Perinatal posttraumatic stress disorder as a predictor of mother-child bonding quality 8 months after childbirth: a longitudinal study.

BACKGROUND: Negative childbirth experiences can be related to the onset of perinatal post-traumatic stress symptomatology (P-PTSS), which significantly impacts the mother and the infant. As a response in the face of the discomfort caused by P-PTSS, maladaptive emotion regulation strategies such as brooding can emerge, contributing to the consolidation of post-partum depressive symptoms. Ultimately, both types of symptomatology, P-PTSS and post-partum depression, can act as risk factors for developing mother-child bonding difficulties. Still, this full set of temporal paths has to date remained untested. The present longitudinal study aimed to analyze the risk factors associated with the appearance of P-PTSS after post-partum and to test a path model considering the role of P-PTSS as an indirect predictor of bonding difficulties at eight months of postpartum. METHODS: An initial sample of pregnant women in the third trimester of gestation (N = 594) participated in a longitudinal study comprising two follow-ups at two and eight months of postpartum. The mothers completed online evaluations that included socio-demographic data and measures of psychological variables. A two-step linear regression model was performed to assess the predictive role of the variables proposed as risk factors for P-PTSS, and a path model was formulated to test the pathways of influence of P-PTSS on bonding difficulties. RESULTS: A history of psychopathology of the mother, the presence of depression during pregnancy, the presence of medical complications in the mother, and the occurrence of traumatic birth experiences all acted as significant predictors of P-PTSS, explaining 29.5% of its variance. Furthermore, the path model tested further confirmed an indirect effect of P-PTSS, triggered by a negative childbirth experience, on subsequent bonding difficulties eight months after labor through its association with higher levels of brooding and, ultimately, postpartum depression levels. A further path showed that bonding difficulties at two months postpartum can persist at eight months postpartum due to the onset of brooding and postpartum depression symptoms. CONCLUSION: We identified a set of robust predictors of P-PTSS: the mother's previous history of depression, perinatal depression during pregnancy, the presence of medical complications in the mother and the occurrence of traumatic birth experiences, which has important implications for prevention. This is particularly relevant, as P-PTSS, when triggered by a negative childbirth experience, further indirectly predicted the development of mother-child bonding difficulties through the mediation of higher use of brooding and symptoms of postpartum depression. These findings can serve as a basis for developing new longitudinal studies to further advance the understanding of perinatal mechanisms of mental health.

Difficulties in Pregnancy Adjustment as Predictors of Perinatal Depression: Indirect Effects through the Role of Brooding Rumination and Maternal-Fetal Bonding.

OBJECTIVE: The aim of this research was to study the ways in which problems of adaptation to pregnancy influence the development of symptoms of perinatal depression via the presence of brooding and low maternal-fetal bonding, in addition to other risk factors previously established in the literature. STUDY DESIGN: Representative sample of pregnant women in the third trimester of gestation (N = 594) completed an online survey that included sociodemographic data and measures of perinatal depression, adjustment to pregnancy, bonding, and brooding. Other risk factors were also assessed as covariates, such as previous history of depression, generalized anxiety, perceived social support, and experience of stressful life events. Descriptive and correlational analyses were performed on the scores obtained by the subjects with the different instruments. A path model was formulated to establish the pathways through which adjustment influences perinatal depression symptomatology. On the one hand, the presence of brooding (worst adjustment to pregnancy → high brooding → perinatal depression symptomatology), and on the other hand, the quality of maternal-fetal bonding (worst adjustment to pregnancy → poor quality fetal-maternal bonding → perinatal depression symptomatology) would act as a mediator. RESULTS: The factors proposed by the literature were predictive of perinatal depressive symptomatology and the quality of adjustment to pregnancy. Problems adjusting to changes during pregnancy and experiencing it unsatisfactorily may predict individual differences in perinatal depressive symptoms. Significantly, this relationship was mediated by two key factors, the presence of brooding and low quality of the maternal-fetal bond. CONCLUSION: Our results provide evidence in favor of the existence of multiple paths through which difficulties in adapting to pregnancy can favor the occurrence of higher levels of perinatal depressive symptoms and identify new avenues for developing research in this area and preventive interventions empirically informed.

Competencies and employment after a university program in young people with intellectual disabilities.

This study analyzes the relationship between the employability competencies acquired after completing an employment training program at university and the subsequent access to employment of young people with intellectual disabilities. To do this, the employability competencies of 145 students were analyzed at the end of the program (T1) and information was gathered on their career path at the time of the study (T2) (n = 72). Sixty-two per cent of the participants have had at least one job since graduation. Job competencies increase the probability of accessing and retaining employment in students who graduated at least 2 years before (X2 = 17.598; p < .001; r2 = .583). These results compel us to complement employment training programs with new opportunities and greater job accessibility.

Enhancing Caregiving in Traumatized Families: An Attachment-Centered Approach to Working with Parent Groups.

This paper outlines a model of attachment-centered group interventions to enhance caregiving among parents suffering from early trauma and/or social hardship. Groups are understood as an essential source of experiences that may restore traumatized adults' relational security, and enhance their parenting capacities, in face of biographical and contextual factors that compromise caregiving. The model is especially suited for intervention within social service/child protection contexts and with families that struggle to establish trusting alliances with professionals and institutions. Proposed intervention strategies are oriented toward making the group function as an attachment figure that meets parents' attachment and exploration needs and enhances parental sensitivity. Group therapists facilitate two sets of group processes: on the one hand, a sense of togetherness, emotional containment, protection and comfort (related to attachment needs); on the other hand, the development of parental mentalization, the revision of parental representations of the child, and the consolidation of parenting competence (related to exploration needs). A theoretical rationale for working with parent groups from an attachment-centered perspective, the basic intervention principles and specific strategies of the model are presented and illustrated.

En este artículo se describe un modelo de intervenciones grupales centradas en el apego para mejorar el cuidado de los niños entre padres que sufren un trauma de la infancia o dificultades sociales. Los grupos se entienden como una fuente imprescindible de experiencias que puede devolverles la seguridad relacional a los adultos traumatizados y mejorar sus habilidades de crianza ante factores biográficos y contextuales que ponen en riesgo el cuidado de los niños. El modelo está especialmente adecuado para intervenciones dentro de contextos de servicios sociales o de protección infantil y con familias que tienen dificultad para establecer alianzas de confianza con profesionales e instituciones. Las estrategias de intervención propuestas están orientadas a lograr que el grupo funcione como una figura de apego que satisfaga las necesidades de exploración y de apego de los padres y mejore la sensibilidad parental. Los terapeutas de grupo facilitan dos conjuntos de procesos grupales: por un lado, una idea de unidad, contención emocional, protección y comodidad (en relación con las necesidades de apego); por otro lado, el desarrollo de la mentalización parental, la revisión de las representaciones parentales del niño, y la consolidación de las competencias de crianza (en relación con las necesidades de exploración). Se presentan y se ejemplifican las bases teóricas para trabajar con grupos de padres desde una perspectiva centrada en el apego, los principios básicos de intervención y las estrategias específicas del modelo.

Enhancing maternal sensitivity in contexts of urban extreme poverty in Sierra Leone: A pilot study.

This pilot study presents preliminary data on the efficacy of Strong Bonds, Strong Pikin (SBSP), a brief intervention program that aims to enhance sensitivity among mothers who care for their preschool children in a slum settlement in Freetown (Sierra Leone). SBSP adapts principles of attachment theory to intervention within a non-Western cultural setting, where families suffer from extreme poverty. A combination of psychoeducation, group work, video-feedback, and storytelling defines the methodology of the program. Maternal sensitivity, parenting stress, and the use of violent discipline practices were measured before (pretest) and after the intervention (posttest) in a sample of 43 mothers who participated in the program. Analyses showed a significant increase in observed maternal sensitivity, as well as a decrease in mother-reported parenting stress, child problems, and use of violent discipline practices from pretest to posttest. These results are discussed in terms of the potential value of culturally sensitive, attachment-centered interventions with caregivers who raise their children in non-Western settings affected by economic vulnerability.

Este estudio experimental presenta información preliminar acerca de la efectividad de "Fuertes Lazos, Fuertes Niños" (Strong Bonds, Strong Pikin - SBSP) un programa de intervención breve para mejorar la sensibilidad entre madres que cuidad a sus niños de edad prescolar en un asentamiento de barrios bajos en Freetown (Sierra Leona). El programa SBSP adapta principios de la teoría de la afectividad para la intervención dentro de un escenario cultural no occidental, donde las familias sufren extrema pobreza. Una combinación de educación sicológica, trabajo de grupo, información acerca de videos, así como el recuento de historias definen la metodología del programa. La sensibilidad materna, el estrés de crianza y el uso de severas prácticas de disciplinas del tipo "disciplinaviolenta" se midieron antes (pre-examen) y después de la intervención (posterior al examen) en un grupo muestra de 43 madres que participaron en el programa. Los análisis mostraron un aumento significativo en la observada sensibilidad materna, así como una reducción en el estrés de crianza reportado por la madre, problemas del niño y el uso de severas prácticas de disciplinas del tipo "disciplinaviolenta" desde el pre-examen hasta después del examen. Estos resultados se discuten en términos del valor potencial de las culturalmente sensibles intervenciones centradas en la afectividad con cuidadores que crían a sus niños en asentamientos no occidentales afectados por la vulnerabilidad económica.

Cette étude pilote présente des données préliminaires sur l'efficacité de « Strong Bonds, Strong Pikin ¼ (SBSP), un programme d'intervention brève qui a pour but d'améliorer la sensibilité chez les mères qui prennent soin de leur enfant d'âge préscolaire dans un bidonville de Freetown en Sierra Leone. Le SBSP adapte les principes de la théorie de l'attachement à une intervention dans un contexte non-occidentale, où les familles souffrent d'une pauvreté extrême. Une combinaison de psychoéducation, de travail de groupe, de commentaires vidéo, et de d'art de conter définit la méthodologie de ce programme. La sensibilité maternelle, le stress de parentage et l'utilisation de pratiques disciplinaires dures et violentes sont mesurés avant (prétest) et après l'intervention (post-test) chez un échantillon de 43 mères qui ont participé au programme. Les analyses ont montré une augmentation importante dans la sensibilité maternelle observée ainsi une baisse dans le stress de parentage rapporté par les mères, une baisse des problèmes avec l'enfant et une baisse dans l'utilisation de pratiques disciplinaires dures et violentes du prétest au post test. Ces résultats sont discutés en termes de valeur potentielle d'interventions sensibles culturellement adaptées et centrées sur l'attachement avec des personnes qui élèvent leurs enfants dans des contextes non-occidentaux et affectées par une vulnérabilité économique.

The role of motivation in shaping social inclusion of people with intellectual disabilities in physical-sports activity contexts.

The present study aims to test a model in which basic psychological needs (BPN) satisfaction in physical-sport activity contexts is associated with self-determined motivation, which, in turn, would predict the social inclusion of people with intellectual disabilities. A total of 286 people with intellectual disabilities (53.5% men) who reported engaging in physical-sport activities responded to a validated questionnaire about the satisfaction of their BPN, motivation (using the Self-determination index [SDI]), and social inclusion. A Pearson's bivariate correlation and structural equation modeling were conducted. The resulting model was reanalyzed in a multigroup analysis to test its invariance across self and proxy reports. Positive associations were found between the satisfaction of the BPN and the SDI. However, the SDI and social inclusion were positively associated only in proxy reports (ßself = 0.07 vs. ßproxy = 0.30). The tested model established positive relationships between the BPN and SDI in autonomy (ßself = 0.21 vs. ßproxy = 0.18), competence (ßself = 0.47 vs. ßproxy = 0.53), and relatedness (ßself = 0.21 vs. ßproxy = 0.23). Further research is needed to understand the factors leading to discrepancies between participants and proxies when relating the SDI to social inclusion in the context of physical-sport activity. However, the results obtained suggest that it would be optimal to develop contexts of practice for people with intellectual disabilities in which the satisfaction of their BPN is favored and that this has a positive impact on their motivation and social inclusion.

Physical Activity and Quality of Life among People with Intellectual Disabilities: The Role of Gender and the Practice Characteristics.

Staying physically active is synonymous with good health and well-being, and its benefits on the health of people with intellectual disabilities (PWIDs) have been studied. However, there is a lack of information on how it can influence their quality of life (QoL). This study aimed to analyze the relationship between QoL and physical activity in PWIDs according to gender and the characteristics of the practiced activity. A questionnaire was administered to 380 PWIDs (mean age of 28.23 ± 12.53), 54.21% of which were men. The QoL dimensions and second-order factors were studied in relation to practicing physical activity, the practice type, the context, and gender. The results indicate that people who practiced any activity showed better QoL values. Those who engaged in a nonregulated physical activity had better values in self-determination, emotional well-being, social inclusion, and personal development, while those who did sports presented higher scores in interpersonal relationships and physical well-being. In addition, it also appears that the association between physical activity and the QoL dimensions is distinct in inclusive and specific contexts. In conclusion, physical activity is related to a better QoL, although the impact of the practice type and context differs for each QoL dimension.

Differentiation of self and its relationship with marital satisfaction and parenting styles in a Spanish sample of adolescents' parents.

The present study aims to test some of the assumptions of Bowen's Family Systems Theory, specifically, to assess the relationships between differentiation of self (DoS), marital satisfaction and parenting styles, as well as the gender differences in these variables in a Spanish sample. The sample includes 140 Spanish non-single adults, over 30 years old, who have at least one adolescent son or daughter, aged between 12 and 19 years old. The instruments used were a sociodemographic questionnaire, the Differentiation of Self Scale, the Warmth Scale-Parents, the Rules and Demands Scale-Parents and the Satisfaction subscale of the Dyadic Adjustment Scale. The results show DoS is related to marital satisfaction, and parenting styles' dimensions. Regarding gender, women show higher emotional reactivity and warmth-communication than men do. Furthermore, marital satisfaction mediates the relationship between DoS and parental warmth-communication, criticism-rejection and inductive form. Finally, implications for clinical practice and future research are discussed.

The reporters' agreement in assessing the quality of life of young people with intellectual disabilities.

A good evaluation of the quality of life (QoL) of young people with disability is essential to detect, monitor and report their support needs in research, and individual, institutional and policy planning. The aim of this study is to evaluate the reporters' agreement in the assessment of the QoL of young people with Intellectual Disabilities in transition to adulthood. Self and proxy-report version of INICO-FEAPS quality of life scale was used to assess 119 students of a post-compulsory educational program, being the proxy-report informed by one of their relatives. Results show poor intraclass correlations between informants. No discrepancies were found in the global QoL. However, small discrepancies were found for some dimensions. Young people's reports were higher for self-determination, personal development and interpersonal relationships. On the contrary, relatives' reports were higher for rights, material and physical wellbeing. The discrepancies in global QoL assessment were not related to student's severity, IQ, diagnosis or parent's gender. These findings underline the importance of young people's participation in the assessment of their QoL as well as the convenience of using both kind of informants when taking appropriate decisions in educational contexts during transition to adulthood.