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Spratling R, Ali SZ, Faulkner MS, Feinberg I, Hayat MJ. Enhancing caregivers self-management for their children who require medical technology: A feasibility study for the COPE-STAR intervention. J Pediatr Nurs 2024; 75:23-30. [PMID: 38096760 DOI: 10.1016/j.pedn.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE To test feasibility of the Creating Opportunities for Personal Empowerment: Symptom and Technology Management Resources intervention for caregivers of children who require medical technologies of tracheostomies and feeding tubes. DESIGN AND METHODS Quasi-experimental one group design with measures at baseline and at 4 weeks. Intervention feasibility was tested from August 2019-June 2021, including recruitment, retention, and adherence, and caregiver satisfaction. Caregiver and child characteristics and outcomes were assessed. RESULTS Caregivers were enrolled (n = 22) and completed (n = 16) the study. Caregivers were primarily female (n = 21), were predominately Caucasian (n = 14, 64%) followed by African-American (n = 8, 36%), and Non-Hispanic/Latino (n = 18, 82%). Feasibility indicators of recruitment (92%), retention (73%), and adherence (100%) were satisfactory. Outcome measures of management of child's chronic condition, caregiver beliefs about managing their child's symptoms and medical technology, anxiety, and depressive symptoms remained stable. Caregivers agreed that the intervention was useful, easy to use, and acceptable, and had positive feedback. CONCLUSIONS This is a feasible and acceptable intervention. With further development and efficacy testing, the intervention has potential for use and expansion to a larger population of caregivers of children who require medical technology. PRACTICE IMPLICATIONS Children who require medical technology have multiple complex chronic conditions and complex care needs at home. This intensive and focused care is provided by informal caregivers who need education and resources for their child's care. This intervention addressed caregiver management of common symptoms and medical technologies of children in the home setting.
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Affiliation(s)
- Regena Spratling
- Professor, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Room 950, Atlanta, GA 30303, USA.
| | - Syeda Zahra Ali
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Melissa Spezia Faulkner
- Adjunct Professor, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, USA.
| | - Iris Feinberg
- Associate Director, Adult Literacy Research Center, College of Education and Human Development, Georgia State University, USA.
| | - Matthew J Hayat
- Chair & Professor of Biostatistics, Department of Population Health Sciences, School of Public Health, Byrdine F. Lewis College of Nursing & Health Professions (Joint), Georgia State University, USA.
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Millard LA, Wittkowski A. Compassion focused therapy for women in the perinatal period: a summary of the current literature. Front Psychiatry 2023; 14:1288797. [PMID: 38179247 PMCID: PMC10766363 DOI: 10.3389/fpsyt.2023.1288797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Compassion focused therapy (CFT) is emerging as an effective psychological intervention to treat those experiencing mental health difficulties. CFT was adapted for women who are mothers during the perinatal period (from conception to 2 year postpartum). Although CFT is being delivered in NHS perinatal mental health services in the United Kingdom (UK), its current evidence-base for the treatment of women's mental health problems is unclear. As part of this Mini Review, we aimed to identify the current findings relating to CFT for women in the perinatal period (with or without a mental health condition) in order to identify any associated future research and clinical implications. Method A systematic search of two databases was undertaken. Included studies were required to meet the following criteria: (1) offered an intervention using CFT or perinatal CFT (P-CFT), (2) participants were women in the perinatal period, and (3) studies used a pre- and post-intervention study design. No language restrictions were used. A narrative synthesis was then conducted. Results Five studies, dating from 2018 to 2023, met the inclusion criteria. A total of 1,258 participants were included across those studies. Significant improvements in compassion-based outcomes (i.e., self-compassion, self-criticism/self-reassurance) were observed. However, these findings were primarily derived from non-clinical samples (n = 4) and could only be seen as preliminary. Conclusion Although these results are encouraging for mothers presenting with sub-clinical mental health symptoms, further research is clearly warranted to determine whether CFT/P-CFT may benefit mothers, including those presenting with more significant perinatal mental health difficulties.
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Affiliation(s)
- Leah Alice Millard
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
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Dekel S, Papadakis JE, Quagliarini B, Pham CT, Pacheco-Barrios K, Hughes F, Jagodnik KM, Nandru R. Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis. Am J Obstet Gynecol 2023:S0002-9378(23)02137-3. [PMID: 38122842 DOI: 10.1016/j.ajog.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder. DATA SOURCES PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials were searched for eligible trials published through September 2023. STUDY ELIGIBILITY CRITERIA Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English. METHODS Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. RESULTS A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists. CONCLUSION Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biologic measures can inform treatment use and the mechanisms at work.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Joanna E Papadakis
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Beatrice Quagliarini
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Christina T Pham
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Francine Hughes
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kathleen M Jagodnik
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rasvitha Nandru
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Williams ME, Strobino DM, Holliday CN. Measuring post-traumatic stress after childbirth: a review and critical appraisal of instruments. J Reprod Infant Psychol 2023; 41:599-613. [PMID: 35083966 PMCID: PMC9325923 DOI: 10.1080/02646838.2022.2030052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Addressing psychological trauma after childbirth requires accurate measurement of its prevalence, risk factors, and outcomes using validated instruments that distinguish perceptions of traumatic birth, subclinical post-traumatic stress (PTS) symptoms, and symptoms meeting a diagnostic threshold. OBJECTIVE The purpose of this study was to review literature on psychological trauma following childbirth and appraise instruments that measure postpartum PTS. METHODS In January 2020, the authors searched for and evaluated peer-reviewed studies that quantitatively measured PTS following hospital-based live births in the United States, United Kingdom, Canada, Australia, Norway, Sweden, and Switzerland; 37 articles were selected and evaluated. RESULTS Levels of post-traumatic stress disorder were most commonly measured, followed by PTS symptoms. Diagnostic instruments suggested lower PTS prevalence estimates than those screening for or assessing PTS symptoms. Community samples yielded lower prevalence estimates than samples recruited from the internet or settings specifically addressing mental health. Measurement sooner after birth yielded higher estimates. CONCLUSION Study design, sample characteristics, instruments, and timing of measurements likely impact postpartum PTS prevalence estimates. Variation in these characteristics make it difficult to draw conclusions on the prevalence of postpartum PTS. Researchers should consider the appraisal of measurement tools presented here and use rigorous study methodology when studying traumatic birth experiences and evaluating interventions.
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Affiliation(s)
- Meagan E Williams
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charvonne N Holliday
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hollins Martin CJ, Reid K. A scoping review of therapies used to treat psychological trauma post perinatal bereavement. J Reprod Infant Psychol 2023; 41:582-598. [PMID: 34989287 DOI: 10.1080/02646838.2021.2021477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Up to 39% of women who experience perinatal bereavement proceed to develop Post-Traumatic-Stress-Disorder (PTSD), with this large proportion meriting treatment. Before setting-up a treatment service for postnatal women who are experiencing psychological trauma, it is important to identify what therapies have been used in-the-past to address this problem. AIM To scope for research that has implemented therapies to treat psychological trauma post perinatal bereavement, for potential inclusion in a flexible treatment package. METHOD A scoping review mapped coverage, range, and type of research that has reported on prior therapies used to treat psychological trauma post perinatal bereavement. FINDINGS Due to the dearth of papers that directly addressed perinatal bereavement, we widened the scope of the review to view what treatments had been used to treat psychological trauma post-childbirth. Out of 23 studies that report on effectiveness of therapies used to treat psychological trauma post-childbirth, only 4-focused upon treating PTSD post perinatal bereavement (3 effective/1 ineffective). Successful treatments were reported by Kersting et al. (2013), who found CBT effective at reducing PTSD symptoms post-miscarriage, termination for medical reasons, and stillbirth (n = 33 & n = 115), and Navidian et al. (2s017)) found that 4-sessions of grief-counselling reduced trauma symptoms post-stillbirth in (n = 50) women. One study by Huberty et al. (2020found on-line yoga to be ineffective at reducing PTSD symptoms post-stillbirth. CONCLUSIONS A dearth of research has explored effectiveness of therapies for treating psychological trauma post perinatal bereavement and post-childbirth, with need to develop and test a research informed flexible counselling package.
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Affiliation(s)
- Caroline J Hollins Martin
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University (Enu), Edinburgh, Scotland, UK
| | - Katrina Reid
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University (Enu), Edinburgh, Scotland, UK
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Davis JA, Ohan JL, Gregory S, Kottampally K, Silva D, Prescott SL, Finlay-Jones AL. Perinatal Women's Perspectives of, and Engagement in, Digital Emotional Well-Being Training: Mixed Methods Study. J Med Internet Res 2023; 25:e46852. [PMID: 37847537 PMCID: PMC10618893 DOI: 10.2196/46852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/30/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Psychological distress in the early postpartum period can have long-lasting deleterious effects on a mother's well-being and negatively affect her infant's development. Intervention approaches based in contemplative practices such as mindfulness and loving-kindness and compassion are intended to alleviate distress and cultivate well-being and can be delivered effectively as digital mental health interventions (DMHIs). OBJECTIVE To understand the feasibility of engaging perinatal women in digital interventions, this study aimed to document participants' experiences in the Mums Minds Matter (MMM) study, a pilot randomized controlled trial comparing mindfulness, loving-kindness and compassion, and progressive muscle relaxation training delivered in a digital format and undertaken during pregnancy. To assess the different stages of engagement during and after the intervention, we adapted the connect, attend, participate, enact (CAPE) framework that is based on the idea that individuals go through different stages of engagement before they are able to enact change. METHODS The MMM study was nested within a longitudinal birth cohort, The ORIGINS Project. We aimed to recruit 25 participants per randomization arm. Data were collected sequentially during the intervention through regular web-based surveys over 8 weeks, with opportunities to provide regular feedback. In the postintervention phase, qualitative data were collected through purposive sampling. RESULTS Of 310 eligible women, 84 (27.1% [connect rate]) enrolled to participate in MMM. Of the remaining 226 women who did not proceed to randomization, 223 (98.7%) failed to complete the baseline surveys and timed out of eligibility (after 30 weeks' gestation), and 3 (1.3%) displayed high psychological distress scores. Across all program groups, 17 (20% [attend rate]) of the 84 participants actively opted out, although more may have disengaged from the intervention but did not withdraw. The main reasons for withdrawal were busy life and other priorities. In this study, we assessed active engagement and ongoing skills use (participate and enact) through postintervention interviews. We undertook 15 participant interviews, conducted 1 month to 3 months after the intervention. Our results provide insights into participant barriers and enablers as well as app changes, such as the ability to choose topics, daily reminders, case studies, and diversity in sounds. Implementing a DMHI that is brief, includes frequent prompts or nudges, and is easily accessible is a key strategy to target perinatal women. CONCLUSIONS Our research will enable future app designs that are sufficiently nuanced to maximize the uptake, engagement, and application of mental health skills and contemplative practices in the perinatal period. Providing convenient access to engaging and effective prevention programs is critical and should be part of prenatal self-care. Our research underscores the appeal and feasibility of digital intervention approaches based in contemplative practices for perinatal women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) 12620000672954p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000672954p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19803.
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Affiliation(s)
- Jacqueline A Davis
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jeneva L Ohan
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Susan L Prescott
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Nova Institute for Health, Baltimore, MD, United States
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Gutiérrez-Hernández ME, Fanjul Rodríguez LF, Díaz Megolla A, Oyanadel C, Peñate Castro W. The Effect of Daily Meditative Practices Based on Mindfulness and Self-Compassion on Emotional Distress under Stressful Conditions: A Randomized Controlled Trial. Eur J Investig Health Psychol Educ 2023; 13:762-775. [PMID: 37185911 PMCID: PMC10137463 DOI: 10.3390/ejihpe13040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
Intervention programs based on self-compassion have demonstrated their efficacy both in reducing psychological distress and increasing well-being. The goal of this study was to test the efficacy of an online intervention to increase mindfulness and self-compassion levels in a non-clinical sample in a highly stressful context: the ten weeks of lockdown imposed in the early stages of the COVID-19 pandemic. The intervention sessions consisted of thirty-minute guided meditations followed by thirty minutes of inquiry. Sixty-one participants completed two thirds of the sessions or more, and 65 individuals participated in a waiting-list (WL) control group. Self-compassion, anxiety, depression and stress levels were assessed. The analysis of pre-post results suggests that the interventions increased self-compassion levels and decreased anxiety, depression and stress levels, whereas the WL group did not show any significant changes. The emotional changes in the intervention group were associated with the increase in self-compassion. However, at follow-up, the scores of emotional distress variables returned to the initial pre-intervention scores. These data can be interpreted in line with previous results that have shown the efficacy of self-compassion-based intervention programs. Given that this efficacy was not maintained at follow-up, data are discussed according to the pervasive role of a highly stressful context and-as described in other studies-the need for regular practice to maintain the benefits obtained.
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Affiliation(s)
| | | | - Alicia Díaz Megolla
- Department of Education, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas, Spain
| | - Cristián Oyanadel
- Department of Psychology, Universidad de Concepción, Concepción 4030000, Chile
| | - Wenceslao Peñate Castro
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
- University Institute of Neuroscience, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
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Goodyear T, Richardson C, Aziz B, Slemon A, Gadermann A, Daly Z, McAuliffe C, Pumarino J, Thomson KC, Jenkins EK. Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada. Digit Health 2023; 9:20552076231173528. [PMID: 37163172 PMCID: PMC10164262 DOI: 10.1177/20552076231173528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Abstract
Objective This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Methods Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Results Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. Conclusions This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.
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Affiliation(s)
- Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
| | - Bilal Aziz
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Allie Slemon
- School of Nursing, University of Victoria, Victoria, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Javiera Pumarino
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kimberly C Thomson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Emily K Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
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Ahmed AN, Raj SP. Self-compassion Intervention for Parents of Children with Developmental Disabilities: A Feasibility Study. Adv Neurodev Disord 2022; 7:277-289. [PMID: 36440059 PMCID: PMC9676721 DOI: 10.1007/s41252-022-00305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 05/05/2023]
Abstract
Objectives Parents of children with developmental disabilities (DDs) experience greater psychological distress (e.g., stress and depression) compared to parents of children without DDs. Self-compassion (i.e., responding with compassion to oneself during times of stress and difficulty) is associated with greater self-care as well as lower levels of stress, depression, and internalized stigma among parents of children with DDs. In this study, we tested the feasibility of a 4-week brief, asynchronous, online intervention targeting self-compassion among parents of children with DDs. Methods Participants were fifty parents (48 mothers; 2 fathers) of children with DDs. Participants' ages ranged from 25 to 62 years (M = 42.1 years, SD = 7.9 years), and 88% of participants had one child with a DD, and the remaining parents had two or more children with DDs. Child diagnoses included Down syndrome, autism spectrum disorder, and intellectual disability. Feasibility was assessed in five domains (i.e., acceptability, demand, implementation, practicability, and limited efficacy) using a combination of self-report measures, qualitative feedback, and data on attrition. Results Most parents (84%) completed ≥ 3 modules, and 74% completed all four modules. Almost all parents (> 90%) reported that they would recommend the intervention to others. Paired-samples t-tests demonstrated significant pre-intervention to post-intervention increases in self-compassion and well-being, and significant reductions in parent depression and stress. Conclusions Overall, data support feasibility of the 4-week intervention targeting parent self-compassion and provide preliminary efficacy data that need to be followed up in a larger randomized control trial.
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Signore AK, Jung ME, Semenchuk B, Kullman SM, Tefft O, Webber S, Ferguson LJ, Kowalski K, Fortier M, McGavock J, Ahmed R, Orr M, Strachan S. A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes. Pilot Feasibility Stud 2022; 8:111. [PMID: 35624519 PMCID: PMC9135984 DOI: 10.1186/s40814-022-01072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
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Affiliation(s)
- Alana K Signore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Brittany Semenchuk
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Sasha M Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Olivia Tefft
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Kent Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Michelle Fortier
- School of Human Kinetics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jon McGavock
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Marion Orr
- Inner Compass Counselling, Winnipeg, MB, R3G 2X6, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
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11
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O'Boyle-Finnegan Ú, Graham CD, Doherty N, Adair P. Exploring the contribution of psychological flexibility processes and self-compassion to depression, anxiety and adjustment in parents of preterm infants. Journal of Contextual Behavioral Science 2022. [DOI: 10.1016/j.jcbs.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Jaynes S, Brathwaite D, Tully KP. Systematic Review of the Effect of Technology-Mediated Education Intervention on Maternal Outcomes in the First Year After Birth. J Obstet Gynecol Neonatal Nurs 2022; 51:278-289. [PMID: 35331669 DOI: 10.1016/j.jogn.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To synthesize the findings on the effect of technology-mediated education intervention in the first year after birth on maternal health outcomes and to evaluate interventions for participant perspectives and health equity. DATA SOURCES We conducted a systematic review of the literature using the electronic databases PubMed, Embase, and CINAHL for articles published between 2010 and 2020. The search strategy was developed by a health sciences librarian. STUDY SELECTION We included articles if the following criteria were met: they reported studies conducted in the United States or a resource-similar nation on the evaluation of a technology-mediated education intervention within the first year after birth and they included the assessment of at least one maternal health outcome. DATA EXTRACTION The lead author extracted data from the full-text articles and entered them into Microsoft Excel. We assessed the quality and risk of bias using the Cochrane Collaboration's tool for examining the potential risk of bias. DATA SYNTHESIS We identified 21 articles that met the inclusion criteria. Videos were the most commonly reported technology-mediated education intervention, followed by text messages, phone calls, and websites. Maternal health outcomes addressed in the included articles were mental health, weight loss, breastfeeding, general postpartum education, perineal care, and substance use. Technology-mediated education interventions positively affected mental health, weight loss, and breastfeeding outcomes. CONCLUSION The current evidence suggests that technology-mediated education intervention is beneficial for the physical and mental health outcomes of women during the first year after birth. Future work may benefit from more attention to health equity and design in collaboration with women to gain a better understanding of the information needs and desired technology features.
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13
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Ferrandez S, Soubelet A, Vankenhove L. Positive interventions for stress-related difficulties: A systematic review of randomized and non-randomized trials. Stress Health 2022; 38:210-221. [PMID: 34453863 DOI: 10.1002/smi.3096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/15/2021] [Accepted: 08/16/2021] [Indexed: 11/09/2022]
Abstract
The effectiveness of positive psychology interventions in the treatment of stress-related difficulties have not been well established. To estimate the effectiveness of positive psychology interventions on the reduction of stress-related symptoms, a systematic review using PubMed, Scopus, Wiley, Psychinfo, Cochrane and Sage databases with no limitation of date of publication was conducted. We identified additional studies by searching positive psychology reviews and academic books. Only studies trying positive interventions that included measures of anxiety, stress, or posttraumatic stress disorder symptoms were reviewed. We extracted data using predefined data fields and study quality was assessed with the National Institutes of Health study quality assessment tools. Twenty-nine records were included in this study: 23 controlled trials and six pre-post studies. Every study showed significant improvement in at least one dimension. Several studies reported improvements in well-being as well. This review shows promising results of positive psychology interventions as a treatment for stress-related difficulties. However, important methodological biases and strong heterogeneity among the studies highlight the need for replication and better validation of positive psychology interventions.
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14
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Xin W. Lack of alternative: Chinese first-time mothers’ construction of social support network of online secondary groups. Digit Health 2022; 8:20552076221129062. [PMID: 36199543 PMCID: PMC9527985 DOI: 10.1177/20552076221129062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background As a result of rapid modernization and the long-term implementation of One Child Policy, Chinese first-time mothers’ primary child-raising social support network is gradually shrinking. At the same time, the social support system for child raising is still very incomplete. Therefore, Chinese first-time mothers generally face great pressure. Objective This paper aims to understand Chinese first-time mothers’ construction of social support network of online secondary groups. Methods This paper employs a qualitative research method, with semi-structured interviews with 23 participants, two focus groups and observations conducted in nine online child-raising communities. Results Based on the principle of instrumental rationality first-time mothers use various strategies to join different types of online communities and their online social support network is always the dynamic changing. The online social support network is a supplementary channel in which first-time mothers can obtain both instrumental and emotional support. But communication risks and ethical issues remain, such as information exchange interfered by commercial capital, widespread anxiety and superficial social relationships. Conclusions Online social support network is an alternative for Chinese first-time mothers and they urgently need a more well-rounded social support network system with government leading and multiple subjects participating in it.
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Affiliation(s)
- Wenjuan Xin
- A School of Journalism and Communication, Sichuan International Studies University, Chongqing, China
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15
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Kotera Y, Kaluzeviciute G, Bennett-Viliardos L. Qualitative Investigation into Pre- and Post-Natal Experience of Parents of Triplets. J Child Fam Stud 2022; 31:1785-1797. [PMID: 34955624 PMCID: PMC8683308 DOI: 10.1007/s10826-021-02200-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 05/13/2023]
Abstract
Although parents of triplets experience substantial mental distress, research about this increasing population has primarily focused on physical health risks of triplets and mothers, failing to capture the subjective wellbeing of parents. Accordingly, this study aimed to understand first-hand experience of parents of triplets, using thematic analysis of semi-structured interviews participated by eight parents (four couples: Age M = 48.63, SD = 10.61 years). Six themes were identified: (1) Negative and (2) Positive experiences of raising triplets prenatally and postnatally, (3) Social, psychological, and material support, (4) Experiences and challenges specific to mothers and (5) fathers, and (6) Advice for future parents. These themes suggest that being reassured and accepting support from others are particularly essential in reducing stress and anxiety. Self-compassion interventions were recommended to support the wellbeing of parents of triplets. Our findings will help parents of triplets, their social circles, and healthcare workers to develop effective approaches to reduce the mental health difficulties that this under-researched population experiences.
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Affiliation(s)
- Yasuhiro Kotera
- University of Nottingham, Jubilee Campus, Nottingham, NG7 2TU UK
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16
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Luo X, Che X, Lei Y, Li H. Investigating the Influence of Self-Compassion-Focused Interventions on Posttraumatic Stress: A Systematic Review and Meta-Analysis. Mindfulness (N Y) 2021; 12:2865-2876. [PMID: 34584575 PMCID: PMC8460848 DOI: 10.1007/s12671-021-01732-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 12/13/2022]
Abstract
Objectives Self-compassion-focused interventions may be able to decrease posttraumatic stress symptoms. However, previous studies demonstrated mixed effects in which a series of confounders were not systematically quantified. In this study, a systematic review with meta-analysis was conducted to quantify the effects of self-compassion-focused therapies on posttraumatic stress disorder. Methods Twelve eligible studies were included after a systematic search of databases. Outcome measures were extracted for posttraumatic stress disorder. Results Our data indicated a medium protective effect on posttraumatic stress symptoms (SMD = − 0.65), with most of the studies (8/12) coming from clinical settings. More importantly, longer interventions were associated with better posttraumatic stress outcomes (p < 0.001). Baseline or changes in self-compassion scores were not associated with posttraumatic stress outcomes post-interventions. Conclusions Overall, findings from this meta-analysis quantified the complex influence of self-compassion-focused interventions on posttraumatic stress symptoms and may provide insights for optimizing intervention strategies. Systematic Review and Meta-analysis Registration: PROSPERO CRD42020208663. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01732-3.
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Affiliation(s)
- Xi Luo
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, School of Psychology, Shenzhen University, Shenzhen, China.,Centre for Studies of Psychological ApplicationsGuangdong Key Laboratory of Mental Health and Cognitive ScienceKey Laboratory of Brain Cognition and Educational Science, Ministry of EducationSchool of Psychology, South China Normal University, No.55, West Zhongshan Avenue, Guangzhou, 510631 China
| | - Xianwei Che
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Hong Li
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, School of Psychology, Shenzhen University, Shenzhen, China.,Centre for Studies of Psychological ApplicationsGuangdong Key Laboratory of Mental Health and Cognitive ScienceKey Laboratory of Brain Cognition and Educational Science, Ministry of EducationSchool of Psychology, South China Normal University, No.55, West Zhongshan Avenue, Guangzhou, 510631 China.,Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
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17
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Kullman SM, Semenchuk BN, Schellenberg BJI, Ceccarelli L, Strachan SM. Adjusting Identities When Times Change: The Role of Self-Compassion. J Sport Exerc Psychol 2021; 43:410-418. [PMID: 34480010 DOI: 10.1123/jsep.2020-0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
Adjusting identity standards may be preferable to relentless pursuit or abandonment of an identity when facing an identity-challenging life transition. Self-compassion (SC) can help people adjust to challenges. The authors examined whether SC was associated with identity adjustment, exercise, and the moderating effect of identity-behavior discrepancy in 279 women exercisers who reported reduced exercise in motherhood. Participants completed the Self-Compassion Scale and reported the extent of and reflected on their identity discrepant behavior (reduced exercise). Reactions to discrepancy (acceptance, shame, guilt, and rumination), correlates of identity adjustment (subjective well-being, autonomous motivation, controlled motivation, and role conflict), and exercise behavior were assessed. SC associated positively with acceptance, correlates of successful identity adjustment, and exercise behavior. SC associated negatively with shame, rumination, and correlates of unsuccessful adjustment. SC may help exercise-identifying women who exercise less after becoming mothers adaptively cope with this identity challenge and continue exercising.
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18
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Fernandes DV, Canavarro MC, Moreira H. The role of mothers' self-compassion on mother-infant bonding during the COVID-19 pandemic: A longitudinal study exploring the mediating role of mindful parenting and parenting stress in the postpartum period. Infant Ment Health J 2021; 42:621-635. [PMID: 34407224 PMCID: PMC8426800 DOI: 10.1002/imhj.21942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/18/2021] [Indexed: 01/02/2023]
Abstract
The current COVID‐19 pandemic is a challenging time for postpartum mothers, and associated challenges may have a negative impact on their parenting and, consequently, on mother–infant bonding. This study aimed to longitudinally explore whether mothers’ self‐compassion was associated with mother–infant bonding and whether this relationship was mediated by mindful parenting and parenting stress. A total of 125 Portuguese mothers of infants aged between 0 and 12 months completed an online survey at two assessment points during the first wave of the COVID‐19 pandemic (T1: April–May 2020; T2: June–July 2020). The survey included several questionnaires assessing sociodemographic, clinical, and COVID‐19 information; self‐compassion; mindful parenting; parenting stress; and mother–infant bonding. Mothers presented significantly higher levels of self‐compassion, less impaired mother–infant bonding, and lower levels of depressive symptoms at T2 than T1. Higher levels of self‐compassion at T1 predicted less impaired mother–infant bonding at T2, and this relationship was mediated by higher levels of mindful parenting and lower levels of parenting stress (both assessed at T1). These results highlight the relevance of mothers’ self‐compassion to establishing mother–infant bonding in the postpartum period, particularly during the COVID‐19 pandemic, and the important role of mindful parenting and parenting stress in determining this relationship.
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Affiliation(s)
- Daniela V Fernandes
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria C Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Helena Moreira
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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19
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Carvalho SA, Skvarc D, Barbosa R, Tavares T, Santos D, Trindade IA. A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness. Clin Psychol Psychother 2021; 29:524-541. [PMID: 34269493 DOI: 10.1002/cpp.2643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/28/2021] [Accepted: 07/06/2021] [Indexed: 12/27/2022]
Abstract
Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.
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Affiliation(s)
- Sérgio A Carvalho
- Universidade Lusófona de Humanidades e Tecnologias, Escola de Psicologia e Ciências da Vida, HEI-Lab, Lisboa, Portugal.,Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Rosa Barbosa
- Unidade de Psico-Oncologia, Núcleo Regional do Centro da Liga Portuguesa Contra o Cancro (Portuguese League Against Cancer), Coimbra, Portugal
| | - Tito Tavares
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Diana Santos
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Inês A Trindade
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Whittingham K, Mitchell AE. Birth, breastfeeding, psychological flexibility and self-compassion as predictors of mother-infant emotional availability in a cross-sectional study. Infant Ment Health J 2021; 42:718-730. [PMID: 34189747 DOI: 10.1002/imhj.21935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study aimed to examine relationships between objective childbirth and breastfeeding events, subjective childbirth and breastfeeding experiences, and emotional availability in the mother-infant relationship. Further, it aimed to test two psychological variables, psychological flexibility and self-compassion, as predictors of emotional availability. A convenience sample of 396 mothers of infants (<2 years) from Australia and New Zealand completed an online cross-sectional survey. Objective breastfeeding events (difficulties), negative subjective birth/breastfeeding experiences, poorer psychological flexibility, and lower self-compassion correlated with poorer emotional availability. After controlling for objective birth and breastfeeding variables using multiple linear regressions, better subjective breastfeeding experiences, psychological flexibility, and self-compassion predicted the mutual attunement aspect of emotional availability, whereas better subjective birth experiences and psychological flexibility predicted the affect quality aspect of emotional availability. Mothers' subjective experiences of birth and breastfeeding are important in understanding the early mother-infant relationship. Psychological flexibility and self-compassion are important predictors of emotional availability and may be useful targets for psychological intervention aimed at optimising early mother-infant relationships.
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Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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21
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Hirani SAA, Pearce M, Lanoway A. Knowledge mobilization tool to promote, protect, and support breastfeeding during COVID-19. Can J Public Health 2021; 112:599-619. [PMID: 34019282 PMCID: PMC8139217 DOI: 10.17269/s41997-021-00532-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/20/2021] [Indexed: 12/23/2022]
Abstract
Setting This knowledge mobilization project was conceptualized to increase awareness among breastfeeding mothers and the general public on safe infant feeding practices during the COVID-19 pandemic by addressing myths and misconceptions associated with breastfeeding practices, guiding breastfeeding mothers to make informed decisions around child feeding practices, and offering meaningful guidance in simple language through a short online animated video. Intervention This project was undertaken in four phases. During phase 1, an informal discussion was held with the breastfeeding mothers, service providers, and community partner in identifying issues surrounding lactation counselling facilities during the COVID-19 pandemic. During phase 2, recommendations from 23 organizations with regard to breastfeeding during COVID-19 were reviewed and analyzed. During phase 3, using evidence from reliable sources, a 5-minute animated e-resource on breastfeeding during COVID-19 was conceptualized and developed. During phase 4, the e-resource was disseminated to the breastfeeding mothers, general public, post-secondary institutions, and organizations providing services to breastfeeding mothers in Canada. Outcomes This evidence-based e-resource facilitated addressing misconceptions around breastfeeding during COVID-19 and raising public awareness on safe infant feeding practices during this pandemic. Overall, the video was described as an informative, user-friendly, useful, and easily accessible resource by breastfeeding mothers who were in self-isolation with little access to healthcare services during the pandemic. Implications This project highlighted the importance of patient engagement and collaboration with the community partner in protecting breastfeeding during the COVID-19 pandemic. It further illustrated how informational e-resources can protect breastfeeding in situations where breastfeeding mothers’ access to healthcare services is compromised.
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Affiliation(s)
- Shela Akbar Ali Hirani
- Faculty of Nursing, University of Regina, 3737 Wascana Parkway, Regina, Saskatchewan, S4S 0A2, Canada.
| | - Megan Pearce
- Faculty of Nursing, University of Regina, 3737 Wascana Parkway, Regina, Saskatchewan, S4S 0A2, Canada
| | - Amanda Lanoway
- United Way Regina, 1440 Scarth Street, Regina, Saskatchewan, S4R 2E9, Canada
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22
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Borghouts J, Eikey E, Mark G, De Leon C, Schueller SM, Schneider M, Stadnick N, Zheng K, Mukamel D, Sorkin DH. Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review. J Med Internet Res 2021; 23:e24387. [PMID: 33759801 PMCID: PMC8074985 DOI: 10.2196/24387] [Citation(s) in RCA: 219] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/24/2020] [Accepted: 02/08/2021] [Indexed: 01/14/2023] Open
Abstract
Background Digital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user’s uptake and sustained interactions with these interventions. Objective This systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs. Methods A systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included. Results A total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one’s own health. Conclusions Although previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions.
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Affiliation(s)
| | - Elizabeth Eikey
- University of California San Diego, San Diego, CA, United States
| | - Gloria Mark
- University of California Irvine, Irvine, CA, United States
| | | | | | | | - Nicole Stadnick
- University of California San Diego, San Diego, CA, United States
| | - Kai Zheng
- University of California Irvine, Irvine, CA, United States
| | - Dana Mukamel
- University of California Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- University of California Irvine, Irvine, CA, United States
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23
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Gómez L, Verd S, de-la-Banda G, Cardo E, Servera M, Filgueira A, Ponce-Taylor J, Mulet M. Perinatal psychological interventions to promote breastfeeding: a narrative review. Int Breastfeed J 2021; 16:8. [PMID: 33407656 PMCID: PMC7789781 DOI: 10.1186/s13006-020-00348-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery. Methods The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria. Results The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding. Conclusions This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.
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Affiliation(s)
- Lidia Gómez
- Department of Child Psychiatry, Son Espases Hospital, Valldemossa road, 07120, Palma de Mallorca, Spain.,Baleares Medical Research Council (IdISBa), Valldemossa road, 07120, Palma de Mallorca, Spain
| | - Sergio Verd
- Baleares Medical Research Council (IdISBa), Valldemossa road, 07120, Palma de Mallorca, Spain. .,Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos street, 07013, Palma de Mallorca, Spain.
| | - Gloria de-la-Banda
- Department of Psychology, Baleares Islands University, Valldemossa road, 07122, Palma de Mallorca, Spain
| | - Esther Cardo
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos street, 07013, Palma de Mallorca, Spain.,Department of Paediatrics, Hospital Son Llatzer, Manacor road, 07128, Palma de Mallorca, Spain
| | - Mateu Servera
- Department of Psychology, Baleares Islands University, Valldemossa road, 07122, Palma de Mallorca, Spain
| | - Ana Filgueira
- Department of Paediatrics, Hospital Son Llatzer, Manacor road, 07128, Palma de Mallorca, Spain
| | - Jaume Ponce-Taylor
- Accidents & Emergency Unit, Department of Primary Care, Illes Balears street., 07014, Palma de Mallorca, Spain
| | - Margarita Mulet
- Mental Health Unit, Department of Primary Care, Simo Tort street, 07500, Mallorca, Manacor, Spain
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Khoury B, Dionne F. Les dimensions incarnée et interpersonnelle de la compassion. Annales Médico-psychologiques, revue psychiatrique 2020. [DOI: 10.1016/j.amp.2020.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Samios C, Townsend M, Newton T. Self-compassion predicts less fear of childbirth in childless women: the mediating role of birth beliefs. Psychol Health 2020; 36:1336-1351. [PMID: 33185123 DOI: 10.1080/08870446.2020.1846737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Women can have fear of childbirth (FOC) in advance of their first pregnancy and such fear can have implications for reproductive and eventual childbirth choices. This study aims to further our understanding of the role of self-compassion in FOC in young childless women, including possible pathways through which self-compassion might relate to less FOC: through natural and medical birth beliefs. DESIGN AND MAIN OUTCOME MEASURES In this correlational study, 316 young childless Australian women completed measures of self-compassion, natural and medical birth beliefs, and FOC. RESULTS Self-compassion predicted less FOC, and although self-compassion as a total score did not relate to natural birth beliefs, it did relate to lower scores on medical birth beliefs. The indirect effect through medical birth beliefs was supported; greater self-compassion predicted lower scores on medical birth beliefs, which in turn predicted less FOC. CONCLUSIONS The findings, although cross-sectional, support the study of self-compassion in FOC, which is in part because self-compassion predicts less medical birth beliefs. With further research, self-compassion training might be incorporated into public health initiatives targeting FOC in young childless women.
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Affiliation(s)
- Christina Samios
- School of Psychology, Bond University, Gold Coast, Australia.,Faculty of Health and Human Sciences, Southern Cross University, Bilinga, Australia
| | | | - Tracy Newton
- School of Psychology, Bond University, Gold Coast, Australia
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Abstract
Self-compassion-treating oneself with care and understanding during difficult times-promotes adaptive coping and self-improvement. Nonetheless, many people are not self-compassionate. We examined a key barrier people face to treating themselves self-compassionately: their negative beliefs about self-compassion (i.e., that it leads to complacency, indulgence, or irresponsibility). Across three studies, the more people held these negative beliefs, the less self-compassionately they reported responding to a real-world event (Study 2) and hypothetical emotional challenges (Studies 1 and 3). Self-compassionate responding, in turn, predicted adaptive coping strategies and intentions for self-improvement. Experimentally inducing people to hold positive, as opposed to negative, beliefs about self-compassion predicted self-compassionate responding 5 to 7 days later (Study 3). By recognizing and targeting peoples' beliefs, our findings highlight the importance of reducing such beliefs that are barriers to practicing self-compassion, as a means to improve the way people respond to difficult times.
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Affiliation(s)
- Christina Chwyl
- Stanford University, CA, USA.,Drexel University, Philadelphia, PA, USA
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Lennard GR, Mitchell AE, Whittingham K. Randomized controlled trial of a brief online self-compassion intervention for mothers of infants: Effects on mental health outcomes. J Clin Psychol 2020; 77:473-487. [PMID: 33063321 DOI: 10.1002/jclp.23068] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/08/2020] [Accepted: 09/19/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test the effectiveness of a brief self-compassion intervention in improving mental health outcomes for mothers of infants. METHOD A randomized controlled trial study design was used. A community sample of mothers of infants (<2 years) completed measures of self-compassion, fears of compassion, psychological flexibility, depression, anxiety, stress, symptoms of posttraumatic stress, and infant feeding experiences. Mothers randomized to intervention received access to online self-compassion resources, and 248 mothers (intervention n = 94, waitlist-control n = 154) completed postintervention assessment 8 weeks later. RESULTS Overall, 62.8% (n = 59) of intervention participants accessed the resources per-protocol, and lower fear of compassion scores predicted resource use. At postintervention, mothers who used the resources had improved scores for posttraumatic stress symptoms (95% confidence interval [CI] = 0.31-5.47, p = .028), depression (95% CI = 0.15-2.01, p = .023), self-compassionate action (95% CI = 0.41-3.45, p = .012), and engagement with compassion from others (95% CI = 0.22-5.49, p = .034) compared to waitlist-control. Fears of compassion moderated intervention effectiveness. There were no effects on other outcome variables. CONCLUSIONS Findings support the potential effectiveness of interventions based on compassion-focused therapy to improve maternal mental health.
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Affiliation(s)
- Georgina R Lennard
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Whittingham K, McGlade A, Kulasinghe K, Mitchell AE, Heussler H, Boyd RN. ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder. BMJ Open 2020; 10:e034315. [PMID: 32819928 PMCID: PMC7440709 DOI: 10.1136/bmjopen-2019-034315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD. METHODS AND ANALYSIS We aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent-child interactions to improve early social reciprocity, while supporting parental mental health and the parent-child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent-infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs. ETHICS AND DISSEMINATION This protocol has been approved by the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12618002046280).
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Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea McGlade
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kavindri Kulasinghe
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Honey Heussler
- Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Bohadana G, Morrissey S, Paynter J. Self-Compassion in Mothers of Children with Autism Spectrum Disorder: A Qualitative Analysis. J Autism Dev Disord 2021; 51:1290-303. [PMID: 32656737 DOI: 10.1007/s10803-020-04612-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Emerging quantitative research found self-compassion to be a unique predictor of parental stress in parents of children with ASD above other predictors. However, research on the lived experience of self-compassion in families of children with ASD is limited. Using a qualitative thematic analysis approach, 19 mothers of children with ASD with a mean age of 39.19 years (SD = 3.56, Range = 31.00-50.00 years) were interviewed about their lived experiences of stress and self-compassion. Themes derived from interviews include: the impact and causes of stress, benefits of self-compassion, barriers to self-compassion, and aids to self-compassion. The findings deepen our understanding of the experience of self-compassion in this population. Limitations and future directions are discussed.
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Sairanen E, Lappalainen R, Lappalainen P, Kaipainen K, Carlstedt F, Anclair M, Hiltunen A. Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial. Journal of Contextual Behavioral Science 2019. [DOI: 10.1016/j.jcbs.2019.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kirby JN, Sampson H, Day J, Hayes A, Gilbert P. Human evolution and culture in relationship to shame in the parenting role: Implications for psychology and psychotherapy. Psychol Psychother 2019; 92:238-260. [PMID: 30932312 DOI: 10.1111/papt.12223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVES There is considerable evidence that early parenting has profound effects on a range of physiological and psychological maturation processes. Furthermore, psychotherapy often addresses some of the distortions and developmental difficulties that have arisen from early childhood. While research has focused on obvious candidates such as abuse and neglect, this paper reviews some of the core themes related to a less investigated area, specifically parental shame on child development. Role shame sensitive parenting styles will be explored against an evolutionary background that contrasts early human and modern human rearing contexts. We also outline a study examining the role of shame in psychological controlling and dysfunctional parenting styles, its relationship to different dimensions of shame and fears of compassion. DESIGN An online survey was conducted containing self-report measures of dysfunctional parenting styles, three dimensions of shame (external, internal, and reflected), fears of compassion, mental health indices, and a measure of psychological flexibility. METHODS An online survey was accessed by 333 parents (306 being female) with a child between the ages of 3-9 years. RESULTS Two hierarchical multiple regressions indicated support for our two primary hypotheses, with shame explaining significant variance in both psychological controlling and dysfunctional parenting styles over and above that explained by psychological inflexibility, parental mental health, and fears of compassion. Additionally, results from standard multiple regressions indicated that fears of compassion account for significant variance in external shame, as well as internal and reflected shame. CONCLUSIONS Recommendations for future research include focusing on parental motivation in order to help support parents and children are provided. PRACTITIONER POINTS Shame is a major factor for how parents engage in parenting practices and respond to their children Practitioners need to be sensitive to the shame parents can experience and asses for it Assessing shame-threat in parenting and shifting to compassionate motivation can lead to more responsive and positive parenting.
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Affiliation(s)
- James N Kirby
- The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Sampson
- The University of Queensland, Brisbane, Queensland, Australia
| | - Jamin Day
- The University of Newcastle, New South Wales, Australia.,Family Action Centre, The University of Newcastle, Australia
| | - Alan Hayes
- The University of Newcastle, New South Wales, Australia.,Family Action Centre, The University of Newcastle, Australia
| | - Paul Gilbert
- The University of Queensland, Brisbane, Queensland, Australia.,The University of Derby, UK
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