A measure of parental stress in mothers with small children: dimensionality, stability and validity

Self-reported parental stress was investigated in three samples of mothers with small children, using a Swedish version of the Parenting Stress Index (PSI). Dimensionality in experienced stress using items from six PSI Parent Domain subscales and eight new items was examined in factor analyses of data from a nationwide representative sample. Cross-validation proved the chosen factor pattern to be stable. Based on an oblique 5-factor solution new subscales were constructed. A second order factor analysis indicated influence from a higher order factor, seen as a general parental stress construct. High alpha coefficients revealed that homogeneous subscales had been formed. Test-retest correlations indicated good stability over a mean time period of 30 days. Influences from maternal background variables were found, but no relation to child age or gender. Global estimates of parental stress, reported child problems, mothers' scoring on the Edinburgh Postnatal Depression Scale and two measures of social support all correlated significantly with overall parental stress, and with some subscales. The justification of the subscale approach to parental stress was discussed. It was concluded that the PSI in its present form could be used as a reliable and valid instrument for measuring experienced parental stress in mothers of young children.     

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.     

A randomized controlled trial of mother–infant psychoanalytic treatment: I. Outcomes on self‐report questionnaires and external ratings

Mother–infant relationship disturbances occur in three domains: maternal distress, infant functional problems, and relationship difficulties. They constitute common clinical problems. In Sweden, they are usually handled by nurses as part of public Child Health Centre care. Severe cases are referred to child psychiatry services. This randomized controlled trial compared two groups of mother–infant dyads in a Stockholm sample. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Eighty dyads of mothers and infants under 1½ years of age where the mothers had serious concerns about themselves in their role as mothers, their infants' well‐being, or the mother–baby relationship were randomly selected for either the MIP or the CHCC group. The primary outcomes were mother‐reported depression, mother‐reported infant functional problems, and interviewer‐based relationship assessments, all at 6 months after joining the project. Secondary outcomes were mother‐reported stress and general psychic distress, externally rated video‐recorded interactions, and the consumption of healthcare at the CHC, again all after 6 months. Intent‐to‐treat analyses of Treatment × Time effects significantly favored MIP treatment for maternal depression, mother–infant relationships, and maternal sensitivity. Effects were nearly significant on maternal stress, but nonsignificant on mother‐reported infant functional problems, general psychic distress, maternal interactive structuring and nonintrusiveness, infant responsiveness and involvement, and healthcare consumption. MIP treatment improved mother–infant relationships and maternal sensitivity and depression, all of which are known to influence child development. If effects persist and are reproduced, MIP treatment holds promise for more widespread use.     

The function of language in parent‐infant psychotherapy

Parent‐infant psychotherapy, a rather new field in psychoanalysis, raises questions of how to conceptualize the clinical process. Previous publications have used semiotic concepts to account for the therapist's non‐verbal communication and investigated the countertransference, including what the baby might grasp of its variations. The present paper focuses on another argument for using verbal interventions to a baby in therapy; they present him with a symbolic order that differs from that of the parent. The qualitative difference between the parent's and the analyst's address is conceptualized by Dolto's term parler vrai. The therapeutic leverage is not the analytic interventions' lexical content but their message that words can be used to expose conflicts. Thereby, one can transform warded‐off desires into demands that can be negotiated with one's objects. The reasons why this address catches the baby's attention are discussed. A prerequisite for such attention is that the infant brain is prewired for perceiving words as a special communicative mode. Relevant neuroscientific research is reviewed in regard to this question. The presentation relies on concepts by Dolto, Lacan and Winnicott and findings from neuroscience and developmental psychology. It also briefly discusses Chomsky's linguistic concepts in relation to these therapies.     

Patenting and Licensing of University Research: Promoting Innovation or Undermining Academic Values?

Since the 1980s in the US and the 1990s in Europe, patenting and licensing activities by universities have massively increased. This is strongly encouraged by governments throughout the Western world. Many regard academic patenting as essential to achieve ‘knowledge transfer’ from academia to industry. This trend has far-reaching consequences for access to the fruits of academic research and so the question arises whether the current policies are indeed promoting innovation or whether they are instead a symptom of a pro-intellectual property (IP) culture which is blind to adverse effects. Addressing this question requires both empirical analysis (how real is the link between academic patenting and licensing and ‘development’ of academic research by industry?) and normative assessment (which justifications are given for the current policies and to what extent do they threaten important academic values?). After illustrating the major rise of academic patenting and licensing in the US and Europe and commenting on the increasing trend of ‘upstream’ patenting and the focus on exclusive as opposed to non-exclusive licences, this paper will discuss five negative effects of these trends. Subsequently, the question as to why policymakers seem to ignore these adverse effects will be addressed. Finally, a number of proposals for improving university policies will be made.     

Semiotic transformations in psychoanalysis with infants and adults

The author addresses issues that emerge when we compare psychoanalytic experiences with adults and with infants. Two analyses-one with a 35 year-old woman and one with a 2 week-old boy and his mother-illustrate that infant psychoanalytic experiences help us understand and handle adult transference. However, we cannot extrapolate infant experiences to adult work. Truly, witnessing the baby's communication widens our sensitivity to non-verbal layers of the adult's communication. Infant work also offers a direct encounter with the container and the contained personified by a mother with her baby. But we need to conceptualize carefully the links between clinical experiences with babies and adults. When we call an adult transference pattern 'infantile', we imply that primeval experience has been transformed into present behaviour. However, if we view the analytical situation as one in which infantile invariants have transformed into adult symptoms, we face the impossible task of indicating the roots of the present symptoms. The author rather suggests that what is transformed is not an invariant infantile essence but signs denoting the patient's inner reality. He proposes we define transformation as a semiotic process instead of building it on an essentialist grounding. If we view the analytic situation as a map of signs that we translate during our psychoanalytic work, we can proceed into defining containment as a semiotic process. This idea will be linked with a conceptualization of the mother-infant relation in semiotic terms.     

The dark side of normal: A psychopathy-linked pattern called aberrant self-promotion

These studies investigate a personality and behavior pattern called aberrant self-promotion, conceptualized as a subclinical form of psychopathy. Aberrant self-promoters (ASPs) are theoretically defined as individuals characterized by a narcissistic personality configuration in combination with antisocial behavior. The first study verifies the existence of persons who manifest the ASP pattern. The second study validates the pattern, using as criteria the Revised Psychopathy Checklist (PCL-R) interview and records of antisocial behavior. In the first study a 179-item questionnaire, composed of five personality instruments, was administered to two separate samples of normal subjects (N = 214 and 367). ASPs were targeted by three methods: cluster analysis, item factor analysis, and person factor analysis. In Sample 1 the three methods demonstrated a convergence of 92 per cent in identifying the same individuals as ASPs; in Sample 2 the convergence rate was 94 per cent. In the second study 32 ASPs targeted in Study 1 were compared to 30 non-ASPS. The ASPs had significantly higher scores on the PCL-R and had committed significantly more antisocial acts than the non-ASPS. The general discussion focuses on the practical, theoretical, and measurement implications of considering aberrant self-promotion a distinct psychological motif.