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Peng Z, Liu J, Liu B, Zhou J, Zhang L, Zhang Y. Psychological interventions to pregnancy-related complications in patients with post-traumatic stress disorder: a scoping review. BMC Psychiatry 2024; 24:478. [PMID: 38937748 PMCID: PMC11212442 DOI: 10.1186/s12888-024-05926-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/21/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD. METHOD Publications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of "Stress Disorders, Post-Traumatic", "Pregnant Women", and "psychotherapy". To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched. RESULTS Twenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population. CONCLUSION Fetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.
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Affiliation(s)
- Zhuo Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Li Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
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Henry CJ, Kelly U, Dunlop AL, Paul S, Chandler RD, Christiansen-Lindquist L, Song MK. Relationships Between Strong Black Woman Belief, Coping Behaviors, Perceived Social Support, and Psychological Distress Symptoms for Black Mothers After Stillbirth. J Midwifery Womens Health 2024; 69:249-257. [PMID: 37903721 DOI: 10.1111/jmwh.13576] [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] [Revised: 08/18/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Psychological distress symptoms (symptoms of depression, anxiety, and posttraumatic stress) are common following stillbirth. Black women who experience stillbirth are less likely to seek support than White women, consistent with the strong Black woman (SBW) construct, which expects Black women to tolerate stress and trauma gracefully, without seeking help. METHODS In this cross-sectional study we sought to determine the relative contributions of SBW belief, perceived lack of social support, and culturally relevant coping behaviors to psychological distress symptoms in Black women bereaved by stillbirth. We partnered with a stillbirth support organization to recruit a sample of 91 Black women bereaved by stillbirth in the 3 years prior to study participation. The online study survey measured SBW belief, culturally relevant coping behaviors, perceived social support, and psychological distress symptoms along with sociodemographics, pregnancy history, and stillbirth characteristics. We used stepwise selection in multiple linear regression to determine the relative contributions of SBW belief, perceived social support, and coping behaviors to measures of psychological distress symptoms in our sample. RESULTS Higher SBW belief, lower perceived social support, and higher collective coping (coping behaviors involving other people) were associated with increases in all 3 measures of psychological distress symptoms, controlling for age and other traumatic events. DISCUSSION Further understanding of the influence of SBW belief on Black women's psychological distress following stillbirth may assist with the development of culturally appropriate interventions to mitigate psychological distress symptoms in this group.
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Affiliation(s)
- Carrie J Henry
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sudeshna Paul
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | | | | | - Mi-Kyung Song
- Center for Nursing Excellence in Palliative Care, Nell Hodgson, Woodruff School of Nursing, Emory University, Atlanta, Georgia
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Bayrı Bingöl F, Karaçam Yılmaz ZD, Topaloğlu S. Partners in Pain, Two Sides of a Zipper - Midwives' Experiences With Stillbirth: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241235429. [PMID: 38404056 DOI: 10.1177/00302228241235429] [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: 02/27/2024]
Abstract
This study was conducted to explore and understand the experiences of midwives who care for women experiencing stillbirth and the challenges they face in this process. A qualitative study was conducted with 11 midwives using the phenomenological method. Descriptive analysis of the data revealed four main themes: 1) Silent screams in the face of despair (women's reactions to stillbirth), 2) Being a partner in pain, "two sides of a zipper" (midwives' experience of stillbirth), 3) Efforts to cope with the pain, and 4) Just two words: "if only." The impact of stillbirths on midwives should not be disregarded. Emotions such as shock, horror, fear, guilt, and anger experienced by midwives following a stillbirth can adversely affect their mental health. The guilt experienced by midwives can also negatively impact their health and quality of life, as well as cause burnout and distancing from the profession.
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Affiliation(s)
- Fadime Bayrı Bingöl
- Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, Türkiye
| | - Zeynep Dilşah Karaçam Yılmaz
- Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, Türkiye
- Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Türkiye
| | - Seçil Topaloğlu
- Midwifery Department, Health Sciences Faculty, Istanbul Medipol University, Istanbul, Türkiye
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Atashsokhan G, Farjamfar M, Khosravi A, Taher M, Keramat A. Desired Care for Perinatal Bereavement: Meeting the Needs of Mothers After Discharge From the Hospital-a Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580231223763. [PMID: 38339829 PMCID: PMC10859064 DOI: 10.1177/00469580231223763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
This study aimed to investigate the understanding and experiences of mothers who have suffered perinatal loss regarding their needs after being discharged from the hospital. Data were collected through semi-structured face-to-face and telephone interviews using purposive sampling with maximum diversity. The sample included 15 mothers and 6 midwives who had experienced fetal loss and perinatal bereavement. The interviews were audio-recorded and transcribed verbatim. Conventional content analysis was used to analyze the data. Sampling was conducted from July 2022 to March 2023, continuing until data saturation was reached. The study identified 2 main categories of needs for mothers who have experienced perinatal loss: continuous healthcare (including the Comprehensive Mother Tracking System, provision of psychological welfare, and educational needs) and provision of a support network, including "spouse and family support" and "peer and colleague support." The primary theme of this study was "Deliberating Care for Grieving Mothers." The study results indicate that mothers who experience perinatal loss require continuity of care after being discharged. Psychological screening and counseling support are essential for both parents. Considering the significant impact of spousal, familial, and community support on an individual's life, it is crucial to prepare the community to comprehend and embrace grieving parents.
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Affiliation(s)
- Giti Atashsokhan
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Maryam Farjamfar
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahboobe Taher
- Department of Psychology, Shahrood Branch, Islamic Azad University, Shahrood, Iran
| | - Afsaneh Keramat
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Miethe S, Wigger J, Wartemann A, Fuchs FO, Trautmann S. Posttraumatic Stress Symptoms and its Association with Rumination, Thought Suppression and Experiential Avoidance: a Systematic Review and Meta-Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023. [DOI: 10.1007/s10862-023-10022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AbstractPosttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 5574 studies, 75 of which were included in the analysis. From those eligible studies 189 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .52) and experiential avoidance (r = .48), whereas a medium effect size was found for thought suppression (r = .29). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .41 for associations with intrusive re-experiencing, between r = .39 and r = .41 for associations with avoidance, between r = .50 and r = .53 for associations with alterations in cognitions and mood and between r = .41 and r = .45 for associations with alterations in arousal and activity. Few available studies provide some evidence that associations might be somewhat reduced but still substantial in longitudinal compared to cross-sectional studies. These findings provide valuable targets for future investigations with the long-term goal of improving targeted interventions for the prevention and treatment of PTSD symptoms.
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Staudt A, Baumann S, Horesh D, Eberhard-Gran M, Horsch A, Garthus-Niegel S. Predictors and comorbidity patterns of maternal birth-related posttraumatic stress symptoms: A Latent Class Analysis. Psychiatry Res 2023; 320:115038. [PMID: 36603381 DOI: 10.1016/j.psychres.2022.115038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/08/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
Birth-related posttraumatic stress symptoms (PTSS) place a significant burden on mothers and their families. The aim was to (1) identify differential profiles of maternal birth-related PTSS; (2) determine the predictive value of established risk factors; (3) examine comorbidity patterns related to depression and anxiety symptoms. As part of the Norwegian Ahus Birth Cohort, 2,088 (expectant) mothers completed self-report questionnaires from 17 weeks of gestation to 2 years postpartum. The Impact of Event Scale was used to assess PTSS 8 weeks after birth. Latent class analysis revealed four latent classes: a High birth-related PTSS class (4%), a Moderate birth-related PTSS class (16%) particularly characterized by endorsement of intrusion symptoms, a Mild birth-related PTSS class (47%), as well as a No birth-related PTSS class (33%). We found similar (younger age, worse subjective birth experience, higher fear of childbirth) and differential predictors (prior posttraumatic stress disorder, lower education, birth complications). Women classified with High, Moderate, or Mild birth-related PTSS showed higher depression and anxiety symptoms compared to women with No birth-related PTSS. A considerable number of mothers experienced birth-related PTSS, most on a subclinical level, but these women still showed signs of mental distress 2 years postpartum, calling for more universal prevention approaches.
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Affiliation(s)
- Andreas Staudt
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany.
| | - Sophie Baumann
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel; Department of Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - Malin Eberhard-Gran
- Norwegian Research Centre for Women's Health, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Jones EE, Crawley R, Brierley-Jones L, Kenny C. Continuing bonds following stillbirth: protective and risk factors associated with parental bereavement adaptation. J Reprod Infant Psychol 2023; 41:93-109. [PMID: 34510967 DOI: 10.1080/02646838.2021.1972951] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate any association between expressions of parents' continuing bond with their stillborn baby and bereavement adaptation. BACKGROUND Continuing bonds theory suggests that bereaved parents adapt to the loss of their child by sharing and transforming mental representations of the child, allowing them to be integrated into parents' everyday lives. Little is known about the mental health benefits of expressing continuing bonds following stillbirth. This study examined any association between aspects of parents' relationship with their stillborn baby, social support for the relationship, and bereavement adaptation. METHODS Cross-sectional questionnaire study. Parents of stillborn babies (N=170) completed an online questionnaire examining engagement in continuing bonds expressions; characteristics of parents' relationship with their stillborn baby and their experience of sharing it; social support, and meaning-making. Measures of mental health were included to quantify bereavement adaptation. RESULTS Regression analyses showed that time since death, meaning-making, engaging with nature, and legacy building are positively linked to bereavement adaptation. Risk factors included inadequate social support for the relationship, a greater desire to share it more freely, an increased sense of integration with baby, and societal pressure to move on. CONCLUSION Key aspects of parents' ongoing relationship with their stillborn baby and the social context are related to bereavement adaptation.
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Affiliation(s)
- Emma E Jones
- School of Psychology, University of Sunderland, Sunderland, UK
| | | | | | - Catherine Kenny
- School of Psychology, University of Sunderland, Sunderland, UK
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8
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Comparing posttraumatic growth in mothers after stillbirth or early miscarriage. PLoS One 2022; 17:e0271314. [PMID: 35939433 PMCID: PMC9359608 DOI: 10.1371/journal.pone.0271314] [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: 01/15/2022] [Accepted: 06/28/2022] [Indexed: 11/19/2022] Open
Abstract
The possibility of posttraumatic growth in the aftermath of pregnancy loss has received limited attention to date. This study investigated posttraumatic growth in mothers following stillbirth compared to early miscarriage. It was hypothesised that mothers following stillbirth will demonstrate more posttraumatic growth, challenge to assumptive beliefs, and disclosure than mothers following early miscarriage. The study also sought to understand how theoretically-derived variables of the Model of Growth in Grief (challenge to assumptive beliefs and disclosure) explained unique variance in posttraumatic growth when key factors were controlled for. One-hundred and twenty women who had experienced a stillbirth (N = 57) or early miscarriage (N = 63) within the last two to six years completed validated questionnaires in an online survey relating to posttraumatic growth and key variables relevant to emotional adjustment post-bereavement. Participants who had experienced a stillbirth demonstrated significantly higher levels of posttraumatic growth, posttraumatic stress symptoms, perinatal grief, disclosure, challenge to assumptive beliefs and rumination than participants who had experienced an early miscarriage (Cohen’s d ranged .38-.94). In a hierarchical stepwise regression analysis, challenge to assumptive beliefs alone predicted 17.5% of the variance in posttraumatic growth. Intrusive and deliberate rumination predicted an additional 5.5% of variance, with urge to talk, reluctance to talk, and actual self-disclosure predicting a further 15.3%. A final model including these variables explained 47.9% of the variance in posttraumatic growth. Interventions targeting challenge to assumptive beliefs, disclosure, and rumination are likely to be clinically useful to promote psychological adjustment in mothers who have experienced stillbirth and early miscarriage.
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Yalniz Dilcen H, Akin B, Türkmen H. The relationship of prenatal attachment level to traumatic childbirth perception and posttraumatic stress in pregnancy. Perspect Psychiatr Care 2022; 58:221-228. [PMID: 34047376 DOI: 10.1111/ppc.12875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the relationship between the extent of prenatal attachment and traumatic childbirth perception (TCP) and posttraumatic stress. METHODS A total of 308 pregnant women admitted to the Obstetrics and Gynecology Department during a period of 6 months were applied a Personal Information Form, the Prenatal Attachment Inventory, the Traumatic Childbirth Perception Scale, and the Posttraumatic Diagnostic Scale, Self-Report version. RESULTS There was a negative correlation between TCP and posttraumatic stress disorder (PTSD). Traumatic stress decreased with increasing prenatal attachment. CONCLUSION Consequently, a negative correlation was found between prenatal attachment and PTSD.
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Affiliation(s)
- Hacer Yalniz Dilcen
- Department of Midwifery, School of Health, Bartın University, Bartın, Turkey
| | - Bihter Akin
- Department of Midwifery, School of Health, Selçuk University, Konya, Turkey
| | - Hülya Türkmen
- Department of Midwifery, School of Health, Balıkesir University, Balikesir, Turkey
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Ferrajão P. Worldviews about the self mediate the impact of immature and mature defense styles on posttraumatic symptoms in bereaved parents. DEATH STUDIES 2021; 46:1390-1400. [PMID: 34514966 DOI: 10.1080/07481187.2021.1975176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The present study analyzed the mediating role of assumptive worldviews on the effect of defense mechanisms on post-traumatic stress symptoms (PTS) in bereaved parents. Sample included a convenience sample of 153 bereaved parents and a control group of 157 nonbereaved parents. Structural equation modeling was conducted to examine our hypotheses. Bereaved parents presented higher levels of PTS and more negative assumptions compared to nonbereaved participants. Worthiness of the self mediated the effect of both immature and mature defense styles on PTS levels, and neurotic defense style directly predicted PTS levels.
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Affiliation(s)
- Paulo Ferrajão
- Faculdade de Ciências da Saúde e do Desporto, Universidade Europeia, Lisbon, Portugal
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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Fernández-Sola C, Camacho-Ávila M, Hernández-Padilla JM, Fernández-Medina IM, Jiménez-López FR, Hernández-Sánchez E, Conesa-Ferrer MB, Granero-Molina J. Impact of Perinatal Death on the Social and Family Context of the Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3421. [PMID: 32422977 PMCID: PMC7277582 DOI: 10.3390/ijerph17103421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Perinatal death (PD) is a painful experience, with physical, psychological and social consequences in families. Each year, there are 2.7 million perinatal deaths in the world and about 2000 in Spain. The aim of this study was to explore, describe and understand the impact of perinatal death on parents' social and family life. METHODS A qualitative study based on Gadamer's hermeneutic phenomenology was used. In-depth interviews were conducted with 13 mothers and eight fathers who had suffered a perinatal death. Inductive analysis was used to find themes based on the data. RESULTS Seven sub-themes emerged, and they were grouped into two main themes: 1) perinatal death affects family dynamics, and 2) the social environment of the parents is severely affected after perinatal death. CONCLUSIONS PD impacts the family dynamics of the parents and their family, social and work environments. Parents perceive that society trivializes their loss and disallows or delegitimizes their grief. IMPLICATIONS Social care, health and education providers should pay attention to all family members who have suffered a PD. The recognition of the loss within the social and family environment would help the families to cope with their grief.
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Affiliation(s)
- Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco 01090, Chile
| | - Marcos Camacho-Ávila
- Hospital La Inmaculada, 04600 Huércal-Overa, Spain;
- Hospital de Torrevieja, 03186 Torrevieja, Spain;
| | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- School of Health and Education, Middlesex University, London NW4 4BH, UK
| | - Isabel María Fernández-Medina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
| | - Francisca Rosa Jiménez-López
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
| | - Encarnación Hernández-Sánchez
- Hospital de Torrevieja, 03186 Torrevieja, Spain;
- Faculty of Health Sciences, Universidad Católica de San Antonio de Murcia, 30107 Guadalupe de Maciascoque, Spain
| | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco 01090, Chile
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Măirean C. Driving cognitions, rumination, and posttraumatic stress disorder in road traffic accidents survivors. Clin Psychol Psychother 2018; 26:47-54. [PMID: 30203885 DOI: 10.1002/cpp.2329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
Abstract
This study evaluated the relationships between driving cognitions (i.e., panic-related cognitions, accident-related cognitions, and social-related cognitions), rumination, and posttraumatic stress disorder (PTSD) symptoms in a sample of road traffic accidents (RTAs) survivors. We also investigated the indirect effect of driving cognitions on PTSD symptoms through rumination. The sample included 633 drivers (62% were men; Mage = 36.09; standard deviation [SD] = 11.42 years). The participants completed scales measuring driving cognitions, rumination, and PTSD symptoms, as well as providing their demographic information. The results showed that all three types of driving cognitions assessed in the present study and rumination were significantly positively associated with PTSD symptoms. Furthermore, rumination mediated the relation between social-related cognitions and PTSD symptoms. The implications for PTSD treatment and future research are discussed.
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Affiliation(s)
- Cornelia Măirean
- Department of Psychology, Alexandru Ioan Cuza University, Iasi, Romania
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Cook N, Ayers S, Horsch A. Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review. J Affect Disord 2018; 225:18-31. [PMID: 28777972 DOI: 10.1016/j.jad.2017.07.045] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Approximately 3.3% of women in pregnancy have posttraumatic stress disorder (PTSD) and 4% of women postpartum PTSD. The impact of maternal PTSD during the perinatal period (from conception until one year postpartum) on child outcomes has not been systematically examined. METHOD A systematic review was conducted to synthesize and critically evaluate quantitative research investigating the association between perinatal PTSD and child outcomes. Databases EMBASE, BNI, Medline, PsycInfo and CINAHL were searched using specific inclusion and exclusion criteria. RESULTS 26 papers reporting 21 studies were identified that examined associations between perinatal PTSD and postpartum birth outcomes, child development, and mother-infant relationship. Studies reviewed were heterogeneous, with poor-to-medium scores of methodological quality. Results showed that maternal postpartum PTSD is associated with low birth weight and lower rates of breastfeeding. Evidence for an association between maternal PTSD and preterm birth, fetal growth, head circumference, mother-infant interaction, the mother-infant relationship or child development is contradictory. Associations between maternal PTSD and infant salivary cortisol levels, and eating/sleeping difficulties are based on single studies, so require replication. LIMITATIONS Methodological weaknesses of the studies included insufficient sample size, use of invalidated measures, and limited external validity. CONCLUSION Findings suggest that perinatal PTSD is linked with some negative child outcomes. Early screening for PTSD during the perinatal period may be advisable and onward referral for effective treatment, if appropriate. Future research using larger sample sizes, validated and reliable clinical interviews to assess PTSD, and validated measures to assess a range of child outcomes, is needed.
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Affiliation(s)
- Natalie Cook
- The Oxford Institute of Clinical Psychology Training, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, United Kingdom.
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
| | - Antje Horsch
- Department Woman-Mother-Child, Lausanne University Hospital, Avenue Pierre-Decker 2, CH-1011 Lausanne, Switzerland.
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Khoramroudi R. The prevalence of posttraumatic stress disorder during pregnancy and postpartum period. J Family Med Prim Care 2018; 7:220-223. [PMID: 29915763 PMCID: PMC5958573 DOI: 10.4103/jfmpc.jfmpc_272_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction and Objective: The majority of formerly conducted studies have focused on the prevalence of posttraumatic stress disorder merely during pregnancy period; however, pregnancy period is by itself accompanied with the stress of getting pregnant again; therefore, the present study was conducted to evaluate the prevalence of posttraumatic stress disorder (PTSD) during pregnancy and postpartum period. Methods: A total of 3475 articles were found by searching keywords of PTSD, pregnancy, stress, and birth, through various research databases, including PubMed, Google Scholar, and Science Direct; 37 papers turned out to be completely relevant, 18 of which had provided through examination of the prevalence of intended disorder. Results: The prevalence rate varied from 0% to 21% in community-related samples; this rate varied from 0% to 43% in high-risk samples. Conclusion: PTSD is a common phenomenon during pregnancy and postpartum period, and it might get worse and worse unless it is diagnosed and treated after delivery. Thus, it is recommended to assess pregnancy and postpartum services.
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Affiliation(s)
- Rozita Khoramroudi
- Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
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Szabo YZ, Warnecke AJ, Newton TL, Valentine JC. Rumination and posttraumatic stress symptoms in trauma-exposed adults: a systematic review and meta-analysis. ANXIETY STRESS AND COPING 2017; 30:396-414. [DOI: 10.1080/10615806.2017.1313835] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Yvette Z. Szabo
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Ashlee J. Warnecke
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Tamara L. Newton
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Jeffrey C. Valentine
- Department of Educational and Counseling Psychology, University of Louisville, Louisville, KY, USA
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17
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Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. J Affect Disord 2017; 208:634-645. [PMID: 27865585 DOI: 10.1016/j.jad.2016.10.009] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 10/04/2016] [Accepted: 10/16/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous reviews have provided preliminary insights into risk factors and possible prevalence of Post-traumatic Stress Disorder (PTSD) postpartum with no attempt to examine prenatal PTSD. This study aimed to assess the prevalence of PTSD during pregnancy and after birth, and the course of PTSD over this time. METHODS PsychINFO, PubMed, Scopus and Web of Science were searched using PTSD terms crossed with perinatal terms. Studies were included if they reported the prevalence of PTSD during pregnancy or after birth using a diagnostic measure. RESULTS 59 studies (N =24267) met inclusion criteria: 35 studies of prenatal PTSD and 28 studies of postpartum PTSD (where 4 studies provided prevalence of PTSD in pregnancy and postpartum). In community samples the mean prevalence of prenatal PTSD was 3.3% (95%, CI 2.44-4.54). The majority of postpartum studies measured PTSD in relation to childbirth with a mean prevalence of 4.0% (95%, CI 2.77-5.71) in community samples. Women in high-risk groups were at more risk of PTSD with a mean prevalence of 18.95% (95%, CI 10.62-31.43) in pregnancy and 18.5% (95%, CI 10.6-30.38) after birth. Using clinical interviews was associated with lower prevalence rates in pregnancy and higher prevalence rates postpartum. LIMITATIONS Limitations include use of stringent diagnostic criteria, wide variability of PTSD rates, and inadequacy of studies on prenatal PTSD measured in three trimesters. CONCLUSIONS PTSD is prevalent during pregnancy and after birth and may increase postpartum if not identified and treated. Assessment and treatment in maternity services is recommended.
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Affiliation(s)
- Pelin Dikmen Yildiz
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK.
| | - Louise Phillips
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
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18
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Christiansen DM. Posttraumatic stress disorder in parents following infant death: A systematic review. Clin Psychol Rev 2016; 51:60-74. [PMID: 27838460 DOI: 10.1016/j.cpr.2016.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 11/19/2022]
Abstract
Parents who have lost an infant prior to, during, or following birth often interpret the event as highly traumatic. The present systematic review included 46 articles based on 31 different studies of posttraumatic stress disorder (PTSD) in parents bereaved by infant death. The PTSD prevalence in mothers differed widely across studies with estimated rates at 0.6-39%. PTSD in fathers following infant loss has been less extensively studied but PTSD levels were generally much lower than in mothers with reported prevalence rates at 0-15.6% across studies. PTSD symptoms were not found to differ much depending on whether the death occurred prior to, during, or following birth and nor was gestational age consistently associated with PTSD severity. A number of risk and protective factors have been found to be associated with PTSD severity. Relevant focus areas for future research are presented along with considerations for future pregnancies and children. The suffering associated with PTSD following infant loss is overwhelming because of the rates at which such losses occur around the world. For this reason, it is problematic that not all types of infant loss resulting in sufficient symptoms of re-experiencing, avoidance, and arousal can elicit a DSM-5 PTSD diagnosis.
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Affiliation(s)
- Dorte M Christiansen
- Institute of Psychology, Aarhus University, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Center for Psychotraumatology, Institute of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
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Huberty JL, Matthews J, Leiferman J, Hermer J, Cacciatore J. When a Baby Dies: A Systematic Review of Experimental Interventions for Women After Stillbirth. Reprod Sci 2016; 24:967-975. [DOI: 10.1177/1933719116670518] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Jennifer L. Huberty
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Jeni Matthews
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Jenn Leiferman
- Colorado School of Public Health, University of Colorado at DenverAnschutz Medical Campus, Aurora, CO, USA
| | - Janice Hermer
- ASU library, Arizona State University, Phoenix, AZ, USA
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McKenzie-McHarg K, Ayers S, Ford E, Horsch A, Jomeen J, Sawyer A, Stramrood C, Thomson G, Slade P. Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research. J Reprod Infant Psychol 2015. [DOI: 10.1080/02646838.2015.1031646] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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