Relations between neonatal states and 8-month developmental outcome in preterm infants

This study investigated longitudinal relations between measures of neonatal state behavior and developmental outcome in a sample of preterm infants (N = 16). Results indicate that irritability/reactivity in the neonatal period is positively associated with Bayley scores and exploratory play at 8 months. Conversely, neonatal alertness was not associated with these developmental measures. These preliminary findings, based on a small sample, are discussed in the context of preterm function.     

Effects of neonatal treatment with 1-(2,5-dimethoxy-4-lodophenyl)-2 aminopropane HCI (DOI) and ritanserin on agonistic behavior in adult male and female rats

The role played by the neonatal 5-hydroxytryptamine (5HT) system in the organization and sexual differentiation of adult agonistic behavior was investigated in rats. Focus was on the 5HT2 receptor subtype, which has been demonstrated to be involved in agonism control in the adult. 5HT2 activity was experimentally manipulated by administration of a specific agonist [1-(2, 5-dimethoxy-4-iodophenyl)-2-aminopropane HCl (DOI)] or antagonist (ritanserin) during the second week of life, when serotonin is known to concur to anatomical and behavioral sexual differentiation. Interactions between early 5HT2 activity, genetic sex, and neonatal circulating testosterone (T) were studied by administering the ligands to males, females, and androgenized females. At adulthood, the animals were tested for both aspects of agonism, i. e., aggression and defense, in a 20-min confrontation with an unfamiliar conspecific of the same sex, age, body weight, and social experience. Neonatal administration of the 5HT2 antagonist ritanserin increased aggression independently of sex; it also increased defense, but this effect was confined to males. The agonist DOI had no effect on aggression, but enhanced defense in males and androgenized females, with an effect which depended therefore more on neonatal T than genetic sex. Females appeared in general less sensitive to neonatal 5HT2 manipulation than both androgenized females and males; this suggests that neonatal T is crucial for experimental modifications of neonatal 5HT2 activity to have any consistent effect on adult agonistic behavior. On the other hand, effects observed in males and androgenized females were dependent on the behavior considered and the drug administered. This was especially evident for defense, enhanced by ritanserin in males only, and in both males and androgenized females by DOI. Neonatal 5HT2 activity seems therefore to play a role in the modulation of adult agonistic behaviors, which depends on the behavior considered and is under multiple control of genetic sex and hormonal neonatal substrate. © 1994 Wiley-Liss, Inc.     

Maternal and paternal infant representations: A comparison between parents of term and preterm infants

Objective

Research on parental attachment representations after preterm birth is limited and inconclusive. The present study is the first in which maternal and paternal attachment representations after term, moderately and very preterm birth are compared. In addition, special attention was directed toward disrupted attachment representations.

Method

Mothers and fathers of term infants (≥37 weeks of gestational age, n = 71), moderately preterm infants (≥32–37 weeks of gestational age, n = 62) and very preterm infants (<32 weeks of gestational age, n = 56) participated in the present study. Attachment representations (balanced, disengaged, distorted) about their infants were evaluated with the Working Model of the Child Interview (WMCI). To asses disrupted representations the coding of the WMCI was extended with the disrupted scale (WMCI-D).

Results

The three main classifications of attachment representations were not affected by preterm birth. In addition, there were no gender differences in the rate of balanced representations. In case of non-balanced representations however, maternal representations were more often distorted, whereas fathers showed more often disengaged representations. Results further revealed that maternal disrupted attachment representations were marked by role/boundary confusion or disorientation, whereas paternal disrupted attachment representations were characterized by withdrawal.

Conclusion

Given the gender differences it is essential to tailor interventions according to the attachment representations of the parent, in order to be able to alter their non-balanced and/or disrupted attachment representations.     

Adult Attachment Dimensions,World View Schemas,and the Psychological Health of Parents of Infants in a Neonatal Intensive Care Unit

This study reports the results of an exploration of the relationship of adult attachment dimensions (closeness, dependence, and anxiety) and world view assumptions (benevolence, meaningfulness, and worthiness) to psychological distress and psychological well-being in 142 parents (71 couples) of newborns recently hospitalized in a neonatal intensive care unit. The results of the Actor-Partner Interdependence Model, hierarchical multiple regression, and mediation analyses showed that parents who were more comfortable with attachment-dependence and parents who held more positive beliefs about benevolence and worthiness had less psychological distress and more well-being. In addition, parents with partners who were more comfortable with attachment-dependence had less psychological distress and more well-being. Attachment-dependence partially mediated the relationships of benevolence and worthiness with psychological distress and the relationship of benevolence with psychological well-being, whereas worthiness had a direct relationship with psychological well-being.     

新生儿重症监护病房患儿家属心理状况分析

探讨新生儿重症监护病房（NICU）住院患儿家属的心理状况及影响因素。采用焦虑自评量表（SAS）及自行设计的调查问卷对190名NICU住院患儿家属进行调查。结果显示患儿家属表现出不同程度的焦虑,与全国常模（29．78±0．46）相比,其焦虑情绪标准分49．54±1．07,高于常模组（P〈O．05）。影响因素主要包括文化水平、家庭人均收入及患儿病情严重程度等。患儿父母关注的主要问题包括：病情严重程度、预后、医护人员解释病情满意度及病房探视制度。笔者认为医护人员应加强与患儿家属的有效沟通,满足其心理需求,提高医疗护理质量,促进医患关系和谐。     

Creating a ‘psychological nest’ for vulnerable infants and children: an interview with Annette Mendelsohn

This is an edited version of a recent interview with Annette Mendelsohn, Child and Adolescent Psychotherapist at the Royal Free Hospital, London, UK. It aims to make available in published form Mendelsohn's thinking and approach in relation to her work with traumatised children in a hospital setting. Mendelsohn also discusses her work in a neonatal intensive care setting and the way in which approaches to psychosocial care in the hospital setting have changed over the course of her professional life.     

Premature twins on a neonatal intensive care unit

This paper presents observations of boy and girl twins on a neonatal intensive care unit, following them through from 10 days old to return home. The observer hypothesizes about the experience of the twins as they progress, based on detailed notes of their actions. The preoccupations of the parents are incorporated, as are reactions and interventions of staff. The place and possible functions of such observation by a child psychotherapist attached to such a unit are elaborated in the concluding section.