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Sansone A. The central role of mindful parenting in child's emotional regulation and human flourishing: a blueprint perspective. Front Psychol 2024; 15:1420588. [PMID: 38988375 PMCID: PMC11233750 DOI: 10.3389/fpsyg.2024.1420588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.
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Affiliation(s)
- Antonella Sansone
- Faculty of Society and Design, School of Psychology, Bond University, Robina, Gold Coast, QLD, Australia
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Abujilban S, Al-Omari H, Issa E, ALhamdan A, Al-Nabulsi L, Mrayan L, Mahmoud KF, Kernohan WG. Effectiveness of Telephone-Based Interpersonal Psychotherapy on Antenatal Depressive Symptoms: A Prospective Randomized Controlled Trial in The Kingdom of Jordan. J Am Psychiatr Nurses Assoc 2024; 30:635-645. [PMID: 37148251 DOI: 10.1177/10783903231171595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Jordanian pregnant women report high prevalence of antenatal depressive symptoms, compared to their counterparts internationally. One potential nonpharmacological intervention is Interpersonal Psychotherapy (IPT), accessed by telephone. AIM The aim of this study is to compare the depressive symptom level(s) among Jordanian pregnant women who received IPT treatment with those who received routine antenatal care. METHODS A prospective randomized controlled trial design was used. Following ethical approval, a sample of 100 pregnant women (50 in each group) at 24 to 37 weeks gestation, was drawn from one governmental public hospital. Seven sessions (each half an hour) of telephone-based IPT were offered twice weekly to those assigned to the intervention arm: one pretherapy orientation, five intermediates, and one closing session. The Edinburgh Postnatal Depression Scale was administered before and after the intervention. Analysis of covariance was used to detect the intervention effect. The two groups were matched based on demographic and health characteristics. RESULTS Compared to the control group, pregnant women who received the intervention reported fewer depressive symptoms. CONCLUSIONS Midwives and general nurses should screen all pregnant women for symptoms of depression. The effectiveness of IPT treatment in alleviating depressive symptoms indicates the importance of using such supportive interventions by midwives and general nurses, who are trained in psycho-educational counseling techniques. Moreover, data provided by this study may encourage policymakers to legislate policies that make psychotherapists available and accessible in antenatal care units and ensure that staff have adequate training via continuing education programs to screen for antenatal depressive symptoms.
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Affiliation(s)
- Sanaa Abujilban
- Sanaa Abujilban, PhD, MSN, CPT, RM, RN, Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Hasan Al-Omari
- Hasan Al-Omari, PhD, ARNP, RN, Department of Community and Mental Health Nursing, Faculty of Nursing. The Hashemite University, Zarqa, Jordan
| | - Esra'a Issa
- Esra'a Issa, MSN, Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Ayat ALhamdan
- Ayat ALhamdan, MSN, National Center Hospital for Mental Health, Amman, Jordan
| | - Lama Al-Nabulsi
- Lama Al-nabulsi, MSN, King Hussein Cancer Center, Amman, Jordan
| | - Lina Mrayan
- Lina Mrayan, PhD, Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Khadejah F Mahmoud
- Khadejah F. Mahmoud, PhD, MSN, RN, Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - W George Kernohan
- W. George Kernohan, PhD, School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
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Kim CY, Goodman SH. Satisfaction with parental responsibilities and disorganized attachment among infants of mothers at risk for depression. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2024; 38:212-222. [PMID: 38059972 PMCID: PMC10922789 DOI: 10.1037/fam0001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Growing attention has been placed on examining the family environment as antecedent of attachment, including the coparenting relationship. Parents' satisfaction with the coparenting relationship may be particularly of interest when parents are at heightened risk for depression, as depression has been consistently linked to negative coparenting, poor quality of parenting, and insecure infant attachment. However, no study has examined the effects of parents' satisfaction with the coparenting relationship on attachment. The present study examined mothers' satisfaction with division of childrearing responsibilities, a component of coparenting, and its longitudinal and cross-sectional links with infant disorganized attachment, examining the quality of mothering as a mediator, in a sample of infants and mothers at elevated risk for depression (N = 234). We assessed maternal depressive symptoms at 3, 6, and 12 months of infant age, mothers' satisfaction with the division of parental responsibilities at 3 and 12 months, the quality of mothering at 6 and 12 months, and infant disorganized attachment at 12 months. Mediation analyses revealed that at 12 months, mothers who were unsatisfied with fathers' childrearing responsibilities had poorer quality of mothering, which in turn was linked to disorganized attachment in their infants. However, the longitudinal indirect association between satisfaction with childrearing responsibilities at 3 months and disorganization at 12 months mediated by maternal parenting at 6 months was not significant. Findings emphasize the importance of partner support in childrearing for mothers at risk for depression in shaping a healthy relationship between mothers and their infants, particularly as infants get older. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Ormsby SM, Dahlen HG, Smith CA. Investigation of Hypothalamic Pituitary Adrenal Axis and Oxytocinergic System Changes in a Pragmatic Randomized Controlled Feasibility Trial of Acupuncture for Antenatal Depression. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:173-184. [PMID: 37566543 DOI: 10.1089/jicm.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Background: Antenatal depression is common and associated with detrimental impacts on women and their families. Disrupted neuroendocrine functioning is reported in women experiencing perinatal mental health disturbances. Preliminary randomized controlled trial (RCT) evidence suggests acupuncture may provide a safe and effective adjunct treatment; however, underlying mechanisms of effect are unclear. We conducted an RCT examination of acupuncture for the management of antenatal depressive symptomologies, which included oxytocinergic and hypothalamic pituitary adrenal (HPA) axis system evaluations. This article reports postintervention changes to cortisol: dehydroepiandrosterone (DHEA) ratios, and oxytocin (OT) hormone concentrations. Methods: Fifty-seven women with Edinburgh Postnatal Depression Scale (EPDS) scores ≥13 were randomized to receive individually tailored depressed specific acupuncture, progressive muscle relaxation (PMR) attention comparator, or treatment as usual (TAU). Weekly 1-h sessions were conducted for 8 weeks (24-31 of pregnancy). Preintervention and postintervention saliva samples were collected. Results: Postintervention mean cortisol: DHEA ratio differences were not significantly predicted by group allocation (n = 46, p = 0.065). Two-group comparisons demonstrated cortisol: DHEA ratios were significantly increased and predicted by group allocation when acupuncture was compared to TAU (p = 0.039); however, not between acupuncture and PMR (p = 0.179), or PMR and TAU (p = 0.421). Postintervention OT concentrations were not significantly predicted by group allocation. Limitations: Small sample size and posthoc analysis Conclusion: Findings suggest positive regulation of the HPA axis may be an underlying mechanism by which acupuncture provided the significant improvements to antenatal depression, stress, and distress observed in this cohort. Trial Registration: Registered on March 19, 2015, with the Australian New Zealand Clinical Trials Registry (ACTRN12615000250538).
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Affiliation(s)
- Simone M Ormsby
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
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Rogers AM, Youssef GJ, Teague S, Sunderland M, Le Bas G, Macdonald JA, Mattick RP, Allsop S, Elliott EJ, Olsson CA, Hutchinson D. Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study. J Affect Disord 2023; 338:278-288. [PMID: 37302506 DOI: 10.1016/j.jad.2023.06.020] [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: 08/16/2022] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Maternal and paternal perinatal depression and anxiety are theorised to adversely impact infant development. Yet, few studies have assessed both mental health symptoms and clinical diagnoses within the one study. Moreover, research on fathers is limited. This study therefore aimed to examine the association between symptoms and diagnoses of maternal and paternal perinatal depression and anxiety with infant development. METHOD Data were from the Triple B Pregnancy Cohort Study. Participants included 1539 mothers and 793 partners. Depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale and Depression Anxiety Stress Scales. Major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia were assessed using the Composite International Diagnostic Interview in trimester three. Infant development was assessed at 12-months using the Bayley Scales of Infant and Toddler Development. RESULTS Antepartum, maternal depressive and anxiety symptoms were associated with poorer infant social-emotional (d = -0.11, p = .025) and language development (d = -0.16, p = .001). At 8-weeks postpartum, maternal anxiety symptoms were associated with poorer overall development (d = -0.11, p = .030). No association was observed for clinical diagnoses in mothers, nor paternal depressive and anxiety symptoms or clinical diagnoses; albeit risk estimates were largely in the expected direction of adverse effects on infant development. CONCLUSIONS Evidence suggests that maternal perinatal depression and anxiety symptoms may adversely impact infant development. Effects were small but findings underscore the importance of prevention, early screening and intervention, alongside consideration of other risk factors during early critical periods.
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Affiliation(s)
- Alana M Rogers
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Samantha Teague
- Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
| | - Matthew Sunderland
- University of Sydney, Matilda Centre for Research in Mental Health and Substance Use, New South Wales, Australia.
| | - Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Richard P Mattick
- The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia.
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Western Australia, Australia.
| | - Elizabeth J Elliott
- University of Sydney, Faculty of Medicine and Health, Discipline of Child and Adolescence, New South Wales, Australia; Sydney Children's Hospitals Network, Westmead, Sydney, Australia.
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
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Ribette C, Rosenthal L, Raynaud JP, Franchitto L, Revet A. Primary care physicians' experience of caring for children with parents with mental health illness: a qualitative study among French general practitioners and paediatricians. BMC PRIMARY CARE 2023; 24:190. [PMID: 37718455 PMCID: PMC10506299 DOI: 10.1186/s12875-023-02145-y] [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: 11/04/2022] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Parental psychiatric disorders can have a significant impact on child development and the parent-infant bond, with a high risk of attachment disorders. Early identification of difficulties in the parent-child relationship is essential to prevent consequences for the child. Childcare practitioners have a major role to play in this early detection process, through regular mandatory consultations during the first two years of a child's life. Thus, the aim of this study was to collect the experience of private practitioners in their care of children of parents with a mental health illness. METHOD This is a cross-sectional, observational, qualitative study. Data were collected by means of semi-structured interviews with eleven general practitioners and private paediatricians between February and July 2021 in Toulouse and its suburbs. We only included practitioners who had followed children of parents with a mental health illness. The interviews were recorded with the agreement of the participants, before being transcribed anonymously. The data were analysed with NVivo software using interpretative phenomenological analysis. RESULTS Three main themes emerged from the results, which were further divided into several sub-themes. Addressing psychiatric disorders presents a risk for the therapeutic relationship. Practitioners express a need to preserve this relationship with the parent in joint care. Care is difficult and is permeated by the parents' emotional issues. Furthermore, practitioners face a conflict between their concerns for the parent-child bond and their desire not to stigmatise these families. They express a feeling of isolation in these follow-ups. This stressful care has a significant emotional impact on the doctors. Access to psychiatric training and multidisciplinary collaboration seem to be essential to improve the follow-up experience for practitioners, as these factors strengthen inter-professional connections. CONCLUSION Practitioners describe a parent-doctor relationship at risk, which is underpinned by the fear of care placement. This study illustrates the need to strengthen multidisciplinary work by promoting interprofessional exchanges, in order to improve the experience of practitioners in this care process. Addressing practitioners' fear of discussing parental psychiatric illness is very important, so as not to delay the implementation of preventive actions that are likely to improve the developmental prognosis for children.
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Affiliation(s)
- Cécile Ribette
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France.
| | - Lucie Rosenthal
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
| | - Jean-Philippe Raynaud
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Ludivine Franchitto
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
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Babineau V, Jolicoeur-Martineau A, Szekely E, Green CG, Sassi R, Gaudreau H, Levitan RD, Lydon J, Steiner M, O'Donnell KJ, Kennedy JL, Burack JA, Wazana A. Maternal prenatal depression is associated with dysregulation over the first five years of life moderated by child polygenic risk for comorbid psychiatric problems. Dev Psychobiol 2023; 65:e22395. [PMID: 37338256 DOI: 10.1002/dev.22395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 03/08/2023] [Accepted: 03/28/2023] [Indexed: 06/21/2023]
Abstract
Dysregulation is a combination of emotion, behavior, and attention problems associated with lifelong psychiatric comorbidity. There is evidence for the stability of dysregulation from childhood to adulthood, which would be more fully characterized by determining the likely stability from infancy to childhood. Early origins of dysregulation can further be validated and contextualized in association with environmental and biological factors, such as prenatal stress and polygenic risk scores (PRS) for overlapping child psychiatric problems. We aimed to determine trajectories of dysregulation from 3 months to 5 years (N = 582) in association with maternal prenatal depression moderated by multiple child PRS (N = 232 pairs with available PRS data) in a prenatal cohort. Mothers reported depression symptoms at 24-26 weeks' gestation and child dysregulation at 3, 6, 18, 36, 48, and 60 months. The PRS were for major depressive disorder, attention deficit hyperactivity disorder, cross disorder, and childhood psychiatric problems. Covariates were biological sex, maternal education, and postnatal depression. Analyses included latent classes and regression. Two dysregulation trajectories emerged: persistently low dysregulation (94%), and increasingly high dysregulation (6%). Stable dysregulation emerged at 18 months. High dysregulation was associated with maternal prenatal depression, moderated by PRS for child comorbid psychiatric problems. Males were at greater risk of high dysregulation.
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Affiliation(s)
- Vanessa Babineau
- Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | | | - Eszter Szekely
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Roberto Sassi
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hélène Gaudreau
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Robert D Levitan
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John Lydon
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Meir Steiner
- Women's Health Concerns Clinic, St-Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kieran J O'Donnell
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jacob A Burack
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ashley Wazana
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
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Severo M, Ventriglio A, Bellomo A, Iuso S, Petito A. Maternal perinatal depression and child neurocognitive development: A relationship still to be clarified. Front Psychiatry 2023; 14:1151897. [PMID: 37020735 PMCID: PMC10067625 DOI: 10.3389/fpsyt.2023.1151897] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/02/2023] [Indexed: 04/07/2023] Open
Abstract
Pregnancy frequently is associated with emotional conditions such as anxiety and depression. Perinatal depression has an incidence of around 12%. Only recently researcher put the attention on the effects of pre- and postpartum psychopathology on infant neurocognitive development. Neurobiology studies indicate that perinatal maternal depression can significantly affect the structure and function of children's prefrontal cortex and modulate the development of cognitive abilities from intrauterine life. On the topic, the scientific literature appears ambiguous, reporting mixed results. Some studies have found no significant differences in developmental outcomes between prenatal and postpartum exposure to maternal depression, others have suggested a greater burden of depression in pregnancy than in postpartum, and still others have emphasized the role of chronicity of symptoms rather than the period of onset. Few studies have examined the effects of different developmental trajectories of maternal depression on children's neurocognitive outcomes. The assessment of maternal health has for years been limited to postpartum depression often neglecting the timing of onset, the intensity of symptoms and their chronicity. These aspects have received less attention than they deserve, especially in relation to the effects on children's neurocognitive development. The aim of this Perspective was to highlight inconsistencies and gaps that need to be filled in the approach to the study of this problem. Given the wide heterogeneity of data in the current literature, further studies are needed to clarify these interactions. This Perspective provides an overview of current progress, future directions, and a presentation of the authors' views on the topic.
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Affiliation(s)
- Melania Severo
- Department of Humanistic Studies, University of Foggia, Foggia, Italy
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Franco P, Olhaberry M, Cuijpers P, Kelders S, Muzard A. App-based intervention for reducing depressive symptoms in postpartum women: Protocol for a feasibility randomized controlled trial. Internet Interv 2023. [DOI: 10.1016/j.invent.2023.100616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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10
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Beebe B, Crown CL, Jasnow M, Sossin KM, Kaitz M, Margolis A, Lee SH. The vocal dialogue in 9/11 pregnant widows and their infants: Specificities of co-regulation. Infant Behav Dev 2023; 70:101803. [PMID: 36565493 DOI: 10.1016/j.infbeh.2022.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Mothers who were pregnant and widowed on September 11, 2001, and their 4-6-month infants (in utero on 9/11) were filmed during face-to-face interaction and their vocal dialogues were examined via microanalysis. Mothers were White, well-educated, mean age 34.3 years, and far from the World Trade Center site on 9/11; infants were 4-6 months, half female. We examined the bi-directional, moment-by-moment co-regulation of the timing of vocal dialogue, and particularly turn taking, in mother-infant and stranger-infant interactions, with time-series models. We analyzed the contingent coordination of durations of (1) vocalizations of the turn-holder, and (2) switching-pauses at the moment of the turn exchange. The switching pause is an aspect of the rhythm of the turn-holder who, after taking a turn, yields the floor to the partner through the switching pause. Turn taking is the lynchpin of dialogue, and the bi-directional contingent coordination of the switching-pause regulates the turn exchange. Both partners showed signs of risk and resilience. The 9/11 mothers did not coordinate the timing of turn taking with their infants, a highly unusual finding. In contrast, the 9/11 infants did coordinate the timing of turn taking with their mothers, and with the "stranger," forms of resilience. We propose that the 9/11 mother's difficulty coordinating with the infant's turn taking rhythm is a mode of transmission of her trauma to the infant. This work expands our knowledge of the specificities of co-regulation in the context of the 9/11 trauma.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | | | | | - K Mark Sossin
- Department of Psychology, Pace University, New York, NY, USA.
| | - Marsha Kaitz
- Department of Psychology, Hebrew University, Jerusalem, Israel.
| | - Amy Margolis
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | - Sang Han Lee
- The Nathan Kline Institute, Orangeburg, NY, USA.
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Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care 2023; 37:333-346. [PMID: 36682969 DOI: 10.1016/j.pedhc.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.
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O'Byrne E, McCusker C, McSweeney S. The impact of the "Attachment and Biobehavioural Catch-Up" program on attachment related parent behavior-A systematic review. Infant Ment Health J 2023; 44:76-91. [PMID: 36565696 DOI: 10.1002/imhj.22025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/08/2022] [Indexed: 12/25/2022]
Abstract
"Attachment and Biobehavioural Catch-Up" (ABC) is a 10 session home visiting program, grounded in attachment theory. It aims to improve child emotion regulation, attachment and behavioral outcomes through changing caregivers' attachment related behaviors. There is increasing evidence with respect to the effectiveness of ABC in producing positive child outcomes, but the intervention's direct effect on parent outcomes remains unclear. This review examined the association of ABC with attachment related parent outcomes. The PubMed, EMBASE, PyschINFO and SCOPUS databases were searched for relevant studies in August 2021, and again in April 2022. The eligibility criteria for included studies were (1) infants aged 0-27 months at time of the ABC intervention, (2) "at risk" parents, (3) controlled trials published in peer-reviewed journals and (4) utilized a measure of attachment related parent outcomes. Eleven eligible studies were included. The findings showed ABC had a significant small to medium effect on a variety of attachment related parent outcomes among parents presenting with multiple psychosocial risk factors. "Sensitivity" was measured most frequently, with small to medium main effect sizes recorded at follow-up, compared to controls. Implications for the clinical effectiveness of the ABC program in community settings are discussed. Future research should clarify who ABC is most effective for and how it compares to similar interventions.
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Affiliation(s)
- Emma O'Byrne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Chris McCusker
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Shane McSweeney
- School of Applied Psychology, University College Cork, Cork, Ireland
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Navarrete L, Lara MA, Berenzon S, Mora-Rios J. Challenges of Perinatal Depression Care in Mexico City Health Centers. Int J Womens Health 2022; 14:1667-1679. [PMID: 36510491 PMCID: PMC9739043 DOI: 10.2147/ijwh.s381196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/05/2022] [Indexed: 12/12/2022] Open
Abstract
Background Perinatal depression is a common mental disorder regarded as a severe public health problem. Studies have shown that incorporating mental health care into primary health services that provide pregnancy care makes it easier for women to seek help for depressive symptoms. In this context, the following question is of interest: How prepared are primary health services in Mexico City that provide pregnancy and postpartum care to treat perinatal depression? This article seeks to explore the perceptions and knowledge of perinatal depression in health professionals and analyze the barriers to its care at primary care centers in Mexico City. Methods An exploratory study with a qualitative approach was conducted. Doctors, nurses, social workers who provide maternal and childcare, mental health personnel, and the directors of four centers were interviewed. Interviews were audio-recorded and transcribed for thematic analysis. Results Most primary care personnel are unaware of the Official Standard that recommends providing maternal mental health care during the perinatal period. There is no initiative for its incorporation into routine care. A significant barrier to its implementation is health professionals' biased, stereotyped perception of perinatal depression, motherhood, and the role of women. Other barriers include the workload of health professionals, the division of care between professionals, and the lack of communication between the latter. Women with psychological symptoms are not referred to mental health staff in a timely manner. Social workers are in closer contact with women and are more willing to address their emotional distress. Conclusion Maternal mental health care, contingent on pregnancy, childbirth, and puerperium care at primary care centers is currently not possible due to the lack of knowledge, barriers, and directors' dependence on hospital management decisions.
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Affiliation(s)
- Laura Navarrete
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City, Mexico,Doctorate Program in Medical, Odontology and Health Sciences of the National Autonomous, University of Mexico, Mexico City, Mexico
| | - Ma Asunción Lara
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City, Mexico,Correspondence: Ma Asunción Lara, Tel +52 55 4160 5170, Fax +52 55 5513 3446, Email
| | - Shoshana Berenzon
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City, Mexico
| | - Jazmin Mora-Rios
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City, Mexico
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14
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Impact of the Timing of Maternal Peripartum Depression on Infant Social and Emotional Development at 18 Months. J Clin Med 2022; 11:jcm11236919. [PMID: 36498494 PMCID: PMC9735611 DOI: 10.3390/jcm11236919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
The study assessed how the timing of maternal perinatal depressive symptoms affects infant socio-emotional characteristics at age 18 months. The study was a longitudinal cohort study that included six assessment points from the third trimester of pregnancy up to age 18 months (±1 month). Assessment of mothers included the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory, while assessments of infant included the Infant Toddler Social and Emotional Assessment (ITSEA) at 18 months. Mothers were categorized into one of the following groups: mothers who presented postnatal depression only (n = 19); mothers who presented both prenatal and postnatal depression (n = 14), and mothers who never showed perinatal depression symptoms (n = 38). Mothers who presented both prenatal and postnatal depression showed significantly higher levels of depressive score, reactivity to stress and level of anxiety trait compared to mothers of the two other groups. Infants of prenatally and postnatally depressed mothers had higher scores on the internalizing subscore of the ITSEA. The number of depression episodes during the study period was positively correlated with the externalizing and internalizing subscores of the ITSEA. These findings support the need to provide specific screening to identify women with prenatal depression.
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15
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Maternal mental health and caregiver competence of HIV-positive and negative women caring for their singleton newborns in KwaZulu-Natal Province, South Africa. S Afr Med J 2022. [DOI: 10.7196/samj.2022.v112i7.15833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background. Maternal mental health during the perinatal period has been of interest to many researchers, with antenatal depression and postnatal depression (PND) being a leading cause of morbidity. The adverse effects of maternal depression on the offspring throughout infancy, childhood and adolescence are well documented. Studies on the mental health of persons living with HIV have also reported a high prevalence of depression.
Objectives. To describe the prevalence of PND in a sample of HIV-positive and HIV-negative mothers delivering healthy singleton infants at one obstetric unit in KwaZulu-Natal (KZN) Province, South Africa, and the subsequent factors influencing neonatal behaviour and perceptions of caregiver competence. Correlations between the presence of PND and perceptions of caregiver competence (with the mother as caregiver), and between infant behaviour, the mother’s confidence in her competence as caregiver, and demographic and medical variables, were also examined.
Methods. Demographic and clinical data were collected from 132 mothers at initial contact and from 32 mothers at the 6-week follow-up appointment. Mothers independently completed the Edinburgh Postnatal Depression Scale at each time point, and the Mother and Baby Scales (MABS) at the 6-week follow-up appointment.Results. The prevalence of depression among all mothers at initial contact was 72.0%, remaining high (68.8%) among the mothers who returned for follow-up. There was a statistically significant correlation between depression and employment at follow-up (p=0.013), and between depression and delivery method (p=0.030). The majority of mothers reported being ‘able to laugh and see the funny side of things’ and ‘looking forward with enjoyment to things’ at initial contact and follow-up. Thoughts of self-harm were reported by 44.7% of mothers at baseline, and by 53.1% at follow-up. Although most infants scored in the average clinical band for neonatal behavioural factors in the MABS, mothers reported lack of confidence, globally and in caring for their infant.
Conclusion. This study of maternal mental health of a sample of HIV-positive and HIV-negative mothers of infants in KZN revealed a higher prevalence of PND than reported in other studies. This population of mothers and infants is at risk of adverse outcomes of maternal depression, in addition to other possible risk factors.
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Antenatal depressive symptoms and behavioral outcomes in children at 78 months: A study from South India. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 9. [PMID: 35811630 PMCID: PMC9261908 DOI: 10.1016/j.jadr.2022.100350] [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] [Indexed: 12/02/2022] Open
Abstract
Background: Low and middle income countries report a higher prevalence of antenatal depression. The association between antenatal depressive symptoms and behavioral outcomes in children at 78 months in motherchild dyads who participated in a randomized control trial of maternal B12 supplementation during pregnancy was examined in this study. Methods: Children of 140 women, out of 366 who had participated in the placebo-controlled, randomized trial of vitamin B12 supplementation during pregnancy and 6 weeks post-partum, on whom serial assessments of depressive symptoms in each of the trimesters were done using the Kessler’s 10 Psychological Distress Scale (K10), were assessed using the Strength and Difficulties Questionnaire (SDQ) at 78 months. Results: Thirty seven women (26.4%) reported depressive symptoms at one trimester (intermittent group) and 28 women (20%) had depressive symptoms in at least 2 trimesters (persistent group). On adjusted bivariate regression analysis, children of women with intermittent antenatal depressive symptoms scored lower on the prosocial behavior subscale of SDQ compared to children of mothers with no depressive symptoms ( B=;−0.91, 95% CI: −1.65,−0.18; p=0.016). Limitations: The use of a screening measure to assess maternal depression, the assessment of the children’s behavior based only on the mothers’ reports and the small number of women with persistent depressive symptoms in our sample is important limitations. Conclusions: The possible association between antenatal depressive symptoms and prosocial behavior in children point to the need for routine assessment and intervention for emotional disorders during pregnancy.
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17
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Bind RH. Immunological and other biological correlates of the impact of antenatal depression on the mother-infant relationship. Brain Behav Immun Health 2022; 20:100413. [PMID: 35112090 PMCID: PMC8790630 DOI: 10.1016/j.bbih.2022.100413] [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: 05/27/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 01/07/2023] Open
Abstract
Antenatal depression affects up to 20% of pregnancies, yet research has historically focused on postnatal depression and its effects on mothers and their offspring. Studies are now emerging highlighting the impact that depression in pregnancy can also carry on both members of the dyad, including difficulties with psychological, physical, and social functioning. More specifically, researchers have begun to examine whether antenatal depression may lead to difficulties in the developing mother-infant relationship and subsequent infant attachment. While much of the research on this has explored psychosocial mechanisms behind the pathway from antenatal depression to a disrupted relationship in the postpartum, few studies have looked at biological underpinnings of this process. Of the literature that exists, it has been found that mothers with depression in pregnancy have lower levels of oxytocin and increased levels of inflammatory markers, plausibly creating difficulties in the mother-infant bonding process, leading to impaired mother-infant interactions and non-secure infant attachment. Furthermore, infants with non-secure attachments are at risk of entering a proinflammatory state due to a dysregulated stress response system. Overall, the literature on the neurobiology of mother-infant interactions and infant attachment in the context of antenatal depression is sparse, thus warranting future research.
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Affiliation(s)
- Rebecca H. Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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18
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Maternal trauma but not perinatal depression predicts infant-parent attachment. Arch Womens Ment Health 2022; 25:215-225. [PMID: 34734355 DOI: 10.1007/s00737-021-01192-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
Understanding if maternal depression is a predictor of infant-parent attachment classification is important to furthering knowledge about the early pathways and predictors of socio-emotional development. Yet few studies that have utilised the Strange Situation Procedure, the gold standard for measurement of infant-parent attachment, have examined antenatal depression as a predictor of attachment, and none has also included a measure of maternal trauma. This study uses data on 224 women recruited in early pregnancy and followed up until 12 months postpartum. Maternal depression was measured in pregnancy using the Structured Clinical Interview for the DSM and repeat Edinburgh Postnatal Depression Scale as well as Stressful Life Events scale across pregnancy and postpartum including items on domestic violence. A past history of trauma was measured using the Childhood Trauma Questionnaire. Attachment was measured using the Strange Situation Procedure (SSP) at 12 months postpartum. We found that maternal depression was not associated with insecure or disorganized attachment. However, a maternal history of childhood trauma and current domestic violence both predicted insecure-avoidant attachment at 12 months, whereas increased number of stressful life events prior to conception and in pregnancy was associated with insecure-resistant attachment. Neither trauma, past or current, nor depression predicted disorganized attachment. In the first study to have included measures of antenatal depression, maternal childhood trauma, and current stressful events as predictors of infant attachment measured using the SSP, we found maternal experiences of past and current trauma but not depression were significant predictors of infant-parent attachment security.
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19
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Abujilban S, Mrayan L, Al-Obeisat S, Tanash M, Sinclair M, Kernohan WG. Factors associated with antenatal depression in the Kingdom of Jordan during the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000194. [PMID: 36962288 PMCID: PMC10021866 DOI: 10.1371/journal.pgph.0000194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022]
Abstract
Fear of infection and measures taken to mitigate infection, such as social distancing, lockdown and isolation can lead to anxiety and depression across the life course, but especially in pregnancy. We set out to identify the prevalence of depression in pregnancy, using Edinburgh Postnatal Depression Scale (EPDS) during national quarantine and to examine women's knowledge, attitude, and practices (KAP) in regard to potential COVID-19-related depression. Following ethical approval, an observational design, with an online questionnaire and snowball sampling was used to recruit 546 pregnant women (231 primi and 315 multiparous) in Jordan via common social media platforms (facebook, WhatsApp). Over one third (36.7%) reported depressive symptoms. There were significantly lower depression scores among pregnant women who exhibited more knowledge about COVID-19 (in high [vs low] knowledge groups, mean EPDS = 10.8 [vs 12.2]; p = 0.007). Depression scores were not significantly associated with attitude nor with practice. This suggests that enhanced knowledge levels may protect pregnant women against depression. Our findings contribute to understanding of the experience of pregnant women in developing countries during the COVID-19 pandemic. Healthcare Professionals should provide health education to all pregnant women and timely services to pregnant women with depressive symptoms. This may lead to the prevention of serious symptoms and reduce negative consequences on the next generation, not only in Jordan, but worldwide.
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Affiliation(s)
- Sanaa Abujilban
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Lina Mrayan
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Salwa Al-Obeisat
- Department of Maternal and Child Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mu'ath Tanash
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, County Antrim, Northern Ireland, United Kingdom
| | - W George Kernohan
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, County Antrim, Northern Ireland, United Kingdom
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20
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Bellomo A, Severo M, Petito A, Nappi L, Iuso S, Altamura M, Marconcini A, Giannaccari E, Maruotti G, Palma GL, Vicino M, Perrone A, Tufariello AM, Sannicandro V, Milano E, Arcidiacono G, Di Salvatore M, Caroli A, Di Pinto I, Ventriglio A. Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy. Front Psychiatry 2022; 13:962948. [PMID: 35990082 PMCID: PMC9389401 DOI: 10.3389/fpsyt.2022.962948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Perinatal depression (PD) is a cluster of clinical depressive symptoms occurring globally during pregnancy or after childbirth, with a prevalence of 11.9%. Risk factors for PD among pregnant women may include personality traits of neuroticism, low personal resilience, higher anxiety, avoidance in close relationships, as well as dysfunctional coping strategies. METHODS We report on descriptive findings of a screening/prevention program aimed to detect depressive symptoms and associated risk factors in a large sample of women (N = 1,664) accessing the gynecological departments of the Regione Puglia (South of Italy) from July to November 2020. Pregnant women were assessed in their third trimester of pregnancy (T0), after childbirth (T1), and those at risk for PD within 1 year from delivery (T2-T4); The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time as well as other standardized measures for neuroticism, resilience, coping strategies, and quality of life. RESULTS Of 1,664, n = 1,541 were tested at T1, and 131 scored ≥ 12 at EPDS (14.6 ± 2.95), showing a higher risk for PD. They were followed over time at 1, 6, and 12 months after childbirth (T2-T4), and 15 of them scored ≥ 12 (EPDS) at T4. Women with a higher risk of PD also reported higher levels of neuroticism, lower levels of personal resilience, more anxiety and avoidance in close relationships, higher employment of dysfunctional coping strategies (e.g., denial, self-blame, etc.), and lower quality of life (0.0008 < all p < 0.0001). CONCLUSION This study confirmed the benefit of screening programs for the early detection of PD among pregnant women. We may suggest a set of risk factors to be considered in the clinical assessment of PD risk as well as the promotion of similar programs to improve depressive outcomes and pathways to care for PD on the basis of a more accurate assessment and referral.
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Affiliation(s)
- Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Melania Severo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Mario Vicino
- Unit of Gynecology, Di Venere Hospital, Bari, Italy
| | | | - Anna Maria Tufariello
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Valeria Sannicandro
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Eleonora Milano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giulia Arcidiacono
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Melanie Di Salvatore
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Isabella Di Pinto
- Dipartimento Promozione Della Salute e del Benessere Animale, Regione Puglia, Bari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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21
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Silva EP, Emond A, Ludermir AB. Depression in childhood: The role of children's exposure to intimate partner violence and maternal mental disorders. CHILD ABUSE & NEGLECT 2021; 122:105305. [PMID: 34517271 DOI: 10.1016/j.chiabu.2021.105305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 06/08/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) is a global problem with high prevalence rates, and is linked to maternal mental disorders (MMD). Children's exposure to IPV (CEIPV) can have impacts on their physical and mental health, including depression. OBJECTIVE To analyze the associations between exposure to both CEIPV and MMD and depression in schoolchildren. PARTICIPANTS AND SETTING 630 mother-child pairs were evaluated in a poor urban district in Recife, Northeast Brazil. METHODS A cohort study investigated the effects of IPV during pregnancy, postpartum and six to nine years after delivery. Women were asked about their experience of IPV, their own mental health, and the exposure of their child to violence. The child's mood was reported by the mother, using the Short Mood and Feelings Questionnaire (SMFQ). Ten types of CEIPV, and the age of onset of exposure, were compared with the child's subsequent risk of depression. RESULTS IPV was associated with MMD in 31.9% of the women at some period of time. Depressive symptoms were reported in 15.7% of school-age children. All types of CEIPV were associated with depression at school age. Multivariable analyses of exposure to IPV and MMD at different ages showed that exposure to both IPV and MMD in the first year of life had the strongest association with childhood depression (OR = 9.1; 95% CI: 2.4-33.9). CONCLUSIONS The frequency of CEIPV and MMD, and the high prevalence of depression at school age, shows the importance of assessing MMD and identifying exposure to IPV in pregnancy and the early years.
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Affiliation(s)
- Elisabete Pereira Silva
- Universidade Federal de Pernambuco, Hospital das Clínicas, 2o andar - Av. Prof. Moraes Rêgo, s/n. Cidade Universitária, 50.670-420, Recife, PE, Brazil.
| | - Alan Emond
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road Clifton, Bristol BS8 1NU, United Kingdom
| | - Ana Bernarda Ludermir
- Universidade Federal de Pernambuco, Av. da Engenharia, s/n, Bloco "D" - 1° Andar - Cidade Universitária, 50.740-600, Recife, PE, Brazil
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22
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Aran P, Lewis AJ, Watson SJ, Nguyen T, Galbally M. Emotional availability in women with bipolar disorder and major depression: A longitudinal pregnancy cohort study. Aust N Z J Psychiatry 2021; 55:1079-1088. [PMID: 33726546 DOI: 10.1177/0004867421998796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Poorer mother-infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother-infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). METHODS Data were obtained for 127 mother-infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder (n = 60) and bipolar disorder (n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant's interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. RESULTS After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. CONCLUSIONS Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring's emotional availability at 6 months postpartum, particularly in maternal intrusiveness.
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Affiliation(s)
- Pavitra Aran
- Disciple of Psychology, College of Science, Health, Education and Engineering, Murdoch University, Murdoch, WA, Australia
| | - Andrew J Lewis
- Disciple of Psychology, College of Science, Health, Education and Engineering, Murdoch University, Murdoch, WA, Australia
| | - Stuart J Watson
- Disciple of Psychology, College of Science, Health, Education and Engineering, Murdoch University, Murdoch, WA, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Thinh Nguyen
- Division of Psychiatry, Faculty of Health and Medical Science, University of Western Australia, Nedlands, WA, Australia.,Peel and Rockingham Kwinana Mental Health Service, Rockingham, WA, Australia
| | - Megan Galbally
- Disciple of Psychology, College of Science, Health, Education and Engineering, Murdoch University, Murdoch, WA, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia.,Women's Health, Genetics and Mental Health, King Edward Memorial Hospital, Subiaco, WA, Australia
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23
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Traube DE, Molina AP, YingWangKay S, Kemner A. Perinatal Mental Health Support and Early Childhood Home Visitation During COVID-19. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:260-270. [PMID: 34718948 PMCID: PMC8557704 DOI: 10.1007/s11121-021-01313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/30/2022]
Abstract
COVID-19 has disrupted many of the preventive service sectors designed to serve mothers at-risk for developing postpartum depression, forcing a rapid transition to telehealth-based modes of delivery. The purpose of this study was to explore differences in early childhood home visitation service provision (enrollment and depression screening) among mothers receiving home visitation services prior to and after the onset of the COVID-19 pandemic. Additional factors related to receipt of virtual home visitation services, family risk factors, and the maternal depressive symptoms were examined. Linear and logistic regression were utilized to examine whether there were differences in family risk factors, the percentage of mothers being screened for depression and maternal depressive symptoms, and associations between risk factors and positive depression screenings, while accounting for clustering by site. Samples compared outcomes for families enrolled during the pre-pandemic period (defined as March 16th to July 27th, 2019, n = 4,743) and the post-pandemic period (defined as March 16th to July 27th, 2020, n = 2,049). Families enrolled after the onset of the pandemic were significantly less likely to be impacted by housing instability, have a child with a disability, or be involved with the military, but more likely to have a history of child abuse or neglect. Fewer mothers were screened for depression during the pandemic and maternal report of depressive symptoms decreased. Virtual home visitation is currently attracting some groups of mothers who are experiencing fewer stressors, which may place them at decreased risk for exhibiting depressive symptoms. There may be aspects of the virtual depression screening experience that make detection more difficult. As a result, many mothers at risk for maternal depression may not receive adequate prevention services.
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Affiliation(s)
- Dorian E Traube
- USC Suzanne Dworak Peck School of Social Work, 669 W 34th Street, Los Angeles, CA, 90089, USA.
| | - Abigail Palmer Molina
- USC Suzanne Dworak Peck School of Social Work, 669 W 34th Street, Los Angeles, CA, 90089, USA
| | - Sheila YingWangKay
- USC Suzanne Dworak Peck School of Social Work, 669 W 34th Street, Los Angeles, CA, 90089, USA
| | - Allison Kemner
- Parents as Teachers National Center, Los Angeles, CA, 90089, USA
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24
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Oxford ML, Hash JB, Lohr MJ, Bleil ME, Fleming CB, Unützer J, Spieker SJ. Randomized trial of promoting first relationships for new mothers who received community mental health services in pregnancy. Dev Psychol 2021; 57:1228-1241. [PMID: 34591567 DOI: 10.1037/dev0001219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The effectiveness of Promoting First Relationships (PFR), a 10-week home visiting program with video feedback, was tested in a randomized controlled trial involving 252 mothers and their 8- to 12-week-old infants. Mothers were eligible if they initiated treatment after mental health screening (depression, anxiety, posttraumatic stress disorder [PTSD]) at a community or public health primary care center in pregnancy. At baseline, 51% had mild to severe depression symptoms, 54% had mild to severe anxiety, and 35% had PTSD. Their ages ranged from 18 to 42 years. Mothers were 66% White, 18% Black, and 16% other races. Forty-seven percent identified as Hispanic, and 33% preferred to read and speak in Spanish. The median family annual income was less than $20,000. The PFR program or receipt of a resource packet (control condition) followed the baseline assessment and randomization; we assessed outcomes when infants were age 6 and 12 months. Compared to mothers in the control condition, mothers in the PFR condition had significantly (ps < .05) higher observed sensitivity scores at both follow-up time points (d = .25, d = .26), had improved understanding of infant-toddler social-emotional needs at both time points (d = .21, d = .45), and reported less infant externalizing behavior at age 12 months (d = .28). This study is the fourth completed randomized controlled trial of the PFR program, all involving populations experiencing adversity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Monica L Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Jonika B Hash
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Mary J Lohr
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Charlie B Fleming
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Jurgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Susan J Spieker
- Department of Child, Family, and Population Health Nursing, University of Washington
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Aran P, Lewis A, Watson S, Galbally M. Major depression and generalised anxiety disorder: An analysis of the effects of remission status and comorbidity on mother-infant emotional availability in the perinatal period. J Clin Psychol 2021; 78:570-589. [PMID: 34398975 DOI: 10.1002/jclp.23235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/21/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effects of maternal depression on mother-infant relationship quality likely vary according to depression heterogeneity. We investigated the effects of different presentations of major depression on mother-infant emotional availability (EA). METHODS Data were obtained from 115 mother-infant dyads from a longitudinal pregnancy cohort. Disorders, symptoms, and antidepressant use were assessed in pregnancy and postpartum, and EA was observed 6-month postpartum. Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) were assessed using the Structured Clinical Interview for the DSM-5. A series of multivariate analyses of covariance analyses' examining the effects of disorder on EA were conducted. RESULTS After controlling for maternal age, antidepressant use, and postpartum depressive symptoms, MDD accounted for 20% of the variance in EA. In the MDD/GAD group, 93% of interactions were rated as emotionally unavailable, nearly threefold the comparison group rate. CONCLUSIONS Findings demonstrate that different presentations of major depression are associated with observed differences in mother-infant EA.
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Affiliation(s)
- Pavitra Aran
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia
| | - Andrew Lewis
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia
| | - Stuart Watson
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Megan Galbally
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia.,Women's Health, Genetics and Mental Health, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
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Behling E, Bloch MH. Don't Forget, Untreated Maternal Depression Poses Health Risks to the Child, Too. Biol Psychiatry 2021; 90:212-213. [PMID: 34325804 DOI: 10.1016/j.biopsych.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Emily Behling
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut
| | - Michael H Bloch
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
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Branquinho M, Rodriguez-Muñoz MDLF, Maia BR, Marques M, Matos M, Osma J, Moreno-Peral P, Conejo-Cerón S, Fonseca A, Vousoura E. Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses. J Affect Disord 2021; 291:294-306. [PMID: 34062397 DOI: 10.1016/j.jad.2021.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. METHODS A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2. RESULTS Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format. LIMITATIONS Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results. CONCLUSIONS CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.
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Affiliation(s)
- Mariana Branquinho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | | | - Berta Rodrigues Maia
- Universidade Católica Portuguesa, Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Portugal
| | - Mariana Marques
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal; Coimbra Hospital and Universitary Centre (CHUC), Portugal; Institute of Psychological Medicine (IPM), Coimbra, Portugal
| | - Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Jorge Osma
- Universidad de Zaragoza and Instituto de Investigación Sanitaria de Aragón, Spain
| | | | | | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Eleni Vousoura
- Department of Psychiatry, Eginition Hospital, University of Athens, Greece
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Nard N, Moulier V, Januel D, Guillin O, Rothärmel M. [Electroconvulsive therapy during the perinatal period: Representations of mental health professionals]. Encephale 2021; 47:445-451. [PMID: 34148646 DOI: 10.1016/j.encep.2021.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Psychiatric disorders are common in peripartum and are associated with adverse outcomes for mother and fetus. Electroconvulsive therapy (ECT) is one of the most effective and safe options to treat severe mental illness, including during the perinatal period. Nevertheless, it remains underutilized during this period, possibly due to negative representations. Research has been carried out on the representations and attitudes of caregivers towards ECT, but the specificities of these attitudes during peripartum have not been explored. OBJECTIVES We aimed to assess the attitudes towards ECT during the peripartum among psychiatrists, nurses, social workers and psychologists. The primary objective was to compare the score of favorability for ECT during peripartum according to the profession. The secondary objective was to highlight other factors involved in the favorability for ECT in peripartum. METHODS We investigated mental health professionals' attitudes sending by e-mail an anonymous questionnaire in five hospitals in France. The questionnaire was composed of demographic details, one scale about the attitudes towards ECT (the Questionnaire on Attitudes and Knowledge of ECT (QuAKE)) used in several studies; in this questionnaire, a specific part for perinatal period has been added for our study, both using a Likert scale. The completion time for this online questionnaire was approximately 5 to 7minutes. A score of favorability for ECT in general and in peripartum was established for each participant. These scores represented the percentage of positive responses to favorable items and of negative responses to unfavorable items towards ECT. Comparison of the QuAKE answers with a sample of English caregivers in 2001 has been determined with χ2 tests. A Bonferroni correction was applied due to the large number of tests performed. Factors involved in the favorability for ECT have been studied with Pearson correlation, Kruskall-Wallis and Wilcoxon tests. RESULTS Two hundred and twenty one professionals (80 psychiatrists, 78 nurses, 19 social workers and 44 psychologists) were included in the study. Their answers to the QuAKE questionnaire were comparable or more favorable to ECT than the English sample answered in 2001. The perinatal part of questionnaire had a good internal consistency (Cronbach coefficient: 0,91). Participants were less favorable to ECT in perinatal period (favorability score: 44.2) than in general (63.6). They more often responded « uncertain » to the perinatal questionnaire (44,9 % against 18.4 % for the ECT in general; W=19931,5; P<0,001). The favorability for ECT in general and during peripartum were statistically associated with profession (psychiatrists were more favorable), specific training and experience in ECT. Gender, perinatal specialization, age, and the number of years in professional service were not associated with favorability for ECT in general and during peripartum in this study. CONCLUSIONS In this study, we have found that profession, training and experience in ECT are linked to the attitudes towards ECT, including in the perinatal period. It is necessary to inform professionals about the possibility of prescribing ECT in the perinatal period by training them in the specificities of pregnancy.
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Affiliation(s)
- Noémie Nard
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; Faculté de médecine, université de Normandie, 22, boulevard Gambetta, 76000 Rouen, France
| | - Virginie Moulier
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; EPS Ville-Evrard, unité de Recherche Clinique, 202, avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France
| | - Dominique Januel
- EPS Ville-Evrard, unité de Recherche Clinique, 202, avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France
| | - Olivier Guillin
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; Faculté de médecine, université de Normandie, 22, boulevard Gambetta, 76000 Rouen, France; CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - Maud Rothärmel
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France.
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Exploring Perinatal Indicators of Infant Social-Emotional Development: A Review of the Replicated Evidence. Clin Child Fam Psychol Rev 2021; 24:450-483. [PMID: 34125355 DOI: 10.1007/s10567-021-00356-2] [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] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
The importance of infant social-emotional development for outcomes across the lifecourse has been amply demonstrated. Despite this, most screening measures of social-emotional development are designed for children 18 months of age and over, with a clear gap in earlier infancy. No systematic review has yet harvested the evidence for candidate indicators in the perinatal window. This paper examines modifiable risk and protective factors for two seminal early markers of social-emotional development: attachment security and behavioral regulation mid-infancy. We searched meta-analytic and longitudinal studies of developmental relationships between modifiable exposures in the perinatal window (pregnancy to 10 months postpartum) and attachment and behavioral regulation status measured between 12 and 18 months. Six electronic databases were used: ERIC, PsycINFO, Medline Complete, Informit, Embase, and Scopus. Twelve meta-analytic reviews and 38 original studies found replicated evidence for 12 indicators across infant, caregiving, and contextual domains predictive of infant behavioral regulation and attachment status between 12 and 18 months. Key among these were caregiving responsiveness, maternal mental health, couple relationship, and SES as a contextual factor. Perinatal factors most proximal to the infant had the strongest associations with social-emotional status. Beyond very low birthweight and medical risk, evidence for infant-specific factors was weaker. Risk and protective relationships were related but not always inverse. Findings from this review have the potential to inform the development of reliable tools for early screening of infant social-emotional development for application in primary care and population health contexts.
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Alto ME, Warmingham JM, Handley ED, Rogosch F, Cicchetti D, Toth SL. Developmental pathways from maternal history of childhood maltreatment and maternal depression to toddler attachment and early childhood behavioral outcomes. Attach Hum Dev 2021; 23:328-349. [PMID: 32126891 PMCID: PMC7483191 DOI: 10.1080/14616734.2020.1734642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
The current study examined the development of toddler attachment and early childhood behavior among children of mothers with a history of childhood maltreatment and current major depressive disorder. Maternal depression, maternal sensitivity, and toddler attachment were assessed as mediators of the association between maternal history of childhood maltreatment and child internalizing and externalizing behavior. Participants were from a low-income, largely racial minority urban sample and included 123 mothers with (n = 69) and without (n = 54) major depressive disorder at baseline and their children assessed at 12, 26, and 36 months old. Findings suggest maternal depression and maternal sensitivity mediated the association between maternal history of childhood maltreatment and disorganized attachment. Maternal depression, but not disorganized attachment, mediated the association between maternal history of childhood maltreatment and child symptomatology. Results suggest that supporting mothers through depression and processing their adverse childhood experiences are critical in fostering positive child development.
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Affiliation(s)
- Michelle E. Alto
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | | | | | - Fred Rogosch
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Sheree L. Toth
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
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Rizzo I, Watsford C. The relationship between disconfirmed expectations of motherhood, depression, and mother–infant attachment in the postnatal period. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
| | - Clare Watsford
- Faculty of Health, University of Canberra, Canberra, Australia,
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32
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Lisanti AJ, Demianczyk AC, Vaughan K, Martino GF, Ohrenschall RS, Quinn R, Chittams JL, Medoff-Cooper B. Parental role alteration strongly influences depressive symptoms in mothers of preoperative infants with congenital heart disease. Heart Lung 2021; 50:235-241. [PMID: 33340826 PMCID: PMC7969439 DOI: 10.1016/j.hrtlng.2020.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Mothers of infants with congenital heart disease are at risk for depression. OBJECTIVES This study explored the influence on maternal depressive symptoms of several known factors for mothers in the pediatric cardiac intensive care unit, including perceived stressors, attachment, and anxiety. METHODS This study was a secondary analysis of 30 mothers of infants awaiting cardiac surgery. Linear regressions were calculated to determine the relationships between perceived stressors, maternal attachment, anxiety, and maternal depressive symptoms. RESULTS Nearly half of mothers reported depressive symptoms above the measure cut-off score, indicating they were at risk for likely clinical depression. Subscales of perceived stress explained 61.7% of the variance in depressive symptoms (F = 11.815, p<0.0001) with parental role alteration subscale as the strongest predictor (standardized beta=0.694, p = 0.03). CONCLUSIONS Findings underscore the importance of mental health screening and instituting nursing practices to enhance parental role for mothers of infants awaiting cardiac surgery.
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Affiliation(s)
- Amy J Lisanti
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America; University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Abigail C Demianczyk
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Kayla Vaughan
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Giordana Fraser Martino
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Rachel Schaake Ohrenschall
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Ryan Quinn
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Jesse L Chittams
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Barbara Medoff-Cooper
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America; Research Institute, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
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33
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Karakaş NM, Sarı BA, Aksakal FNB, Özdemir DF, Dağlı FŞ. Mother-child attachment patterns in mothers with and without a history of adverse childhood experiences. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-00657-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Morgan JE, Channon S, Penny H, Waters CS. Longitudinal studies examining the impact of prenatal and subsequent episodes of maternal depression on offspring antisocial behaviour. Eur Child Adolesc Psychiatry 2021; 30:5-40. [PMID: 31792693 PMCID: PMC7864821 DOI: 10.1007/s00787-019-01447-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/20/2019] [Indexed: 12/16/2022]
Abstract
Maternal depression is associated with adverse child outcomes including antisocial behaviour (ASB). Prospective longitudinal studies have focused on the timing and cumulative exposure to maternal depression to further delineate the association and mechanisms of effect. The objective of this systematic review was to synthesise and evaluate the findings of longitudinal studies of maternal depression and offspring antisocial behaviour. Three databases were searched (Psychinfo, Web of Science, and Medline). Twenty of 5936 studies met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme criteria [Critical Appraisal Skills Programme (2017) CASP (cohort observation checklist). https://casp-uk.net/wpcontent/uploads/2018/01/CASP-Cohort-Study-Checklist.pdf ]. Results of individual studies were highly varied, using diverse analytical approaches and not all studies explored the independent effects of different episodes. Only three studies examined hypothesised mechanisms. Prenatal, postnatal, and later episodes of depression were all predictive of antisocial outcomes. One particular time period of depression exposure did not emerge as more predictive of offspring ASB than another. However, measures of maternal depression after the perinatal period were limited and typically included a one-off assessment of mothers' depressive symptoms that was concurrent to the assessment of offspring ASB. When cumulative exposure to maternal depression and specific timing effects were measured within the same study it was cumulative exposure that conferred the greatest risk for offspring ASB-particularly when this exposure began during the perinatal period. Findings are discussed in terms of limitations in the literature and highlight the need for future research to examine the biological and environmental mechanisms that underpin associations between maternal depression and offspring antisocial behaviour during different stages of development.
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Affiliation(s)
- Joanne E Morgan
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Sue Channon
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Helen Penny
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Cerith S Waters
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK.
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Pregnant women misusing opioids: Depression, anxiety, stress, and neonatal opioid withdrawal syndrome. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Hazell Raine K, Thorpe K, Boyce P. Perinatal depression screening in Australia: A position paper. Nurs Health Sci 2020; 23:279-287. [PMID: 33241903 DOI: 10.1111/nhs.12793] [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] [Received: 05/31/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 01/24/2023]
Abstract
Perinatal depression can have enduring adverse effects on women and their children and families, incurring substantial ongoing economic and personal costs. A significant proportion of the cost of perinatal depression relates to adverse impacts on the child, most likely mediated through impairment to the mother-infant relationship. In recognition of this problem, Australia has invested in routine perinatal depression screening. Our previous research produced convergent findings suggesting that expected benefits for children have not yet been realised through perinatal depression screening. We question the potential of including a measure of personality in current perinatal depression screening for identifying maternal mental health problems and suboptimal mother-infant relationships. This paper reviews our previous research findings within the broader context of perinatal depression screening. We propose a position, that perinatal depression screening in Australia should be redesigned to more precisely detect vulnerable mother-infant relationships, parenting, maternal mental health, and infant psychosocial and psychological development. Practice change to appropriately target antenatal interventions may more efficiently improve both maternal and child outcomes, thereby contributing to greater efficiency and cost savings for the health system.
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Affiliation(s)
- Karen Hazell Raine
- Nursing, School of Health, Faculty of Medicine and Health, University of New England; School of Nursing, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Thorpe
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, Queensland, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Medication-Assisted Treatment for Opioid Use Disorder in Pregnancy: Practical Applications and Clinical Impact. Obstet Gynecol Surv 2020; 75:175-189. [PMID: 32232496 DOI: 10.1097/ogx.0000000000000744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Importance Opioid use disorder is increasingly common in the United States and affects many pregnancies. Given the rise in pregnancies complicated by opioid use, providers should understand the diagnosis and management of opioid use disorder in pregnancy. Objective This article focuses on screening for opioid misuse, selecting appropriate treatment for patients, initiating medication-assisted treatment in the inpatient setting, and providing appropriate peripartum care. Evidence Acquisition A PubMed search was undertaken using the following search terms: "opioid use disorder", "pregnancy," "medication assisted treatment," "buprenorphine," "methadone," "heroin," "addiction," "neonatal abstinence syndrome," and "detoxification." The search was limited to the English language publications, with most being published after 2000. Results All women should be screened for opioid use disorder during pregnancy. Opioid use has profound effects on the mother and infant. Medication-assisted treatment is the standard of care for pregnant women with opioid use disorder. Patients will require a multidisciplinary approach to management in the intrapartum and postpartum period. Conclusions Conclusions Opioid use disorder is a common, chronic condition with significant implications during pregnancy. Recognition and appropriate treatment of this disorder can optimize maternal and fetal outcomes. Conclusions Obstetricians are increasingly being challenged to manage pregnancies complicated by opioid use disorder and should be proficient in providing safe and effective care.
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Flowers AGD, Mcgillivray JA, Galbally M, Lewis AJ. Perinatal maternal mental health and disorganised attachment: A critical systematic review. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Jane A. Mcgillivray
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia,
| | - Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia,
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia,
- Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Western Australia, Australia,
| | - Andrew J. Lewis
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
- Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Western Australia, Australia,
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Rogers A, Obst S, Teague SJ, Rossen L, Spry EA, Macdonald JA, Sunderland M, Olsson CA, Youssef G, Hutchinson D. Association Between Maternal Perinatal Depression and Anxiety and Child and Adolescent Development: A Meta-analysis. JAMA Pediatr 2020; 174:1082-1092. [PMID: 32926075 PMCID: PMC7490743 DOI: 10.1001/jamapediatrics.2020.2910] [Citation(s) in RCA: 200] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic, meta-analytic review on the long-term developmental outcomes spanning infancy through adolescence. OBJECTIVE To provide a comprehensive systematic review and meta-analysis of the extant literature on associations between maternal perinatal depression and anxiety and social-emotional, cognitive, language, motor, and adaptability outcomes in offspring during the first 18 years of life. DATA SOURCES Six databases were searched (CINAHL Complete, Cochrane Library, Embase, Informit, MEDLINE Complete, and PsycInfo) for all extant studies reporting associations between perinatal maternal mental health problems and offspring development to March 1, 2020. STUDY SELECTION Studies were included if they were published in English; had a human sample, quantitative data, a longitudinal design, and measures of perinatal depression and/or anxiety and social-emotional, cognitive, language, motor, and/or adaptability development in offspring; and investigated an association between perinatal depression or anxiety and childhood development. DATA EXTRACTION AND SYNTHESIS Of 27 212 articles identified, 191 were eligible for meta-analysis. Data were extracted by multiple independent observers and pooled using a fixed- or a random-effects model. A series of meta-regressions were also conducted. Data were analyzed from January 1, 2019, to March 15, 2020. MAIN OUTCOMES AND MEASURES Primary outcomes included social-emotional, cognitive, language, motor, and adaptability development in offspring during the first 18 years of life. RESULTS After screening, 191 unique studies were eligible for meta-analysis, with a combined sample of 195 751 unique mother-child dyads. Maternal perinatal depression and anxiety were associated with poorer offspring social-emotional (antenatal period, r = 0.21 [95% CI, 0.16-0.27]; postnatal period, r = 0.24 [95% CI, 0.19-0.28]), cognitive (antenatal period, r = -0.12 [95% CI, -0.19 to -0.05]; postnatal period, r = -0.25 [95% CI, -0.39 to -0.09]), language (antenatal period, r = -0.11 [95% CI, -0.20 to 0.02]; postnatal period, r = -0.22 [95% CI, -0.40 to 0.03]), motor (antenatal period, r = -0.07 [95% CI, -0.18 to 0.03]; postnatal period, r = -0.07 [95% CI, -0.16 to 0.03]), and adaptive behavior (antenatal period, r = -0.26 [95% CI, -0.39 to -0.12]) development. Findings extended beyond infancy, into childhood and adolescence. Meta-regressions confirmed the robustness of the results. CONCLUSIONS AND RELEVANCE Evidence suggests that perinatal depression and anxiety in mothers are adversely associated with offspring development and therefore are important targets for prevention and early intervention to support mothers transitioning into parenthood and the health and well-being of next-generation offspring.
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Affiliation(s)
- Alana Rogers
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Shelley Obst
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Samantha J. Teague
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Larissa Rossen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia,Counselling Psychology Department, Trinity Western University, Langley, British Columbia, Canada,British Columbia Children’s Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Elizabeth A. Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
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40
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Suparare L, Watson SJ, Binns R, Frayne J, Galbally M. Is intimate partner violence more common in pregnant women with severe mental illness? A retrospective study. Int J Soc Psychiatry 2020; 66:225-231. [PMID: 31902275 DOI: 10.1177/0020764019897286] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy. METHODS We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau of Statistics, which included data on pregnant women in Western Australia. Additional measures included reported demographics, substance use and pregnancy variables. RESULTS Around 48% of pregnant women with SMI had experienced IPV and were three times the risk when compared with the general pregnant population in Australia. There was no difference in rates of IPV in those women with psychotic disorders when compared with bipolar disorder. Furthermore, the rates of smoking and illicit substance use were significantly higher in pregnant women with SMI who experienced IPV compared with those who have not experienced IPV. CONCLUSION These findings suggest women with SMI in pregnancy are at significantly higher risk of having experienced or experiencing IPV. In addition, IPV in pregnant women with SMI may increase the risk of smoking and illicit substance use. Together this suggests that maternity and mental health services should ensure there are both screening and support pathways for IPV that are developed and evaluated specifically for pregnant women with SMI.
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Affiliation(s)
| | - Stuart J Watson
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, Australia.,School of Medicine, University of Notre Dame, Perth, WA, Australia
| | - Ray Binns
- King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Jacqueline Frayne
- King Edward Memorial Hospital, Subiaco, WA, Australia.,School of Medicine, Division of General Practice, The University of Western Australia, Perth, WA, Australia
| | - Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, Australia.,School of Medicine, University of Notre Dame, Perth, WA, Australia.,King Edward Memorial Hospital, Subiaco, WA, Australia
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41
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Preconception and perinatal predictors of offspring attachment disorganization: Advancing the replicated evidence. Dev Psychopathol 2020; 33:240-251. [PMID: 32299518 DOI: 10.1017/s095457941900172x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Attachment disorganization in early childhood is an influential yet modifiable risk factor for later mental health problems. Beyond established transmission through parents' unresolved attachment representations and caregiving sensitivity, little replicated evidence exists for wider determinants of offspring attachment disorganization. This study examined the replicated evidence for psychosocial risk factors in the preconception, prenatal, and postnatal periods. We identified all relevant longitudinal studies, and examined all risk relationships for which evidence existed in two or more cohorts (48 effects, 17 studies, N = 6,099). Study-specific and pooled risk associations were estimated and a range of moderators evaluated. Mothers' low socioeconomic status (r = .28, k = 2), perinatal loss of a child (r = .26, k = 2), caregiving intrusiveness (r = .31, k = 2), and infant male sex (r = .26, k = 4) predicted offspring attachment disorganization. Maternal sensitivity (r = -.25, k = 6) and higher metacognition during pregnancy (r = -.23, k = 3) predicted lower risk of offspring attachment disorganization. Findings suggest the origins of offspring disorganized attachment include but extend beyond maternal unresolved attachment representations and caregiving. We discuss implications for theory and for identification of modifiable risk pathways in the perinatal window.
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Śliwerski A, Kossakowska K, Jarecka K, Świtalska J, Bielawska-Batorowicz E. The Effect of Maternal Depression on Infant Attachment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082675. [PMID: 32295106 PMCID: PMC7216154 DOI: 10.3390/ijerph17082675] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/12/2022]
Abstract
Aims and objectives: The aim of this systematic review was to summarize the key findings of empirical studies assessing the influence of maternal depression on child attachment security measured before 24 months after birth. Method: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was conducted on the EBSCO (Academic Search Complete; Health Source: Nursing/Academic Edition; MEDLINE; PsycARTICLES) and PubMed databases, with infant attachment AND depression as search terms with Boolean operators. Study design or sample size did not affect inclusion. After screening, 29 of the 1510 unique publications originally identified were included in the review. Results: The studies reveal an equivocal association between maternal depression and child attachment security. Our findings indicate that depression had a significant influence on the attachment style almost only when diagnosed by structured interview: Depression measured by self-descriptive questionnaires was unrelated to attachment style. Furthermore, postpartum depression was found to be significant only when measured up to six months after childbirth. Conclusion: The relationship between maternal depression and infant attachment is both complex and dynamic, and the possible negative effects of depression might be compensated by maternal involvement in childcare. Therefore, further studies in this area should employ a reliable methodology for diagnosing depression and a suitable time point for measuring it; they should also adopt a multifactorial and prospective approach. It is important to note that breastfeeding/formula feeding was omitted as a factor in the majority of studies.
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43
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Rotem-Kohavi N, Williams LJ, Oberlander TF. Advanced neuroimaging: A window into the neural correlates of fetal programming related to prenatal exposure to maternal depression and SSRIs. Semin Perinatol 2020; 44:151223. [PMID: 32122645 DOI: 10.1016/j.semperi.2020.151223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fetal programming is a conceptual framework whereby the in utero environment shapes the offspring's neurodevelopment. Maternal depression and treatment with selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy are common prenatal exposures that affect critical early life developmental programming processes. Prenatal depression and SSRIs both have been reported to increase the risks for preterm birth, low birth weight, and are associated with behavioral disturbances across the early life span. However, not all exposures lead to adverse developmental outcomes and distinguishing how each exposure contributes to variations in development remains challenging. Advances in neuroimaging, using MR and EEG, offer novel insights into central processes that might reveal the neural correlates of fetal programming. This review focuses on emerging findings from neuroimaging studies reflecting early brain functional and structural development associated with prenatal exposure to maternal depression and SSRI antidepressants. Suggestions for future research directions that use neuroimaging as a tool to advancing our understanding of the early origins of developmental plasticity are offered.
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Affiliation(s)
- Naama Rotem-Kohavi
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | - Tim F Oberlander
- BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
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The effectiveness of Nurture and Play: a mentalisation-based parenting group intervention for prenatally depressed mothers. Prim Health Care Res Dev 2019; 20:e157. [PMID: 31839012 PMCID: PMC7003526 DOI: 10.1017/s1463423619000914] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM This randomised control trial (RCT) study examined the effectiveness of a mentalisation-based perinatal group intervention, Nurture and Play (NaP), in improving mother-infant interaction quality and maternal reflective functioning and in decreasing depressive symptoms. BACKGROUND Few preventive prenatal interventions have been developed for primary health care settings for mothers with depressive symptoms. Furthermore, previous prenatal intervention studies have only concentrated on reducing depressive symptoms and have not directly addressed enhancing optimal parenting qualities. METHODS The participants were 45 pregnant women with depressive symptoms. Women in the randomly assigned intervention group (n = 24) participated in the manualised, short-term NaP intervention group from pregnancy until the baby's age of seven months, whereas control group women received treatment as usual (TAU). Maternal emotional availability (EA), reflective functioning (RF) and depressive symptoms were measured before the intervention and at the infants' 12 months of age, and changes were evaluated using repeated measure analyses of variances (ANOVAs). FINDINGS The results showed that the intervention group displayed higher maternal sensitivity and RF and more reduction in depressive symptoms than the control group when babies were 12 months old. These findings provide preliminary support for the effectiveness of the NaP intervention.
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45
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Hazell Raine K, Nath S, Howard LM, Cockshaw W, Boyce P, Sawyer E, Thorpe K. Associations between prenatal maternal mental health indices and mother-infant relationship quality 6 to 18 months' postpartum: A systematic review. Infant Ment Health J 2019; 41:24-39. [PMID: 31524300 DOI: 10.1002/imhj.21825] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Maternal mental disorders can significantly impact on children's psychosocial and psychological development, incurring substantial ongoing economic and personal costs. A key mediating mechanism is mother-infant relationship quality (MIRQ). Research studies and perinatal mental health screening initiatives have predominantly focused on depressive symptoms and perinatal depression as predictors of MIRQ. While maternal depression is associated with suboptimal MIRQ, the findings have not been consistent. Personality characteristics are associated with parenting and proneness to depression, presenting a potential addition to prenatal mental health assessment. We conducted a systematic review of studies that have examined the link between prenatal depressive symptoms and/or personality characteristics with postnatal MIRQ. Our findings suggest that both maternal personality traits and depressive symptoms measured in early pregnancy are associated with postnatal MIRQ. A measure of personality characteristics may enhance prenatal mental health assessment, affording opportunities for targeted intervention commencing in pregnancy to improve MIRQ, parenting, maternal mental health outcomes, and infant psychosocial and psychological development, and thereby contributing to the reduction of human and economic cost burdens.
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Affiliation(s)
- Karen Hazell Raine
- Discipline of Psychiatry, Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Selina Nath
- Section of Women's Mental Health, King's College, London, United Kingdom
| | - Louise M Howard
- Section of Women's Mental Health, King's College, London, United Kingdom
| | - Wendell Cockshaw
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Emily Sawyer
- Faculty of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Karen Thorpe
- Institute for Social Science Research, University of Queensland, Queensland, Australia
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Maternal perinatal mental health: Associations with bonding, mindfulness, and self‐criticism at 18 months’ postpartum. Infant Ment Health J 2019; 41:69-81. [DOI: 10.1002/imhj.21827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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47
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Abstract
The ability to form attachments with other human beings is an essential skill that typically begins early in life. The parent/caregiver-child relationship is the first crucial relationship that an infant forms, and the health of this relationship has a profound effect on the child's social and emotional development. Children who form secure relationships with their parent or other primary caregiver have fewer internalizing and externalizing behaviors, are more socially competent, and have better-quality friendships. Conversely, children with attachment disorders exhibit a varying capacity to form and sustain relationships and demonstrate emotional depth, they and experience a higher level of peer conflict. Children with insecure attachments have a greater likelihood for physical health morbidities and impaired social, psychological, and neurobiological functioning extending into adulthood. It is crucial that pediatric nurse practitioners implement practice behaviors to better identify children at risk for attachment disorders and link them with appropriate interventions. This continuing education article will explore attachment; and attachment theory; and attachment disorders in terms of types, risk factors, consequences, and treatment and will also provide implications for practice.
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48
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Du Rocher Schudlich TD, Jessica NW, Erwin SE, Rishor A. Infants' emotional security: The confluence of parental depression, Interparental conflict, and parenting. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2019. [DOI: 10.1016/j.appdev.2019.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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49
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Smith A, Twynstra J, Seabrook JA. Antenatal depression and offspring health outcomes. Obstet Med 2019; 13:55-61. [PMID: 32714436 DOI: 10.1177/1753495x19843015] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/18/2019] [Indexed: 12/11/2022] Open
Abstract
Background Depression is the most common mental disorder during pregnancy, with prevalence rates between 4% and 20%. The objective of this review was to synthesize the literature on the association between antenatal depression and offspring birth outcomes, as well as developmental, behavioral, and psychiatric outcomes. Methods A search of PubMed, Cochrane, and Medline databases was conducted for articles published until December 2017. Articles focusing on the effects of antenatal depression on the offspring were selected to be reviewed. Reference lists of all studies were examined for any missed articles. A total of 32 articles were included in this review. Results Antenatal depression is associated with preterm birth, excessive infant crying, and offspring mental health problems. Untreated antenatal depression is strongly associated with adverse effects on the infant nervous system. Conclusion Antenatal depression increases the likelihood of poor offspring health outcomes. Research should investigate whether medication use confounds this relationship.
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Affiliation(s)
- Alexandra Smith
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.,Department of Paediatrics, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
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50
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Volling BL. Widening the lens on family processes and the development of parent-child attachment relationships. Attach Hum Dev 2019; 22:124-128. [PMID: 30907251 DOI: 10.1080/14616734.2019.1589068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This commentary addresses the research conducted by McConnachie et al. (this issue) on attachment in gay father families, lesbian mother families, and heterosexual parent families. Strengths of the research included the inclusion of different family constellations, the focus on between-family and within-family differences, the longitudinal research design, and the age-appropriate assessment of attachment. Some limitations noted included the lack of control for age at adoption in analyses, the lack of information on parenting processes and parental mental health in the formation of attachment, and questions about information obtained from parent reports of children's prior caregiving histories.
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Affiliation(s)
- Brenda L Volling
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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