Parental grief following the death of an infant—a follow-up over one year

The course of parental bereavement during the first year following an infant's death was investigated. Also, the differences in mothers' and fathers' reactions, the differences according to the mothers' occupational role, and the similarities in couples' reactions were studied. From a total sample of 59 families, 13 families answered their questionnaires at all three time points (1, 6 and 13 months), 22 families responded at two time points, and 37 families responded at some point following the loss. Measures relating to anxiety, depression, bodily discomfort, general well being and impact of event were used at the three time points. The results showed that grief, as measured by the different inventories, decreased over time. The decrease was most evident from 6 to 13 months, and most prominent in women. A considerable number of the parents were still actively dealing with the loss all through the first year of bereavement. In most couples the mother reported most distress. Mothers were significantly more depressed than fathers at all time points, and mothers also had significantly higher anxiety and lower general health at 1 and 13 months, and intrusive scores of 1 and 6 months. Women at home evidenced more grief at all three time points than women employed outside the home. A high or low score in one spouse was more strongly correlated with a similar score in the other at 1 and 13 months, than at 6 months. The implications for counselling of parents, with special emphasis on the employment situation of the mother, is emphasized.     

Social support after the loss of an infant child: A long-term perspective

The article presents findings from a survey among 251 parents whose infant child had died. For most of the parents, the loss occurred several years ago. The survey assessed the amounts of instrumental, emotional and informational support received by these parents from various sources in connection with the death. The findings revealed that different sources provided different kinds of support. There was only one significant difference between bereaved males and females with regard to amount of support: females received more emotional support from their friends than males did. Furthermore, large amounts of support received by one spouse was associated with a similar level of support received by the other spouse. Social support in connection with the death was to some extent related to long-term psychological adaptation. Particularly support from neighbours and professionals was consistently associated with psychological adaptation. In general, however, the findings with regard to long-term effects of social support were ambiguous.     

Sensing the presence of the deceased: A narrative review

Researchers have reported that bereaved people often continue to sense the presence of the deceased. A particular collection of such experiences can be identified as instilling a perception that the deceased person is in some manner present in the company of the bereaved person. The aim of the current review was to synthesise the results on this topic to provide a comprehensive over-view for practitioners working with bereaved people who report these experiences. The studies were reviewed in terms of the nature of the experiences described, the provision of explanatory models to understand the significance of these experiences, describing any culturally specific aspects of these experiences, discussion of the personal impact of having the experiences, and for recommendations of how people who have these experiences can be supported.     

Parental satisfaction in child abuse and neglect: A review of standardized measures

Low levels of parental satisfaction have been implicated in parents' utilization of harsh disciplining strategies and perpetration of child abuse and neglect. Although measures of parental satisfaction have been present for more than 3 decades, the employment of these instruments in child maltreatment populations has been limited, perhaps due to a lack of empirical evaluation. This paper reviews extant studies that demonstrate the need to examine the relationship between parental satisfaction and child maltreatment, and provides a critical examination of existing measures of parental satisfaction, including their psychometric support and application to child maltreatment. Recommendations are offered regarding the utility of these measures in child maltreatment.     

Mapping grief: A study in practice using a quantitative and qualitative approach to exploring and addressing the range of responses to loss

The Adult Attitude to Grief (AAG) scale was devised for an earlier study (Machin, 2001) to test the validity of a concept of loss, which proposed that grief reactions fall broadly into three categories — ‘overwhelmed’, ‘balanced’ and ‘controlled’. There was statistical support for the proposed differences but the AAG scale, more importantly, provided insight into the diverse reactions taking place in individual bereaved respondents. This paper describes a second study undertaken to examine the clinical usefulness of the AAG scale with clients receiving help within the Psychological Services Operating Unit of the North Staffordshire Combined Healthcare (NHS) Trust. The scale has been used both in its original form with bereaved clients and in a modified form with clients having distress symptoms associated with other losses, such as relationship breakdown or the onset of chronic illness. The use of the AAG scale in this clinical setting suggests that, both as an assessment tool and as a cue for therapeutic dialogue, it provides a promising way of mapping the general and particular characteristics of response to loss in individual clients. Consideration is also given to varying therapeutic approaches needed to help clients regain the equilibrium disturbed by their grief.     

Maternal and paternal infant representations: A comparison between parents of term and preterm infants

Objective

Research on parental attachment representations after preterm birth is limited and inconclusive. The present study is the first in which maternal and paternal attachment representations after term, moderately and very preterm birth are compared. In addition, special attention was directed toward disrupted attachment representations.

Method

Mothers and fathers of term infants (≥37 weeks of gestational age, n = 71), moderately preterm infants (≥32–37 weeks of gestational age, n = 62) and very preterm infants (<32 weeks of gestational age, n = 56) participated in the present study. Attachment representations (balanced, disengaged, distorted) about their infants were evaluated with the Working Model of the Child Interview (WMCI). To asses disrupted representations the coding of the WMCI was extended with the disrupted scale (WMCI-D).

Results

The three main classifications of attachment representations were not affected by preterm birth. In addition, there were no gender differences in the rate of balanced representations. In case of non-balanced representations however, maternal representations were more often distorted, whereas fathers showed more often disengaged representations. Results further revealed that maternal disrupted attachment representations were marked by role/boundary confusion or disorientation, whereas paternal disrupted attachment representations were characterized by withdrawal.

Conclusion

Given the gender differences it is essential to tailor interventions according to the attachment representations of the parent, in order to be able to alter their non-balanced and/or disrupted attachment representations.     

The Underlying Structure of Grief: A Taxometric Investigation of Prolonged and Normal Reactions to Loss

Recent studies have supported the distinctiveness of complicated and prolonged forms of grief as a cluster of symptoms that is separate from other psychiatric disorders. The distinction between prolonged and normal reactions to loss remains unclear, however, with some believing that prolonged grief represents a qualitatively distinct clinical entity and others conceptualizing it as the extreme end of a continuum. Thus, in this study a taxometric methodology was used to examine the underlying structure of grief. Participants included 1,069 bereaved individuals who had lost a first-degree relative. Each participant completed the Dutch version of the Inventory of Complicated Grief–Revised, which was used to create indicators of prolonged grief. The mean above and mean below a cut (MAMBAC) and maximum eigenvalue (MAXEIG) tests supported a dimensional conceptualization, indicating that pathological reactions might be best defined by the severity of grief symptoms rather than the presence or absence of specific symptoms.

Participant loss due to "fussiness" in infant visual paradigms: a review of the last 20 years

One hundred and one published articles that used visual habituation or violation-of-expectation techniques with infants of 12 months or younger were surveyed. Information was compiled on the number of infants who failed to complete experimental procedures due to "fussiness" or other factors. Also noted for each experiment was whether or not infants as a group demonstrated differential responding to the test display. On average 13.7% (range 0-62%) of infants failed to complete these visual procedures as a result of fussiness. There was no correlation between experimental outcome and infant attrition due to fussiness or to any other factor. We thus found no evidence to suggest that differential exclusion rates systematically influence experimental outcomes. However, we urge researchers to provide operational definitions of "fussiness."     

A Phonological Existential Analysis to the Book of Job

This current article “A Phonological Existential Analysis to the Book of Job” explores the various ways that Job’s friends attempted to help him deal with his grief. Dr. Johnson is able to identify the various stages of grief that Job goes through and correlate each stage and the response from the friends in current psychological terms. It becomes clear that various practices of modern psychotherapy can be seen in each response from Job’s friends. It is reasonable to conclude that the responses from Job’s friends were part of the therapeutic process that moved Job to a state of rationality and wholeness. While the article approaches the Book of Job from a psychotherapeutic standpoint, it does not distract for the spiritual teachings found in the document. Fred Johnson is licensed as a counseling psychologist and is certified as a school psychologist. Dr. Johnson has worked many over 15 years as a private practicing family therapist and behavior specialist. Dr. Johnson completed his doctorate in counseling psychologist at the University of Louisville and attended Southern Baptist Theological Seminary obtaining a degree in pastoral psychology. He currently owns Educational Resource Services, a company that is dedicated to providing seminars in classroom behavior management throughout the United States and Canada. Dr. Johnson has published two books, Effective Discipline for the Difficult Child and From Chaos to Control: Managing Disruptive Classroom Behavior. He has also published several research studies, including ones dealing with the role of the ministers and a pastoral approach to divorce.     

Fear of snakes and facial reactions: A case of rapid emotional responding

The aim of the present study was to explore how rapid emotional responses are manifested as facial electromyographic (EMG) reactions when people with explicit fear of snakes are exposed to their fear relevant stimuli. Fifty-six subjects, high or low in fear of snakes, were exposed to pictures of snakes and flowers while facial EMG activity from the corrugator supercilii and the zygomatic major muscle regions was recorded. Measures of autonomic activity and ratings of the stimuli were also collected. Pictures of snakes evoked a rapid corrugator supercilii muscle reaction which was larger in the High fear group as early as 500ms after stimulus onset. The High fear group also rated snakes as more unpleasant and displayed larger skin conductance responses (SCRs) and increased heart rate (HR) when exposed to snakes. Pictures of flowers tended to evoke increased zygomatic major muscle activity which did not differ among the groups. The present results demonstrate that the facial EMG technique is sensitive enough to detect rapidly evoked negative emotional reactions. The results support the hypothesis that people high in fear of snakes are disposed to react very rapidly with a negative emotional response to their fear relevant stimuli.     

From child pornography offending to child sexual abuse: A review of child pornography offender characteristics and risks for cross-over

In this review, concrete directions are provided for individual risk assessment, treatment planning, and future research on child pornography offending. First, based on reviewing offender characteristics, including demographics, socio-affective difficulties, cognitive distortions and psychosexual issues, it is concluded that despite individual differences, many child pornography offenders have psychological difficulties in multiple areas of functioning. Based on earlier child pornography offender typologies, it is proposed that risk factors of individual offenders can be viewed along the lines of two continua: (1) features related to criminal behavior, and (2) sexual deviance/fantasy. These continua not only give insight into psychological differences between offender types, but also allow for variation in the severity of psychological difficulties within offender types and therefore may enhance individual risk assessment and treatment planning. Moreover, risk factors for cross-over are discussed, including individual characteristics, factors related to engagement with the internet, and the offline environment. Future research should focus on the integration of risk domains within particular offending types. Specifically, research is needed on non-offending pedophiles in order to gain more insight into the relationship between pedophilia and child pornography offending in general.     

Effects of cocaine exposure on infant development: A review

We review the effects of maternal cocaine use on the developing human fetus and infant in terms of methodological problems; the physiological action of cocaine on adults and on the developing fetus; the epidemiology of cocaine use; effects on fetal and infant mortality; growth of cocaine-exposed fetuses and infants; physical anomalies; evidence for and against infant withdrawal from cocaine; neurological effects; behavioral effects as shown by the NBAS; findings related to mother-infant interaction and emotional development; and parenting by cocaine-using mothers. Findings in most areas should be considered preliminary due to methodological problems. Published studies of long-term development are not yet available. In general, deleterious consequences of prenatal cocaine exposure are found for some portion of prenatally exposed infants. However, many findings of no difference are also available in methodologically well-controlled studies.     

From infant to child: the dynamics of cognitive change in the second year of life

The authors review several key areas of early cognitive development in which an abrupt shift in ability at the end of the second year of life has been traditionally assumed. These areas include deferred imitation, self-recognition, language, and categorization. Contrary to much conventional theorizing, the evidence shows robust continuities in all domains of early cognitive development. Where there is evidence of a reorganization of behavior that makes a new level of performance possible, dynamic-systems analyses indicate that even these may be driven by underlying processes that are continuous. Although there remain significant definitional and methodological issues to be resolved, the outcome of this review augers well for newer models in which cognitive development is viewed as a continuous, dynamic process.     

The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature

The sibling relationship has recently become the focus of much research in developmental psychology. The family system perspective implies the presence of a sibling with mental retardation will impact on the psychological development and functioning of their typically developing siblings. Past reviews of the literature have found this impact to be negative but there is the suggestion of positive consequences to having a sibling with mental retardation. The present meta-analysis sought to quantitatively integrate 25 studies and 79 effect sizes from the literature on the siblings of individuals with mental retardation. A small negative effect for having a sibling with mental retardation was discovered that could not be attributed to a publication bias or some other artifact. This negative effect was greatest for direct observation measures, measures of psychological functioning, especially depression, and for children. Limitations to this meta-analysis and directions for future research are discussed.     

Risk factors in child maltreatment: A meta-analytic review of the literature

This review presents the results of a series of meta-analyses identifying the relative strength of various risk factors for child physical abuse and neglect. Data from 155 studies examining 39 different risk factors were included in the review. Large effect sizes were found between child physical abuse and three risk factors (parent anger/hyper-reactivity, family conflict and family cohesion). Large effect sizes were also found between child neglect and five risk factors (parent–child relationship, parent perceives child as problem, parent's level of stress, parent anger/hyper-reactivity, and parent self-esteem).     

Measuring grief: A short version of the perinatal grief scale

Despite a considerable number of studies, there are two major drawbacks in the literature on grief and bereavement. One is a lack of adequate and generally agreed upon measures for assessing grief. The second is a lack of ability to predict from existing measures the likelihood of what has been termed chronic or pathological grief reactions. This paper reports the results of the development of a bereavement measure for the study of perinatal loss which attempts to address these gaps. The measure is specific to a pregnancy-related loss, although it has the potential for adaptation to use for other types of loss. Analysis of responses from 138 women has resulted in the reduction of the original measure from 104 to a more manageable and almost equally comprehensive and reliable 33 items. In addition, a factor analysis has produced three factors, two of which indicate the possibility for longer-term and more severe grief reactions. Because of its sound psychometric qualities and interesting factor structure, the measure shows promise of being useful for both research and clinical purposes.This research was funded by National Institute of Child Health and Human Development Grant R01 H18431-04, with additional assistance from the Center for Social Research at Lehigh University. Dr. Potvin is supported by the Quebec Health Research Fund.     

Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation

Background: To introduce a person with multiple disabilities to a microswitch-aided program, one has to select a plausible response(s), that is, a response(s) that can be performed reliably and without excessive effort by the person and can successfully activate the microswitch(es) available (producing preferred stimuli). This paper provides an overview of the responses adopted for microswitch activation in research studies during the last 20 years. Method: Computerized and manual searches were carried out to identify the studies published between 1986 and 2005. Forty-eight research studies were identified. They concerned the use of (1) a single (typical) response, (2) a single (non-typical) response, (3) multiple (typical and non-typical) responses, and (4) multiple (vocal) responses. Results and discussion: The results showed that 151 of the 190 participants involved in the studies had a positive outcome (i.e., clear increases in their responding, which suggested that they had learned the association between responding and consequent preferred stimuli). Failures were largely concentrated in the first group of studies. The discussion focused on (a) the importance of selecting plausible responses for increasing the chances of success, (b) the need of non-typical responses for persons with minimal motor behavior, (c) implications of programs with multiple responses on engagement and choice, and (d) relevance of using vocal utterances. Some suggestions for future research concerning these points were also examined.     

Parental divorce as a factor in children''s perception of human relationships: An analysis of human movement responses in the Rorschach test

The subjects were 108 Swedish children between 10 and 12 years old, who constituted a divorce and a non-divorce group of 27 girls and 27 boys each. Rorschach Tests were administered individually and human movement responses were analysed. Non-divorce children perceived more cooperative and fewer hostile interactions than the divorce children. Responses containing figures engaged in hostile interaction were most common among divorce girls, whereas the divorce boys had difficulties in perceiving any interaction whatsoever. The different effect of parental divorce on the ability of girls and boys to develop satisfactory social relationships is discussed.     

A longitudinal analysis of organizational fairness: an examination of reactions to tenure and promotion decisions

Most organizational justice research takes a cross-sectional approach to examining the relationship between perceived fairness and individuals' attitudes. This study examines the effect of procedural and distributive justice over time. It is suggested that individuals acquire more information and experience with procedures and outcomes over time. These changes in information and experience affect the influence of procedural and distributive justice on organizational attitudes. Faculty perceptions of tenure and promotion decisions were assessed 3 times (preallocation, short-term postallocation, long-term postallocation) over a 2-year period. Results generally supported the hypotheses. Procedural justice was most influential prior to and soon after outcome decisions were made. Distributive justice was most influential 1 year later.     

Threat to Parental Role: A Possible Mechanism of Altered Self-Concept Related to Carrier Knowledge

Researchers and clinicians have suggested that learning one is a carrier for a genetic disorder has the potential to alter self-concept. Concerns about self-concept have influenced the development of policies regarding the availability of carrier testing for minors and the informed-consent process. A literature review identified three mechanisms through which self-concept has been proposed to be affected: altered perception of genetic identity, diminished social identity, and an altered perception of health. This paper presents a conceptual framework developed from identity theory and the self's response to threat to propose a fourth mechanism: threat to the parental role. Clarification of the role of self-concept, the threat to self-concept related to carrier knowledge, and coping behaviors activated in response to this threat would help to target appropriate genetic counseling interventions.