Prenatal depression predicts postpartum maternal attachment in low-income Latina mothers with infants

Although maternal attachment is an important predictor of infant attachment security and other developmental outcomes, little is known about the formation of maternal attachment in the first few months of the infant's life, particularly among ethnic minority mothers. The current study examined the predictors of postpartum maternal attachment in a sample of 217 Latina women enrolled in a perinatal depression prevention trial. Mothers’ attachment to their infants was measured at 6-8 weeks postpartum using the Maternal Postnatal Attachment Scale. A variety of predictors of early attachment were explored including: depressive symptoms during pregnancy, pregnancy intention, feelings about the pregnancy, and the quality of the partner relationship. The strongest predictor of lower maternal attachment was depressive symptoms late in pregnancy; pregnancy intention was marginally predictive of attachment, with lower scores being associated with unwanted pregnancies. The study fills a critical gap in our understanding of the role of depressive symptoms during pregnancy in shaping mothers’ early attachment to their infants.     

Comorbidity of Anxiety and Depression in Children and Adolescents: An Integrative Review

Much evidence exists documenting the comorbidity of anxiety and affective disorders in youth. Furthermore, comorbidity appears to have serious implications both in terms of severity of impairment and course of disorder. Despite this, little is known about the meaning behind the high rate of co-occurrence of anxiety and depression in children and adolescents. Several conditions exist that may give rise to comorbidity. Specifically, two disorders may be comorbid when there is a high rate of symptom overlap between the disorders, when one underlying construct is split into two separate disorders, when the disorders share common risk or etiological factors, or because one disorder causes or increases the risk of developing the second disorder. The present paper examines each of these explanations as they relate to the comorbidity of anxiety and depression in youth.     

Maternal prenatal psychological distress and temperament in 1–4 month old infants – A study in a non-western population

In this longitudinal study, conducted in women attending antenatal visits at the obstetrics and gynecology clinic of a general hospital in Bangalore, India, we aimed to assess the relationship between prenatal distress in mothers, and maternal report of infant temperament at four months. 100 mothers with normal full term deliveries completed the General Health Questionnaire-28 item version (GHQ) in the third trimester and postnatally. Salivary cortisol and temperament (using the Early Infancy Temperament Questionnaire – EITQ) were assessed in their infants aged 1–4 months. In this study, maternal prenatal psychological distress was not significantly associated with maternal report of difficult temperament in infants. Infants of mothers who were a negative screen for psychological distress (GHQ < 7), n = 85 had higher scores on the adaptability and approach dimensions of temperament. Infant salivary cortisol was significantly higher in infants with higher intensity scores. These results introduce the possibility of cultural differences in the relationship between prenatal distress in the mother and infant temperament. These could be factors linked to child rearing practices or to the measures employed to study infant temperament. These findings derive from a small sample with few mothers with psychological distress, and need replication in a larger sample.     

Specific Life Events and Chronic Experiences Differentially Associated with Depression and Anxiety in Young Twins

Behavioral genetic analyses indicate that environmental influences associated with depression and anxiety are specific to each symptom type; however, this has not been tested specifically in children. Sixty-one (61) child twin pairs in which at least one twin had a very high anxiety or depression score, and 29 nonanxious, nondepressed pairs were interviewed about life events and chronic stressors in the previous 12 months. Loss events, schoolwork stressors, family relationship problems, and friendship problems were all significantly associated with depression but not anxiety. Threat events were significantly associated with anxiety but not depression. Loss events and schoolwork stressors appeared to act as shared environment influences in that they made twin pairs resemble one another. Threat events, friendship problems, and family relationship problems were individual specific and accounted for differences within the pairs. These results clarify the associations between life events and depressive and anxious symptoms in children and adolescents and reveal specific associations previously unidentified in this age range.     

Hierarchical Model of Vulnerabilities for Anxiety: Replication and Extension with a Clinical Sample

This study served to replicate and extend our previously obtained hierarchical model of the relationships among general anxiety vulnerabilities, specific anxiety vulnerabilities and specific anxiety manifestations including panic symptoms, health anxiety, obsessive‐compulsive symptoms and worry. Questionnaires assessing these variables, as well as positive affectivity and depressiveness, were administered to 125 outpatients seeking treatment for panic disorder, social anxiety disorder, obsessive‐compulsive disorder, generalized anxiety disorder or major depressive disorder. The results, using a clinical sample, were highly consistent with the hierarchical model obtained in the previous study using a student sample. A more elaborate model, based on published theoretical and empirical evidence, was identified and tested, and similar results were obtained. Negative affectivity had expected direct positive effects on all of the specific anxiety and depression manifestations, with the exception of health anxiety, which showed a negative relationship, and OCD symptoms, which showed no relationship. Positive affectivity was found to be a specific risk factor for depression, while intolerance of uncertainty was found to be a specific risk factor for worry and depression. Finally, anxiety sensitivity appears to be a significant risk factor for panic and health anxiety.     

Test–Retest Reliability of Dominic Anxiety and Depression Items Among Young Children

Assessing anxiety and depressive symptoms through direct interviewing of young children has been found to be particularly difficult utilizing standard interview methods. Test–retest reliability of selected anxiety and depression items from the revised Dominic (Valla, Bergeron, Bidaut-Russell, St-Georges, & Gaudet, 1997), a cartoon-based questionnaire based on DSM diagnostic criteria, was investigated among two geographically diverse samples (Los Angeles and St. Louis; N = 37). Overall, kappas were higher for the anxiety items than for the depression items. In both cities the sample included clinic and non-clinic cases of African-American, Hispanic/Latino, and Caucasian children age 6–8; kappas for the anxiety and depression items were higher among the clinic cases than for the community cases. Given the need for psychometrically sound measures for culturally diverse samples of children, this initial report suggests that the use of selected Dominic items holds promise as a cartoon-based assessment of young children.     

Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant responses to the still-face procedure

Animal studies have demonstrated the interactive effects of prenatal stress exposure and postnatal rearing style on offspring capacity to manage stress. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and stress reactivity in human infants. This prospective study examined the impact of prenatal anxiety disorder and maternal caregiving sensitivity on infants’ responses to a standardised interactive stressor (still-face procedure). Eighty-four women completed a clinical interview during pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7 months, maternal sensitivity to infant distress and infant negative affect were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Results indicated a negative association between maternal sensitivity to infant distress and infant negative affect responses to the still-face procedure. An unexpected finding was a positive association between parity and infant reactivity. The main effect for sensitivity was qualified by a significant interaction, p < .05, suggesting that the impact of sensitivity was particularly marked among infants of women who experienced an anxiety disorder during pregnancy. This finding is consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes.     

A Longitudinal Examination of Correlates of Depressive Symptoms Among Inner-City African-American Children and Adolescents

We longitudinally examined across four years the presence and correlates of depressive symptoms in a sample of inner-city African-American children, an ethnic minority population which is understudied regarding child depressive symptoms. Results, based on mother- and child-report, did not indicate gender differences in depressive symptoms at the onset of adolescence. However, depressive symptoms did significantly predict future child adjustment problems. Implications for the understanding and future study of depressive symptoms in ethnic minority youth are discussed.     

A scale to assess the restrictiveness of educational settings

The placement of students into educational settings is perhaps one of the most debated issues in special education, particularly for students with emotional and behavioral disorders (EBD). A primary consideration in this decision is the restrictiveness of the setting, yet no scale to assess restrictiveness of educational settings exists. We undertook two surveys that asked respondents to rate the restrictiveness of 18 educational placements. The first survey was sent to a national panel of experts, the second survey was sent to supervisors of programs for students with EBD. The results of the surveys led to the development of theScale to Assess Restrictiveness of Educational Settings. This scale is designed to provide a measure of restrictiveness of educational settings that can provide data to evaluate student progress and program outcomes.     

Depressive symptoms during pregnancy: impact on neuroendocrine and neonatal outcomes

Objective

To explore the interplay of maternal depressive symptoms on the infant limbic-hypothalamic-pituitary axis (LHPA) and neurological development.

Design

Pregnant women were monitored for depressive symptoms using the Beck Depression Inventory (BDI) at 28, 32, and 37 weeks of gestation and at delivery. A mixture growth curve analysis divided the women into three risk groups: low/stable, intermediate, and high/increasing depression based on BDI scores. The infant neuroendocrine system was examined using cord blood for adrenocorticotrophic hormone (ACTH) and cortisol measurements. Two-week-old infants were examined using Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS).

Results

Infants born to women of the high/increasing depression group had significant ACTH elevation at birth. On NNNS examination, these infants were more hypotonic and habituated to auditory and visual stimuli.

Conclusion

When compared to non-depressed women, maternal depressive symptoms, even in the absence of major depressive disorder, appeared to facilitate a different developmental pathway for the infant LHPA and early neurological development.     

Prenatal paternal depression

Prenatal depressive symptoms, anxiety, anger and daily hassles were investigated in 156 depressed and non-depressed pregnant women and their depressed and non-depressed partners (fathers-to-be). Depressed versus non-depressed fathers had higher depression, anxiety and daily hassles scores. Although the pregnant women in general had lower anxiety, anger and daily hassles scores than the men, the scores on the measures for depressed fathers and depressed mothers did not differ. Paternal depression appeared to have less effect than maternal depression on their partners’ scores. However, the similarity between the scores of depressed mothers and depressed fathers highlights the importance of screening for depression in fathers-to-be as well as mothers-to-be during pregnancy.     

Validation française d’une échelle d’anxiété spécifique à la grossesse (PRAQ-R2)

ObjectivesPregnancy specific anxiety (PSA) may have many consequences on the health of the unborn child and the mother. Nowadays, in French, there is no validated tool to measure it. The aim of this study is to validate the French version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R2). This 10 items scale measures three PSA dimensions: worries about child health, fear of giving birth and concern about own appearance.MethodsAfter a translation and a back-translation step, the structural validity and the internal consistency of the scale were assessed in 160 pregnant women recruited online. Convergent validity (STAI-Y) and correlates of the construct were also examined.ResultsThe model fit indices are satisfactory, confirming the three- factor structure of the PRAQ-R2 in its French version. The dimensions and the total scores have a good internal consistency (α > .80), and convergent validity was also demonstrated.ConclusionThe PRAQ-R2 is the first tool designed to measure PSA and validated in France. This French validation has promising psychometric qualities. However, its discriminant validity and stability remain to be explored.