Delimiting Family in Syntheses of Research on Childhood Chronic Conditions and Family Life

Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results.     

THE IMPACT OF DEPRESSION ON MATERNAL RESPONSES TO INFANT FACES IN PREGNANCY

Research has suggested that prenatal depression may be associated with disrupted maternal responses to infant stimuli, with depressed pregnant women not showing the bias toward distressed infants as that observed in nondepressed pregnant women. The current study examined the effects of depression on self‐ reported responses to infant stimuli, in early pregnancy. Women with clinical depression (n = 38), and nondepressed women (n = 67) were recruited from a wider cognitive behavioral therapy trial. They completed Maternal Response Scales in which they were presented with images of distressed, neutral, and happy infant faces, with no time limit. The women rated their responses to these images along three dimensions—wanting to comfort, wanting to turn away, and feelings of anxiety—using Likert scales via a computerized task. There was evidence that women with depression in pregnancy showed different responses than did women without depression. Women with depression were substantially more likely to be in the highest quartile for ratings of wanting to turn away, odds (OR) ratio = 4.15, 95% confidence intervals (CIs) = 1.63–10.5, p = .003, and also were substantially less likely to be in the highest quartile for wanting to comfort a distressed infant face, OR = 0.22, 95% CIs = 0.09–0.54, p < .001. Findings are consistent with there being both a heightened avoidant and a reduced comforting response toward distressed infants in depressed pregnant women, providing some support that depression disrupts maternal preparations at a conscious level.     

‘You were not born here,so you are classless,you are free!’ Social class and cultural complex in analysis

The unconscious impact of differences in culture and social class is discussed from the perspective of an analyst practising in London whose ‘foreign accent’ prevents patients from placing her within the social stratifications by which they feel confined. Because she is seen by them as an analyst from both ‘inside’ and ‘outside’ the British psycho‐social fabric and cultural complex, this opens a space in the transference that enables fuller exploration of the impact of the British social class system on patients’ experience of themselves and their world. The paper considers this impact as a trans‐generational trauma of living in a society of sharp socio‐economic divisions based on material property. This is illustrated with the example of a patient who, at the point of moving towards the career to which he aspired, was unable to separate a sense of personal identity from the social class he so desperately wanted to leave behind and walk the long avenue of individuation. The dearth of literature on the subject of class is considered, and the paper concludes that not enough attention is given to class identification in training.