Journal of Reproductive and Infant Psychology最新文献

Aims/background: Social factors are increasingly recognised as influential on antenatal physical activity. While pregnant women describe the people and support they require to remain physically active, little is known about how pregnant women select and make sense of their social experiences throughout pregnancy. This study followed pregnant women's sense-making of their physical activity-related social experiences as pregnancy progressed, and physical activity declined.

Design/methods: This study used a qualitative design. Four pregnant women were recruited in their second trimester, participated in three individual semi-structured interviews and submitted diary entries throughout trimesters two and three. Data were analysed using longitudinal interpretative phenomenological analysis.

Results: To facilitate physical activity, pregnant women were 'searching for the "like-minded" people who motivate, share and understand', namely pregnant women and prenatally trained exercise professionals. When making sense of social experiences, pregnant women were 'grading and critiquing the quality and paucity of "active pregnancy" information', and'cherry-picking social experiences necessary for "nesting", obtaining support and protecting self-esteem as physical activity declined'. This involved disengaging from social experiences, and consequently, some pregnant women found themselves 'lamenting interactions with the "like-minded" people, contending with grief and inner conflict'.

Conclusion: Pregnant women proactively seek and make sense of social experiences to facilitate physical activity. In an increasingly digitalised society, interventions should support pregnant women to utilise social media constructively and safely to access 'like-minded' people, provide in-person and virtual networks to meet individual support needs throughout pregnancy and encourage health professionals to demonstrate interest in the 'active pregnancy' to maximise influence.

Background and aim: PTSD after childbirth is a significant but often under-recognised mental health problem. This systematic review aims to examine the measures used to assess childbirth-related PTSD (CB-PTSD) and posttraumatic stress symptoms (CB-PTSS) in mothers in the first year postpartum and to evaluate their psychometric properties.

Methods: Following PRISMA guidelines, a comprehensive search of multiple databases and grey literature sources was conducted. Studies that involved mothers in the first year postpartum and reported measures of CB-PTSD and/or CB-PTSS were included. Quality assessment was based on the CASP Checklist.

Results: 149 studies met the inclusion criteria. Self-report questionnaires, particularly the IES and its revisions, were the most commonly used measurement instruments. In recent years, however, specialised instruments such as the City Birth Trauma Scale have emerged that were developed specifically for assessing CB-PTSD. Psychometric properties varied from study to study, with some lacking detailed information on validity and reliability.

Conclusion: The results emphasises the importance of using validated and tailored tools for the assessment of CB-PTSD. Whilst self-report questionnaires remain widely used, the development and use of specialised instruments such as the City BiTS provide greater precision in the assessment of CB-PTSD symptoms. Future research should focus on refining measurement tools, conducting longitudinal studies to explore symptom trajectories, and investigating the effectiveness of early intervention strategies. By refining measurement methods and intervention approaches, clinicians can better support mothers with CB-PTSD and ultimately fostering improve the mental health outcomes for both mothers and their families.

Background: Although the association between a history of infertility treatment and perinatal depression has been investigated, most research has been cross-sectional and has not used diagnostic assessment tools.

Aims: This study investigates longitudinally the association between a history of infertility treatment and perinatal depression using WHO-Composite International Diagnostic Interview 3.0 (WHO-CIDI 3.0) and the Edinburgh Postnatal Depression Scale (EPDS).

Methods: This study used data (N = 2,435) from the control group of a randomised controlled trial on a sample of pregnant women. Survival analysis was used to examine the influence of infertility treatment on perinatal depressive disorder evaluated by WHO-CIDI 3.0. The EPDS scores at four time points (T1 [baseline]: 18 ± 2 weeks gestation, T2: 32 weeks gestation, T3: 1 week postpartum, T4: 3 months postpartum) were analysed using generalised mixed model analysis.

Results: The risk of experiencing a major depressive episode evaluated by WHO-CIDI 3.0 did not significantly differ between women conceiving through infertility treatment and those conceiving spontaneously (adjusted hazard ratio = 1.64, p = 0.109). The longitudinal analysis demonstrated that EPDS scores significantly increased at T3 and T4 among women conceiving through infertility treatment compared with those conceiving spontaneously (adjusted estimates of fixed effect from T1 to T3: 1.17, p < 0.01; from T1 to T4: 0.71, p = 0.022).

Conclusion: Women conceiving through infertility treatment were not found to have a higher risk of diagnosable perinatal depressive disorder than those conceiving naturally. However, a history of infertility treatment can marginally increase sub-clinical postpartum depressive symptoms.

Background: The attachment between father and infant is essential to a child's later development and well-being; yet, hardly any research has examined father-to-infant attachment during the outbreak of COVID-19. This study, therefore, aims to examine psychological, interpersonal, and health-related factors associated with father-to-infant attachment at 3-12 months postpartum during the pandemic.

Method: An online cross-sectional study was conducted between June and December 2021. A total of 775 fathers with at least one child aged 3-12 months were recruited. Participants completed measures of depression, COVID-19-related distress, relationship satisfaction, social support and other health-related factors including COVID-19 diagnosis and hospitalisation. Data on psycho-socio-demographic, obstetric, and COVID-19-related characteristics were also collected.

Results: Findings demonstrated that paternal depression (β = -.33, p < .001); relationship satisfaction (β = .19, p < .001); COVID-19-related psychological distress (β = -.14, p < .001) and social support (β = .13, p < .001) had a significant effect on father-to-infant attachment. Fathers who were multiparous, had COVID-19 diagnosis, and hospitalised due to COVID-19 were more likely to report poorer father-to-infant attachment. Paternal depression was the most influential factor on father-to-infant attachment, which attenuated the strength of the relationships between marital status, prematurity, history of trauma, sleep quality, and father-to-infant attachment once included into the analyses. No significant associations between educational level, employment, socioeconomic status, delivery mode, and father-to-infant attachment were observed.

Conclusion: These findings highlight the critical role of paternal psychological well-being in establishing healthy father-to-infant attachment and the relevance of having satisfied interpersonal relationships in promoting this early relationship particularly during crises such as COVID-19 pandemic.

Aims: The aim of this study was to examine potential mediators of the relationship between traumatic experiences, perceived stress, and the subjective, retrospectively measured, intensity of symptoms of premenstrual disorders. It was hypothesised that pessimistic attributional style and trait anger mediate the said relationship.

Methods: The study sample comprised 150 non-clinical subjects (aged 18-31; M = 21.82; SD = 2.19). Study variables were assessed with self-report questionnaires: the Premenstrual Symptoms Screening Tool (PSST); the Traumatic Experiences Checklist (TEC); the Perceived Stress Scale-4 Short Form (PSS-4); the Attributional Style Questionnaire (ASQ); and the State-Trait Anger Expression Inventory-2 (STAXI-2 - trait anger subscale). Correlation and mediation analyses were performed.

Results: The symptoms of premenstrual disorders were significantly and positively associated with both trait anger and pessimistic attributional style, as well as with trauma and stress. The correlations were moderate to strong, ranging from rho = 0.57 (pessimistic attributional style and trauma) to rho = 0.85 (stress and premenstrual symptoms). Both anger and pessimistic attributional style partially mediated the relationship between trauma and premenstrual symptoms and between stress and premenstrual symptoms.

Conclusion: Although the design of the study does not allow to infer causality, it demonstrates strong, positive relationship between the symptoms of premenstrual disorders, trauma, stress, attributional style, and anger. The results of mediation analyses may point to some practical implications (e.g. for psychotherapeutic interventions) but further studies employing prospective methods are needed.

Objective: This study will seek to understand the lived experiences of birth trauma among African American women.

Background: Racial discrimination affects society and individuals, both physically and mentally. Racial discrimination has the capacity to affect birth outcomes (Alhusen et al., 2016). Overall, adverse pregnancy outcomes in general have been found to be higher in African Americans than in Caucasians (Christian et al., 2012). Reducing disparities in birth outcomes has been said to be a national priority in the U.S for some time (Sage MacDorman, 2011); yet, the problem still exists, with no known decreases in reporting. One important initiative to decrease the risk of further problems is to understand the lived experiences of birth trauma and racism.

Methods: This study used a descriptive phenomenological approach to understand the lived experiences of birth trauma among African American women.

Results: There were six themes that consistently emerged from participants narratives: (1) feeling alone, (2) feeling misunderstood, (3) doubting oneself/feeling incapable, (4) loss of hope, (5) feeling angry, and (6) prompt to action.

Conclusion: Understanding the lived experiences of birth trauma can contribute to greater empathy and understanding. It may also contribute to changing policies and/or changes in responses. By seeking to understand the lived experiences of a minority population, the study may impact initiatives aimed at reducing disparities in birth outcomes.

Objective: This study aimed to explore the prevalence of prenatal depression and to determine the dyadic relationship between perceived stress, marital satisfaction, and prenatal depression in pregnant women with gestational diabetes mellitus (GDM) and their partners.

Background: GDM during pregnancy is a very stressful event for couples. However, previous studies have largely focused on pregnant women, with few including their partners.

Methods: A cross-sectional study was conducted in Guangzhou, China, from 30 July to 2 December 2021. Three hundred fourteen couples with GDM completed the Perceived Stress Scale, Locke-Wallace Marital Adjustment Scale, and Edinburgh Postnatal Depression Scale. Dyadic analysis was conducted using the actor-partner interdependence mediation model.

Results: The prevalence of depressive symptoms was 13.4% in pregnant women with GDM and 8.3% in their partners. Regarding the actor effects, perceived stress was positively associated with prenatal depression in pregnant women with GDM and their partners, respectively, and marital satisfaction acted as a mediating role. Regarding the partner effects, paternal perceived stress was negatively associated with maternal marital satisfaction, and maternal marital satisfaction mediated the association between paternal perceived stress and maternal prenatal depression.

Conclusions: Dyadic effects of perceived stress, marital satisfaction, and prenatal depression exist in couples with GDM.

Objectives: To examine, in depth, the perspectives of facilitators of a videoconference-delivered group Acceptance Commitment Therapy (ACT) intervention for perinatal women with moderate-severe mood and/or anxiety disorders.

Design: Qualitative study.

Methods: Thematic analysis was used to analyse semi-structured interviews with seven facilitators and post-session reflections with six facilitators.

Results: Four themes were generated. First, there are barriers to accessing psychological therapies during the perinatal period and improvements are required. Second, COVID-19 has accelerated the provision of remote therapies, including videoconference-delivered group therapy, enabling a continuity of service, and facilitating diversification of treatment access and choice. Third, there are benefits of videoconference-delivered group ACT in the perinatal period, with reservations. Attending a group via videoconference is perceived to be less exposing, and offers normalisation, social support, empowerment, and flexibility. Facilitators also shared reservations including whether service users would prioritise videoconference-delivered group therapy, concerns about limited non-verbal cues and the therapeutic alliance, reporting a lack of an evidence base, and technology challenges when working online. Finally, facilitators offered recommendations for videoconference-delivered group therapy best practice in the perinatal period, including the provision of equipment and data, contracts for attendance and suggestions to maximise engagement and group cohesion.

Conclusions: This study raises important considerations regarding the use of videoconference-delivered group ACT in the perinatal context. There are opportunities afforded by videoconference-delivered group therapies, which is important and timely given the increased drive towards improving access to perinatal services and psychological therapies, and the need for 'COVID-proof' therapies. Recommendations for best practice are offered.

Background: Whereas the maternal 'blues' has been widely researched, comparatively less is known about the "highs" following childbirth, and the relation between mothers and fathers' mood in this early period. We aimed to investigate the association between maternal 'blues' and 'highs' with paternal postpartum mood (here described as 'lows' and 'highs') in the early postpartum and their associations with the quality of child bonding.

Methods: Women and their cohabitating male partners, fathers of the index child (N = 98 couples), attending an obstetric hospital unit completed questionnaires on mood, bonding and socio-demographics between the 3rd and the 5th postpartum day. We used generalised estimating equations to analyse the data.

Results: The 'blues' scores were higher in mothers, whereas 'highs' and bonding were higher in fathers. Maternal 'blues' were significantly correlated with paternal 'lows' (r_s = .23, p < .05) and maternal 'highs' were also associated with paternal 'highs' (r_s = .22, p < .05). Parental 'highs' were significantly associated with better baby bonding (B = .13, p = .02).

Conclusions: Our study demonstrates moderate associations between both 'blues/lows' and 'highs' in mothers and fathers shortly after the birth of the child. Associations between mood, particularly 'highs', and bonding were similar for mothers and fathers. Greater consideration of 'blues/lows' and 'highs' in both parents is needed to promote adjustment in the postpartum period.

Background: Insecure adult attachment, shame, self-blame, and isolation following perinatal loss place bereaved women at risk of adverse psychological outcomes, which can impact child and family outcomes. To date, no research has considered how these variables continue to influence women's psychological health in pregnancy subsequent to loss.

Objective: This study explored associations between prenatal psychological adjustment (less grief and distress) and adult attachment, shame, and social connectedness, in women pregnant after loss.

Method: Twenty-nine pregnant Australian women accessing a Pregnancy After Loss Clinic (PALC) completed measures of attachment styles, shame, self-blame, social connectedness, perinatal grief, and psychological distress.

Results: Four 2-step hierarchical multiple regression analyses revealed adult attachment (secure/avoidant/anxious; Step 1), shame, self-blame, and social connectedness (Step 2) explained 74% difficulty coping, 74% total grief, 65% despair, and 57% active grief. Avoidant attachment predicted more difficulty coping and higher levels of despair. Self-blame predicted more active grief, difficulty coping, and despair. Social connectedness predicted lower active grief, and significantly mediated relationships between perinatal grief and all three attachment patterns (secure/avoidant/anxious).

Conclusions: Although avoidant attachment and self-blame can heighten grief in pregnancy after loss, focusing on social connectedness may be a helpful way for prenatal clinicians to support pregnant women during their subsequent pregnancy - and in grief.