Do Maternal Self-Criticism and Symptoms of Postpartum Depression and Anxiety Mediate the Effect of History of Depression and Anxiety Symptoms on Mother-Infant Bonding? Parallel-Serial Mediation Models

Assessing Parent-Infant Bonding in a Community Perinatal Mental Health Service

OBJECTIVES

Perinatal mental health (PMH) services support the mental health needs of women and birthing people in pregnancy and postnatal, alongside the developing relationship between parent and infant. Mental health symptoms in PMH services are routinely screened for, yet there are inconsistencies in whether parent-infant bond is assessed and how. The aim of this study is to assess the predictive validity of screening for parent-infant bonding difficulties (Postpartum Bonding Questionnaire (PBQ)) and psychopathology (CORE-10) to predict patient outcomes at discharge from a PMH service.

METHODS

Secondary analysis of clinical data from a PMH service in Birmingham, United Kingdom, encompassed 948 patient records. A structural equation model was constructed on patient data containing PBQ and CORE-10 scores recorded at initial assessment and discharge from the service.

RESULTS

Analysis revealed a significant decrease in bonding difficulties and psychopathology scores from initial assessment to discharge from the service. The predictive model showed CORE-10 scores at discharge were predicted by both initial CORE-10 and PBQ scores, whereas PBQ scores at discharge were predicted solely by initial PBQ scores. Demographic factors including age, parity and ethnicity did not present any direct association with psychopathology or bonding difficulties at either timepoint.

CONCLUSIONS

This analysis provides evidence of a pathway between early parent-infant bond and later psychopathology symptoms, which exists independently from the pathway between psychopathology symptoms at intake and discharge alone. These findings support embedding self-report assessments of parent-infant bond, in addition to measures of psychopathology, to better predict patient outcomes at discharge from a PMH service.

Understanding Parenting Stress in Adoptive Parents: A Longitudinal Multilevel Study of Parents' Self-Criticism, Child Negative Emotionality, and Child Age at Placement

INTRODUCTION

Research on parenting stress in adoptive parents during the early years post-placement reveals significant variability, yet few studies examine both parent- and child-related factors. This study investigates the role of the personality dimension of self-criticism and perceived negative child emotionality in relation to parenting stress during the first four years after transnational adoption. Additionally, it explores the moderating effect of child age at placement, a key factor associated with early adversity.

METHODS

Drawing upon a longitudinal five-wave dataset in the first 4 years after the child arrived in the adoptive family, this study used multi-informant data of 96 adoptive mothers and fathers of transnationally adopted children (mean child age at placement = 13.48 months). Data were analyzed using a multilevel structural equation modeling approach.

RESULTS

Parents' self-criticism was positively associated with parenting stress at the between-parent level. At the within-parent level, year-to-year fluctuations in both parents' self-criticism and perceived child's negative emotionality were positively associated with corresponding fluctuations in parenting stress. Child age at placement did not moderate any of these associations.

CONCLUSIONS

Overall, this study yielded convincing evidence for the dynamic nature of parenting stress in the first years after child placement, the role of parental self-criticism, and the child's perceived negative emotionality herein.

A very, very lonely, unmagical time. The lived experience of perinatal anxiety: A longitudinal interpretative phenomenological analysis

PROBLEM

Minimal longitudinal qualitative evidence examining lived experience of anxiety over the perinatal continuum limits holistic understanding of the course of antenatal and postnatal anxiety.

BACKGROUND

Perinatal anxiety has deleterious effects on the mother and infant and is more commonly experienced yet less well investigated than perinatal depression.

AIM AND METHOD

To explore women's experiences living with perinatal anxiety to increase understanding of the condition; inform support given by midwives and other health professionals and provide practice, education, and research recommendations. Five women were interviewed at three timepoints, producing 15 datasets. Data was analysed using longitudinal interpretative phenomenological analysis.

FINDINGS

Nine Group Experiential Themes emerged: the anxious mother, transformation, sets of ears and the anxious pregnancy (antenatal); baby as external focus, returning to oneself and the emotional unknown (early postnatal); and moving on, and shifting sands (late postnatal). Three Longitudinal Experiential Concepts explicated lived experience over time: maternal eyes, transforming existence, and emotional kaleidoscope. The lived experience of perinatal anxiety was revealed as socially constructed, with relationships with self, others, and the world key. The collision between anxiety and motherhood as social constructs provides perinatal anxiety with its unique characteristics.

CONCLUSION

Midwives and other healthcare professionals should understand the significance of perinatal anxiety, enabling disclosure of stigmatising and uncomfortable feelings without judgement. Research examining whether perinatal specific screening tools should be used by midwives and exploring the relationship between perinatal anxiety and depression is recommended. Education for clinicians on the significance of perinatal anxiety is essential.

"Little by little, I started feeling I am unable to handle my child alone" - Lived experiences of mothers with postpartum depression and anxiety

Background

Anxiety and depression during the postpartum period can have a significant impact on mothers' perceived sense of responsive caregiving, causing considerable distress. This association may be affected by mothers' perception about social support. In the context of low-and-middle-income countries where prevalence rates of maternal mental illnesses are high and access to health care services is limited, informal supports become more relevant.

Aim

The study aims to understand the lived experience of mothers who had postpartum depression or anxiety and their perceived distress related to infant care giving. It also explores the role of social support in the motherhood experience.

Methods

Six mothers with postpartum depression or anxiety were interviewed to understand their experience of postpartum depression and/or anxiety and their perceptions about social support. The interviews were analyzed using a reflexive thematic analysis approach.

Results

The thematic analysis revealed four themes, namely, (a) uncertainty and helplessness, (b) misattunement with the immediate family, (c) personal strength rooted in the family support system, and (d) other means of coping. Mothers with postpartum anxiety and depression can have emotional, informational, and tangible social support needs in the context of uncertainty and helplessness, which are associated with different challenges and barriers for infant care in the Indian context.

Conclusion

Support from family members is viewed as a pillar of comfort and recovery for the mothers. At the same time, if it is not adequately attuned to the needs of the mother, it can become a major source of distress.

Revisiting Carl Jung's archetype theory a psychobiological approach

This paper delves into the concept of archetypes, universal patterns of behavior and cognition, and proposes a novel tripartite model distinguishing between structural, regulatory, and representational archetypes. Drawing on insights from code biology, neuroscience, genetics, and epigenetics, the model provides a nuanced framework for understanding archetypes and their role in shaping cognition and behavior. The paper also explores the interplay between these elements to express representational archetypes. Furthermore, it addresses the informational capacity of the genome and its influence on post-natal development and the psyche. The paper concludes by discussing the future trajectory of psychology, emphasizing the need for an integrative approach that combines our understanding of social constructs with insights into our inherent organizational propensities or archetypes. This exploration holds the potential to advance our understanding of the human condition.

Postpartum Maternal Emotional Disorders and the Physical Health of Mother and Child

Purpose

The purpose of this study is to identify the relationships between postpartum emotional manifestations and various neonatal variables, as well as variables within this category, in the context of hospitalization together after birth.

Patients and Methods

Between 1 March 2020 and 1 September 2020, a cross-sectional research design was used including mother–child couples (112 mothers, 121 newborns - 13 twins/triplets).

Results

Using a t-test for independent samples, we observed: a) the symptoms of depression were more severe in mothers of newborns hospitalized in neonatal intensive care units (NICUs) [t(110) = 4.334)], provided oxygen therapy [t(109.99) = 3.162], born prematurely [t(110) = 3.157], or with adjustment disorders [t(109) = −2.947] (p < 0.01); b) a similar, for anxiety as a state [t(82.38) = 5.251], t(107.29) = 4.523, t(110) = 3.416, t(109) = −3.268, p < 0.01], and as a trait was more common [t(80.79) = 4.501, t(108.790) = 4.669, t(109) = −3.268, p < 0.001] compared to other mothers. Using Pearson’s test (p < 0.001), several very strong correlations were observed between neonatal variables, including number (no.) of days of hospitalization with birth weight (BW) (r = −0.802), head circumference (HC) (r = −0.822), and gestational age (GA) (r = −0.800) and the mother’s postpartum anxiety as a state/trait (r = 0.770). Using Poisson regression, it was observed that anxiety as a state (Λ = 0.020, z = 4.029, p < 0.001) and as a trait (Λ = 0.800, z = 6.160, p < 0.001) stimulated the intensity of symptoms of postpartum depression (optimal models).

Conclusion

Postpartum maternal psychological manifestations were associated with NICU hospitalization, pathology, and some neonatal therapies. We also noticed, that the duration of hospitalization, BW, HC, and GA, were correlated with maternal emotional disorders. Results will facilitate future optimization of birth management and postnatal care.