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Bdier D, Mahamid F, Fallon V, Amir M. Posttraumatic stress symptoms and postpartum anxiety among palestinian women: the mediating roles of self-esteem and social support. BMC Womens Health 2023; 23:420. [PMID: 37559047 PMCID: PMC10413689 DOI: 10.1186/s12905-023-02567-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 07/23/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Women are estimated to develop several mental disorders during pregnancy and/or for up to a year postpartum, with anxiety and depression being the most common co-morbidities. Postpartum anxiety is less well studied compared with postpartum depression in the Palestinian context in terms of risk factors, mental health outcomes and protective factors. PURPOSE The aim of the current study was to investigate whether self-esteem and social support mediated the association between posttraumatic stress symptoms and postpartum anxiety among Palestinian women. METHODS Berlin Social Support Scales, Postpartum Specific Anxiety Scale, Impact of the Event Scale, and Rosenberg self-esteem scale were administered to 408 Palestinian women recruited from health centers in northern of the West Banks/ Palestine using a convenience sample. RESULTS The findings of our study revealed that postpartum anxiety positively correlated with posttraumatic stress symptoms (r = .56, p < .01), and negatively correlated with social support (r = - .30, p < .01), and self-esteem (r = - .27, p < .05). Moreover, posttraumatic stress symptoms negatively correlated with social support (r = - .24, p < .01), and self-esteem (r = - .25, p < .01). Results of structural equation modeling (SEM) showed a good fit of the hypothesized model. CONCLUSIONS Given this, it is recommended to conduct similar studies with diverse samples in the Palestinian society. It would also be useful for health professionals who work with Palestinian pregnant women (i.e., mental health providers, nurses, midwives, physicians) to assess self-esteem and social support in an effort to identify women who may be at greater risk of developing postpartum anxiety. It may also be worthwhile to develop and implement interventions during pregnancy which serve to enhance a women's sense of self-esteem during this particularly stressful period.
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Affiliation(s)
- Dana Bdier
- Psychology and Counseling Dept, An-Najah National University, Nablus, Palestine
- University of Milano-Bicocca, Milan, Italy
| | - Fayez Mahamid
- Psychology and Counseling Dept, An-Najah National University, Nablus, Palestine.
| | - Vicky Fallon
- School of Psychology, University of Liverpool, Liverpool, UK
| | - Moath Amir
- Department of Medical Laboratory, Palestinian Ministry of Health, Thabet-Thabet Hospital, Tulkarm, Palestine
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2
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Olazábal DE, Bertoni B, Grandi G, Musetti D, Rey G, Sandberg N, Fernández L, Laporte G, Medici F, Nicolaisen-Sobesky E. Oxytocin system polymorphisms rs237887 and rs2740210 variants increase the risk of depression in pregnant women with early abuse. Dev Psychobiol 2023; 65:e22400. [PMID: 37338248 DOI: 10.1002/dev.22400] [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: 08/02/2022] [Revised: 04/12/2023] [Accepted: 04/27/2023] [Indexed: 06/21/2023]
Abstract
Prepartum depression is associated with early adversity, pregnancy complications, preterm delivery, postpartum depression, and long-term effects on child neurodevelopment. The oxytocin (OXT) system is affected by early adverse experiences and has been associated with depression. In the current study, we investigated risk factors for prenatal depressive symptoms, mainly the effects of early childhood and adolescence trauma, in combination with the presence of certain variants of polymorphisms of OXT and OXT receptor (OXTR) genes. We hypothesized that early childhood and adolescence trauma has higher negative effects in carriers of genetic variants of the OXT/OXTR system, increasing their risk for depression. Early in pregnancy (8-14 weeks), 141 pregnant women from a Uruguayan population were asked to provide DNA samples and complete questionnaires that assessed their experience of child abuse, depression symptoms, and other variables that included demographic information. Our results showed that 23.5% of pregnant women had depressive symptoms. Several OXT and OXTR genetic variants were associated with higher risk of prepartum depression only in those pregnant women who suffered emotional abuse during infancy or adolescence. Logistic regression (Nagelkerke's R2 = .33) revealed that women who suffered early abuse and were carriers of the variants CC of rs2740210 (OXT) or AA of rs237887 (OXTR) had significantly higher risk of experiencing depressive symptoms. Antecedents of psychiatric disorders also contributed to the risk of depression. We conclude that emotional abuse contributes to the risk of depression in different ways in women carrying different OXT and OXTR genetic variants. Early detection and closer follow-up of women with child abuse and certain OXT genetic variants, among other risk factors, could reduce the long-term impact of prepartum depression.
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Affiliation(s)
- Daniel Ernesto Olazábal
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Bernardo Bertoni
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | | | - Dora Musetti
- Asociación de Psicopatología y Psiquiatría de la Infancia y la Adolescencia, Montevideo, Uruguay
| | - Grazzia Rey
- Hospital de Clínicas Manuel Quintela, Montevideo, Uruguay
| | - Natalia Sandberg
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Lucia Fernández
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | | | | | - Eliana Nicolaisen-Sobesky
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
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Suomi A, Bolton A, Pasalich D. The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1032-1046. [PMID: 34736361 DOI: 10.1177/15248380211048444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. METHOD Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. RESULTS Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies (n = 4871) was 26.0% (95% CI 20.0-32.0%) for mothers, and estimate based on three studies (n = 2606) was 13.0% (95% CI 7.0%-18.0%) for fathers and 23.0% (95% CI 17.0-29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents' PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. CONCLUSION There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.
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Affiliation(s)
- Aino Suomi
- Institute of Child Protection Studies, 95359Australian Catholic University, Canberra, VIC, Australia
- Research School of Population Health, 2219Australian National University, Canberra, ACT, Australia
| | - Annalese Bolton
- Matilda Centre, University of Sydney, Sydney, NSW, Australia
- Forensic Psychology Clinic, 7800University of New South Wales, Sydney, NSW, Australia
| | - Dave Pasalich
- Research School of Psychology, 2219Australian National University, Canberra, ACT, Australia
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Ma X, Biaggi A, Sacchi C, Lawrence AJ, Chen PJ, Pollard R, Matter M, Mackes N, Hazelgrove K, Morgan C, Harding S, Simonelli A, Schumann G, Pariante CM, Mehta M, Montana G, Rodriguez-Mateos A, Nosarti C, Dazzan P. Mediators and moderators in the relationship between maternal childhood adversity and children's emotional and behavioural development: a systematic review and meta-analysis. Psychol Med 2022; 52:1817-1837. [PMID: 35730541 PMCID: PMC9340854 DOI: 10.1017/s0033291722001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/06/2022]
Abstract
Maternal experiences of childhood adversity can increase the risk of emotional and behavioural problems in their children. This systematic review and meta-analysis provide the first narrative and quantitative synthesis of the mediators and moderators involved in the link between maternal childhood adversity and children's emotional and behavioural development. We searched EMBASE, PsycINFO, Medline, Cochrane Library, grey literature and reference lists. Studies published up to February 2021 were included if they explored mediators or moderators between maternal childhood adversity and their children's emotional and behavioural development. Data were synthesised narratively and quantitatively by meta-analytic approaches. The search yielded 781 articles, with 74 full-text articles reviewed, and 41 studies meeting inclusion criteria. Maternal mental health was a significant individual-level mediator, while child traumatic experiences and insecure maternal-child attachment were consistent family-level mediators. However, the evidence for community-level mediators was limited. A meta-analysis of nine single-mediating analyses from five studies indicated three mediating pathways: maternal depression, negative parenting practices and maternal insecure attachment, with pooled indirect standardised effects of 0.10 [95% CI (0.03-0.17)), 0.01 (95% CI (-0.02 to 0.04)] and 0.07 [95% CI (0.01-0.12)], respectively. Research studies on moderators were few and identified some individual-level factors, such as child sex (e.g. the mediating role of parenting practices being only significant in girls), biological factors (e.g. maternal cortisol level) and genetic factors (e.g. child's serotonin-transporter genotype). In conclusion, maternal depression and maternal insecure attachment are two established mediating pathways that can explain the link between maternal childhood adversity and their children's emotional and behavioural development and offer opportunities for intervention.
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Affiliation(s)
- Xuemei Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - Andrew J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Pei-Jung Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Rebecca Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Maryam Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nuria Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Seeromanie Harding
- Division of Diabetes and Nutritional Sciences, King's College London, London, UK
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - Gunter Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carmine M. Pariante
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
| | | | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
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Varela RB, Cararo JH, Tye SJ, Carvalho AF, Valvassori SS, Fries GR, Quevedo J. Contributions of epigenetic inheritance to the predisposition of major psychiatric disorders: theoretical framework, evidence, and implications. Neurosci Biobehav Rev 2022; 135:104579. [DOI: 10.1016/j.neubiorev.2022.104579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/10/2022] [Accepted: 02/11/2022] [Indexed: 02/08/2023]
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Mueller I, Snidman N, DiCorcia JA, Tronick E. Acute Maternal Stress Disrupts Infant Regulation of the Autonomic Nervous System and Behavior: A CASP Study. Front Psychiatry 2021; 12:714664. [PMID: 34867513 PMCID: PMC8635696 DOI: 10.3389/fpsyt.2021.714664] [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: 05/25/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Exposure to maternal stress is assumed to influence infant health and development across the lifespan. The autonomic nervous system (ANS) is especially sensitive to the effects of the early caregiving environment and linked to predictors of later mental health. Understanding how exposure to maternal stress adversely affects the developing ANS could inform prevention. However, there is no agreed upon definition of maternal stress making its study difficult. Here we use the Caretaker Acute Stress Paradigm (CASP) to study the effects of maternal stress in an experimentally controlled laboratory setting. The CASP has 5 episodes, a natural play, followed by a caretaker stressor (or control) condition, another play, a classic still face episode, followed by another play. A total of 104 4-months-old infants and their mothers were randomly assigned to either the caretaker-stress or caretaker-control condition. Changes in behavior, heart rate (HR), and respiratory sinus arrhythmia (RSA) before and after the introduction of the stressor (or control condition) were recorded and compared. Infants in the maternal stress condition showed significantly more behavioral distress [X 2 = (1, N = 104) = 4.662, p = 0.031]. Moreover, infants whose mothers were in the stress condition showed an significant increase in heart rate after the caretaker condition [F (1, 102) = 9.81, p = 0.002]. Finally we observed a trend to faster RSA recovery in infants of the control condition [F (1, 75) = 3.539, p = 0.064]. Results indicate that exposure to acute maternal stress affects infant regulation of the autonomic nervous system and behavior.
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Affiliation(s)
- Isabelle Mueller
- Department of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Nancy Snidman
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Jennifer A. DiCorcia
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Ed Tronick
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
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Rodríguez-Soto NC, Buxó CJ, Morou-Bermudez E, Pérez-Edgar K, Ocasio-Quiñones IT, Surillo-González MB, Martinez KG. The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review. Dev Psychobiol 2021; 63:e22195. [PMID: 34674245 PMCID: PMC8549868 DOI: 10.1002/dev.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022]
Abstract
The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.
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Affiliation(s)
- Nayra C. Rodríguez-Soto
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
- Carlos Albizu University, San Juan, PR
| | - Carmen J. Buxó
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
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Qouta SR, Vänskä M, Diab SY, Punamäki RL. War trauma and infant motor, cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes. Infant Behav Dev 2021; 63:101532. [PMID: 33588286 DOI: 10.1016/j.infbeh.2021.101532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Taking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers' prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants' developmental skills at 18 months. METHOD This prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants' language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants' motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2. RESULTS First, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants' developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2. CONCLUSION Improving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.
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Affiliation(s)
- Samir R Qouta
- Doha Institut for Graduate Studies, School of Social Sciences and Humanities, Qatar
| | - Mervi Vänskä
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Safwat Y Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland.
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Spry EA, Aarsman SR, Youssef GJ, Patton GC, Macdonald JA, Sanson A, Thomson K, Hutchinson DM, Letcher P, Olsson CA. Maternal and paternal depression and anxiety and offspring infant negative affectivity: A systematic review and meta-analysis. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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10
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Khalil D, Giurgescu C, Misra DP, Templin T, Javanbakht A. Recruiting Immigrant and Refugee Arab American Mother-Father-Infant Triads Resettling in the United States: A Feasibility Study. Can J Nurs Res 2020; 52:139-148. [PMID: 32192379 DOI: 10.1177/0844562120910856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent Iraqi and Syrian immigrant families are exposed to stress, anxiety, and depressive symptoms due to civil war. Recruitment challenges specific to conducting research within this population include the lack of knowledge about research, stigma of mental illness, and mistrust. PURPOSES Among immigrant Iraqi and Syrian families: (1) evaluate the approach to recruitment and retention; and (2) evaluate the acceptability of the study procedures. METHODS This feasibility study was conducted based on the work of Orsmond and Cohn. It is focused on the evaluation of recruitment capability and resulting sample characteristics and evaluation of acceptability and suitability of the study procedures. Mother-father-infant triads were recruited from a community center. Parents completed questionnaires about stress and depressive symptoms. Buccal swab samples were obtained from the triads to measure telomere length, and infant hair samples were obtained to measure cortisol level. Telomere length and hair cortisol were utilized as measures of chronic stress. RESULTS Ten mother-father-infant triads were enrolled out of 11 approached. Challenges faced this study included inability to reach families by telephone and the effect of cultural norms where the husband's permission was needed before proceeding, resulting in a slow pace of recruitment. The study strategy and procedures appeared to be feasible as all of the families who participated completed all study protocols. CONCLUSION This study provides feasibility data to inform the launching of a larger study to examine the associations of family stress with infant stress and development. These findings from Iraqi and Syrian families may be generalizable to studies seeking to recruit these and other immigrant and refugee population families.
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Affiliation(s)
- Dalia Khalil
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Carmen Giurgescu
- College of Nursing, University of Central Florida, Orlando, FL, USA
| | - Dawn P Misra
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Thomas Templin
- College of Nursing, Wayne State University, Detroit, MI, USA
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Punamäki RL, Qouta SR, Diab SY. The role of maternal attachment in mental health and dyadic relationships in war trauma. Heliyon 2020; 5:e02867. [PMID: 31890934 PMCID: PMC6926227 DOI: 10.1016/j.heliyon.2019.e02867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/01/2019] [Accepted: 11/12/2019] [Indexed: 01/16/2023] Open
Abstract
Background Infant care is a demanding task in dangerous war conditions, but research on the wellbeing of mother-infant dyads is mainly available in peaceful conditions. Knowledge on protective versus risking processes is especially vital for tailoring effective help, and the present study proposes the maternal attachment style to play an important role in dangerous war conditions. Objective The study analyses, first, how various traumatic war events, such as losses, horrors and life-threat, are associated with maternal mental health and dyadic mother-infant interaction quality, indicated by maternal emotional availability (EA). Second, it tests a hypothesis that maternal insecure attachment risks and secure attachment protects good mental health and optimal EA from negative impacts of traumatic war events. Method The prospective three-wave study involved 502 Palestinian mothers, who were pregnant during the 2014 War on Gaza, and participated at delivery (T1), and when the infant was seven (T2; N = 392) and eighteen (T3; N = 386) months. Mothers reported about war events at T1 and T2 (death and losses, witnessing horrors and life-threat), and posttraumatic stress disorder (PTSD) and depression symptoms at T2 and T3. Dyadic interaction quality was assessed by mother-perceived emotional availability (EA) scale at T2 and T3, and attachment styles by mothers’ self-reports at T3. Results Death and losses, witnessing horrors, and life-threat were all associated with a high level of maternal PTSD, but only at T2, whereas death and losses were associated with her depressive symptoms both at T2 and T3. Witnessing horrors was associated with a low close and positive and a high distant and negative emotional availability at T2 and T3. As hypothesized, maternal avoidant attachment was associated with a low level of close and positive EA in general, and especially when the dyads were exposed to a high level of traumatic war events, thus indicating a risking function. Against the hypothesis, secure attachment did not show any protective function on emotional availability, while, unexpectedly, maternal preoccupied attachment was associated with close and positive emotional availability, when dyads were exposed to a high level of traumatic war events. Conclusion Mothering in conditions of war and military violence is an overwhelmingly demanding task, and mother-infant dyads need legal, social, and psychological assistance. Knowledge and reflection of unique responses and meanings of different attachment styles would be fruitful in tailoring effective help.
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Affiliation(s)
- Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
- Corresponding author.
| | - Samir R. Qouta
- Doha Institute For Graduate Studies, Qatar
- Islamic University Gaza, Department of Education and Psychology, Gaza, Palestine
| | - Safwat Y. Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
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12
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Data Collection Tools for Maternal and Child Health in Humanitarian Emergencies: An Updated Systematic Review. Disaster Med Public Health Prep 2019; 14:601-619. [PMID: 31818343 DOI: 10.1017/dmp.2019.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors' interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO.
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Vänskä M, Diab SY, Perko K, Quota SR, Albarqouni NM, Myöhänen A, Punamäki RL, Manduca P. Toxic Environment of war: Maternal prenatal heavy metal load predicts infant emotional development. Infant Behav Dev 2019; 55:1-9. [DOI: 10.1016/j.infbeh.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 01/10/2019] [Accepted: 01/18/2019] [Indexed: 02/08/2023]
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Lahti K, Vänskä M, Qouta SR, Diab SY, Perko K, Punamäki RL. Maternal experience of their infants' crying in the context of war trauma: Determinants and consequences. Infant Ment Health J 2019; 40:186-203. [PMID: 30715730 DOI: 10.1002/imhj.21768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We examined, first, how prenatal maternal mental health and war trauma predicted mothers' experience of their infant crying, indicated by emotions, cognitions, and behavior; and second, how these experiences influenced the mother-infant interaction and infant development. Participants were 511 Palestinian mothers from the Gaza Strip, reporting their war trauma, symptoms of posttraumatic stress disorder (PTSD), depression, and perceived stress during pregnancy (Time 1). They reported experiences of infant crying at 4 months (Time 2), and the mother-infant interaction and infant sensorimotor and language development at 12 months of infants' age (Time 3). Results revealed that maternal mental health problems, but not war trauma, were important to experiences of infant crying. A high level of PTSD symptoms predicted negative emotions evoked by infant crying, and high depressive symptoms predicted low active and positive responses to crying. Unexpectedly, high prenatal perceived stress predicted high active and positive responsiveness. Concerning the consequences, mothers' sensitive interpretation of infant crying predicted optimal infant sensorimotor development, and mothers' active and positive responses predicted high emotional availability in mother-infant interaction. Crying is the first communication tool for infants, and mothers' sensitive responses to crying contribute to infant well-being. Therefore, reinforcing mother's optimal responses is important when helping war-affected dyads.
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Affiliation(s)
- Katri Lahti
- Department of Psychology, University of Tampere, Tampere, Finland
| | - Mervi Vänskä
- Department of Psychology, University of Tampere, Tampere, Finland
| | - Samir R Qouta
- Department of Education and Psychology, Islamic University Gaza, Gaza City, Palestine
| | - Safwat Y Diab
- Department of Educational Psychology, Al Quds Open University, Gaza Strip, Palestine
| | - Kaisa Perko
- Department of Psychology, University of Tampere, Tampere, Finland
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Madigan S, Oatley H, Racine N, Fearon RMP, Schumacher L, Akbari E, Cooke JE, Tarabulsy GM. A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development. J Am Acad Child Adolesc Psychiatry 2018; 57:645-657.e8. [PMID: 30196868 DOI: 10.1016/j.jaac.2018.06.012] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/23/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children. METHOD Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators. RESULTS A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened. CONCLUSION Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.
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Affiliation(s)
| | - Hannah Oatley
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | - Emis Akbari
- George Brown College, Toronto, Ontario, Canada
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