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Harris SA, Eapen V, Kohlhoff J. Implementing a National Navigation Service for Perinatal and Infant Mental Health: Early Learnings from the ForWhen Model. Community Ment Health J 2024; 60:581-588. [PMID: 37991577 DOI: 10.1007/s10597-023-01211-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
ForWhen is an Australia-based national navigation service aimed at helping parents and carers navigate the perinatal mental health service landscape and connect them with appropriate support and clinical services. The current study forms part of a mixed-methods evaluation of the ForWhen program. Semi-structured interviews were conducted with ForWhen navigators during the early design and implementation phases of the service. Results were used to characterise the ForWhen navigator activities and responsibilities, identify navigator core competencies, and examine facilitators and barriers to successful implementation of a large-scale navigation program for perinatal and infant mental health. Further research will be crucial for evidencing the utility and potential of navigation models in addressing identified issues with access to treatment for perinatal and infant mental health issues.
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Affiliation(s)
- Sophia A Harris
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Academic Unit of Infant, Child & Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
- , Karitane, Sydney, Australia.
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Traynor NM, Hughes M, Wood A, Onslow G, Edwards K, Clements J, Kohlhoff J. Supporting families with complex early parenting needs through a virtual residential parenting service: An investigation of outcomes, facilitators and barriers. J Clin Nurs 2024; 33:1122-1133. [PMID: 37962242 DOI: 10.1111/jocn.16927] [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: 06/03/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
AIM To investigate clients' perspectives about outcomes of a telehealth residential unit (RU) program for families experiencing complex early parenting issues, and to explore facilitators and barriers to positive client outcomes. DESIGN Qualitative study using semi-structured interviews. METHODS Semi-structured interviews were conducted with mothers (n = 18) admitted to a telehealth RU program. Interview transcripts were analysed using thematic analysis. RESULTS Mothers reported short-term improvements in their child's presenting issues (e.g. feeding to sleep, night-time waking, co-sleeping), increased confidence and increased partner involvement. According to participants, program outcomes were facilitated by a positive parent-clinician relationship, the accessibility of clinicians and being able to take part in the program from their own home. Barriers included difficulties with technical equipment and connecting with the clinician overnight, and challenges with implementing strategies in the longer term. CONCLUSION This nurse-led telehealth program was viewed positively by parents and the study identified a number of areas for improvement. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Telehealth early parenting programs provide an important way for parents to receive support with early child sleep, settling and feeding issues. Clinicians working in this area should focus on the development of positive parent-nurse relationships, enhancing communication and availability for parents during overnight periods and supporting parents to develop early parenting skills that will be applicable across the early childhood period. IMPACT The study is the first to address client experiences of a telehealth RU program. Facilitators and barriers identified will inform service improvements to the program going forward, and similar telehealth programs for families; to ensure benefits and service outcomes are maximised for parents for such a crucial service. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed.
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Affiliation(s)
- Nicole M Traynor
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | | | - Angela Wood
- Karitane, Kensington, New South Wales, Australia
| | | | | | | | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
- Karitane, Kensington, New South Wales, Australia
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Kohlhoff J, Traynor NM. Prospective evaluation of parent and child outcomes following admission to a 'virtual' early parenting residential programme. BMJ Open 2024; 14:e077024. [PMID: 38355170 PMCID: PMC10868264 DOI: 10.1136/bmjopen-2023-077024] [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] [Received: 06/23/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES Australian early parenting residential services provide interventions for families experiencing complex early parenting issues. Many services have recently shifted to virtual care models but the clinical effectiveness of such programmes is currently unknown. This study sought to test outcomes of a 'virtual' early parenting residential programme and to compare these with those of an in-person programme. DESIGN Prospective cohort study; self-report questionnaires on admission, at discharge and 6-week follow-up. SETTING An early parenting residential unit in Sydney, Australia. PARTICIPANTS Consecutive series of parent-child dyads admitted to the unit virtually (n=56) or in person (n=44) between August 2021 and January 2022. INTERVENTIONS Participants in both groups received a 4-night/5-day intervention programme involving access to 24-hour support from a multidisciplinary team of health professionals. The in-person programme was delivered at a residential unit; the virtual programme involved provision of support via video calls, phone calls, SMS and emails. PRIMARY AND SECONDARY OUTCOME MEASURES Infant sleep, parenting self-efficacy (primary outcomes); parenting empathy, emotion, hostility, helplessness, mentalisation and stress (secondary outcomes). RESULTS Parents who received the virtual programme reported improvements from admission to discharge, and from admission to 6-week follow-up, in a range of areas including parenting self-efficacy, empathy, mentalisation, hostility, helplessness, stress and infant sleep resistance (ps<0.05). At 6 weeks, they also reported improvements in emotion and understanding related to their child (p<0.05). In contrast to expectation, outcomes at discharge and 6 weeks were not superior in the in-person group. In fact, at 6 weeks, parents who attended the virtual residential group reported significantly lower levels of parenting hostility and parenting stress, and greater levels of parenting confidence compared with those in the in-person group (ps<0.05). CONCLUSIONS Virtual early parenting residential interventions may be effective in bringing positive changes for families, and there is no evidence to suggest that outcomes are inferior to those of in-person programmes.
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Affiliation(s)
- Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
- Karitane, Carramar, New South Wales, Australia
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Chau V, Eapen V, Hawkins E, Kohlhoff J. Parenting Characteristics and Callous-Unemotional Traits in Children Aged 0-6 Years: A Systematic Narrative Review. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01634-6. [PMID: 38127204 DOI: 10.1007/s10578-023-01634-6] [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] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
There has been a growing interest in research examining the relationship between parenting and child callous-unemotional (CU) traits, particularly in early childhood. This study reviewed evidence from studies that investigated the relationship between parenting characteristics (e.g., caregiving beliefs, attitudes, behaviour or quality, or parental mental health) and callous-unemotional traits in children aged 0 to 6 years. A systematic search conducted according to PRISMA guidelines yielded 27 peer-reviewed articles. Analysis of the included articles suggested that there was strong evidence to support links between child CU traits and parenting characteristics (particularly, parental feelings about their child, warm parenting, and harsh/ inconsistent parenting). Taken together, the results of this review demonstrate the links between both positive and negative dimensions of parenting and CU traits in early childhood; however, mixed findings highlight the need for further research.
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Affiliation(s)
- Vivian Chau
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Erinn Hawkins
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Karitane, Sydney, Australia
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Barbaro J, Winata T, Gilbert M, Nair R, Khan F, Lucien A, Islam R, Masi A, Diaz AM, Dissanayake C, Karlov L, Descallar J, Eastwood J, Hasan I, Jalaludin B, Kohlhoff J, Liaw ST, Lingam R, Ong N, Tam CWM, Woolfenden S, Eapen V. General practitioners' perspectives regarding early developmental surveillance for autism within the australian primary healthcare setting: a qualitative study. BMC Prim Care 2023; 24:159. [PMID: 37563549 PMCID: PMC10416397 DOI: 10.1186/s12875-023-02121-6] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Significant challenges remain in the early identification of child developmental disabilities in the community. Implementing supports and services early in the life course has been shown to promote positive developmental outcomes for children at high likelihood of developmental disabilities, including autism. As part of a cluster randomised controlled trial, this study seeks to examine and compare the perspectives and experiences of Australian general practitioners (GPs) in relation to a digital developmental surveillance program for autism and usual care pathway, in general practice clinics. METHODS A qualitative research methodology with semi-structured interviews and thematic inductive analysis underpinned by grounded theory was utilised. All GPs from South Western Sydney (NSW) and Melbourne (Victoria) who participated in the main program ("GP Surveillance for Autism") were invited to the interview. GPs who provided consent were interviewed either over online or in-person meeting. Interviews were audio-recorded, transcribed, and coded using NVivo12 software. Inductive interpretive approach was adopted and data were analysed thematically. RESULTS Twenty-three GPs across the two sites (NSW: n = 11; Victoria: n = 12) agreed to be interviewed; data saturation had reached following this number of participants. Inductive thematic coding and analysis yielded eight major themes and highlighted common enablers such as the role of GPs in early identification and subsequent supports, enhanced communication between clinicians/professionals, relationship-building with patients, and having standardised screening tools. Specific facilitators to the feasibility and acceptability of a digital screening program for the early identification of developmental disabilities, including the early signs of autism, and encouraging research and education for GPs. However, several practical and socioeconomic barriers were identified, in addition to limited knowledge and uptake of child developmental screening tools as well as COVID-19 lockdown impacts. Common and specific recommendations involve supporting GPs in developmental/paediatrics training, streamlined screening process, and funding and resources in the primary healthcare services. CONCLUSIONS The study highlighted the need for practice and policy changes, including further training of GPs alongside sufficient time to complete developmental checks and appropriate financial remuneration through a Medicare billing item. Further research is needed on implementation and scale up of a national surveillance program for early identification of developmental disabilities, including autism.
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Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Teresa Winata
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Feroza Khan
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Abbie Lucien
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Raisa Islam
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Anne Masi
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Antonio Mendoza Diaz
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Lisa Karlov
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Joseph Descallar
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - John Eastwood
- Faculty of Medicine and Health, School of Medicine, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine, School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Iqbal Hasan
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Siaw-Teng Liaw
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Sue Woolfenden
- Faculty of Medicine, School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia.
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Sydney, NSW, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
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Harris SA, Harrison M, Hazell-Raine K, Wade C, Eapen V, Kohlhoff J. Patient navigation models for mental health of parents expecting or caring for an infant or young child: A systematic review. Infant Ment Health J 2023. [PMID: 37422890 DOI: 10.1002/imhj.22075] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/07/2023] [Accepted: 05/11/2023] [Indexed: 07/11/2023]
Abstract
Patient navigation (PN) aims to improve timely access to healthcare by helping patients to "navigate" complex service provision landscapes. PN models have been applied in diverse healthcare settings including perinatal mental health (PMH). However, the practice models and implementation of PN programs vary widely, and their impact on engagement with PMH services has not been systematically investigated. This systematic narrative review study aimed to (1) identify and describe existing PMH PN models, (2) understand their effectiveness in improving service engagement and clinical outcomes, (3) review patient and provider perceptions, and (4) explore facilitators and barriers to program success. A systematic search of published articles/reports describing PMH PN programs/service delivery models targeting parents in the period from conception to 5 years postpartum was conducted. In total, 19 articles describing 13 programs were identified. The analysis yielded a number of commonalities and differences across program settings, target populations, and the scope of the navigator role. While there was promising evidence to support the clinical efficacy and impact on service utilization of PN programs for PMH, the current evidence base is sparse. Further research evaluating the efficacy of such services, and facilitators and barriers to their success, is warranted.
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Affiliation(s)
- Sophia A Harris
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Michelle Harrison
- Parenting Research Centre, Melbourne, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- South Western Sydney Local Health District, Liverpool, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Kohlhoff J, Harris SA, Lawson KD, Eapen V. ForWhen Australian perinatal and infant mental health navigation programme: evaluation protocol. BMJ Open 2023; 13:e070067. [PMID: 37277223 DOI: 10.1136/bmjopen-2022-070067] [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] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Many parents and carers experience mental health challenges during pregnancy and early postpartum years, and there are cumulative shortfalls in the identification, follow-up, and treatment of those experiencing perinatal and infant mental health (PIMH) challenges. ForWhen is a new national navigation programme in Australia that aims to improve outcomes for families by supporting parents and carers to access PIMH services that best meet their needs. This paper presents the protocol of an evaluation of the ForWhen programme, to be conducted over the first 3 years of its implementation. The specific objectives of the evaluation include examining the characteristics of navigation service delivery, its implementation and clinical impact, and identifying potential moderators of change. METHODS AND ANALYSIS Utilising a mixed-methods design, this evaluation will incorporate three phases that reflect the stages of the programme life-cycle: (1) programme description, (2) implementation evaluation and (3) outcomes evaluation. The evaluation will use a mix of quantitative and qualitative data including deidentified routinely collected service data, participant observations, semistructured interviews, surveys and questionnaires, and a resource audit. DISCUSSION Evaluation findings will be used to inform the development of a refined clinical navigation model, identify barriers and facilitators to successful navigation programme implementation, examine the impact of the ForWhen programme on client clinical outcomes and health service utilisation, understand how the programme is/can be best embedded in the evolving service system, and assess the cost-effectiveness and sustainability of a national navigation programme in improving health outcomes for PIMH in Australia. ETHICS AND DISSEMINATION This research was approved by South Western Sydney Local Health District Human Research Ethics Committee (2021/ETH11611). This study was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001443785). Results will be disseminated at conferences, in scientific journals, and in a final evaluation report.
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Affiliation(s)
- Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
- Karitane Research Department, Karitane, Sydney, New South Wales, Australia
| | - Sophia A Harris
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenny D Lawson
- Western Sydney University, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child & Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Ingham Institute, Sydney, New South Wales, Australia
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Kohlhoff J, Karlov L, Dadds M, Barnett B, Silove D, Mendoza Diaz A, Eapen V. Preschool Behavioral Problems: Links with Maternal Oxytocin and Caregiving Sensitivity in the Postnatal Period, and Concurrent Maternal Psychopathology and Attachment State-of-Mind. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01529-6. [PMID: 37022532 DOI: 10.1007/s10578-023-01529-6] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
This study investigated maternal oxytocin, caregiving sensitivity and mother-to-infant bonding at 3-months postpartum as predictors of child behavior and psychological outcomes in the preschool years, when controlling for concurrent maternal negative emotional symptoms and adult attachment state-of-mind. Forty-five mother-child dyads were assessed at 3-months and 3.5 years postpartum using mix of questionnaires, observational, interview and biological methods. Results showed that lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted emotional reactivity in the child at 3.5 years. When maternal adult attachment state-of-mind and negative emotional symptoms were included, lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted withdrawn child behavior. In addition, unresolved adult attachment and maternal negative emotional symptoms were significantly associated child behavioral disturbance in a range of areas. Findings highlight maternal postnatal oxytocin as a potential indicator of children who may be more likely to show emotional reactivity and withdrawn behavior in the preschool years.
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Affiliation(s)
- Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
- Research Department, Karitane, Sydney, Australia.
- Ingham Institute for Medical Research, Sydney, Australia.
| | - Lisa Karlov
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Mark Dadds
- School of Psychology, University of Sydney, Sydney, Australia
| | | | - Derrick Silove
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Antonio Mendoza Diaz
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Ingham Institute for Medical Research, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
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Kohlhoff J, Tooke S, Philipov M, Hickinbotham R, Knox C, Roach V, Barnett B. Antenatal depression screening and psychosocial assessment in an Australian private hospital: An evaluation. Aust N Z J Obstet Gynaecol 2023; 63:42-51. [PMID: 35754379 DOI: 10.1111/ajo.13550] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Universal mental health screening and psychosocial assessment during pregnancy have been recommended as best practice, but uptake of universal programs in the private hospital system has been slow. AIM The aim of this study was to evaluate the Pre-admission Midwife Appointment Program (PMAP), an antenatal mental health screening program at the Mater Hospital, Sydney. MATERIALS AND METHODS In this mixed-methods design study, PMAP interview data were collected for a consecutive series of 485 women who attended the PMAP during a 10-month period. Women also completed two postnatal telephone interviews (10 weeks and 9 months postpartum). The interviews involved depression screening and questions about the program. RESULTS Of the 485 participants, 4.1% screened positive for depression on the Edinburgh Postnatal Depression Scale. In total, 19% were identified as currently suffering from, or at risk of developing, perinatal mental health issues; referrals to support services were provided for the 13% who were not already linked in with appropriate supports. All women displayed a decrease in depressive symptom severity from pregnancy to 10 weeks and 9 months postpartum. The PMAP was viewed positively by consumers, with >93% viewing the program as helpful and >98% saying that they would recommend the program to others. Additional program benefits identified included opportunities to gain practical information and prepare for motherhood and to think/reflect on their emotional well-being. CONCLUSIONS Given the observed rates of psychosocial risk among this sample, related referral opportunities and positive consumer feedback, we recommend other Australian private hospitals consider implementing PMAP or similar programs.
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Affiliation(s)
- Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.,Karitane, Carramar, New South Wales, Australia
| | - Sarah Tooke
- The Mater Hospital, North Sydney, New South Wales, Australia
| | | | - Rachael Hickinbotham
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | - Catherine Knox
- University of Sydney, Sydney, New South Wales, Australia
| | - Vijay Roach
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | - Bryanne Barnett
- Gidget Foundation Australia, North Sydney, New South Wales, Australia
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Cibralic S, Pickup W, Diaz AM, Kohlhoff J, Karlov L, Stylianakis A, Schmied V, Barnett B, Eapen V. The impact of midwifery continuity of care on maternal mental health: A narrative systematic review. Midwifery 2023; 116:103546. [PMID: 36375410 DOI: 10.1016/j.midw.2022.103546] [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: 05/05/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Systematic reviews have shown that midwifery continuity of care programs lead to improvements in birth outcomes for women and babies, but no reviews have focused specifically on the impact of midwifery continuity of care on maternal mental health outcomes. OBJECTIVE To systematically review the available evidence on the impact of midwifery continuity of care on maternal mental health during the perinatal period. METHOD A systematic search of published literature available through to March 2021 was conducted. A narrative approach was used to examine and synthesise the literature. RESULTS The search yielded eight articles that were grouped based on the mental health conditions they examined: fear of birth, anxiety, and depression. Findings indicate that midwifery continuity of care leads to improvements in maternal anxiety/worry and depression during the perinatal period. CONCLUSION There is preliminary evidence showing that midwifery continuity of care is beneficial in reducing anxiety/worry and depression in pregnant women during the antenatal period. As the evidence stands, midwifery continuity of care may be a preventative intervention to reduce maternal anxiety/worry and depression during the perinatal period.
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Affiliation(s)
- Sara Cibralic
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
| | - Wendy Pickup
- South Western Sydney Local Health District, New South Wales, Australia
| | | | - Jane Kohlhoff
- University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Karlov
- University of New South Wales, Sydney, New South Wales, Australia; South Western Sydney Local Health District, New South Wales, Australia
| | | | | | - Bryanne Barnett
- University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia; South Western Sydney Local Health District, New South Wales, Australia
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11
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Eapen V, Winata T, Gilbert M, Nair R, Khan F, Lucien A, Islam R, Masi A, Lam-Cassettari C, Mendoza Diaz A, Dissanayake C, Karlov L, Descallar J, Eastwood J, Hasan I, Jalaludin B, Kohlhoff J, Liaw ST, Lingam R, Ong N, Tam CWM, Woolfenden S, Barbaro J. Parental experience of an early developmental surveillance programme for autism within Australian general practice: a qualitative study. BMJ Open 2022; 12:e064375. [PMID: 36442896 PMCID: PMC9710335 DOI: 10.1136/bmjopen-2022-064375] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Implementing support and services early in the life course has been shown to promote positive developmental outcomes for children at high likelihood of developmental conditions including autism. This study examined parents'/caregivers' experiences and perceptions about a digital developmental surveillance pathway for autism, the autism surveillance pathway (ASP), and usual care, the surveillance as usual (SaU) pathway, in the primary healthcare general practice setting. DESIGN This qualitative study involves using a convenience selection process of the full sample of parents/caregivers that participated in the main programme, 'General Practice Surveillance for Autism', a cluster-randomised controlled trial study. All interviews were audio-recorded, transcribed and coded using NVivo V.12 software. An inductive thematic interpretive approach was adopted and data were analysed thematically. PARTICIPANTS Twelve parents/caregivers of children with or without a developmental condition/autism (who participated in the main programme) in South Western Sydney and Melbourne were interviewed. SETTINGS All interviews were completed over the phone. RESULTS There were seven major themes and 20 subthemes that included positive experiences, such as pre-existing patient-doctor relationships and their perceptions on the importance of knowing and accessing early support/services. Barriers or challenges experienced while using the SaU pathway included long waiting periods, poor communication and lack of action plans, complexity associated with navigating the healthcare system and lack of understanding by general practitioners (GPs). Common suggestions for improvement included greater awareness/education for parents/carers and the availability of accessible resources on child development for parents/caregivers. CONCLUSION The findings support the use of digital screening tools for developmental surveillance, including for autism, using opportunistic contacts in the general practice setting. TRIAL REGISTRATION NUMBER ANZCTR (ACTRN12619001200178).
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Affiliation(s)
- Valsamma Eapen
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Teresa Winata
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Feroza Khan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Abbie Lucien
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Raisa Islam
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Anne Masi
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christa Lam-Cassettari
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Antonio Mendoza Diaz
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Saint Lucia, Queensland, Australia
| | - Lisa Karlov
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Joseph Descallar
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Faculty of Medicine and Health, School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Iqbal Hasan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Centre for Research, Evidence Management and Surveillance, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Jane Kohlhoff
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Siaw-Teng Liaw
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
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12
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Eapen V, Liaw ST, Lingam R, Woolfenden S, Jalaludin B, Page A, Kohlhoff J, Scott JG, Lawson KD, Lam-Cassettari C, Heussler H, Descallar J, Karlov L, Ong N, Colditz PB, Littlewood R, Murphy E, Deering A, Short K, Garg P, Blight V, Rodgers K, Chalmers L, Webb KL, Atkins H, Newcomb D, Beswick R, Thomas C, Marron C, Chambers A, Scheinpflug S, Statham M, Samaranayake D, Chay P, Tam CWM, Khan F, Mendoza Diaz A, Cibralic S, Winata T, Pritchard M. Watch me grow integrated (WMG-I): protocol for a cluster randomised controlled trial of a web-based surveillance approach for developmental screening in primary care settings. BMJ Open 2022; 12:e065823. [PMID: 35977775 PMCID: PMC9389092 DOI: 10.1136/bmjopen-2022-065823] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The increasing prevalence of developmental disorders in early childhood poses a significant global health burden. Early detection of developmental problems is vital to ensure timely access to early intervention, and universal developmental surveillance is recommended best practice for identifying issues. Despite this, there is currently considerable variation in developmental surveillance and screening between Australian states and territories and low rates of developmental screening uptake by parents. This study aims to evaluate an innovative web-based developmental surveillance programme and a sustainable approach to referral and care pathways, linking primary care general practice (GP) services that fall under federal policy responsibility and state government-funded child health services. METHODS AND ANALYSIS The proposed study describes a longitudinal cluster randomised controlled trial (c-RCT) comparing a 'Watch Me Grow Integrated' (WMG-I) approach for developmental screening, to Surveillance as Usual (SaU) in GPs. Forty practices will be recruited across New South Wales and Queensland, and randomly allocated into either the (1) WMG-I or (2) SaU group. A cohort of 2000 children will be recruited during their 18-month vaccination visit or opportunistic visit to GP. At the end of the c-RCT, a qualitative study using focus groups/interviews will evaluate parent and practitioner views of the WMG-I programme and inform national and state policy recommendations. ETHICS AND DISSEMINATION The South Western Sydney Local Health District (2020/ETH01625), UNSW Sydney (2020/ETH01625) and University of Queensland (2021/HE000667) Human Research Ethics Committees independently reviewed and approved this study. Findings will be reported to the funding bodies, study institutes and partners; families and peer-reviewed conferences/publications. TRIAL REGISTRATION NUMBER ANZCTR12621000680864.
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Affiliation(s)
- Valsamma Eapen
- ICAMHS, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Siaw-Teng Liaw
- University of New South Wales, Sydney, New South Wales, Australia
| | - Raghu Lingam
- University of New South Wales, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- University of New South Wales, Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Bin Jalaludin
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia
| | - Jane Kohlhoff
- University of New South Wales, Sydney, New South Wales, Australia
- Karitane, Villawood, New South Wales, Australia
| | - James G Scott
- The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - K D Lawson
- Translational Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia
| | - Christa Lam-Cassettari
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Helen Heussler
- Children's Health Queensland Hospital and Health Service, Herston, Queensland, Australia
- Centre for Children's Health Research, The University of Queensland, South Brisbane, Queensland, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Karlov
- University of New South Wales, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Natalie Ong
- University of New South Wales, Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Paul B Colditz
- The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
| | - Robyn Littlewood
- Children's Health Queensland Hospital and Health Service, Herston, Queensland, Australia
- Health and Wellbeing, Milton, Queensland, Australia
| | - Elisabeth Murphy
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - April Deering
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - Kate Short
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Pankaj Garg
- University of New South Wales, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Victoria Blight
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Kim Rodgers
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | | | - Kerri-Lyn Webb
- Developmental Paediatrics, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Heidi Atkins
- Queensland Child & Youth Clinical Network, Queensland Health, Brisbane, Queensland, Australia
| | - Dana Newcomb
- Integrated Care, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
- The University of Queensland Primary Care Clinical Unit, Herston, Queensland, Australia
| | - Rachael Beswick
- Queensland Child & Youth Clinical Network, Queensland Health, Brisbane, Queensland, Australia
| | - Clare Thomas
- Queensland Child & Youth Clinical Network, Queensland Health, Brisbane, Queensland, Australia
| | - Catherine Marron
- Queensland Child & Youth Clinical Network, Queensland Health, Brisbane, Queensland, Australia
| | - Aaron Chambers
- Integrated Care, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Sue Scheinpflug
- Brisbane South PHN, Upper Mount Gravatt, Queensland, Australia
| | - Matt Statham
- Brisbane South PHN, Upper Mount Gravatt, Queensland, Australia
| | - Dimuthu Samaranayake
- School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Paul Chay
- University of New South Wales, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Chun Wah Michael Tam
- University of New South Wales, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Feroza Khan
- Academic Unit of Infant, Child and Adolescent Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Antonio Mendoza Diaz
- Academic Unit of Infant, Child and Adolescent Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Sara Cibralic
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Teresa Winata
- ICAMHS, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, UNSW, Sydney, New South Wales, Australia
| | - Margo Pritchard
- Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia
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13
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Kohlhoff J, Dadich A, Varghese J, McKenzie A, Ong N, Pritchard M, Tam CWM, Woolfenden S, Blight V, Eastwood J, Garg P, Jalaludin B, Liaw ST, Murphy E, Schmied V, Williams K, Eapen V. Consumer and health professional perceptions of Watch Me Grow – Electronic (WMG-E) platform for developmental surveillance in early childhood: A qualitative study. Aust J Gen Pract 2022; 51:439-445. [DOI: 10.31128/ajgp-06-21-6043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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14
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Kohlhoff J, Cibralic S, Hawes D, Eapen V. Oxytocin receptor gene (OXTR) polymorphisms and social, emotional and behavioral functioning in children and adolescents: a systematic narrative review. Neurosci Biobehav Rev 2022; 135:104573. [PMID: 35149102 DOI: 10.1016/j.neubiorev.2022.104573] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/18/2021] [Revised: 01/28/2022] [Accepted: 02/06/2022] [Indexed: 10/19/2022]
Abstract
This study systematically reviewed available evidence regarding associations between polymorphisms of the oxytocin receptor (OXTR) gene and socio-emotional and behavioral functioning in children and adolescents. The search yielded 69 articles, which were grouped into nine categories: depression, anxiety, and internalizing symptoms, alcohol abuse, borderline personality disorder, conduct disorder symptoms or diagnosis, autism spectrum disorder, Attention deficit hyperactivity disorder, early childhood attachment and behavior, pro-social skills, and resilience. Direct and/or gene x environment interactions were identified in over half of the studies. ASD and conduct disorder (including callous unemotional traits) were the diagnoses that were most studied and for which there was the strongest evidence of direct links with OXTR polymorphisms. In most studies identifying gene x environment interactions, the candidate OXTR polymorphism was rs53576. Results suggest that OXTR polymorphisms are associated with social, emotional or behavioural functioning in children and adolescents. The mixed findings do, however, highlight the need for further research.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney NSW 2052, Australia; Karitane, P.O. Box 241, Villawood NSW 2163, Australia.
| | - Sara Cibralic
- School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney NSW 2052, Australia.
| | - David Hawes
- School of Psychology, Faculty of Science, University of Sydney, Camperdown NSW 2006, Australia.
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney NSW 2052, Australia; Academic Unit of Child Psychiatry and Clinical Academic, South West Sydney Local Health District, Liverpool Hospital, Elizabeth Street, Liverpool NSW 2170, Australia.
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15
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Kohlhoff J, Karlov L, Dadds M, Barnett B, Silove D, Eapen V. The contributions of maternal oxytocin and maternal sensitivity to infant attachment security. Attach Hum Dev 2021; 24:525-540. [PMID: 34963414 DOI: 10.1080/14616734.2021.2018472] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study investigated links between maternal postnatal oxytocin, maternal sensitivity, and infant attachment security. At 3-months postpartum, participants (n=88) took part in a structured parent-infant interaction. Maternal oxytocin levels were assessed via blood, before and after the interaction. At 12-months postpartum, mother-child dyads completed the Strange Situation Procedure. Neither baseline oxytocin, oxytocin response, or maternal sensitivity were identified as significant independent predictors of infant attachment security or organisation. However, an interaction effect was identified, with higher maternal sensitivity being associated with secure infant attachment for mothers who showed an increase in oxytocin during parent-child interaction. Results indicate that maternal sensitivity, when accompanied by an increase in maternal oxytocin during parent-child interaction, is associated with the establishment of a positive early parent-child attachment relationship. This adds to the growing body of evidence highlighting maternal oxytocin response as a key adaptive process in the postpartum period.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Research Department, Karitane, Sydney, Australia.,Ingham Institute for Medical Research, Sydney, Australia
| | - Lisa Karlov
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Mark Dadds
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia.,School of Psychology, University of Sydney, Sydney, Australia
| | - Bryanne Barnett
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Derrick Silove
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Ingham Institute for Medical Research, Sydney, Australia.,Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
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16
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Eapen V, Woolfenden S, Schmied V, Jalaludin B, Lawson K, Liaw ST, Lingam R, Page A, Cibralic S, Winata T, Mendoza Diaz A, Lam-Cassettari C, Burley J, Boydell K, Lin P, Masi A, Katz I, Dadich A, Preddy J, Bruce J, Raman S, Kohlhoff J, Descallar J, Karlov L, Kaplun C, Arora A, Di Mento B, Smead M, Doyle K, Grace R, McClean T, Blight V, Wood A, Raine KH. "Watch Me Grow- Electronic (WMG-E)" surveillance approach to identify and address child development, parental mental health, and psychosocial needs: study protocol. BMC Health Serv Res 2021; 21:1240. [PMID: 34789234 PMCID: PMC8596348 DOI: 10.1186/s12913-021-07243-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/13/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) – developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents’ mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the ‘care-as-usual’ group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and ‘warm hand over’ by a ‘service navigator’ to ensure their needs are met. Methods Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the ‘care-as-usual’ or ‘intervention’ group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. Conclusions Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. Trial registration The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Affiliation(s)
- V Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia. .,South Western Sydney Local Health District, Liverpool, Australia.
| | - S Woolfenden
- Sydney Children's Hospital Randwick, Randwick, Australia
| | - V Schmied
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - B Jalaludin
- South Western Sydney Local Health District, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - K Lawson
- School of Business, Western Sydney University, Sydney, Australia
| | - S T Liaw
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,WHO Collaborating Centre for eHealth, University of New South Wales, Sydney, Australia
| | - R Lingam
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - A Page
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - S Cibralic
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - T Winata
- South Western Sydney Local Health District, Liverpool, Australia
| | - A Mendoza Diaz
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - C Lam-Cassettari
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - J Burley
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - K Boydell
- Black Dog Institute, Sydney, Australia
| | - P Lin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.,South Western Sydney Local Health District, Liverpool, Australia
| | - A Masi
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - I Katz
- Social Policy Research Centre, Faculty of Arts, Design, & Architecture, University of New South Wales, Sydney, Australia
| | - A Dadich
- School of Business, Western Sydney University, Sydney, Australia
| | - J Preddy
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - J Bruce
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - S Raman
- South Western Sydney Local Health District, Liverpool, Australia
| | - J Kohlhoff
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Karitane, Carramar, Australia
| | - J Descallar
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - L Karlov
- South Western Sydney Local Health District, Liverpool, Australia
| | - C Kaplun
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,TeEACH -Transforming early Education and Child Health Research Centre, Western Sydney University, Sydney, Australia
| | - A Arora
- School of Health Sciences, Western Sydney University, Sydney, Australia.,Sydney Local Health District, Camperdown, Australia
| | - B Di Mento
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - M Smead
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - K Doyle
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - R Grace
- TeEACH -Transforming early Education and Child Health Research Centre, Western Sydney University, Sydney, Australia
| | | | - V Blight
- South Western Sydney Local Health District, Liverpool, Australia
| | - A Wood
- Karitane, Carramar, Australia
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17
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Kohlhoff J, Tooke S, Cibralic S, Hickinbotham R, Knox C, Roach V, Barnett B. Antenatal psychosocial assessment and depression screening in an Australian Private Hospital setting: A qualitative examination of women's perspectives. Midwifery 2021; 103:103129. [PMID: 34487949 DOI: 10.1016/j.midw.2021.103129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/11/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Australia, clinical practice guidelines have been developed to support the implementation of antenatal psychosocial assessment and depression screening in routine clinical obstetric care. While there has been widespread uptake of such programs in Australian public hospitals, implementation in private hospitals has been slower. However, the situation in this regard may be changing, with the emergence of examples of midwife delivered screening programs in a number of private hospital settings. At present, patient experiences of these programs are largely unknown. AIM The aim of this study was to gain feedback from women who participated in the 'Pre-admission midwife appointment' program at an Australian private hospital about their experiences of, and perspectives about, the program. METHODS Semi-structured interviews were conducted with 20 women (Mage 36.04 years, range 30-48) who had given birth to a child between 9 and 14 months prior to the interview (M = 11.87 months, SD = 1.76) and who had attended the Pre-admission midwife appointment program during the pregnancy. Interviews were transcribed and analysed using an inductive thematic analysis approach with an essentialist-realistic theoretical framework. FINDINGS Data analysis revealed five major themes: 'increased awareness and support for perinatal mental health issues', 'enhanced quality of care provided at the hospital', 'experience with the midwife impacts perceptions of the program'; 'partners', and 'preparation for the program'. DISCUSSION This study provides useful information from the perspective of consumers, about a psychosocial assessment and depression screening program at an Australian private hospital. It highlights a number of program benefits for pregnant women, their partners, and the hospital, as well as factors facilitating program success.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney Australia; Karitane, Sydney Australia.
| | | | - Sara Cibralic
- School of Psychiatry, University of New South Wales, Sydney Australia
| | | | - C Knox
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists; University of Sydney, Sydney Australia
| | - V Roach
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists
| | - B Barnett
- Gidget Foundation Australia; Australasian Birth Trauma Association
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18
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Kohlhoff J, Cibralic S, Tooke S, Hickinbotham R, Knox C, Roach V, Barnett B. Health professional perspectives on an antenatal mental health screening program in a private hospital. Aust N Z J Obstet Gynaecol 2021; 61:891-897. [PMID: 34121178 DOI: 10.1111/ajo.13394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/28/2020] [Revised: 04/11/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Perinatal mental ill-health is a global health priority. Mental health screening during pregnancy is a routine part of clinical practice in many public hospital obstetric services across Australia, but implementation in the private hospital system has lagged. AIMS This study explored health professionals' perspectives on the Pre-admission Midwife Appointment Program (PMAP), an antenatal mental health screening program at the Mater Hospital, Sydney. MATERIALS AND METHODS Nine midwives and three medical specialists participated in focus groups or individual interviews; key themes were determined using thematic qualitative analysis. RESULTS Five major themes and three sub-themes were identified: immediate benefits to women (identifying women at risk; referrals to support services; supporting and educating women); enhanced overall quality of care at the hospital; the dilemma of partners attending; factors that make the program successful; and recommendations for improvement. CONCLUSIONS Results will inform the implementation of antenatal mental health screening programs at other private hospitals across Australia.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Karitane, Sydney, New South Wales, Australia
| | - Sara Cibralic
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah Tooke
- The Mater Hospital, Sydney, New South Wales, Australia
| | - Rachael Hickinbotham
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | | | - Vijay Roach
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | - Bryanne Barnett
- Gidget Foundation Australia, Sydney, New South Wales, Australia
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19
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Harel D, Levis B, Ishihara M, Levis AW, Vigod SN, Howard LM, Thombs BD, Benedetti A, He C, Krishnan A, Wu Y, Bhandari PM, Neupane D, Negeri Z, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Barnes J, Beck CT, Bindt C, de Figueiredo FP, Fellmeth G, Figueiredo B, Green EP, Helle N, Kettunen PA, Kohlhoff J, Kozinszky Z, Leonardou AA, Nakić Radoš S, Rochat TJ, Smith‐Nielsen J, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Tran TD, Turner K, Væver MS, Vega‐Dienstmaier JM. Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS-Dep-5. Acta Psychiatr Scand 2021; 143:348-362. [PMID: 33354768 DOI: 10.1111/acps.13272] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 01/03/2023]
Abstract
AIMS This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria. METHODS Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID. RESULTS A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). CONCLUSION The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
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Affiliation(s)
- Daphna Harel
- PRIISM Applied Statistics Center, New York University, New York, NY, USA.,Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Miyabi Ishihara
- Department of Statistics, University of California Berkeley, Berkeley, California, USA
| | - Alexander W Levis
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, ON, Canada
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,Department of Psychology, McGill University, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.,Biomedical Ethics Unit, McGill University, Montréal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada
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20
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Kohlhoff J, Cibralic S, Morgan S. A qualitative investigation of consumer experiences of the child directed interaction phase of parent–child interaction therapy with toddlers. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jane Kohlhoff
- University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Villawood, New South Wales, Australia,
| | - Sara Cibralic
- University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Villawood, New South Wales, Australia,
| | - Sue Morgan
- Karitane, Villawood, New South Wales, Australia,
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21
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Lyubenova A, Neupane D, Levis B, Wu Y, Sun Y, He C, Krishnan A, Bhandari PM, Negeri Z, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Ioannidis JPA, Cuijpers P, Gilbody S, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Vigod SN, Aceti F, Barnes J, Bavle AD, Beck CT, Bindt C, Boyce PM, Bunevicius A, Chaudron LH, Favez N, Figueiredo B, Garcia-Esteve L, Giardinelli L, Helle N, Howard LM, Kohlhoff J, Kusminskas L, Kozinszky Z, Lelli L, Leonardou AA, Meuti V, Radoš SN, García PN, Pawlby SJ, Quispel C, Robertson-Blackmore E, Rochat TJ, Sharp DJ, Siu BWM, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Torres-Giménez A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Benedetti A, Thombs BD. Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis. Int J Methods Psychiatr Res 2021; 30:e1860. [PMID: 33089942 PMCID: PMC7992289 DOI: 10.1002/mpr.1860] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/28/2020] [Accepted: 10/13/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. METHODS We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. RESULTS Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%-34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%-11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%-12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: -13.7%, 12.3%). CONCLUSION EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.
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Affiliation(s)
- Anita Lyubenova
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,School of Primary, Centre for Prognosis Research, Community and Social Care, Keele University, Keele, Staffordshire, UK
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Parash M Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada
| | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, California, USA.,Department of Health Research and Policy, Stanford University, Stanford, California, USA.,Department of Biomedical Data Science, Stanford University, Stanford, California, USA.,Department of Statistics, Stanford University, Stanford, California, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Franca Aceti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Amar D Bavle
- Department of Psychiatry, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
| | - Cheryl T Beck
- University of Connecticut School of Nursing, Mansfield, Connecticut, USA
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philip M Boyce
- Discipline of Psychiatry, Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia
| | - Adomas Bunevicius
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Linda H Chaudron
- Departments of Psychiatry, Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Nicolas Favez
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,IUP, University of Lausanne, Lausanne, Switzerland
| | | | - Lluïsa Garcia-Esteve
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Lisa Giardinelli
- Department of Health Sciences, Psychiatry Unit, University of Florence, Firenze, Italy
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Karitane, Carramar, New South Wales, Australia
| | | | - Zoltán Kozinszky
- Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden
| | - Lorenzo Lelli
- Department of Health Sciences, Psychiatry Unit, University of Florence, Firenze, Italy
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Athens, Greece
| | - Valentina Meuti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sandra N Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Purificación N García
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Psychology Service, Regidoria de Polítiques de Gènere, Ajuntament de Terrassa, Terrassa, Spain
| | - Susan J Pawlby
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Chantal Quispel
- Department of Obstetrics and Gynaecology, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands
| | | | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Programme, Human Sciences Research Council, Pretoria, South Africa
| | - Deborah J Sharp
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bonnie W M Siu
- Department of Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland, UK.,Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - S Darius Tandon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Iva Tendais
- School of Psychology, University of Minho, Braga, Portugal
| | | | - Anna Torres-Giménez
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Thach D Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Turner
- Epilepsy Center-Child Neuropsychiatry Unit, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada.,Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
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22
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Fleming GE, Kohlhoff J, Morgan S, Turnell A, Maiuolo M, Kimonis ER. An Effectiveness Open Trial of Internet-Delivered Parent Training for Young Children With Conduct Problems Living in Regional and Rural Australia. Behav Ther 2021; 52:110-123. [PMID: 33483109 DOI: 10.1016/j.beth.2020.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/20/2019] [Revised: 01/13/2020] [Accepted: 03/08/2020] [Indexed: 01/13/2023]
Abstract
There is accumulating evidence for the efficacy of online parent management training (PMT) programs to improve conduct problems in young children, and findings have been used to support the potential of online programs to close the research-to-practice gap in underserved rural settings. However, to date, no study has evaluated the effectiveness of online PMT under real-world conditions; that is, delivered by community practitioners as part of services-as-usual to families residing in rural communities. This has resulted in a critical lack of evidence supporting the capacity of online PMT to ameliorate actual geographical disparities in service accessibility. Accordingly, the current study evaluated effectiveness and engagement outcomes of Internet-delivered Parent-Child Interaction Therapy (I-PCIT) delivered from a community-based early childhood clinic to rural consumers. Participants were 27 mothers and their 1.5- to 4-year-old child with conduct problems (M age = 3.02, SD = 0.73) living in regional and rural New South Wales, Australia. Parent-rated and observed child conduct problems and observed parenting behaviors were assessed pre and post I-PCIT, and treatment attrition, parental satisfaction with treatment, and homework compliance provided indicators of treatment engagement. Results of linear mixed and marginal models indicated that I-PCIT produced significant improvements in parent-reported and observed child conduct problems and observed parenting behaviors, with "small" to "very large" effect sizes (ds = 0.3-1.4). Treatment retention was adequate (63%), and treatment-completing parents reported high treatment satisfaction and good homework compliance. Findings provide preliminary evidence for the real world effectiveness of I-PCIT, supporting its capacity to narrow the research-to-practice gap. Findings suggest a role for I-PCIT in a stepped care model of remote treatment for childhood conduct problems in Australia.
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Affiliation(s)
| | - Jane Kohlhoff
- University of New South Wales; Karitane Toddler Clinic, Karitane, Sydney
| | | | | | | | - Eva R Kimonis
- University of New South Wales; Karitane Toddler Clinic, Karitane, Sydney
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23
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Barbaro J, Masi A, Gilbert M, Nair R, Abdullahi I, Descallar J, Dissanayake C, Eastwood J, Hasan I, Jalaludin B, Karlov L, Khan F, Kohlhoff J, Liaw ST, Lingam R, Mendoza Diaz A, Ong N, Tam CWM, Unwin K, Woolfenden S, Eapen V. A Multistate Trial of an Early Surveillance Program for Autism Within General Practices in Australia. Front Pediatr 2021; 9:640359. [PMID: 33968847 PMCID: PMC8102783 DOI: 10.3389/fped.2021.640359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/11/2020] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The early detection of developmental conditions such as autism is vital to ensure children can access appropriate and timely evidence-based supports, services, and interventions. Children who have undetected developmental conditions early in life are more likely to develop later health, developmental, learning, and behavioral issues, which in turn can have a cumulative effect over the life course. Methods: The current protocol describes a multi-site, cluster randomized control trial comparing a developmental surveillance pathway for autism to usual care, using opportunistic visits to general practitioners (GPs). Units of randomization are GP clinics across two Australian states (New South Wales and Victoria), with thirty clinics within each state, each of which will aim to recruit approximately forty children aged between ~18- and 24-months, for a total of ~2,400 participants. Children will be randomized to two clusters; namely, an autism surveillance pathway (ASP) or surveillance as usual (SaU). The screening process for the ASP arm involves primary and secondary screenings for developmental concerns for autism, using both parent and GP reports and observations. Children in both arms who show signs of developmental concerns for autism will be offered a full developmental assessment by the research team at 24 months of age to determine the efficacy of developmental surveillance in successfully identifying children with autism. Trial Registration: The trial is registered with ANZCTR (ACTRN12619001200178) and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia.,Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Anne Masi
- Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Ifrah Abdullahi
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia.,Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Faculty of Medicine and Health, School of Medicine, University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine, School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Iqbal Hasan
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Lisa Karlov
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Feroza Khan
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jane Kohlhoff
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S T Liaw
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Antonio Mendoza Diaz
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia.,Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Katy Unwin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Sue Woolfenden
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
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24
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Thombs BD, Levis B, Lyubenova A, Neupane D, Negeri Z, Wu Y, Sun Y, He C, Krishnan A, Vigod SN, Bhandari PM, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Barnes J, Beck CT, Bindt C, Figueiredo B, Helle N, Howard LM, Kohlhoff J, Kozinszky Z, Leonardou AA, Radoš SN, Quispel C, Rochat TJ, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Benedetti A. Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis. Can J Psychiatry 2020; 65:835-844. [PMID: 33104415 PMCID: PMC7658422 DOI: 10.1177/0706743720934959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID). METHODS We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 ≥7, pooled SCID major depression prevalence, and the pooled difference in prevalence. RESULTS A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 ≥7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times. CONCLUSIONS Prevalence estimated based on EPDS-5 ≥7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence.
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Affiliation(s)
- Brett D Thombs
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Psychology, 5620McGill University, Montréal, Québec, Canada.,Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada.,Department of Medicine, 5620McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montréal, Québec, Canada.,Biomedical Ethics Unit, 5620McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, United Kingdom
| | - Anita Lyubenova
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Dipika Neupane
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Zelalem Negeri
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Yin Wu
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada
| | - Ying Sun
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Ontario, Canada
| | - Parash Mani Bhandari
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Mahrukh Imran
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Danielle B Rice
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, 5620McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, 5620McGill University, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, 1190Vrije Universiteit Amsterdam, the Netherlands
| | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, 8748University of York, Heslington, York, United Kingdom
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, 10624Stanford University, Stanford, CA, USA
| | - Lorie A Kloda
- Library, 5618Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, 2129University of Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, 2129University of Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, 2129University of Calgary, Alberta, Canada
| | - Ian Shrier
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Family Medicine, 5620McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, 1466Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, 3158University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, 2129University of Calgary, Alberta, Canada
| | - Jacqueline Barnes
- 215826Department of Psychological Sciences, Birkbeck, University of London, United Kingdom
| | | | - Carola Bindt
- Department of Child and Adolescent Psychiatry, 234015University Medical Center Hamburg-Eppendorf, Germany
| | | | - Nadine Helle
- Department of Child and Adolescent Psychiatry, 234015University Medical Center Hamburg-Eppendorf, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, 4616King's College London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jane Kohlhoff
- School of Psychiatry, 7800University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, Australia.,Karitane, Carramar, Australia
| | - Zoltán Kozinszky
- 72227Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Greece
| | | | - Chantal Quispel
- Department of Obstetrics and Gynaecology, 2998Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands
| | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, Faculty of Health Sciences, 37707University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Program, Human Sciences Research Council, South Africa
| | - Alan Stein
- 105611Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, 37707University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Division of Psychiatry, 270079University of Edinburgh, Scotland.,Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - S Darius Tandon
- 12244Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Iva Tendais
- School of Psychology, 219951University of Minho, Portugal
| | | | - Thach D Tran
- School of Public Health and Preventive Medicine, 161667Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, 4616King's College London, United Kingdom
| | - Katherine Turner
- Epilepsy Cter-Child Neuropsychiatry Unit, 444273ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Medicine, 5620McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, 5620McGill University Health Centre, Montréal, Québec, Canada
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25
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Kohlhoff J, Cibralic S, Lennie L, Rabbetts L, Morgan S. Qualitative evaluation of Australian Caregiver's experiences of parent–child interaction therapy delivered in a community‐based clinic setting. Australian Psychologist 2020. [DOI: 10.1111/ap.12431] [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] [Indexed: 11/30/2022]
Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Sydney, New South Wales, Australia,
| | - Sara Cibralic
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Sydney, New South Wales, Australia,
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26
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Kohlhoff J, Wallace N, Morgan S, Maiuolo M, Turnell A. Internet‐delivered parent–child interaction therapy: Two clinical case reports. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia,
- Karitane Toddler Clinic, Karitane, Sydney, New South Wales, Australia,
| | - Nancy Wallace
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia,
- Karitane Toddler Clinic, Karitane, Sydney, New South Wales, Australia,
| | - Susan Morgan
- Karitane Toddler Clinic, Karitane, Sydney, New South Wales, Australia,
| | - Michelle Maiuolo
- Karitane Toddler Clinic, Karitane, Sydney, New South Wales, Australia,
| | - Adrienne Turnell
- Karitane Toddler Clinic, Karitane, Sydney, New South Wales, Australia,
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27
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Cibralic S, Kohlhoff J, Wallace N, McMahon C, Eapen V. Treating Externalizing Behaviors in Toddlers with ASD Traits Using Parent-Child Interaction Therapy for Toddlers: A Case Study. Clin Case Stud 2020. [DOI: 10.1177/1534650120969854] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Up to 27% of children with autism spectrum disorder (ASD) experience clinically significant externalizing behavior. Child emotional dysregulation is thought to be one of the main reasons for the manifestation of externalizing behaviors during toddlerhood and has also been associated with insecure and disorganized parent-child attachment relationships. Parent-Child Interaction Therapy for Toddlers (PCIT-T) is an attachment and behavioral based parent training program targeted at children aged 12 to 24 months with externalizing behavior. This study assessed the effectiveness of PCIT-T in reducing child externalizing behavior as well as improving child emotional regulation and the parent-child attachment relationship in a child with moderate-to-severe ASD traits, low intellectual and adaptive functioning, externalizing behaviors within the clinical range, and a disorganized/insecure mother-child attachment relationship. The intervention occurred over a 12-week period and focused on improving positive parenting skills, parent emotional regulation, and child emotional regulation. Treatment progress was tracked using the Child Behavior Checklist Externalizing Behavior subscale, the Deverux Early Childhood Assessment for Toddlers Attachment/Relationship and Self-Regulation subscales, the Dyadic Parent-Child Interaction Coding System, version 4, and the Strange Situation Procedure. Study results provide preliminary support for the use of PCIT-T in reducing externalizing behavior, improving the parent-child attachment relationship and child emotional regulation. These results indicate that PCIT-T can be beneficial for children with ASD traits, however, further research with a larger sample size is needed to strength these findings.
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Affiliation(s)
- Sara Cibralic
- University of New South Wales, Randwick, NSW, Australia
- Karitane, Carramar, NS, Australia
| | - Jane Kohlhoff
- University of New South Wales, Randwick, NSW, Australia
- Karitane, Carramar, NS, Australia
| | - Nancy Wallace
- University of New South Wales, Randwick, NSW, Australia
- Karitane, Carramar, NS, Australia
| | | | - Valsamma Eapen
- University of New South Wales, Randwick, NSW, Australia
- Liverpool Hospital, Liverpool, NSW, Australia
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28
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Kohlhoff J, Lee S, Cibralic S, Jones P, Khajehei M. Development and validation of the Karitane Family Outcomes Tool. J SPEC PEDIATR NURS 2020; 25:e12295. [PMID: 32445615 DOI: 10.1111/jspn.12295] [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: 01/17/2020] [Revised: 03/26/2020] [Accepted: 05/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to develop the Karitane Family Outcomes Tool (KFOT), a brief parent-report questionnaire to measure outcomes of Australian Early Parenting Centres (EPCs) and similar programmes worldwide. DESIGN AND METHODS The study was conducted in two stages. In Stage One, an initial item pool (80 items) was developed via focus group discussions with clinical experts and parents. In Stage Two, three samples of parents were recruited (online community sample: n = 849, clinical sample 1: n = 141, clinical sample 2: n = 109). The online community sample completed the 80-items and then non-normally distributed items were culled, leaving a total item pool of 57 items. The online community sample was then split into two subsamples (subsample 1: n = 650, subsample 2: n = 199). Exploratory factor analysis (EFA) was then conducted on online community subsample 1 and confirmatory factor analysis (CFA) on online community subsample 2 and clinical sample 1. Using clinical sample 2, concurrent validity was assessed by examining correlations between KFOT factor scores with scores on the Parenting Stress Index. Finally, discriminant validity was assessed by examining the KFOTs sensitivity to change following EPC intervention and by comparing KFOT scores of clinical and community samples. RESULTS EFA revealed 13 items loading onto three factors: "Parental feelings," "Reading cues & meeting the child's needs" and "Perceptions of child behaviour." The factor structure was confirmed using CFA in both the community and clinical samples. Significant differences on all three KFOT factors and on the total score were found between the clinical and community samples, suggesting that the scale is able to discriminate between clinical and nonclinical groups. Significant differences were also found between pre- and postintervention scores, and between pre- and follow-up scores, on all three KFOT factors, providing further indication of discriminant validity. The KFOT factors correlated in the expected direction with scores on the Parenting Stress Index, showing concurrent validity. PRACTICAL IMPLICATIONS Results indicate that the KFOT is a brief, valid and reliable parent-report scale that can be used by nurses to evaluate outcomes of EPC and similar parenting programmes.
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Affiliation(s)
- Jane Kohlhoff
- University of New South Wales, Kensington, New South Wales, Australia.,Karitane, Villawood, New South Wales, Australia
| | - Sally Lee
- Population and Community Health, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - Sara Cibralic
- University of New South Wales, Kensington, New South Wales, Australia.,Karitane, Villawood, New South Wales, Australia
| | - Penny Jones
- Primary and Community Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Marjan Khajehei
- University of New South Wales, Kensington, New South Wales, Australia.,Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
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29
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Kohlhoff J, Cibralic S, Wallace N, Morgan S, McMahon C, Hawkins E, Eapen V, Briggs N, Huber A, McNeil C. A randomized controlled trial comparing parent child interaction therapy - toddler, circle of security- parenting™ and waitlist controls in the treatment of disruptive behaviors for children aged 14-24 months: study protocol. BMC Psychol 2020; 8:93. [PMID: 32867832 PMCID: PMC7457749 DOI: 10.1186/s40359-020-00457-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/05/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Parent Child Interaction Therapy - Toddler is an intervention model designed to meet the specific developmental needs of toddlers aged 12-24 months presenting with disruptive behaviors. METHODS This study will use a randomized controlled design to evaluate the efficacy of the Parent Child Interaction Therapy - Toddler intervention for children aged 14-24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior will be randomly allocated to either Parent Child Interaction Therapy - Toddler, Circle of Security- Parenting™ or a waitlist control group. Key parenting capacity outcome variables will include positive and negative parenting, parenting sensitivity, parental sense of competence in managing negative toddler emotions, parent sense of caregiving helplessness, parent mentalizing about the child, parent emotion regulation, child abuse potential and parental stress. Key outcome variables for children will include child social-emotional functioning (initiative, relationship functioning, self-regulation), child emotion regulation, child attachment security, and child behavior. DISCUSSION Delivered in the early intervention period of toddlerhood, Parent Child Interaction Therapy - Toddler has the potential to bring about significant and lasting changes for children presenting with early onset behavioral issues. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), 12618001554257 . Registered 24 September 2018 - retrospectively registered.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia.
- Karitane, Carramar, NSW, Australia.
- Ingham Institute for Medical Research, Liverpool, NSW, Australia.
| | - Sara Cibralic
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Karitane, Carramar, NSW, Australia
| | - Nancy Wallace
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Karitane, Carramar, NSW, Australia
| | | | | | | | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Ingham Institute for Medical Research, Liverpool, NSW, Australia
- South Western Sydney Local Health District, Liverpool, Australia
| | - Nancy Briggs
- Mark Wainwright Analytical Centre, University of New South Wales, Kensington, NSW, Australia
| | - Anna Huber
- Families In Mind Psychology, Canberra, Australia
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30
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Lam-Cassettari C, Kohlhoff J. Effect of maternal depression on infant-directed speech to prelinguistic infants: Implications for language development. PLoS One 2020; 15:e0236787. [PMID: 32730322 PMCID: PMC7392317 DOI: 10.1371/journal.pone.0236787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 07/14/2020] [Indexed: 01/24/2023] Open
Abstract
The nature and timing of caregivers' speech provides an important foundation for infant attention and language development in the first year of life. Infant-directed speech is a key component of responsive parent-infant communication that is typically characterised by exaggerated intonation and positive affect. This study examines the effect of postnatal depression on the expression of positive vocal affect and pitch, the quantity of mothers' infant-directed speech input and the timing of vocal responses between mother and infant. Postnatal mothers currently experiencing symptoms of depression (n = 13) were matched to postnatal mothers who were not experiencing symptoms of depression (n = 13), and audio-recorded while playing with their 6-month-old infants. Compared with depressed mothers, non-depressed mothers used a higher mean pitch and pitch range, spoke more, gave faster verbal responses and were rated as expressing more positive valence in their voice. These preliminary findings indicate that mothers experiencing low mood use less infant-directed speech and less exaggerated pitch with prelinguistic infants. Postnatal depression is a major health issue that adversely impacts the parent and child. Early interventions for PND may benefit from identifying ways to support the timing of conversations and mothers' use of appropriate vocal pitch and infant-directed speech modifications. Further research is needed to confirm whether these strategies support early conversations.
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Affiliation(s)
- Christa Lam-Cassettari
- Western Sydney University, Sydney, Australia
- MARCS Institute for Brain, Behaviour & Development, Sydney, Australia
| | - Jane Kohlhoff
- Karitane, Carramar, NSW, Australia
- University of New South Wales, Kensington, NSW, Australia
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31
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Bennett E, Simpson W, Fowler C, Munns A, Kohlhoff J. Enhancing access to parenting services using digital technology supported practices. ACTA ACUST UNITED AC 2020. [DOI: 10.33235/ajcfhn.17.1.4-11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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32
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Kohlhoff J, Morgan S, Briggs N, Egan R, Niec L. Parent-Child Interaction Therapy with Toddlers in a community-based setting: Improvements in parenting behavior, emotional availability, child behavior, and attachment. Infant Ment Health J 2020; 41:543-562. [PMID: 32589327 DOI: 10.1002/imhj.21864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Parent-Child Interaction Therapy with Toddlers (PCIT-T) is a new attachment-based parenting intervention designed to meet the needs of children aged 12-24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT-T, Child Directed Interaction-Toddler (CDI-T), 4-months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI-T over an 8-week period at an Australian community-based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post-treatment (Time 2), and 4-month follow-up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent-reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Research Department, Karitane, Sydney, Australia
| | - Susan Morgan
- Research Department, Karitane, Sydney, Australia
| | - Nancy Briggs
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Ryan Egan
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Larissa Niec
- Center for Children, Families, and Communities, Department of Psychology, Central Michigan University, Mount Pleasant, Michigan, USA
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33
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Kohlhoff J, Mahmood D, Kimonis E, Hawes DJ, Morgan S, Egan R, Niec LN, Eapen V. Callous-Unemotional Traits and Disorganized Attachment: Links with Disruptive Behaviors in Toddlers. Child Psychiatry Hum Dev 2020; 51:399-406. [PMID: 31894435 DOI: 10.1007/s10578-019-00951-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/13/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Children with callous-unemotional (CU) traits and children with disorganized attachment patterns are at heightened risk of poor psychological outcomes but little is known about the overlap between these constructs and their unique contributions to conduct problems in early childhood. This study examined associations between CU traits, disorganized attachment, and conduct problem (CP) severity in a sample of clinic-referred toddlers with behavioral problems. Mother-child dyads (n = 56; mean child age 19.50 months) completed parent-report questionnaires, a dyadic play session, and the Strange Situation Procedure to assess child attachment pattern. Significant positive associations were found between CU traits and disorganized attachment, independent of CP severity. CU traits but not disorganized attachment predicted CP severity. Results indicate that among toddlers with clinic-referred disruptive behavior problems, there are clear links between CU traits and attachment disorganization. Of the two constructs, however, CU traits appear to be most salient in the expression of CPs.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, Australia. .,Research Department, Karitane, Sydney, Australia.
| | - Dina Mahmood
- Department of Psychological Medicine, Children's Hospital at Westmead, Sydney Children's Hospital Network, Sydney, Australia
| | - Eva Kimonis
- School of Psychology, University of New South Wales, Sydney, Australia
| | - David J Hawes
- School of Psychology, University of Sydney, Sydney, Australia
| | - Sue Morgan
- Research Department, Karitane, Sydney, Australia
| | - Ryan Egan
- University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - Larissa N Niec
- Center for Children, Families and Communities, Department of Psychology, Central Michigan University, Mt. Pleasant, MI, USA
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute for Medical Research, Sydney, Australia
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Baker J, Kohlhoff J, Onobrakpor SI, Woolfenden S, Smith R, Knebel C, Eapen V. The Acceptability and Effectiveness of Web-Based Developmental Surveillance Programs: Rapid Review. JMIR Mhealth Uhealth 2020; 8:e16085. [PMID: 32324149 PMCID: PMC7206511 DOI: 10.2196/16085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/05/2020] [Accepted: 02/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Web-based developmental surveillance programs may be an innovative solution to improving the early detection of childhood developmental difficulties, especially within disadvantaged populations. Objective This review aimed to identify the acceptability and effectiveness of web-based developmental surveillance programs for children aged 0 to 6 years. Methods A total of 6 databases and gray literature were searched using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses–informed protocol. Data extraction included variables related to health equity. Results In total, 20 studies were identified. Most papers implemented web-based versions of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up screener for autism spectrum disorder or Parent Evaluation of Developmental Status screeners for broad developmental delay. Caregivers and practitioners indicated a preference for web-based screeners, primarily for user-friendliness, improved follow-up accuracy, time, and training efficiencies. Conclusions Although evidence is limited as to the necessity of web- versus face-to-face–based developmental screening, there are clear efficiencies in its use. Trial Registration PROSPERO CRD42019127894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127894
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Affiliation(s)
- Jess Baker
- The University of New South Wales, Liverpool, Australia
| | - Jane Kohlhoff
- The University of New South Wales, Carramarr, Australia
| | | | | | - Rebecca Smith
- South Eastern Sydney Local Health District, Sydney, Australia
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Kohlhoff J, Morgan S, Briggs N, Egan R, Niec L. Parent–Child Interaction Therapy with Toddlers: A Community-based Randomized Controlled Trial with Children Aged 14-24 Months. Journal of Clinical Child & Adolescent Psychology 2020; 50:411-426. [DOI: 10.1080/15374416.2020.1723599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales
- Research Department, Karitane
| | | | - Nancy Briggs
- Mark Wainwright Analytical Centre, University of New South Wales
| | - Ryan Egan
- University of Oklahoma Health Sciences Center, University of Oklahoma
| | - Larissa Niec
- Center for Children, Families, and Communities, Department of Psychology, Central Michigan University
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Kohlhoff J, Cibralic S, Horswood D, Turnell A, Maiuolo M, Morgan S. Feasibility and acceptability of internet-delivered parent-child interaction therapy for rural Australian families: a qualitative investigation. Rural Remote Health 2020; 20:5306. [PMID: 31917594 DOI: 10.22605/rrh5306] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Parent-child interaction therapy (PCIT) is an evidence-based parent management training program for the treatment of childhood disruptive behaviour disorders (DBDs). In Australia, however, due to a lack of services in regional, rural and remote areas, the program is not accessible to all families who might benefit. Preliminary evidence demonstrates that telehealth technologies can be leveraged to deliver PCIT via internet (I-PCIT) to urban families. It is not known, however, to what extent I-PCIT is acceptable and effective for regional and remote families, who are traditionally underserved and face a range of stressors unique to living outside major cities. The present study represents the first qualitative investigation into the experience of I-PCIT for rural or regional Australian families. METHODS Qualitative interviews were conducted with 10 parents who were living in regional, rural and remote areas of New South Wales (NSW), Australia, and who were referred to an I-PCIT program for treatment of DBD in a child aged 2-4 years. RESULTS Thematic analysis yielded two pre-treatment themes: motivation for seeking treatment and barriers to previous service access. Three overarching themes were identified in post-treatment interviews: positive outcomes, valuable program components and challenges and acceptability of internet delivery. Results demonstrate that consumers from regional, rural and remote NSW view I-PCIT as an acceptable and effective treatment of childhood DBD, bolstering preliminary evidence about the utility of internet technologies to deliver the high-quality results of PCIT. While internet connection issues were a hindrance to treatment for some participants, all parents reported meaningful positive outcomes for both child and parents. CONCLUSION The study highlights that I-PCIT effectively expands the reach of mental health services to Australian communities that previously could not access clinic-based parenting services.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, NSW 2051, Australia; and Karitane, PO Box 241, Villawood, NSW 2163, Australia
| | - Sara Cibralic
- School of Psychiatry, University of New South Wales, Sydney, NSW 2051, Australia
| | | | | | - Michelle Maiuolo
- Western Sydney Local Health District, North Parramatta, NSW 2151, Australia
| | - Susan Morgan
- Karitane, PO Box 241, Villawood, NSW 2163, Australia
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Levis B, McMillan D, Sun Y, He C, Rice DB, Krishnan A, Wu Y, Azar M, Sanchez TA, Chiovitti MJ, Bhandari PM, Neupane D, Saadat N, Riehm KE, Imran M, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Vigod SN, Aceti F, Alvarado R, Alvarado-Esquivel C, Bakare MO, Barnes J, Beck CT, Bindt C, Boyce PM, Bunevicius A, Couto TCE, Chaudron LH, Correa H, de Figueiredo FP, Eapen V, Fernandes M, Figueiredo B, Fisher JRW, Garcia-Esteve L, Giardinelli L, Helle N, Howard LM, Khalifa DS, Kohlhoff J, Kusminskas L, Kozinszky Z, Lelli L, Leonardou AA, Lewis BA, Maes M, Meuti V, Nakić Radoš S, Navarro García P, Nishi D, Okitundu Luwa E-Andjafono D, Robertson-Blackmore E, Rochat TJ, Rowe HJ, Siu BWM, Skalkidou A, Stein A, Stewart RC, Su KP, Sundström-Poromaa I, Tadinac M, Tandon SD, Tendais I, Thiagayson P, Töreki A, Torres-Giménez A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Wynter K, Yonkers KA, Benedetti A, Thombs BD. Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta-analysis. Int J Methods Psychiatr Res 2019; 28:e1803. [PMID: 31568624 PMCID: PMC7027670 DOI: 10.1002/mpr.1803] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/05/2019] [Accepted: 08/16/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum. METHODS Data accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics. RESULTS Among fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased. CONCLUSION Different interviews may not classify major depression equivalently.
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Affiliation(s)
- Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, York, UK
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Tatiana A Sanchez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, York, UK
| | - John P A Ioannidis
- Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Franca Aceti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Rubén Alvarado
- Escuela de Salud Pública Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cosme Alvarado-Esquivel
- Laboratorio de Investigación Biomédica, Facultad de Medicina y Nutrición, Avenida Universidad, Durango, Mexico
| | - Muideen O Bakare
- Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu, Nigeria.,Childhood Neuropsychiatric Disorders Initiatives, Enugu, Nigeria
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck, University of London, Bloomsbury London, UK
| | | | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philip M Boyce
- Discipline of Psychiatry, Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia
| | - Adomas Bunevicius
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tiago Castro E Couto
- School of Medicine, Universidade Federal De Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Linda H Chaudron
- Departments of Psychiatry, Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Humberto Correa
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Sydney South West Local Health District, Liverpool, New South Wales, Australia
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University of Southampton and Southampton Children's Hospital, Southampton, UK.,The Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | | | - Jane R W Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lluïsa Garcia-Esteve
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Generalitat de Catalunya, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Lisa Giardinelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Dina Sami Khalifa
- Faculty of Health Sciences, Ahfad University for Women, Omdurman, Sudan.,Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,The Center for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Karitane, Carramar, New South Wales, Australia
| | | | - Zoltán Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
| | - Lorenzo Lelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Athens, Greece
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Impact Strategic Research Center, Deakin University, Geelong, Victoria, Australia
| | - Valentina Meuti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Purificación Navarro García
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Psychology Service, Regidoria de Polítiques de Gènere, Ajuntament de Terrassa, Terrassa, Spain
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daniel Okitundu Luwa E-Andjafono
- Unité de Neuropsychologie, Département de Neurologie, Centre Neuro-psycho-pathologique, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Programme, Human Sciences Research Council, Johannesburg, South Africa
| | - Heather J Rowe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bonnie W M Siu
- Department of Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alan Stein
- Department of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Department of Mental Health, College of Medicine, University of Malawi, Zomba, Malawi.,Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan.,Mind-Body Interface Laboratory and Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | | | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - S Darius Tandon
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Iva Tendais
- School of Psychology, University of Minho, Braga, Portugal
| | - Pavaani Thiagayson
- Institute of Mental Health, Hougang, Singapore.,KK Women's and Children's Hospital, Kallang, Singapore.,National Healthcare Group, Singapore
| | | | - Anna Torres-Giménez
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Generalitat de Catalunya, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Thach D Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Turner
- Epilepsy Center-Child Neuropsychiatry Unit, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Karen Wynter
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Kimberly A Yonkers
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.,School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
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Baker JR, Raman S, Kohlhoff J, George A, Kaplun C, Dadich A, Best CT, Arora A, Zwi K, Schmied V, Eapen V. Optimising refugee children's health/wellbeing in preparation for primary and secondary school: a qualitative inquiry. BMC Public Health 2019; 19:812. [PMID: 31242897 PMCID: PMC6595577 DOI: 10.1186/s12889-019-7183-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 01/30/2019] [Accepted: 06/16/2019] [Indexed: 01/27/2023] Open
Abstract
Background Children from refugee backgrounds are less likely to access appropriate health and social care than non-refugee children. Our aim was to identify refugee children’s health/wellbeing strengths and needs, and the barriers and enablers to accessing services while preparing for primary and secondary school, in a low socio-economic multicultural community in Australia. Method Ten focus groups were facilitated with Arabic-speaking refugee parents of children aged 2–5 years (n = 11) or in first year secondary school (n = 22); refugee adolescents starting high school (n = 16); and key service providers to refugee families (n = 27). Vignettes about a healthy child and a child with difficulties guided the discussions. Data was thematically analysed and feedback sought from the community via the World Café method. Results Personal resilience and strong family systems were identified as strengths. Mental health was identified as a complex primary need; and whilst refugees were aware of available services, there were issues in knowing how to access them. Opportunities for play/socialisation were recognised as unmet adolescent needs. Adults spoke of a need to support integration of “old” and “new” cultural values. Parents identified community as facilitating health knowledge transfer for new arrivals; whilst stakeholders saw this as a barrier when systems change. Most parents had not heard of early childhood services, and reported difficulty accessing child healthcare. Preschooler parents identified the family “GP” as the main source of health support; whilst parents of adolescents valued their child’s school. Health communication in written (not spoken) English was a significant roadblock. Differences in refugee family and service provider perceptions were also evident. Conclusions Refugee families face challenges to accessing services, but also have strengths that enable them to optimise their children’s wellbeing. Culturally-tailored models of care embedded within GP services and school systems may assist improved healthcare for refugee families. Electronic supplementary material The online version of this article (10.1186/s12889-019-7183-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jess R Baker
- the University of New South Wales, Liverpool Hospital Mental Health Centre Level 1, Liverpool, NSW, 2170, Australia.
| | - Shanti Raman
- South Western Sydney Local Health District, Health Services Building Level 3, Cnr Campbell & Goulburn St, Liverpool, NSW, 2170, Australia
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick, NSW, 2031, Australia.,Karitane, 138-150 The Horsley Dr, Carramar, NSW, 2163, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,University of Sydney, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
| | - Catherine Kaplun
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, 2751, Australia
| | - Catherine T Best
- Western Sydney University, The MARCS Institute, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Science and Health, Penrith, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.,Oral Health Service, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
| | - Karen Zwi
- Sydney Children's Hospital, Corner Avoca and Barker Street, Randwick, NSW, 2031, Australia
| | - Virginia Schmied
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry South West Sydney (AUCS), University of New South Wales & Ingham Institute, Elizabeth Street, Liverpool, Sydney, 2170, Australia.,Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, 2170, Australia
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Brunton R, Dryer R, Saliba A, Kohlhoff J. Re-examining pregnancy-related anxiety: A replication study. Women Birth 2019; 32:e131-e137. [DOI: 10.1016/j.wombi.2018.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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Brunton RJ, Dryer R, Krägeloh C, Saliba A, Kohlhoff J, Medvedev O. The pregnancy-related anxiety scale: A validity examination using Rasch analysis. J Affect Disord 2018; 236:127-135. [PMID: 29730512 DOI: 10.1016/j.jad.2018.04.116] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 11/21/2017] [Revised: 03/21/2018] [Accepted: 04/08/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pregnancy-related anxiety is increasingly recognised as a common condition that is associated with many deleterious outcomes for both the mother and infant (e.g., preterm birth, postnatal depression). Limitations in the psychometric properties and/or breadth of existing scales for pregnancy-related anxiety highlight the need for a psychometrically sound measure to facilitate effective screening and possible early interventions. The recently developed Pregnancy-related Anxiety Scale (PrAS) was evaluated using Rasch analysis to explore how the scale's psychometric properties could be fine-tuned. METHOD A sample of 497 pregnant women completed the PrAS. Data were subjected to Rasch analysis, and the resulting scale structure examined using Confirmatory Factor Analysis. RESULTS After minor modifications, the Rasch model with 33-items and 8-factors demonstrated good fit, unidimensionality and excellent targeting and internal consistency. Confirmatory Factor Analysis confirmed the final structure, and Cronbach's alpha demonstrated excellent reliability. LIMITATIONS The use of the same sample for all analyses was a potential limitation due to the possibility of sample-specific influences. CONCLUSIONS The Rasch analysis further supports the internal construct validity of the PrAS. Ordinal to interval score conversions provide added precision to the analysis of the PrAS scores. The Rasch results, together with previous validation evidence, point to the PrAS as a comprehensive and psychometrically sound screening scale for pregnancy-related anxiety. The PrAS offers clinicians the ability to screen for pregnancy-related anxiety. The subscales provide additional insights into a woman's pregnancy-related anxiety and her specific areas of concern, enabling more targeted interventions.
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Affiliation(s)
- Robyn J Brunton
- Charles Sturt University, School of Psychology, Bathurst NSW 2795, Australia.
| | - Rachel Dryer
- Charles Sturt University, School of Psychology, Bathurst NSW 2795, Australia
| | - Chris Krägeloh
- Auckland University Technology, Department of Psychology, School of Public Health and Psychosocial Studies Faculty of Health and Environmental Studies, New Zealand
| | - Anthony Saliba
- Charles Sturt University, School of Psychology, Bathurst NSW 2795, Australia
| | - Jane Kohlhoff
- University of New South Wales, School of Psychiatry, Randwick NSW, 2031, Australia; Karitane, Po Box 241 Villawood NSW 2163, Australia
| | - Oleg Medvedev
- The University of Auckland, School of Medicine, Auckland, New Zealand
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McMahon C, Huber A, Kohlhoff J, Camberis AL. DOES TRAINING IN THE CIRCLE OF SECURITY FRAMEWORK INCREASE RELATIONAL UNDERSTANDING IN INFANT/CHILD AND FAMILY WORKERS? Infant Ment Health J 2017; 38:658-668. [PMID: 28834602 DOI: 10.1002/imhj.21661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article evaluated whether attendance at Circle of Security training workshops resulted in attendees showing greater empathy and attachment-related knowledge and understanding, and fewer judgmental responses to viewing a stressful parent-child interaction. Participants were 202 practitioners who attended and completed a 2-day (n = 70), 4-day (n = 105), or 10-day (n = 27) COS training workshop in Australia or New Zealand in 2015. In a pre/post design, participant reactions to a video clip of a challenging parent-child interaction were coded for empathic, judgmental, or attachment-focused language. Attachment understanding was coded in response to questions about the greatest challenge that the dyad faced. In all training conditions, participants provided significantly more attachment-focused descriptors and showed significantly greater attachment understanding after training, but significantly fewer empathic descriptors. While participants at the longer workshops provided significantly fewer judgmental/critical descriptors, there was no change for those attending the 2-day workshop. Irrespective of workshop duration or professional background, participants took a more relational perspective on the vignette after the training workshops. More detailed research is required to establish the extent to which this increased knowledge and understanding is retained and integrated into infant mental health practice with parents and young children.
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Affiliation(s)
| | | | - Jane Kohlhoff
- University of New South Wales, Sydney, and Karitane, New SouthWales
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Ogbo FA, Eastwood J, Page A, Arora A, McKenzie A, Jalaludin B, Tennant E, Miller E, Kohlhoff J, Noble J, Chaves K, Jones JM, Smoleniec J, Chay P, Smith B, Oei JL, Short K, Collie L, Kemp L, Raman S, Woolfenden S, Clark T, Blight V, Eapen V. Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia. Int Breastfeed J 2017; 12:16. [PMID: 28405212 PMCID: PMC5385049 DOI: 10.1186/s13006-017-0110-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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: 02/02/2017] [Accepted: 03/27/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia. METHODS The study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother's breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1-4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors. RESULTS Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20-39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9-3.8, P <0.001 and AOR = 2.5, 95%CI 2.1-3.0, P <0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period. CONCLUSIONS Our findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.
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Affiliation(s)
- Felix A. Ogbo
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, NSW Australia
- Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, NSW Australia
- School of Public Health, Griffith University, Gold Coast, QLD Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
- Sydney Children’s Hospital Network, Randwick, NSW Australia
| | - Andrew Page
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
| | - Anne McKenzie
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Healthy People and Places Unit, South Western Sydney Local Health, Liverpool, NSW Australia
| | - Elaine Tennant
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Erin Miller
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Jane Kohlhoff
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Psychiatry, UNSW Medicine, University of New South Wales, Randwick, NSW Australia
| | - Justine Noble
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Karina Chaves
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Jennifer M. Jones
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - John Smoleniec
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Women and Child Health, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia
| | - Paul Chay
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Peadiatrics and Neonatology, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia
| | - Bronwyn Smith
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Ju-Lee Oei
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Newborn Care, Royal Hospital for Women, Randwick, NSW Australia
| | - Kate Short
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Laura Collie
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Lynn Kemp
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Translational Research and Social Innovation, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW Australia
| | - Shanti Raman
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Community Paediatrician for Child Protection, South Western Sydney Local Health District, Liverpool, NSW Australia
- Maari Ma Health Aboriginal Corporation, Broken Hill, NSW Australia
| | - Sue Woolfenden
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, NSW Australia
- Department of Community Child Health/Integrated Care, Sydney Children’s Hospital Network, High Street, Randwick, NSW 2031 Australia
| | - Trish Clark
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Victoria Blight
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Valsamma Eapen
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, Liverpool Hospital, Liverpool, NSW Australia
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Rollans M, Kohlhoff J, Meade T, Kemp L, Schmied V. PARTNER INVOLVEMENT: NEGOTIATING THE PRESENCE OF PARTNERS IN PSYCHOSOCIAL ASSESSMENT AS CONDUCTED BY MIDWIVES AND CHILD AND FAMILY HEALTH NURSES. Infant Ment Health J 2016; 37:302-12. [PMID: 27111339 DOI: 10.1002/imhj.21562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 06/22/2015] [Revised: 12/22/2015] [Accepted: 01/30/2016] [Indexed: 11/10/2022]
Abstract
Universal screening for maternal depression and assessment of psychosocial risks has been integrated into the routine perinatal care provided in many Australian hospitals, but to date, partners/fathers have been largely excluded from the process. This study explored the ways in which clinicians in health service settings include partners who attend antenatal and postnatal visits with women. Qualitative data were collected using observations (n = 54), interviews (n = 60), and discussion groups (n = 7) with midwives and child and family health nurses who conducted the appointments. Transcripts from observations, interviews, and discussion groups underwent qualitative analysis, and key themes were identified. Results showed partners to have little or no involvement in psychosocial assessment and depression screening. Thematic analysis revealed four key themes: negotiating partner exclusion, partial inclusion, women's business or a couple concern? and they know anyway. Partner involvement appeared to be challenged particularly by mandatory interpersonal violence screening, which, according to health service policy, is to be conducted confidentially. Overall, results highlighted partner involvement in perinatal depression screening and psychosocial assessment processes and identified some of the benefits such as partner disclosure, but also the challenges and complexities of inclusion of partners. Clinical implications and directions for further education and research are discussed.
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Abstract
Extensive research has shown that callous-unemotional (CU) traits in middle-childhood and adolescence are markers for a particularly severe and chronic pattern of antisocial behavior (Frick et al. in Psychol Bull 140:1-57, 2014). Comparatively little, however, is known about the relationship between CU traits and antisocial behavior in early childhood. A meta-analysis of k = 10 studies comprising n = 5731 participants was conducted to examine the relationship between CU traits and conduct problem severity prior to 5 years of age. Overall, a significant positive relationship was found between CU traits and conduct problem severity, in the order of large effect size (r = .39, p < .001). Moderator analyses revealed that this relationship differed based on use of same versus different informant across measures, but was consistent across sex and sample type (at-risk/clinic referred or community). This supports the view that CU traits represent a potentially informative focus for clinical assessment in early childhood.
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Affiliation(s)
- Thea Longman
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - David J Hawes
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Jane Kohlhoff
- Karitane, Sydney South West Area Health Service, PO Box 241, Villawood, NSW, 2163, Australia
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Dahlen HG, Barnett B, Kohlhoff J, Drum ME, Munoz AM, Thornton C. Obstetric and psychosocial risk factors for Australian-born and non-Australian born women and associated pregnancy and birth outcomes: a population based cohort study. BMC Pregnancy Childbirth 2015; 15:292. [PMID: 26552427 PMCID: PMC4640409 DOI: 10.1186/s12884-015-0681-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 10/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One in four Australians is born overseas and 47% are either born overseas or have a parent who was. Obstetric and psychosocial risk factors for these women may differ. METHOD Data from one Sydney hospital (2012-2013) of all births recorded in the ObstetriX database were analysed (n = 3,092). Demographics, obstetric and psychosocial risk profile, obstetric interventions and complications and selected maternal and neonatal outcomes were examined for women born in Australia and overseas. RESULTS Women born in Australia were younger, more likely to be primiparous (28.6 v 27.5%), be obese (32.0% v 21.4%), smoke (19.7 % v 3.0%), have an epidural (26.2% v 20.2%) and were less likely to have gestational diabetes mellitus (GDM) (6.8% v 13.7% when compared to non-Australian born women. The highest rates of GDM, Gestational Hypertension (GH) and maternal anaemia were seen in women born in China, the Philippines and Pakistan respectively. Differences were also seen in psychosocial screening between Australian and non-Australian women with Australian-born women more likely to smoke and report a mental health disorder. There was an association between having an Edinburgh Postnatal Depression Scale (EPDS) ≥ 13 and other psychosocial issues, such as thoughts of self-harm, domestic violence, childhood abuse etc. These women were also less likely to breastfeed. Women with an EPDS ≥ 13 at booking compared to women with EPDS ≤12 had a higher chance of being diagnosed with GDM (AOR 1.85 95% CI 1.14-3.0). CONCLUSIONS There are significant differences in obstetric and psychosocial risk profiles and maternal and neonatal outcomes between Australian-born and non-Australian born women. In particular there appears to be an association between an EPDS of ≥13 and developing GDM, which warrants further investigation.
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Affiliation(s)
- Hannah Grace Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Bryanne Barnett
- School of Psychiatry, Clinical Director, St John of God Raphael Centre, Medicine, University of New South Wales, 36-38 First Avenue, Blacktown, NSW, 2148, Australia. .,St John of God Raphael Centre Blacktown, 36-38 First Ave, Blacktown, 2148, NSW, Australia.
| | - Jane Kohlhoff
- St John of God Raphael Centre Blacktown, 36-38 First Ave, Blacktown, 2148, NSW, Australia. .,Karitane, P.O. Box 241, Villawood, 2163 NSW, Australia.
| | - Maya Elizabeth Drum
- St John of God Raphael Centre Blacktown, 36-38 First Ave, Blacktown, 2148, NSW, Australia.
| | - Ana Maria Munoz
- Clinical Midwifery Consultant, Blacktown Hospital, Blacktown, Australia.
| | - Charlene Thornton
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Kohlhoff J, Hickinbotham R, Knox C, Roach V, Barnett Am B. Antenatal psychosocial assessment and depression screening in a private hospital. Aust N Z J Obstet Gynaecol 2015; 56:173-8. [PMID: 26515785 DOI: 10.1111/ajo.12418] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/21/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND It has been recommended that psychosocial assessment (including depression screening) be integrated into routine antenatal care across Australia, but implementation in the private sector has lagged. AIMS This study aimed to report preliminary outcomes associated with an antenatal psychosocial assessment and depression screening program implemented at an Australian private obstetric hospital setting and to report characteristics and correlates of elevated depression symptoms in this sample. MATERIALS AND METHODS A total of 993 pregnant women (mean ± SD gestational age 27.9 ± 6.7 weeks) participated in a structured psychosocial assessment interview and completed the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Six per cent of participants scored ≥13 on the EPDS. Psychosocial correlates of antenatal depressive symptoms included low income, history of pregnancy termination, poor practical support, lack of confidence and history of depression. Almost 1 in 10 of the total sample was referred for further assessment and clinical support. CONCLUSIONS The prevalence of clinically significant antenatal depressive symptoms in this sample highlights the importance of antenatal depression screening for all women, including those who choose to access private obstetric care.
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Affiliation(s)
- Jane Kohlhoff
- Clinical Psychologist & Research Coordinator, Karitane, Villawood, New South Wales, Australia
| | | | - Catherine Knox
- Gidget Foundation, North Sydney, New South Wales, Australia
| | - Vijay Roach
- North Shore Private Hospital, St Leonards, New South Wales, Australia
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Kohlhoff J, Barnett B, Eapen V. Adult separation anxiety and unsettled infant behavior: Associations with adverse parenting during childhood and insecure adult attachment. Compr Psychiatry 2015; 61:1-9. [PMID: 26094158 DOI: 10.1016/j.comppsych.2015.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/05/2015] [Accepted: 05/08/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study examined the prevalence and correlates of Adult Separation Anxiety Disorder (ASAD) and Adult Separation Anxiety (ASA) symptoms in a sample of first-time mothers with an unsettled infant during the first postpartum year. METHODS Eighty-three primiparous women admitted to a residential parent-infant program participated in a structured clinical interview for DSM-IV diagnosis and questionnaires assessing ASA symptoms, adult attachment and childhood parenting experiences. Nurses recorded infant behavior using 24-hour charts. RESULTS The prevalence of ASAD in this sample was 19.3% and women with ASAD were, on average, more likely to be diagnosed with depression and anxiety disorders, report aversive parenting experiences during childhood and show adult attachment style insecurity. Both ASAD and ASA symptoms were predicted by adult attachment anxiety, and ASAD was associated with unsettled infant behavior. Attachment anxiety and attachment avoidance mediated relations between parental over-control and ASAD diagnosis, and between parental abuse and ASAD diagnosis. Attachment anxiety mediated the relation between parental over-control and ASA symptoms, and attachment avoidance mediated the relations of parental over-control and parental abuse with ASA symptoms. CONCLUSIONS This study highlights the prevalence of ASAD among first time mothers experiencing early parenting difficulties and the roles of childhood parenting experiences and adult attachment style in the development of the disorder. This points to the importance of introducing universal screening for ASAD in postnatal settings, and for the development of targeted interventions.
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Affiliation(s)
- Jane Kohlhoff
- Karitane, PO Box 241, Villawood, NSW, 2163, Australia.
| | - Bryanne Barnett
- St John of God Raphael Services, 36-38 First Avenue, Blacktown, NSW, 2148, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Mental Health Centre, L1 Liverpool Hospital, Elizabeth Street, Liverpool, NSW, 2170, Australia; School of Psychiatry & Ingham Institute, University of New South Wales
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Brunton RJ, Dryer R, Saliba A, Kohlhoff J. Pregnancy anxiety: A systematic review of current scales. J Affect Disord 2015; 176:24-34. [PMID: 25687280 DOI: 10.1016/j.jad.2015.01.039] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [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: 07/26/2014] [Revised: 01/14/2015] [Accepted: 01/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depression in pregnancy is a serious health issue; however, anxiety in pregnancy, with a reported higher prevalence, may also be a serious issue. Anxiety symptoms in pregnancy can relate to several anxiety types, such as general anxiety, anxiety disorders, and pregnancy-related anxiety (PrA), anxiety characterised by pregnancy specific fears and worries. Awareness of these distinctions however, is not always widespread. Both general anxiety and PrA are associated with maternal negative outcomes (e.g. increased nausea) however; PrA is more often associated with negative outcomes for the child (e.g. preterm birth). Furthermore, PrA is potentially a risk factor for postnatal depression with assessment of PrA potentially affording important intervention opportunities. Currently several different instruments are used for PrA however their psychometric properties are unclear. To our knowledge a review of current instruments and their psychometric properties is lacking, this paper aims to fill that gap. METHODS Studies, which assessed PrA, published between 1983 and 2013 in peer-reviewed journals, were identified. RESULTS Sixty studies were identified after applying inclusion/exclusion criteria, and classified as: pregnancy-related anxiety specific, scales for other constructs, sub scales of another instrument and general anxiety scales. Each scale's strengths and limitations were discussed. LIMITATIONS Our findings may be limited by restricting our review to peer-reviewed journals. This was done however as we sought to identify scales with good psychometric properties. CONCLUSIONS Currently no scales are available for pregnancy-related anxiety with sound theoretical and psychometric properties. Clinically the need for such a scale is highlighted by the potential intervention opportunities this may afford. Future research should be directed towards the development of such a scale.
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Affiliation(s)
- Robyn J Brunton
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia.
| | - Rachel Dryer
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Anthony Saliba
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia
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Eapen V, Dadds M, Barnett B, Kohlhoff J, Khan F, Radom N, Silove DM. Separation anxiety, attachment and inter-personal representations: disentangling the role of oxytocin in the perinatal period. PLoS One 2014; 9:e107745. [PMID: 25229827 PMCID: PMC4168132 DOI: 10.1371/journal.pone.0107745] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 08/22/2014] [Indexed: 11/20/2022] Open
Abstract
In this paper, we aimed to assess cross-sectionally and longitudinally associations between disturbances in maternal early attachment experiences, symptoms of separation anxiety and depression and oxytocin plasma levels. We examined a mediational model that tested the hypothesis that anxious attachment style arising from the mothers’ early bonding experiences with her own parents was associated with high levels of separation anxiety which, via its impact on depression, was associated with reduced levels of oxytocin in the postnatal period. Data is reported on a structured sample of 127 women recruited during pregnancy from a general hospital antenatal clinic and an initial follow up cohort of 57 women who were re-assessed at 3-months post-partum. We found an association between lower oxytocin level in the post partum period and symptoms of separation anxiety and depression during pregnancy, as well as maternal negative interpersonal representations, upbringing attributes and anxious attachment style. Further meditational analysis revealed that the unique association between anxious attachment and depression is mediated by separation anxiety and that depressed mood mediated the relationship between separation anxiety and oxytocin. In conjunction with evidence from the literature suggesting that lower oxytocin level is associated with bonding difficulties, our findings have significant implications for understanding the biological processes underpinning adverse attachment experiences, negative affect state, and mother-to-infant bonding difficulties.
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Affiliation(s)
- Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool, New South Wales, Australia
- * E-mail:
| | - Mark Dadds
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Bryanne Barnett
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Karitane, Villawood, New South Wales, Australia
| | | | - Feroza Khan
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Naomi Radom
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Derrick M. Silove
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Population Mental Health Research, Psychiatry Research and Teaching Unit, South West Sydney Local Health District, Liverpool, New South Wales, Australia
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Mence M, Hawes DJ, Wedgwood L, Morgan S, Barnett B, Kohlhoff J, Hunt C. Emotional flooding and hostile discipline in the families of toddlers with disruptive behavior problems. J Fam Psychol 2014; 28:12-21. [PMID: 24392687 DOI: 10.1037/a0035352] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined the relationship between negative parenting practices and dysfunction in parents' cognitive processing of child affect cues in families of toddlers with disruptive behavior problems. This dysfunction comprised a bias toward the misclassification of child affect as anger (affect appraisal bias) and parents' proneness to emotional flooding (Gottman, 1991, 1993). Participants were families of toddlers (n = 82; 53% male; aged 18-48 months) referred to a tertiary-level health service for the treatment of disruptive behavior problems. Affect appraisal bias was indexed in terms of the discrepancy between rates of child anger coded from video recordings of parent-child interactions and rates of child anger estimated by parents immediately after these interactions. Parenting practices and emotional flooding were assessed using the Parenting Scale and the Parental Flooding Scale. Both hostile and overreactive discipline were positively associated with severity of disruptive behavior problems, however only hostile discipline was associated with the biased appraisal of child affect and emotional flooding. Emotional flooding was found to be a unique predictor of hostile discipline, independent of covariates including the severity of disruptive behavior problems. Variance in hostile discipline was further explained by the interaction between emotional flooding and affect appraisal bias. Emotional flooding appears to be particularly proximal to hostile discipline in the families of toddlers with disruptive behavior problems, consistent with evidence previously reported for nonclinical families.
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