Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women.

The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant.

Se ha asociado el nacimiento de un niño con una disminución en la satisfacción de la pareja, lo cual tiene implicaciones para el desarrollo socioemocional del niño. Este estudio investigó el potencial efecto derrame en las relaciones de mujeres embarazadas con sus parejas, del programa STEP, un grupo prenatal de intervención breve, informado sobre el trauma y con base en la mentalización. A las participantes (94% blancos) se les reclutó en clínicas prenatales y por medio de anuncios en línea en Quebec, Canadá. Se recogió información tanto cuantitativa como cualitativa de las participantes asignadas al programa STEP (n = 42) y de aquellas que recibían tratamiento como de costumbre (TAU; n = 125). Las mujeres que participaban en STEP reportaron significativas mejoras en las relaciones con sus parejas comparadas con aquellas asignadas al grupo TAU. Más precisamente, ellas reportaron una más alta satisfacción de acoplamiento, una mejorada comunicación y un aumento en el interés en la experiencia emocional de sus parejas. Los análisis cualitativos sustentaron además estos resultados, con reportes de las participantes de haber hecho a sus parejas partícipes en el embarazo, compartido su sentir acerca de sí mismas con sus parejas y haber adquirido perspectivas renovadas acerca de sus relaciones. Las participantes en STEP también expresaron que habían compartido materiales del programa con sus parejas y considerado que tales intervenciones deben extenderse a los papás que esperan un hijo. Este estudio subraya la potencialidad de las intervenciones con base en la mentalización para contribuir indirectamente a las relaciones de pareja, lo cual pudiera tener implicaciones positivas para la crianza y el infante.

Association entre la fréquence de consultation des médias d'information et la détresse psychologique chez les femmes enceintes durant la pandémie de COVID-19: Association between news media consulting frequency and psychological distress in pregnant women during the COVID-19 pandemic.

OBJECTIVE: Examine the association between news media use frequency during the COVID-19 pandemic and the scale of psychological distress in pregnant women, considering this distress known harmful effects on the fetus development. METHOD: Pregnant women living in Quebec province (N = 1014) have been recruited in April 2020 through social media, while a state of health emergency was declared. Participants were divided in 4 groups, according to self-reported frequency of news media consulting (little or none; one time a day; several times a day; constant). They filled measures of depressive symptoms, negative affects, post-traumatic stress symptoms and anxiety specific to COVID-19. Instrument scores were grouped under a unique factor of psychological distress. RESULTS: An ANCOVA controlling for age, gestational age, education level, household annual revenue and a diagnosed mental disorder present at the time of participation in study shows that news media exposure frequency is significantly associated with psychological distress severity in pregnant women, during COVID-19 pandemic, F(3,998) = 27.02, p < 0.001, η2 partial = 0.08. Given the mean comparisons a posteriori, higher psychological distress rates are found as soon as news media exposure exceeds once a day (effect sizes between 0.38 and 0.81). CONCLUSIONS: The more pregnant women report consulting the news media during the COVID-19 pandemic, the more likely they are to exhibit psychological distress. Results provide one of the first empirical supports to recommendations of World Health Organization, Canada government and psychiatric associations that encourage population to limit their news media consulting during the COVID-19 pandemic.

OBJECTIF: Examiner l'association entre la fréquence d'utilisation des médias d'information durant la pandémie de COVID-19 et l'ampleur de la détresse psychologique chez les femmes enceintes, considérant les impacts délétères connus de cette détresse sur le développement du fœtus. MÉTHODE: Des femmes enceintes habitant la province de Québec (N = 1014) ont été recrutées en avril 2020 par le biais des médias sociaux, alors qu'un état d'urgence sanitaire prévalait. Les participantes ont été divisées en quatre groupes, selon la fréquence auto-rapportée de consultation des médias d'information (peu ou pas; une fois par jour; plusieurs fois par jour; constante). Elles ont rempli des mesures des symptômes dépressifs, des affects négatifs, des symptômes de stress post-traumatique et d'anxiété spécifique de la COVID-19. Les scores aux instruments se regroupaient sous un facteur unique de détresse psychologique. RÉSULTATS: Une ANCOVA contrôlant pour l'âge, l'âge gestationnel, le niveau d'éducation, le revenu familial annuel et la présence d'un trouble mental diagnostiqué au moment de la participation à l'étude montre que la fréquence d'exposition aux médias d'information est significativement associée à la sévérité de la détresse psychologique chez les femmes enceintes au moment de la pandémie de COVID-19, F(3,998) = 27,02, p < 0,001, η2 partiel = 0,08. Selon les comparaisons de moyennes a posteriori, des taux plus élevés de détresse psychologique s'observent dès que l'exposition aux médias d'information dépasse une fois par jour (tailles de l'effet entre 0,38 et 0,81). CONCLUSIONS: Plus les femmes enceintes consultent les médias d'information pendant la pandémie de COVID-19, plus elles sont sujettes à présenter de la détresse psychologique. Les résultats offrent un des premiers appuis empiriques aux recommandations de l'Organisation mondiale de la santé, du gouvernement du Canada et d'associations de psychiatres encourageant la population à limiter sa consultation des médias d'information durant la pandémie de COVID-19.

Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic.

INTRODUCTION: Prenatal maternal distress has a negative impact on the course of pregnancy, fetal development, offspring development, and later psychopathologies. The study aimed to determine the extent to which the coronavirus disease 2019 (COVID-19) pandemic may aggravate the prenatal distress and psychiatric symptomatology of pregnant women. MATERIAL AND METHODS: Two cohorts of pregnant volunteer women were evaluated, one that was recruited before the COVID-19 pandemic (n = 496) through advertisements in prenatal clinics in Quebec, Canada, from April 2018 to March 2020; the other (n = 1258) was recruited online during the pandemic from 2 April to 13 April 2020. Prenatal distress and psychiatric symptomatology were measured with the Kessler Distress Scale (K10), Post-traumatic Checklist for DSM-5 (PCL-5), Dissociative Experiences Scale (DES-II), and Positive and Negative Affect Schedule (PANAS). RESULTS: The 1754 pregnant women (Mage  = 29.27, SD = 4.23) were between 4 and 41 gestational weeks (M = 24.80, SD = 9.42), were generally educated (91.3% had post-high-school training), and financially well-resourced (85.3% were above the low-income cut-off). A multivariate analysis of covariance controlling for age, gestational age, household income, education, and lifetime psychiatric disorders showed a large effect size (ES) in the difference between the two cohorts on psychiatric symptoms (Wilks' λ = 0.68, F6,1400  = 108.50, P < .001, partial η2  = 0.32). According to post-hoc analyses of covariance, the COVID-19 women reported higher levels of depressive and anxiety symptoms (ES = 0.57), dissociative symptoms (ES = 0.22 and ES = 0.25), symptoms of post-traumatic stress disorder (ES = 0.19), and negative affectivity (ES = 0.96), and less positive affectivity (ES = 0.95) than the pre-COVID-19 cohort. Women from the COVID-19 cohort were more likely than pre-COVID-19 women to present clinically significant levels of depressive and anxiety symptoms (OR = 1.94, χ2 [1] = 10.05, P = .002). Multiple regression analyses indicated that pregnant women in the COVID-19 cohort having a previous psychiatric diagnosis or low income would be more prone to elevated distress and psychiatric symptoms. CONCLUSIONS: Pregnant women assessed during the COVID-19 pandemic reported more distress and psychiatric symptoms than pregnant women assessed before the pandemic, mainly in the form of depression and anxiety symptoms. Given the harmful consequences of prenatal distress on mothers and offspring, the presently observed upsurge of symptoms in pregnant women calls for special means of clinical surveillance.

[Child abuse and parenting]. / Maltraitance dans l'enfance et parentalité.

Maltreatment suffered during childhood has long-term consequences which risk impacting on parenthood. Supporting victims of violence in childhood as they adapt to parenthood represents a challenge for health professionals working in perinatal services.

STEP-COVID: a pilot study of a prenatal intervention for pregnant women during the COVID-19 pandemic.

The COVID-19 pandemic has been associated with a global increase in psychological distress in pregnant women. This study evaluated the effects of STEP-COVID, a six-session mentalization-based prenatal group program offered online during the COVID-19 pandemic. The 100 participants were allocated to STEP-COVID or to the natural trajectory of prenatal care. Pre- and post-intervention assessments included measures of psychological distress, post-traumatic symptoms and positive affectivity. Perception of change during pregnancy on resilience-promoting factors was also assessed at post-intervention. A significant decrease in psychological distress and post-traumatic symptoms and an increase in positive affectivity were observed in participants in the intervention condition, whereas only post-traumatic symptoms improved in the control condition. Women who participated in STEP-COVID also reported greater changes during pregnancy on resilience-promoting factors than women in the control condition. Results hold promise for buffering the effect of the pandemic on the mental health of pregnant women using brief online interventions. Clinical trial registration: NCT05419167 (15/06/2022).

Evaluation of the Acceptability of a Prenatal Program for Women With Histories of Childhood Trauma: The Program STEP.

Background: Childhood trauma would negatively affect pregnant women's mental health and would have intergenerational repercussions. However, there is a paucity of prenatal interventions specifically designed for women exposed to childhood trauma. The study aims to evaluate the acceptability of STEP, a manualized group intervention designed for pregnant women having experienced early life adversity. Methods: The acceptability of STEP was assessed in four phases. In Phase 1, six experts evaluated whether the program activities were pertinent and trauma sensitive. In Phase 2, three parents read the intervention manuals and evaluated whether they considered each session relevant, interesting, and clear. In Phase 3, the program was briefly presented by phone to 309 pregnant women from the community. Women were inquired about their interest in the program, and the reasons for their lack of interest were assessed. In Phase 4, 30 pregnant women exposed to childhood trauma participated in the program and completed anonymous satisfaction questionnaires after each session. Psychological distress was also measured before and after the program. Results: All activities were rated by independent experts as highly pertinent, adequate, and sufficiently safe to be offered to pregnant women. Parents who read through the intervention manuals also considered that the sessions were relevant, clear, and interesting. About half of the pregnant women from the community showed interest in the program. Participants reported very high levels of satisfaction and a significant decrease in psychological distress during the program. Conclusions: Our findings show a high level of convergence among various indicators of program acceptability.

Parental Cannabis Use: Contradictory Discourses in the Media, Government Publications, and the Scientific Literature.

Approximately 7% of Americans and 13% of Canadians older than 25 years old use cannabis,1,2 suggesting that millions of parents across North America are users. We hypothesize that parental cannabis use may affect children in two ways: by increasing personal exposure to the substance (eg, in utero exposure) and through its impact on parenting (Figure 1). Regarding direct exposure, scientific evidence suggests that using cannabis during pregnancy is unsafe and may lead to complications at birth, such as preterm delivery, lower birth weight, lower Apgar scores, and decreased fetal growth.3 In addition, in one study, offspring of parents consuming cannabis were more likely to use cannabis themselves in adolescence,4 which was found, in a systematic review, to be associated with higher odds of depression, suicidal behavior, and psychotic illness.5 Paradoxically, we believe that our field is not well informed by scientific research about the effects of parental cannabis use on parenting and offspring development at early developmental periods when the child is highly sensitive to the types of parental behaviors identified at the bottom of Figure 1. Such a gap in our knowledge is of definite concern for public health and child psychiatry, particularly considering that parents and professionals have access to very conflictual information on this issue. To support our standpoint that the important gaps in our knowledge about the issue of parental cannabis use open the door for highly diverse opinions regarding the harmfulness of parental cannabis use, we reviewed the portrayal of parental cannabis use provided by three sources: the scientific literature, media (online media, print news, and print media), and publications of government and other public agencies (more information on the search strategy is provided in Supplement 1, available online).