Demographic, Medical, and Psychosocial Predictors of Pregnancy Anxiety.

BACKGROUND: Pregnancy anxiety is associated with risk of preterm birth and an array of other birth, infant, and childhood outcomes. However, previous research has not helped identify those pregnant women at greatest risk of experiencing this specific, contextually-based affective condition. METHODS: We examined associations between demographic, medical, and psychosocial factors and pregnancy anxiety at 24-26 weeks of gestation in a prospective, multicentre cohort study of 5271 pregnant women in Montreal, Canada. RESULTS: Multivariate analyses indicated that higher pregnancy anxiety was independently related to having an unintended pregnancy, first birth, higher medical risk, and higher perceived risk of complications. Among psychosocial variables, higher pregnancy anxiety was associated with lower perceived control of pregnancy, lower commitment to the pregnancy, more stressful life events, higher perceived stress, presence of job stress, lower self-esteem and more social support. Pregnancy anxiety was also higher in women who had experienced early income adversity and those who did not speak French as their primary language. Psychosocial variables explained a significant amount of the variance in pregnancy anxiety independently of demographic and medical variables. CONCLUSIONS: Women with pregnancy-related risk factors, stress of various kinds, and other psychosocial factors experienced higher pregnancy anxiety in this large Canadian sample. Some of the unique predictors of pregnancy anxiety match those of earlier US studies, while others point in new directions. Screening for high pregnancy anxiety may be warranted, particularly among women giving birth for the first time and those with high-risk pregnancies.

Regenerative Strategies in Treatment of Peripheral Nerve Injuries in Different Animal Models.

BACKGROUND: Peripheral nerve damage mainly resulted from traumatic or infectious causes; the main signs of a damaged nerve are the loss of sensory and/or motor functions. The injured nerve has limited regenerative capacity and is recovered by the body itself, the recovery process depends on the severity of damage to the nerve, nowadays the use of stem cells is one of the new and advanced methods for treatment of these problems. METHOD: Following our review, data are collected from different databases "Google scholar, Springer, Elsevier, Egyptian Knowledge Bank, and PubMed" using different keywords such as Peripheral nerve damage, Radial Nerve, Sciatic Nerve, Animals, Nerve regeneration, and Stem cell to investigate the different methods taken in consideration for regeneration of PNI. RESULT: This review contains tables illustrating all forms and types of regenerative medicine used in treatment of peripheral nerve injuries (PNI) including different types of stem cells " adipose-derived stem cells, bone marrow stem cells, Human umbilical cord stem cells, embryonic stem cells" and their effect on re-constitution and functional recovery of the damaged nerve which evaluated by physical, histological, Immuno-histochemical, biochemical evaluation, and the review illuminated the best regenerative strategies help in rapid peripheral nerve regeneration in different animal models included horse, dog, cat, sheep, monkey, pig, mice and rat. CONCLUSION: Old surgical attempts such as neurorrhaphy, autogenic nerve transplantation, and Schwann cell implantation have a limited power of recovery in cases of large nerve defects. Stem cell therapy including mesenchymal stromal cells has a high potential differentiation capacity to renew and form a new nerve and also restore its function.

Symptom change prior to treatment discontinuation (dropout) from a naturalistic Veterans Affairs evidence-based psychotherapy clinic for PTSD and depression.

Dropout or treatment discontinuation from evidence-based psychotherapies (EBPs) has been a concern for clinicians as it is thought that such discontinuation prevents patients from achieving a full course of therapy and obtaining maximum benefit. Recent studies, however, suggest that treatment discontinuation may sometimes be due to symptom improvement. The purpose of the current evaluation was to examine change in self-reported symptoms in participants who completed versus did not complete treatment in a Veterans Affairs outpatient clinic offering EBPs for both depression and posttraumatic stress disorder (PTSD). Data were collected from 128 participants who had at least one treatment session postintake and had been discharged from the clinic. Data were collected on self-reported PTSD and depression symptoms. Of the 128 veterans, 61 completed treatment and 67 did not complete treatment (54.0% noncompletion in PTSD EBPs and 48.7% noncompletion in depression EBPs). Of those who did not complete, 47 were enrolled in a PTSD EBP and 20 in a depression EBP. Of those who did not complete a PTSD EBP, 51.1% had no change in PTSD symptoms prior to treatment discontinuation, whereas 12.8% had a symptom increase, and 27.7% had a symptom decrease. Of those who did not complete a depression EBP, 55% had no change in depression symptoms prior to treatment discontinuation, 15% had a symptom increase, and 30% had a decrease. Overall, results suggest that treatment discontinuation is not as straightforward as it may seem and that prematurely discontinuing an EBP may not necessarily represent treatment failure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The birth of a story: Childbirth experiences, meaning-making, and postpartum adjustment.

The present study investigated how meaning-making around a birth experience predicts relationship quality and parenting stress across the transition to first-time parenthood, a time that many new parents find stressful and challenging. Childbirth experiences may set the stage for these challenges, and how new parents make meaning of childbirth could play a role in their subsequent postpartum adjustment. Meaning-making processes (sense making, benefit finding, and changes in identity) were coded from birth narratives collected from 77 mixed-sex biological parent dyads (n = 154 individuals) shortly after the birth of their first child. Parents reported on their relationship quality during pregnancy and at 6 months postpartum, and on their parenting stress postpartum. Mothers' greater sense making and benefit finding buffered longitudinal declines in their own relationship quality, and maternal sense making also buffered declines for fathers. Fathers' greater sense making and benefit finding predicted lower levels of their own parenting stress, whereas mothers' greater sense making and benefit finding were linked with higher paternal parenting stress. Finally, fathers' discussion of changes in identity predicted lower levels of parenting stress in mothers. These results suggest the importance of meaning-making following childbirth for couples adjusting to parenthood and highlight the value of studying meaning-making processes dyadically. Clinicians may be able to support new parents by facilitating their coconstruction of meaning during their shared birth experience and transition to parenthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Physiological linkage in pregnancy: Couples' cortisol, negative conflict behavior, and postpartum depression.

Within-couple concordance in momentary cortisol levels ("cortisol linkage") may reflect meaningful relationship dynamics. In this study, we examined couple cortisol linkage during pregnancy, associations with negative conflict couple behavior, and subsequent postpartum depressive symptoms. Eighty-two opposite-sex couples expecting their first child engaged in a conflict discussion, provided six salivary cortisol samples over the course of a laboratory visit, and then reported on depressive symptoms six months after their baby's birth. Couples' cortisol levels were significantly positively associated with each other, indicating linkage. When mothers and fathers behaved less negatively during the prenatal conflict discussion, they exhibited stronger couple cortisol linkage. Stronger cortisol linkage also predicted fewer postpartum depressive symptoms for fathers. Negative conflict behavior did not moderate the association between cortisol linkage and postpartum depression. These findings suggest that stronger physiological associations between partners during pregnancy may reflect healthier relationship interactions and be beneficial to fathers' postpartum mental health.

Prenatal relationship conflict behavior predicts childbirth experiences and birth outcomes.

Despite evidence linking prenatal psychosocial stress and social support to perinatal maternal and infant health, no study has explored couple conflict behavior during pregnancy as a predictor of subsequent birth outcomes. The current study examines whether couples' positive and negative conflict behaviors during pregnancy predict their stress during the birth experience and gestational and birth outcomes. Forty-seven first-time expectant couples participated in a conflict discussion during pregnancy that was observationally coded. Several months later, following the birth of their child, couples reported on their subjective childbirth stress. By summing medical chart data on gestational outcomes and birth complications, we computed a cumulative birth risk score. Negative conflict behavior was related to higher cumulative birth risk scores, and conversely, positive conflict behavior was associated with lower birth risk, even after controlling for maternal pregnancy symptoms. Similarly, more negative conflict behavior predicted higher mother-reported birth stress, while positive conflict behavior predicted lower father-reported birth stress. However, birth stress effects became nonsignificant after controlling for maternal pregnancy symptoms. Although the pregnancy literature has focused primarily on maternal characteristics, these findings highlight the significance of couple interactions in predicting parental birth stress and birth outcomes. This study integrates psychological, behavioral, and medical chart data to enhance our understanding of how interpersonal factors influence gestational outcomes and the birth experience. These results have important clinical implications for potential couple interventions during pregnancy that can shape fetal development, the labor and delivery experience, and influence child and family health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Maternal prenatal plasma oxytocin is positively associated with prenatal psychological symptoms, but method of immunoassay extraction may affect results.

We examined associations between prenatal plasma oxytocin levels and depressive symptoms, state anxiety, and pregnancy anxiety in 75 women who visited the laboratory with their partners during mid-to-late pregnancy and engaged in relationship discussion tasks prior to a blood draw. Given controversy in the literature regarding oxytocin measurement, we compared two widely-used immunoassay approaches (with and without extraction prior to immunoassay). Levels of immunoreactive oxytocin measured with and without extraction were not correlated with each other. However, both extracted and unextracted oxytocin were positively associated with women's prenatal depressive symptoms in a model that controlled for pregnancy stage and body mass index. Only unextracted oxytocin was associated with state anxiety and pregnancy-specific anxiety. In summary, elevated plasma oxytocin levels in expectant mothers might indicate risk for mental health symptoms during the prenatal period, but results for anxiety are mixed and appear to depend on the immunoassay approach employed.

The weight of fatherhood: identifying mechanisms to explain paternal perinatal weight gain.

Men appear to gain weight during the transition to parenthood, and fathers are heavier than non-fathers. Paternal perinatal weight gain may set weight trajectories in midlife and have long-term health implications. Since men do not undergo the physical demands of pregnancy and breastfeeding, the specific mechanisms underlying weight gain in new fathers warrant investigation. This review aims to stimulate research on paternal perinatal weight gain by suggesting testable potential mechanisms that (1) show change across the transition to parenthood and (2) play a role in weight and body composition. We identify seven mechanisms, within three categories: behavioural mechanisms (sleep, physical activity, and diet), hormonal mechanisms (testosterone and cortisol), and psychological mechanisms (depression and stress). We also discuss direct effects of partner pregnancy influences (e.g., 'couvade syndrome') on men's body weight. In presenting each mechanism, we discuss how it may be affected by the transition to parenthood, and then review its role in body composition and weight. Next, we describe bidirectional and interactive effects, discuss timing, and present three broad research questions to propel theoretical development.

Correlates of self-efficacy for disease management in adolescent/young adult cancer survivors: A systematic review.

OBJECTIVE: The primary objective of this review was to summarize the literature regarding factors associated with self-efficacy for disease management (SEDM) in cross-sectional studies and the efficacy/effectiveness of psychosocial interventions that are designed to improve SEDM in adolescent and young adult (AYA) cancer survivors. The secondary aim was to assess the quality of included studies. METHOD: We conducted a systematic review using PsycINFO and PubMed to identify studies for review. Eligible studies were conducted in AYA cancer survivors ages 15 to 39; included a measure of SEDM assessed as an outcome or in a cross-sectional analysis; and were published in a peer-reviewed, English-language journal. RESULTS: From the 2,910 records screened, 7 cross-sectional studies and 4 intervention studies met criteria for inclusion. Eleven of the 12 SEDM measures in the studies were author-constructed, limiting the ability to draw conclusions across studies. All cross-sectional studies met at least 21 of 26 relevant quality assessment criteria, and intervention studies met between 4 and 11 of 14 criteria. Cross-sectional findings indicate that SEDM is positively associated with health-promoting behaviors and inversely related to physical and mental health problems. The intervention studies demonstrated that behavioral and educational interventions have the potential to increase SEDM. CONCLUSION: Directions for research include the need for validated measures of SEDM for AYA cancer survivors, as well as interventions that target both the health care team's and the patient's role in promoting SEDM. (PsycINFO Database Record