An Exploration of Resiliency Among Nurse Educators During the COVID-19 Pandemic.

AIM: The purpose of this study was to explore resilience among nursing faculty during the COVID-19 pandemic and to examine associations or differences that may exist among variables and between groups. BACKGROUND: Nurse educators' resilience has been identified as an important characteristic because of the challenges involved in nursing education. It is important to explore resilience among nurse educators to determine which factors promote or inhibit this important characteristic. METHOD: This correlational research study used an online survey to explore factors related to resilience among nurse faculty during the COVID-19 pandemic. Correlational analyses were used to determine the relationship between various resilience constructs and select demographic variables. RESULTS: Findings indicated that higher levels of resilience were associated with age (ρ = .21, p < .001), experience teaching online ( r = .22, p < .001), and professional development related to online teaching ( M = 80.7, SD = 11.0), t (276) = 2.41, p = .017. CONCLUSION: Resilience and related characteristics have the potential to assist nurse educators in adapting successfully to stressful circumstances. It is crucial that schools of nursing develop programs to enhance or develop resilience among nurse educators. Support and training in the area of online education are also of paramount importance.

General and sport-specific weight pressures as risk factors for body dissatisfaction and disordered eating among female collegiate athletes.

Female collegiate athletes are a high-risk group for disordered eating. Petrie and Greenleaf's (2007) sociocultural model proposes that both general and sport-related weight pressures lead athletes to internalize unrealistic body ideals, ultimately resulting in body dissatisfaction and disordered eating. In this study, we used structural equation modeling to assess general and sport-specific weight pressures in relation to thin- and muscular-ideal internalization, body dissatisfaction, and disordered eating among 212 female Division I college athletes. General weight pressures from parents, peers, and the media were associated with disordered eating indirectly via thin- and muscular-ideal internalization. In contrast, sport-specific weight pressures were not associated with disordered eating in the full model. After controlling for weight pressures and body ideal internalization, body dissatisfaction was also not associated with disordered eating. These findings suggest that female athletes are vulnerable to weight- and appearance-related pressures from outside the sport context and that the mechanisms underlying the development of disordered eating may differ between athletes and non-athletes.

Romantic Relationship Satisfaction and Parent-Infant Bonding During the Transition to Parenthood: An Attachment-Based Perspective.

An important element of well-being during the transition to parenthood is new parents' relationships with their partners and babies. Attachment theory posits that early caregiving experiences influence close relationships throughout the lifespan. Disruptions to the parent-child relationship, such as parental divorce or separation, may therefore have intergenerational effects as adult children of divorce navigate changes in their later relationships. This study examined whether new parents who have experienced a divorce or separation in their family of origin report greater romantic relationship dissatisfaction or impairment in the parent-infant bond during the early postpartum period, and if these associations are mediated by adult attachment. First-time parents of infants through 6 months of age (N = 94) completed measures of adult attachment, romantic relationship satisfaction, and parent-infant bonding. New parents who had experienced parental divorce or separation did not differ from those from intact families with regard to romantic relationship satisfaction, parent-infant bonding, attachment anxiety, or attachment avoidance. Attachment anxiety and avoidance were both associated with romantic relationship dissatisfaction and greater impairment in the parent-infant bond. These findings suggest that the experience of parental divorce or separation, in and of itself, does not confer increased risk for negative relational outcomes among new parents. Securely attached adults, regardless of their own parents' marital status, report more positive relationships with their partners and infants during the early postpartum period.

Age-related differences in flashbulb memories: A meta-analysis.

Recent meta-analyses reveal age-related declines in short-term memory (STM), working memory, associative memory, prospective memory, face memory, recognition, and recall. The present meta-analyses extend this work beyond predominantly laboratory-based tasks to a naturalistic phenomenon. Flashbulb memories are vivid autobiographical recollections for the circumstances in which one learns of a distinct event that may be surprising, emotional, or personally important (the reception event). The existing literature on aging and flashbulb memories includes inconsistent findings. The present meta-analyses included 16 studies (N = 1898) that examined flashbulb memory in nonclinical samples of younger adults (below age 40 years) and older adults (above age 60 years). Findings, after exclusion of an outlier, suggest a small-to-moderate age-related impairment in flashbulb memory scores (k = 14, Hedges' g = -0.30, 95% CI [-0.45, -0.15], p < .001) that was not moderated by study characteristics. After exclusion of an outlier, older adults' flashbulb memories were also significantly less consistent across time than younger adults' (k = 7, Hedges' g = -0.29, 95% CI [-0.47, -0.11], p = .002). Secondary analyses investigated age-related differences in the presence and consistency of canonical categories of flashbulb memories and encoding and rehearsal variables associated with flashbulb memory formation and retention. Age-related differences were found only for consistency of memory for ongoing activity at the time of the reception event, favoring younger adults (k = 3, Hedges' g = -0.40, 95% CI [-0.65, -0.15], p = .002). Overall, these findings are consistent with age-related impairment in flashbulb memory formation and retention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mind the Gap: The Underrepresentation of Female Participants and Authors in Virtual Reality Research.

A common goal of human-subject experiments in virtual reality (VR) research is evaluating VR hardware and software for use by the general public. A core principle of human-subject research is that the sample included in a given study should be representative of the target population; otherwise, the conclusions drawn from the findings may be biased and may not generalize to the population of interest. In order to assess whether characteristics of participants in VR research are representative of the general public, we investigated participant demographic characteristics from human-subject experiments in the Proceedings of the IEEE Virtual Reality Conferences from 2015-2019. We also assessed the representation of female authors. In the 325 eligible manuscripts, which presented results from 365 human-subject experiments, we found evidence of significant underrepresentation of women as both participants and authors. To investigate whether this underrepresentation may bias researchers' findings, we then conducted a meta-analysis and meta-regression to assess whether demographic characteristics of study participants were associated with a common outcome evaluated in VR research: the change in simulator sickness following head-mounted display VR exposure. As expected, participants in VR studies using HMDs experienced small but significant increases in simulator sickness. However, across the included studies, the change in simulator sickness was systematically associated with the proportion of female participants. We discuss the negative implications of conducting experiments on non-representative samples and provide methodological recommendations for mitigating bias in future VR research.

A systematic review and meta-analysis of interpersonal psychotherapy for perinatal women.

BACKGROUND: Interpersonal psychotherapy (IPT) has demonstrated efficacy for the prevention and treatment of perinatal depression. Previous systematic reviews have not evaluated the effects of IPT on other outcomes, most notably symptoms of anxiety and interpersonal functioning, or assessed moderators of treatment efficacy specific to IPT. METHOD: A systematic review identified 28 studies assessing the efficacy of IPT during pregnancy or the first year postpartum. Random effects meta-analyses assessed the average change in outcomes (depression, anxiety, relationship quality, social adjustment, and social support) from pre- to post-treatment, the difference in the change in outcomes between treatment and comparison conditions, and the difference in prevalence of depressive episodes between treatment and comparison conditions. Study, intervention, and sample characteristics were evaluated as potential moderators of effect sizes. RESULTS: In prevention studies, IPT was effective for reducing depressive symptoms and the prevalence of depressive episodes. In treatment studies, IPT reduced symptoms of depression and anxiety and improved relationship quality, social adjustment and social support. Few significant moderators were identified, and results of moderation analyses were inconsistent across outcomes. LIMITATIONS: There are insufficient studies to evaluate the effects of preventive IPT on anxiety and interpersonal outcomes. Analyses of potential moderators were limited by the number of studies available for subgroup comparisons. CONCLUSIONS: IPT is an effective preventive intervention for perinatal depression. IPT is clearly effective for treating depressive symptoms and promising as a treatment for anxiety and improving interpersonal functioning. Further research is necessary to assess whether adaptations to IPT enhance its efficacy.

A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression.

BACKGROUND: Cognitive behavioral therapy (CBT) is an empirically supported treatment for treating and preventing depression that has been widely studied in perinatal populations. Previous meta-analytic reviews of CBT interventions in this population have not investigated potential moderators of treatment efficacy specific to this type of therapy. METHOD: Forty randomized and quasi-randomized controlled trials assessing the efficacy of CBT during pregnancy and the first year postpartum were included in the meta-analyses. Change in depressive symptoms from pre-treatment to post-treatment was assessed in both treatment and prevention trials, and the difference in prevalence of postpartum depressive episodes was assessed in prevention trials. Characteristics of included studies, interventions and samples were assessed as potential moderators of effect sizes. RESULTS: CBT interventions resulted in significant reductions in depressive symptoms compared to control conditions in both treatment and prevention studies. In prevention studies, individuals who received CBT had significantly lower rates of postpartum depressive episodes compared to control conditions. In both treatment and prevention trials, interventions initiated during the postpartum period were more effective than antenatal interventions. In prevention trials, individually-administered treatments were more effective than group interventions and greater reductions in depressive symptoms were found in studies that included higher proportions of nonwhite, single, and multiparous participants. LIMITATIONS: The methodological quality of included studies varied widely among studies eligible for inclusion in the meta-analysis. CONCLUSIONS: There is strong evidence that CBT interventions are effective for treating and preventing depression during the perinatal period. Further methodologically rigorous studies are needed to further investigate potential moderators of treatment efficacy.

Maternal attitudes, depression, and anxiety in pregnant and postpartum multiparous women.

The Attitudes Toward Motherhood (AToM) Scale was developed to assess women's beliefs about motherhood, a specific risk factor for emotional distress in perinatal populations. As the measure was initially developed and validated for use among first-time mothers, this study assessed the reliability and validity of the AToM Scale in a sample of multiparous women. Maternal attitudes were significantly associated with symptoms of depression, even after controlling for demographic, cognitive, and interpersonal risk factors. Maternal attitudes were also associated with symptoms of anxiety after controlling for demographic risk factors, but this association was not significant after accounting for cognitive and interpersonal risk factors. Compared to primiparous women from the initial validation study of the AToM Scale, multiparous women reported lower levels of social support and marital satisfaction. The relationships between cognitive and interpersonal risk factors and symptoms of depression and anxiety were comparable between multiparous and primiparous women.

Correlates of impaired mother-infant bonding in a partial hospital program for perinatal women.

Maternal psychopathology is a risk factor for impaired mother-infant bonding, but not all women with this illness experience impaired bonding. This study investigated correlates of mother-infant bonding among 180 postpartum women treated in a psychiatric partial hospitalization program. Women completed self-report measures of depressive symptoms and mother-infant bonding, and a retrospective chart review assessed demographic characteristics, clinician-rated diagnoses, and obstetric factors. Symptoms of depression, self-reported suicidality, demographic characteristics, and mode of delivery were significantly associated with impaired bonding.

The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers.

Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others' judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period.

Preventing postpartum depression: a meta-analytic review.

This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g=0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes.

Elevated risk of adverse obstetric outcomes in pregnant women with depression.

In this study, we evaluated the association between prenatal depression symptoms adverse birth outcomes in African-American women. We conducted a retrospective cohort study of 261 pregnant African-American women who were screened with the Edinburgh Postnatal Depression Scale (EPDS) at their initial prenatal visit. Medical records were reviewed to assess pregnancy and neonatal outcomes, specifically preeclampsia, preterm birth, intrauterine growth retardation, and low birth weight. Using multivariable logistic regression models, an EPDS score ≥10 was associated with increased risk for preeclampsia, preterm birth, and low birth weight. An EPDS score ≥10 was associated with increased risk for intrauterine growth retardation, but after controlling for behavioral risk factors, this association was no longer significant. Patients who screen positive for depression symptoms during pregnancy are at increased risk for multiple adverse birth outcomes. In a positive, patient-rated depression screening at the initial obstetrics visit, depression is associated with increased risk for multiple adverse birth outcomes. Given the retrospective study design and small sample size, these findings should be confirmed in a prospective cohort study.

A meta-analysis of treatments for perinatal depression.

This meta-analysis assessed efficacy of pharmacologic and psychological interventions for treatment of perinatal depression. A systematic review identified 27 studies, including open trials (n=9), quasi-randomized trials (n=2), and randomized controlled trials (n=16) assessing change from pretreatment to posttreatment or comparing these interventions to a control group. Uncontrolled and controlled effect sizes were assessed in separate meta-analyses. There was significant improvement in depressive symptoms from pretreatment to posttreatment, with an uncontrolled overall effect size (Hedges' g) of 1.61 after removal of outliers and correction for publication bias. Symptom levels at posttreatment were below cutoff levels indicative of clinically significant symptoms. At posttreatment, intervention groups demonstrated significantly greater reductions in depressive symptoms compared to control groups, with an overall controlled effect size (Hedges' g) of 0.65 after removal of outliers. Individual psychotherapy was superior to group psychotherapy with regard to changes in symptoms from pretreatment to posttreatment. Interventions including an interpersonal therapy component were found to have greater effect sizes, compared to control conditions, than interventions including a cognitive-behavioral component. Implications of the findings for clinical practice and future research are discussed.