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Lindstedt J, Korja R, Carter A, Pihlaja P, Ahlqvist-Björkroth S. Parental prenatal representations of the child are related to 18-month-old children's social-emotional competence. Attach Hum Dev 2024; 26:383-401. [PMID: 38984818 DOI: 10.1080/14616734.2024.2376765] [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: 03/06/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024]
Abstract
Parental representations of the child are linked to positive developmental outcomes in children, but the impact of prenatal representations on early social-emotional development, particularly from fathers, is less understood. This study explores how fathers' and mothers' prenatal representations within two-parent families are associated with early social-emotional development. Prenatal representations of fathers (n = 88) and mothers (n = 92) were assessed between 28 and 32 weeks of gestation using the Working Model of the Child Interview, categorizing them as balanced or nonbalanced. The children's (n = 97; 49.5% girls) social-emotional and behavioral problems and competencies were measured at 18 months using the Brief Infant-Toddler Social and Emotional Assessment. Balanced prenatal representations of both parents were related to higher social-emotional competence in toddlers. However, prenatal representations were not related to social-emotional and behavioral problems. The results highlight the benefits of balanced prenatal representations in promoting early social-emotional competence in children.
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Affiliation(s)
- Johanna Lindstedt
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Alice Carter
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Päivi Pihlaja
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
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Bailes LG, Blum A, Barnett W, Piersiak H, Takemoto S, Fleming B, Alexander C, Humphreys KL. Stressful life events and prenatal representations of the child. Attach Hum Dev 2024; 26:116-132. [PMID: 38655855 PMCID: PMC11218892 DOI: 10.1080/14616734.2024.2345242] [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: 11/11/2023] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
Caregivers' mental representations of their children can be assessed prenatally and are prospectively associated with later caregiving quality and caregiver-child attachment. Compared to balanced, distorted or disengaged representations are linked to insecure caregiver-child attachments. The present study explored factors (i.e. stressful life experiences and positive experiences) that may be linked to risk for distorted and disengaged representations. We used a brief version of the Prenatal Working Model of the Child Interview in a sample of 298 pregnant people (ages 19 to 45 years; M = 30.83, SD = 5.00) between gestational age 11-38 weeks (M = 23.49, SD = 5.70). A greater number of stressful events across three developmental periods (i.e., lifespan, childhood, and pregnancy) were related to increased odds of distorted, compared to balanced classification. Pregnancy stress had the largest association. Positive experiences from childhood did not buffer the association between stress and representations. Findings highlight the importance of stress on prenatal representations of one's child.
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Affiliation(s)
- Lauren G Bailes
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Abigail Blum
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Whitney Barnett
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Hannah Piersiak
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Sydney Takemoto
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Brooke Fleming
- Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Caelan Alexander
- Psychology and Human Development, Vanderbilt University, Nashville, USA
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Svendsrud H, Fredriksen E, Moe V, Smith L, Tsotsi S, Ullebø AK, Brean GV, Kaasen A, Bekkhus M. Becoming Dad: Expectant Fathers' Attachment Style and Prenatal Representations of the Unborn Child. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1187. [PMID: 37508684 PMCID: PMC10377903 DOI: 10.3390/children10071187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
How expectant fathers think and feel about the unborn child (prenatal representations), has shown associations with fathers' postnatal parenting behaviors, observed father-infant interactional quality and child cognitive development. There is limited knowledge about fathers' prenatal representations. The present study examined if fathers' partner-related attachment styles were related to their prenatal representations of the unborn child. In the "Little in Norway Study", an ongoing prospective, longitudinal population-based study, 396 expectant fathers completed the Experiences in Close Relationships Scale at enrollment (mean gestational week = 23.76, SD = 4.93), and in gestational weeks 27-35 completed three questions assessing prenatal representations. Correlations of attachment style and prenatal representations were reported using logistic regression analyses. We found that an avoidant attachment style by fathers were predicted to have absent or negative representations on all three items (1) "strongest feeling about the unborn child" (Cl = 1.19-2.73), (2) "thoughts about child personality" (Cl = 1.16-1.87), and (3) "experiences of relationship with the child" (Cl = 1.14-1.75). Father anxious attachment style was not significantly associated with absent or negative prenatal representations. Results suggest that expectant fathers with a partner related avoidant attachment style have an increased risk of having absent or negative prenatal representations of the unborn child.
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Affiliation(s)
- Hedvig Svendsrud
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
- Vestfold Hospital Trust, 3103 Tønsberg, Norway
| | | | - Vibeke Moe
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
| | - Lars Smith
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
| | - Stella Tsotsi
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
| | | | - Gro Vatne Brean
- Center for Child and Adolescent Mental Health, Southern and Eastern Norway, 0484 Oslo, Norway
| | - Anne Kaasen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Mona Bekkhus
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
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Kårstad SB, Bjørseth Å, Lindstedt J, Brenne AS, Steihaug H, Elvrum AKG. Parental Coping, Representations, and Interactions with Their Infants at High Risk of Cerebral Palsy. J Clin Med 2022; 12:jcm12010277. [PMID: 36615077 PMCID: PMC9820974 DOI: 10.3390/jcm12010277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/16/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study is to describe parental coping, representations, and interactions during the time of inclusion in the Small Step early intervention program for infants at high risk of cerebral palsy (CP) in Norway (ClinicalTrials.gov: NCT03264339). Altogether, 11 infants (mean age 4.8 months, SD: 1.5) and their parents (mothers: n = 10, fathers: n = 9) were included. Parental coping was assessed using the Parenting Stress Index-Short Form (PSI-SF) and the Hospital Anxiety and Depression Scale (HADS). Parental representations and parent-infant interactions were assessed using the Working Model of the Child Interview (WMCI) and the Parent-Child Early Relational Assessment (PCERA). Parents' PSI-SF and HADS scores were within normal range; however, 26.7% showed symptoms of stress, 52.6% showed symptoms of anxiety, and 31.6% showed symptoms of depression above the cut-off. WMCI results indicate that 73.7% of the parents had balanced representations. For PCERA, the subscale Dyadic Mutuality and Reciprocity was of concern, while two other subscales were in areas of strength and three subscales in some concern areas. There were no differences between mothers and fathers. Most of the parents had balanced representations, some had mental or stress symptoms and many were struggling with aspects of the parent-infant interaction. This knowledge could be useful when developing more family-centered interventions.
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Affiliation(s)
- Silja Berg Kårstad
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Child and Adolescent Mental Health Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
- Correspondence: ; Tel.: +47-9775-2958
| | - Åse Bjørseth
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
| | - Johanna Lindstedt
- Department of Psychology and Speech-Language Pathology, University of Turku, 20500 Turku, Finland
| | - Anne Synnøve Brenne
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
| | - Helene Steihaug
- Child and Adolescent Mental Health Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
| | - Ann-Kristin Gunnes Elvrum
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Clinical Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
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Comparison of Antenatal Maternal Mental Representations Between Depressed and Non-depressed of Pregnant Mothers. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-129589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Depression is the most prevalent mental health problem in the pregnant women with significant implications for mother and infant’s health. The content of maternal antenatal representations may be related to their depressive symptoms during the perinatal period. Objectives: This study aimed to compare maternal mental representations between depressed and non-depressed groups of pregnant women. Methods: In a causal-comparative study, participants were selected using an inverse stratified sampling method among pregnant women in the last trimester of pregnancy (depressed mothers = 93, and non-depressed mothers = 97). All participants completed Edinburgh Postnatal Depression Scale (EPDS), Dépistage Anténatal de la Dépression Postnatale (DADP), and semi-structure Interview-R after the consent form. Independent- samples t-test, Two-way ANOVA, and Pearson correlation coefficient were applied to compare maternal mental representations subscales between groups, using SPSS-26. Results: The results showed significantly fewer positive ratings for all subscales of Interview-R, including child, partner, self as mother, and mother as own mother in the depressed group (P < 0.05). In the group of depressed mothers, 57% and 32% of the correlations among the representations of child/self as mother and child/partner were significant, while in the non-depressed group, 28% and 48% of the correlations between child/self as mother and child/ partner were significant (P < 0,05), respectively. The characteristics of self as mother and own mother showed significant differences in the depressed group compared to the non-depressed group (P < 0.05). Conclusions: Depressed pregnant mothers are less likely to differentiate themselves from their children compared to non-depressed pregnant mothers. Besids, depressed pregnant mothers perceive themselves as mothers more positively than their own mothers, while the opposite is true for non-depressed pregnant mothers.
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Pulliainen H, Sari-Ahlqvist-Björkroth, Ekholm E. Does interactive ultrasound intervention relieve minor depressive symptoms and increase maternal attachment in pregnancy? A protocol for a randomized controlled trial. Trials 2022; 23:313. [PMID: 35428357 PMCID: PMC9012065 DOI: 10.1186/s13063-022-06262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background Perinatal depression, especially minor depression, is common during pregnancy and is likely to continue into the postpartum period. It may impair the mother’s health, the infant’s neurodevelopment, and the mother-infant relationship. Screening for perinatal depression is recommended; however, there is no consensus on how to treat depressive symptoms while simultaneously supporting the mother-infant relationship. Ultrasound examination has been shown to improve maternal-fetal attachment among pregnant women. Our aim is to develop a four-dimensional (4D) based interactive ultrasound intervention and test whether it relieves minor depressive symptoms and improves maternal-fetal attachment. Previous studies show that supporting the mother-infant relationship aids in relieving maternal depression. Until now, few studies have combined pregnancy ultrasound and psychological support. Methods A controlled randomized setting was designed to assess whether interactive 4D-ultrasound intervention would decrease maternal depressive symptoms, strengthen maternal-fetal attachment, and mother-infant relationship. An obstetrician and a psychologist specialized in infant mental health conduct the interventions. The focus is to jointly observe the behavior of the fetus according to the mothers’ wishes. Altogether, 100 women scoring 10–15 on Edinburgh Pre-/Postnatal Depression Scale (EPDS) and with singleton pregnancy are recruited using a web-based questionnaire. Half of the participants will be randomized to the intervention group and will undergo three interactive ultrasound examinations. The primary outcomes are a decrease in perinatal depressive symptoms assessed with EPDS and an increase in maternal attachment. The maternal attachment was assessed using the Working Model of the Child Interview (WMCI), the Maternal Antenatal Attachment Scale (MAAS), and the Maternal Postnatal Attachment Scale (MPAS). Secondly, we hypothesize that if the intervention decreases prenatal depressive symptoms and improves prenatal attachment, the decrease in depressive symptoms and improvement in mother-infant relationship is seen postnatally. Discussion Ultrasound is widely used during pregnancy. The interactive approach is unique and may be feasible as part of routine screenings and maternity clinic visits. Intervention that decreases depression and simultaneously supports maternal-fetal attachment would be a valuable addition to the treatment of minor depression among pregnant women. Trial registration ClinicalTrials.gov NCT03424642. Registered on January 5 2018.
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Holmberg E, Kataja EL, Davis EP, Pajulo M, Nolvi S, Hakanen H, Karlsson L, Karlsson H, Korja R. The Connection and Development of Unpredictability and Sensitivity in Maternal Care Across Early Childhood. Front Psychol 2022; 13:803047. [PMID: 35330718 PMCID: PMC8940198 DOI: 10.3389/fpsyg.2022.803047] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/14/2022] [Indexed: 01/02/2023] Open
Abstract
Both patterns of maternal sensory signals and sensitive care have shown to be crucial elements shaping child development. However, research concerning these aspects of maternal care has focused mainly on maternal sensitivity with fewer studies evaluating the impact of patterns of maternal behaviors and changes in these indices across infancy and childhood. The aims of this study were to explore how maternal unpredictability of sensory signals and sensitivity develop and associate with each other from infancy to toddlerhood and whether elevated maternal depressive and anxiety symptoms relate to maternal unpredictable signals and sensitivity in toddlerhood. The study population consisted of 356 mother–child dyads assessed at 30 months; a subset of 103 mother–child dyads additionally participated in 8 months assessment. Maternal unpredictability and sensitivity were assessed from video-recorded free-play episodes at 8 and 30 months. Maternal depressive and anxiety symptoms were assessed with questionnaires at gestational weeks 14, 24, 34 and 3, 6, 12, and 24 months. Mean level of mothers’ unpredictability decreased on average whereas sensitivity did not change between infancy and toddlerhood. Both maternal unpredictability and sensitivity showed moderate level of individual stability from infancy to toddlerhood and these two measures were modestly correlated within each age. Elevated maternal depressive and anxiety symptoms were not related to unpredictability but related to lower maternal sensitivity in toddlerhood. These results identify unpredictable sensory signals as a characteristic of parental care that is independent of standard quality measures and suggest that it may be less influenced by maternal depressive and anxiety symptoms.
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Affiliation(s)
- Eeva Holmberg
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- *Correspondence: Eeva Holmberg,
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, United States
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
| | - Marjukka Pajulo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Hetti Hakanen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Hospital District of Southwest Finland, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Hospital District of Southwest Finland, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
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Vismara L, Sechi C, Lucarelli L. Reflective function in first-time mothers and fathers: Association with infant temperament and parenting stress. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [DOI: 10.1016/j.ejtd.2020.100147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Holmberg E, Teppola T, Pajulo M, Davis EP, Nolvi S, Kataja EL, Sinervä E, Karlsson L, Karlsson H, Korja R. Maternal Anxiety Symptoms and Self-Regulation Capacity Are Associated With the Unpredictability of Maternal Sensory Signals in Caregiving Behavior. Front Psychol 2020; 11:564158. [PMID: 33414740 PMCID: PMC7782240 DOI: 10.3389/fpsyg.2020.564158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
The unpredictability of maternal sensory signals in caregiving behavior has been recently found to be linked with infant neurodevelopment. The research area is new, and very little is yet known, how maternal anxiety and depressive symptoms and specific parental characteristics relate to the unpredictable maternal care. The aims of the current study were to explore how pre- and postnatal maternal anxiety and depressive symptoms and self-regulation capacity associate with the unpredictability of maternal sensory signals. The study population consisted of 177 mother-infant dyads. The unpredictability of the maternal sensory signals was explored from the video-recorded mother-infant free play situation when the infant was 8 months of age. Pre- and postnatal anxiety and depressive symptoms were measured by questionnaires prenatally at gwks 14, 24, 34, and 3 and 6 months postpartum. Maternal self-regulation capacity, a trait considered to be stable in adulthood, was assessed using adult temperament questionnaire when the infant was 12 months of age. We found that elevated prenatal maternal anxiety symptoms associated with higher unpredictability in the maternal care while depressive symptoms were unrelated to the unpredictability of maternal care. Moreover, the association was moderated by maternal self-regulation capacity, as higher anxiety symptoms during pre-and postnatal period were associated more unpredictability among the mothers with low self-regulation capacity. The combination of higher amount of maternal anxiety symptoms and lower self-regulation capacity seems to constitute specific risk for the unpredictable maternal care.
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Affiliation(s)
- Eeva Holmberg
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Turku, Turku, Finland
| | - Taija Teppola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Turku, Turku, Finland
| | - Marjukka Pajulo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, United States.,Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland.,Charité Universitätsmedizin Berlin, a Corporate Member of Freie Universität Berlin, Humboldt - Univeristät zu Berlin, Berlin, Germany
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Turku, Turku, Finland
| | - Eija Sinervä
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Hospital District of Southwest Finland, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Turku, Turku, Finland
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Thiel F, Pittelkow MM, Wittchen HU, Garthus-Niegel S. The Relationship Between Paternal and Maternal Depression During the Perinatal Period: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11:563287. [PMID: 33192682 PMCID: PMC7658470 DOI: 10.3389/fpsyt.2020.563287] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background: Meta-analyses suggest an increased prevalence of paternal depression during the perinatal period of around 10%. The relationship between paternal and maternal symptoms, however, has received little attention. Objective: To determine pooled estimates pertaining to the relationship between paternal and maternal depression during the perinatal period according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: Studies reporting on the relationship between depression in fathers and mothers between the first trimester and the first year following childbirth were identified using PubMed, PsycINFO, and EMBASE for the period between November 2009 and February 2020. Study selection: A total of 28 primary, empirical studies published in English or German, reporting effect estimates for the relationship of depression in mother-father/partner dyads, involving 11,593 couples, were included. Ten studies included multiple assessments, resulting in 64 extracted effects. Analysis: Information on correlations and odds ratios were extracted. Four random-effects analyses were conducted for the pooled association between paternal and maternal depression: (a) during the prenatal and (b) during the postnatal period, as well as for the prospective relationships between (c) paternal depression and maternal depression at a later timepoint, and (d) vice versa. Models were specified as restricted maximum-likelihood estimation. Heterogeneity was assessed using H 2 and I 2. Funnel plots, the Egger method, and the trim-and-fill test were used to assess publication bias. Sensitivity analyses with and without studies for which we approximated r were conducted. Data synthesis: With substantial heterogeneity, positive associations were found between paternal and maternal depression (a) during pregnancy (r = 0.238), (b) in the postnatal period (r = 0.279), as well as for the prospective relationship between (c) paternal and later maternal depression (r = 0.192), and (d) maternal and later paternal depression (r = 0.208). Conclusion: Paternal depression showed positive correlations with maternal depression across the perinatal period. Given notable methodological and cultural heterogeneity and limitations of individual studies, it was not possible to further identify determining or moderating factors. Increasing evidence for implications of parental depression for child development warrants further scientific attention.
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Affiliation(s)
- Freya Thiel
- Department of Medicine, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technical University of Dresden, Dresden, Germany
| | - Merle-Marie Pittelkow
- Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Hans-Ulrich Wittchen
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - 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, Technical University of Dresden, Dresden, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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11
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Meier J, Edginton E. The prenatal maternal representations of mothers at risk of recurrent care proceedings in the Family Drug and Alcohol Court: A thematic analysis. Infant Ment Health J 2020; 41:628-641. [PMID: 32602972 DOI: 10.1002/imhj.21876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A substantial number of birth mothers experience repeat removals of their infants and children due to child protection concerns. The perspectives of mothers going through repeat removals and their experiences of pregnancy are insufficiently researched. AIMS AND METHODS The current qualitative study aimed to explore the maternal representations of five pregnant mothers at risk of recurrent care proceedings. A thematic analysis of these mothers' responses to the Pregnancy Interview focused on their representations of themselves as mothers, of their babies, and of the mother-baby relationship. RESULTS Seven key themes were identified: (1a) "Uncertainty and fear of losing the baby," (1b) "Uncertainty but hope of becoming a mother," (2) "Not wanting to be like their own mother," (3) "Experiencing recovery and pregnancy as two interdependent processes," (4) "Struggling to imagine the baby," (5) "The omnipresence of previous children," (6) "Pleasure at starting to have a connection with the baby," and (7) "Noting the baby's dependency." CONCLUSION The results are clinically relevant as they highlight grief, maternal self-identity, recovery from substance abuse, and ability to manage uncertainty as critical areas of intervention for these mothers.
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Affiliation(s)
- Jasmin Meier
- Anna Freud National Centre for Children and Families, London, UK
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12
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Isosävi S, Diab SY, Qouta S, Kangaslampi S, Sleed M, Kankaanpää S, Puura K, Punamäki R. Caregiving representations in war conditions: Associations with maternal trauma, mental health, and mother–infant interaction. Infant Ment Health J 2020; 41:246-263. [DOI: 10.1002/imhj.21841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Sanna Isosävi
- The Faculty of Social SciencesTampere University Tampere Finland
- Traumacentre Finland Helsinki Finland
| | | | | | | | - Michelle Sleed
- University College London & Anna Freud Centre London United Kingdom
| | - Saija Kankaanpää
- The Outpatient Clinic for Multicultural PsychiatryHelsinki University Hospital District Helsinki Finland
| | - Kaija Puura
- University Hospital of Tampere Tampere Finland
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Pulliainen H, Niela-Vilén H, Ekholm E, Ahlqvist-Björkroth S. Experiences of interactive ultrasound examination among women at risk of preterm birth: a qualitative study. BMC Pregnancy Childbirth 2019; 19:338. [PMID: 31533655 PMCID: PMC6751623 DOI: 10.1186/s12884-019-2493-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/05/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pregnant women who are at risk of preterm birth are often stressed, anxious and depressed because of worries and fears related to the health of the unborn baby, their own health and uncertainty about the future. Only a few studies have assessed the types of psychological support that would relieve these stress symptoms among women with high-risk pregnancies. The aim of this study was to describe 1) how women at risk of preterm birth experienced an interactive 3/4-dimensional (3/4D) ultrasound examination, and 2) their need for psychological support during the antenatal period. METHODS This qualitative study was conducted at one university hospital in Finland in 2017. Women with a singleton pregnancy of 26-32 gestational weeks (gwks) were included in the study. The interactive 3/4D ultrasound included a joint observation of the baby, based on the mother's wishes, with an obstetrician and psychologist. After the examination, the experiences were explored with a semi-structured interview. The data was analyzed using inductive thematic analysis. RESULTS The women enjoyed the fact that the staff were focused on her fetus and genuinely present during the session and also enabled the women to actively participate. Watching the baby and her/his activities made the baby more concrete and relieved their concerns. The need for additional psychological support varied individually. CONCLUSIONS Interactive ultrasound examination is an interesting way to awaken mental images, increase attachment, and reduce stress. The results imply that an interactive way of jointly looking at the fetus supports pregnant women at risk of preterm birth and may be useful in clinical practice.
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Affiliation(s)
| | | | - Eeva Ekholm
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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