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.     

Assessing the impact of a family nurse-led intervention on young mothers’ references to internal states

A mother's propensity to refer to internal states during mother–child interactions is important for her child's developing social understanding. However, adolescent mothers are less likely to reference internal states when interacting with their children. We investigated whether young mothers’ references to internal states are promoted by the Family Nurse Partnership (FNP) intervention, an intensive home-visiting programme designed to support adolescent mothers in England. We also investigated family, maternal, and child factors associated with young mothers’ references to inner states during interactions with their children. Adolescent mothers (n = 483, aged ≤ 19 years when recruited in pregnancy) and their children participated in an observational substudy of a randomized controlled trial investigating the impact of FNP compared to usual care. Mother–child dyads were video-recorded during free play, and mothers’ speech was coded for use of internal state language (references to cognitions, desires, emotions, intentions, preferences, physiology, and perception). We found no differences in mothers’ use of internal state language between the FNP and usual care groups. A sample-wide investigation identified that other features of mothers’ language and relationship status with the child's father were associated with internal state language use. Findings are discussed with reference to targeted interventions and implications for future research.     

群体认同对群际敏感效应及其行为表现的影响

通过实验研究了群际互动中个体对不同来源身份的消极群体评价的情绪反应及群体认同的调节作用, 并从情绪-行为反应的连续性视角探索群际敏感效应的行为表现及内在机制。结果发现:(1)相比内群体的消极群体评价, 外群体的消极群体评价更能引起消极情绪反应; (2)群体认同对群际敏感效应起调节作用, 高群体认同者对来自外群体消极评价的情绪反应更加负面, 而低群体认同者这种趋势并不明显; (3)高群体认同者在经历外群体的消极群体评价后会表现出更多的内群体积极行为, 且消极情绪反应对此起中介作用。研究扩展了群际敏感效应的适用范围, 并为探讨其内部机制和后续影响提供了新的研究思路。     

Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system

The positive clinical effects caused by skin-to-skin contact immediately after birth or after repeated skin-to-skin contact of premature infants (kangaroo care) or fullterm infants are well documented in the literature. However, information regarding the physiological mechanisms mediating these effects are surprisingly scarce and incomplete. In this article the oxytocinergic system and the cutaneous sensory pathways by which the oxytocinergic system is activated in response to skin-to-skin contact are presented in more detail. In addition, we discuss how the effects of skin-to-skin treatment can be attributed to different aspects of the effect spectrum of the oxytocinergic or calm and connection system.The structure of the oxytocinergic system, comprising the peripheral (circulating, hormonal) and the central (neurotransmitter) components, as well as, the pathways and mechanisms by which these functions are coordinated are described. Also the various effects induced by the oxytocinergic system (the calm and connection system) are reviewed.The sensory pathways, which include visual, auditory, olfactory and tactile stimuli, given and received by both mother and newborn and which activate the oxytocinergic system in response to skin-to-skin contact, are reviewed. A special emphasis is placed on the role of cutaneous sensory nerves and their activation by touch, light pressure and in particular warmth. The important role of the rise and the pulsatility of maternal temperature in mediating the positive effects of skin-to-skin contact in the newborn is highlighted. The concept of maternal giving of warmth and its possible link to the experience of trust and safety in the newborn is discussed from an evolutionary perspective.The effects induced by skin-to-skin contact can be attributed to the different functions of the oxytocinergic system. Ameliorated social interaction (e.g., more tactile and auditory interaction, more sensitive and synchronous interaction between mother and baby, the baby’s crawling behavior) are expressions of oxytocin’s ability to stimulate social interaction. The decreased levels of fear and stress are expressions of oxytocin’s ability to reduce the activity of the amygdala and of the stress system, e.g. the activity in the HPA-axis and the sympathetic nervous system. Increased HRV, increased activity in endocrine system of the gastrointestinal tract as well as stimulation of growth and maturation are examples of oxytocin’s ability to stimulate the activity of the parasympathetic nervous system and other peripheral and central mechanisms related to restoration and growth.The propensity of different types of treatment with skin-to-skin contact to induce long-term effects is also highlighted. We propose that the sustained effects caused by skin-to-skin contact are induced by an enduring shift in the balance between the oxytocinergic system (the calm and connection system) and the stress system (fight flight reaction) in favor of the oxytocinergic system. This shift leads to a sustained decrease in the HPA-axis and the sympathetic nervous system probably involving alpha 2-adrenoceptors.It is of clinical importance to be aware of the mechanisms by which skin-to-skin contact induces short and longterm positive effects in parents and newborns. If ward routines are adapted to ascertain a maximal stimulation of these mechanisms, the function of the oxytocinergic system will be optimized, which will be linked to a better clinical outcome for parents and newborns.     

Understanding the role and function of maternal touch in children with neurodevelopmental disabilities

During the first years of life, maternal touch can serve different functions including facilitation of child’s gaze orientation to faces which is a key precursor for social attention. Although children with neurodevelopmental disability (ND) may have reduced social skills, the role of maternal touch in contributing to gaze orientation to maternal face has not been explored in previous research. In the present study, we investigate the functions of maternal touch in dyads of mothers and children with ND, compared to dyads of children with typical development (TD). Micro-analytic 2-s coding of maternal touch (i.e., affectionate, playful, facilitating, holding, no touch) and children’s gaze orientation (i.e., mother-oriented, object-oriented, non-oriented) occurred during 5-minute interactions between mothers and their 12-to-24-month-old ND and TD children. Dyads were paired for children chronological age and sex. Mothers of children with ND used more touch – especially facilitating and holding types –, compared to mothers of TD peers. Children with ND exhibited more non-orientated gaze compared to TD counterparts. Playful touch associated with increased mother-oriented gaze in children with ND, whereas affectionate and holding touch associated with greater mother-oriented gaze in TD children. Findings suggest that specific types of touch support children’s attention to social partners.     

Inherited and Environmental Moderators of Mother-Child Behavioral Contingency and Contingent Negativity at 27 Months

Previous research has shown that as depressive symptomology increases, mothers tend to show withdrawn or harsh interaction patterns with their children, and the quality of these interaction patterns have subsequently been linked to child behavior problems. However, little research has examined bidirectional influences between mothers and their children, and how these moment-to-moment contingencies differ based on heritable and environmental characteristics. We used data from the Early Growth and Development Study a prospective adoption study to examine how adoptive mothers’ depressive symptoms and children’s heritable tendencies for negative affectivity interact to predict the quality of mother-child interactions at child age 27-months. Results detected two distinct dyadic interaction patterns. The first was a withdrawn interaction style and was observed in children with a high heritable tendency for negative affect. In that style, mother and child interactions were not contingent upon each other, suggesting a lack of joint engagement. The second was a volatile interaction style, observed in children with a low heritable tendency for negative affect. In these cases, mother and child interactions were highly contingent but negative. Our findings demonstrate essential differences in how dyadic interaction patterns vary according to level of depressive symptomology and heritable tendency for negative affect.     

内隐创业领导与多层次积极追随力的互动机制

多层次积极追随力是创业企业成长的重要保证。已有研究强调不同显性领导对积极追随力的影响, 结论存在较多争议。对此, 以内隐领导理论为基础, 构建了“内隐创业型领导-积极追随力”的多层次互动模型。根据此模型, 内隐创业型领导通过关系认同和领导代表性对个体与团队积极追随力产生促进作用; 团队积极追随力通过积极心理资本塑造内隐创业型领导; 团队差序氛围、员工传统性和领导特质调节焦点是互动关系重要的边界条件。     

Post-decision consolidation: group members in different social settings compared to individual decision makers

Two experiments were conducted to examine how making decisions in a 3-member group affects the degree of post-decision consolidation, defined as attractiveness changes in favor of the chosen alternative. Both experiments were conducted in two sessions one week apart. In the first session (decision phase), participants estimated the importance of each of four different attributes describing two decision alternatives. They were then shown predetermined attractiveness ratings on each of the attributes and were to decide on the two alternatives, either individually or as a group. In the second session (post-decision phase), the participants were to attempt to recall the attractiveness ratings for the attributes as presented to them in session one. In both experiments, significant post-decision consolidation was found for individual decision makers but not for group members. In experiment 2, this result was replicated, no difference in consolidation being found between group members with face-to-face interaction and without.