Newborn behavioral observations system in rural Pakistan: A feasibility and acceptability study

The Newborn Behavioral Observations (NBO) system is a relationship-based tool that helps parents recognize their infant's competencies and learn their behavioral cues, with the goals of enhancing parental responsiveness and satisfaction in the infant-parent relationship. In our study, a pediatrician integrated the NBO into 44 pediatric health care visits of infants in rural Pakistan villages, under the remote guidance of two U.S.-based child psychiatrists. A clinician then gave the mothers a survey about their experience of the NBO and found that the mothers were highly satisfied, reporting greater appreciation of their infant's strengths, greater understanding of their infant's behavioral cues, stronger attachment to their infant, and greater self-confidence as a mother. In their consideration of these results, the authors explore cultural reasons for the mothers’ responses and generate hypotheses to inform an outcome study of a similar intervention. This was a feasibility and acceptability study and was not randomized, had no control group, and did not use objective measures of outcome.     

Longitudinal changes in term and preterm infant night wakings: The role of caregiver anxious-depression

Changes in infant night waking during the first year of life are associated with individual (e.g., prematurity) and family (e.g., caregiver psychopathology) factors. This study examined the association between infant night waking and caregiver anxious-depressive symptoms during the first year of life in preterm and term infants. We considered between-person differences and within-person changes in caregiver anxious-depressive symptoms in relation to changes in infant night waking from 2- to 9-months. Racially (30.0% Black, 60.4% White, 9.5% multiracial/other) and socioeconomically (40.0% below median household income) diverse caregivers (N = 445) of full term (n = 258) and preterm (n = 187) infants were recruited from hospitals and clinics in two midwestern states. Caregivers completed measures of anxious-depression and their infant's night waking at four sampling periods (2-, 4-, 6-, and 9-months). Infant night wakings declined from 2- to 9-months. Between-person differences were observed, such that caregivers with higher average anxious-depressive symptoms or infants born full term reported more night wakings. Within-person effects of caregiver anxious-depressive symptoms were not significant. Caregiver anxious-depression is closely associated with infant night wakings. By considering a caregiver's average severity of anxious-depression, healthcare providers can more effectively plan infant sleep interventions. If caregiver anxious-depressive symptoms are ameliorated, night wakings may also decrease.     

The Unreal Child1

Unrepresented mental states lead to an impaired ability to feel emotions and trust in oneself, one’s history and in the world. The article explores the question of how representations of oneself and the relevant other, the mother, become possible in the course of therapy when dissociative processes previously made this impossible, and what role unconscious communication plays in the analytic realm. This question will be explored by examining the theories of André Green, Philip Bromberg, and Howard Levine.     

Devouring and Asphyxia: Symptoms of a Cultural Complex in Present Times1

The article discusses dominance and oppression in society due to cultural complexes filled with collective memories of destructiveness and perpetration, implicit memories which have remained repressed. Individual personal complexes and traumas are intertwined with traumatizing historical circumstances, setting up pairs of perpetrator and victim. The metaphors of devouring and asphyxiation are used to denote interpersonal and group relationships in which feelings of imprisonment, suffocating anxiety and expulsion are predominant, all of which leads to painful projections and introjections, dissociation and suffering. Asphyxiating death symbolizes not only environmental devastation by fire, the pandemic and the plague, but is also seen as a symptom of acute anxiety in modern times. Devouring stands for the annulment of the objectified Other in a patriarchal society best revealed in fratricidal struggles, the oppression of women and, ultimately, wars.     

Thinking Childbirth from an Emancipatory Perspective? Phenomenology and Psychoanalysis1

Feminist thought, despite the importance of its work, has not resolved the phenomenon of women's subordination in the care and education of children, and in society as a whole. Meanwhile, we are witnessing a gradual but continuous process of disconnection between women's bodies and subjectivity, and the conception, pregnancy and birth of children, due to developments in reproductive techniques. Considering this paradoxical tension, the author proposes to return to the very place where this subordination and anticipated rupture occur, to consider whether mothers could find there both the means to reclaim their childbirth experiences and potential levers for emancipation and rebirth, on both a personal and societal level. To this end, she describes, from the point of view of a singular woman, and from an emancipatory perspective, the phenomenological and psychoanalytical itinerary of childbirth by which this woman, in becoming a mother, is born to herself by giving birth to her child. By co-constituting the universal meaning of childbirth and becoming a philosophical mother, this singular woman operates a real paradigm shift in our representations of the mother and the metaphysical structure of the sexes.     

20世纪医学发展态势 21世纪医学发展预测--1901～1999年诺贝尔生理学/医学奖综合分析

通过对 190 1～ 1999年诺贝尔生理学 /医学奖综合分析 ,发现生物医学科学的发展规律。并对 2 1世纪医学发展的进行预测 :人类将完成庞大的人体基因组计划 ;攻克各种顽症 ;生产各种人造器官 ,以供移植所需。总结两种治疗疾病的思路 :一种是通过修正致病基因 ,另一种思路可通过器官移植 ,从根本上达到治病的目的     

Effectiveness of an attachment-based intervention for the assessment of parenting capacities in maltreating families: A randomized controlled trial

Even though Parenting Capacity Assessments (PCAs) are essential for child protection services to support placement decisions for maltreating families, presently no evidence-based PCA protocols are available. In this randomized controlled trial, we tested the quality of an attachment-based PCA protocol based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We recruited 56 parent-child dyads (M_age children = 3.48 years) in Dutch family residential clinics that conduct PCAs to support placement decisions. After pretest, families were randomized to receive the Regular Assessment Procedure (RAP) (n = 28), or an additional assessment based on VIPP-SD (n = 28). An immediate post-test and a 10-month follow-up were conducted. Multilevel models showed that therapists felt equally confident about their recommendations regarding child placement for both groups and that they equally often modified their initial placement recommendations. Moreover, children in the VIPP-SD group did not show fewer behavior problems and did not experience recurring child maltreatment less often than children in the RAP group. Thus, we found no evidence that PCAs incorporating the VIPP-SD protocol outperformed PCAs as usual. We discuss possible explanations why in the current study VIPP-SD did not seem to add to the quality of the RAP.