Aleksandra Staneva

Gamification for health and wellbeing: A systematic review of the literature

Background Compared to traditional persuasive technology and health games, gamification is posited to offer several advantages for motivating behaviour change for health and well-being, and increasingly used. Yet little is known about its effectiveness. Aims We aimed to assess the amount and quality of empirical support for the advantages and effectiveness of gamification applied to health and well-being. Methods We identified seven potential advantages of gamification from existing research and conducted a systematic literature review of empirical studies on gamification for health and well-being, assessing quality of evidence, effect type, and application domain. Results We identified 19 papers that report empirical evidence on the effect of gamification on health and well-being. 59% reported positive, 41% mixed effects, with mostly moderate or lower quality of evidence provided. Results were clear for health-related behaviours, but mixed for cognitive outcomes. Conclusions The current state of evidence supports that gamification can have a positive impact in health and wellbeing, particularly for health behaviours. However several studies report mixed or neutral effect. Findings need to be interpreted with caution due to the relatively small number of studies and methodological limitations of many studies (e.g., a lack of comparison of gamified interventions to non-gamified versions of the intervention).

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

BACKGROUND Experiencing psychological distress such as depression, anxiety, and/or perceived stress during pregnancy may increase the risk for adverse birth outcomes, including preterm birth. Clarifying the association between exposure and outcome may improve the understanding of risk factors for prematurity and guide future clinical and research practices. AIM The aims of the present review were to outline the evidence on the risk of preterm associated with antenatal depression, anxiety, and stress. METHODS Four electronic database searches were conducted to identify quantitative population-based, multi-centre, cohort studies and randomised-controlled trial studies focusing on the association between antenatal depression, anxiety, and stress, and preterm birth published in English between 1980 and 2013. FINDINGS Of 1469 electronically retrieved articles, 39 peer-reviewed studies met the final selection criteria and were included in this review following the PRISMA and MOOSE review guidelines. Information was extracted on study characteristics; depression, anxiety and perceived stress were examined as separate and combined exposures. There is strong evidence that antenatal distress during the pregnancy increases the likelihood of preterm birth. CONCLUSION Complex paths of significant interactions between depression, anxiety and stress, risk factors and preterm birth were indicated in both direct and indirect ways. The effects of pregnancy distress were associated with spontaneous but not with medically indicated preterm birth. Health practitioners engaged in providing perinatal care to women, such as obstetricians, midwives, nurses, and mental health specialists need to provide appropriate support to women experiencing psychological distress in order to improve outcomes for both mothers and infants.

Young Love: Romantic Concerns and Associated Mental Health Issues among Adolescent Help-Seekers

Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10–18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.

Pregnancy-specific distress: the role of maternal sense of coherence and antenatal mothering orientations

Abstract Background: Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women’s sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress. Design: During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women’s SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ). Results: Low SoC was the best determinant of women’s pregnancy-specific distress, accounting for over 45% of the variance (β = −0.33, p < 0.001, 95% CI [−0.43, −0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model. Conclusions: This study further highlights the importance of better understanding women’s perceptions of emotional health and their mothering role while taking into consideration their wider social context.

Maternal psychological distress during pregnancy does not increase the risk for adverse birth outcomes

ABSTRACT Maternal psychological distress during pregnancy is a potential risk factor for various birth complications. This study aimed to explore psychological factors associated with adverse birth outcomes. Symptoms of psychological distress, individual characteristics, and medical complications were assessed at two time points antenatally in 285 women from Australia and New Zealand; birth outcomes were assessed postpartum, between January 2014 and September 2015. Hierarchical multiple regression analyses were conducted to examine the relation of psychological distress to adverse birth outcomes. Medical complications during pregnancy, such as serious infections, placental problems and preeclampsia, and antenatal cannabis use, were the factors most strongly associated with adverse birth outcomes, accounting for 22 percent of the total variance (p < .001). Symptoms of depression and/or anxiety, low social support, and low sense of coherence were not associated with birth complications. In unadjusted analyses, self-reported diagnosis of anxiety disorder during pregnancy and an orientation toward a Regulator mothering style were associated with adverse birth outcomes; however, after controlling for medical complications, these were no longer associated. Our study results indicate that antenatal depressive and/or anxiety symptoms were not independently associated with adverse birth outcomes, a reassuring finding for women who are already psychologically vulnerable during pregnancy.

“I just feel like I am broken. I am the worst pregnant woman ever”: A qualitative exploration of the “at odds” experience of women's antenatal distress

ABSTRACT Advances in perinatal mental health research have provided valuable insights around risk factors for the overall development of maternal distress. However, there is still a limited understanding of the experience of women struggling emotionally during pregnancy. We explored how women view, experience, and interpret psychological distress antenatally. Eighteen Australian women participated in in-depth interviews that were analyzed thematically within a critical realist theoretical framework. We present and situate the current findings within the dominant discourse of the good mother, which arguably promotes guilt and stigma and results in women self-labeling as bad mothers.

The happiness imperative: Exploring how women narrate depression and anxiety during pregnancy:

This article explores how women account for their experiences of pregnancy distress in light of cultural imperatives to be the perfect, happy mother. Our analysis is based on the accounts of 18 Australian women, interviewed during pregnancy on the basis of their reports of experiencing depression and/or anxiety. Working within a feminist discursive framework, we focus on the discourses that informed (and threatened) women’s positions as a good mother. In particular, we focus on the discourses women relied on to explain their distress and the discursive strategies they used in the construction of their (“distressed”) maternal identity(ies). We ask how women articulate and label distress, and with what rhetorical effects. Our analysis explores how women’s experiences of negative moods and distress were in direct opposition to cultural imperatives for mothers to stay happy and positive during pregnancy and beyond, posing rhetorical challenges to women’s accounts and hence their capacity to make meaning of their (negative) experiences. Three discursive strategies are explored: distancing from the depressed self, speaking between/around/without words, and in search of a balance. We close by considering the implications of the complex ways in which women account for idealised motherhood and how this serves to oppress vulnerable women.