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Porreca A, De Carli P, Filippi B, Bakermans-Kranenburg MJ, van IJzendoorn MH, Simonelli A. Maternal cognitive functioning and psychopathology predict quality of parent-child relationship in the context of substance use disorder: A 15-month longitudinal study. Dev Psychopathol 2024:1-12. [PMID: 38282537 DOI: 10.1017/s0954579424000026] [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: 01/30/2024]
Abstract
This longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects.We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment.A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement.These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.
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Affiliation(s)
- Alessio Porreca
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
| | - Pietro De Carli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, MI, Italy
| | - Bianca Filippi
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
| | | | - Marinus H van IJzendoorn
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, London, UK
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
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Pacho M, Aymerich C, Pedruzo B, Salazar de Pablo G, Sesma E, Bordenave M, Dieguez R, Lopez-Zorroza I, Herrero J, Laborda M, Fernandez-Rivas A, Garcia-Rizo C, Gonzalez-Torres MA, Catalan A. Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1264998. [PMID: 38025481 PMCID: PMC10666188 DOI: 10.3389/fpsyt.2023.1264998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use). Methods A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051). Conclusion This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. Systematic review registration This study protocol was registered at PROSPERO (registration number: CCRD42022375500).
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Affiliation(s)
- Malein Pacho
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Eva Sesma
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Rodrigo Dieguez
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Itziar Lopez-Zorroza
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Maria Laborda
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Aranzazu Fernandez-Rivas
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Miguel Angel Gonzalez-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIH Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
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Porreca A, Simonelli A, De Carli P, Barone L, Filippi B, Rigo P, van IJzendoorn MH, Bakermans-Kranenburg MJ. A randomized wait-list controlled trial to investigate the role of cognitive mechanisms in parenting interventions on mothers with substance use disorder. Trials 2022; 23:588. [PMID: 35870942 PMCID: PMC9308363 DOI: 10.1186/s13063-022-06420-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 05/24/2022] [Indexed: 11/11/2022] Open
Abstract
Background Maternal substance use disorder (SUD) represents a risk condition for quality of parenting and child development. The current literature highlights the need to identify interventions that effectively enhance the quality of parenting and to better understand which mechanisms are involved in the process of change. The present study protocol describes a randomized wait-list controlled trial that aims to examine (1) the efficacy of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in improving the quality of parenting (i.e., sensitive parenting and sensitive discipline) in mothers with SUD, (2) whether the intervention affects parental cognitive mechanisms (i.e., attentional disengagement to infant negative emotions, inhibitory control confronted with children’s affective expression, and parental reflective functioning), and (3) whether changes in these processes act as mechanisms of change, mediating the effect of the VIPP-SD program on quality of parenting. Moreover, the study aims (4) to explore whether the VIPP-SD has an effect on parenting stress and (5) to compare mothers with SUD to low-risk mothers on the outcome measures. Methods The study will involve 40 mothers with SUD and 20 low-risk mothers of children aged between 14 months and 6 years old. Mothers in the SUD group will be randomly divided into two groups, one receiving the intervention (SUD experimental group) and one undergoing treatment as usual (SUD control group). All the mothers will be assessed pre-test and post-test. Quality of parenting will be assessed through observed parenting behaviors, whereas parental cognitive mechanisms will be assessed through neuropsychological tasks and self-report measures. Discussion The results of the study will reveal whether an intervention that has been proven effective in other at-risk samples is also effective in improving parenting behaviors in the context of SUD. The results will also provide insight into potential cognitive mechanisms involved in the process of change. Trial registration ISRCTN registry ISRCTN63070968. Registered on 25 June 2021. Retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06420-8.
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Firoz T, Pineles B, Navrange N, Grimshaw A, Oladapo O, Chou D. Non-communicable diseases and maternal health: a scoping review. BMC Pregnancy Childbirth 2022; 22:787. [PMID: 36273124 PMCID: PMC9587654 DOI: 10.1186/s12884-022-05047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Non-communicable diseases [NCDs] are leading causes of ill health among women of reproductive age and an increasingly important cause of maternal morbidity and mortality worldwide. Reliable data on NCDs is necessary for accurate measurement and response. However, inconsistent definitions of NCDs make reliable data collection challenging. We aimed to map the current global literature to understand how NCDs are defined, operationalized and discussed during pregnancy, childbirth and the postnatal period. METHODS: For this scoping review, we conducted a comprehensive global literature search for NCDs and maternal health covering the years 2000 to 2020 in eleven electronic databases, five regional WHO databases and an exhaustive grey literature search without language restrictions. We used a charting approach to synthesize and interpret the data. RESULTS: Only seven of the 172 included sources defined NCDs. NCDs are often defined as chronic but with varying temporality. There is a broad spectrum of conditions that is included under NCDs including pregnancy-specific conditions and infectious diseases. The most commonly included conditions are hypertension, diabetes, epilepsy, asthma, mental health conditions and malignancy. Most publications are from academic institutions in high-income countries [HICs] and focus on the pre-conception period and pregnancy. Publications from HICs discuss NCDs in the context of pre-conception care, medications, contraception, health disparities and quality of care. In contrast, publications focused on low- and middle-income countries discuss NCDs in the context of NCD prevention. They take a life cycle approach and advocate for integration of NCD and maternal health services. CONCLUSION Standardising the definition and improving the articulation of care for NCDs in the maternal health setting would help to improve data collection and facilitate monitoring. It would inform the development of improved care for NCDs at the intersection with maternal health as well as through a woman's life course. Such an approach could lead to significant policy and programmatic changes with the potential corresponding impact on resource allocation.
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Affiliation(s)
- Tabassum Firoz
- Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USA
| | - Beth Pineles
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | | | - Alyssa Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA
| | | | - Doris Chou
- World Health Organization, Geneva, Switzerland.
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Park S, Ji Y, Hong X, Zuckerman B, Wang X, Surkan PJ. Effects of Stress and Nativity on Maternal Antenatal Substance Use and Postnatal Mental Disorders. J Womens Health (Larchmt) 2021; 31:878-886. [PMID: 34935494 DOI: 10.1089/jwh.2021.0016] [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: 12/17/2022] Open
Abstract
Background: Maternal substance use and common mental disorders (CMDs) during or after pregnancy can lead to negative health outcomes among mothers and infants. We examined whether nativity (US-born versus foreign-born) and stress levels during pregnancy were associated with antenatal substance use and postnatal CMDs. Methods: We analyzed the Boston Birth Cohort, a racially diverse cohort recruited at birth with rolling enrollment since 1998. Information on antenatal substance use (tobacco and/or alcohol use) was obtained using an in-person postpartum questionnaire (n = 6,514). Information on postnatal CMDs (depression and/or anxiety) was obtained from medical records (n = 2,052). Nativity and stress during pregnancy were self-reported. We performed multivariate logistic regression to examine how nativity and stress levels were jointly associated with antenatal substance use and postnatal CMDs. We further investigated if blacks, Hispanics, and whites were differentially at risk. Results: We found that US-born mothers were at higher risk of substance use and CMDs than their foreign-born counterparts. In analyses combining nativity and stress, being US-born with high stress was associated with increased odds of antenatal substance use (adjusted odds ratio [aOR] = 14.91, 95% confidence interval [CI]: 12.09-18.39) and postnatal CMDs (aOR = 4.09, 95% CI: 2.72-6.15) compared with foreign-born mothers with low stress. The results of the subanalyses limited to black and Hispanic women separately were similar; high stress alone was associated with fourfold increased odds of CMDs among foreign-born Hispanic mothers (aOR = 4.27, 95% CI: 1.96-9.33). Conclusions: Findings suggest that identifying and alleviating high stress among pregnant women may reduce their risk of antenatal substance use and postnatal CMDs.
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Affiliation(s)
- Soim Park
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Yuelong Ji
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Barry Zuckerman
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Burenkova OV, Podturkin AA, Naumova OY, Hein S, Li N, Cicchetti D, Luthar SS, Grigorenko EL. Neuroendocrine and autonomic stress systems activity in young adults raised by mothers with mental health and substance abuse problems: A prospective cohort study. Dev Psychobiol 2021; 63:e22213. [PMID: 34813100 PMCID: PMC8650616 DOI: 10.1002/dev.22213] [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: 03/05/2021] [Revised: 07/27/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Abstract
Among the well-known physiological consequences of early adverse environments is dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. A number of studies demonstrate that negative parenting and living with parents with a history of substance abuse and mental health problems may be associated with HPA axis dysregulation in children. In contrast, studies of more delayed effects in adult offspring, especially prospective, are still scarce. This study was a prospective longitudinal investigation of the association between maternal mental illnesses/substance abuse and maternal negative parenting/parental stress on one side and, on the other side, adult offspring outcomes 10 years later-specifically, we studied the activity of offspring's neuroendocrine (cortisol) and autonomic (heart rate) systems when exposed to a mild psychological stressor. Children of mothers with mental illnesses and/or substance abuse were exposed to more disadvantaged conditions (higher negative parenting and community violence). Despite this, maternal risk groups (having a mother with mental illnesses and/or substance abuse) were not associated with any of the indicators of stress systems activity. Regardless of the risk group, participants with dysregulated HPA axis activity experienced a higher level of negative parenting. Altogether, our study provides evidence that negative parenting may have long-lasting effects on stress-sensitive physiological mechanisms.
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Affiliation(s)
- Olga V. Burenkova
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
| | | | - Oksana Yu. Naumova
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
- Human Genetics Laboratory, Vavilov Institute of General
Genetics RAS, Moscow, Russian Federation
| | - Sascha Hein
- Department of Education and Psychology, Free University of
Berlin, Berlin, Germany
| | - Nan Li
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
| | - Dante Cicchetti
- University of Minnesota, Institute of Child Development,
Minneapolis, United States of America
| | - Suniya S. Luthar
- Authentic Connections, Tempe, AZ; Emerita - Teachers
College, Columbia University, New York City, New York, United States of
America
| | - Elena L. Grigorenko
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
- Baylor College of Medicine, Houston, Texas, United States
of America
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Wallin CM, Bowen SE, Brummelte S. Opioid use during pregnancy can impair maternal behavior and the Maternal Brain Network: A literature review. Neurotoxicol Teratol 2021; 86:106976. [PMID: 33812002 DOI: 10.1016/j.ntt.2021.106976] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/26/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
Opioid Use Disorder (OUD) is a global epidemic also affecting women of reproductive age. A standard form of pharmacological treatment for OUD is Opioid Maintenance Therapy (OMT) and buprenorphine has emerged as the preferred treatment for pregnant women with OUD relative to methadone. However, the consequences of BUP exposure on the developing Maternal Brain Network and mother-infant dyad are not well understood. The maternal-infant bond is dependent on the Maternal Brain Network, which is responsible for the dynamic transition from a "nulliparous brain" to a "maternal brain". The Maternal Brain Network consists of regions implicated in maternal care (e.g., medial preoptic area, nucleus accumbens, ventral pallidum, ventral tegmentum area) and maternal defense (e.g., periaqueductal gray). The endogenous opioid system modulates many of the neurochemical changes in these areas during the transition to motherhood. Thus, it is not surprising that exogenous opioid exposure during pregnancy can be disruptive to the Maternal Brain Network. Though less drastic than misused opioids, OMTs may not be without risk of disrupting the neural and molecular structures of the Maternal Brain Network. This review describes the Maternal Brain Network as a framework for understanding how pharmacological differences in exogenous opioid exposure can disrupt the onset and maintenance of the maternal brain and summarizes opioid and OMT (in particular buprenorphine) use in the context of pregnancy and maternal behavior. This review also highlights future directions for evaluating exogenous opioid effects on the Maternal Brain Network in the hopes of raising awareness for the impact of the opioid crisis not only on exposed infants, but also on mothers and subsequent mother-infant bonds.
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Affiliation(s)
- Chela M Wallin
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
| | - Scott E Bowen
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
| | - Susanne Brummelte
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
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Porreca A, De Carli P, Filippi B, Parolin M, Simonelli A. Mothers' alexithymia in the context of parental Substance Use Disorder: Which implications for parenting behaviors? CHILD ABUSE & NEGLECT 2020; 108:104690. [PMID: 32890853 DOI: 10.1016/j.chiabu.2020.104690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Maternal substance use disorder (SUD) represents a severe risk for caregiving, affecting diverse domains of parenting behaviors, such as sensitivity, structuring, intrusiveness, and hostility. Various studies highlighted that difficulties in parenting behaviors in the context of SUD are exacerbated by the co-occurrence of psychopathological symptoms. A large body of research points out the presence of high rates of alexithymia in individuals with SUD, and some studies provide evidence of an association between this psychopathological aspect and parenting. Nevertheless, no prior research has explored how alexithymic traits could affect quality of parenting behaviors in mothers with SUD. OBJECTIVE To investigate the impact of maternal alexithymia on parenting behaviors in mothers with SUD. METHODS Sixty women in residential treatment for SUD and their children participated in the study. The participants were assessed with respect to alexithymia, quality of parenting behaviors, and depressive symptoms. RESULTS Forty-three percent of the mothers reported the presence of alexithymia. These mothers presented with significantly low scores on sensitivity (β = -.25, p < .05) and structuring (β = -.32, p < .05). After controlling for depressive symptomatology, the effect of alexithymia on parenting behaviors remained only for structuring (β=.35, p < .05). CONCLUSIONS In the context of SUD, maternal alexithymia significantly impacts the quality of parenting behaviors, specifically structuring, indicating that difficulties in becoming aware of one's own feelings jeopardize the ability to scaffold interactions and set age-appropriate limits in an emotionally attuned way. Clinical implications of the findings are discussed.
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Affiliation(s)
- Alessio Porreca
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy.
| | - Pietro De Carli
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy.
| | - Bianca Filippi
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy.
| | - Micol Parolin
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy.
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy.
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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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Mother-Infant Bonding and Emotional Availability at 12-Months of Age: The Role of Early Postnatal Bonding, Maternal Substance Use and Mental Health. Matern Child Health J 2019; 23:1686-1698. [PMID: 31529248 DOI: 10.1007/s10995-019-02809-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The quality of the mother-child relationship in the first year of life has far reaching implications across the life course (Bornstein in Annu Rev Psychol 65:121-158, 2014). Yet little is known about predictors of maternal bonding and emotional availability in early infancy. In this study we examined the extent to which postnatal bonding, maternal mental health, and substance use at 8-weeks postpartum predicted mother-infant bonding (self-report) and mother emotional availability (observational) at 12-months of age. METHODS Data were obtained from an Australian longitudinal cohort study of pregnancy (n = 308). Data were collected during pregnancy, at birth, and postnatally at 8-weeks and 12-months. RESULTS The results show strong continuity between postnatal bonding at 8-weeks and 12-months. Early postpartum stress and depression were associated with bonding at 12-months; however, the effect did not persist after adjustment for bonding at 8-weeks. Tobacco use at 8-weeks, but no other indicators of mental health, predicted lower emotional availability scores at 12-months. DISCUSSION Results suggest that the mother's felt bond to her child is stable across the first year of life and that early bonding is a more robust indicator of bonding at 12-months than a mother's mental health or substance use. These findings point to the importance of clinical and public health investments in establishing a strong bond between mother and child in the early postpartum period.
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Kimmel MC, Bauer A, Meltzer-Brody S. Toward a framework for best practices and research guidelines for perinatal depression research. J Neurosci Res 2019; 98:1255-1267. [PMID: 30924191 PMCID: PMC10127524 DOI: 10.1002/jnr.24425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 02/06/2023]
Abstract
This review article highlights the current state of perinatal depression (PND) research including established standards of care and innovative research in progress. PND can have a significant adverse impact on mother, child, and family; however, to date, wide-scale identification, prevention, and treatment have been limited. PND is heterogenous in presentation with likely multifactorial etiologies for each woman. Challenges in PND research are discussed including a need for universal tools, standardized measures, benchmarks, and best practices. Current examples are reviewed that highlight approaches to novel treatment paradigms and interventions. This includes reviewing epidemiologic studies in PND research, examining the biological underpinnings of PND, and discussing examples from this field and other fields currently developing translational research that spans from bench to bedside. Current and future challenges and opportunities in developing best practices for the treatment of PND are outlined. We also discuss the use of the NIMH Research Domain Criteria approach for PND research and provide recommendations for future directions in PND research collaboration. In conclusion, greater precision in perinatal psychiatry can be possible in the future with the development of guidelines and best practices that build on current work and apply innovative and collaborative approaches of scientists, providers, patients, community members, and government officials.
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Affiliation(s)
- Mary C Kimmel
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Anna Bauer
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Samantha Meltzer-Brody
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
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12
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Frigerio A, Porreca A, Simonelli A, Nazzari S. Emotional Availability in Samples of Mothers at High Risk for Depression and With Substance Use Disorder. Front Psychol 2019; 10:577. [PMID: 30936847 PMCID: PMC6431618 DOI: 10.3389/fpsyg.2019.00577] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/01/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Maternal substance use disorder (SUD) and depression have been extensively associated with dysfunctions in parent-child interactions. However, few studies have compared caregiving behaviors of these mothers. The current study aims to explore maternal emotional availability (EA) in mothers with maternal SUD and depressive symptoms in order to investigate whether these conditions represent a different risk gradient for early parenting. Methods: Mother-infant relationship was investigated in 18 mothers with SUD, 11 mothers at risk for depression, and 39 mothers from general population. The dyads were videotaped during a free-play session and the quality of parent-child interactions was assessed using the EA Scales (EAS) and the Emotional Attachment and EA Clinical Screener (EA2-CS). Results: Mothers with SUD scored lower on sensitivity, non-intrusiveness, and non-hostility with respect to the low-risk sample, whereas mothers at risk for depression scored lower on sensitivity and non-hostility compared to the latter. No significant differences between mothers with SUD and mothers at risk for depression emerged on the EAS, whereas different specific classifications on the EA Clinical Screener were found for the SUD (i.e., Complicated), depression (i.e., Detached), and low-risk (i.e., Emotionally Available) samples. Conclusion: If the current findings are replicated, they might have significant implications for selecting targets of early mother-infant interventions.
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Affiliation(s)
- Alessandra Frigerio
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
| | - Alessio Porreca
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padua, Italy
| | - Alessandra Simonelli
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padua, Italy
| | - Sarah Nazzari
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
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Cataldo I, Azhari A, Coppola A, Bornstein MH, Esposito G. The Influences of Drug Abuse on Mother-Infant Interaction Through the Lens of the Biopsychosocial Model of Health and Illness: A Review. Front Public Health 2019; 7:45. [PMID: 30915325 PMCID: PMC6422866 DOI: 10.3389/fpubh.2019.00045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/15/2019] [Indexed: 01/01/2023] Open
Abstract
Women who abuse illicit drugs often engage in atypical parenting behaviors that interfere with the natural development of mother-infant interaction and attachment. Maternal caregiving deficits leave pronounced adverse consequences in the wake of drug abuse relapse, which often occurs and in early infancy. These are times when the child requires optimal parental care. The contemporary literature documents long-term implications of illicit drug-abuse in parenting on infants. However, factors that drive and sustain the influence of drug abuse on parent-infant outcomes remain elusive. This review adopts a biopsychosocial approach to synthesizing the existing state of knowledge on this issue. Mother-infant interaction is a dynamic socio-relational process that occurs at multiple levels of organization. As such, a biopsychosocial perspective enables us to uncover: (i) roles of specific physiological mechanisms and biological characteristics of atypical parenting in mothers who abuse drugs, (ii) the influence of drugs on maternal psychological state (i.e., beliefs regarding parenting practices, emotional regulation), and (iii) social relationships (i.e., relationships with spouse and other drug abusers) and contextual cues (i.e., triggers) that moderate non-optimal maternal caregiving. A comprehensive review of these key domains provides a nuanced understanding of how these several sources interdependently shape atypical parent-infant interaction amongst drug abusing mothers. Systematic elucidation of major factors underlying drug-abused maternal behaviors facilitates the development of targeted and more effective interventions.
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Affiliation(s)
- Ilaria Cataldo
- Affiliative Behavior and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Atiqah Azhari
- Social and Affective Neuroscience Lab, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Aurora Coppola
- Psychology Unit, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.,Service for Addiction-Ser.D, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States.,Institute for Fiscal Studies, London, United Kingdom
| | - Gianluca Esposito
- Affiliative Behavior and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Social and Affective Neuroscience Lab, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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14
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15
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Haabrekke K, Siqveland T, Nygaaard E, Bjornebekk A, Slinning K, Wentzel-Larsen T, Walhovd KB, Smith L, Moe V. COGNITIVE AND SOCIOEMOTIONAL FUNCTIONING AT 4½ YEARS IN CHILDREN BORN TO MOTHERS WHO HAVE RECEIVED TREATMENT FOR SUBSTANCE-ABUSE PROBLEMS WHILE PREGNANT. Infant Ment Health J 2018; 39:581-594. [PMID: 30084491 DOI: 10.1002/imhj.21733] [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: 11/09/2022]
Abstract
Cognitive and socioemotional functioning at 4½ years of age were examined in children born to mothers with substance-abuse problems (n = 22) recruited from residential treatment institutions while pregnant, and then compared to children born to mothers with mental health problems (n = 18) and children from a low-risk group (n = 26). No significant group differences in cognitive functioning were found, but the children born to mothers with substance-abuse problems showed more caregiver-reported socioemotional problems than did the low-risk children, like the children born to mothers with mental health problems. Birth weight had an effect on internalizing problems at 4½ years and mediated the relation between group and socioemotional problems, although not when controlling for caregiver education, single parenthood, and anxiety and depression. At 4½ years, 7 children born to mothers with substance-abuse problems were placed in foster care. These children had lower birth weight and higher caregiver-rated internalizing problems. In addition to emphasizing the importance of the quality of the prenatal environment, this study suggests that families with previous substance abuse are in need of long-term follow-up to address socioemotional problems and enhance further positive child cognitive development. The foster-placed children may be in particular need of long-term follow-up.
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Affiliation(s)
| | | | | | | | - Kari Slinning
- The Center for Child and Adolescent Mental Health, Oslo
| | - Tore Wentzel-Larsen
- The Center for Child and Adolescent Mental Health, Oslo and Norwegian Center for Violence and Traumatic Stress Studies, Oslo
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16
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Emotional Availability, Neuropsychological Functioning, and Psychopathology: The Context of Parental Substance Use Disorder. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5359037. [PMID: 29888268 PMCID: PMC5985126 DOI: 10.1155/2018/5359037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/11/2018] [Indexed: 11/17/2022]
Abstract
Parental Substance Use Disorder (SUD) constitutes a high-risk condition for parent-child interactions and child development. Empirical evidence indicates high rates of psychopathology and neuropsychological impairments in individuals with SUD. Despite research indicating that parenting skills are related to psychological well-being and cognitive/neuropsychological functioning, prior studies have not examined the associations between these areas of parental functioning and the quality of parent-child interactions in the context of SUD. Aim(s). The present study adopts an integrated perspective to investigate the way in which maternal neuropsychological functioning and psychopathology are associated with mother-child emotional availability (EA), in the context of parental Substance Use Disorder. Methods. Twenty-nine mothers with SUD were assessed in interaction with their children, as well as with respect to their neuropsychological functioning and psychopathology. Results. In this group, high rates of maternal neuropsychological impairments and psychopathology, as well as generally low levels of EA, were uncovered. Regression analyses showed that maternal neuropsychological functioning was significantly associated with mother-child EA, specifically sensitivity; the role of maternal psychopathology, however, was only marginally significant. Conclusion. In the context of SUD, maternal neuropsychological impairments are significantly associated with mother-child EA. Clinical implications of the findings are discussed.
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17
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Abstract
NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families.
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18
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Hatzis D, Dawe S, Harnett P, Barlow J. Quality of Caregiving in Mothers With Illicit Substance Use: A Systematic Review and Meta-analysis. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2017; 11:1178221817694038. [PMID: 28469425 PMCID: PMC5398331 DOI: 10.1177/1178221817694038] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/25/2017] [Indexed: 12/31/2022]
Abstract
Background: The quality of caregiving in mothers with substance abuse problems appears to be compromised. However, divergent findings, methodological variability, and sample characteristics point to the need for research synthesis. Methods: A comprehensive systematic search was undertaken. Studies were eligible if they (1) compared substance-misusing mothers with non–substance-misusing mothers, (2) involved children from birth to 3 years, and (3) maternal sensitivity and child responsiveness were measured using observational methodology. Results: A global meta-analysis for maternal sensitivity (n = 24 studies) and child responsiveness (n = 16 studies) on 3433 mother-infant dyads yielded significant population effect sizes and significant heterogeneity. Subgroup analyses found reduced heterogeneity when the meta-analysis was conducted on studies where groups were matched on key demographic characteristics; although the effect size was small, it was still significant for maternal sensitivity but not child responsiveness. Conclusions: Compromised quality of caregiving is found in high-risk, substance-misusing mothers, emphasising the importance of early intervention that draws from attachment-based interventions.
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Affiliation(s)
- Denise Hatzis
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia.,Australian Centre for Child Protection, University of South Australia, Adelaide, SA, South Australia
| | - Paul Harnett
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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19
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Guttmannova K, Hill KG, Bailey JA, Hartigan L, Small CM, Hawkins JD. Parental Alcohol Use, Parenting, and Child On-Time Development. INFANT AND CHILD DEVELOPMENT 2016; 26. [PMID: 29062266 DOI: 10.1002/icd.2013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined whether parental alcohol use in adolescence, adulthood, and, for mothers, during pregnancy was related to their young children's functioning in terms of their on-time development as indicated by the number of developmental areas in which children experienced delay. Observed parenting practices and family socioeconomic status were tested as potential explanatory mechanisms of these links. Data came from the surveys and videotaped observations of a community sample of 123 biological parents and their 1-5 year old children followed longitudinally. Results suggest that the negative association between parental alcohol use and children's development operates primarily through fathers' alcohol use. Additionally, father's adolescent regular alcohol use predicted the family's low SES, which in turn predicted less-skilled maternal parenting practices and children's developmental delay.
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Affiliation(s)
- Katarina Guttmannova
- Center for the Study of Health and Risk Behaviors (CSHRB), Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Karl G Hill
- Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, Washington, USA
| | - Jennifer A Bailey
- Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, Washington, USA
| | - Lacey Hartigan
- Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, Washington, USA
| | - Candice M Small
- Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, Washington, USA
| | - J David Hawkins
- Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, Washington, USA
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20
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Abstract
The aim of this qualitative study was to describe the mothering experiences of women with substance use disorders. We conducted semistructured, individual interviews with 15 mothers. Using thematic analysis, 5 themes were identified: (1) facing the reality of a pregnancy complicated by substance use, trauma, and loss, (2) finding a higher meaning, (3) dealing with the consequences, (4) managing the details of daily life, and (5) looking toward a future with my children. Moreover, the women described entering motherhood with uncertainty, fear, shame, and stress. We hope that these findings will lead to more compassionate nursing care for this population.
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21
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Porreca A, De Palo F, Simonelli A, Capra N. Attachment Representations and Early Interactions in Drug Addicted Mothers: A Case Study of Four Women with Distinct Adult Attachment Interview Classifications. Front Psychol 2016; 7:346. [PMID: 27014153 PMCID: PMC4793774 DOI: 10.3389/fpsyg.2016.00346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 02/25/2016] [Indexed: 11/29/2022] Open
Abstract
Drug addiction is considered a major risk factor that can influence maternal functioning at multiple levels, leading to less optimal parental qualities and less positive interactive exchanges in mother-child dyads. Moreover, drug abusers often report negative or traumatic attachment representations regarding their own childhood. These representations might affect, to some extent, later relational and developmental outcomes of their children. This study explored whether the development of dyadic interactions in addicted women differed based on attachment status. The longitudinal ongoing of mother-child emotional exchanges was assessed among four mothers with four different attachment statuses (F-autonomous, E-preoccupied, Ds-dismissing, and U-unresolved/with losses). Attachment representations were assessed using the Adult Attachment Interview (George et al., 1985), while mother-child interactions were evaluated longitudinally during videotaped play sessions, through the Emotional Availability Scales (Biringen, 2008). As expected, the dyad with the autonomous mother showed better interactive functioning during play despite the condition of drug-abuse; the mother proved to be more affectively positive, sensitive, and responsive, while her baby showed a better organization of affects and behaviors. On the other side, insecure mothers seemed to experience more difficulties when interacting with their children showing inconsistency in the ability to perceive and respond to their babies' signals. Finally, children of insecure mothers showed less clear affects and signals. While differences between secure and insecure dyads appeared clear, differences between insecure patterns where less linear, suggesting a possible mediating role played by other factors. Clinical implications and suggestions for future research are discussed.
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Affiliation(s)
- Alessio Porreca
- Department of Developmental and Social Psychology, University of Padua Padua, Italy
| | - Francesca De Palo
- Therapeutic Community "Casa Aurora" - Comunità di Venezia s.c.s. Venice, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua Padua, Italy
| | - Nicoletta Capra
- Therapeutic Community "Casa Aurora" - Comunità di Venezia s.c.s. Venice, Italy
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22
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Håkansson U, Halsa A, Söderström K, Skårderud F, Øie MG. Keeping Mind in Mind: Mentalizing and Executive Functioning in Substance-Abusing Infant Mothers: Effect on Dyadic Relationship and Infant Outcome. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:93-8. [PMID: 26819554 PMCID: PMC4720184 DOI: 10.4137/sart.s23502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/01/2015] [Accepted: 10/02/2015] [Indexed: 11/18/2022]
Abstract
Although it is well documented that maternal substance abuse has a negative effect on the mother–child interaction, less is known about the pathways through which the interaction is compromised. The main objective of this research proposal is to describe an ongoing research project that focuses on associations between maternal executive function and the quality of mother–infant interaction when the mother has a history of substance abuse. We will also investigate the effects of multiple variables, including maternal relationship experiences, personality disposition, parental stress, comorbid mental illness, and addiction severity, on the dyadic interaction and child functioning. A group of 40–50 mothers with substance abuse problems and their infants aged 6–18 months will be included. The mothers will be assessed with neuropsychological tests, clinical interviews, self-administered questionnaires, and dyadic interaction observations as well as observation and assessment of child functioning. We will use a cross-sectional correlational design. The inclusion of the participants will end in October 2015. Further knowledge about the variables that are important for the mother–infant relationship can inform future research and clinical practice.
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Affiliation(s)
| | - Astrid Halsa
- Lillehammer University College, Lillehammer, Norway
| | - Kerstin Söderström
- Lillehammer University College, Lillehammer, Norway.; Division Mental Health Care, Innlandet Hospital Trust, Lillehammer, Norway
| | - Finn Skårderud
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Research Division, Innlandet Hospital Trust, Lillehammer, Norway.; Institute of Psychology, University of Oslo, Oslo, Norway
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23
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Siqveland TS, Haabrekke K, Wentzel-Larsen T, Moe V. Patterns of mother–infant interaction from 3 to 12 months among dyads with substance abuse and psychiatric problems. Infant Behav Dev 2014; 37:772-86. [DOI: 10.1016/j.infbeh.2014.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/04/2014] [Accepted: 09/29/2014] [Indexed: 11/24/2022]
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Siqveland TS, Moe V. Longitudinal development of mother-infant interaction during the first year of life among mothers with substance abuse and psychiatric problems and their infants. Child Psychiatry Hum Dev 2014; 45:408-21. [PMID: 24158304 DOI: 10.1007/s10578-013-0411-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The quality of mother-infant interaction during the first year may be hampered by maternal substance abuse and co-existing non-optimal factors such as psychiatric problems and difficult relational experiences. In the present study three groups of women were recruited during pregnancy: One group with substance abuse problems from residential treatment centers (n = 28), a second group from psychiatric outpatient treatment centers (n = 22), and a third group from well-baby clinics (n = 30). Four maternal optimality indexes were assessed (substance abuse, psychiatric problems, relational experiences and SES). Mother-infant interaction was observed at 3 and 12 months. The substance abuse group showed the most disturbed mother-infant interaction at 12 months. Low maternal optimality as well as impairments in maternal affective involvement at 3 months influenced negatively both on infant and dyadic affective behavior in interaction at 12 months. Long-term interventions are needed to promote affective reciprocity among mother-baby pairs with low optimality.
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Affiliation(s)
- Torill S Siqveland
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0317, Oslo, Norway,
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25
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Cleveland LM, Bonugli R. Experiences of mothers of infants with neonatal abstinence syndrome in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs 2014; 43:318-29. [PMID: 24754258 DOI: 10.1111/1552-6909.12306] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To describe the experiences of mothers of infants with neonatal abstinence syndrome (NAS) in the neonatal intensive care unit (NICU). DESIGN Qualitative description. SETTING We recruited participants from community-based, out-patient, addiction treatment facilities in a large urban city in the southwestern region of the United States. PARTICIPANTS A convenience sample of 15 Hispanic, substance addicted mothers of infants with NAS participated. METHODS We conducted semistructured, individual, interviews and analyzed the data using qualitative content analysis. First, we analyzed the data independently and then discussed the themes until a consensus was reached. RESULTS We identified four themes: (a) understanding addiction, (b) watching the infant withdraw, (c) judging, and (d) trusting the nurses. The participants felt there was a lack of understanding concerning addiction that was particularly noted when interacting with the nurses. They shared their feelings of guilt and shame when observing their infants withdrawing. The participants felt judged by the nurses for having used illicit drugs during pregnancy. Feeling judged interfered with the participants' ability to trust the nurses. CONCLUSION These findings provide nurses with a better understanding of the experiences of mothers who have addiction problems and may lead to more customized nursing care for this high-risk population of mothers and their infants.
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Abstract
National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression may be at high risk for substance use. Understanding postpartum substance use and its relationship to postpartum depression can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999-2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%-49%) and drug use (4.5%-8.5%) were lower than use among not pregnant, not postpartum women (41.5%-57.5%, 7.6%-10.6%, respectively) but higher than use among pregnant women (5.4%-11.6%, 3.7%-4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by blacks and Hispanics, but black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%-46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use.
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Affiliation(s)
- Shawna L Carroll Chapman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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27
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Koponen AM, Kalland M, Autti-Rämö I, Laamanen R, Suominen S. Socio-emotional development of children with foetal alcohol spectrum disorders in long-term foster family care: a qualitative study. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/2156857x.2013.766234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chapman SLC, Wu LT. Substance Use among Adolescent Mothers: A Review. CHILDREN AND YOUTH SERVICES REVIEW 2013; 35:806-815. [PMID: 23641120 PMCID: PMC3638998 DOI: 10.1016/j.childyouth.2013.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Maternal substance abuse is a critical problem, and adolescent mothers appear to be at high risk for such behaviors. We review studies on postpartum adolescent substance use to explore the extent of this problem and avenues for new research. Authors screened 1,300 studies, identifying 12 articles on substance use among postpartum adolescent mothers for this review. Adolescent mothers reported greater substance use before pregnancy compared to other adolescent females. Although some adolescents continued substance use during pregnancy, most stopped using only to resume within six months after birth. Comparisons of use to national samples of nulliparous adolescent females showed a higher prevalence of substance use in this population. Substances used often varied by race/ethnicity, with white mothers more likely to smoke cigarettes and use marijuana, and Black mothers more likely than whites to drink and use drugs. Of all identified studies, only one focused on Hispanics. Beliefs about drug use grew less negative as girls transitioned from pregnancy to parenthood. As they transitioned to adulthood, substance use remained prevalent and stable. Psychological distress and low self-esteem appeared to influence continued use. Friends' cigarette smoking predicted early initiation of and persistent smoking, while increased education predicted quitting. Early initiation of substances often predicted problem behaviors. Adolescent mothers are a vulnerable population, implicating use of problem behavior theory or the self-medication hypothesis in future research. Multiple avenues for new studies are needed to help identify effective treatment and intervention for this understudied population.
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Affiliation(s)
- Shawna L. Carroll Chapman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA
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29
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Gilchrist G, Cameron J, Nicolson S, Galbally M, Moore P. Reducing depression among perinatal drug users – what is needed? A triangulated study. ADVANCES IN DUAL DIAGNOSIS 2012. [DOI: 10.1108/17570971211281666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Motz M, Espinet SD, Jeong JJ, Zimmerman P, Chamberlin J, Pepler DJ. Use of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R) with Canadian Infants and Young Children Prenatally Exposed to Substances. Infant Ment Health J 2012. [DOI: 10.1002/imhj.21351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Mary Motz
- Mothercraft, Toronto and York University
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Flykt M, Punamäki RL, Belt R, Biringen Z, Salo S, Posa T, Pajulo M. Maternal representations and emotional availability among drug-abusing and nonusing mothers and their infants. Infant Ment Health J 2012; 33:123-138. [DOI: 10.1002/imhj.21313] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months. Infant Behav Dev 2012; 35:60-70. [DOI: 10.1016/j.infbeh.2011.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 03/09/2011] [Accepted: 09/28/2011] [Indexed: 11/21/2022]
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33
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Murphy-Oikonen J, Brownlee K, Montelpare W, Gerlach K. The experiences of NICU nurses in caring for infants with neonatal abstinence syndrome. Neonatal Netw 2011; 29:307-13. [PMID: 20829177 DOI: 10.1891/0730-0832.29.5.307] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study explored the experiences of NICU nurses in caring for infants with neonatal abstinence syndrome (NAS). DESIGN A qualitative research approach was used with open-ended questions employing computer-assisted personal interviews. SAMPLE Fourteen NICU nurses employed in a regional hospital provided responses. RESULTS The nurses reflected a personal struggle between a desire to employ their technical and critical nursing skills and the need to provide expected maternal care to NAS infants. Other themes included frustration and burnout, challenges to values about parenting, and increased awareness of drug use in the community and at home. DISCUSSION The results suggest that nurses underrate the skill required to care for infants with NAS. The level of knowledge, patience, and commitment to these newborns should be reframed to increase job satisfaction, and education should be offered to nurses about women struggling with addictions.
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Abstract
Depression affects more women than men, with a preponderance of cases occurring during prime childbearing years (15-44 years of age). Research shows newborns and infants exposed to maternal antepartum depression, anxiety and stress exhibit pronounced neurobiobehavioral dysregularities. The present study investigated the relationship between maternal psychosocial and biochemical profiles during the antepartum period. Participants were recruited from prenatal registration at a large metropolitan hospital in the southeastern USA--the sample consisted of 59 pregnant women (mean age = 22 years). Structured clinical interviews and maternal self-report were utilized to assess maternal psychosocial distress at mid- (26-28 weeks) and late- (32-34 weeks) gestation. Salivary cortisol levels served as an objective stress measure. The resultant high incidences of maternal depression, anxiety and stress provide evidence of the need for nurses to closely monitor psychosocial and biochemical profiles of all women to thwart the negative effects on the developing human foetus. Clinical nursing implications of the requisite consideration of antepartum maternal psychosocial conditions are discussed.
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Affiliation(s)
- D A Parcells
- Department of Psychology, Emory University, Atlanta, GA, USA.
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Sarfi M, Martinsen H, Bakstad B, Røislien J, Waal H. Patterns in sleep-wakefulness in three-month old infants exposed to methadone or buprenorphine. Early Hum Dev 2009; 85:773-8. [PMID: 19931991 DOI: 10.1016/j.earlhumdev.2009.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 09/22/2009] [Accepted: 10/29/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Infants exposed to opioides in-utero frequently demonstrate withdrawal symptoms in the neonatal period and have difficulties with state regulation. AIM This study examines sleep-wakefulness-distress patterns as indicators of regulatory mechanisms at 3 months of age. PARTICIPANTS A national infant cohort (N=35) born to women in high-dose maintenance treatment during pregnancy and a comparison group (N=36) of low-risk infants born in the same period. OUTCOME MEASURES Distributions and frequencies of sleep, wakefulness and distress measured in hours and episodes on sleep charts recorded by the mothers in the two groups. RESULTS Women in maintenance treatment were monitored closely during pregnancy to avoid illicit drug use and to be prepared for motherhood. They were also offered residential treatment before pregnancy and after the child was born. There were no statistical differences between the two groups in any of the 10 measures reflecting diurnal and nocturnal rhythmicity at 3 months despite of neonatal abstinence syndrome in 47% of the exposed infants and significant differences in infant characteristics with respect to birth weight, gestational age and maternal characteristics. CONCLUSIONS Follow-up procedures combining drug monitoring and counseling during pregnancy and in the first months after birth enhance the development of state regulation in terms of sleep-wakefulness patterns.
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Affiliation(s)
- Monica Sarfi
- Institute of Psychiatry, Centre for Addiction Research, Oslo University of Oslo, Kirkeveien 166, N-0407 Oslo, Norway.
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36
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Morton J, Konrad SC. Introducing a caring/relational framework for building relationships with addicted mothers. J Obstet Gynecol Neonatal Nurs 2009; 38:206-13. [PMID: 19323716 DOI: 10.1111/j.1552-6909.2009.01006.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Health care practice with addicted mothers requires health professionals to both desire and acquire knowledge, skills, and attitudes geared toward developing relationships that foster trust. In this article, nursing and social work theories are used to offer an integrated and interdisciplinary framework for building relationships with addicted mothers in health care settings. Embracing and utilizing caring/relational concepts serve as an impetus to the development of effective relationships with this vulnerable population.
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Affiliation(s)
- Jennifer Morton
- University of New England, College of Health Professions, Department of Nursing, 716 Stevens Avenue, Portland, ME 04103, USA.
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The Prevalence of Postpartum Depression among Women with Substance Use, an Abuse History, or Chronic Illness: A Systematic Review. J Womens Health (Larchmt) 2009; 18:475-86. [DOI: 10.1089/jwh.2008.0953] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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GILCHRIST GAIL, TAYLOR AVRIL. Drug-using mothers: Factors associated with retaining care of their children. Drug Alcohol Rev 2009; 28:175-85. [DOI: 10.1111/j.1465-3362.2008.00017.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mäntymaa M, Puura K, Luoma I, Kaukonen P, Salmelin RK, Tamminen T. Infants’ social withdrawal and parents’ mental health. Infant Behav Dev 2008; 31:606-13. [DOI: 10.1016/j.infbeh.2008.07.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 03/14/2008] [Accepted: 07/19/2008] [Indexed: 11/29/2022]
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Belt R, Punamäki RL. Mother – infant group psychotherapy as an intensive treatment in early interaction among mothers with substance abuse problems. JOURNAL OF CHILD PSYCHOTHERAPY 2007. [DOI: 10.1080/00754170701437096] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Pajulo M, Suchman N, Kalland M, Mayes L. ENHANCING THE EFFECTIVENESS OF RESIDENTIAL TREATMENT FOR SUBSTANCE ABUSING PREGNANT AND PARENTING WOMEN: FOCUS ON MATERNAL REFLECTIVE FUNCTIONING AND MOTHER-CHILD RELATIONSHIP. Infant Ment Health J 2006; 27:448. [PMID: 20119507 PMCID: PMC2813060 DOI: 10.1002/imhj.20100] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article.
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Affiliation(s)
- Marjukka Pajulo
- University of Tampere, Finland, and Yale University, Child Study Center
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42
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Mäntymaa M, Tamminen T, Puura K, Luoma I, Koivisto A, Salmelin RK. Early mother–infant interaction: associations with the close relationships and mental health of the mother. J Reprod Infant Psychol 2006. [DOI: 10.1080/02646830600826214] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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43
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Shieh C, Kravitz M. Severity of Drug Use, Initiation of Prenatal Care, and Maternal‐Fetal Attachment in Pregnant Marijuana and Cocaine/Heroin Users. J Obstet Gynecol Neonatal Nurs 2006; 35:499-508. [PMID: 16881994 DOI: 10.1111/j.1552-6909.2006.00063.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare the severity of drug use, initiation of prenatal care, and maternal-fetal attachment between pregnant marijuana and cocaine/heroin users. DESIGN A cross-sectional design. SETTING A prenatal clinic of a medical center in the northeast of the United States. PARTICIPANTS 19 marijuana, 17 cocaine, and 4 heroin users. Cocaine and heroin users were combined in one group. MAIN OUTCOME MEASURES The Severity of Drug Use Questionnaire containing 11 questions of withdrawal, dependence, and medical, legal, and interpersonal issues was used to assess the severity of drug use. Initiation of prenatal care was obtained from the chart and was calculated by weeks of gestation when care began. Cranley's Maternal-Fetal Attachment Scale measured maternal-fetal attachment. RESULTS Pregnant cocaine/heroin users were 6 years older, had experienced more pregnancies, had higher drug severity scores, and initiated prenatal care later than marijuana users. No significant difference in maternal-fetal attachment was found. CONCLUSION Interventions to help especially cocaine/heroin users initiate early prenatal care and reduce severity of drug use are indicated.
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Affiliation(s)
- Carol Shieh
- Department of Environments for Health in Indiana University School of Nursing, Indianapolis 46202-5107, USA.
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Nicholson J, Finkelstein N, Williams V, Thom J, Noether C, DeVilbiss M. A Comparison of Mothers with Co-occurring Disorders and Histories of Violence Living with or Separated from Minor Children. J Behav Health Serv Res 2006; 33:225-43. [PMID: 16645909 DOI: 10.1007/s11414-006-9015-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Data from the Women with Co-occurring Disorders and Histories of Violence Study are used to examine characteristics distinguishing mothers currently providing care for all their minor children (n = 558) from mothers separated from one or more minor children (n = 1396). Mothers are described and compared on background characteristics and experiences, well-being and current functioning, situational context, and services used. Analyses control for number of children, race, and years of education. Mothers separated from children have more children, less education, have more often been homeless, in juvenile detention or jail, and have lower incomes than mothers living with all their children. Mothers separated from children have more extensive experiences of traumatic and stressful life events, and the groups differ in current functioning and patterns of services used. While cross-sectional data do not allow causal inferences, challenges faced by mothers have significant implications for policy and programs.
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Affiliation(s)
- Joanne Nicholson
- Department of Psychiatry, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, 01655, USA.
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Minnes S, Singer LT, Arendt R, Satayathum S. Effects of prenatal cocaine/polydrug use on maternal-infant feeding interactions during the first year of life. J Dev Behav Pediatr 2005; 26:194-200. [PMID: 15956868 PMCID: PMC2593854 DOI: 10.1097/00004703-200506000-00005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The effects of prenatal cocaine use on quality of maternal-infant interactions were evaluated using the Nursing Child Assessment Feeding Scale (NCAFS). A total of 341 (155 cocaine using; 186 non-cocaine using) low socioeconomic, primarily African-American dyads were evaluated longitudinally at birth, 6.5, and 12 months. Group differences over time were examined, controlling for covariates, using a mixed-model linear approach. Women who used cocaine during pregnancy were less sensitive to their infants than non-cocaine-using women at 6.5 and 12 months. At 6.5 months, heavier prenatal cocaine users were less responsive to their infants than lighter users. In infants, prenatal cocaine exposure was related to poorer clarity of cues. There were no significant cocaine effects on maternal social-emotional growth fostering, cognitive growth fostering, or infant responsiveness to mother. Controlling for covariates, concentration of cocaine metabolites predicted maternal sensitivity to infant cues and infant clarity of cues at 1 year. Maternal cocaine use during pregnancy and other pre- and postnatal factors adversely affect maternal-infant interactions during the first year of life.
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Affiliation(s)
- Sonia Minnes
- Department of General Medical Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA.
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46
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Kemppinen K, Kumpulainen K, Räsänen E, Moilanen I, Ebeling H, Hiltunen P, Kunelius A. Mother-child interaction on video compared with infant observation: Is five minutes enough time for assessment? Infant Ment Health J 2005; 26:69-81. [DOI: 10.1002/imhj.20031] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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47
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Savonlahti E, Pajulo M, Ahlqvist S, Helenius H, Korvenranta H, Tamminen T, Piha J. Interactive skills of infants with their high-risk mothers. Nord J Psychiatry 2005; 59:139-47. [PMID: 16195112 DOI: 10.1080/08039480510022990] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this pilot study, the interactive skills of infants with their high-risk, substance-dependent mothers were explored in residential treatment from pregnancy until the infant was 6 months of age. Fourteen mother-infant pairs were videotaped in feeding and free play situations at 6 months after birth. A comparison, low-risk group consisted of 12 ordinary Finnish mother-infant pairs with minimal clinical risks. The findings show significantly higher levels of dyadic interactive deficiencies among the high-risk mother-infant pairs compared to the low-risk pairs, displayed especially in the feeding situation as lack of mutuality and flat, empty, constricted affective tone of interaction. Also, more interactive deficiencies were found among the high-risk infants compared to the low-risk infants, but the differences were not significant. In this study, this finding might reflect the reduced amount of somatic complications and the benefits of treatment, the impacts of which were not explored. The differences between the high- and low-risk infants were displayed as more withdrawal, depressed mood and avoiding behavior and as less alertness and attentional abilities, robustness and focus on parent's emotional state among the high-risk group.
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48
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Pajulo M, Savonlahti E, Sourander A, Piha J, Helenius H. Maternal representations, depression and interactive behaviour in the postnatal period: a brief report. J Reprod Infant Psychol 2004. [DOI: 10.1080/0264683042000205954] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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