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.     

Social anxiety, sexual behavior, and contraceptive use

Two hundred and sixty college students completed a questionnaire that provided information regarding their sexual experience, knowledge, and attitudes; their self-evaluations on dimensions related to sexuality; and their level of heterosocial anxiety (anxiety experienced in social interactions with members of the other sex). Compared with subjects low in heterosocial anxiety, highly anxious respondents were less sexually experienced, engaged in sexual activity less frequently, had fewer sexual partners, were less likely to have engaged in oral sex, expressed a higher degree of apprehension about sex, and had a somewhat higher incidence of sexual dysfunctions. In addition, low socially anxious women tended to use the pill, whereas highly anxious women preferred the condom. High and low heterosocially anxious respondents also differed on self-ratings related to their sexuality but did not differ in their attitudes or knowledge regarding sex. The results are discussed in terms of the cognitive, behavioral, and affective concomitants of social anxiety.     

Stability of maternal postnatal bonding between 3 and 6 months: Associations with maternal mental health and infant temperament

Maternal bonding is key for infant development and well-being. Research to date focused on prenatal bonding experience, with fewer studies looking at the postnatal period. Moreover, evidence suggests significant associations among maternal bonding, maternal mental health, and infant temperament. The joint impact of maternal mental health and infant temperament on maternal postnatal bonding remains unclear, with limited research reporting longitudinal data. Hence, the present study aims (1) to explore the impact of maternal mental health and infant temperament on postnatal bonding at both 3 and 6 months of age, (2) to explore postnatal bonding stability from 3 to 6 months, and (3) to determine which factors are linked with 3-to-6-month changes in bonding. At the infants' 3 months (n = 261) and 6 months of age (n = 217), mothers provided measures of bonding, depressive and anxious symptoms, and infant temperament via validated questionnaires. At 3 months, higher levels of maternal bonding were predicted by lower levels of anxiety and depression in the mothers and by higher infants' regulation scores. At 6 months, lower levels of anxiety and depression predicted higher levels of bonding. Moreover, mothers showing decreases in bonding were characterized by 3-to-6-month increases in depression and anxiety, as well as increased reported difficulties in regulation dimensions of infant temperament. This study highlights the impact of both maternal mental health and infant temperament on maternal postnatal bonding in a longitudinal sample and could offer useful information for early childhood prevention and care.     

Setting for exercise and concerns about body appearance of women who exercise.

The present study examined the association between the sex composition of exercise environment and concerns related to body appearance of women who exercise. A questionnaire concerning social physique anxiety, body dissatisfaction, and attitude toward women-only exercise environment was administered to 81 women who used either the women-only area or the co-ed area in a fitness club. A one-way analysis of variance indicated that those who exercised in a women-only area reported more social physique anxiety and dissatisfaction with body size and favored exercising in areas exclusively reserved for women than women who exercised primarily in co-ed areas. The women-only area served as a protective environment for those who were heavier, anxious about their body appearances, and dissatisfied about their body images. These women also preferred to exercise in an exclusively female setting compared to women who used the co-ed area.     

Health anxiety moderates the effects of distraction versus attention to pain

Little is known about the relationship between health anxiety and chronic pain. The present study explored whether individual differences in health anxiety would influence the response of chronic pain patients to physical therapy. Furthermore, the interaction of health anxiety with coping strategy usage (distraction versus attention) was studied. Participants were 81 chronic pain patients who were interviewed and completed measures of pain, anxiety and cognition following an active physiotherapy session in which they either: (1) attended to physical sensations; (2) distracted from physical sensations or (3) completed the session as usual. Health anxious, compared to non-health anxious, individuals worried more about their health and injury during the session and attended to and catastrophically misinterpreted sensations more frequently. A complex interaction between health anxiety and coping strategy emerged. Among health anxious patients, attention to sensations resulted in lower anxiety and pain than did distraction. It appears as though attention had a short-term anxiety reducing effect for health anxious patients. Among non-health anxious patients, attention resulted in greater worry about health than distraction. Clinical and theoretical implications are discussed.     

Social Anxiety Symptoms in Young Children: Investigating the Interplay of Theory of Mind and Expressions of Shyness

Children’s early onset of social anxiety may be associated with their social understanding, and their ability to express emotions adaptively. We examined whether social anxiety in 48-month-old children (N = 110; 54 boys) was related to: a) a lower level of theory of mind (ToM); b) a lower proclivity to express shyness in a positive way (adaptive); and c) a higher tendency to express shyness in a negative way (non-adaptive). In addition, we investigated to what extent children’s level of social anxiety was predicted by the interaction between ToM and expressions of shyness. Children’s positive and negative expressions of shyness were observed during a performance task. ToM was measured with a validated battery, and social anxiety was assessed using both parents’ reports on questionnaires. Socially anxious children had a lower level of ToM, and displayed more negative and less positive shy expressions. However, children with a lower level of ToM who expressed more positive shyness were less socially anxious. Additional results show that children who displayed shyness only in a negative manner were more socially anxious than children who expressed shyness only in a positive way and children who did not display any shyness. Moreover, children who displayed both positive and negative expressions of shyness were more socially anxious than children who displayed shyness only in a positive way. These findings highlight the importance of ToM development and socio-emotional strategies, and their interaction, on the early development of social anxiety.     

Greek women's attitudes toward pregnancy,labor, and infant: Their significance for intervention

Greek women's needs, attitudes, and experiences during the months immediately prior to and subsequent to the birth of their infants were evaluated. Themes considered were women's feelings and attitudes toward pregnancy, labor and the expected infant; breast feeding; emotional and practical needs; experiences from perinatal care and relationships with medical care personnel and with the family; perceptions of physical and emotional stress; and their relationships with infant and partner. Findings showed, among others, that women emphasized a desire for more personal care — more time, continuity of care, information about their pregnancy, and less distance from the doctor. Moreover, they expressed their need for emotional support. Anxiety was found to be a central feature of women's feelings during labor and delivery. The same anxiety was related to efforts to deal with infant crying, attempts to console the infant, and concern for picking the baby up. Understanding maternal attitudes provides guidelines for designing an intervention program that would integrate emotional and cognitive factors.     

Stigma, social context, and mental health: lesbian and gay couples across the transition to adoptive parenthood

This is the first study to examine change in depression and anxiety across the first year of adoptive parenthood in same-sex couples (90 couples: 52 lesbian, 38 gay male). Given that sexual minorities uniquely contend with sexual orientation-related stigma, this study examined how both internalized and enacted forms of stigma affect the mental health of lesbians and gay men during the transition to parenthood. In addition, the role of contextual support was examined. Higher perceived workplace support, family support, and relationship quality were related to lower depressive and anxious symptoms at the time of the adoption, and higher perceived friend support was related to lower anxiety symptoms. Lower internalized homophobia and higher perceived neighborhood gay-friendliness were related to lower depressive symptoms. Finally, individuals with high internalized homophobia who lived in states with unfavorable legal climates regarding gay adoption experienced the steepest increases in depressive and anxious symptoms. Findings have important implications for counselors working with sexual minorities, especially those experiencing the transition to parenthood.     

Pattern of perceived stress and anxiety in pregnancy predicts preterm birth.

OBJECTIVE: To determine whether the pattern of prenatal stress, as compared to prenatal stress assessed at a single gestational time point, predicts preterm delivery (PTD). DESIGN: Perceived stress and anxiety were assessed in 415 pregnant women at 18-20 and 30-32 weeks' gestation. MAIN OUTCOME MEASURES: Gestational length was determined by last menstrual period and confirmed by early pregnancy ultrasound. Births were categorized as preterm (< 37 weeks) or term. RESULTS: At neither assessment did levels of anxiety or perceived stress predict PTD. However, patterns of anxiety and stress were associated with gestational length. Although the majority of women who delivered at term exhibited declines in stress and anxiety, those who delivered preterm exhibited increases. The elevated risk for PTD associated with an increase in stress or anxiety persisted when adjusting statistically for obstetric risk, pregnancy-related anxiety, ethnicity, parity, and prenatal life events. CONCLUSIONS: These data suggest that the pattern of prenatal stress is an important predictor of PTD. More generally, the findings support the possibility that a decline in stress responses during pregnancy may help to protect mother and fetus from adverse influences associated with PTD.     

Maternal pre‐ and postnatal anxiety and infant temperament. The generation R study

The aim of this study was to investigate whether maternal anxiety that is temporary or chronic during the pre‐ and postnatal period predicts infant temperament. Mothers of 2997 infants in a population‐based birth cohort reported levels of pregnancy‐specific anxiety (Pregnancy Outcome Questionnaire) and general anxiety symptoms (Brief Symptom Inventory) prenatal and at 6 months postnatal. Temperament characteristics were assessed by maternal report using the Infant Behavior Questionnaire—Revised when the infants were 6 months of age. Maternal pregnancy‐specific and general anxiety during the pre‐ and postnatal period were all independently associated with perceived infant temperamental difficulties. Chronically high maternal anxiety predicted the highest perceived infant activity level and negative affectivity. These findings show that different forms of maternal anxiety during both the pre‐ and postnatal period are independently related to perceived temperamental problems in infancy. They also emphasize the significance of chronic maternal anxiety for infant mental health. Copyright © 2009 John Wiley & Sons, Ltd.     

Adverse psychological outcomes in colorectal cancer screening: does health anxiety play a role?

People who are anxious about their health are more likely to misinterpret health information as personally threatening and less likely to be reassured by medical investigations that show they are free from disease. Consequently, health anxious people would be expected to react more adversely to cancer screening, but this possibility has rarely been explored. The moderating role of health anxiety on the psychological impact of participating in colorectal cancer screening was examined among a sub-sample of 3535 participants in a large, community-based trial of colorectal cancer screening in the UK. The screening modality was flexible sigmoidoscopy, which examines the bowel for pre-cancerous polyps. It was predicted that health anxiety would be associated with more worry about cancer before screening, a greater increase in worry if polyps were detected, and less reassurance after a clear result. As expected, health anxious participants were more anxious and more worried about bowel cancer both before and after screening. However, they experienced greater reductions in anxiety and worry about cancer following the examination. They reported lower levels of reassurance following screening, but also expressed more positive reactions to the experience. The positive psychological benefits of attending medical investigations should be examined in future work, because this may go some way towards explaining why health anxious people repeatedly seek medical interventions.     

Prenatal Cocaine Exposure and Infant Sleep at 7 Months of age: The Influence of the Caregiving Environment

The primary goal of this study was to examine sleep problems in a sample of cocaine-exposed 7-month-old infants and to determine if maternal psychopathology mediated any existing association between substance exposure and sleep behaviors. We also examined the differences in sleep behaviors of cocaine-exposed infants in parental custody and cocaine-exposed infants in nonparental custody. Participants were 65 cocaine-exposed and 53 nonexposed infants and their primary caregivers who were recruited at delivery and assessed at 7 months of infant age. As expected, women who used cocaine during pregnancy had more psychiatric symptoms than nonusers. Prenatal exposure to heavier amounts of cocaine was significantly related to more severe sleep difficulties, and maternal anxiety mediated this association. Approximately 28% of cocaine mothers lost custody of their infants by 7 months of age. Nonmaternal caregivers had significantly fewer symptoms of psychopathology than the cocaine-using women who retained custody of their children. Infants who were in nonparental care at 7 months of age also had less severe sleep problems than did infants who remained in parental care.     

Health anxiety,anxiety sensitivity,and attentional biases for pictorial and linguistic health‐threat cues

The study investigated attentional biases for pictorial and linguistic health‐threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health‐threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health‐threat cues than the low health anxious group was not supported despite the groups being well‐differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Hassles,anxiety, and negative well-being

Adult volunteers (N = 234) responded to a “decontaminated” hassles scale plus measures of trait anxiety, perceived stress, psychiatric symptomatology, and minor physical ailments. All but the anxiety scale were time-referenced to the past month. Major findings were as follows: (1) Hassles and trait anxiety contributed positively to perceived stress, both individually and interactively, accounting altogether for 55% of the variance; highly anxious subjects showed lower increments in perceived stress with increasing hassles-exposure than did low anxious subjects. (2) Hassles and trait anxiety had a positive synergistic effect on psychiatric symptomatology which, along with the nonsignificant marginal main effects, accounted for 64% of the variance. (3) Hassles and trait anxiety had a positive synergistic effect on minor physical ailments in men; however, highly anxious women, who showed very high levels of illness under even low hassles-exposure, responded less to incremental stress than did low-anxious women. The significant Sex x Hassles x Trait-Anxiety interaction effect and all the implicated lower-order effects jointly accounted for 22% of the variance in minor ailments.     

Gender differences in social support for socially anxious individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Gender Differences in Social Support for Socially Anxious Individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

Effects of social anxiety and depressive symptoms on the frequency and quality of sexual activity: a daily process approach

Diminished positive experiences and events might be part of the phenomenology of social anxiety; however, much of this research is cross-sectional by design, limiting our understanding of the everyday lives of socially anxious people. Sexuality is a primary source of positive experiences. We theorized that people with elevated social anxiety would have relatively less satisfying sexual experiences compared to those who were not anxious. For 21 days, 150 college students described their daily sexual episodes. Social anxiety was negatively related to the pleasure and feelings of connectedness experienced when sexually intimate. The relationship between social anxiety and the amount of sexual contact differed between men and women—it was negative for women and negligible for men. Being in a close, intimate relationship enhanced the feelings of connectedness during sexual episodes for only individuals low in social anxiety. Depressive symptoms were negatively related to the amount of sexual contact, and the pleasure and feelings of connectedness experienced when sexually intimate. Controlling for depressive symptoms did not meaningfully change the social anxiety effects on daily sexuality. Our findings suggest that fulfilling sexual activity is often compromised by social anxiety.     

Health anxiety, anxiety sensitivity, and attentional biases for pictorial and linguistic health-threat cues

The study investigated attentional biases for pictorial and linguistic health-threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health-threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health-threat cues than the low health anxious group was not supported despite the groups being well-differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Sense of control predicts depressive and anxious symptoms across the transition to parenthood.

In this study, the authors examined the relationship between sense of control and depressive and anxious symptoms for mothers and fathers during the 1st year of parenthood. Participants were 153 dual-earner, working-class couples who were recruited during the 3rd trimester of pregnancy at prenatal education courses. Data were collected 1 month antenatally and 1, 4, 6, and 12 months postnatally. Sense of control was decomposed into 2 distinct parts: an enduring component and a malleable component that changes with context. Consistent with a cognitive theory of emotional problems, results demonstrated that a sense of control served a protective function for mental health outcomes. A higher sense of enduring control predicted lower levels of psychological distress for new parents, and increases in control over time predicted decreases in depression and anxiety. Findings hold implications for interventions with expectant parents, such as expanding prenatal education courses to include strategies for enhancing and maintaining a sense of personal control.