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Lochmannová A, Hollins Martin CJ, Martin CR. Translation and validation of the Czech Partner version of the Birth Satisfaction Scale-Revised (BSS-R). J Reprod Infant Psychol 2024:1-15. [PMID: 39268730 DOI: 10.1080/02646838.2024.2401828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 09/01/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND The Birth Satisfaction Scale-Revised (BSS-R) is a widely used, psychometrically robust and brief self-report measure of birth experience from the mothers perspective. The current study sought to adapt and validate the BSS-R for partners, evaluating key psychometric properties, including the underlying tri-dimensional factor structure of stress experienced, personal attributes and quality of care. AIM To translate and validate a Czech speaking partner version of the Birth Satisfaction Scale-Revised (BSS-R) and examine key measurement characteristics and association with fundamental clinical outcome variables. METHOD Following translation of the UK partner BSS-R into Czech, the Czech Partner BSS-R (CZP-BSS-R) was administered to 225 partners of women who had given birth within the past 5-years. Key psychometric characteristics were examined, including factor structure, divergent and known-groups discriminant validity and internal reliability. RESULTS Established measurement models of the BSS-R observed in mothers were found to offer an excellent fit to partner data. The CZP-BSS-R also demonstrated excellent validity and reliability characteristics. CONCLUSIONS The CZP-BSS-R was found to be valid and reliable, with results from Czech partners 'mirroring' factor structure and key validity characteristics previously established in Czech mothers. The BSS-R validated for completion by Czech speaking mothers now has a matched version available for use with Czech speaking partners.
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Affiliation(s)
- Alena Lochmannová
- Department of Emergency Medicine, Diagnostic Disciplines and Public Health, Faculty of Health Care Studies, University of West Bohemia, Plzeň, Czech Republic
| | | | - Colin R Martin
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, UK
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Frankham LJ, Thorsteinsson EB, Bartik W. Birth related PTSD and its association with the mother-infant relationship: A meta-analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 38:100920. [PMID: 37847956 DOI: 10.1016/j.srhc.2023.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/02/2023] [Accepted: 10/08/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE There is a growing body of research showing that birth related posttraumatic stress disorder (PTSD) symptoms may impact the mother-infant relationship. The present study assessed the strength of the association between birth related PTSD symptoms and the mother-infant relationship. METHOD A total of twelve studies (5,572 participants) were included based on database searches using PubMed, EBSCO and ProQuest. RESULTS The findings showed that greater levels of birth related PTSD symptoms were associated with poorer mother-infant relationship, r = -0.36, 95% CI: [-0.43 - -0.28], random effects model. The outcomes appeared to be heterogeneous (Q(11) = 81.63, p <.001, tau2 = 0.0123, I2 = 80.73%), despite all outcomes being in the same direction as the overall outcome. CONCLUSIONS The results indicated that birth related PTSD symptoms are negatively associated with the mother-infant relationship. Further investigation into the prevention of birth related trauma is suggested. Improving birthing experiences for mothers is likely to contribute to improved infant mental health, thereby reducing overall social and economic costs.
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Affiliation(s)
- Lucy J Frankham
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW 2351, Australia.
| | - Einar B Thorsteinsson
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW 2351, Australia
| | - Warren Bartik
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW 2351, Australia
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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] [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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Silva-Fernandez CS, de la Calle M, Arribas SM, Garrosa E, Ramiro-Cortijo D. Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review. NURSING REPORTS 2023; 13:1553-1576. [PMID: 37987409 PMCID: PMC10661273 DOI: 10.3390/nursrep13040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
Postpartum depression (PPD) and post-traumatic stress disorder (PTSD) continue to be prevalent, and disabling women with mental disorders and obstetric violence (OV) may be a trigger for them, particularly during maternity. We aimed to analyze the association between manifestations of OV with the development of PPD and PTSD during pregnancy, childbirth, and postpartum. This systematic review was based on the PRISMA 2020 statement and explored original articles published between 2012 and 2022. A total of 21 articles were included in the analysis, and bias was assessed by the Effective Public Health Practice Project's Quality Assessment Tool. The highest rate of PPD symptoms appeared in women under 20 years old, multiparous, and with low education levels. The higher PTSD ratio was present in women under 35 years, primiparous, and with secondary studies. The mode of labor (instrumental or C-section) was identified as a major risk factor of PPD, being mediator variables of the informal coercion of health professionals and dissatisfaction with newborn healthcare. Instead, partner support during labor and high satisfaction with healthcare during birth were protective factors. Regarding PTSD, the mode of labor, several perineal tears, and the Kristeller technique were risk factors, and loss of autonomy and coercion modulated PTSD symptomatology. The protective factors for PTSD were respect for the labor plan, adequate communication with health professionals, social support during labor, and the skin-to-skin procedure. This systematic review provides evidence that OV contributes to PPD and PTSD, being important in developing standardized tools to prevent it. This study recommends changes in maternal healthcare policies, such as individualized healthcare assistance, humanized pregnancy protocols, and women's mental health follow-up, and improvements in the methodological quality of future research.
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Affiliation(s)
- Claudia Susana Silva-Fernandez
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - Eva Garrosa
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
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Yeo JH, Sagong H. Korean women's perceptions of traumatic childbirth: a qualitative descriptive study. BMC Pregnancy Childbirth 2023; 23:687. [PMID: 37741996 PMCID: PMC10517454 DOI: 10.1186/s12884-023-05986-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Previous studies have established that negative or traumatic childbirth can create childbirth-related post-traumatic stress disorder (CB-PTSD). Because of the negative implications of CB-PTSD for mothers, children, and families, global qualitative research on traumatic or negative childbirth has risen in recent years. However, few studies have been conducted in South Korea. This study aims to explore women's various perceptions of traumatic childbirth in South Korea. METHODS This qualitative descriptive study examined nine women who were at high risk of PTSD (IES-R-K > 24) at the time of the interview, between 1 and 11 years after childbirth. Semi-structured interviews were conducted. Interview transcripts were subjected to thematic analysis. RESULTS The analysis identified two themes with six subthemes, as follows: (1) person-centred factors (pain, guilt, maternal identity conflict, and damaged femininity); (2) society-centred factors (threatened dignity and disrupted relationships). These findings may be attributed to Korean culture (excessive motherhood and lookism), as well as unbearable pain, disrespectful childbirth environments, lack of spouse's support, loss of their lifestyle, and unrealistic expectations. CONCLUSIONS This study demonstrates various negative consequences, ranging from psychological damage to conflict in women's relationships with their spouses, and others. This highlights the various perceptions stemming from traumatic childbirth and emphasizes the significance of clinical intervention. Therefore, healthcare professionals' greater understanding of women's perceptions and increased concern about childbirth and respectful childbirth environments are required. In addition, based on our findings, there is a need to develop interventions that can alleviate CB-PTSD and further improve women's mental health, particularly through women-centred interventions.
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Affiliation(s)
- Jung Hee Yeo
- College of Nursing, Dong-A University, Busan, South Korea
| | - Hae Sagong
- College of Nursing, Auburn University, 710 South Donahue Drive, Auburn, AL, 36849, USA.
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Jiang L, Yang C, Pi Z, Li Y, Liu S, Yi X. Individuals with High Metacognitive Ability Are Better at Divergent and Convergent Thinking. J Intell 2023; 11:162. [PMID: 37623545 PMCID: PMC10455872 DOI: 10.3390/jintelligence11080162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/29/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Is metacognitive ability a predictor of creative performance? Previous studies have produced conflicting findings. To clarify whether this relationship exists, the current study used eye tracking techniques and vocal thinking reports to explore creativity differences in individuals with different levels of metacognitive ability. One hundred and twelve participants completed the Metacognitive Ability scale, and were divided into two groups (with thirty participants in each group) based on their metacognition scores (the highest and lowest 27% of metacognitive ability scores). Then, participants in both groups completed two creative thinking tasks (AUT and CCRAT) while their eye behaviors were recorded by eye tracking. The results showed that participants with high metacognitive ability were better at divergent thinking, as evidenced by greater fixation and saccade counts, as well as smaller saccade amplitudes in the AUT task. In addition, Bayesian analyses provide anecdotal evidence that participants with high metacognitive ability tended to be better at convergent thinking. Furthermore, eye tracking results demonstrated that they exhibited longer fixation duration and more fixation count on the materials in the CCRAT task. These findings reflect an important role of metacognition in creative thinking, especially in divergent thinking.
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Affiliation(s)
- Lan Jiang
- Key Laboratory of Modern Teaching Technology (Ministry of Education), Shaanxi Normal University, No. 199 Chang’an Road, Yanta District, Xi’an 710062, China; (L.J.); (Z.P.)
| | - Chunliang Yang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China; (C.Y.); (S.L.)
| | - Zhongling Pi
- Key Laboratory of Modern Teaching Technology (Ministry of Education), Shaanxi Normal University, No. 199 Chang’an Road, Yanta District, Xi’an 710062, China; (L.J.); (Z.P.)
| | - Yangping Li
- School of Foreign Studies, Xi’an Jiaotong University, No. 28 Xianning West Road, Xi’an 710049, China;
| | - Shaohang Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China; (C.Y.); (S.L.)
| | - Xinfa Yi
- Key Laboratory of Modern Teaching Technology (Ministry of Education), Shaanxi Normal University, No. 199 Chang’an Road, Yanta District, Xi’an 710062, China; (L.J.); (Z.P.)
- The Branch Center of National Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal University, Shaanxi Normal University, No. 199 Chang’an Road, Yanta District, Xi’an 710062, China
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Emmens B, Hollins Martin CJ, Martin CR. Translation and validation of the Dutch version of the Birth Satisfaction Scale-Revised (BSS-R). J Reprod Infant Psychol 2023; 41:213-227. [PMID: 34792408 DOI: 10.1080/02646838.2021.1979200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recent observations suggest birth satisfaction may be significantly associated with postpartum post-traumatic stress disorder (PP-PTSD). The Birth Satisfaction Scale-Revised (BSS-R) is increasingly used Internationally as a short, valid and reliable multi-dimensional measure of birth experience. The current study sought to develop a Dutch version of the BSS-R (D-BSS-R) for clinical and research application in the Netherlands. METHODS Post-translation, a cross-sectional design with an embedded between-subjects component was used to evaluate key indices of validity and reliability of the D-BSS-R in a purposive sampled cohort of 244 Dutch-speaking women in the Netherlands. Confirmatory factor analysis, divergent, convergent and known-groups discriminant validity were evaluated as was the internal consistency of the measure. RESULTS The D-BSS-R was found to be a generally valid and reliable measure of birth experience with the key measurement characteristics of the original English-language measure transferring well to the Dutch context. Statistically significant negative correlations were observed between all D-BSS-R sub-scales and a validated measure of PTSD. CONCLUSIONS The D-BSS-R represents a valid and reliable measure of birth experience suitable and appropriate for use in the Netherlands. The study corroborates previous suggestions of linkage between birth satisfaction and PP-PTSD using a robust and diagnostically valid measure of trauma.
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Affiliation(s)
- Berbel Emmens
- Independent Researcher, Counselor, MSc Applied Psychology
| | - Caroline J Hollins Martin
- Maternal Health, School of Nursing, Midwifery and Social Care Edinburgh Napier University, Scotland, UK
| | - Colin R Martin
- Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK
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Van Sieleghem S, Danckaerts M, Rieken R, Okkerse JME, de Jonge E, Bramer WM, Lambregtse-van den Berg MP. Childbirth related PTSD and its association with infant outcome: A systematic review. Early Hum Dev 2022; 174:105667. [PMID: 36152399 DOI: 10.1016/j.earlhumdev.2022.105667] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Maternal postnatal mental health problems may negatively impact child development. Postpartum research has mainly focused on the impact of maternal depression and anxiety due to their high prevalence (13-25 % and 10-18 %, respectively). However, maternal childbirth-related PTSD (CB-PTSD) could be another important risk factor in child development (estimated prevalence: 4.7 %). OBJECTIVE We investigated whether maternal CB-PTSD (symptoms) are associated with a negative mother-child relationship and/or child developmental outcome for children aged 0-5 years. Furthermore, we examined whether maternal trauma-focused therapy can positively impact mother and child outcomes. METHODS We performed a systematic review by searching three databases (Embase, Medline, PsycInfo). Search terms involved: 'birth or delivery modes', 'PTSD psychological trauma', and 'child development or child behavior'. Two independent reviewers evaluated all eligible papers. RESULTS Thirty-five papers (30 samples) were included and qualitatively reported. Results suggest a negative association of maternal CB-PTSD (symptoms) with mother-infant attachment and child behavior. However, confounding factors may explain this association. The evidence on associations with breastfeeding, sleeping, socio-emotional development, and weight gain is insufficient. Research investigating the effect of maternal trauma-focused therapy on a child's outcome is scarce, contradictory, and of low quality. CONCLUSION This systematic review suggests that maternal CB-PTSD may be associated with an increased number of problems in mother-infant attachment and child behavior, but other domains remain scarcely investigated and methodologic issues are present (cross-sectional study design, influence of confounding variables, sample representativeness, diversity in assessment tools). Our results support a multidisciplinary approach to providing early prevention and screening of the maternal mental health state.
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Affiliation(s)
- Sofie Van Sieleghem
- Department of Child and Adolescent Psychiatry, UPC KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Marina Danckaerts
- Department of Child and Adolescent Psychiatry, UPC KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Rob Rieken
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands
| | - Jolanda M E Okkerse
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands
| | - Ellen de Jonge
- Department of psychiatry, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Mijke P Lambregtse-van den Berg
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands; Department of psychiatry, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands
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Stapelberg NJC, Branjerdporn G, Adhikary S, Johnson S, Ashton K, Headrick J. Environmental Stressors and the PINE Network: Can Physical Environmental Stressors Drive Long-Term Physical and Mental Health Risks? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13226. [PMID: 36293807 PMCID: PMC9603079 DOI: 10.3390/ijerph192013226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Both psychosocial and physical environmental stressors have been linked to chronic mental health and chronic medical conditions. The psycho-immune-neuroendocrine (PINE) network details metabolomic pathways which are responsive to varied stressors and link chronic medical conditions with mental disorders, such as major depressive disorder via a network of pathophysiological pathways. The primary objective of this review is to explore evidence of relationships between airborne particulate matter (PM, as a concrete example of a physical environmental stressor), the PINE network and chronic non-communicable diseases (NCDs), including mental health sequelae, with a view to supporting the assertion that physical environmental stressors (not only psychosocial stressors) disrupt the PINE network, leading to NCDs. Biological links have been established between PM exposure, key sub-networks of the PINE model and mental health sequelae, suggesting that in theory, long-term mental health impacts of PM exposure may exist, driven by the disruption of these biological networks. This disruption could trans-generationally influence health; however, long-term studies and information on chronic outcomes following acute exposure event are still lacking, limiting what is currently known beyond the acute exposure and all-cause mortality. More empirical evidence is needed, especially to link long-term mental health sequelae to PM exposure, arising from PINE pathophysiology. Relationships between physical and psychosocial stressors, and especially the concept of such stressors acting together to impact on PINE network function, leading to linked NCDs, evokes the concept of syndemics, and these are discussed in the context of the PINE network.
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Affiliation(s)
- Nicolas J. C. Stapelberg
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Grace Branjerdporn
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Sam Adhikary
- Mater Young Adult Health Centre, Mater Hospital, Brisbane, QID 4101, Australia
| | - Susannah Johnson
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia
| | - Kevin Ashton
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - John Headrick
- School of Medical Science, Griffith University, Gold Coast, QID 4215, Australia
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Sommer JL, Shamblaw A, Mota N, Reynolds K, El-Gabalawy R. Mental disorders during the perinatal period: Results from a nationally representative study. Gen Hosp Psychiatry 2021; 73:71-77. [PMID: 34624829 DOI: 10.1016/j.genhosppsych.2021.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study examined mental health profiles of pregnant and postpartum females, with and without perinatal complications, compared to non-perinatal females of childbearing age. METHODS We analyzed nationally representative data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309; 51.9% female). A validated semi-structured interview assessed past-year DSM-5 mental disorders. Multivariable regressions examined associations between perinatal status and mental disorders, controlling for sociodemographic characteristics. RESULTS Using females who were not pregnant in the past year as a reference group, those who were postpartum with complications during pregnancy or delivery had increased odds of any past-year mental disorder (58.7% vs. 46.8%; AOR = 1.56), any depressive/bipolar disorder (26.4% vs. 18.8%; AOR = 1.57), and posttraumatic stress disorder (14.0% vs. 7.3%; AOR = 1.99). In contrast, those who were postpartum without complications did not have increased odds of these disorders. Those who were pregnant without pregnancy complications had reduced odds of any past-year mental disorder (33.7% vs. 46.8%; AOR = 0.55) and any depressive/bipolar disorder (11.7% vs. 18.8%; AOR = 0.60). All perinatal groups had reduced odds of any substance use disorder compared to those who were not pregnant in the past year (18.9-25.7% vs. 29.8% AORs: 0.49-0.78), except those who were postpartum with pregnancy or delivery complications (28.8%). CONCLUSION Results highlight the importance of mental health screening among perinatal females, particularly those who are postpartum and experience perinatal complications. Findings may inform the development of targeted interventions for this subpopulation.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Shamblaw
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
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Cataudella S, Lampis J, Busonera A, Congia F, Melis GB, Zavattini GC. From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective. J Reprod Infant Psychol 2021; 40:266-287. [PMID: 34693840 DOI: 10.1080/02646838.2021.1995597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman's and infant's age, and difficulty of delivery. METHODS 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). RESULTS Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (β = 0.379, p < .001), anxiety in the romantic relationships (β=-0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, β=-0.323, p=0.025 ;t2, β=0.329, p=0.014) in the couple's relationship. These variables explained 20.2% of variance in mother-infant attachment (R2adjusted=0.202). DISCUSSION The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman's reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child.
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Affiliation(s)
- Stefania Cataudella
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Jessica Lampis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Alessandra Busonera
- Department of Dynamic and Clinical Psychology, Sapienza, University of Rome, Italy
| | - Francesca Congia
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
| | - Gian Benedetto Melis
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
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Kalfon Hakhmigari M, Peled Y, Krissi H, Levy S, Molmen-Lichter M, Handelzalts JE. Anxious Attachment Mediates the Associations Between Early Recollections of Mother's Own Parental Bonding and Mother-Infant Bonding: A 2-Month Path Analysis Model. Front Psychiatry 2021; 12:682161. [PMID: 34366916 PMCID: PMC8336863 DOI: 10.3389/fpsyt.2021.682161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022] Open
Abstract
Parental bonding (recollection of own parents' parenting), adult attachment, and mother-infant bonding are all closely related yet distinct concepts of the parent-child relationship, sometimes used interchangeably in the literature. This study aimed to examine the associations between these concepts in a longitudinal path analysis design. A total of 262 postpartum women who gave birth at the maternity ward of a large tertiary health center in Israel completed a demographic questionnaire, the Experiences in Close Relationships Scale (ECR), the Parental Bonding Instrument (PBI) at 1-4 days postpartum, and the Postpartum Bonding Questionnaire (PBQ) at 2 months postpartum. Parental care factor (PBI) was found to be associated with mother-infant bonding (PBQ), directly and indirectly through insecure anxious attachment (ECR). Denial of autonomy factor (PBI) was found to be associated with mother-infant bonding (PBQ) only through insecure anxious attachment (ECR). Encouragement of behavioral freedom factor (PBI) was found to be associated with mother-infant bonding (PBQ) in a simple correlation but not in the complete model. The results highlight the intergenerational aspects of parenting and suggest that early childhood interventions with parents may have a long-term impact on child-rearing though generations, and by that on children's development.
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Affiliation(s)
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Levy
- Statistics Education Unit, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Maayan Molmen-Lichter
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Jonathan E. Handelzalts
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
- Psychiatry Department, University of Michigan, Ann Arbor, MI, United States
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13
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Family Minds: A randomized controlled trial of a group intervention to improve foster parents' reflective functioning. Dev Psychopathol 2021; 34:1177-1191. [PMID: 33583462 DOI: 10.1017/s095457942000214x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Family Minds is a brief group psychoeducational parenting intervention designed to increase the reflective functioning (RF) and mentalization skills of foster parents. RF is important for foster parents who have to build relationships with children whose adverse experiences increase their risk for psychosocial challenges. A randomized controlled trial (RCT) for Family Minds was conducted in Texas with 89 foster parents. The main aims of this study were to examine whether the intervention could significantly increase the RF/mentalization skills of the foster parents and decrease their parenting stress. After 6 weeks, compared with the control group, intervention foster parents improved their RF via a lowering of pre-mentalizing and also significantly decreased parenting stress related to parent-child dysfunctional interactions. Other measures of RF and parenting stress showed no significant differences between groups. Foster child behavior was not significantly different between groups, although data at 6 months showed a possible lowering of internalizing symptoms for children of intervention parents. This RCT provides some encouraging evidence that Family Minds may increase RF in foster parents, improve parental sensitivity and their ability to emotionally regulate, decrease parenting stress related to challenging interactions with their foster children, and possibly decrease children's internalizing behavior.
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14
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Türkmen H, Yalniz Dilcen H, Akin B. The Effect of Labor Comfort on Traumatic Childbirth Perception, Post-Traumatic Stress Disorder, and Breastfeeding. Breastfeed Med 2020; 15:779-788. [PMID: 32896164 DOI: 10.1089/bfm.2020.0138] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: This study aims to examine the effect of labor comfort on traumatic childbirth perception, post-traumatic stress disorder (PTSD), and breastfeeding after the fourth postpartum week. Methods: This prospective longitudinal study was conducted between June 2019 and February 2020 in Turkey (n = 102). A personal information form and the Childbirth Comfort Questionnaire were administered to pregnant women with cervical dilatation of 5-8 cm in the delivery room. They were also administered the Traumatic Childbirth Perception Scale (TCPS), PTSD Scale, and Breastfeeding Self-Efficacy Scale twice, including 4 weeks and 3 months after childbirth. Additionally, the TCPS and PTSD Scale were reapplied 6 months after childbirth. Results: The prevalence of traumatic childbirth perceptions and PTSD at 4 weeks of the postpartum period was 68.6% and 59.8%, respectively. The multiple linear regression analysis revealed a significant relationship between physical labor comfort (p = 0.003), transcendence (p = 0.023), family history of labor difficulty (p = 0.027), and feelings about birth before labor begins (p = 0.005) and traumatic childbirth perceptions 4 weeks after childbirth. Additionally, there was a significant relationship between physical labor comfort (p = 0.001), psychospiritual labor comfort (p = 0.006), transcendence (p = 0.001), primiparity (p = 0.009), place of residence (p = 0.044), and traumatic childbirth perceptions (p < 0.001) and PTSD 4 weeks after childbirth. Physical labor comfort affected traumatic childbirth perceptions 3 and 6 months after childbirth (p < 0.05). Physical labor comfort affected breastfeeding self-efficacy 4 weeks and 3 months after childbirth (p < 0.05). A significant relationship was also found between high traumatic childbirth perception levels, high PTSD prevalence, and low breastfeeding self-efficacy 3 months after giving birth (p < 0.05). Conclusions: Puerperal women had high traumatic childbirth perception levels and PTSD prevalence. Low labor comfort increased traumatic childbirth perception and PTSD prevalence. There was a significant relationship between low labor comfort, high traumatic childbirth perception level, high PTSD prevalence, and low breastfeeding self-efficacy. Therefore, midwives should support pregnant women to increase labor comfort by using alternative methods. Thus, traumatic childbirth perception may decrease and breastfeeding self-efficacy may increase.
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Affiliation(s)
- Hülya Türkmen
- Department of Midwifery, Faculty of Health Sciences, Balıkesir University, Balıkesir Turkey
| | - Hacer Yalniz Dilcen
- Department of Midwifery, Faculty of Health Sciences, Bartın University, Bartın Turkey
| | - Bihter Akin
- Department of Midwifery, Faculty of Health Sciences, Selçuk University, Konya, Turkey
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15
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Cameron EE, Joyce KM, Delaquis CP, Reynolds K, Protudjer JLP, Roos LE. Maternal psychological distress & mental health service use during the COVID-19 pandemic. J Affect Disord 2020; 276:765-774. [PMID: 32736186 PMCID: PMC7370903 DOI: 10.1016/j.jad.2020.07.081] [Citation(s) in RCA: 218] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Mental health problems are increasingly recognized as a significant and concerning secondary effect of the COVID-19 pandemic. Research on previous epidemics/pandemics suggest that families, particularly mothers, may be at increased risk, but this population has yet to be examined. The current study (1) described prevalence rates of maternal depressive and anxiety symptoms from an online convenience sample during the COVID-19 pandemic, (2) identified risk and protective factors for elevated symptoms, and (3) described current mental health service use and barriers. METHODS Participants (N = 641) were mothers of children age 0-8 years, including expectant mothers. Mothers completed an online survey assessing mental health, sociodemographic information, and COVID-19-related variables. RESULTS Clinically-relevant depression was indicated in 33.16%, 42.55%, and 43.37% of mothers of children age 0-18 months, 18 months to 4 years, and 5 to 8 years, respectively. Prevalence of anxiety was 36.27%, 32.62%, and 29.59% for mothers across age groups, respectively. Binary logistic regressions indicated significant associations between risk factors and depression/anxiety across child age groups. LIMITATIONS Cross-sectional data was used to describe maternal mental health problems during COVID-19 limiting the ability to make inferences about the long-term impact of maternal depression and anxiety on family well-being. CONCLUSIONS Maternal depression and anxiety appear to be elevated in the context of COVID-19 compared to previously reported population norms. Identified risk factors for depression and anxiety across different child age ranges can inform targeted early intervention strategies to prevent long-term impacts of the COVID-19 pandemic on family well-being and child development.
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Affiliation(s)
- Emily E Cameron
- Department of Psychology, University of Calgary, 2500 University Drive, NW, Calgary, AB T2N 1N4, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada.
| | - Kayla M Joyce
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | | | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Canada; George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
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16
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Radoš SN, Matijaš M, Anđelinović M, Čartolovni A, Ayers S. The role of posttraumatic stress and depression symptoms in mother-infant bonding. J Affect Disord 2020; 268:134-140. [PMID: 32174471 DOI: 10.1016/j.jad.2020.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 02/19/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is some evidence posttraumatic stress disorder (PTSD) following childbirth may impact on the mother-infant bond. However, the evidence is inconsistent over whether PTSD or co-morbid depressive symptoms are primarily related to impaired bonding. This study therefore aimed to examine the relationship between PTSD symptoms, depressive symptoms and mother-infant bonding. METHODS A cross-sectional online study included 603 mothers of infants aged 1-12 months. Measures were taken of PTSD (City Birth Trauma Scale, Ayers et al., 2018) which has two subscales of birth-related PTSD symptoms and general PTSD symptoms; depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987) and mother-infant bonding (Postpartum Bonding Questionnaire, Brockington et al., 2001). RESULTS Impaired bonding was related to both dimensions of PTSD symptoms and depressive symptoms in bivariate analysis. Path analysis testing the model of whether depressive symptoms mediated the effect of PTSD symptoms on mother-infant bonding found a differential role of birth-related and general PTSD symptoms. Birth-related PTSD symptoms did not have any effect on bonding or depressive symptoms. In contrast, general PTSD symptoms had a direct effect on bonding and an indirect effect on bonding via depressive symptoms. LIMITATIONS Self-report measures of PTSD and depression symptoms were used. CONCLUSIONS Further research regarding different aspects of postpartum PTSD, depression and other disorders in the context of mother-infant bonding are needed. Future preventive programs should focus on diminishing symptoms of postpartum PTSD and depression so that the mother-infant bonding remains optimal.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia.
| | - Marijana Matijaš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maja Anđelinović
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Anto Čartolovni
- Digital Healthcare Ethics Laboratory, Catholic University of Croatia, Zagreb, Croatia
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University of London, London, UK
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17
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Stuijfzand S, Garthus-Niegel S, Horsch A. Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study. Front Psychiatry 2020; 11:570727. [PMID: 33173518 PMCID: PMC7540215 DOI: 10.3389/fpsyt.2020.570727] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/21/2020] [Indexed: 12/03/2022] Open
Abstract
The parent-infant bond following childbirth is an important facilitator of optimal infant development. So far, research has mainly focused on mother-infant bonding. Data on fathers are still sparse. Parental mental health, such as posttraumatic stress symptoms (PTSD), may influence mother-infant relations and/or interactions. There is evidence that both parents can experience PTSD symptoms following childbirth (PTSD-CB). The aim of this study is to investigate the prospective relationship between parental PTSD-CB symptoms at 1 month postpartum and perceived parent-infant bonding at 3 months postpartum, while adjusting for antenatal confounders. A subsample was used for this study (n Totalsample 488, n mothers = 356, n fathers = 132) of an ongoing prospective cohort study. Future parents awaiting their third trimester antenatal appointments at a Swiss university hospital were recruited. Self-report questionnaires assessed PTSD-CB symptoms and psychological distress at 1 month postpartum, and parent-infant bonding at 3 months postpartum. Confounders included antenatal PTSD symptoms and social support measured via self-report questionnaires, and gestity and gestational age, extracted from medical records. Using structural equation modeling, the predictive ability of PTSD-CB symptoms at 1 month postpartum on parent-infant bonding at 3 months postpartum was assessed for both parents respectively. Maternal PTSD-CB symptoms at 1 month postpartum were found to be negatively prospectively associated with mother-infant bonding at 3 months postpartum; however, this effect disappeared after adjusting for psychological distress at 1 month postpartum. No such effects were found for fathers. There was no evidence of mediation of the relationship between parental PTSD-CB symptoms at 1 month postpartum and parental-infant bonding at 3 months postpartum via psychological distress at 1 month postpartum. However, such a mediation was found for maternal intrusion and hyperarousal symptom subscales. Results expand the current literature on the impact of PTSD-CB on parent-child relations to also include fathers, and to a community sample. Any adverse effects of mental health symptoms on parent-infant bonding were evidenced by 3 months postpartum only for mothers, not fathers. Our results may inform the development of prevention/intervention strategies.
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Affiliation(s)
- Suzannah Stuijfzand
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Department of Medicine, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Dresden University of Technology, Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Antje Horsch
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
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18
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Schobinger E, Stuijfzand S, Horsch A. Acute and Post-traumatic Stress Disorder Symptoms in Mothers and Fathers Following Childbirth: A Prospective Cohort Study. Front Psychiatry 2020; 11:562054. [PMID: 33414729 PMCID: PMC7783161 DOI: 10.3389/fpsyt.2020.562054] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/30/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Up to 30% of women view their childbirth as traumatic. This experience can lead to acute stress disorder or post-traumatic stress disorder. The negative impact of maternal post-traumatic stress disorder following childbirth reaches beyond the mother, potentially affecting her child's development and the couple's relationship. Research on paternal post-traumatic stress disorder following childbirth is scarce. Acute stress disorder is suggested to be an important predictor of post-traumatic stress disorder in mothers, but little is known about paternal acute stress disorder following childbirth. Furthermore, there is limited information about the comparison or relation of acute stress disorder and post-traumatic stress disorder following childbirth between parents. Aim: [1] To compare the prevalence rates and severity of acute stress disorder and post-traumatic stress disorder symptoms between parents following childbirth by taking anxiety and depression symptoms, as well as obstetric variables and previous traumatic events into account and [2] To determine if acute stress disorder is a predictor of post-traumatic stress disorder. Method: A prospective population-based design was used. N = 647 participants were recruited from future parents who attended appointments at the Obstetrics and Gynecology unit at a Swiss university hospital. Self-report questionnaires were used: Post-traumatic Diagnostic Scale in the third trimester of pregnancy (T1) and 1 month post-partum (T3), Acute Stress Disorder Scale at 1 week post-partum (T2), and Hospital Anxiety and Depression Scale at all time points. Obstetric and neonatal variables were retrieved from hospital records. Results: At T2, 63.9% of mothers and 51.7% of fathers presented symptoms of acute stress disorder. At T3, 20.7% of mothers and 7.2% of fathers had symptoms of post-traumatic stress disorder. Acute stress disorder was a predictor of post-partum post-traumatic stress disorder (Odds ratio: 8.6, IC 95% [1.85; 40.42]). Depression symptoms was a significant confounder in the prediction of post-traumatic stress disorder following childbirth, but not anxiety or previous perinatal loss. Conclusion: Little is known about parental differences in acute stress disorder and post-traumatic stress disorder symptoms following childbirth. Results indicate that both parents may suffer from acute stress disorder and post-traumatic stress disorder symptoms after childbirth and that acute stress disorder is a predictor of post-traumatic stress disorder after childbirth for both parents. Sensitization of maternity staff to these results may assist in earlier identification of and appropriate treatment for at-risk parents.
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Affiliation(s)
- Elisabeth Schobinger
- Institute of higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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19
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Ohara M, Nakatochi M, Okada T, Aleksic B, Nakamura Y, Shiino T, Yamauchi A, Kubota C, Morikawa M, Murase S, Goto S, Kanai A, Kato R, Ando M, Ozaki N. Impact of perceived rearing and social support on bonding failure and depression among mothers: A longitudinal study of pregnant women. J Psychiatr Res 2018; 105:71-77. [PMID: 30205250 DOI: 10.1016/j.jpsychires.2018.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/02/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Although previous studies have reported associations between bonding failure, depression, social support among mothers, and perceived rearing, the causal relationships remain unclear. METHODS A total of 855 women (mean age, 32.4 ± 4.4 years) completed the Mother-Infant Bonding Questionnaire (MIBQ), the Edinburgh Postnatal Depression Scale (EPDS), the Japanese version of the Social Support Questionnaire, and the Parental Bonding Instrument in early pregnancy before week 25 (T1) and at 1 month after delivery (T2). We created a path model to clarify the causal relationships between perinatal bonding failure, depression, social support, and perceived rearing during pregnancy and at 1 month after delivery. The model was tested using structural equation modeling. RESULTS Our recursive model showed acceptable fit (chi-squared statistic/degree of freedom = 2.1, comparative fit index = 0.98, root mean square error of approximation = 0.04). It was revealed that: (1) at T1, higher overprotection significantly predicted MIBQ scores; (2) at T1, poorer social support significantly predicted both MIBQ and EPDS scores; and (3) at T1, both MIBQ and EPDS scores significantly predicted respective scores at T2. CONCLUSIONS These results showed that bonding failure in the postpartum period was significantly influenced by mothers' own perceived rearing and social support during pregnancy. In addition, depression in the postpartum period was strongly influenced by social support during pregnancy. These findings suggest that psychosocial interventions that focus on both mothers' recollections of their own upbringing and social support during pregnancy are effective for preventing bonding failure and depression in the postpartum period.
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Affiliation(s)
- Masako Ohara
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiro Nakatochi
- Division of Data Science, Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Takashi Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Shiino
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Aya Yamauchi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chika Kubota
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Mako Morikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Atsuko Kanai
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Ryuji Kato
- Department of Basic Medical Sciences, Graduate School of Pharmaceutical Sciences, Nagoya University, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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20
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Dekel S, Stuebe C, Dishy G. Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors. Front Psychol 2017; 8:560. [PMID: 28443054 PMCID: PMC5387093 DOI: 10.3389/fpsyg.2017.00560] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/27/2017] [Indexed: 12/03/2022] Open
Abstract
Background: Posttraumatic stress related with the childbirth experience of full-term delivery with health outcomes has been recently documented in a growing body of studies. The magnitude of this condition and the factors that might put a woman at risk for developing childbirth-related postpartum posttraumatic stress disorder (PP-PTSD) symptoms are not fully understood. Methods: In this systematic review of 36 articles representing quantitative studies of primarily community samples, we set to examine PP-PTSD prevalence rates and associated predictors with a focus on the role of prior PTSD and time since childbirth. Results: A significant minority of women endorsed PP-PTSD following successful birth. Acute PP-PTSD rates were between 4.6 and 6.3%, and endorsement of clinically significant PP-PTSD symptoms was identified in up to 16.8% of women in community samples of high quality studies. Negative subjective experience of childbirth emerged as the most important predictor. Endorsement of PTSD before childbirth contributed to PP-PTSD; nevertheless, women without PTSD also exhibited PP-PTSD, with acute rates at 4.6%, signifying a new PTSD onset in the postpartum period. Conclusion: Although the majority of women cope well, childbirth for some can be perceived as a highly stressful experience and even result in the development of PP-PTSD symptoms. More research is needed to understand postpartum adaption and childbirth-related posttraumatic stress outcomes.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Harvard Medical SchoolBoston, MA, USA.,Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
| | - Caren Stuebe
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
| | - Gabriella Dishy
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
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