Music and Lyric Characteristics of Popular Dutch Funeral Songs

This study compared the characteristics of 150 songs (Dutch lyrics, N = 47, English lyrics, N = 103), popular at Dutch funerals, to an equal number of non-funeral songs. The variables explored included those linked with the music (valence, energy, danceability, acousticness, key, and tempo); and lyrics, namely: linguistics-related (first-person singular/plural, second-person pronouns; past, present, future tense; expressed emotion (positive, negative words, and the discrete emotional categories anger, anxiety, sadness); and category words (those relating to family, friends, death, religion). Funeral music was lower in valence, energy, and danceability and higher in acousticness than non-funeral music. Furthermore, English funeral music lyrics contained more second-person pronouns and were more future-focused than comparison songs. Funeral lyrics were not particularly negative, but English texts contained more words relating to sadness. In conclusion, funeral music differs in severable notable respects from general popular songs that may reflect the special purpose of this music.

Crying does not alleviate acute pain perception: Evidence from an experimental study

BACKGROUND

Whereas previous studies revealed positive effects of emotional expressions such as swearing and laughing on acute pain, systematic research on the effects of crying on pain is missing. The rationale for the current study is that either a mere emotional distraction or changes in oxytocin and opioid levels represent a mechanism through which crying modulates pain, with the timing of mood changes as crucial information for distinguishing between potential mechanisms.

METHODS

In two studies, we exposed participants (Study 1: n = 57; Study 2: n = 70) to a sad movie and measured their mood, and exposed them to pain induction procedures (electric shock and cold-pressor test, respectively) before and after the film. Dependent variables were pain threshold, tolerance, and intensity. In addition to baseline and one immediate post-crying mood and pain response measurement in both studies, in Study 2, we repeated these procedures 20 and 50 min later to discern between the potential role of neurobiological substances and distraction.

RESULTS

Crying was elicited in 28 participants in Study 1 (49.1%) and 49 (70%) in Study 2. We found no systematic differences in pain and mood changes between criers and non-criers and no systematic dose-response relationship between crying and pain responses and mood. The only significant effects ran contrary to our hypotheses, showing detrimental effects of the occurrence (Study 1) and frequency of crying (both studies) on pain threshold.

CONCLUSIONS

Results do not support the idea that crying has pain-alleviating effects, either via distraction or direct biological mechanisms.

Personality, gender, and crying

This study examined gender differences in crying as well as associations between basic personality traits and self‐reported indices of crying. Forty‐eight men and 56 women completed the Five‐Factor Personality Inventory and the Adult Crying Inventory. Substantial gender differences were demonstrated in crying frequency and crying proneness, but not with respect to mood changes after crying. As predicted, women reported a higher frequency of crying and more proneness to cry both for negative and positive reasons. For women, all these crying indices were negatively associated with Emotional Stability. For men, only a significant negative relationship between Emotional Stability and crying for negative reasons emerged. No clear links were found between personality and mood changes after crying. Multiple regression analysis revealed a significant predictive role of gender for crying proneness, even when controlling for personality differences, but not for crying frequency. Adding personality by gender interaction terms resulted in a disappearance of the main effect of sex, while significant interactions with personality factors showed up for crying frequency and general crying proneness. It is suggested that future research on the relationship between personality and crying should focus more on the underlying mechanisms of observed relationships. Furthermore, it is recommended that future research should examine the role of different emotion regulation strategies. In addition, biological factors, temperament, upbringing measures, and socio‐demographic variables should be taken into account. Copyright © 2001 John Wiley & Sons, Ltd.

A clinical practice review of crying research

The goal of this clinical practice review is to assess the current state of the theoretical and empirical literature on emotional crying (i.e., crying in response to an emotional stimulus), a topic that has received surprisingly limited attention of behavioral scientists and clinicians. Although the empirical research on emotional crying remains in a nascent state, we draw upon the existing scientific knowledge to provide preliminary suggestions for clinicians on how to interpret and respond to crying in clinical contexts. We also identify research gaps and provide recommendations for further research to improve our understanding of this intriguing and still poorly understood human behavior. We suggest that a better understanding of individual differences in crying behavior and the postulated intraindividual and interindividual functions of crying is of critical importance for clinicians, given its frequent occurrence and notable associations with emotional and social functioning. An improved characterization of this important phenomenon will lead to improvements in clinical assessment, treatment planning, and psychotherapy interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Damaging Effects of Perceived Crocodile Tears for a Crier's Image

Emotional tears are uniquely human and play an essential role in the communication of distress in adults. Several studies have shown that individuals are more willing to offer emotional support and help a person in tears. Preliminary evidence suggests that this greater willingness to provide support is mediated via perceived warmth and helplessness. Moreover, tearful individuals are regarded as more reliable and honest. In the current study, we examined whether people can reliably distinguish genuine and fake crying, and what the consequences for the further evaluation of the crier are. A total of 202 participants (73 men, 129 women) were exposed to brief movie clips of genuine and fake crying adults and were asked to assess the criers. Results show that women were slightly better at identifying fake and genuine crying. How the crying was perceived subsequently seemed to have a strong influence on the further evaluation of the "crier." Criers qualified as pretenders were perceived as significantly more manipulative, less reliable, less warm, and less competent. Further, the respondents felt less connected with the perceived pretenders, who also were less welcomed as friends, colleagues, neighbors, and babysitter. They were additionally qualified as significantly less fit for "reliable" professions (judge, teacher, police officer, scientist, and physician). In contrast, the ratings of their fitness for "unreliable" professions (banker, CEO, journalist, real estate salesman, and politician) yielded a significant difference in only one video clip (and contrary to expectations). Our findings thus indicate that the subjective labeling of crying as fake is associated with a significantly less positive perception of the "crying" person, regardless of whether the crying is actually fake or genuine. The qualification of tears as crocodile tears thus seems to affect the crier's image strongly negatively.

The Relationship of Gender Roles and Beliefs to Crying in an International Sample

This study aimed to (1) investigate the variation in self ascription to gender roles and attitudes toward gender roles across countries and its associations with crying behaviors, emotion change, and beliefs about crying and (2) understand how the presence of others affects our evaluations of emotion following crying. This was a large international survey design study (N = 893) conducted in Australia, Croatia, the Netherlands, Thailand, and the United Kingdom. Analyses revealed that, across countries, gender, self-ascribed gender roles, and gender role attitudes (GRA) were related to behavioral crying responses, but not related to emotion change following crying. How a person evaluates crying, instead, appeared to be highly related to one’s beliefs about the helpfulness of crying, irrespective of gender. Results regarding crying when others were present showed that people are more likely both to cry and to feel that they received help around a person that they know, compared to a stranger. Furthermore, closeness to persons present during crying did not affect whether help was provided. When a crier reported that they were helped, they also tended to report feeling better following crying than those who cried around others but did not receive help. Few cross-country differences emerged, suggesting that a person’s responses to crying are quite consistent among the countries investigated here, with regard to its relationship with a person’s gender role, crying beliefs, and reactions to the presence of others.

Using crying to cope: Physiological responses to stress following tears of sadness

This research tested the hypothesis that emotional crying facilitates coping and recovery, specifically through physiological changes that occur during crying. Female undergraduate students (N = 197) were randomly assigned to either a sad or neutral condition using short videos. Sad videos were selected for their extreme emotion elicitation. We predicted that compared to those who did not cry to the stimuli and those who were exposed to neutral videos, people who cried would (a) be able to withstand a stressful task for longer; (b) show lower levels of cortisol following crying and exposure to the stressor; and (c) have faster recovery (i.e., return to baseline levels of affect). The final groups consisted of the neutral group (n = 65), sad criers (n = 71), and sad noncriers (n = 61). After a 5-min baseline period, participants watched either the sad or neutral videos for 17 min and then completed a physical stressor (cold pressor test). Heart rate and respiration were continuously recorded, whereas salivary samples for cortisol were taken at 4 separate time points during testing. Analyses revealed no differences between the 3 groups in time withstanding the stressor or cortisol changes. Respiration rate, however, increased in the neutral group and noncriers while watching the videos, with criers' respiration remaining stable. Furthermore, heart rate was found to decelerate just before crying, with a return to baseline during the first crying period. These results suggest that crying may assist in generally maintaining biological homeostasis, perhaps consciously through self-soothing via purposeful breathing and unconsciously through regulation of heart rate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial

OBJECTIVE

To evaluate the effect of haptotherapy on severe fear of childbirth in pregnant women.

DESIGN

Randomized controlled trial.

SETTING

Community midwifery practices and a teaching hospital in the Netherlands.

POPULATION OR SAMPLE

Primi- and multigravida, suffering from severe fear of childbirth (N = 134).

METHODS

Haptotherapy, psycho-education via Internet and care as usual were randomly assigned at 20-24 weeks of gestation and the effects were compared at 36 weeks of gestation and 6 weeks and 6 months postpartum. Repeated measurements ANOVA were carried out on the basis of intention to treat. Since there were crossovers from psycho-education via Internet and care as usual to haptotherapy, the analysis was repeated according to the as treated principle.

MAIN OUTCOME MEASURES

Fear of childbirth score at the Wijma Delivery Expectancy/Experience Questionnaire.

RESULTS

In the intention to treat analysis, only the haptotherapy group showed a significant decrease of fear of childbirth, F(2,99) = 3.321, p = .040. In the as treated analysis, the haptotherapy group showed a greater reduction in fear of childbirth than the other two groups, F(3,83) = 6.717, p < .001.

CONCLUSION

Haptotherapy appears to be more effective in reducing fear of childbirth than psycho-education via Internet and care as usual.

Subjective emotional responses to IAPS pictures in patients with borderline personality disorder, cluster-C personality disorders, and non-patients

According to Linehan (1993), emotion dysregulation is a central feature of borderline personality disorder (BPD). We hypothesized that patients with BPD are emotionally hyperresponsive. For BPD treatment, it is important to evaluate this hypothesis, because, if it is supported, therapeutic interventions could be designed to help patients to better manage hyperemotional reactions. We investigated the subjective reactions (in terms of valence and arousal) of patients with BPD to visual emotional stimuli of the International Affective Picture System (IAPS). We hypothesized that, compared to patients with Cluster-C personality disorders and non-patients, BPD patients would show higher scores on the arousal dimension and higher negative scores on the valence dimension when rating IAPS pictures with varying degrees of arousal and valence. Ratings of valence and arousal for 40 IAPS pictures were collected from 39 borderline personality disorder (BPD), 36 patients diagnosed with Cluster-C personality disorders (PD), and a group of 226 non-patients. Contrary to expectations, BPD patients did not differ from the non-patients. This indicates that their self-report scores do not reflect hypersensitivity. We found that patients with BPD showed lower scores on arousal than Cluster-C PD patients. The scores on valence suggested that Cluster-C PD patients also experienced more positive emotions than BPD patients.

Crying in borderline personality disorder patients

Emotion dysregulation and hyperreactivity are considered central features of Borderline Personality Disorder (BPD). We assumed that such emotion dysregulation is also reflected in increased crying behavior of these patients and, consequently, hypothesized that BPD patients (N = 62), compared to Cluster C personality disorder patients (Cluster C-PD; N = 25) and non-patients (N = 54), would show higher scores on crying measures. To evaluate crying behavior, we used a set of specially designed tools. Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears. They also reported less awareness of the influence of crying on others. However, Cluster C-PD patients showed a very similar pattern of findings. Overall, our results suggest that the increased crying of BPD patients likely results from environmental factors or the misperception of situations, rather than from stable traits. Remarkable is that the observed discrepancies in crying behavior compared to non-patients seem to be similar for Cluster-C PDs and BPD.

The neurobiology of human crying

The production of emotional tears appears to be uniquely present in Homo sapiens. Despite the ubiquity of this human behavior, research is only just beginning to uncover the neurobiologic underpinnings of human emotional crying. In this article, we review the current state of the literature investigating the neurobiologic aspects of this uniquely human behavior, including the neuroanatomical, neurochemical, and psychophysiologic findings. To set the context for this review, we first provide a brief overview of the evolutionary background and functions of tearful crying. Despite an accumulating understanding of the neurobiology of human emotional crying, the primary sources of information are currently from animal studies and observations in neurologic patients suffering from pathologic crying. Currently, most of the research on the neurobiology of crying in humans has focused on autonomic physiologic processes underlying tearful crying, which may yield essential clues regarding the neural substrates of the production of crying behavior and its effects on the crier. Further challenges in elucidating the neurobiology of crying involve the complexity of crying behavior, which includes vocalizations, tear production, the involvement of facial musculature, subjective emotional experience, emotion regulatory behaviors, and social behaviors. Future research is needed to comprehensively characterize the neurobiology of this intriguing and complex human behavior.

The Effects of Tears on Approach-Avoidance Tendencies in Observers

Emotional tears have been proposed to represent a robust affiliative signal whose main function is to promote the willingness to help the crying individual. However, little is known about the psychological mechanisms at the basis of such responses. To investigate whether tears facilitate approach relative to avoidance tendencies, we exposed participants ( N = 77) to pictures of faces with and without visible tears, in two different approach-avoidance tasks. In the first task, participants were instructed to either move toward tearful faces and away from nontearful faces, or the other way around, by using a joystick. In the second task, participants made approaching or avoiding responses to tearful and nontearful faces by pressing buttons. The results suggest that tears facilitate behavior that reduces the distance between the observer and the crying person. However, while tears appear to promote approach relative to avoidance behavior, the current findings do not allow firm conclusions about whether tears specifically facilitate approach or rather block avoidance tendencies in observers, or whether they possibly have both effects. Findings are discussed in the context of tears' ability to act as a prosocial stimulus that signals non-aggressive intentions, as well as in the context of the functional goals that predispose humans to approach or avoid crying individuals.

Attachment styles and secure base priming in relation to emotional reactivity after frustration induction

In two experimental studies, we explored the role of attachment in predicting emotional reactivity after frustration induction. In the first study, using a cognitive frustration task, we examined in a college sample (N = 134) how attachment styles related to the experience and expression of emotions after frustration induction. In the second study, we investigated in college students (N = 198) the effect of conscious priming of the secure base schema on mood disturbance after the performance of a cognitive frustration task. Results showed that individuals experienced and expressed emotions after frustration induction independent of their attachment styles. Conscious priming of the secure base script attenuated self-reported emotional reactivity after frustration induction independent of individuals' attachment styles. These findings suggest that the mechanism of attachment-related emotional reactivity might not pertain to frustration during an unsolvable cognitive task, but that the activation of the sense of having a secure base is useful in reducing mood disturbance in the context of a frustrating performance task.

Maternal psychological distress after preterm birth: Disruptive or adaptive?

BACKGROUND

Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly prevalent in mothers of preterm born infants, necessarily affect a mother's quality of parenting.

METHOD

Latent Class Analysis was used to group mothers (N=197) of term, moderately, and very preterm born infants, based on their levels of distress (depression, anxiety, and PTSD symptoms) at one month postpartum, and their quality of parenting at one and six months postpartum. Parenting quality was assessed on the basis of maternal interactive behaviors (sensitivity, intrusiveness, and withdrawal) using observations, and maternal attachment representations (balanced, disengaged, or distorted) using interviews.

RESULTS

A 5-Class model yielded the best fit to the data. The first Class (47%) of mothers was characterized by low distress levels and high-quality parenting, the second Class (20%) by low distress levels and low-quality parenting, the third Class (22%) by high distress levels and medium-quality parenting, the fourth Class (9%) by high distress levels and high-quality parenting, and finally the fifth Class (2%) by extremely high levels of distress and low-quality parenting.

CONCLUSIONS

While heightened distress levels seem inherent to preterm birth, there appears to be substantial heterogeneity in mothers' emotional responsivity. This study indicates that relatively high levels of distress after preterm birth do not necessarily place these mothers at increased risk with regard to poor parenting. Conversely, low distress levels do not necessarily indicate good-quality parenting. The results of the present study prompt a reconsideration of the association between postpartum distress and parenting quality, and challenge the notion that high levels of maternal distress always result in low-quality parenting practices.

Different aspects of emotional intelligence of borderline personality disorder

OBJECTIVES

The present study investigated deficiencies in different components of emotional intelligence in borderline personality disorder (BPD).

METHOD

The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Emotional Quotient Inventory (EQ-i) were used to assess EI dimensions. BPD patients (N = 85; 69 women; M = 33.6 years) were compared with Cluster C personality disorder (PD) patients (N = 39; 23 women; M = 36.6 years) and nonpatients (N = 69; 44 women; M = 35.6 years).

RESULTS

Compared to the Cluster C PD patients and the nonpatient group, BPD patients displayed only deficits in their ability to understand emotions as measured with the Mayer-Salovey-Caruso Emotional Intelligence Test. The Emotional Quotient Inventory only revealed deficits in stress management in BPD patients compared to Cluster C PD patients.

CONCLUSIONS

Our findings suggest that BPD patients have the ability to regulate emotions effectively, but they subjectively experience deficits in emotion regulation and therefore may not use this ability when they need it.

As tears go by: Baby tears trigger more brain activity than adult tears in nulliparous women

The current functional magnetic resonance imaging study examines brain activity during the perception of infant and adult tears. Infant tears evoke stronger responses in the visual cortex than adult tears, indicating that infant tears are highly salient. In addition, our study shows that infant tears uniquely activate somatosensory pain regions, which could stimulate actions directed at the elimination of the source of pain. Shedding tears may be a strong means to elicit the parent's sharing of the infant's feelings, thereby strengthening caregiver-infant bonding and securing infant survival.

The Riddle of Human Emotional Crying: A Challenge for Emotion Researchers

Until now, adult crying has received relatively little interest from investigators, whereas in the popular media there are many strong claims about crying (e.g., crying brings relief) of which the scientific basis is not clear. In this review, we provide an overview of the current state of the scientific literature with respect to crying. We identify gaps in knowledge and propose questions for future research. The following topics receive special attention: Ontogenetic development, antecedents, individual and gender differences, and the intra- and interindividual effects of crying. We conclude that the study of crying may help us obtain better insight into human nature, that is, not only our emotional, but also social, and moral functioning.

The social impact of emotional tears

The question what specific functions the production of emotional tears fulfills has received only limited attention of behavioral scientists. We report the results of two studies on the social impact of emotional tears. In Study 1 (96 Dutch females), perceived helplessness and felt connectedness predicted the willingness to help a person depicted as crying tearfully, while perceived friendliness did not. In Study 2 (US sample, 128 males, 68 females) all three of these variables mediated the effect the display of tears had on the willingness to help. Our results replicate and extend previous work and add to current knowledge by showing that tearful crying facilitates helping behavior and by identifying reasons why people are more willing to help criers. These findings help to put forth novel predictions on the impact of tearful crying on others.

Why crying does and sometimes does not seem to alleviate mood: a quasi-experimental study

Whereas retrospective studies suggest that crying can be beneficial in terms of mood enhancement, results of quasi-experimental laboratory studies consistently demonstrate its negative effects on mood. The present study was specifically designed to evaluate a parsimonious explanation for this paradox by assessing mood after crying in a laboratory, both immediately and at follow up. Mood ratings of 28 objectively established criers and 32 non-criers were compared before and immediately after the exposure to an emotional movie, as well as 20 and 90 min later. As expected, immediately after the film, negative mood significantly increased in criers, while it did not change in non-criers. This mood deterioration was followed by a recovery that resulted in return to the baseline mood levels at the third measurement. Criers subsequently reported mood enhancements at the final measurement compared to the pre-film measurement. Crying frequency did not predict mood changes above those predicted by the presence of crying. The observed relation between crying and more long-term mood recovery reconciles seemingly contrasting earlier results and provides a simple and obvious explanation. After the initial deterioration of mood following crying that was observed in laboratory studies, it apparently takes some time for the mood, not just to recover, but also to become even less negative than before the emotional event, which corresponds to the results of retrospective studies.

Longitudinal changes in functioning and disability in patients with disorders of consciousness: the importance of environmental factors

Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in "Activities &amp; Participation" were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in "Activities &amp; Participation" decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor "support and relationships" reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in "Environmental Factors" were significant predictors of relative variability in "Activities &amp; Participation". It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness.

Longitudinal associations between maternal disrupted representations, maternal interactive behavior and infant attachment: a comparison between full-term and preterm dyads

This prospective study examined whether or not a mother's representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and infant attachment. The participants were mothers of full-term (n = 75), moderately preterm (n = 68) and very preterm infants (n = 67). Maternal representations were assessed by the Working Model of the Child Interview at 6 months post-partum. Maternal interactive behavior was evaluated at 6 and 24 months post-partum, using the National Institute of Child Health and Human Development Early Care Research Network mother-infant observation scales. Infant attachment was observed at 24 months post-partum and was coded by the Attachment Q-Set. The results reveal that a premature childbirth does not necessarily generate disrupted maternal representations of the infant. Furthermore, maternal interactive behavior appears to be an important mechanism through which maternal representations influence the development of infant attachment in full-term and preterm infants. Early assessment of maternal representations can identify mother-infant dyads at risk, in full-term and preterm samples.

Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth: A randomized controlled trial

OBJECTIVE

This study examined the effectiveness of hospital-based Video Interaction Guidance (VIG; Eliëns, 2010; Kennedy, Landor, & Todd, 2011) for mothers and fathers of infants born preterm (25-37 weeks of gestation).

METHOD

VIG is a preventive video-feedback intervention to support the parent-infant relationship. One hundred fifty families (150 infants, 150 mothers, 144 fathers) participated in a pragmatic randomized controlled trial to evaluate the effects of VIG as adjunct to standard hospital care. Primary outcome was parental interactive behavior (sensitivity, intrusiveness, and withdrawal) as observed in videotaped dyadic parent-infant interaction. Secondary outcomes comprised parental bonding, stress responses, and psychological well-being based on self-report. The intervention effects were assessed at baseline, mid-intervention, 3-week, 3-month, and 6-month follow-ups. Data were analyzed on an intention-to-treat basis, using multilevel modeling and analyses of covariance.

RESULTS

VIG proved to be effective in enhancing sensitive behavior and diminishing withdrawn behavior in mothers (Cohen's d range = .24-.44) and in fathers (d range: .54-.60). The positive effects of VIG were particularly found in mothers who experienced the preterm birth as very traumatic (d range = .80-1.04). The intervention, however, did not change parents' intrusive behavior. Analyses additionally revealed positive effects on parental bonding, especially for fathers, yet no significant effects on stress and well-being were detected.

CONCLUSIONS

The results indicate that VIG is a useful addition to standard hospital care, reducing the possible negative impact of preterm birth on the parent-infant relationship. VIG appeared particularly beneficial for fathers, and for mothers with traumatic birth experiences. High levels of parental intrusiveness, however, need complementary intervention. (PsycINFO Database Record

From the father's point of view: how father's representations of the infant impact on father-infant interaction and infant development

Despite the knowledge that fathers uniquely contribute to the development of their infants, relatively few studies have focused on the father-infant relationship during early infancy. In the present longitudinal study we included 189 fathers and examined whether their early attachment representations of the infant predicted future quality of father-infant interaction. We also investigated whether these representations were related to the infant's development. Paternal attachment representations were assessed by the Working Model of Child Interview (WMCI) at 6 months post-partum and classified fathers' representations as 'balanced' or 'unbalanced' (disengaged or distorted). At 24 months, father-infant interaction was videotaped and analyzed by the NICHD coding scales. Further, the Peabody Picture Vocabulary Test (PPVT-III) was administered to evaluate the infant's verbal development. Results revealed that fathers' early attachment representations of the infant predict the quality of future father-infant interaction, with balanced representations more strongly associated with more favorable behaviors in fathers and infants. In addition, paternal interactive behavior appears an important mechanism through which paternal representations influence the development of the infant. These results underline the importance of early identification of fathers with unbalanced attachment representations, and we therefore recommend that more attention should be directed to the quality of the early father-infant relationship in clinical settings.

Is crying a self-soothing behavior?

This contribution describes the current state-of-the-art of the scientific literature regarding the self-soothing effects of crying. Starting from the general hypothesis that crying is a self-soothing behavior, we consider different mechanisms through which these effects may appear. In the first section, we briefly explain the main functions of human crying. Then we define self-soothing in terms of homeostatic processes of mood regulation and stress reduction and we underline the importance of distinguishing self-soothing effects of crying from social-soothing that it may elicit. We then provide a comprehensive review of the putative mood-enhancing and -relieving effects of crying and their variations stemming from characteristics of crying person, antecedents, manifestations, and social consequences of crying. We also discuss the possible methodological explanations for the seemingly discrepant findings regarding mood improvement and relief that may follow crying. We then provide theoretical and empirical support for our general hypothesis that crying is a self-soothing behavior by presenting and evaluating the possible physiological, cognitive, and behavioral mechanisms that may play a mediating role in the relationship between crying and homeostatic regulation that includes mood improvement and relief. Starting from the idea that social-soothing and self-soothing mechanisms share the same physiological systems, we propose that biological processes act in parallel with learning and reappraisal processes that accompany crying, which results in homeostatic regulation. Given the parallels between self-soothing behaviors in humans and animals, we also propose that crying might self-soothe through a mechanism that shares key properties with rhythmical, stereotypic behaviors. We conclude that, in addition to the importance of socially mediated mechanisms for the mood-enhancing effects of crying, there is converging evidence for the direct, self-soothing effects of crying.

Development of the Crying Proneness Scale: associations among crying proneness, empathy, attachment, and age

Crying is a unique form of human emotional expression that is associated with both positive and negative evocative antecedents. This article investigates the psychometric properties of a newly developed Crying Proneness Scale by examining the factor structure, test-retest reliability, and theoretically hypothesized relationships with empathy, attachment, age, and gender. Based on an analysis of data provided by a Dutch panel (Time 1: N = 4,916, Time 2: N = 4,874), exploratory and confirmatory factor analyses suggest that crying proneness is a multidimensional construct best characterized by four factors called attachment tears, societal tears, sentimental/moral tears, and compassionate tears. Test-retest reliability of the scale was adequate and associations with age, gender, empathy, and attachment demonstrated expected relations. Results suggest that this scale can be used to measure crying proneness, and that it will be useful in future studies that aim to gain a better understanding of normal and pathological socioemotional development.

Engagement of pleasant activities in patients with substance use disorders: a correlational study

BACKGROUND

There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients' involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pleasant activities.

METHODS

Patients with SUDs (N = 265) were assessed at treatment entry on sociodemographic characteristics, primary type of substance (ie, alcohol or illicit drugs), addiction severity, craving, personality factors, and psychiatric distress.

RESULTS

Regression analyses identified dissimilar predictor sets underlying frequency, enjoyability, and cross-product ratings, highlighting the multifaceted behavioral nature of activity engagement. Personality measures showed the strongest associations with patients' activity engagement, with extraversion as the key predictor.

CONCLUSIONS

The present findings emphasize the complexity of patients' involvement in pleasant non-substance-related activities and further investigation is necessary to gain more insight into the underlying mechanisms of activity engagement.

Parental perceptions and experiences after childbirth: a comparison between mothers and fathers of term and preterm infants

BACKGROUND

Parents experience a lot of positive and negative feelings and emotions after birth. The main purpose of this study was to compare perceptions and experiences of mothers and fathers with term, moderately and very preterm infants.

METHODS

We included 202 infants with both parents, divided into three groups: 1) term infants (≥ 37 weeks' gestation), 2) moderately preterm infants (≥32-<37 weeks' gestation) and 3) very preterm infants (< 32 weeks' gestation). The Clinical Interview for Parents of High-risk Infants (CLIP) was used to examine parental perceptions and experiences in eight areas: 1) Infant's current condition, 2) Course of the pregnancy, 3) Labor and delivery, 4) Relationship with infant and feelings as a parent, 5) Reactions to hospital and staff, 6) Support system, 7) Discharge and beyond, and 8) Quality of narratives during the interview.

RESULTS

The lower the gestational age of the infant, the more negative parental experiences and perceptions were on the following five areas: infant's current condition, pregnancy course, labor and delivery, relationship with the infant, and discharge and beyond. No differences were found between maternal and paternal perceptions on any of the eight CLIP areas.

CONCLUSIONS

Negative parental perceptions and experiences were mainly associated with the gestational age of the infant and not at all with the gender of the parent. These findings resulted in several recommendations to optimize care for parents after preterm birth.

Pictorial representation of attachment: measuring the parent-fetus relationship in expectant mothers and fathers

Background

Over the past decades, attachment research has predominantly focused on the attachment relationship that infants develop with their parents or that adults had with their own parents. Far less is known about the development of feelings of attachment in parents towards their children. The present study examined a) whether a simple non-verbal (i.e., pictorial) measure of attachment (Pictorial Representation of Attachment Measure: PRAM) is a valid instrument to assess parental representations of the antenatal relationship with the fetus in expectant women and men and b) whether factors such as gender of the parent, parity, and age are systematically related to parental bonding during pregnancy.

Methods

At 26 weeks gestational age, 352 primi- or multiparous pregnant women and 268 partners from a community based sample filled in the PRAM and the M/PAAS (Maternal/Paternal Antenatal Attachment Scale, Condon, 1985/1993).

Results

Results show that the PRAM was significantly positively associated to a self-report questionnaire of antenatal attachment in both expectant mothers and fathers. Age and parity were both found significantly related to M/PAAS and PRAM scores.

Conclusions

The present findings provide support that the PRAM is as a valid, quick, and easy-to-administer instrument of parent-infant bonding. However, further research focusing on its capacity as a screening instrument (to identify parents with serious bonding problems) and its sensitivity to change (necessary for the use in evaluation of intervention studies) is needed, in order to prove its clinical value.

Influence of religiosity on the quality of life and on pain intensity in chronic pancreatitis patients after neurolytic celiac plexus block: case-controlled study

The quality of life in patients with chronic pancreatitis (CP) is reduced due to their suffering of high levels of pain. It has been presented that quality of life can also be linked to religiosity and/or spirituality. The aim of this study is to assess the influence of religious practices on the quality of life and on the subjective level of pain in CP patients. Ninety-two patients (37 women and 55 men) with chronic pancreatitis were treated invasively for pain with neurolytic celiac plexus block (NCPB). The religiosity of the patients was recorded and served as a dichotomizer. Group 1 was for patients who claimed to have no contact with the church or to have very sporadic contact (N = 35 patients). Group 2 was for patients who claimed to have deep faith and were regular participants at church activities (N = 57 patients). Visual analogue scale was used to assess pain, while the quality of life was measured by using QLQ C-30 questionnaire adapted for chronic pancreatitis patients in Polish population. The patients were assessed prior to the pain-relieving intervention and subsequently 2 and 8 weeks after it. The intensity of pain was reduced in both groups significantly after performing the NCPB. Patients who declared a deep faith reported higher level of pain on the VAS scale prior to intervention than non-religious patients. Quality of life in both groups of patients significantly improved after NCPB. Following NCPB, global quality of life in patients who declared higher religiosity/church attendance was significantly higher (79.88) than for those patients who have no contact or sporadic contact with the church (44.21, P < 0.05). NCPB resulted in significant reduction of pain and increase in quality of life in both groups of patients with CP. Nevertheless, in the group declaring higher religiosity/church attendance, reported pain was higher, but, despite that, quality of life better. It may be concluded that religious practices might serve as an additional factor improving quality of life and coping in patients suffering from chronic pancreatitis.

Emotional tears facilitate the recognition of sadness and the perceived need for social support

The tearing effect refers to the relevance of tears as an important visual cue adding meaning to human facial expression. However, little is known about how people process these visual cues and their mediating role in terms of emotion perception and person judgment. We therefore conducted two experiments in which we measured the influence of tears on the identification of sadness and the perceived need for social support at an early perceptional level. In two experiments (1 and 2), participants were exposed to sad and neutral faces. In both experiments, the face stimuli were presented for 50 milliseconds. In experiment 1, tears were digitally added to sad faces in one condition. Participants demonstrated a significant faster recognition of sad faces with tears compared to those without tears. In experiment 2, tears were added to neutral faces as well. Participants had to indicate to what extent the displayed individuals were in need of social support. Study participants reported a greater perceived need for social support to both sad and neutral faces with tears than to those without tears. This study thus demonstrated that emotional tears serve as important visual cues at an early (pre-attentive) level.

Emotional Tears Facilitate the Recognition of Sadness and the Perceived Need for Social Support

The tearing effect refers to the relevance of tears as an important visual cue adding meaning to human facial expression. However, little is known about how people process these visual cues and their mediating role in terms of emotion perception and person judgment. We therefore conducted two experiments in which we measured the influence of tears on the identification of sadness and the perceived need for social support at an early perceptional level. In two experiments (1 and 2), participants were exposed to sad and neutral faces. In both experiments, the face stimuli were presented for 50 milliseconds. In experiment 1, tears were digitally added to sad faces in one condition. Participants demonstrated a significant faster recognition of sad faces with tears compared to those without tears. In experiment 2, tears were added to neutral faces as well. Participants had to indicate to what extent the displayed individuals were in need of social support. Study participants reported a greater perceived need for social support to both sad and neutral faces with tears than to those without tears. This study thus demonstrated that emotional tears serve as important visual cues at an early (pre-attentive) level.

The impact of premature childbirth on parental bonding

The development of an affectionate parent-infant bond is essential for a newborn infant's survival and development. However, from evolutionary theory it can be derived that parental bonding is not an automatic process, but dependent on infants' cues to reproductive potential and parents' access to resources. The purpose of the present study was to examine the process of bonding in a sample of Dutch mothers (n = 200) and fathers (n = 193) of full-term (n = 69), moderately premature (n = 68), and very premature infants (n = 63). During the first month postpartum parents completed the Pictorial Representation of Attachment Measure (PRAM) and Postpartum Bonding Questionnaire (PBQ). Longitudinal analyses revealed that mothers' PRAM scores decreased after moderately preterm delivery, whereas decreases in PRAM scores occurred in both parents after very preterm delivery. As lower PRAM scores represent stronger feelings of parent-infant connectedness, our findings suggest a higher degree of bonding after premature childbirth. Results of the PBQ analysis were in line with PRAM outcomes, as parents of preterm infants reported less bonding problems compared to parents of full-terms. These findings support the hypothesis that in affluent countries with adequate resources, bonding in parents of preterm infants on average may be higher than in parents of full-term infants.

The effectiveness of video interaction guidance in parents of premature infants: a multicenter randomised controlled trial

Background

Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG) is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour.

Methods/design

This study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA), n = 70 moderate term infants (32–37 weeks GA) which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (<32 weeks GA) recruited by the NICU of 2 specialized hospitals. The participating families will be divided into 3 groups: a reference group (i.e. full term infants and their parents, receiving care as usual), a control group (i.e. premature infants and their parents, receiving care as usual) and an intervention group (i.e. premature infants and their parents, receiving VIG). The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic) stress symptoms, depression, anxiety and feelings of anger and hostility. Infant secondary outcomes are behavioral aspects such as crying, eating, and sleeping.

Discussion

This is the first prospective study to empirically evaluate the effect of VIG in parents of premature infants. Family recruitment is expected to be completed in January 2012. First results should be available by 2012.

Trail registration number

NTR3423

Individual Differences in Adult Crying: the Role of Attachment Styles

We carried out 2 studies to evaluate the relationship between attachment style and crying in adults. Data were collected from 2 independent large samples, measuring as 2 different operationalizations crying in general and in response to music. The results in both studies showed a consistent pattern. As anticipated, the group with a dismissive attachment style cried less than the other groups, and the preoccupied attachment style group cried more intensely than the secure group. The preoccupied and fearful attachment style groups reported the most negative emotions while crying, whereas the secure group reported more crying over positive emotions. These results show that attachment style is a determinant of adult crying behavior.

Posttraumatic stress disorder, anxiety and depression following pregnancies conceived through fertility treatments: the effects of medically assisted conception on postpartum well-being

OBJECTIVE

To compare the postpartum prevalence of Posttraumatic Stress Disorder (PTSD), anxiety and depression in women who conceived via medically assisted conception (MAC) and women who conceived naturally.

STUDY DESIGN

All women (n = 907) who delivered under supervision of four independent midwifery practices and three hospitals in the Netherlands during a 3-month period were asked to complete questionnaires on demographic, logistic, psychosocial and obstetric characteristics two to six months postpartum. In this cross-sectional study PTSD was measured with the Traumatic Event Scale-B; anxiety and depression were measured with the Hospital Anxiety and Depression Scale.

RESULTS

The response rate was 47% (428 participants). No significant differences were found in the prevalence of PTSD (0.0% vs. 1.3%; odds ratio [OR] = 0.0, confidence interval [CI]: 0-infinity), anxiety (28.1% vs. 22.2%; OR = 1.4, CI: 0.6-3.1) and depression (9.4% vs. 14.6%; OR = 0.6, CI: 0.8-2.0) between the 32 women who conceived via MAC and the 396 women who conceived naturally.

CONCLUSION

We did not find significant differences in the prevalence of PTSD, anxiety and depression between women who conceived via MAC and women who conceived naturally.

Assessing the impact of chemotherapy-induced peripheral neurotoxicity on the quality of life of cancer patients: the introduction of a new measure

Purpose

To investigate the impact of chemotherapy-induced neurotoxicity on daily activities and quality of life (QoL) of cancer patients.

Methods

QoL of all patients visiting the oncological outpatient ward of the Maxima Medical Centre in the Netherlands from October 2006 until March 2007 treated with taxanes, vinca-alkaloids and/or platinum compounds (n = 88) was compared with the QoL of patients that did not receive these treatments yet (n = 43). Patient-reported neuropathy symptoms were evaluated with the newly developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group/Neurotoxicity (FACT/GOG-Ntx) questionnaire.

Results

Patients treated with chemotherapy reported significantly more complaints of neuropathy (p < 0.001) and more paresthesias and dysesthesias in the upper (p < 0.001; p < 0.01) and lower extremities (p < 0.001) compared to those not treated with chemotherapy. They additionally experienced problems with fine motor function (e.g., getting (un)dressed, writing, and picking up small objects). Moreover, cold-induced paresthesias were frequently reported. Overall, patients indicated that their neuropathy had a negative effect on QoL.

Conclusions

The newly developed CINQ and the FACT/GOG-Ntx results suggest a considerable negative impact of patient-reported neuropathy symptoms on daily activities and QoL in cancer patients treated with chemotherapy. However, further validation of the CINQ is needed.

Posttraumatic stress following childbirth in homelike- and hospital settings

OBJECTIVE

To assess the prevalence of posttraumatic stress disorder (PTSD) following childbirth in homelike versus hospital settings and to determine risk factors for the development of posttraumatic stress symptoms. METHODS.: Multi-center cross-sectional study at midwifery practices, general hospitals and a tertiary (university) referral center. An unselected population of 907 women was invited to complete questionnaires on PTSD, demographic, psychosocial, and obstetric characteristics 2 to 6 months after delivery. Prevalence of PTSD was based on women who met all criteria of the diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV), whereas risk factors were determined using the severity (sum-score) of posttraumatic stress symptoms.

RESULTS

PTSD following childbirth was found in 1.2% of the respondents (5/428 women, response rate 47%), while 9.1% of women (39/428) had experienced the delivery as traumatic. Posttraumatic stress symptoms were associated with unplanned cesarean section, low sense of coherence (coping skills), and high intensity of pain. Initial differences in posttraumatic stress symptoms between home and hospital deliveries disappeared after taking into account the (by definition) uncomplicated nature of home births.

CONCLUSION

In this Dutch study, 1 in 100 women had PTSD following childbirth, with no differences between home- and hospital deliveries after controlling for complications and interventions. Emergency cesarean section, severe labor pain, and poor coping skills were associated with more posttraumatic stress symptoms.

The effects of psychiatric distress, inhibition, and impulsivity on decision making in patients with substance use disorders: A matched control study

In the present study, the decision making abilities of patients with substance use disorders were compared to those of healthy controls and, subsequently, the impact of psychiatric distress, behavioral inhibition, and impulsivity on Iowa Gambling Task (IGT) performance were evaluated. A total of 31 patients and 31 matched healthy controls performed the IGT and completed the Symptom Checklist-90-Revised (SCL-90-R) and the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS). The results confirmed that the patient group had severe impairments on the IGT relative to the controls, which appeared to be virtually unrelated to the employed measures. It is concluded that self-reported psychiatric symptoms, behavioral inhibition, and impulsivity have no impact on the IGT performance in this patient sample.

Suffering in long-term cancer survivors: an evaluation of the PRISM-R2 in a population-based cohort

PURPOSE

The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as generic measure to assess suffering. The aim of this study was to evaluate the ability of this instrument to identify long-term cancer survivors with high levels of suffering who may need additional support.

METHODS

1299 cancer survivors completed the PRISM-R2, the Short Form Health Survey (SF-36), and the Quality of Life-Cancer Survivors questionnaire (QoL-CS). The PRISM-R2 distinguishes between the Self-Illness Separation (SIS) and Illness Perception Measure (IPM), both measuring aspects of suffering.

RESULTS

112 (9%) cancer survivors reported high suffering according to IPM. This group had a higher cancer stage at diagnosis, more cancer recurrences, more comorbidities, and were lower educated compared to people reporting less suffering. The PRISM-R2 could explain substantial amounts of variance (10-14%) in the psychological aspects of the SF-36 and QoL-CS. The IPM also discriminated statistically and clinically significant between high- and low-health status.

CONCLUSION

The PRISM-R2 proved to be able to discriminate between individuals with good and deteriorated levels of QoL. Further evaluation of its validity and screening potential is recommended.