剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性

了解剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性,对剖宫产患者进行抑郁状况的调查,并对其影响因素进行分析。对抑郁组与非抑郁组的一般情况构成比比较,并采用抑郁自评量表（SDS）、应付方式评定量表（YFFS）、社会支持问卷（ISSI）、防御方式问卷（DSQ）进行测评。社会支持、应对方式及防御方式对产后抑郁的发生均产生一定作用。应付方式、社会支持及防御方式是影响剖宫产患者产后抑郁的重要因素。     

心理干预对产褥期精神障碍患者生活质量的影响

探讨心理干预对产褥期精神障碍患者生活质量的影响。将85例产褥期精神障碍患者随机分为研究组45例和对照组40例,两组均给予精神科常规护理,研究组在此基础上根据患者的具体情况,实施有针对性的心理护理干预。于心理护理干预后采用Hamilton抑郁量表（HAMD）、Hamilton焦虑量表（HAMA）和生存质量量表（SF－36...     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据。研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障。集体心理干预值得推广,应加强实施效果评估,并将产后抑郁干预融入孕产妇保健体系。     

Postpartum return to smoking: staging a "suspended" behavior.

Two hundred fifty-six pregnant women who had quit smoking were classified into the precontemplation (PC), contemplation (C), preparation (PA), or action (A) stages of change for postpartum smoking cessation based on a 3-item algorithm assessing personal goals, self-efficacy, and smoking behavior. Logistic regression and event history analyses indicated group differences in return to smoking at 6 weeks and 3, 6, and 12 months postpartum. The percentage of women who returned to postpartum smoking was highest in the precontemplation stage and decreased with each subsequent stage, that is, at 6 weeks 83% of PCs, 64% of Cs, 35% of PAs, and 24% of As had returned to smoking. Results lend support for the stages of change for postpartum smoking abstinence. Stage-based interventions may be developed to assist women in maintaining abstinence postpartum.     

Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables

Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.     

石河子市剖宫产患者产后抑郁状况调查及影响因素分析

为了了解剖宫产患者产后抑郁的发生情况,对剖宫产患者进行抑郁状况的调查,并对其影响因素进行分析,对抑郁组与非抑郁组的一般情况构成比比较,并采用抑郁自评量表（SDS）、应付方式评定量表（YFFS）、社会支持问卷（ISSI）进行测评。结果显示,应付方式评定量表中的主观支持（P〈0．05）,社会支持问卷中退避倾向性进入回归方程,提示应付方式及社会支持是影响剖宫产患者产后抑郁的重要因素。     

Intergenerational effects of cocaine on maternal aggressive behavior and brain oxytocin in rat dams

Gestational cocaine treatment results in significantly increased maternal aggression towards an intruder by postpartum day six, while acute postpartum treatment dose dependently decreases maternal aggressive (MA) behavior. Both increased and decreased aggression in the cocaine-treated dams are correlated with either decreased or increased levels of oxytocin in the amygdala, respectively. The current study was an effort to determine whether the effect of gestational cocaine on maternal aggression is transient or would continue into the postpartum period; whether an intermittent cocaine treatment regimen, which incorporates gestational and postpartum intermittent cocaine treatment, would differ from chronic daily gestational treatment; and finally, whether next generation female offspring of cocaine-treated or control dams would have altered MA behavior and oxytocin system changes attributable to either prenatal drug exposure, rearing condition or both. We now report no increase in maternal aggression following chronic gestational treatment and significantly lower levels of aggression in intermittently treated dams on postpartum day eight, with no significant effects in either group on postpartum day 12. Young adult female offspring of the cocaine-treated and control dams, who reared their own natural litters and were tested on postpartum day eight for maternal aggression, had higher levels of maternal aggression towards an intruder attributable to both prenatal cocaine exposure and rearing condition. Higher aggression in cocaine-reared next generation dams was associated with lower levels of oxytocin in the amygdala. Intergenerational effects of cocaine were apparent with respect to aggression and oxytocin system changes.     

Parenting attitudes of adolescent and older mothers

The parenting attitudes of adolescent and older mothers were assessed at 1 and 12 months postpartum to explore group differences and determine if these attitudes predicted quality of home environment and parenting behaviors at 12 months. Adolescent mothers scored significantly lower than did older mothers in empathy toward children's needs, but there were no significant group differences on three other parenting attitude constructs. There were no significant correlations between parenting attitudes at 1 month and parenting behaviors at 12 months for either group. For adolescent mothers at 12 months postpartum, the only attitude construct that was significantly related to concurrent quality of parenting was developmental expectations of the child. These and other findings are discussed in the context of current theory and intervention related to adolescent parenting.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

The Effects of a Couples‐Based Health Behavior Intervention During Pregnancy on Latino Couples’ Dyadic Satisfaction Postpartum

Many couples tend to report steadily decreasing relationship quality following the birth of a child. However, little is known about the postpartum period for Latino couples, a rapidly growing ethnic group who are notably underserved by mental and physical health caregivers in the United States. Thus, this study investigated whether a brief couples’ intervention focused on helping couples support each other while increasing healthy behaviors might improve dyadic functioning postpartum. This study presents secondary analyses of data regarding couple functioning from a larger randomized controlled trial with 348 Latino couples to promote smoking cessation. Portions of the intervention taught the couple communication and problem‐solving skills to increase healthy behavior. Couples participated in four face‐to‐face assessments across 1 year starting at the end of the first trimester. Latent growth curve analyses revealed that the treatment group reported an increase in relationship satisfaction and constructive communication after the intervention, which diminished by 1‐year follow‐up, returning couples to their baseline levels of satisfaction. Results suggest that incorporating a brief couple intervention as part of a larger health intervention for Latinos may prevent postpartum decreases in relationship satisfaction.     

Anger After Childbirth: An Overlooked Reaction To Postpartum Stressors

Other than postpartum depression, little is known about women's emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed the Beck Depression Inventory and the anger subset of the Affect Balance Scale. A number of childbirth–relevant variables were examined as predictors of postpartum emotional response, controlling for prepartum levels and for the association between anger and depressed mood. As expected, a substantial group of women reported high levels of anger irrespective of depressed mood. Although the majority of variables predicted depressed mood, childcare stress, age, and religious self–identification were independently predictive of postpartum anger (all p values > .05). Implications for research and clinical intervention are discussed.     

Maternal perceptions of the infant: Relationship to maternal self‐efficacy during the first six weeks' postpartum

Mothers' perceptions of their infants and their own levels of self‐efficacy contribute to developing maternal‐infant attunement. The purpose of this investigation was to examine the associations between maternal perceptions of their own infants relative to other infants and maternal self‐efficacy in a group of ethnically diverse, low‐income, first‐time mothers during the first six weeks postpartum. By employing a structural equation model approach, we explored relationships between the predictor (maternal neonatal perceptions) and dependent variable (maternal self‐efficacy). Changes in maternal perceptions of their own infants significantly contributed to self‐reported levels of self‐efficacy while controlling for concurrent self‐esteem. Maternal perceptions of her infant as less difficult than the average infant at six weeks postpartum predicted increased levels of maternal self‐reported self‐efficacy. The present study supports further exploration of the first six weeks postpartum as a sensitive period for targeting intervention and support, particularly for mothers and infants at highest risk.     

Effects of extended father-infant contact during the newborn period

Studies within the past decade have suggested that extended contact between mothers and newborns may have positive effects on later parent-infant interaction and may impact favorably upon the establishment of the mother-to-infant attachment bond. The present study was designed to determine whether similar extended contact effects occur for fathers. The results indicated that a group of fathers who attended their infants' births and received extended postpartum hospital contact with their infants engaged in greater amounts of en face behavior and vocalization with their infants and were more involved in infant caretaking responsibilities at 6 weeks postpartum and had higher self-esteem scores following the births compared to another group of fathers who attended their infants' births but received traditional amounts of hospital contact. Although there were more behavioral similarities than differences between the two groups of fathers, positive effects were found on behavioral measures, standardized psychometric measures, and on self-report questionnaires. The results indicated that extended contact effects are at least as salient with fathers as with mothers.     

A Counselor's Primer on Postpartum Depression

Women are more likely than men to experience depression, and they are particularly vulnerable to depression during the postpartum period. Postpartum depression is distinguished from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Biological, psychodynamic, and diathesis-stress perspectives on postpartum depression are described. Counselors are encouraged to fashion individualized treatments for postpartum depression that are matched to the stressors and vulnerabilities of their clients.     

Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?

We investigated whether postpartum anxiety (PPA) and breastfeeding self-efficacy and bonding at the early postpartum period can be used to predict postpartum depression and the breastfeeding method, and we sought to identify factors related to postpartum depression. Of the 510 eligible women, 185 (36%) returned the questionnaire on all three occasions (1 day, 3 days, and 1 month after childbirth). The mothers' progress on the State-Trait Anxiety Inventory (STAI), Breastfeeding Self-Efficacy Scale Short Form (BFSES-SF), and Postnatal Bonding Questionnaire (PBQ) was observed over three periods. A repeated-measures ANOVA revealed that the mothers at high risk of developing postpartum depression (PPD) were those who did not show an increase in BFSES-SF score at early postpartum, and mothers whose bonding disorders have deteriorated rapidly. The results of the logistic regression analysis revealed a significant difference in employment as a factor related to postpartum depression. Compared to Regular, Part-time status was 4.4 times more likely and Unemployed status was 2.3 times more likely to cause postpartum depression. For the early detection of PPD, it is necessary to identify (1) mothers who do not show an increase in the BFSES-SF score, (2) mothers whose bonding disorders have deteriorated rapidly, and (3) part-time or unemployed mothers as characteristic of postpartum depression.     

Maternal touch in caregiving behavior of mothers with and without postpartum depression

The way a mother touches her infant plays a central role in maternal caregiving behavior. Thus, the purpose of the present study was to examine associations between touch and positive and negative caregiving behavior and whether this association differed in mothers with and without postpartum depression, an episode of depressive disorder following childbirth. Positive caregiving behavior was operationalized as sensitive behavior, i.e. the mother’s ability to notice the child’s signals, interpret these signals correctly and respond to them promptly and appropriately. Negative caregiving behavior was operationalized as overriding behavior, i.e. behavior which disturbs the child’s behavior or redirects the child’s attention to follow the parent’s agenda. Seventy mother-infant dyads (44 in the nonclinical group and 26 in the clinical group) participated in a 10 minutes long mother-infant interaction at four months postpartum. The sample is part of an archival dataset of a longitudinal study investigating the parent-child relationship and child development. Three minutes of the interaction were coded a) microanalytically for touch, using a modified version of the Maternal Touch Scale (Beebe et al., 2010), and b) macroanalytically for sensitive and overriding behavior, using the Coding Interactive Behavior measure (Feldman, 1998). Hierarchical regression analyses with bootstrapping showed that caregiving touch, but not affectionate and static touch, was associated with sensitive behavior across the whole sample. Moreover, playful, but not rough-intrusive touch, was associated with overriding behavior across the whole sample. Associations did not differ between mothers with and without postpartum depression.     

Self‐perception of cognitive changes during pregnancy and the early postpartum: salience and attentional effects

The reports from 198 pregnant women of changes experienced during pregnancy suggested that cognitive changes are not salient since only 2% of women spontaneously mentioned such changes. When asked specifically about cognitive changes, the majority reported no change although most who reported a change indicated it was for the worse. In this respect they differed from a group of 132 students who had recently left home. In a second study, 13 women were asked to rate a range of cognitive functions during pregnancy and the postpartum period. Their ratings for certain aspects of cognition were lower than those of a group of non‐pregnant women. They also reported more cognitive failures and readily provided examples of perceived impairments in cognition. It would appear that cognitive deficits are of low salience to pregnant women but, if prompted, impairments in memory, concentration, clarity of thought and attention will be reported by women both during pregnancy and the first‐year postpartum. Copyright © 2002 John Wiley & Sons, Ltd.     

Stress and support as related to postpartum paternal mental health and perceptions of the infant

This study examined the relationship of stress and social support to psychological adjustment, attitudes towards the parental role, and perceptions of infant behavior in two groups of fathers: an index group of 50 men whose wives had a diagnosed postpartum depression, and a control group of 50 men whose wives had no such disorder. Fathers with more stress and less support had higher levels of psychological symptomatology. Index fathers reported more stress, particularly from work and economic pressures. Index fathers were also less likely than controls to report support from in-laws, other relatives, and friends. Stress, but not support, was associated with more negative perceptions of the marriage, the parental role, and infant behavior. Work-related stress was most likely to have an impact on paternal attitudes. These findings suggest the need to adopt a family focus when studying postpartum depression. © 1997 Michigan Association for Infant Mental Healt     

Effects of maternal postpartum depression in a well‐resourced sample: Early concurrent and long‐term effects on infant cognitive,language, and motor development

This study examined early and long‐term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full‐term born children from the urban region of Copenhagen, Denmark. Of this group, 28 mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal postpartum depression was associated with poorer cognitive development at infant age four months, the effect size being large (Cohen's d = 0.8) and with similar effects for boys and girls. At 13 months of age infants of clinical mothers did not differ from infants of non‐clinical mothers. At this time most (79%) of the clinical mothers were no longer, or not again, depressed. These results may indicate that maternal depression can have an acute, concurrent effect on infant cognitive development as early as at four months postpartum. At the same time, in the absence of other risk factors, this effect may not be enduring. The main weaknesses of the study include the relatively small sample size and that depression scores were only available for 35 of the non‐clinical mothers at 13 months.     

Be a Mom: Formative Evaluation of a Web-Based Psychological Intervention to Prevent Postpartum Depression

A formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention should be short-term, delivered postnatally, and grounded in cognitive-behavior therapy principles. Moreover, the intervention should include weekly sessions targeting basic contents: motherhood changes, reorganizations and emotional experience; cognitions, self-criticism, and self-compassion; parenting values, social support, and assertive communication skills; couple relationship, negotiation and conflict resolution skills; and postpartum depression signs and professional help-seeking. These results may improve the Be a Mom’s adequacy, implementation success, and effectiveness.