An Open Trial of Web-Based Mindfulness-Based Cognitive Therapy for Perinatal Women at Risk for Depressive Relapse

Depression occurring during pregnancy and postpartum (i.e., the perinatal period) is common and associated with adverse outcomes for women and their offspring. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce risk for depressive relapse among at-risk individuals generally, and recent adaptations document the efficacy of MBCT among perinatal women specifically. In addition, MBCT, when delivered using a web-based format (Mindful Mood Balance [MMB] program), has demonstrated acceptability and feasibility for at-risk individuals generally. The aim of the present open trial study was to examine the feasibility, acceptability, and preliminary outcomes of MMB for use with pregnant women at risk for depressive relapse (N = 37). We predicted that MMB would be feasible and acceptable as assessed by session completion and participation in phone coaching calls, home practice completion, and self-reported satisfaction via questionnaire and interview. We also predicted that women would not demonstrate significant worsening of depression symptom severity during MMB, consistent with our focus on prevention. A brief case example based on a composite of participants is presented to illustrate the MMB structure and content and the phone coaching protocol. Participants demonstrated engagement with the program, reported perceiving benefits in the intended depression prevention targets of MMB, and sustained minimal to mild depressive symptom severity over the course of the program. Given these promising results and the potential benefits of averting depression for women and their families, further development and rigorous testing of MMB among at-risk pregnant women is warranted.     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

MDR3基因在妊娠期肝内胆汁淤积症中的研究及思考

妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)病因复杂,目前研究认为遗传因素在其发病机制中起着相当关键的作用。其中MDR3基因与ICP的发病尤为密切。文章从哲学的角度对MDR3基因的发现过程以及未来的发展前景展开了综合分析。     

Long-acting reversible contraception: A route to reproductive justice or injustice

This article presents information on unintended pregnancies and the ongoing efforts of policy makers to promote long-acting reversible contraception (LARC) to reduce the numbers of such pregnancies. Also discussed is the tension between the encouragement of LARC to promote the public's interests in achieving that goal versus the need to assure that all women can decide about their bodies and reproductive needs. Our discussion includes information, primarily from the United States, on (a) risks associated with unintended pregnancies, (b) LARC devices approved in the United States (copper intrauterine devices (IUDs), hormone IUDs, and implants), (c) public and social benefits of increasing the use of LARC, (d) disadvantages and barriers to using LARC, (e) dangers of promoting LARC in unjust ways, and (f) the meaning of reproductive justice and its connection to social justice. By sharing the information with the audience of this journal, we hope that it will be integrated into clinical work and research on mental health and development. We also hope that experts in those fields will become discussants in the conversation regarding women's reproductive health and social justice that is taking place in the United States and elsewhere.     

Hostile/Helpless maternal representations in pregnancy and later child removal: A pilot study

This article presents the results of a small pilot study examining links between Hostile/Helpless (HH) representations of caregiving in pregnancy and later child removal by child protective services. The sample was drawn from a replication study of the Minding the Baby^® attachment‐based home‐visiting intervention conducted in the United Kingdom, serving young first‐time mothers in under resourced communities. The HH classification system (Lyons‐Ruth et al.) was adapted for use with the Pregnancy Interview (PI) (Slade); 26 PIs were assessed (coders blinded) in a sample that included 13 mothers whose infants were removed from custody due to anticipated or documented maltreatment within 2 years of childbirth, and 13 mothers who did not have their infants removed. Mothers whose infants were removed from their custody had significantly higher HH scores than mothers of infants who were not removed from their care (F(1, 24) = 14.500, p < .001), and the relation between overall HH classification and infant removal status was also significant (χ²(1, N = 26) = 12.462, p < .001). Results suggest that prenatal maternal caregiving representations may predict postnatal relationship disruptions, and indicate the need for larger studies further testing this prenatal approach to maltreatment risk assessment in at‐risk populations.     

Exploring Conflict Resolution and Psychological Abuse Across Romantic Relationships

Although strengthening skills is recommended to improve the effectiveness of programs to prevent dating violence, little research has analyzed how conflict resolution strategies relate to victimization/perpetration trajectories. This study explores retrospectively self-reported conflict resolution strategies (positive problem-solving, engagement, and withdrawal) across 2 romantic relationships, paying special attention to possible changes. Participants were 309 college students who had been involved in 1, 2, or no abusive relationships. Based on these experiences, they were first classified into 4 groups according to their psychological victimization (non-victimized, pre-victimized, newly-victimized, and re-victimized) in each of their 2 relationships. Subsequently, they were also classified into 4 different groups according to their perpetration (non-perpetrators, pre-perpetrators, new perpetrators, and re-perpetrators). Changes in conflict resolution strategies were self-reported by both the victims and the perpetrators with a single abusive relationship, whereas persistence was detected in those involved in either 2 abusive relationships (re-victimized and re-perpetrators) or none at all. The results can help prevent dating violence across relationships and its negative consequences for health.     

Does change in perceptions of peer teen dating violence predict change in teen dating violence perpetration over time?

Research has previously demonstrated that perceptions of peer's teen dating violence (TDV) is associated with one's own perpetration of TDV, although little research has examined whether this relationship is consistent across developmental time periods (i.e., mid‐to‐late adolescence). The present study examined whether changes in perceptions of peer's TDV predicted change in one's own perpetration of TDV in a sample of ethnically diverse adolescents from ages 15 to 18 (N = 1,042). Parallel process modeling demonstrated that decreases in perceptions of peer's TDV predicted decreases in TDV perpetration over time, and this relationship was more pronounced for males than females. These findings lend further support to the need for TDV prevention and intervention programs to include peer influence in their programs.

     

Lived experiences of school-going early mothers in Swaziland

This study explored the lived family and community experiences of Swazi school-going early mothers (N = 15; age range 13–22 years). Participants responded to family and community relationship experiences focus group discussions. The data were content thematically analysed. The findings suggest that early mothers experience strained relationships with their fathers, and receive emotional and material support from their mothers. The young mothers perceived themselves to be discriminated against by teachers in educational support. Early motherhood appeared to cause feelings of happiness, regret and anxiety in many, and a personal sense of satisfaction and accomplishment in some.     

The effects of mindfulness interventions on prenatal well-being: A systematic review

Objective: Low well-being during pregnancy can have significant adverse outcomes for mother and child. The effects of mindfulness interventions on prenatal maternal well-being are increasingly examined but outcomes have yet to be systematically evaluated. The aims of the current paper are to systematically evaluate intervention effects and current research approaches with pregnant groups.

Design: A systematic review of eight studies examining mindfulness intervention effects on prenatal well-being.

Results: Findings indicate potential benefits of mindfulness interventions for reducing levels of depression, anxiety and negative affect during pregnancy. There is also evidence for improved self-compassion and perceived childbirth self-efficacy. Further, these effects may be more pronounced for vulnerable groups, such as women currently experiencing low prenatal well-being. Less consistent findings were observed for stress, and positive affect. Variations in research design, gestational characteristics, timing of assessments and outcome measurement may explain some inconsistencies in the extant literature.

Conclusion: Mindfulness interventions present a potentially useful means to improve prenatal well-being but improved methodological quality is essential to rigorously examine intervention effects.     

Miscarriage,Religious Participation,and Mental Health

Approximately 15–20 percent of pregnancies result in miscarriage, yet pregnancy loss remains a socially taboo topic and one that has received limited attention in the literature. Utilizing nationally representative longitudinal data from the NLSY97, this study examines the influence of miscarriage on mental health and whether this relationship is moderated by religious participation. Results from this study suggest that miscarriage is associated with lower mental health among women who also experience a live birth. Results also suggest that religious participation moderates the relationship between miscarriage and mental health; religion is more likely to lead to increases in mental health among women who experience a miscarriage than among women who do not experience a miscarriage. Overall, evidence suggests that religion may be an important coping mechanism for women who deal with pregnancy loss.