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Boekhorst MGBM, de Waal N, Smit L, Hulsbosch LP, van den Heuvel MI, Schwabe I, Pop V, Nyklíček I. A longitudinal study on the association between trait mindfulness and maternal bonding across the perinatal period. J Reprod Infant Psychol 2024:1-17. [PMID: 38655861 DOI: 10.1080/02646838.2024.2342904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
AIMS/BACKGROUND The mother-to-infant is important for healthy child development. The current study focused on the association between maternal trait mindfulness and the course of maternal bonding from pregnancy to one year postpartum. DESIGN/METHODS Women participating in a prospective perinatal cohort study (n = 1003) completed online questionnaires on maternal bonding (Pre- and Post-natal Bonding Scale) at 28 weeks of pregnancy, and at 8 weeks, 6 months and 12 months postpartum. At 20 weeks of pregnancy, women completed the Three Facet Mindfulness Questionnaire - Short Form. Multilevel analyses were used to analyse 1) changes in maternal bonding over time and 2) the relationship of these changes with different facets of trait mindfulness measured once during pregnancy. Demographics, obstetrics, and depressive symptoms were controlled for. RESULTS Results showed that maternal bonding first increased from pregnancy to 8 weeks postpartum and then remained relatively stable throughout the first-year postpartum. On average, women with high scores on acting with awareness and non-judging also scored higher on maternal bonding, but demonstrated a smaller increase in maternal bonding scores over time when compared to women with medium and low scores on these mindfulness facets. Furthermore, non-reacting was also positively associated with the level of maternal bonding but was not related to the course of bonding over time. The main effects of non-reacting and non-judging were not significant after adjusting for covariates. Depressive symptoms and a high educational level were negatively associated with bonding. CONCLUSION Mindfulness-based interventions may be helpful in supporting expectant mothers who are at risk for suboptimal bonding.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Noor de Waal
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lisanne Smit
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lianne P Hulsbosch
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Victor Pop
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Ivan Nyklíček
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Muskens L, Boekhorst MGBM, Pop VJM, van den Heuvel MI. Browsing throughout pregnancy: The longitudinal course of social media use during pregnancy. Midwifery 2024; 129:103905. [PMID: 38070217 DOI: 10.1016/j.midw.2023.103905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The number of people using social media has substantially increased over the past years. Previous studies have shown associations between social media overuse and mental health problems during pregnancy. The current study evaluates changes in social media use during pregnancy. METHODS Pregnant women were recruited at their first antenatal appointment between January 2020 and July 2022 (N = 1135). The time spent on social media, frequency of social media use and problematic social media use, using the Bergen Social Media Addiction Scale (BSMAS), were assessed at 12, 20 and 28 weeks of pregnancy. Pearson r correlations and repeated measures ANOVAs were performed to assess possible changes in social media use over the course of pregnancy. Lastly, we stratified social media use throughout pregnancy for parity. RESULTS There was a significant change in social media use over time, for the time spent on social media, frequency of social media use and problematic social media use. Mean social media scores were the lowest at 12 weeks of pregnancy and increased significantly at 20 weeks of pregnancy, after which they remained stable at 28 weeks. Compared to multiparous women, primiparous women spent more time on social media at 20 weeks of pregnancy, but not at 12 or 28 weeks. CONCLUSION Because overuse of social media has been associated with poor mental health, healthcare professionals should be aware of the intensity of social media use throughout pregnancy.
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Affiliation(s)
- Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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Muskens L, Hulsbosch LP, van den Heuvel MI, Croes EAJ, Kop WJ, Pop VJM, Boekhorst MGBM. Social media use as a risk factor for depressive symptoms during pregnancy. J Affect Disord 2023; 338:495-501. [PMID: 37364655 DOI: 10.1016/j.jad.2023.06.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/22/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Accumulating research has shown associations between excessive social media use (SMU) with depressive symptoms. Depression is common during pregnancy, but it is not known whether SMU plays a role in the etiology and clinical course of depressive symptoms during pregnancy. METHODS The current study is a prospective cohort study with Dutch-speaking pregnant women recruited at the first antenatal appointment (N = 697). Depressive symptoms were measured at each trimester of pregnancy using the Edinburgh Depression Scale. Growth mixture modeling was used to determine classes of women based on longitudinal trajectories of depressive symptoms. SMU was assessed at 12 weeks of pregnancy, specifically, intensity (time and frequency) and problematic SMU (Bergen Social Media Addiction Scale). Multinomial logistic regression analyses were used to examine the associations between SMU and trajectories of depressive symptoms. RESULTS Three trajectories of depressive symptoms during pregnancy were identified: a low stable (N = 489, 70.2 %), intermediate stable (N = 183, 26.3 %), and high stable (N = 25, 3.6 %) class. SMU Time and Frequency were significantly associated with belonging to the high stable class. Problematic SMU was significantly associated with belonging to the intermediate or high stable class. LIMITATIONS The study does not allow to draw conclusions about causality. The group sizes of the three trajectories differed considerably. Data were collected during the COVID-19 pandemic which may have influenced the results. SMU was measured by self-report. CONCLUSIONS These results indicate that both higher intensity of SMU (time and frequency) and problematic SMU may be a risk factor for higher levels of prenatal depressive symptoms during pregnancy.
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Affiliation(s)
- Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Lianne P Hulsbosch
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | | | - Emmelyn A J Croes
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands
| | - Willem J Kop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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Leyland AF, Boekhorst MGBM, Offermans JE, Emerson LM, Hulsbosch LP, Potharst ES. The protective value of trait mindfulness for mothers' anxiety during the perinatal period. Acta Psychol (Amst) 2023; 240:104034. [PMID: 37716215 DOI: 10.1016/j.actpsy.2023.104034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/26/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023] Open
Abstract
OBJECTIVES Anxiety is highly prevalent in the perinatal period and can have negative consequences for the mother and the child. Extensive research has been done on risk factors for anxiety during the perinatal period, but less is known about protective factors. The current study aims to determine the relative contribution of trait mindfulness as a protective factor for anxiety. METHODS A longitudinal study design was used, with four measurement points: 12, 22, and 32 weeks of pregnancy (T0, T1, and T2, respectively), and 6 weeks postpartum (T3). General anxiety was measured at T1, T2, and T3, pregnancy-specific distress was measured at T1 and T2, mindfulness facets (acting with awareness, non-reacting, and non-judging) and partner involvement were measured at T1, and other known risk factors for anxiety were measured at T0. Multilevel regression models were used for statistical analyses. RESULTS Mindfulness facets measured at T1 were negatively associated with anxiety at T1, T2, and T3, and pregnancy-specific distress at T1 and T2. Of the mindfulness facets, non-judging was shown to have the largest protective effect against anxiety and pregnancy-specific distress. Also compared to partner-involvement and known risk factors, non-judging showed the largest effect on anxiety and pregnancy-specific distress. CONCLUSIONS For pregnant women who are at risk for developing or experiencing high levels of anxiety, it may be beneficial to participate in a mindfulness training with special attention for the attitudinal aspects of mindfulness.
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Affiliation(s)
- Anna F Leyland
- Department of Sociological Studies, University of Sheffield, Elmfield Building, Northumberland Road, Sheffield S10 2TU, UK.
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, the Netherlands.
| | - Julia E Offermans
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands; UvA minds, Academic Treatment Center for Parents and Children, Banstraat 29, 1071 JW Amsterdam, the Netherlands.
| | - Lisa-Marie Emerson
- School of Health Sciences, University of Canterbury, Rehua 305, Christchurch, New Zealand.
| | - Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, the Netherlands.
| | - Eva S Potharst
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands; UvA minds, Academic Treatment Center for Parents and Children, Banstraat 29, 1071 JW Amsterdam, the Netherlands.
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de Waal N, van den Heuvel MI, Nyklíček I, Pop VJM, Boekhorst MGBM. Paternal bonding in pregnancy and early parenthood: a qualitative study in first-time fathers. J Reprod Infant Psychol 2023:1-16. [PMID: 37650726 DOI: 10.1080/02646838.2023.2252890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
The birth of an infant marks a period of profound change in first-time parents. Parental love and warmth, however, already begin to develop during pregnancy. Also for fathers, the development of bonding to the infant may be a unique process. The current qualitative study aimed to explore views and experiences of first-time fathers on the origins and development of paternal bonding during pregnancy and early childhood. In total, 30 in-depth semi-structured interviews were conducted with expectant fathers (second or third trimester of pregnancy; n = 10) and fathers of infants (0-6 months postpartum; n = 11) and toddlers (2-3 years of age; n = 9). Two major themes were uncovered from the data: feelings of bonding and facilitators of bonding. The first theme was supported with three subthemes: 1) from abstract to concrete, 2) positive emotions, and 3) uncertainties and worries. The second theme, facilitators of bonding, was supported with four subthemes: 1) experiencing the foetus, 2) meeting the child, 3) interaction, and 4) communication. Similar to previous studies, our results suggested that, in most fathers, paternal bonding originates in pregnancy and that it evolves over time. Seeing or feeling the child, both during pregnancy and postpartum, as well as interacting or communicating with the child, appears to facilitate fathers' feelings of bonding. Involving fathers in pregnancy, childbirth, and parenting may be essential for their bonding process.
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Affiliation(s)
- Noor de Waal
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | | | - Ivan Nyklíček
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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de Waal N, Boekhorst MGBM, Nyklíček I, Pop VJM. Maternal-infant bonding and partner support during pregnancy and postpartum: Associations with early child social-emotional development. Infant Behav Dev 2023; 72:101871. [PMID: 37544195 DOI: 10.1016/j.infbeh.2023.101871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
The first 1000 days after conception are considered critical for healthy development and well-being throughout life. Fundamental to health practices during pregnancy and positive parenting after birth is the development of maternal-infant bonding. Previous research has demonstrated the importance of having an involved partner during pregnancy and in parenting for optimal maternal-infant bonding. The current study examined maternal-infant bonding and partner support during pregnancy and the postpartum period, and their associations with early child social-emotional development. A total of 227 women completed the Pre- and Postnatal Bonding Scale (PPBS) and Tilburg Pregnancy Distress Scale (TPDS) during pregnancy (32 weeks of gestation) and at 8 months postpartum, assessing maternal-infant bonding and partner support. Additionally, a questionnaire on social-emotional behavior of the Bayley Scales of Infant and Toddler Development was administered to mothers to measure child development at 2 years of age. Path analyses revealed an indirect positive effect of prenatal maternal-infant bonding on child social-emotional development through postnatal maternal-infant bonding, as well as mediating effects of pre- and postnatal maternal-infant bonding on the association between pre- and postnatal partner support and child social-emotional development. Our findings support the notion that an emotional connection from mother to child originates in pregnancy and that experiencing positive feelings towards the fetus promotes positive maternal-infant bonding after birth and social-emotional capacities of the child. Additionally, having a supportive partner during pregnancy and postpartum, might be essential for the development of optimal maternal-infant bonding.
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Affiliation(s)
- Noor de Waal
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe G B M Boekhorst
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Hulsbosch LP, Potharst ES, Schwabe I, Boekhorst MGBM, Pop VJM, Nyklíček I. Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial. J Affect Disord 2023; 332:262-272. [PMID: 37054897 DOI: 10.1016/j.jad.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Pregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. METHODS Pregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. RESULTS Significant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LIMITATIONS Low adherence to the intervention and assessment of secondary outcome measures in the intervention group only. CONCLUSIONS An intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. TRIAL REGISTRATION ClinicalTrials.gov: NCT03917745, registered on 4 March 2019.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands.
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, the Netherlands
| | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
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Hulsbosch LP, Boekhorst MGBM, Lodder P, Potharst ES, Nyklíček I, Bergink V, Oei SG, Verhoeven CJM, Pop VJM. Association between high levels of comorbid anxiety and depressive symptoms and decreased likelihood of birth without intervention: A longitudinal prospective cohort study. BJOG 2023; 130:495-505. [PMID: 35974689 DOI: 10.1111/1471-0528.17273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/23/2022] [Accepted: 06/02/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the association between trajectories of comorbid anxiety and depressive (CAD) symptoms assessed in each pregnancy trimester and physiological birth. DESIGN Large longitudinal prospective cohort study with recruitment between January 2013 and September 2014. SETTING Primary care, in the Netherlands. POPULATION Dutch-speaking pregnant women with gestational age at birth ≥37 weeks, and without multiple pregnancy, severe psychiatric disorder or chronic disease history. METHODS Pregnancy-specific anxiety and depressive symptoms were measured prospectively in each trimester of pregnancy using the negative affect subscale of the Tilburg Pregnancy Distress Scale and Edinburgh (Postnatal) Depression Scale. Data on physiological birth were obtained from obstetric records. Multivariate growth mixture modelling was performed in MPLUS to determine longitudinal trajectories of CAD symptoms. Multiple logistic regression analysis was used to examine the association between trajectories and physiological birth. MAIN OUTCOME MEASURES Trajectories of CAD symptoms and physiological birth. RESULTS Seven trajectories (classes) of CAD symptoms were identified in 1682 women and subsequently merged into three groups: group 1-persistently low levels of symptoms (reference class 1; 79.0%), group 2-intermittently high levels of symptoms (classes 3, 6 and 7; 11.2%), and group 3-persistently high levels of symptoms (classes 2, 4 and 5; 9.8%). Persistently high levels of CAD symptoms (group 3) were associated with a lower likelihood of physiological birth (odds ratio 0.67, 95% confidence interval 0.47-0.95, P = 0.027) compared with the reference group (persistently low levels of symptoms), after adjusting for confounders. CONCLUSIONS This study is the first showing evidence that persistently high CAD levels, assessed in each pregnancy trimester, are associated with a lower likelihood of physiological birth.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Paul Lodder
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Eva S Potharst
- UvA Minds, Academic Outpatient (child and adolescent) Treatment Center of the University of Amsterdam, Amsterdam, The Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Veerle Bergink
- Departments of Psychiatry and Obstetrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - S Guid Oei
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
| | - Corine J M Verhoeven
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, VU Medical Centre, Amsterdam, The Netherlands.,Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Hulsbosch LP, Boekhorst MGBM, Lodder P, Potharst ES, Nyklíček I, Bergink V, Oei SG, Verhoeven CJM, Pop VJM. Antenatal anxiety and depressive symptoms and physiological birth. BJOG 2023; 130:429-430. [PMID: 36507593 DOI: 10.1111/1471-0528.17357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Lianne P Hulsbosch
- Centre of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Myrthe G B M Boekhorst
- Centre of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Paul Lodder
- Centre of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Eva S Potharst
- UvA minds Academic Outpatient (Child and Adolescent) Treatment Centre of the University of Amsterdam, Amsterdam, The Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Ivan Nyklíček
- Centre of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Veerle Bergink
- Departments of Psychiatry and Obstetrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Swan Guid Oei
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
| | - Corine J M Verhoeven
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, VU Medical Centre, Amsterdam, The Netherlands.,Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Victor J M Pop
- Centre of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Hulsbosch LP, Boekhorst MGBM, Gigase FAJ, Broeren MAC, Krabbe JG, Maret W, Pop VJM. The first trimester plasma copper-zinc ratio is independently related to pregnancy-specific psychological distress symptoms throughout pregnancy. Nutrition 2022; 109:111938. [PMID: 36736090 DOI: 10.1016/j.nut.2022.111938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES High plasma copper (Cu) and low zinc (Zn) levels have been associated with depression. However, most studies used low sample sizes and a cross-sectional design, and perinatal data are scarce. We investigated the possible association between pregnancy-specific psychological distress and the plasma CuZn ratio using a prospective design. METHODS Pregnancy-specific distress symptoms were assessed at each trimester by means of the Tilburg Pregnancy Distress Scale, negative affect subscale, in 2036 pregnant women. Cu and Zn were assessed at 12 wk of gestation in plasma samples by inductively coupled plasma mass spectrometry. Growth mixture modeling determined trajectories of women's pregnancy-specific negative affect (P-NA) symptoms, which were entered in a multiple logistic regression analysis as dependent variable and the CuZn ratio as independent variable. RESULTS Two P-NA symptom classes were found: 1) persistently low (n = 1820) and 2) persistently high (n = 216). A higher CuZn ratio was independently associated with persistently high P-NA symptom scores (odds ratio = 1.52; 95% confidence interval, 1.13-2.04) after adjustment for confounders. A sensitivity analysis was performed excluding all women with high P-NA scores at 12 wk (>1 SD above the mean P-NA score). In the 1719 remaining women, a higher CuZn ratio significantly predicted the development of increasing P-NA symptom scores after adjustment for confounders (odds ratio = 1.40; 95% confidence interval, 1.04-1.95). CONCLUSIONS A higher CuZn plasma ratio is an independent determinant of developing pregnancy-specific distress symptoms throughout pregnancy, suggesting that micronutrients could be used as novel biomarkers for psychological distress research of perinatal mood disorders.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Frederieke A J Gigase
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maarten A C Broeren
- Laboratory for Clinical Chemistry and Haematology, Máxima Medical Center, Veldhoven, the Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, the Netherlands
| | - Wolfgang Maret
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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Pop VJ, Hulsbosch LP, Boekhorst MGBM, Broeren MAC, Krabbe JG, Wiersinga WM. Hypothyroid Symptoms Throughout Pregnancy Are Predominantly Associated with Thyroxine and Not with Thyrotropin Concentrations. Thyroid 2022; 32:1249-1258. [PMID: 35999708 DOI: 10.1089/thy.2022.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: It is unclear whether levels of hypothyroid symptoms in pregnant women with (sub)clinical thyroid dysfunction differ from euthyroid controls and whether free thyroxine (fT4)/thyrotropin (TSH) changes throughout pregnancy affect hypothyroid symptom levels. The objective was twofold: (1) To compare hypothyroid symptom levels between thyroid dysfunction subgroups and a carefully defined reference group; (2) to assess the association between fT4/TSH changes throughout pregnancy and hypothyroid symptom levels adjusted for depressive symptoms. Methods: The current study was a longitudinal prospective cohort study in 1800 healthy pregnant women. At each trimester of pregnancy, hypothyroid symptoms were assessed with a 12-item symptom hypothyroidism checklist and depressive symptoms with the Edinburgh Depression Scale. Thyroid dysfunction was defined using the 2.5-97.5th fT4/TSH percentile of thyroid peroxidase antibodies-negative women. Euthyroid controls consisted of women with appropriate fT4 levels within the 10-90th percentile and with a normal TSH level. Hypothyroid symptom mean scores were compared between controls and several thyroid dysfunction subgroups. Growth mixture modeling was performed to evaluate possible longitudinal trajectories of hypothyroid and depressive symptoms. The association between hypothyroid symptom trajectories (adjusted for depression) and fT4/TSH changes was assessed with multivariate logistic regression analysis. Results: Women with overt hypothyroidism (fT4 < 2.5th, TSH >97.5th) and hypothyroxinemia (fT4 < 2.5th, TSH: 2.5-97.5th) showed higher hypothyroid symptom levels compared with the euthyroid controls and women with subclinical hypothyroidism (SCH, fT4: 2.5-97.5th, TSH >97.5th), because 82% of these SCH women had fT4 levels in the euthyroid range. Two groups of hypothyroid and depressive symptoms were defined: a persistently low and persistently high symptom group. fT4 decreased in 98% of the women from the first to third trimester and per unit pmol/L fT4 decrease (not TSH increase), the likelihood to present persistently high hypothyroid symptoms increased with 46%, adjusted for depression. Conclusions: A properly defined euthyroid control group distinguishes women with hypothyroid symptoms. An fT4 decrease toward end term is associated with persistently high hypothyroid symptom levels. Clinicians should be aware of the importance of fT4 stratification in SCH women.
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Affiliation(s)
- Victor J Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Maarten A C Broeren
- Laboratory for Clinical Chemistry and Hematology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands
| | - Wilmar M Wiersinga
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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12
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Gigase FAJ, Boekhorst MGBM, Rommel A, Dolan SM, Pop V, Bergink V, De Witte LD. Effects of severe acute respiratory syndrome coronavirus 2 infection on obstetric outcomes: Results from a prospective cohort in the Netherlands. Int J Gynaecol Obstet 2022; 160:337-339. [PMID: 35965408 PMCID: PMC9538041 DOI: 10.1002/ijgo.14405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/22/2022] [Accepted: 08/10/2022] [Indexed: 12/15/2022]
Abstract
Results of a large prospective pregnancy cohort in the Netherlands show no association of severe acute respiratory syndrome coronavirus 2 infection prior to 28 weeks of gestation with adverse obstetric outcomes.
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Affiliation(s)
- Frederieke A. J. Gigase
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA,Department of Clinical and Medical PsychologyTilburg UniversityTilburgThe Netherlands
| | | | - Anna‐Sophie Rommel
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA
| | - Siobhan M. Dolan
- Department of Obstetrics, Gynecology and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA
| | - Victor Pop
- Department of Clinical and Medical PsychologyTilburg UniversityTilburgThe Netherlands
| | - Veerle Bergink
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA,Department of Obstetrics, Gynecology and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA,Blavatnik Family Women's Health Research InstituteIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA,Department of PsychiatryErasmus Medical CentreRotterdamThe Netherlands
| | - Lotje D. De Witte
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew York CityNew YorkUSA
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13
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Potharst ES, Schaeffer MA, Gunning C, de Lara MC, Boekhorst MGBM, Hulsbosch LP, Pop VJM, Duijff SN. Implementing "Online Communities" for pregnant women in times of COVID-19 for the promotion of maternal well-being and mother-to-infant bonding: a pretest-posttest study. BMC Pregnancy Childbirth 2022; 22:415. [PMID: 35585565 PMCID: PMC9116067 DOI: 10.1186/s12884-022-04729-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/26/2022] [Indexed: 12/17/2022] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) pandemic elevated the risk for mental health problems in pregnant women, thereby increasing the risk for long-term negative consequences for mother and child well-being. There was an immediate need for easily accessible interventions for pregnant women experiencing elevated levels of pandemic related stress. Methods A three-session intervention “Online Communities” (OC) was developed at the beginning of the Dutch lockdown, and implemented by a team of midwives and psychologists specialized in Infant Mental Health. Pretest (N = 34) and posttest (N = 17) measurements of depressive symptoms, worries about COVID-19 and worries in general, and mother-to-infant bonding were administered, as well as a posttest evaluation. Results At pretest, the OC group was compared to two reference groups of pregnant women from an ongoing pregnancy cohort study: a COVID-19 (N = 209) and pre-COVID-19 reference group (N = 297). OC participants had significantly more depressive symptoms than both reference groups, and less positive feelings of bonding than the COVID-19 but not the pre-COVID-19 reference group. Compared to pretest, significant decreases in depressive symptoms (with significantly less participants scoring above cut-off) and worries about COVID-19 (large effect sizes) and worries in general (moderate to large effect size) were found at posttest for the OC participants. No significant improvement was found in bonding. Participants rated the intervention positively. Conclusions The current study provides initial evidence supporting the idea that OC is a promising and readily accessible intervention for pregnant women experiencing stress due to the COVID-19 pandemic, and possibly also applicable to other stressors. Trial registration This intervention was registered in the Netherlands Trial Registration (registration number Trial NL8842, registration date 18/08/2020).
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Affiliation(s)
- Eva S Potharst
- Research Institute of Child Development and Education, University of Amsterdam, Gebouw D, Roeterseilandcomplex, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands. .,UvA Minds, Academic Outpatient (child and adolescent) Treatment Center of the University of Amsterdam, Banstraat 29, 1071 JW, Amsterdam, the Netherlands.
| | - Mirla A Schaeffer
- UvA Minds, Academic Outpatient (child and adolescent) Treatment Center of the University of Amsterdam, Banstraat 29, 1071 JW, Amsterdam, the Netherlands.,Amsterdam Law and Behaviour Institute (A-LAB), Vrije Universiteit Amsterdam, De Boelelaan 1077a, 1081 HV, Amsterdam, the Netherlands.,Netherlands Institute for the Study of Crime and Law Enforcement, De Boelelaan 1077, 1081 HV, Amsterdam, the Netherlands
| | - Cecile Gunning
- Infant Mental Health Expertise Centre OuderKindLijn, Javastraat 155, 1095 CC, Amsterdam, The Netherlands
| | - Merith Cohen de Lara
- Outpatient Maternal Mental Health Practice Psyche en Zwangerschap, Cornelis Anthoniszstraat 28, 1071 VV, Amsterdam, The Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Lianne P Hulsbosch
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Sasja N Duijff
- Infant Mental Health Expertise Centre OuderKindLijn, Javastraat 155, 1095 CC, Amsterdam, The Netherlands.,Clinical Child, Family and Education Studies, University of Utrecht, Heidelberglaan 1, Postbus 80140, 3508 TC, Utrecht, The Netherlands
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14
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Pop VJM, Boekhorst MGBM, Deneer R, Oei G, Endendijk JJ, Kop WJ. Psychological Distress During Pregnancy and the Development of Pregnancy-Induced Hypertension: A Prospective Study. Psychosom Med 2022; 84:446-456. [PMID: 35067651 DOI: 10.1097/psy.0000000000001050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Pregnancy-induced hypertension (PIH) is associated with serious complications in both the mother and the unborn child. We examined the possible association between trajectories of maternal psychological distress symptoms and PIH separately in primiparous and multiparous women. METHODS Pregnancy-specific negative affect (P-NA) and depressive symptoms were assessed prospectively at each trimester using the Tilburg Pregnancy Distress Scale pregnancy negative affect subscale (P-NA) and the Edinburgh Depression Scale (EDS). Data on PIH were collected from medical records. Growth mixture modeling analysis was used to identify trajectories of P-NA and EDS. The independent role of P-NA and EDS symptom trajectories on developing PIH was examined using multivariate logistic regression models. RESULTS One hundred (7.6%) women developed PIH and were compared with 1219 women without hypertension or other complications during pregnancy. Three P-NA trajectories were identified: low stable (reference group; 90%), decreasing (5.2%), and increasing (4.8%). The latter two classes showed persistently and significantly higher P-NA symptoms during pregnancy compared with the reference group. In multiparous women, high P-NA scores (belonging to classes 2 and 3) were related to PIH (odds ratio [OR] = 6.91, 95% confidence interval [CI] = 2.26-21.2), independent of body mass index (OR = 1.17, 95% CI = 1.06-1.27) and previous PIH (OR = 14.82, 95% CI = 6.01-32.7). No associations between P-NA and PIH were found in primiparous women. EDS trajectories were not related to PIH in both primiparous and multiparous women. CONCLUSIONS In multiparous women, persistently high levels of P-NA symptoms but not depressive symptoms were independently associated with development of PIH.
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Affiliation(s)
- Victor J M Pop
- From the Department of Medical and Clinical Psychology (Pop, Boekhorst, Deneer, Kop), Tilburg University, Tilburg; Department of Obstetrics and Gynecology (Oei), Máxima Medical Centre Veldhoven, Veldhoven; and Child and Adolescent Studies (Endendijk), Utrecht University, Utrecht, the Netherlands
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15
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van den Heuvel MI, Vacaru SV, Boekhorst MGBM, Cloin M, van Bakel H, Riem MME, de Weerth C, Beijers R. Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown. BMC Pregnancy Childbirth 2022; 22:302. [PMID: 35397538 PMCID: PMC8994419 DOI: 10.1186/s12884-022-04618-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/16/2022] [Indexed: 01/05/2023] Open
Abstract
Background The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. Aim To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. Methods The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. Results Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. Conclusions The results emphasize the strain of the pandemic on young fathers’ and mothers’ mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation.
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16
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Muskens L, Boekhorst MGBM, Kop WJ, van den Heuvel MI, Pop VJM, Beerthuizen A. The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study. Arch Womens Ment Health 2022; 25:611-620. [PMID: 35347473 PMCID: PMC9072423 DOI: 10.1007/s00737-022-01225-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/18/2022] [Indexed: 12/25/2022]
Abstract
Perinatal depression is common, affecting approximately 7-13% of women. Studies have shown an association between unplanned pregnancy and perinatal depressive symptoms, but many used a cross-sectional design and limited postnatal follow-up. The current study investigated the association of unplanned pregnancy with perinatal depressive symptoms using a longitudinal cohort study that followed women from the first trimester until 12 months postpartum. Pregnant women (N = 1928) provided demographic and clinical data and information about pregnancy intention at the first trimester. Depressive symptoms were assessed during each trimester of pregnancy and five times postpartum using the Edinburgh Postnatal Depression Scale (EPDS) until 12 months postpartum. Mixed model analyses were used to investigate the association between an unplanned pregnancy and the level of depressive symptoms. Women with an unplanned pregnancy (N = 111, 5.8%) reported persistently higher levels of depressive symptoms during the entire perinatal period compared to women with a planned pregnancy, after adjustment for confounders (p < 0.001). However, the course of depressive symptom scores over time in women with an unplanned pregnancy was similar to that of women with a planned pregnancy. Lower age (p = 0.006), unemployment (p = 0.004), and history of depression (p < 0.001) were significantly associated with higher levels of perinatal depressive symptoms. An unplanned pregnancy may have a long-lasting negative impact on a woman's perinatal mental health. Therefore, women with an unplanned pregnancy may benefit from systematic follow-up during the perinatal period with contingent mental health support.
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Affiliation(s)
- Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, Netherlands.
| | - Myrthe G. B. M. Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | - Willem J. Kop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | | | - Victor J. M. Pop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, Netherlands
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17
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van den Heuvel MI, Bülow A, Heininga VE, de Moor EL, Janssen LHC, Vanden Abeele M, Boekhorst MGBM. Tracking Infant Development With a Smartphone: A Practical Guide to the Experience Sampling Method. Front Psychol 2021; 12:703743. [PMID: 35035365 PMCID: PMC8752460 DOI: 10.3389/fpsyg.2021.703743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has forced developmental researchers to rethink their traditional research practices. The growing need to study infant development at a distance has shifted our research paradigm to online and digital monitoring of infants and families, using electronic devices, such as smartphones. In this practical guide, we introduce the Experience Sampling Method (ESM) – a research method to collect data, in the moment, on multiple occasions over time – for examining infant development at a distance. ESM is highly suited for assessing dynamic processes of infant development and family dynamics, such as parent-infant interactions and parenting practices. It can also be used to track highly fluctuating family dynamics (e.g., infant and parental mood or behavior) and routines (e.g., activity levels and feeding practices). The aim of the current paper was to provide an overview by explaining what ESM is and for what types of research ESM is best suited. Next, we provide a brief step-by-step guide on how to start and run an ESM study, including preregistration, development of a questionnaire, using wearables and other hardware, planning and design considerations, and examples of possible analysis techniques. Finally, we discuss common pitfalls of ESM research and how to avoid them.
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Affiliation(s)
- Marion I. van den Heuvel
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, Netherlands
- *Correspondence: Marion I. van den Heuvel,
| | - Anne Bülow
- Department of Psychology Education & Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Vera E. Heininga
- Department of Developmental Psychology, Groningen University, Groningen, Netherlands
- Department of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | | | - Loes H. C. Janssen
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Mariek Vanden Abeele
- imec-mict-UGent, Department of Communication Sciences, Ghent University, Ghent, Belgium
| | - Myrthe G. B. M. Boekhorst
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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18
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Meems M, Boekhorst MGBM, Pop VJM. Long-Term Follow-Up Results of Mechanical Wrist Traction as Non-Invasive Treatment for Carpal Tunnel Syndrome. Front Neurol 2021; 12:668549. [PMID: 34552548 PMCID: PMC8450522 DOI: 10.3389/fneur.2021.668549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: For patients with carpal tunnel syndrome (CTS), the only long-term effective treatment option is carpal tunnel release surgery. Up to one-third report recurrent symptoms, and 12% needs repeated surgery. This study aimed to evaluate the long-term effects of mechanical traction as a non-invasive treatment option for CTS compared to care as usual. Methods: Patients with electrodiagnostically confirmed CTS [N = 181; mean age, 58.1 (13.0) years; 67% women] were recruited from an outpatient neurology clinic in the Netherlands. Patients completed baseline questionnaires and randomized to the intervention group (12 treatments with mechanical traction, twice a week for 6 weeks) or care as usual. The primary clinical outcome measure was surgery during the 12-month follow-up. Secondly, we assessed symptom severity with the Boston Carpal Tunnel Questionnaire (BCTQ) at baseline and at the 12-month follow-up. Changes in CTS symptom severity between baseline and the 12-month follow-up were analyzed between groups using t-tests and a multiple linear regression analyses, adjusting for duration of complaints, age, gender, and symptom severity at baseline. Results: At the 12-month follow-up, 35 of 94 (37%) patients in the intervention group had surgery, compared to 38 of 87 (44%) in the care-as-usual group (χ12 = 0.78, p = 0.377). Symptom severity and functional status scores did not significantly differ between the intervention (n = 81) and care-as-usual group (n = 55) at follow-up. For patients who did not have surgery, BCTQ scores decreased significantly more from baseline to the 12-month follow-up in the intervention group (n = 53) compared to patients in the care-as-usual group (n = 25). For patients who did not have surgery, belonging to the intervention group and a higher BCTQ score at baseline were related to a greater decrease in BCTQ scores from baseline to the 12-month follow-up, as well as symptom severity and functional status. Conclusions: Mechanical traction is effective in reducing symptom severity compared to current conservative treatment options in standard care and can therefore benefit the large number of patients that prefer conservative treatment for CTS. Clinical Trial Registration: Clinical Trials NL44692.008.13. Registered 19 September 2013, https://clinicaltrials.gov/ct2/show/NCT01949493
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Affiliation(s)
- Margreet Meems
- Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, Netherlands
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19
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Boekhorst MGBM, Muskens L, Hulsbosch LP, Van Deun K, Bergink V, Pop VJM, van den Heuvel MI. The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression. Arch Womens Ment Health 2021; 24:1037-1043. [PMID: 33830373 PMCID: PMC8027291 DOI: 10.1007/s00737-021-01104-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/14/2021] [Indexed: 12/26/2022]
Abstract
The COVID-19 pandemic affects society and may especially have an impact on mental health of vulnerable groups, such as perinatal women. This prospective cohort study of 669 participating women in the Netherlands compared perinatal symptoms of depression and stress during and before the pandemic. After a pilot in 2018, recruitment started on 7 January 2019. Up until 1 March 2020 (before the pandemic), 401 women completed questionnaires during pregnancy, of whom 250 also completed postpartum assessment. During the pandemic, 268 women filled out at least one questionnaire during pregnancy and 59 postpartum (1 March-14 May 2020). Pregnancy-specific stress increased significantly in women during the pandemic. We found no increase in depressive symptoms during pregnancy nor an increase in incidence of high levels of postpartum depressive symptoms during the pandemic. Clinicians should be aware of the potential for increased stress in pregnant women during the pandemic.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands.
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
| | - Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Lianne P Hulsbosch
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Katrijn Van Deun
- Department of Methodology & Statistics, Tilburg University, Tilburg, The Netherlands
| | - Veerle Bergink
- Departments of Psychiatry and Obstetrics, Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
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20
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Boekhorst MGBM, Beerthuizen A, Hillegers M, Pop VJM, Bergink V. Mother-to-Infant Bonding in Women With a Bipolar Spectrum Disorder. Front Pediatr 2021; 9:646985. [PMID: 33816406 PMCID: PMC8017118 DOI: 10.3389/fped.2021.646985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: Offspring of mothers with a bipolar disorder are at high-risk for impaired developmental outcomes and psychopathology (e. g., mood, anxiety, sleep disorders) later in life. This increased risk of psychopathology is not only because of genetic vulnerability, but environmental factors may play an important role as well. The often long and debilitating mood episodes of mothers with bipolar disorder might hamper their qualities as a caregiver and may impact the child. We examined early mother-to-infant bonding 1 year postpartum in mothers with bipolar spectrum disorder as compared to mothers of the general population. The association between mother-to-infant bonding and the type of bipolar spectrum diagnosis (bipolar I, bipolar II, bipolar Not Otherwise Specified) as well as relapse within 12 months postpartum was also assessed. Methods: In total, 75 pregnant women with a bipolar spectrum disorder participated in the current study. The participants were included in a longitudinal cohort study of women with bipolar spectrum disorder and were prospectively followed from pregnancy until 1 year postpartum. Mother-to-infant bonding was assessed using the Pre- and Postnatal Bonding Scale. A longitudinal population-based cohort of 1,419 pregnant women served as the control group. Multiple linear regression analyses were used to assess the association between bipolar spectrum disorder and mother-to-infant bonding scores, controlling for several confounders. Results: Women with bipolar spectrum disorder perceived the bonding with their child as less positive compared to the control group. The type of bipolar spectrum disorder was not associated with poorer bonding scores. Relapse during the 1st year after delivery also did not affect bonding scores in women with bipolar spectrum disorder. Conclusions: Our findings could imply that women with bipolar spectrum disorder are more vulnerable to impairments in bonding due to the nature of their psychopathology, regardless of the occurrence of postpartum relapse. Careful follow-up including monitoring of mother-to-infant bonding of pregnant women with a history of bipolar spectrum disorder should be a standard to this vulnerable group of women. In addition, regardless of severity and mood episode relapse, an intervention to improve bonding could be beneficial for all mothers with bipolar spectrum disorder and their newborns.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Veerle Bergink
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Departments of Psychiatry and Obstetrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Hulsbosch LP, Nyklíček I, Potharst ES, Meems M, Boekhorst MGBM, Pop VJM. Online mindfulness-based intervention for women with pregnancy distress: design of a randomized controlled trial. BMC Pregnancy Childbirth 2020; 20:159. [PMID: 32169030 PMCID: PMC7069182 DOI: 10.1186/s12884-020-2843-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/25/2020] [Indexed: 02/08/2023] Open
Abstract
Background Psychological distress during pregnancy is common: up to 20% of the childbearing women experience symptoms of depression and anxiety. Apart from the adverse effects on the woman herself, pregnancy distress can negatively affect pregnancy outcomes, infant health, postpartum mother-child interaction and child development. Therefore, the development of interventions that reduce pregnancy distress is very important. Mindfulness-based interventions (MBIs) show promising positive effects on pregnancy distress, but there is a need for randomized controlled trials with sufficient power. Trials on online MBIs, which are readily accessible and not expensive, also show positive effects on stress reduction in non-pregnant populations. Moreover, specific working mechanisms of MBIs remain unclear. The aim of the current study is to test the effectiveness of an online MBI in pregnant women with pregnancy distress, as well as exploring potential working mechanisms. Methods The current study is a randomized controlled trial with repeated measures. Consenting women with elevated levels of pregnancy distress will be randomized into an intervention group (MBI) or control group (care as usual) around 12 weeks of pregnancy, with an intended sample size of 103 women in each group. The primary outcome, pregnancy distress, will be assessed via questionnaires at baseline, halfway through the intervention and post intervention in both intervention and control group, and after 8 weeks follow-up in the intervention group. Secondary outcomes are mindfulness skills, rumination and self-compassion, which are also seen as potential working mechanisms, and will be assessed via questionnaires before intervention, halfway through the intervention, post intervention and after 8 weeks follow-up in the intervention group. Tertiary outcome variables are obstetric data and will be collected from the obstetric records for both intervention and control group. Analyses will be based on the intention-to-treat principle. Multilevel regression models for repeated measures (mixed models) will be used to evaluate changes in primary and secondary outcome variables. Tertiary outcomes will be compared between groups using independent t-tests and Chi Square analyses. Discussion The trial is expected to increase knowledge about the effectiveness of online MBIs during pregnancy in women with pregnancy distress and to evaluate potential working mechanisms. Trial registration ClinicalTrials.gov: NCT03917745, registered on 4 March 2019. Protocol Version 3.0., 20 February 2020.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, Warandelaan 2, 5000 LE, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, Warandelaan 2, 5000 LE, Tilburg, the Netherlands
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, the Netherlands
| | - Margreet Meems
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, Warandelaan 2, 5000 LE, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, Warandelaan 2, 5000 LE, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, Warandelaan 2, 5000 LE, Tilburg, the Netherlands.
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Boekhorst MGBM, Beerthuizen A, Van Son M, Bergink V, Pop VJM. Psychometric aspects of the Tilburg Pregnancy Distress Scale: data from the HAPPY study. Arch Womens Ment Health 2020; 23:215-219. [PMID: 31049709 PMCID: PMC7183490 DOI: 10.1007/s00737-019-00974-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/23/2019] [Indexed: 11/21/2022]
Abstract
We previously developed the Tilburg Pregnancy Distress Scale (TPDS). The aim of the current study was to further assess its test-retest reliability, internal consistency, and construct and concurrent validity in 1739 pregnant women. TPDS scores during pregnancy were highly inter-correlated (r ≥ .70), with similar findings for its Negative Affect and Partner Involvement subscales. Pregnancy and delivery worries varied in different subgroups of women regarding their obstetric history. Nullipara reported more pregnancy- and delivery-related worries at all trimesters of pregnancy. Women with previous pregnancy-related complications reported more pregnancy-related worries, and those with previous delivery-related problems reported more delivery-related worries than women without these problems in the past. The TPDS seems to be a valid and reliable instrument to assess pregnancy-specific distress.
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Affiliation(s)
- Myrthe G. B. M. Boekhorst
- grid.12295.3d0000 0001 0943 3265Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000, 5037 AB LE Tilburg, The Netherlands ,grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands ,grid.414711.60000 0004 0477 4812Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
| | - Annemerle Beerthuizen
- grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Maarten Van Son
- grid.5477.10000000120346234Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Veerle Bergink
- grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands ,grid.59734.3c0000 0001 0670 2351Departments of Psychiatry and Obstetrics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Victor J. M. Pop
- grid.12295.3d0000 0001 0943 3265Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000, 5037 AB LE Tilburg, The Netherlands
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23
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Potharst ES, Boekhorst MGBM, Cuijlits I, van Broekhoven KEM, Jacobs A, Spek V, Nyklíček I, Bögels SM, Pop VJM. A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress. Front Psychol 2019; 10:1550. [PMID: 31379646 PMCID: PMC6650592 DOI: 10.3389/fpsyg.2019.01550] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/19/2019] [Indexed: 01/02/2023] Open
Abstract
Objectives The prevalence of maternal stress in early years of parenting can negatively impact child development. Therefore, there is a need for an early intervention that is easily accessible and low in costs. The current study examined the effectiveness of an 8-session online mindful parenting training for mothers with elevated levels of parental stress. Methods A total of 76 mothers were randomized into an intervention (n = 43) or a waitlist control group (n = 33). The intervention group completed pretest assessment prior to the online intervention. Participants completed a post intervention assessment after the 10 weeks intervention and a follow-up assessment 10 weeks later. The waitlist group completed waitlist assessment, followed by a 10-week waitlist period. After these 10 weeks, a pretest assessment took place, after which the waitlist group participants also started the intervention, followed by the posttest assessment. Participating mothers completed questionnaires on parental stress (parent-child interaction problems, parenting problems, parental role restriction) and other maternal (over-reactive parenting discipline, self-compassion, symptoms of depression and anxiety) and child outcomes (aggressive behavior and emotional reactivity) while the non-participating parents (father or another mother) were asked to also report on child outcomes. Results The online mindful parenting intervention was shown to be significantly more effective at a 95% level than a waitlist period with regard to over-reactive parenting discipline and symptoms of depression and anxiety (small and medium effect sizes), and significantly more effective at a 90% level with regard to self-compassion, and mother-rated child aggressive behavior and child emotional reactivity (small effect sizes). The primary outcome, parental stress, was found to have a 95% significant within-group effect only for the subscale parental role restriction (delayed small effect size improvement at follow-up). No significant improvements on child outcomes were found for the non-participating parent. Conclusion To conclude, the results provide first evidence that an online mindful parenting training may be an easily accessible and valuable intervention for mothers with elevated levels of parental stress.
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Affiliation(s)
- Eva S Potharst
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Center, University of Amsterdam, Amsterdam, Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands.,Department of Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Ivon Cuijlits
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Kiki E M van Broekhoven
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Anne Jacobs
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Viola Spek
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Psychology, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Ivan Nyklíček
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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