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1.
Psychopathology ; 56(1-2): 64-74, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35835007

RESUMEN

In interaction with their mother, infants not only learn how human relationships work, but - on an even more basic level - the continuous bidirectional, interactive regulation between mother and infant shapes the infant's socioemotional development. Coordinated interactions alternate with uncoordinated ones, the latter resulting in momentary ruptures during this dyadic exchange. Usually, these are quickly repaired. The mother's capacity for engaging with her infant in a sensitive and appropriate manner is crucial for successful socioemotional development. On a transgenerational level, a mother will draw on her own relational experiences - embodied as implicit memory - when interacting with her baby. Thus, comprehensive and effective treatment of maternal postpartum disorders that often impair the mother's interactive skills and capacity for maternal bonding is of great importance. One aim of modern mother-infant treatment is to target dysfunctional interactive patterns, often with the help of video feedback and microanalysis of behavioral observations. In this paper, after giving an overview of affective regulation in mother-infant dyads and the role of maternal factors and postpartum mental health, we describe relationship-focused approaches to mother-infant treatment. Our focus lies on video feedback and body-oriented interventions. We also explore classical as well as contemporary theoretical underpinnings in mother-infant research and how psychoanalytic concepts like containment and mentalization not only enrich approaches to mother-infant treatment but also adult treatment in general. We conclude that working with and expanding one's own implicit relational knowledge is central for the therapeutic process and can be initiated by video-based interventions or by genuinely experiencing and reflecting on interactions in dyads and groups.


Asunto(s)
Relaciones Madre-Hijo , Psicoanálisis , Femenino , Adulto , Lactante , Humanos , Relaciones Madre-Hijo/psicología , Madres/psicología , Psicoterapia , Apego a Objetos
2.
Infancy ; 28(2): 435-453, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36397657

RESUMEN

Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected children are burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent-child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N = 6598 mothers (M = 31.51 years) of children between zero to three years of age (M = 14.08 months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants' excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.


Asunto(s)
Llanto , Trastornos del Sueño-Vigilia , Lactante , Femenino , Humanos , Masculino , Llanto/psicología , Madres/psicología , Padres , Aislamiento Social
3.
Psychopathology ; 53(5-6): 298-305, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32937629

RESUMEN

BACKGROUND: Early life maltreatment (ELM) has a high risk of transmission across generations, known as "the cycle of abuse." ELM is also an important risk factor for developing mental disorders, and having a mental disorder increases the risk of child abuse. Both the abuse potential in mothers with ELM and in mothers with a history of mental disorders might be associated with a disturbed mother-child interaction. OBJECTIVE: The current study examined differences in emotional availability between mothers with a history of ELM and previous or current mental disorders (non-resilient), mothers with ELM without mental disorders (resilient), and control mothers without ELM and without mental disorders. METHODS: Thirty-three non-resilient mothers, 18 resilient mothers, and 37 control mothers and their 5- to 12-year-old children participated in a standardized mother-child interaction task. Videotaped interactions were rated by three independent, trained raters based on the Emotional Availability Scales (EA Scales) and compared between the groups. RESULTS: The non-resilient mothers and their children showed reduced maternal sensitivity, structuring, non-intrusiveness, non-hostility, responsiveness, and involvement compared to the resilient mothers and their children and the control mothers and their children (p = 0.006, ηp2 = 0.12). No differences on any of the EA Scales were found between resilient mothers and control mothers. CONCLUSIONS: These deficits in mother-child interaction in non-resilient mothers might contribute to mechanisms that could explain the cycle of abuse. Interestingly, resilient mothers, who did not develop a mental disorder despite having experienced ELM, did not show these deficits. Thus, prevention programs promoting resilience might be a key to break the cycle of abuse.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Maltrato a los Niños/psicología , Trastornos Mentales/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad
4.
Arch Gynecol Obstet ; 301(1): 107-117, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31875254

RESUMEN

PURPOSE: Maternal mental disorders develop frequently during the perinatal period, and can have detrimental effects on the developing bond between a mother and her child. While depression has already been widely associated with bonding disorders, the link between anxiety disorders and maternal-fetal attachment has received only limited attention. This study aimed to explore the link between maternal-fetal attachment in the third trimester and postpartum anxiety, as previous research has suggested a potentially protective association. Additionally, we hypothesized a mediating influence of postpartum bonding and partnership satisfaction as additional measurements of attachment capacity. METHODS: Self-report questionnaires assessing maternal-fetal attachment, postpartum bonding, anxiety, depression, and partnership quality were completed at three time points: third trimester (T1, N = 324), first week postpartum (T2, N = 249), and 4 months postpartum (T3, N = 166). Conditional process analyses were used to test for mediation. RESULTS: A statistically significant negative correlation of maternal-fetal attachment was found with maternal anxiety postpartum. Overall, the analyses supported the mediation hypothesis. There was a significant, indirect effect of maternal-fetal attachment during pregnancy on state anxiety in the first week postpartum, mediated through postpartum bonding quality and partnership satisfaction. All three variables together accounted for 18.25% (state anxiety) or 30.35% (trait anxiety) of the variance in postpartum anxiety. CONCLUSIONS: Our results showed that a close maternal-fetal attachment buffers postpartum symptoms of anxiety, partially mediated through postpartum bonding and partnership satisfaction. Therefore, strengthening the maternal-fetal attachment and the partnership during pregnancy has the potential to reduce maternal postpartum symptoms of anxiety.


Asunto(s)
Trastornos de Ansiedad/prevención & control , Trastornos de Ansiedad/psicología , Relaciones Madre-Hijo/psicología , Periodo Posparto/psicología , Adulto , Femenino , Humanos , Estudios Longitudinales , Satisfacción Personal , Embarazo , Autoinforme , Encuestas y Cuestionarios
5.
Arch Gynecol Obstet ; 299(1): 69-77, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30327862

RESUMEN

INTRODUCTION: Female sexual dysfunction is known to have a huge impact on quality of life and is highly prevalent during the peripartum period. Several influencing variables were found to be associated with impaired sexual function postpartum, among them breastfeeding and partnership quality. However, little is known about the predictive value of these variables. Therefore, this longitudinal cohort study aimed to examine prospectively the influence of the two variables on sexual function 4-month postpartum. MATERIALS AND METHODS: Questionnaires were administered to 330 women prenatally (TI, third trimester) and postpartum (TII, 1 week; TIII, 4 months). Medical data were collected from the respondents' hospital records. The Female Sexual Function Index (FSFI) was used to determine overall sexual function, desire, arousal, lubrication, orgasm, satisfaction, and pain perinatally. RESULTS: At all timepoints, mean FSFI scores were below the critical FSFI-score of 26.55. Partnership quality, breastfeeding, high maternal education, and maternal depressive symptoms correlated significantly with FSFI scores postpartum. Further analyses confirmed antenatal partnership quality and breastfeeding behavior as strong predictors of sexual function 4-month postpartum, explaining 24.3% of variance. Women who stopped breastfeeding or never breastfed at all showed the highest FSFI scores. CONCLUSION: Our findings indicate that exclusively breastfeeding women and those who report low partnership quality have an increased likelihood of sexual functioning problems 4-month postpartum. Health-care providers need to be encouraged to counsel on postpartum sexuality and influencing factors during prenatal classes to de-pathologize those changes and to foster a positive approach to peripartum sexuality.


Asunto(s)
Lactancia Materna/psicología , Depresión/psicología , Calidad de Vida , Conducta Sexual/psicología , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Psicológicas/psicología , Esposos/psicología , Mujeres/psicología , Adulto , Nivel de Alerta , Femenino , Humanos , Estudios Longitudinales , Orgasmo , Parto , Satisfacción Personal , Periodo Posparto , Embarazo , Prevalencia , Conducta Sexual/estadística & datos numéricos , Sexualidad , Encuestas y Cuestionarios
6.
Child Psychiatry Hum Dev ; 50(2): 278-290, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30132095

RESUMEN

The study addresses the impact of maternal early life maltreatment (ELM) and maternal history of depression (HoD) on offspring's mental health. Maternal sensitivity was examined as a potential mediator explaining the relationship between maternal ELM, maternal HoD and child psychopathology. Participants were 194 mothers with and without HoD and/or ELM as well as their children between 5 and 12 years. Maternal sensitivity was assessed using the Emotional Availability Scales. Parent and teacher ratings were utilized to assess child psychopathology. Path analyses showed an indirect effect of maternal HoD on parents' ratings of child psychopathology with maternal sensitivity as mediating variable. In contrast, maternal ELM was directly linked to teachers' ratings of child psychopathology; this effect was not mediated by maternal sensitivity. Our results indicate that the impact of maternal HoD, maternal ELM, and maternal sensitivity on offspring psychopathology might vary depending on the context in which child psychopathology is assessed.


Asunto(s)
Maltrato a los Niños/psicología , Hijo de Padres Discapacitados/psicología , Depresión/psicología , Conducta Materna , Trastornos del Neurodesarrollo/psicología , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Madres/psicología , Apego a Objetos , Relaciones Padres-Hijo , Psicopatología
7.
Horm Behav ; 97: 128-136, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29129623

RESUMEN

Early life maltreatment (ELM) is associated with different neurobiological alterations. Lower oxytocin and altered grey matter volumes (GMV) in brain regions associated with the central oxytocin system, such as the hypothalamus, amygdala, and nucleus accumbens, have been reported in women with ELM. However, the association between peripheral oxytocin and brain morphometry in women with ELM has not been studied yet. We therefore collected blood samples from 33 women with and 25 women without ELM, all without current mental disorders to measure and compare oxytocin levels between the two groups. Furthermore, T1-weighted high-resolution structural magnetic resonance brain images of a subsample of these women were collected, analyzed with voxel-based morphometry, compared between the two groups, and correlated with oxytocin levels. There were no differences in oxytocin levels between the groups. However, oxytocin levels were associated with different brain regions in women with ELM compared with control women without ELM: A positive association between GMV in the nucleus accumbens and oxytocin was specific for control women but not for women with ELM. For the hypothalamus, there was a positive association between GMV and oxytocin in control women. However, the same region was negatively associated with oxytocin in women with ELM and it showed larger GMV compared to control women without ELM. For the amygdala, a negative association between GMV and oxytocin was specific for women with ELM. Results are discussed with regard to previous research on endocrine and neurostructural alterations in individuals with ELM.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños , Encéfalo/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Oxitocina/sangre , Adulto , Amígdala del Cerebelo/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Núcleo Accumbens/diagnóstico por imagen , Tamaño de los Órganos
8.
J Psychiatry Neurosci ; 43(4): 273-282, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29947610

RESUMEN

BACKGROUND: Early-life maltreatment has severe consequences for the affected individual, and it has an impact on the next generation. To improve understanding of the intergenerational effects of abuse, we investigated the consequences of early-life maltreatment on maternal sensitivity and associated brain mechanisms during mother-child interactions. METHODS: In total, 47 mothers (22 with a history of physical and/or sexual childhood abuse and 25 without, all without current mental disorders) took part in a standardized real-life interaction with their 7- to 11-year-old child (not abused) and a subsequent functional imaging script-driven imagery task. RESULTS: Mothers with early-life maltreatment were less sensitive in real-life mother-child interactions, but while imagining conflictual interactions with their child, they showed increased activation in regions of the salience and emotion-processing network, such as the amygdala, insula and hippocampus. This activation pattern was in contrast to that of mothers without early-life maltreatment, who showed higher activations in those regions in response to pleasant mother-child interactions. Mothers with early-life maltreatment also showed reduced functional connectivity between regions of the salience and the mentalizing networks. LIMITATIONS: Region-of-interest analyses, which were performed in addition to whole-brain analyses, were exploratory in nature, because they were not further controlled for multiple comparisons. CONCLUSION: Results suggest that for mothers with early-life maltreatment, conflictual interactions with their child may be more salient and behaviourally relevant than pleasant interactions, and that their salience network is poorly modulated by the brain regions involved in mentalizing processes. This activation pattern offers new insights into the mechanisms behind the intergenerational effects of maltreatment and into options for reducing these effects.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Amígdala del Cerebelo/fisiopatología , Corteza Cerebral/fisiopatología , Hipocampo/fisiopatología , Imaginación , Imagen por Resonancia Magnética , Relaciones Madre-Hijo/psicología , Adulto , Estudios de Casos y Controles , Niño , Femenino , Neuroimagen Funcional , Humanos , Masculino , Vías Nerviosas/fisiopatología , Adulto Joven
9.
Arch Gynecol Obstet ; 297(5): 1157-1167, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29404742

RESUMEN

OBJECTIVES: In understanding early disturbances in the mother-child relationship, maternal-fetal attachment has become an important concept. To date no study has investigated the reliability and validity of the German version of the Maternal Fetal Attachment Scale (MFAS). The present study aimed to close this gap. METHODS: Questionnaires were completed in a sample of 324 women [third trimester (T1), first week postpartum (T2), and 4 months postpartum (T3)]. In addition to the MFAS (T1), the following measures were assessed: the questionnaire of partnership (T1), the postpartum bonding questionnaire (T2), the Edinburgh Postnatal Depression Scale (T1-T3), the State Trait Anxiety Inventory (T1-T3), and the pregnancy related anxiety questionnaire (T1-T3). Factor structure was analyzed using a principal component analysis (PCA) with varimax rotation. Internal and convergent validities were calculated. RESULTS: In contrast to the original version with five subscales, PCA yielded a three-factor solution, consisting of the three independent dimensions "anticipation", "empathy", and "caring", explaining 34.9% of the variance together. Good internal reliabilities were found for the total MFAS scale. Maternal-fetal attachment showed a significant negative correlation with postpartum bonding impairment. While no correlations were found with depression, general anxiety and pregnancy-related anxiety during pregnancy, maternal-fetal attachment was significantly related to aspects of partnership quality. In the postpartum period, maternal attachment showed a strong negative correlation with maternal anxiety. CONCLUSIONS: Our results suggest that the German version of the MFAS is a reliable and valid questionnaire to measure the emotional relationship of the mother to the unborn child during pregnancy.


Asunto(s)
Depresión Posparto/diagnóstico , Relaciones Materno-Fetales , Madres/psicología , Apego a Objetos , Mujeres Embarazadas/psicología , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Adulto , Ansiedad/complicaciones , Ansiedad/diagnóstico , Ansiedad/psicología , Depresión/complicaciones , Depresión/diagnóstico , Depresión/psicología , Depresión Posparto/complicaciones , Depresión Posparto/psicología , Femenino , Alemania , Humanos , Inventario de Personalidad , Periodo Posparto , Embarazo , Tercer Trimestre del Embarazo , Psicometría , Reproducibilidad de los Resultados
10.
Arch Womens Ment Health ; 20(4): 477-486, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28612177

RESUMEN

Early life maltreatment (ELM) poses a risk for the development of insecure attachment and depression over the life span, depending on the type of maltreatment (physical, sexual, emotional, neglect) and its severity. The aim of this study was to investigate the influence of ELM and lifetime depression on adult insecure attachment in a female sample (N = 188), consisting of n = 81 women with ELM and n = 107 without ELM. Women with ELM reported significantly higher scores on insecure attachment than women without ELM. A significant interaction effect for ELM × lifetime depression was found: Contradictory to the hypotheses, women with ELM but without lifetime depression scored highest on avoidant attachment, differing significantly from women with ELM and lifetime depression, even though the severity of ELM was higher among women with ELM and lifetime depression and they experienced significantly more severe neglect and sexual abuse, but not physical or emotional abuse. Regression analyses revealed that ELM was the only predictor of avoidant attachment, explaining 15.5% of the variance. Results underline the strong influence of ELM on adult attachment and are of special importance for prevention and intervention programs.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Maltrato a los Niños/psicología , Apego a Objetos , Adulto , Niño , Depresión/psicología , Femenino , Humanos , Encuestas y Cuestionarios
11.
Arch Gynecol Obstet ; 295(4): 873-883, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28251311

RESUMEN

PURPOSE: Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors. METHODS: Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB). RESULTS: The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains. CONCLUSIONS: Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.


Asunto(s)
Conducta Sexual/psicología , Disfunciones Sexuales Psicológicas/epidemiología , Adulto , Lactancia Materna/efectos adversos , Cesárea/efectos adversos , Depresión , Depresión Posparto/complicaciones , Femenino , Humanos , Estudios Longitudinales , Periodo Posparto , Embarazo , Tercer Trimestre del Embarazo , Prevalencia , Factores de Riesgo , Disfunciones Sexuales Psicológicas/etiología , Sexualidad/psicología
12.
Depress Anxiety ; 33(7): 648-57, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26697826

RESUMEN

BACKGROUND: The association between maternal depression and adverse outcomes in children is well established. Similar links have been found for maternal childhood abuse. One proposed pathway of risk transmission is reduced maternal emotional availability. Our aim was to investigate whether sensitive parenting is impaired in mothers with depression in remission, and whether among these mothers childhood abuse has an additional impact. METHODS: The mother-child interaction of 188 dyads was assessed during a play situation using the Emotional Availability Scales, which measure the overall affective quality of the interaction: maternal sensitivity, structuring, nonhostility, and nonintrusiveness. Mothers with depression in remission were compared to healthy mothers. Children were between 5 and 12 years old. Group differences and impact of additional childhood abuse were analyzed by one-factorial analyses of covariance and planned contrasts. RESULTS: Mothers with depression in remission showed less emotional availability during mother-child interaction compared to healthy control mothers. Specifically, they were less sensitive and, at trend-level, less structuring and more hostile. Among these mothers, we found an additional effect of severe maternal childhood abuse on maternal sensitivity: Mothers with depression in remission and a history of severe childhood abuse were less sensitive than remitted mothers without childhood abuse. CONCLUSIONS: Our data suggest that depression impacts on maternal emotional availability during remission, which might represent a trait characteristic of depression. Mothers with depression in remission and additional severe childhood abuse were particularly affected. These findings may contribute to the understanding of children's vulnerability to develop a depressive disorder themselves.


Asunto(s)
Maltrato a los Niños/psicología , Trastorno Depresivo/psicología , Emociones , Conducta Materna/psicología , Relaciones Madre-Hijo , Madres/psicología , Adulto , Niño , Preescolar , Femenino , Alemania , Humanos , Masculino , Remisión Espontánea
13.
Psychopathology ; 49(4): 211-216, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27383771

RESUMEN

Maternal bonding has been described as the quality of the affective tie from a mother to her infant. This early bond's mental components and its longitudinal impact on child outcome have been markedly understudied. Although most researchers assume impaired maternal bonding to have a negative impact on child development, there is a lack of prospective studies evaluating this hypothesis. Since maternal mental health problems may negatively affect both bonding quality and child development, it is still to be determined whether there is a unique contribution of bonding quality to child behavior problems over and above maternal psychopathology. We examined a community sample of 101 mother-child dyads at the child's age of 2 weeks (t1) and 6 weeks (t2), 4 months (t3), 14 months (t4), and 5.5 years (t5). Maternal bonding and psychopathology were assessed at time points t1-t4 using the Postpartum Bonding Questionnaire (PBQ-16) and the Symptom Checklist Revised (SCL 90-R). Child behavior problems were rated in a multi-informant design by mothers and teachers at t5 using the Strengths and Difficulties Questionnaire (SDQ). In the case of maternal judgment of child behavior problems, bonding at 14 months (t4) proved to be a significant predictor (ß = 0.30; p = 0.011). Teacher-rated child behavior problems were significantly predicted by maternal bonding at 2 weeks (t1; ß = 0.48; p = 0.025). Our results indicate a prospective influence of the early mother-infant bond on child development and underline the unique contribution of bonding quality to child behavior problems over and above the impact of maternal psychopathology in a community sample.


Asunto(s)
Trastornos de la Conducta Infantil/psicología , Conducta Infantil/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Maestros/psicología , Adulto , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/epidemiología , Desarrollo Infantil , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios
14.
Psychopathology ; 49(4): 277-284, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27399847

RESUMEN

BACKGROUND: Maternal depression and anxiety disorders are risk factors for the development of internalizing disorders in offspring. Maternal attachment has been discussed as one factor accounting for transmission. The aim of this study was to investigate child internalizing behavior at preschool age on a symptomatic and behavioral level and possible links to maternal mental health over time and maternal attachment style insecurity in a sample of postpartum depressed and anxious mothers. SAMPLING AND METHODS: Child internalizing behavior at preschool age was rated by the Child Behavior Checklist (CBCL), the Caregiver-Teacher Report Form (C-TRF), and during a mother-child free-play situation. We focused on child responsiveness as it has been linked to child internalizing behavior. Maternal attachment style insecurity was tested to mediate the link between maternal mental health (assessed postpartum and at preschool age with the Structured Clinical Interview for DSM-IV Axis-I Disorders, SCID-I) and child internalizing behavior/child responsiveness. Of the overall sample (n = 58), 28 women were diagnosed with postpartum depression and/or anxiety disorders according to DSM-IV, and 30 were healthy controls. Data were collected 3-9 months after delivery and at preschool age (mean = 4.6 years). RESULTS: At preschool age, children of postpartum depressed and anxious mothers were rated significantly higher on child internalizing behavior by mothers, fathers, and additional caregivers compared to the control group. Child internalizing behavior rated by mothers was influenced by current psychiatric symptoms; maternal attachment style insecurity did not mediate this link. During interaction, children in the clinical group displayed significantly less child responsiveness compared to the control group. Maternal attachment style insecurity mediated the relationship between maternal mental health over time and child responsiveness. CONCLUSIONS: The results emphasize the need for interventions focusing on mother-child interaction and maternal attachment.


Asunto(s)
Trastornos de Ansiedad/psicología , Conducta Infantil/psicología , Depresión Posparto/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Adulto , Trastornos de Ansiedad/diagnóstico , Niño , Preescolar , Depresión Posparto/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Relaciones Intergeneracionales , Masculino , Persona de Mediana Edad , Psicopatología , Factores de Riesgo
15.
Psychopathology ; 49(5): 334-340, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27498091

RESUMEN

BACKGROUND/AIMS: High maternal emotional availability (EA) positively affects various domains of child development. However, the question of which factors promote or hinder maternal EA has not been investigated systematically. The present study investigated several maternal characteristics, namely maternal psychopathology, maternal attachment style insecurity, and theory of mind (ToM) as possible factors that influence maternal EA. METHODS: The sample was comprised of 56 mothers and their preschool-aged children. Half of the mothers were diagnosed with postpartum depression and or anxiety disorders according to DSM-IV, and the other half were healthy controls. RESULTS: The results showed that both low maternal attachment style insecurity and high ToM skills significantly predicted maternal EA sensitivity, independently from maternal postpartum and concurrent psychopathology and education. Moreover, maternal attachment style insecurity fully mediated the link between maternal postpartum psychopathology and sensitivity. CONCLUSION: The findings suggest that maternal attachment style security can buffer negative effects of maternal psychopathology on maternal sensitivity in the mother-child interaction.


Asunto(s)
Depresión Posparto/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Teoría de la Mente , Adulto , Trastornos de Ansiedad/psicología , Niño , Preescolar , Femenino , Humanos , Masculino , Psicopatología , Autoimagen
16.
Arch Gynecol Obstet ; 294(5): 937-944, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27084763

RESUMEN

PURPOSE: To analyze the current proportions and characteristics of women using Internet (eHealth) and smartphone (mHealth) based sources of information during pregnancy and to investigate the influence, this information-seeking behavior has on decision-making. METHODS: A cross-sectional study was conducted at two major German university hospitals. Questionnaires covering socio-demographic data, medical data and details of Internet, and smartphone application use were administered to 220 pregnant women. Data analysis utilized descriptive statistics and multiple regression analysis. RESULTS: 50.7 % of pregnant women were online information seekers. 22.4 % used an mHealth pregnancy application. Women using eHealth information showed no specific profile, while women using mHealth applications proved to be younger, were more likely to be in their first pregnancy, felt less healthy, and were more likely to be influenced by the retrieved information. Stepwise backward regression analysis explained 25.8 % of the variance of mHealth use. 80.5 % of cases were classified correctly by the identified predictors. All types of Web-based information correlated significantly with decision-making during pregnancy. CONCLUSIONS: Pregnant women frequently use the Internet and smartphone applications as a source of information. While Web usage was a common phenomenon, this study revealed specific characteristics of mHealth users during pregnancy. Improved, medically accurate smartphone applications might provide a way to specifically target the mHealth user group. As user influenceability was of major relevance to all types of information, all medical content should be carefully reviewed by a multidisciplinary board of medical specialists.


Asunto(s)
Internet , Embarazo/estadística & datos numéricos , Mujeres Embarazadas/psicología , Teléfono Inteligente , Telemedicina/métodos , Adulto , Estudios Transversales , Toma de Decisiones , Femenino , Alemania/epidemiología , Humanos , Teléfono Inteligente/estadística & datos numéricos , Encuestas y Cuestionarios , Telemedicina/estadística & datos numéricos
17.
Arch Gynecol Obstet ; 294(3): 455-66, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-26711837

RESUMEN

PURPOSE: This study aimed to investigate socio-demographic, medical and psychological factors that have an impact on breastfeeding. METHODS: Questionnaires were administered to 330 women prenatally (TI third trimester) and postpartum (TII 3-4 days, TIII 4 months). Medical data were collected from the hospital records. Self-reported data on initiation and maintenance of breastfeeding was collected simultaneously. Primary endpoint was breastfeeding initiation and maintenance. Data analyses were performed using Spearman's ρ correlations between breastfeeding and other study variables and generalized multiple ordinal logistic regression analysis. RESULTS: Neonatal admission to the NICU, high BMI, cesarean section, difficulties with breastfeeding initiation and high maternal state anxiety were the strongest predictors of impaired breastfeeding initiation, explaining together 50 % of variance. After 4 months, the strongest predictors of impaired maintenance of breastfeeding were maternal smoking, a high BMI and a history of postpartum anxiety disorder, explaining 30 % of variance. CONCLUSIONS: Successful initiation and maintenance of breast feeding is a multifactorial process. Our results underline the need of interdisciplinary approaches to optimise breastfeeding outcomes by demonstrating the equality of medical and psychological variables. Whereas practices on maternity wards are crucial for optimal initiation, continuous lifestyle modifying and supporting approaches are essential for breastfeeding maintenance. Healthcare providers can also significantly influence breastfeeding initiation and maintenance by counselling on the importance of maternal BMI.


Asunto(s)
Lactancia Materna , Adulto , Trastornos de Ansiedad/psicología , Índice de Masa Corporal , Lactancia Materna/psicología , Femenino , Humanos , Modelos Logísticos , Embarazo , Encuestas y Cuestionarios
18.
Arch Womens Ment Health ; 18(5): 707-16, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25833807

RESUMEN

To enhance understanding of impaired socio-emotional development in children of postpartum depressed or anxious mothers, this longitudinal study addressed the question of whether maternal postpartum depression and anxiety disorders result in deficits in children's processing of facial emotional expressions (FEEs) at pre-school age. Thirty-two mothers who had fulfilled Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria for postpartum depression and/or anxiety disorder and their pre-school aged children were tested for FEE processing abilities and compared to a healthy control group (n = 29). Child assessments included separate tasks for emotion recognition and emotion labelling. Mothers completed an emotion recognition test as well as the Structured Clinical Interview for DSM-IV Axis I Disorders I (SCID-I). Children of postpartum depressed and/or anxious mothers performed significantly worse than control children at labelling, but not at recognizing facial expressions of basic emotions. Emotion labelling at pre-school age was predicted by child age and maternal postpartum mental health, but neither current maternal mental health nor current maternal emotion recognition was associated with child FEE processing. Results point to a specific importance of early social experiences for the development of FEE labelling skills. However, further studies involving sensitive measures of emotion recognition are needed to determine if there might also exist subtle effects on FEE recognition.


Asunto(s)
Trastornos de Ansiedad/complicaciones , Trastornos del Conocimiento/etiología , Depresión Posparto/complicaciones , Emociones , Expresión Facial , Adulto , Trastornos de Ansiedad/psicología , Niño , Hijo de Padres Discapacitados , Preescolar , Trastornos del Conocimiento/psicología , Depresión Posparto/psicología , Femenino , Alemania , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Madres/psicología , Periodo Posparto , Embarazo , Reconocimiento en Psicología
19.
Psychopathology ; 48(3): 173-83, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25833227

RESUMEN

BACKGROUND/AIMS: Affective behavioural matching during face-to-face interaction fosters the transition from mutual regulation to infant self-regulation. Optimum midrange models of mother-infant interaction hold that moderate degrees of dyadic matching facilitate infant socio-emotional development. The aim of this study was to examine which degree of dyadic matching is most beneficial for infant self-regulation. METHODS: To evaluate this model, 3 groups of highly, midrange and poorly matched dyads were created from a mixed sample of 68 dyads with healthy and post-partum depressed mothers and their infants (age range = 1-8 months, mean age = 3.9 months). Mother-infant interactions were videotaped in the face-to-face still-face paradigm (FFSF) and micro-analytically coded. Specifically, the relation between affective behavioural matching in FFSF play and infant positive and negative affect in FFSF still face and FFSF reunion was explored. RESULTS: Contrary to our expectation, we found a monotonous trend for all groups: the more matching in FFSF play, the more positive and less negative affect the infant showed in FFSF still face and FFSF reunion, respectively. CONCLUSION: The present findings further illuminate the association between different degrees of dyadic matching in early mother-infant interaction and infant self-regulation. Further research should focus on the integration and replication of findings and conceptual approaches to further evaluate and refine the concept of midrange matching and make it applicable to therapeutic work with mothers and their infants.


Asunto(s)
Afecto , Desarrollo Infantil , Depresión Posparto/psicología , Expresión Facial , Relaciones Madre-Hijo/psicología , Madres/psicología , Juego e Implementos de Juego , Controles Informales de la Sociedad , Adulto , Emociones , Femenino , Humanos , Lactante , Masculino , Conducta Materna , Conducta Social , Grabación en Video
20.
Psychopathology ; 48(6): 386-99, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26550998

RESUMEN

BACKGROUND: The latency to reparation of interactive mismatches (interactive repair) is argued to regulate infant distress on a psychobiological level, and maternal anxiety disorders might impair infant regulation. SAMPLING AND METHODS: A total of 46 dyads (19 mothers with an anxiety disorder, 27 controls) were analyzed for associations between interactive repair and infant cortisol reactivity during the Face-to-Face-Still-Face paradigm 3-4 months postpartum. Missing cortisol values (n = 16) were imputed. Analyses were conducted on both the original and the pooled imputed data. RESULTS: Interactive repair during the reunion episode was associated with infant cortisol reactivity (original data: p < 0.01; pooled data: p < 0.01) but not maternal anxiety disorder (p > 0.23). Additional stepwise regression analyses found that latency to repair during play (p < 0.01), an interaction between distress during the first trimester of pregnancy and latency to repair during reunion (p < 0.01) and infant self-comforting behaviors during the reunion episode (p = 0.04) made independent contributions to cortisol reactivity in the final regression model. CONCLUSIONS: This is the first study demonstrating that interactive repair is related to infant psychobiological stress reactivity. The lack of a relation to maternal anxiety disorder may be due to the small sample size. However, this result emphasizes that infants respond to what they experience and not to the maternal diagnostic category.


Asunto(s)
Depresión Posparto/sangre , Hidrocortisona/sangre , Conducta del Lactante/fisiología , Apego a Objetos , Adaptación Psicológica/fisiología , Adulto , Femenino , Humanos , Lactante , Masculino , Relaciones Madre-Hijo , Madres/psicología , Embarazo , Análisis de Regresión
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