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BACKGROUND: While past research detected a direct link between symptoms of fibromyalgia (FM) and psychological distress, body appreciation was suggested as a viable mediator of this link. The aim of the present study was to further develop an explanatory model for the effect of FM on women's psychological distress and identify possible protective and risk factors. Specifically, it was hypothesized that self-compassion would moderate the indirect effect of body appreciation and self-criticism on psychological distress in women with FM. METHOD: This study comprised a total of 293 women, aged 20-68 (M = 34.8, SD = 12.3), of whom 146 were women with FM and 147 were heathy controls. All the women completed questionnaires regarding demographic characteristics, depression (PHQ-9), anxiety (GAD-7), self-criticism (DEQ-SC), body appreciation (BAS2), and the self-compassion scale (SCS). RESULTS: A moderated serial mediation model demonstrated lower body appreciation in participants with FM compared to controls. These lower levels of body appreciation, together with lower levels of self-compassion, were associated with greater self-criticism and, consequently, higher levels of psychological distress. CONCLUSIONS: The results emphasize the role of self-compassion as a protective mechanism against psychological distress among women with FM. Future studies should further investigate the effect of self-compassion-focused interventions on patients with FM.
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Objective: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder associated with reduced quality of life and psychological distress (PD) including anxiety and depression. The mechanisms linking IBS to PD are unclear. Previous studies showed that body image and self-criticism may be contributory factors. Thus, the objective of this study was to test the potential mediating roles of these factors in the relationship between IBS and PD. Method: 507 adults participated, including 142 with IBS (Mean age = 31.9, SD = 11.7), and 365 healthy peers (Mean age = 26.2, SD = 6.4), ranging in age from 18 to 75. The majority of participants were women (78%). Self-report measures assessed IBS status, body appreciation, body dissatisfaction, self-criticism, sociodemographic status, depression, and anxiety. Path analysis tested the hypothesized mediation model. Results: IBS participants reported greater PD, lower body appreciation, higher body dissatisfaction, and higher self-criticism than controls. Body appreciation and self-criticism sequentially mediated the link between IBS status and both depression and anxiety. IBS was associated with reduced body appreciation, which in turn was linked to heightened self-criticism, thereby leading to elevated psychological distress. Conclusion: Results suggest IBS negatively impacts body image appreciation, fostering self-critical judgments that exacerbate psychological symptoms. This study is the first to demonstrate a significant association between body appreciation and IBS, specifically highlighting this relationship. Findings clarify the psychosocial pathways at play in the comorbidity of mental health issues in IBS. Physicians and other health professionals are advised to detect women with IBS who are distressed, and to offer them appropriate intervention to prevent downstream consequences.
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PROBLEM: Research suggests that breastfeeding self-efficacy (i.e., a mother's perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations. BACKGROUND: To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel. HYPOTHESIS: We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers. METHOD: A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs. FINDINGS: Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers. DISCUSSION: In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy. CONCLUSION: Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.
Subject(s)
Body Image , Self Efficacy , Female , Humans , Infant , Body Image/psychology , Breast Feeding/psychology , Israel , Postpartum Period/psychology , Mothers/psychologyABSTRACT
PURPOSE: The purpose of this study was to assess the trajectory of women's depressive symptoms during the first six months postpartum, identify risk factors (sociodemographic, obstetric and personality) associated with classes, and examine associations between classes and postpartum PTSD at two months and bonding at six months. METHODS: The final sample included 212 women who gave birth in the maternity wards of a large tertiary health center that were approached at 1-3 days, two months, and six months postpartum and completed a demographic questionnaire and measures of neuroticism (BFI) and postpartum depression (EPDS), postpartum PTSD (City Birth Trauma Scale) and bonding (PBQ). Obstetric data were taken from the medical files. RESULTS: Cluster analysis revealed three distinctive clusters: "stable-low" (64.2%), "transient-decreasing" (25.9%), and "stable-high" (9.9%). Neuroticism, general-related PTSD symptoms, and bonding were associated with differences between all trajectories. Birth-related PTSD symptoms were associated with differences between both stable-high and transient-decreasing trajectories and the stable-low trajectory. No obstetric or demographic variables were associated with differences between trajectories. CONCLUSION: We suggest that screening women for vulnerabilities such as high levels of neuroticism and offering treatment can alleviate the possible deleterious effects of high-symptom depression trajectories that may be associated with their vulnerability.
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Objective: To determine genealogical, clinical and pathological characteristics of a cohort with Cys618Arg mutation from an Israeli multicenter MTC study. Methods: Retrospective database analysis examining RET mutations and comparing Cys618Arg and Cys634Arg/Thr/Tyr subgroups. Results: Genetic testing was performed in 131/275 MTC patients (47.6%). RET mutations were found in 50/131 (38.2%), including Cys618Arg (28/50 cases,56%), and Cys634Arg/Thr/Tyr (15/50,30%). Through genealogical study, 31 MTC patients were found descendants of one family of Jewish Moroccan descent, accounting for 27/28 patients with documented Cys618Arg mutation and 4 patients without available genetic testing. Familial Cys618Arg cases (n=31) and Cys634Arg/Thr/Tyr cases (n=15, from 6 families) were compared. Although surgical age was similar (25.7 vs 31.3 years, p=0.19), the Cys618Arg group had smaller tumors (8.9mm vs 18.5mm, p=0.004) and lower calcitonin levels (33.9 vs 84.5 X/ULN, p=0.03). Youngest ages at MTC diagnosis were 8 and 3 years in Cys618Arg and Cys634Arg/Thr/Tyr cohorts, respectively. Long-term outcome was similar between groups. The Cys618Arg cohort had lower rates of pheochromocytoma (6.5% vs 53.3%, p=0.001) and primary hyperparathyroidism (3.2% vs 33.3%, p=0.01). Conclusion: This is the first description of RET mutation distribution in Israel. Of 131 tested MTC patients, Cys618Arg was the predominant mutation. To the best of our knowledge, this is the largest cohort of Cys618Arg mutation described. For Cys618Arg and Cys634Arg/Thr/Tyr cohorts, MTC was diagnosed earlier than expected, likely due to familial genetic screening, and MTC outcomes were similar between groups. International studies are necessary to further characterize the clinical features of Cys618 mutations due to their relative rarity.
Subject(s)
Adrenal Gland Neoplasms , Carcinoma, Medullary , Multiple Endocrine Neoplasia Type 2a , Thyroid Neoplasms , Humans , Adult , Israel/epidemiology , Carcinoma, Medullary/surgery , Multiple Endocrine Neoplasia Type 2a/diagnosis , Retrospective Studies , Proto-Oncogene Proteins c-ret/genetics , Thyroid Neoplasms/pathology , MutationABSTRACT
BACKGROUND CONTEXT: The annular epiphysis (AE) is a peripheral ring of cortical bone that forms a secondary ossification center in the superior and inferior surfaces of vertebral bodies (VBs). The AE is the last ossification site in the skeleton, typically forming at about the 25th year of life. The AE functions jointly with vertebral endplates to anchor the intervertebral discs to the VBs. PURPOSE: To establish accurate data on the sizes of the AE of the cervical spine (C3-C7); to compare the ratios between areas and the ratios of the AE to VBs; to compare the ratios between the superior and inferior VB surface areas; and to compare AE lengths between the posterior and anterior midsagittal areas. STUDY DESIGN: Measurement of 424 cervical spines (C3-C7) obtained from the skeletal collection of the Natural History Museum, Cleveland, Ohio (USA). METHODS: The sample was characterized by sex, age, and ethnic origin. The following measurements were recorded for each vertebra: (1) the surface area of the VBs and the AE, (2) the midsagittal anterior and posterior length of the AE, (3) the ratios between the AE and VB surface areas, and (4) the ratios between the superior and inferior disc surface areas. RESULTS: The study revealed that the AE and VBs in men were larger than in women. With age, the AE and VBs became larger; the ratio between the AE and VB surface was approximately 0.5 throughout the middle to lower cervical spine. The ratio of superior to inferior VBs was approximately 0.8. We found no differences between African Americans versus European Americans or between the anterior versus the posterior midsagittal length of the AE of the superior and inferior VBs. CONCLUSIONS: The ratios between the superior and inferior VBs are ≥0.8, and the ratio is the same for the entire middle to lower spine. Thus, the ratio between the superior and inferior VBs to the AE is ≥ 0.5. Men had larger AEs and VBs than women did, with both VBs and AEs becoming larger with age. Knowing these relationships are important so that orthopedic surgeons can best correct these issues in young patients (<25 years old) during spine surgery. The data reported here provide, for the first time, all the relevant sizes of the AE and VB. In future studies, AEs and VBs of living patients can be measured with computed tomography. CLINICAL SIGNIFICANCE: The ER location and function are clinically significant showing any changes during life that might lead to clinical issues related to intervertebral discs such as intervertebral disc asymmetry, disc herniation, nerve pressure, cervical osteophytes and neck pain.
Subject(s)
Cervical Vertebrae , Intervertebral Disc , Male , Humans , Female , Adult , Cervical Vertebrae/physiology , Neck , Tomography, X-Ray Computed , Epiphyses/diagnostic imagingABSTRACT
Perinatal distress affects approximately 10% of fathers, but little is known about how gay fathers experience the challenges surrounding childbirth and early parenting of a child. This study explored gay fathers' experiences of having a baby via transnational surrogacy, raising that baby as a gay parent, and the context of the COVID-19 pandemic. In-depth qualitative interviews were conducted with 15 Israeli men to understand their experiences of surrogacy and early parenthood, focusing on the impact on their mental health and the relational factors involved. Secondary narrative analysis revealed that fathers constructed surrogacy as a perilous quest that required strong intentionality to undertake. The first year of parenthood was conceptualised alternately as a joyful experience and/or one that challenged fathers' identities and mental health. A relational framework was applied to better conceptualise the fathers' narratives, revealing that actual connections-and the potentials for links-considerably shaped experiences of surrogacy, perinatal distress and recovery. Implications for research and policy are discussed.
Subject(s)
COVID-19 , Sexual and Gender Minorities , Male , Pregnancy , Infant , Child , Female , Humans , Fathers/psychology , Mental Health , Israel , Pandemics , Surrogate Mothers/psychology , Parenting/psychologyABSTRACT
Dream sharing is a universal practice, and various incentives have been identified, including emotional processing, emotional relief, and demands for containment. Shared dreams can contribute to an individual's understanding of social reality during traumatic and stressful events. The present study examined dreams shared on social network sites (SNS) during the first COVID-19 lockdown, applying a group-analytic approach. A qualitative dream content analysis conducted by a group of researchers analyzed 30 dreams shared on SNS, focusing on their contents, dominant emotions, and unique group processes. The dream content analysis yielded three meaningful and coherent themes: (1) dominant threats: enemy, danger, and COVID-19; (2) emotional fusion: confusion and despair alongside recovery and hope; and (3) group processes characterized by movement between being alone and being together. The results deepen our understanding of both unique social and psychological group processes and of people's main experiences and key psychological coping mechanisms in times of collective trauma and natural disasters. They also demonstrate the transformative potential of dreamtelling for individuals' coping experiences and building hope through the creative social relationships formed within SNS groups.
Subject(s)
COVID-19 , Pandemics , Humans , Communicable Disease Control , Emotions , Social NetworkingABSTRACT
The purpose of the present study was to identify the protective and risk factors related to psychological distress during COVID-19 in an Israeli sample. An online survey was administered from April 19 to May 2, 2020, while a strict lockdown was in place. Participants were recruited by snowball sampling. Psychological distress was evaluated using the Generalized Anxiety Disorder questionnaire (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Risk and protective factors for psychological distress were assessed on the Multi-dimensional Perceived Social Support (MSPSS), the coping strategies (COPE), the Life Orientation Test (LOT), and the Gratitude questionnaire. Out of the 655 valid questionnaires collected (from participants ranging in age from 18 to 86, 246 males, 409 females), 138 (21.3%) were positive for moderate to very severe depression and 87 (13.2%) for moderate to extremely severe anxiety. Participants who were screened for depression and anxiety were more likely to be women and young adults (18-24). After adjusting statistically for gender, age, and socioeconomic status, depression and anxiety remained significantly associated with both emotion-focused (PHQ-ß =.437, p < .001, GAD-ß=.441, p < .001) and problem-focused (PHQ-ß =-.219, p < .001, GAD-ß=-.143, p < .001) coping strategies, as well as on the social support (PHQ-ß =-.167, p < .001, GAD-ß=-.155, p < .001), life orientation (GAD-ß=-.09, p < .001), and gratitude scales (PHQ-ß =-.07, p < .001). Levels of anxiety and depression were generally associated with gender (women), age (younger population), socioeconomic status (low), and an emotion-focused strategy as risk factors. A problem-focused strategy, social support, life orientation, and gratitude served as protective factors above and beyond personal background.
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BACKGROUND: The study's aims were to examine whether the COVID-19 pandemic was associated with increases in depression levels of 21 months postpartum women who were initially sampled before the pandemic and whether COVID-19-related worries mediated the association between women's attachment orientations and this hypothesized increase. METHODS: Participants comprised 185 postpartum women sampled in the maternity ward of a tertiary healthcare center in Israel followed from childbirth to 21 months postpartum in four-time points. . We analyzed demographic and obstetric information and the Experiences in Close Relationships (ECR) scale at T1; changes in the Edinburgh Postnatal Depression Scale (EPDS) levels at all timepoints (T1-4); and COVID-19-related worries at T4. RESULTS: Results showed a significant increase in depression levels at T4 compared to T2 and T3, and an increase in the prevalence of women at the lower clinical EPDS threshold. COVID-19-related worries mediated the association between anxious attachment and depression (indirect effect: B = .21, p < .05, 95% CI = (.015, .47), R2=0.12). DISCUSSION: The evident effect of COVID-19 on postpartum depression is associated with variability between people. Thus, early assessment of women's attachment orientations might provide a strategy for identifying and treating women at risk.
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This study aimed to explore the psychological welfare, as indicated by postnatal depressive symptomatology, life satisfaction, and posttraumatic growth (growth after contending with stressful birth events), of Israeli gay fathers through surrogacy in comparison to heterosexual fathers. For that purpose, a sample of 167 Israeli fathers (M = 35.6, SD = 4.4) was recruited (68 identified as gay fathers through surrogacy and 99 as heterosexual fathers). Participants completed questionnaires assessing their postnatal depressive symptomatology, life satisfaction, and sense of posttraumatic growth after becoming fathers. Results indicated that gay fathers through surrogacy reported higher levels of life satisfaction and posttraumatic growth than heterosexual fathers. Yet, gay fathers also reported higher levels of postnatal depressive symptomatology than heterosexual fathers when life satisfaction or posttraumatic growth values were low or medium. The findings were interpreted in light of the hardships associated with cross-border surrogacy and the psychological outcomes associated with succeeding to become fathers after contending with them. The study contributes to the limited literature on postnatal depressive symptomatology and posttraumatic growth among gay fathers through surrogacy and provides clinicians and policymakers with relevant information on the psychological strengths and potential difficulties associated with cross-border surrogacy among gay fathers.
Subject(s)
COVID-19 , Posttraumatic Growth, Psychological , Sexual and Gender Minorities , Fathers/psychology , Female , Heterosexuality/psychology , Homosexuality, Male/psychology , Humans , Israel/epidemiology , Male , Personal Satisfaction , Pregnancy , Surrogate Mothers/psychologyABSTRACT
Although continuous support during childbirth is recommended by the World Health Organization (WHO) and has well-established benefits, the practice is still not routinely implemented in all maternity settings. We studied the possible effect of an additional lay companion (other than the partner) on childbirth experience and postpartum post-traumatic stress disorder (PTSD). Two hundred and forty-six women, who gave birth in maternity wards of a large tertiary health center in Israel, responded to questionnaires in person at 1-4 days (Demographic questions and the childbirth experience questionnaire) and on-line at 8-10 weeks postpartum (City Birth Trauma Scale). Obstetric data were taken from the medical files. Women who were accompanied by their partners and an additional companion were lower in birth-related PTSD symptoms (M = 1.17, SD = 2.61) than women accompanied by only their partner (M = 1.53, SD = 2.79) (F(2, 240) = 4.0, p < 0.05). Women who had a single companion (M = 1.44, SD = 2.61) showed more birth-related PTSD symptoms than women who had two or more companions (M = 1.17, SD = 2.52) (F(1, 241) = 6.4, p < 0.05). In addition, women who had a single companion were higher in general PTSD symptoms (M = 3.91, SD = 4.73) than women who had two or more companions (M = 2.31, SD = 4.29) (F(1, 241) = 4.2, p < 0.05). No differences were found in childbirth experiences of women with single or multiple companions. Allowing more than one lay companion (other than the partner) may be a simple cost-effective way of providing beneficial support in all birth settings, promoting respectful maternity care and reducing childbirth-related PTSD levels and by that future psychopathology sequela.
Subject(s)
Maternal Health Services , Parturition , Stress Disorders, Post-Traumatic , Delivery, Obstetric , Female , Humans , Israel/epidemiology , Parturition/psychology , Postpartum Period , Pregnancy , Stress Disorders, Post-Traumatic/epidemiologyABSTRACT
Sharing dreams is a common practice, and several motives, such as emotional processing, emotional relief, and request for containment, have been identified. An exploratory single case study research design was used to explore the experiences of the COVID-19 pandemic and local military conflict among a group of Israeli students. The group discussed a dream previously shared in social network sites during the first COVID-19 lockdown. A qualitative content analysis of the meeting transcript yielded three meaningful and coherent themes: feeling blocked and helpless in front of a barrier; a sense of intrusion, defense, and psychological coping; belonging to the group as a means of coping with an individual and a collective threat. Each of these themes reflected personal, interpersonal, and social aspects of the participants' experiences. The results deepen the understanding of people's dominant experiences and main psychological coping mechanisms during a collective stressful event. Further, they support the positive effect of the dreamtelling approach on individuals' coping experiences and on enhancing hope by sharing and discussing dreams with others.
Subject(s)
COVID-19 , Military Personnel , Adaptation, Psychological , COVID-19/epidemiology , Communicable Disease Control , Humans , PandemicsABSTRACT
The research aim was to study the possible effect of epidural analgesia, as well as other possible demographic/obstetric variables and subjective birth experience on postpartum depression, PTSD, and impaired bonding. This was a longitudinal study of 254 women who gave birth at the maternity wards of a large tertiary health center and responded to questionnaires at T1 (Childbirth Experience Questionnaire and level of fatigue question; in person, 1-4 days postpartum) and at T2 (Postnatal Depression Scale, Postpartum Bonding Questionnaire, and the City Birth Trauma Scale; online-two months postpartum). Obstetric and demographic data were taken from medical files. Having a previous psychiatric diagnosis and higher levels of fatigue significantly predicted worse outcomes in all measures (level of fatigue was not associated with the City Birth Trauma birth-related symptoms factor). Having higher education, being primiparous, worse birth experience, and longer second stage of birth predicted worse outcomes in some measures. Although epidural administration had no effect on any of the outcome variables, special attention should be devoted to women who had long second-stage births and/or suffering from postpartum fatigue to prevent postpartum psychopathology. In addition, demographic variables, such as primiparity, education, and prior psychopathology diagnosis should be considered to treat women and prevent postpartum psychopathology.
Subject(s)
Analgesia, Epidural , Depression, Postpartum , Stress Disorders, Post-Traumatic , Female , Pregnancy , Humans , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Depression/psychology , Longitudinal Studies , Postpartum Period/psychology , Depression, Postpartum/diagnosis , Surveys and QuestionnairesABSTRACT
OBJECTIVES: While symptoms of fibromyalgia (FM) and psychological distress are directly linked, indirect effects are also apparent. The aim of the present study was to develop an explanatory model for the effect of FM on women's psychological distress and identify possible protective and risk factors. METHODS: This study comprised of total of 293 women aged 20-68 (M= 34.3, SD = 12.1), of which 141 were women with FM and 152 healthy peers (HP), who completed questionnaires regarding demographic characteristics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), social comparison strategies, and pain assessment (SF-MPQ). RESULTS: FM patients demonstrated higher psychological distress, i.e., depression and anxiety and lower body appreciation. Body appreciation significantly correlated with social comparison coping strategies. Body appreciation and social comparison strategies mediated the link between FM and psychological distress. Among FM patients, body appreciation moderated the links between pain intensity and aspects of social comparison strategies, thus explaining the link between pain intensity and psychological distress. CONCLUSIONS: Women with FM demonstrated higher levels of anxiety and depression symptoms and lower body appreciation compared to HP. The unique role of body appreciation in moderating the indirect link between pain and psychological distress appears to be protective.
Subject(s)
Fibromyalgia , Psychological Distress , Anxiety/psychology , Depression/psychology , Female , Fibromyalgia/diagnosis , Fibromyalgia/psychology , Humans , Male , Pain/diagnosis , Pain/etiology , Pain/psychology , Protective Factors , Social Comparison , Social Perception , Stress, Psychological/diagnosis , Stress, Psychological/psychologyABSTRACT
AIM: The aim of this study was to evaluate the incidence of positive WBS in patients with negative stimulated thyroglobulin (sTg), to define the clinical characteristics of this group, and the association with disease outcome. METHODS: DTC patients who underwent surveillance with simultaneous sTg and WBS were included. RESULTS: Two hundred seventy-two patients were included. Age at diagnosis was 46.5 ± 15.2 years, 79% were female. Mean duration of follow-up was 11.6 ± 6.8 years. Patients were categorised according to stimulation test results: sTg(-)/WBS(-) in 192/272 (70.6%); sTg(+) regardless of WBS results in 33/272 (12.1%); and sTg(-)/WBS(+) in 47/272 (17.3%) subjects. sTg > 10 mg/dl was considered positive. The three groups had similar demographic and pathologic characteristics. During follow-up, additional treatment was given in 77 patients (28.3%). Twelve (4.4%) developed distant metastases; 16 patients (5.8%) died. No deaths were disease-related. There was no difference in mortality rate between categories (P = 0.182). On multivariate analysis, additional treatment was associated with male gender (P = 0.046) and positive stimulation test results, either sTg (P < 0.001) or WBS (P < 0.001). Of the 47 WBS(+)/sTg(-) patients, 7(15%) were treated due to positive WBS results, including two who underwent additional surgery. CONCLUSION: A substantial proportion of stimulation test results were discordant. There was a significant association between WBS results and administration of additional treatment. Routine WBS had additional value for a small proportion of patients with no other evidence for disease and no indication for WBS.
Subject(s)
Adenocarcinoma , Thyroid Neoplasms , Adult , Aged , Female , Follow-Up Studies , Humans , Iodine Radioisotopes/therapeutic use , Male , Middle Aged , Retrospective Studies , Thyroglobulin , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/drug therapy , Whole Body ImagingABSTRACT
The purpose of this paper was to assess the impact and the post-traumatic potential of late termination of pregnancy (TOP) and stillbirth on medical staff and characterise personal attributes that modulate these possible outcomes. Fifty-one participants involved in the treatment of women undergoing late TOPs and stillbirths answered questionnaires including demographics, Neuroticism subscale of the Big Five Inventory (BFI), Life Orientation Test-Revised (LOT-R), Posttraumatic Diagnostic Scale (PDS), Brief Symptom Inventory (BSI-18) and questions regarding exposure to stillbirths and late TOPs. None of the participants met the full post-traumatic stress disorder (PTSD) criteria. A correlation with a marginal significance was found between the number of TOP's/stillbirths attended during the past year and traumatic symptoms. Neuroticism moderated the association between presence in TOP's/stillbirths and post-traumatic symptoms among those who attended this event over the past month. According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths. Impact StatementWhat is already known on this subject? There is a very little research on the ways in which medical personnel respond to Stillbirths, late miscarriages and terminations of pregnancy (TOP) of their patients and on the possible effect of their personality traits in this response.What do the results of this study add? According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths.What are the implications of these findings for clinical practice and/or further research? Further studies are warranted to better assess the impact of exposure to traumatic events in general and on the effect of late TOP and stillbirths in particular, on medical personnel and to identify interventions that may prevent posttraumatic symptoms among staff members when they happen.
Subject(s)
Abortion, Induced , Abortion, Spontaneous , Stress Disorders, Post-Traumatic , Abortion, Spontaneous/epidemiology , Abortion, Spontaneous/etiology , Female , Health Personnel , Humans , Pregnancy , Stillbirth/epidemiology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiologyABSTRACT
The aim of this study was to ask whether a substantial external stressor, such as the COVID-19 pandemic, affects the association between postpartum depression (PPD) and mother-infant bonding. Specifically, we aimed to determine whether worry regarding such an external threat differentially affected PPD and bonding by analyzing a longitudinal sample of postpartum women assessed before and during the pandemic. One-hundred forty women responded to online questionnaires at (T1) Pre-COVID-19: Six months postpartum (February 2018 to December 2019), and (T2) During COVID-19: Twenty-one months postpartum (April 2020 to January 2021). The strength of correlation between mother-infant bonding and PPD significantly declined from before (T1: R = 0.64, p < 0.00) to during the pandemic (T2: R = 0.44, p < 0.001; Difference = 0.20, p = 0.05). Furthermore, only PPD correlated with the worry due to the pandemic; thus the PPD-bonding association was weaker among women who were less concerned about the pandemic (F(3, 136) = 15.4, R2 = 0.25). The study suggests that emotions and cognitions related to motherhood, such as mother-infant bonding, may be more resilient to external pressures such as a pandemic than affective states such as PPD. (174 words).
Subject(s)
COVID-19 , Depression, Postpartum , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Humans , Infant , Mother-Child Relations/psychology , Mothers/psychology , Pandemics , Postpartum PeriodABSTRACT
OBJECTIVE: As mother-infant bonding difficulties are potentially detrimental to child development, it is of importance to study its etiology and associated factors. Only a minority of studies have focused on the role of personality and postpartum depression and posttraumatic stress disorder (PTSD) in the etiology of bonding difficulties. The present article attempted to ascertain the association of vulnerability (Neuroticism) and resilience (Dispositional Optimism) with bonding, wherein postpartum depression and PTSD symptoms were possible mediators. METHOD: There were 504 mothers of infants, 0-13 months, who were sampled cross-sectionally using social media. Respondents completed an online survey consisting of the following questionnaires: demographic details, Neuroticism (subscale of the Big Five Inventory, BFI), Dispositional Optimism (Life Orientation Test-Revised), postpartum PTSD symptoms (City Birth Trauma Scale, BiTS), postpartum depression symptoms (Edinburgh Postpartum Depression Scale, EPDS), and mother-infant bonding difficulties (Postpartum Bonding Questionnaire, PBQ). RESULTS: Path analysis revealed 5 significant indirect paths: Dispositional Optimism affected bonding through EPDS (ß = -0.04, p = .010) and through BiTS general symptoms (ß = -.02, p = .019), and BFI-Neuroticism affected bonding through EPDS (ß = 0.14, p = .001), BiTS birth-related symptoms (ß = -0.03, p = .013), and BiTS general symptoms (ß = 0.11, p = .001). CONCLUSIONS: Both Dispositional Optimism and Neuroticism correlated with bonding difficulties, mediated by postpartum depression and PTSD symptoms. When all variables were measured in a single model, postpartum PTSD birth-related symptoms predicted fewer bonding difficulties while general postpartum PTSD symptoms were associated with more bonding difficulties. Taken together, these results can promote better understanding of postpartum psychopathology and mother-infant bonding to allow for better treatments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Subject(s)
Depression, Postpartum , Stress Disorders, Post-Traumatic , Child , Cross-Sectional Studies , Depression, Postpartum/diagnosis , Female , Humans , Infant , Mother-Child Relations , Mothers , Object Attachment , Personality , Postpartum Period , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Anemia is a known complication of diabetes mellitus (DM); however, its prevalence and prognostic relevance in patients with DM and pre-DM with normal kidney function have not been well defined. This study assessed the prevalence of anemia in patients with DM and pre-DM and evaluated its association with clinical outcomes during a 4-year follow-up period. METHODS: This retrospective analysis included patients with DM and pre-DM referred to the Meir Medical Center Endocrine Institute in 2015. Patients with an estimated glomerular filtration rate (eGFR) of <60 mL/min or any other recognized cause of anemia were excluded. The risk of developing microvascular or macrovascular complications or of death during the 4-year follow-up period was determined. RESULTS: A total of 622 patients (408 with DM and 214 with pre-DM) were included. The mean age of the patients was 64 ± 10.6 years, and 70% were women. The baseline hemoglobin A1C level was 7.1% ± 1.7% (54 mmol/mol), and the eGFR was 86.1 ± 15.3 mL/min. At the time of inclusion, 77 patients (19%) with DM and 23 (11%) with pre-DM had anemia (hemoglobin level 11.9 ± 0.8 and 11.8 ± 0.8 g/dL, respectively), compared with normal hemoglobin levels of 13.8 ± 0.9 and 13.7± 0.9 g/dL, respectively, in the others. A multivariable analysis demonstrated an inverse correlation between baseline hemoglobin (as a continuous variable) and mortality (P = .035), microvascular complications (P = .003), and eGFR decline (P < .001) but not between baseline hemoglobin and macrovascular complications (P = .567). CONCLUSION: This study found a significant prevalence of anemia unrelated to renal failure, both in patients with DM and pre-DM. Anemia in these patients is associated with the development of microvascular complications, eGFR decline, and mortality. These results underscore the need for intensive lifestyle and pharmacologic interventions in these patients.