Be a Mom,a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom’s efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.     

Emotion Beliefs,Emotion Regulation,and Emotional Experiences in Daily Life

One potential factor that could influence how individuals with at least moderate symptoms of depression cope with upsetting events in their daily lives is the beliefs that these individuals hold about whether emotions are malleable or fixed. The current study adopted an experience sampling approach to examine how the beliefs about emotion’s malleability related to daily positive and negative affect and daily emotion regulation efforts among individuals with at least moderate symptoms of depression (N = 84). Results demonstrated that individuals having at least moderate symptoms of depression who held more malleable beliefs about emotions reported decreased negative affect both overall during the day and specifically in response to daily upsetting events. Additionally, these individuals who held more malleable beliefs about their emotions also reported more daily use of cognitive reappraisal to regulate their emotions in response to upsetting daily events. Results from the current study extend previous work examining the relationship between emotion malleability beliefs, emotional experiences, and emotion regulation to examine these relationships in people who are moderately depressed as they navigate the emotional landscape of their daily lives.     

Fibromyalgia impact and depressive symptoms: Can perceiving a silver lining make a difference?

Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day-to-day functioning. However, individual-level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a “silver lining” in one’s illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self-report measures including the Fibromyalgia Impact Questionnaire-Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia.     

A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care: Parents’ perspectives

A child's emotional and social development depends on the parents’ provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short-term consultations at Child Health Centers. This study qualitatively explored parents’ experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists’ technique. Parents were also clustered into three so-called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight-promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.     

Postnatal trajectories of maternal depressive symptoms: Postpartum antecedents and differences in toddler adjustment

Infants are uniquely vulnerable to maternal depression's noxious effects, but few longitudinal studies have tried to identify discrete postnatal trajectories of maternal depressive symptoms (MDS) beginning in infancy. This study extends evidence of heterogeneous change in postnatal MDS by examining their cross-contextual antecedents in infancy and their consequences for children's early behavior problems and language skills in late toddlerhood. A community sample of mother–child dyads (N = 235, 72% Caucasian) was assessed when children were 7, 15, and 33 months old. Mothers reported their socioeconomic status (SES), social support, marital relationship quality, family dysfunction, parenting stress, and infants’ functional regulatory problems at 7 months postpartum, and children's internalizing and externalizing symptoms at 33 months. Children completed a receptive vocabulary assessment at 33 months in the lab. Latent class growth analysis identified three postnatal MDS trajectory classes that fit the data best: low-decreasing, moderate, and increasing. Psychosocial measures at seven months postpartum primarily predicted membership to these postnatal trajectory classes, which subsequently differed in children's internalizing, externalizing, and receptive vocabulary in late toddlerhood, controlling for family SES and functional regulatory problems in infancy. We discuss salient antecedents and consequences of postnatal depression for mothers and their offspring.     

Age-related differences in the association between autistic sons’ challenging behaviour and maternal anxiety and depression: implications for counsellors

ABSTRACT

The associations between sons' challenging behaviour and mothers' anxiety and depression were investigated in four age-subgroups of boys with Autism Spectrum Disorder and their mothers (n?=?49). Significant correlations were found only for the 6-yr-old boys' irritability and their mothers' anxiety (r?=?.808) and depression (r?=?.762), and for the 7-yr-old boys' stereotypy and their mothers' depression (r?=?.745). MANOVA and ANOVA found no significant differences between the irritability of the 6-yr-old boys and that of the remaining boys, nor between the 7-yr-olds' stereotypy and the remaining boys, plus no significant difference in the mothers' anxiety and depression scores across age groups. Implications are drawn for counselling and psychotherapy.     

Antenatal caregiving representations and perinatal behavior in mothers with severe lifetime psychopathology

Psychopathology poses a risk for optimal parenting. The current study explored antenatal caregiving representations as markers for later risk of nonoptimal maternal behavior among mothers with severe mental illness. Sixty-five mothers diagnosed with psychosis, bipolar disorder, depression (psychopathology group), and nonclinical controls participated in a longitudinal study from pregnancy to 16 weeks after birth. Mental health diagnoses and caregiving representations were assessed during pregnancy. Maternal behavior was assessed during the 5-min recovery phase of the still-face paradigm at 16 weeks. Mothers with psychopathology reported significantly higher levels of “heightened” caregiving representations (i.e., separation anxiety from the child) than did controls. The only significant diagnostic group difference in perinatal maternal behavior was that mothers diagnosed with depression exhibited more overriding-intrusive behavior than did nonclinical control mothers. Regression modeling results showed that antenatal caregiving representations of “role reversal” predicted significantly lower levels of sensitivity and higher levels of overriding-intrusive behavior independent of the effect of psychopathology. The findings can be interpreted in the context of representational transformation to motherhood during pregnancy. The results provide preliminary evidence for the potential of a new questionnaire measure of caregiving representations as a screening instrument for antenatal representational risk.     

社会比较对大学生抑郁的影响:有调节的中介效应

探讨社会比较对大学生抑郁的影响机制,采用社会比较倾向量表、物质主义价值观量表、正念注意觉知量表和抑郁问卷,对980名大学生进行了调查研究。结果表明:1.社会比较和物质主义价值观都显著正向预测了大学生抑郁; 2.物质主义价值观在社会比较对大学生抑郁的影响中起部分中介作用; 3.正念在社会比较通过物质主义价值观对大学生抑郁产生影响的中介过程中起调节作用,正念调节了中介过程的后半路径。因此,在社会比较对大学生抑郁的影响过程中,物质主义价值观起到了部分中介作用,正念起到了调节作用。     

“A definite feel‐it moment”: Embodiment,externalisation and emotion during chair‐work in compassion‐focused therapy

Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.