"It kind of strips down your relationship to its defining features……it just kind of shone a light on what was already there": A grounded theory of the impact of postpartum psychosis on the couple's relationship

BACKGROUND

Postpartum psychosis is a severe mental health illness following childbirth. Studies to date have developed from initial focus on experiences of women to address the role and experiences of partners, and recently to touch on the effect on their relationship. This study aimed to build on this work, by focussing directly on the impact of postpartum psychosis on the couple's relationship, from the perspectives of both the woman and her partner.

METHOD

A constructivist grounded theory approach was utilised to generate a theory that explained the impact of postpartum psychosis on the couple's relationship. In-depth semi-structured interviews were completed with a sample of eight women and six partners.

RESULTS

Four stages and five general categories described the processes that the couple experienced, and the impact postpartum psychosis had on their relationship.

DISCUSSION

The grounded theory adds to current evidence and helps increase understanding of factors that play a role in adjustment and outcomes. New insights were identified, including postpartum psychosis amplifying existing relational patterns; and the mediating role of the pre-existing relationship and couplehood. Clinical implications and areas for further research are considered.

Sex-typed preferences in three domains: do two-year-olds need cognitive variables?

Gender schema theory proposes that sex-typed behaviour flows from the child's ability to 'tag' incoming information in terms of gender categories leading to heightened attention, recall and performance of sex-congruent behaviour. We investigate three questions in relation to this proposal: (1) the order of emergence of the child's ability to apply gender labels in each of three domains (social behaviour, same-sex peer preference and sex-congruent toy preference) and its impact upon sex-typed behaviour, (2) the role of the child's knowledge of his or her own sex in sex-typed preferences, and (3) the generality versus specificity of sex-typed behaviour across three domains. Participants were 56 two-year old children. Correct labelling of gender was achieved by 67% of children for self, by 54% for other children, by 23% for toys and by 13% for activities. There was a significant preference for sex-congruent toys and boys engaged in significantly more negative social interaction behaviours than did girls, but same-sex peer preference was not found. There was no effect of domain-specific labelling ability on corresponding sex-typed behaviour nor did sex-of-self knowledge explain sex-typed preference. There was no evidence of domain generality in sex-typed behaviours. The findings suggest that the impact of cognitive variables may have been overestimated.

Infra-red thermography in the assessment of sacro-iliac inflammation

In a cross-sectional study designed to investigate the sensitivity of infra-red thermography in the detection of sacro-iliac regions were examined by thermography in a group of patients with ankylosing spondylitis and compared with normal volunteers and patients with other causes of low back pain. Thermograms were recorded both quantitatively via profile measurements across the sacro-iliac regions and sacrum and qualitatively via the pattern recorded by photography. Sacro-iliac disease activity was recorded clinically on the same day and was low overall in the patients examined. Thirteen of the 30 ankylosing spondylitis patients were abnormal thermographically either by profile or pattern measurements. None of the 13 patients with other causes of low back pain had increased sacro-iliac activity on thermography. None of four patients without X-ray evidence of sacro-iliitis was abnormal thermographically but there was a trend for increasing thermographic activity to be associated with increasing clinical activity. It was concluded that the thermographic technique examined was of little help in the diagnosis of early sacro-iliitis but might be more helpful in the objective serial assessment of sacro-iliitis in individual patients with active disease.