Salud mental materna en el posparto y apoyo social percibido durante la pandemia por COVID-19 / Postpartum maternal mental health and perceived social support during the covid-19 pandemic

Introducción: La presente investigación tuvo como propósito describir la salud mental materna y su relación con el apoyo social percibido en mujeres cuyo parto ocurrió durante la pandemia por COVID-19 en Argentina durante los meses de mayo a agosto del año 2020. Métodos: Se realizó un estudio cuantitativo de alcance descriptivo correlacional. La población de estudio estuvo compuesta por 83 mujeres de nacionalidad y residencia argentina. Las edades de las participantes oscilaron entre 20 y 53 años, siendo la media de 32,86 (DE: 4,73). Se utilizó el Cuestionario de Salud General de Goldberg GHQ-12 (Goldberg, 1978; Burrone, 2015) y el Cuestionario de Apoyo Social Percibido MOS (Sherbourne & Stewart, 1991; Rodríguez Espínola & Enrique, 2007). Resultados: El 48,2% de las madres no presentó indicadores de psicopatología, 14,5% presentó indicadores de riesgo o sospecha de psicopatología y el 37,3% presentó indicadores de psicopatología. En la percepción de apoyo social total presentaron una puntuación correspondiente a un nivel bajo, en apoyo emocional informacional, apoyo afectivo y apoyo instrumental presentaron una puntuación correspondiente a un nivel bajo . Se encontraron asociaciones significativas negativas entre indicadores de salud mental y percepción de apoyo social total y apoyo afectivo, en cuanto a apoyo instrumental los valores indicarían tendencia de asociación; entre apoyo emocional, informacional no se encontró asociación con indicadores de salud mental. No se encontraron diferencias significativas en la percepción de apoyo social e indicadores de salud mental en el período postparto, en relación al hecho de haber sido acompañadas o no durante el parto. Discusión: La mayor parte de la evidencia sobre la salud mental materna en tiempos de Covid-19 informa la prevalencia de problemas de salud mental, además de la amenaza al apoyo social debido a los protocolos de aislamiento.(AU)

Introduction: The purpose of this research was to describe maternal mental health and its relationship with perceived social support in mothers whose birth occurred during the COVID-19 pandemic in Argentina during the months of May to August 2020. Methods: A quantitative study of correlational descriptive scope was conducted. The study population was composed of 83 women of Argentine nationality and residence. The ages of the participants ranged from 20 and 53 years, with the mean of 32.86 (SD: 4.73). The Goldberg GHQ-12 General Health Questionnaire (Goldberg, 1978; Burrone, 2015) was used and the MOS Perceived Social Support Questionnaire (Sherbourne & Stewart, 1991; Rodríguez Espínola & Enrique, 2007) were used. Results: 48.2% of the mothers did not present indicators of psychopathology, 14.5% presented indicators of risk or suspicion of psychopathology and 37.3% presented indicators of psychopathology. In total perceived social support they presented a low level score, in informational emotional support, affective support and instrumental support they presented a low level score. Significant negative associations were found between mental health indicators and perception of total social support and affective support, in tems of instrumental support the values would indicate association trend; between emotional and informational support, no association was found with mental health indicators. No significant differences were found in the perception of social support and mental health indicators in the postpartum period, in relation to the fact of having been accompanied or not during childbirth. Discussion: Most of the evidence on maternal mental health in times of Covid-19 reports the prevalence of mental health problems, in addition to the threat to social support due to isolation protocols.(AU)

Percepción de eficacia materna y autoestima materna luego de una internación en una unidad de cuidados intensivos neonatal / Perception of maternal efficacy and mother self-esteem after admission in a neonatal intensive care unit

El presente estudio de investigación tuvo como objetivos: analizar la percepción de eficacia materna en madres cuyos hijos estuvieron internados en una Unidad de Cuidados Intensivos Neonatales y analizar dimensiones de autoestima materna y posibles correlaciones entre sí. Se trabajó con un enfoque cuantitativo, diseño no experimental transversal, descriptivo con encuestas, con alcance correlacional. La muestra estuvo conformada por 45 madres, cuyos bebés cursaban el post-alta, luego de un período internación en una Unidad de Cuidados Intensivos Neonatal. Se empleó: Entrevista Psicológica Perinatal en Unidad de Cuidados Intensivos Neonatales (UCIN) (Waldheim-Arizu, 2013); Cuestionario de eficacia maternal (Teti & Gelfand, 1991); y Cuestionario de Autoestima Materna - versión corta (Shea & Tronick,1988). Se analizan resultados obtenidos

The aim of this paper was to analyze the perception of maternal efficacy in mothers whose children were hospitalized in a Neonatal Intensive Care Unit and analyze the dimensions of maternal self-esteem and possible correlations among each other. Quantitative approach, transversal non-experimental design, descriptive with surveys, with correlational scope. The sample consisted of 45 mothers, whose babies were post-discharged, after a period of hospitalization in a Neonatal Intensive Care Unit. The following was used: Perinatal Psychological Interview in the Neonatal Intensive Care Unit (NICU) (Waldheim-Arizu, 2013); Maternal Efficacy Questionnarie (Teti & Gelfand, 1991); and Maternal self-report inventory ­ short version(Shea & Tronick, 1988). Results are analyzed

Estudio de las actitudes hacia la ética profesional en estudiantes de grado y posgrado de psicología / Study of attitudes towards professional ethics in undergraduate and graduate students of psychology

El objetivo del estudio es realizar un relevamiento y estudio sobre las actitudes hacia la ética en estudiantes de grado y posgrado de psicología. A fin de comparar competencias más valoradas y menos valoradas en cuanto a ética profesional, se aplica a una muestra intencional (n=273) de estudiantes de grado (n=193) y posgrado (n=80) la Escala sobre Actitudes hacia la Ética Profesional (Hirsch Adler, 2005, adaptación de Ormart, Esteva y Navés, 2012), cuenta con 55 proposiciones que miden 4 competencias: cognitivo-técnicas, sociales, éticas y afectivo-emocionales. Los resultados obtenidos evidencian que, tanto para los estudiantes de grado como de posgrado, la competencia más valorada es la de ética y no se presentan grandes diferencias en el resto de las competencias.

The present investigation has as objective to make a survey and a study of the attitudes from grade and postgraduate students of the Faculty of Psychology at the University of Aconcagua (UDA), in what regards to professional ethic. With the purpose of being able to compare between the grade and postgraduate students, the most valued competences and those less valued towards professional ethic are weighted, it has been applied to an intentional sample: 193 volunteer students from grade and 80 from postgraduate level, The Ethical Attitudes Scale (Hirsch Adler, 2005, adaptation by Ormart, Esteva y Navés, 2012), which consists of 55 propositions relating to four skills: technical-cognitive, socials, ethics and affective-emotional. The results obtained in this research show that for both, grade and postgrad students, the most valued skill is Ethics and in the rest of the competences there are not major differences.

Influence of the estrous cycle on some non reproductive behaviors and on brain mechanisms in the female rat

Sex hormone fluctuations in females are involved in some behavioral states such as mood, anxiety, aggression and stress response, due to functional changes in the central nervous system (CNS) activity induced by the cyclic sex hormone fluctuation. This review includes three sections. 1.- A description of the three major hormone fluctuations in the estrous cycle: estrogens (E2), progesterone (P4) and prolactine (PRL). E2 achieves the maximum circulation levels during P.E2 is mainly excitatory and has been considered to have an antidepressive action. The highest plasma levels of P4 and its metabolite allopregnenolone(ALLO) occur in P. Ovulation takes place in the night of P, and the resulting corpora lutea produces a secondary increase in P4 (and ALLO) on D. The P4 peak level occurring in D1 and in the evening of P was shown to exert benzodiazepine-like effects, including sedation. It has been proposed that ALLO, rather than P4 is the one acting on GABA systems. Circulating levels of ALLO parallel those of P4 across the estrous cycle and is known to have anxiolytic properties. PRL is produced mainly in the adenohypophysis, though synthesis in other sites of the brain also occurs. Its regulation is mostly inhibitory and is exerted by dopamine (DA) released in the hypothalamus. A surge in PRL secretion occurs during P. PRL would be a modulator of the HPA-axis, and is considered as a stress hormone. 2.- Some behavioral and neural changes occur at each stage of the cycle. Lower anxiety level in P females was described. This has been correlated with increased circulating levels of endogenous ALLO in P. PRL is another hormone that may cause the lower scores of anxiety observed at P, since the peak of plasma PRL is observed at this stage. A novel peptide, the Prolactin Releasing Peptide (PrRP), which is sensitive to E2 fluctuation, has also been linked to the lower activity of the HPA axis. Stress-induced activation of PrRP neurons is significantly decreased in E compared with P and D, suggesting that E2 suppresses the activation of PrRP neurons. The late luteal phase (D) correlates with the premenstrual phase in women, commonly associated with psychological disturbances, including mood disorders and increased aggression. Consistently, increased levels of anxiety and aggression have been detected in rats during D. 3.- Findings about cyclic hormone influences on the CNS neurotransmitters and on the stress mediator, prolactine-releasing peptide (PrRP) were described. GABA is the main inhibitory system in the brain. Estrous-cycle-dependent increases in -GABA A receptors were reported; this subtype underlying a tonic inhibitory current, is the most sensitive target of P4 and ALLO. E2 causes a reduction in GABAergic inhibition, leading to an increase in the excitatory tone. It also acts on hippocampus causing a transient lowering of GABA synthesis in the interneuron. These findings suggest an excitatory role for E2 through inhibition of the GABA system. The serotonin system, involved in behavioral responses such as stress, anxiety and depression, also exhibits variations along the estrous cycle, in part dependant of GABA-receptor changes. Gender differences were described for DA function in the brain, due to E2 and P4 modulation. DA release and reuptake fluctuate with changes in circulating steroid levels. E2 enhances DA release and DA-mediated behaviors, such as general activity stimulation, food seeking behavior and sexual motivation. PrRP is produced in hypothalamic and extra hypothalamic structures. It has been proposed as a mediator of stress responses. Though gender differences have been shown, distribution of PrRP does not change during the estrous cycle. We hope this review may contribute to understand the mechanism of female behavioral variations and their pharmacological and diagnostic implications.

El rol de las hormonas sexuales sobre el comportamiento reproductivo ha sido extensamente documentado. La fluctuación periódica de hormonas sexuales en hembras de numerosas especies ha sido relacionada con cambios comportamentales no sexuales tales como humor, ansiedad, agresión y respuesta a estrés. El sustrato biológico-neural de estos cambios se basa en los cambios que estas hormonas inducen en el Sistema Nervioso Central. Este trabajo resume algunos cambios que afectan a receptores y neurotrasmisores de los sistemas GABAérgico, serotoninérgico, dopaminérgico y péptido liberador de prolactina del SNC de la rata. La rata hembra posee un ciclo sexual de 4 días de duración, denominado ciclo estrual. La presente revisión se informa en tres secciones. (1) Se presenta una breve descripción de la variación de tres hormonas sexuales principales con acción directa sobre el SNC: estrógenos (E2), progesterona (P4) y prolactina (PRL). Se han descripto propiedades ansiolíticas para P4 y anti-estrés para PRL; para E2, la bibliografía es controvertida, describiéndose acciones excitatorias y anti-estrés. (2) Se informan algunos cambios cerebrales y comportamentales que tienen lugar en cada estadio del ciclo estrual. Las fluctuaciones hormonales se consideran básicas para la interpretación de tales cambios. (3) Se mencionan algunos hallazgos acerca de la influencia hormonal cíclica sobre los sistemas de neurotransmisión del SNC y sobre un nuevo péptido propuesto como mediador de la respuesta a estrés, el péptido liberador de prolactina (PrRP). Esperamos que este trabajo contribuya a un mejor entendimiento de los mecanismos del comportamiento de las hembras y sus variaciones, y sus implicancias farmacológicas y diagnósticas.

Influence of the estrous cycle on some non reproductive behaviors and on brain mechanisms in the female rat

Sex hormone fluctuations in females are involved in some behavioral states such as mood, anxiety, aggression and stress response, due to functional changes in the central nervous system (CNS) activity induced by the cyclic sex hormone fluctuation. This review includes three sections. 1.- A description of the three major hormone fluctuations in the estrous cycle: estrogens (E2), progesterone (P4) and prolactine (PRL). E2 achieves the maximum circulation levels during P.E2 is mainly excitatory and has been considered to have an antidepressive action. The highest plasma levels of P4 and its metabolite allopregnenolone(ALLO) occur in P. Ovulation takes place in the night of P, and the resulting corpora lutea produces a secondary increase in P4 (and ALLO) on D. The P4 peak level occurring in D1 and in the evening of P was shown to exert benzodiazepine-like effects, including sedation. It has been proposed that ALLO, rather than P4 is the one acting on GABA systems. Circulating levels of ALLO parallel those of P4 across the estrous cycle and is known to have anxiolytic properties. PRL is produced mainly in the adenohypophysis, though synthesis in other sites of the brain also occurs. Its regulation is mostly inhibitory and is exerted by dopamine (DA) released in the hypothalamus. A surge in PRL secretion occurs during P. PRL would be a modulator of the HPA-axis, and is considered as a stress hormone. 2.- Some behavioral and neural changes occur at each stage of the cycle. Lower anxiety level in P females was described. This has been correlated with increased circulating levels of endogenous ALLO in P. PRL is another hormone that may cause the lower scores of anxiety observed at P, since the peak of plasma PRL is observed at this stage. A novel peptide, the Prolactin Releasing Peptide (PrRP), which is sensitive to E2 fluctuation, has also been linked to the lower activity of the HPA axis. Stress-induced activation of PrRP neurons is significantly decreased in E compared with P and D, suggesting that E2 suppresses the activation of PrRP neurons. The late luteal phase (D) correlates with the premenstrual phase in women, commonly associated with psychological disturbances, including mood disorders and increased aggression. Consistently, increased levels of anxiety and aggression have been detected in rats during D. 3.- Findings about cyclic hormone influences on the CNS neurotransmitters and on the stress mediator, prolactine-releasing peptide (PrRP) were described. GABA is the main inhibitory system in the brain. Estrous-cycle-dependent increases in -GABA A receptors were reported; this subtype underlying a tonic inhibitory current, is the most sensitive target of P4 and ALLO. E2 causes a reduction in GABAergic inhibition, leading to an increase in the excitatory tone. It also acts on hippocampus causing a transient lowering of GABA synthesis in the interneuron. These findings suggest an excitatory role for E2 through inhibition of the GABA system. The serotonin system, involved in behavioral responses such as stress, anxiety and depression, also exhibits variations along the estrous cycle, in part dependant of GABA-receptor changes. Gender differences were described for DA function in the brain, due to E2 and P4 modulation. DA release and reuptake fluctuate with changes in circulating steroid levels. E2 enhances DA release and DA-mediated behaviors, such as general activity stimulation, food seeking behavior and sexual motivation. PrRP is produced in hypothalamic and extra hypothalamic structures. It has been proposed as a mediator of stress responses. Though gender differences have been shown, distribution of PrRP does not change during the estrous cycle. We hope this review may contribute to understand the mechanism of female behavioral variations and their pharmacological and diagnostic implications.(AU)

El rol de las hormonas sexuales sobre el comportamiento reproductivo ha sido extensamente documentado. La fluctuación periódica de hormonas sexuales en hembras de numerosas especies ha sido relacionada con cambios comportamentales no sexuales tales como humor, ansiedad, agresión y respuesta a estrés. El sustrato biológico-neural de estos cambios se basa en los cambios que estas hormonas inducen en el Sistema Nervioso Central. Este trabajo resume algunos cambios que afectan a receptores y neurotrasmisores de los sistemas GABAérgico, serotoninérgico, dopaminérgico y péptido liberador de prolactina del SNC de la rata. La rata hembra posee un ciclo sexual de 4 días de duración, denominado ciclo estrual. La presente revisión se informa en tres secciones. (1) Se presenta una breve descripción de la variación de tres hormonas sexuales principales con acción directa sobre el SNC: estrógenos (E2), progesterona (P4) y prolactina (PRL). Se han descripto propiedades ansiolíticas para P4 y anti-estrés para PRL; para E2, la bibliografía es controvertida, describiéndose acciones excitatorias y anti-estrés. (2) Se informan algunos cambios cerebrales y comportamentales que tienen lugar en cada estadio del ciclo estrual. Las fluctuaciones hormonales se consideran básicas para la interpretación de tales cambios. (3) Se mencionan algunos hallazgos acerca de la influencia hormonal cíclica sobre los sistemas de neurotransmisión del SNC y sobre un nuevo péptido propuesto como mediador de la respuesta a estrés, el péptido liberador de prolactina (PrRP). Esperamos que este trabajo contribuya a un mejor entendimiento de los mecanismos del comportamiento de las hembras y sus variaciones, y sus implicancias farmacológicas y diagnósticas.(AU)

Estrés neonatal y frustración / Neonatal stress and frustration

El estrés neonatal altera la respuesta emocional de ratas adultas. En una de sus formas, el estrés crónico neonatal aleatorio, produce una reducción comportamental, neurofisiológica y hormonal en respuesta a presentaciones de estímulos aversivos. La devaluación u omisión de los reforzadores esperados por aprendizajes previos provoca respuestas similares al dolor, al miedo y a la ansiedad, y esta reacción se denomina frustración. En este trabajo se presentan dos experimentos en los cuales las ratas sometidas a un estrés neonatal aleatorio y sus controles sin tratamiento se expusieron a dos procedimientos experimentales de frustración: el contraste sucesivo negativo consumatorio (CSNc, Experimento1) y la extinción consumatoria (Ec, Experimento 2). En el CSNc, la respuesta del tiempo de bebedero de animales que pasan de recibir una solución azucarada del 32% al 4%, se compara con el desempeño de animales que siempre recibieron solución al 4%. En la Ec, los animales reciben durante la adquisición la solución al 4% y luego se les presenta el bebedero vacío. Los resultados obtenidos señalan que en el CSNc los animales expuestos a estrés neonatal presentaron una respuesta atenuada de frustración y en la Ec, una extinción más acelerada, en relación con sus controles sin tratamiento neonatal. Estos hallazgos extienden los efectos del estrés neonatal hacia respuestas provocadas por situaciones de pérdida o decremento de incentivos.

Emotional neonatal stress alters the emotional response in adult rats. In one of its forms, the chronic random neonatal stress, produces behavioral, neurophysiological and hormonal reductions, in response to aversive stimuli. Devaluation or omission of expected reinforcers for acquired skills provokes responses similar to pain, fear and anxiety and this reaction is known as frustration. In this paper we will present, two different experiments in which, both, rats that were subjected to random neonatal stress and the no-treatment condition, were exposed to two procedures of experimental frustration: the consummatory negative successive contrast (CSNc, experiment 1) and the consummatory extinction (EC, experiment 2). In the CSNc, the response time to drinking a glucose solution of 32% to 4%, compares to the performance of animals that always received a 4% solution. In the EC, the animals received the 4% solution during acquisition and were presented with the empty water source. The obtained results show that in CSNc, the animals exposed to neonatal stress presented an adecuate response to frustration and in the EC, an accelerated extinction, in relation to controls without neonatal treatment. These findings extend the effects of neonatal stress to provoked responses to situations of loss or decrease of incentives.

Acute sublethal global hypoxia induces transient increase of GAP-43 immunoreactivity in the striatum of neonatal rats.

We assessed immunoreactivity (IR) in the cerebral cortex (CC), hippocampus (Hipp), and striatum (ST) of a growth-associated protein, GAP-43, and of proteins of the synaptic vesicle fusion complex: VAMP-2, Syntaxin-1, and SNAP-25 (SNARE proteins) throughout postnatal development of rats after submitting the animals to acute global postnatal hypoxia (6.5% O(2), 70 min) at postnatal day 4 (PND4). In the CC only the IR of the SNARE protein SNAP-25 increased significantly with age. The hypoxic animals showed the same pattern of IR for SNAP-25, although with lower levels at PND11, and also a significant increase of VAMP-2. SNAP-25 (control): PND11 P < 0.001 vs. PND18, 25, and 40, SNAP-25 (hypoxic): P < 0.001 vs. PND18, 25, and 40; VAMP-2 (hypoxic): P < 0.05 PND11 vs. PND18, and P < 0.01 vs. PND25 and PND40; one-way ANOVA and Bonferroni post-test. In the Hipp, SNAP-25 and syntaxin-1 increased significantly with age, reaching a plateau at PND25 through PND40 in control animals (one-way ANOVA: syntaxin-1: P = 0.043; Bonferroni: NS; SNAP-25: P = 0.013; Bonferroni: P < 0.01 PND11 vs. PND40). Hypoxic rats showed higher levels of significance in the one-way ANOVA than controls (syntaxin-1: P = 0.009; Bonferroni: P < 0.05 PND11 vs. PND25 and P < 0.001 PND11 vs. PND40). In the ST, GAP-43 differed significantly among hypoxic and control animals and the two-way ANOVA revealed significant differences with age (F = 3.23; P = 0.037) and treatment (F = 4.84; P = 0.036). VAMP-2 expression also reached statistical significance when comparing control and treated animals (F = 6.25, P = 0.018) without changes regarding to age. Elevated plus maze test performed at PND40 indicated a lower level of anxiety in the hypoxic animals. At adulthood (12 weeks) learning, memory and locomotor abilities were identical in both groups of animals. With these results, we demonstrate that proteins of the presynaptic structures of the ST are sensitive to acute disruption of homeostatic conditions, such as a temporary decrease of the O(2) concentration. Modifications in the activity of these proteins could contribute to the long term altered responses to stress due to acute hypoxic insult in the neonatal period.