Ferro V, Gallucci M, Parodi C, Astengo M. Mother-Infant Emotion Regulation at Three Months: The Role of Maternal Anxiety, Depression and Parenting Stress. Psychopathology 2016; 49:285-294. [PMID: 27410251 DOI: 10.1159/000446811] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/08/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND While the association between anxiety and postpartum depression is well known, few studies have investigated the relationship between these two states and parenting stress. Furthermore, a number of studies have found that postpartum depression affects mother-infant emotion regulation, but there has been only one study on anxiety and emotion regulation and no studies at all on parenting stress and emotion regulation. Therefore, the primary aim of our study is to identify, in a community sample of 71 mothers, the relationship between maternal depression, anxiety, and parenting stress. The second aim is to examine the relationship between anxiety, postpartum depression, and parenting stress and mother-infant emotion regulation assessed at 3 months. METHODS Mother-infant interaction was coded with a modified version of the Infant Caregiver and Engagement Phases (ICEP) using a microanalytic approach. The Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), and Parenting Stress Index-Short Form (PSI-SF) were administered to the mothers to assess depression, anxiety, and parenting stress, respectively. RESULTS Analysis revealed correlations between anxiety and depression, showing that parenting stress is associated with both states. In a laboratory observation, depression was correlated with both negative maternal states and negative dyadic matches as well as infant positive/mother negative mismatches; anxiety was correlated with both negative maternal states and infant negative states as well as mismatches involving one of the partners having a negative state. Multiple regression analysis showed that anxiety is a greater predictor than depression of less adequate styles of mother-infant emotion regulation. Parenting stress was not shown to predict such regulation.
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Brockington I. Emotional Rejection of the Infant: Status of the Concept. Psychopathology 2016; 49:247-260. [PMID: 27583348 DOI: 10.1159/000448334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/11/2016] [Indexed: 11/19/2022]
Abstract
Emotional rejection of the infant is a morbid, clinical phenomenon, central to mother-infant psychiatry. It occurs in about 1% of births in the general population, but much more often in mothers referred to specialist services. It has severe consequences for children, but responds well to treatment. It is now better recognized, but research is required, especially cohort studies and neuroscientific investigations.
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Affiliation(s)
- Ian Brockington
- Professor Emeritus, University of Birmingham, Birmingham, UK
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Sidor A, Kunz E, Eickhorst A, Cierpka M. Wirksamkeit des Präventionsprojekts „Keiner fällt durchs Netz“ (KfdN) in Modellprojektstandorten im Saarland. ZEITSCHRIFT FUR ENTWICKLUNGSPSYCHOLOGIE UND PADAGOGISCHE PSYCHOLOGIE 2016. [DOI: 10.1026/0049-8637/a000139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Ziel der Studie war es, die Wirksamkeit des Präventionsprojekts „Keiner fällt durchs Netz“ zur Unterstützung risikobelasteter Familien in Saarland zu evaluieren. Die Stichprobe von 182 Mutter-Kind-Dyaden setzte sich aus 91 risikobelasteten Dyaden, die am Präventionsprojekt teilnahmen und 91 risikobelasteten Dyaden aus Kontrollfamilien zusammen. Ergebnisse: Der erwartete bessere Entwicklungsstand der Kinder in der Treatmentgruppe nach der Intervention im Vergleich zu den Kindern aus der Kontrollgruppe konnte im Bereich der sozialen Entwicklung bestätigt werden (d = 0.53). Zudem schätzten die Mütter in der KfdN-Gruppe ihre einjährigen Kinder tendenziell als weniger temperamentsschwierig ein (d = 0.18). Interventionseffekte im Bereich mütterlicher Feinfühligkeit, Stressbelastung und depressiver Symptomatik waren nicht nachweisbar. Fazit: Die Intervention hat einen positiven Effekt auf die kindliche soziale Entwicklung und die elterliche Wahrnehmung des kindlichen Temperaments. Der ausbleibende Interventionseffekt im Bereich der mütterlichen Feinfühligkeit legt eine stärkere Berücksichtigung dieses Aspektes in der Konzeption des Projekts nahe.
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Affiliation(s)
- Anna Sidor
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Elisabeth Kunz
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | | | - Manfred Cierpka
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
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Logsdon MC, Mittelberg M, Morrison D, Robertson A, Luther JF, Wisniewski SR, Confer A, Eng H, Sit DKY, Wisner KL. Theoretical approaches to maternal-infant interaction: which approach best discriminates between mothers with and without postpartum depression? Arch Psychiatr Nurs 2014; 28:384-8. [PMID: 25457688 PMCID: PMC7043928 DOI: 10.1016/j.apnu.2014.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 07/01/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The purpose of this study was to determine which of the four common approaches to coding maternal-infant interaction best discriminates between mothers with and without postpartum depression. METHODS After extensive training, four research assistants coded 83 three minute videotapes of maternal infant interaction at 12month postpartum visits. Four theoretical approaches to coding (Maternal Behavior Q-Sort, the Dyadic Mini Code, Ainsworth Maternal Sensitivity Scale, and the Child-Caregiver Mutual Regulation Scale) were used. Twelve month data were chosen to allow the maximum possible exposure of the infant to maternal depression during the first postpartum year. The videotapes were created in a laboratory with standard procedures. Inter-rater reliabilities for each coding method ranged from .7 to .9. The coders were blind to depression status of the mother. RESULTS Twenty-seven of the women had major depressive disorder during the 12month postpartum period. Receiver operating characteristics analysis indicated that none of the four methods of analyzing maternal infant interaction discriminated between mothers with and without major depressive disorder. CONCLUSION Limitations of the study include the cross-sectional design and the low number of women with major depressive disorder. Further analysis should include data from videotapes at earlier postpartum time periods, and alternative coding approaches should be considered. Nurses should continue to examine culturally appropriate ways in which new mothers can be supported in how to best nurture their babies.
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Affiliation(s)
- M Cynthia Logsdon
- School of Nursing, University of Louisville and University of Louisville Hospital/Brown Cancer Center, Louisville, KY.
| | - Meghan Mittelberg
- Betty and David Jones Undergraduate Scholar, School of Nursing, University of Louisville, Louisville, KY.
| | | | | | | | | | - Andrea Confer
- University of Pittsburgh Medical Center, Pittsburgh, PA.
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Thomason E, Volling BL, Flynn HA, McDonough SC, Marcus SM, Lopez JF, Vazquez DM. Parenting stress and depressive symptoms in postpartum mothers: bidirectional or unidirectional effects? Infant Behav Dev 2014; 37:406-15. [PMID: 24956500 DOI: 10.1016/j.infbeh.2014.05.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 04/04/2014] [Accepted: 05/26/2014] [Indexed: 11/28/2022]
Abstract
Despite the consistent link between parenting stress and postpartum depressive symptoms, few studies have explored the relationships longitudinally. The purpose of this study was to test bidirectional and unidirectional models of depressive symptoms and parenting stress. Uniquely, three specific domains of parenting stress were examined: parental distress, difficult child stress, and parent-child dysfunctional interaction (PCDI). One hundred and five women completed the Beck Depression Inventory and the Parenting Stress Index - Short Form at 3, 7, and 14 months after giving birth. Structural equation modeling revealed that total parenting stress predicted later depressive symptoms, however, there were different patterns between postpartum depressive symptoms and different types of parenting stress. A unidirectional model of parental distress predicting depressive symptoms best fit the data, with significant stability paths but non-significant cross-lagged paths. A unidirectional model of depressive symptoms predicted significant later difficult child stress. No model fit well with PCDI. Future research should continue to explore the specific nature of the associations of postpartum depression and different types of parenting stress on infant development and the infant-mother relationship.
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Affiliation(s)
- Elizabeth Thomason
- University of Michigan, School of Social Work, Ann Arbor, MI, United States.
| | - Brenda L Volling
- University of Michigan, Center for Human Growth and Development, Ann Arbor, MI, United States
| | - Heather A Flynn
- Florida State University, College of Medicine in the Department of Behavioral Sciences and Social Medicine, Tallahassee, FL, United States
| | - Susan C McDonough
- University of Michigan, School of Social Work, Ann Arbor, MI, United States
| | - Sheila M Marcus
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, United States
| | - Juan F Lopez
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, United States
| | - Delia M Vazquez
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, United States
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Horowitz JA, Murphy CA, Gregory K, Wojcik J, Pulcini J, Solon L. Nurse home visits improve maternal/infant interaction and decrease severity of postpartum depression. J Obstet Gynecol Neonatal Nurs 2014; 42:287-300. [PMID: 23682696 DOI: 10.1111/1552-6909.12038] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To test the efficacy of the relationship-focused behavioral coaching intervention Communicating and Relating Effectively (CARE) in increasing maternal/infant relational effectiveness between depressed mothers and their infants during the first 9 months postpartum. DESIGN Randomized clinical trial (RCT) with three phases. METHODS In this three-phase study, women were screened for postpartum depression (PPD) in Phase I at 6 weeks postpartum. In Phase II, women were randomly assigned to treatment or control conditions and maternal/infant interaction was video recorded at four intervals postpartum: 6 weeks, 3 months, 6 months, and 9 months. Phase III involved focus group and individual interviews with study participants. SETTING Phase I mothers were recruited from obstetric units of two major medical centers. Phase II involved the RCT, a series of nurse-led home visits beginning at 6 weeks and ending at 9 months postpartum. Phase III focus groups were conducted at the university and personal interviews were conducted by telephone or in participants' homes. PARTICIPANTS Postpartum mother/infant dyads (134) representative of southeastern New England, United States participated in the RCT. One hundred and twenty-five mother/infant dyads were fully retained in the 9-month protocol. RESULTS Treatment and control groups had significant increases in quality of mother/infant interaction and decreases in depression severity. Qualitative findings indicated presence of the nurse, empathic listening, focused attention and self-reflection during data collection, directions for video-recorded interaction, and assistance with referrals likely contributed to improvements for both groups. CONCLUSIONS Efficacy of the CARE intervention was only partially supported. Nurse attention given to the control group and the data collection process likely confounded results and constituted an unintentional treatment. Results suggest that nurse-led home visits had a positive effect on outcomes for all participants.
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Affiliation(s)
- June Andrews Horowitz
- Boston College, W. F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
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[Assessing risk exposure in families within the scope of early intervention: the Heidelberg Stress scale (HBS) and its quality criteria]. Prax Kinderpsychol Kinderpsychiatr 2013; 61:766-80. [PMID: 23367808 DOI: 10.13109/prkk.2012.61.10.766] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the study presented is to introduce the newly developed instrument to assess stress, the Heidelberg Stress Scale (Heidelberger Belastungsskala--HBS), and to examine its psychometric characteristics. The HBS was developed for a low-threshold and multi-professional assessment of a family's stresses and resources after the birth of a child. The HBS can be used in the outreach work of family midwives, for instance, as well as in research. The validity of the HBS was tested in a sample of 284 psychosocially stressed families after the birth of their child; the inter-rater reliability was tested in a sample of 41 families that were also in stress. The HBS exhibits an excellent inter-rater reliability within a homogeneous professional group (psychology students). As relates to the construct validity, a strong positive connection between the HBS and Kindler's screening sheet was found; the HBS exhibits a negative correlation with maternal sensitivity and a positive correlation with maternal stress level. With a high level of stress in the HBS, the risk of taking the child into care is increased by 4.5 times; the sensitivity amounts to 63.6%. The quality criteria are satisfactory.
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Sidor A, Kunz E, Eickhorst A, Cierpka M. Effects of the Early Prevention Program “Keiner FÄllt Durchs Netz” (“Nobody Slips Through the Net”) on Child, Mother, and Their Relationship: A Controlled Study. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21362] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anna Sidor
- Institute for Psychosomatic Cooperative Research and Family Therapy; University Hospital Heidelberg
| | - Elisabeth Kunz
- Institute for Psychosomatic Cooperative Research and Family Therapy; University Hospital Heidelberg
| | - Andreas Eickhorst
- Institute for Psychosomatic Cooperative Research and Family Therapy; University Hospital Heidelberg
| | - Manfred Cierpka
- Institute for Psychosomatic Cooperative Research and Family Therapy; University Hospital Heidelberg
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Prevalence and predictors of postpartum depression among Arabic Muslim Jordanian women serving in the military. J Perinat Neonatal Nurs 2013; 27:25-33; quiz 34-5. [PMID: 23360938 DOI: 10.1097/jpn.0b013e31827ed6db] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this cross-sectional correlational study was to investigate the prevalence of symptoms and psychosocial predictors of postpartum depression (PPD) among Arabic Muslim Jordanian women serving in the military. Jordanian active-duty military women who had given birth within the last year (n = 300) and were working in 4 military hospitals participated in the study. Tools used included the Edinburgh Postnatal Depression Scale, the Impact of Event Scale-Revised, and the Multidimensional Perception of Social Support. Sixty-seven percent of study participants had mild to moderate symptoms of PPD, and 16% had high levels of symptoms of PPD. Seventy-five percent reported having adequate social support, and 75% reported perceived stress above the cutoff score. There was a strong positive significant relationship between symptoms of PPD and perceptions of stress. There was a significant moderate negative relationship between symptoms of PPD and perception of social support. Income, intendedness of pregnancy, mode of birth, family social support, and perception of stress were the strongest predictors of PPD. There was a reciprocal relationship between PPD and psychosocial variables, with women having low levels of perceived stress and satisfaction with social support having fewer symptoms of postpartum. These findings demonstrate the need to address the psychosocial needs of Arabic Muslim Jordanian childbearing women serving in the military through comprehensive interventions. Findings highlight the importance of social support in decreasing perceived stress and symptoms of PPD in these women.
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Sidor A, Thiel-Bonney C, Kunz E, Eickhorst A, Cierpka M. Das exzessive Schreien bei 5 Monate alten Säuglingen und prä-, peri- und postnatale Belastungen ihrer Mütter in einer Hoch-Risiko-Stichprobe. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2012; 40:239-50. [DOI: 10.1024/1422-4917/a000177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Fragestellung: Zusammenhänge zwischen persistierendem, exzessivem Schreien des Säuglings im fünften Lebensmonat und den prä- und perinatalen Belastungen sowie der postnatalen Befindlichkeit ihrer Mütter zu untersuchen. Methodik: Alle Daten wurden erhoben, als die Kinder im Durchschnitt 18.5 Wochen alt waren. Die Stichprobe von 300 Mutter-Kind-Dyaden war durch psychosoziale Risiken wie Armut, Mangel an sozialer Unterstützung, Minderjährigkeit der Mütter, Substanzmissbrauch oder psychische Störungen der Mutter belastet. Das exzessive Schreien wurde nach der Wessel-Regel erfasst, für die Erhebung von prä-, peri- und postnatalen Belastungen wurden Fragebögen vorgelegt. Ergebnisse: Multivariate Analysen zeigten ein erhöhtes Risiko für soziale Belastung in der Schwangerschaft (OR = 17.66) und für eine unerwünschte Schwangerschaft (OR = 13.77). Postnatal war das persistierende exzessive Schreien mit höheren Ausprägungen einer postpartalen depressiven Symptomatik der Mutter, mütterlicher Stressbelastung, Dysfunktionalität der Mutter-Kind-Interaktion, dem Wahrnehmen des Säuglings als «schwierig» sowie mit Schwierigkeiten bei der emotionalen Beziehungsaufnahme assoziiert. Schlussfolgerungen: Die Ergebnisse unterstreichen den Einfluss erhöhter pränataler Stressbelastung der Mütter und einer unerwünschten Schwangerschaft auf das persistierende exzessive Schreien der Säuglinge. Ein herabgesetztes Wohlbefinden der Mütter sowie ihre Schwierigkeiten bei der emotionalen Beziehungsaufnahme implizieren einen erhöhten Bedarf an Unterstützungsangeboten. Das Zusammenwirken von pränatalen und Beziehungsvariablen spielt eine Rolle für das Auftreten und die Aufrechterhaltung von frühen Regulationsproblemen.
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Affiliation(s)
- Anna Sidor
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Consolata Thiel-Bonney
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Elisabeth Kunz
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Andreas Eickhorst
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Manfred Cierpka
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
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Lagerberg D, Magnusson M. Infant gender and postpartum sadness in the light of region of birth and some other factors: a contribution to the knowledge of postpartum depression. Arch Womens Ment Health 2012; 15:121-30. [PMID: 22382282 DOI: 10.1007/s00737-012-0265-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 02/14/2012] [Indexed: 11/30/2022]
Abstract
The purpose of this paper is to analyse postpartum depressive symptoms as related to baby gender, maternal region of birth, stress, perception of child difficult temperament and some demographic factors. The setting was 36 Swedish child health centres. Mothers of 1,848 19-month-old children completed a questionnaire, including an item about recall of postpartum sadness. A subsample of 360 answered the Edinburgh Postnatal Depression Scale (EPDS). Overall, significantly more mothers of boys than of girls recalled postpartum sadness. The same was found in mothers born in Sweden and in other regions, except for the Middle East (no significant result). Among those born in Sweden and in other regions, more mothers of boys than of girls scored ≥12 on the EPDS, except for Middle East mothers with the opposite pattern (no significant finding). More mothers of "difficult" boys than of "difficult" girls recalled postpartum sadness. Our findings are tentative but may inspire future research. Immigrant mothers in Sweden seem rather like the majority population, possibly with the exception of Middle East mothers. The significance of parents' knowledge of their child's gender in advance is an important area for research. Future parents could benefit from discussing gender expectations with a nurse or other professional.
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Affiliation(s)
- Dagmar Lagerberg
- Department of Women's and Children's Health, Section for Paediatrics, University Children's Hospital, Uppsala, Sweden.
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