Cheryl Anderson

Exploring the Factors Influencing Relapse and Recovery Among DRUG & ALCOHOL Addicted Women

1. Both women who were in treatment for relapse to and in sustained recovery from drugs and alcohol had multiple co-occurring addictions such as relationship, spending, food, and shopping that complicated the recovery process. 2. Depression is a major trigger for relapse in women with alcohol and drug problems. Recognition and treatment of depression is critical to achieve successful outcomes of treatment for these women, and teaching them to monitor their mood changes and seek help will improve the chances of preventing relapse. 3. Subjects in neither the relapse nor recovery sample recognized the significant influence of current violent partnerships or the ending of a violent relationship on their relapse or recovery.

Postpartum depression, marital dysfunction, and infant outcome: a longitudinal study.

This longitudinal study explores the relationship of postpartum depression (PPD) and marital dysfunction on infant outcomes from birth to 2 1/2 years of age among middle-class, postpartum women. Participants were recruited during the prenatal period. Twelve mothers completed the study throughout a 2 1/2-year period. Questionnaires, semistructured interviews, and observations were used to collect data. Content analysis of the interviews (Morse & Field, 1995) was conducted and thematic patterns were identified. Clinical PPD and marital dysfunction (defined as little or no support or closeness, or verbal, emotional or physical abuse) characterized nearly one in three mothers. Four themes describing the womens postpartum progression were identified: stress, isolation, resentment, and eventual adjustment by creating a new normal. No major developmental delays or behavioral problems were found among the infants. Eight of the 12 mothers who were initially identified as breastfeeding nursed their infants for 6-18 months. Regardless of financial and educational advantages, mothers in the study experienced depression and marital dysfunction. These findings support other studies that confirm the lack of association of PPD with social class or marital status. Childbirth educators and other health care professionals are encouraged to continue providing expectant families with anticipatory education and community resources in order to increase awareness of mental health and marital risks during the postpartum transition.

Impact of Traumatic Birth Experience on Latina Adolescent Mothers

Background: The childbirth experience can be a wonderful event, or one of horror. One in 3 adult mothers appraises her childbirth experience as traumatic, with up to 10% of women reporting a severe traumatic stress response post-delivery. The impact of the birth experience on adolescents is unknown. Methods: Eighty-five Latinas ages 13 to 19 appraised their childbirth experience and reported symptoms of trauma impact as measured via the Impact of Event Scale (IES) within 72 hours of delivery. Descriptive statistics included demographic, obstetrical, and personal factors, and trauma scores. ANOVAs were used to examine differences in birth appraisal and trauma impact by demographic, obstetrical, and personal factors. Spearman rho and Pearsons r was used to compute correlations between birth appraisal, depression, and trauma impact. Results: One-third of adolescents appraised their childbirth as traumatic; one-half displayed symptoms of trauma impact. Items influencing appraisal of the birth experience included marital status, fear of dying, fear of loss of control, and partner violence. Birth appraisal and symptoms of depression were found to influence trauma impact. Conclusions: One-third of teens appraised childbirth as traumatic with 50% displaying symptoms suggestive of acute trauma at immediate postpartum. Nursing recommendations focus on providing a non-traumatic birth experience and follow-up by mental health professionals for assessment of potential chronic trauma, posttraumatic stress and depression. Teens can enter labor and delivery with stressors, depression, and past traumas; collaboration of care between maternal-child and mental health professionals is encouraged.

Do teenage mothers experience childbirth as traumatic

Although several hundred thousand teenagers give birth each year in the United States, little is known about their psychological experience of childbirth, especially with respect to its traumatic impact. This article highlights the findings of a pilot study of 28 teenage mothers who reported on their traumatic and depressive symptoms related to childbirth. Literature on adolescent childbearing, posttraumatic stress, and postpartum depression is also reviewed.

Childbirth related fears and psychological birth trauma in younger and older age adolescents

AIM The aim of this study is to explore childbirth fears on psychological birth trauma (PBT) by adolescent age. BACKGROUND Among adults parity and intrapartum fears including fear of dying, loss of control, pain, and limited support have been associated with negative birth appraisal and symptoms of traumatic stress, defined here as PBT. METHODS This cross-sectional study surveyed a convenience sample of 201 adolescents at a large, county hospital. RESULTS Over 75% of adolescents perceived fear. Younger and older adolescents, similar in fears, were distinguished only by parity. The effects of parity, overall rating of fear, and father of baby absence were found to vary by age on birth appraisal; however, only parity varied by age on IES scores. CONCLUSIONS All age adolescents can be fearful and will benefit with childbirth education and labor support to help reduce fears and subsequent PBT.

Psychological birth trauma in adolescents experiencing an early birth.

Purpose: To explore and compare associations among demographics, childbirth-related stressors, depressive symptoms, gestational age, and psychological birth trauma (PBT) among adolescents. Study Design and Methods: This cross-sectional, descriptive, comparative study compared two groups of adolescents for PBT. From a larger study dataset, we identified all adolescents delivering prior to 38 weeks (n = 30) and randomly selected 30 adolescents delivering between 38 and 42 weeks gestation for comparison. PBT was defined via birth appraisal, assessed by a one-item rating scale, and trauma impact, assessed via the Impact of Event Scale. Surveys, including the Center for Epidemiological Studies-Depression Scale, were completed within 72 hours of birth. We used frequencies and percentages to describe the sample and Chi square, Spearman Rank-Order Correlation, and Pearsons Product Moment Correlation to determine relationships between variables. Chi square and ANOVA statistical tests determined group differences. Results: Adolescents were primarily Latina, single, primigravidas, and over 16 years of age. Adolescents delivering before 38 weeks experiencing cesarean births reported symptoms of depression and were highest risk for PBT. Additionally adolescents delivering before 38 weeks reported lack of pain control and unsupportive caregivers in labor. Clinical Implications: Healthcare professionals cognizant of the potential risk factors for PBT can help vulnerable adolescents through caregiver support, adequate pain control in labor, education, and screening and treatment of depressive symptoms. Follow-up postdischarge, especially for high-risk adolescents, should be arranged to monitor for continued, delayed, or remitting symptoms of depression and PBT.

Construct Validity of the Childbirth Trauma Index for Adolescents

The potentially traumatic nature of childbirth for adult mothers has been confirmed in research; however, adolescent childbirth trauma is unexplored. This article presents research on the construct validity of the Childbirth Trauma Index by providing a conceptual analysis of psychological childbirth trauma, factor validity of the Childbirth Trauma Index, and discussion of testing the Childbirth Trauma Index via contrasted-groups approach. Childbirth trauma can result in an acute stress reaction or actual posttraumatic stress disorder. Using subjective reports, the Impact of Event Scale, and the Childbirth Trauma Index, an appraisal of birth trauma, trauma impact, and indicators associated with childbirth trauma were revealed among 112 adolescents. Clinical implications and research recommendations are offered.

Implications of Preterm Birth for Maternal Mental Health and Infant Development.

Preterm birth remains a major contributor to infant mortality and morbidity including neurodevelopmental delay and childhood disability. Mothers experiencing a preterm birth are at risk for maternal mental health issues, inclusive of depression and posttraumatic stress disorder (PTSD), which may affect mother-infant attachment and infant development. Depression and PTSD, frequently comorbid, following preterm birth and relationships between these symptoms, maternal-infant attachment, and infant development are reviewed. Assessments and interventions potentially capable of benefitting mother and infant are noted. The need for healthcare professionals to intervene prenatally and at postpartum is significant as maternal distress remains one of the most consistent factors related to infant development. Although depression has received much attention in the literature as a risk factor for preterm birth, impaired attachment, and delayed infant development, some of the consequences of PTSD have only recently gained research attention. A few studies support the role of PTSD in impaired maternal-infant attachment; yet, it is unclear whether preterm infants of mothers experiencing symptoms of PTSD following birth are at a higher risk for motor development problems. Because early mother-infant interactions are influenced by prematurity as well as maternal mental health, consideration for home interventions that stimulate infant development and encourage mother-infant relationships concurrently are important. Directed interventions may be beneficial for infant development and aid in strengthening the mother-infant relationship, potentially reducing depression and PTSD symptoms in the mother.

Depressive Symptoms and Violence Exposure: Contributors to Repeat Pregnancies Among Adolescents.

ABSTRACT Depressive symptoms and violence exposure (VE) often cooccur and have been recognized to influence childbearing; contribution to repeat pregnancy is unclear and examined in this article. This cross-sectional, descriptive, study screened for depressive symptoms and VE among 193 adolescent mothers at a large county hospital in Southwestern United States. Repeat pregnancy and depressive symptoms characterized one-third and one-quarter of adolescents, respectively. Despite minimal disclosure of VE, repeat pregnancy was significantly influenced by child abuse and past traumatic life experiences. Assessments and interventions with adolescents should focus on frequency of repeat pregnancies and symptoms of depression and VE. Nurses and childbirth educators are poised to offer birth control information and education, support, and resources highlighting depression and VE to adolescents.

Reports of violence and relationship addiction: Triggers to alcohol and other drug relapse

&NA; Relapse is the most common outcome of programs treating addictive behaviors (James, 1993) with rates as high as 50%‐90% (Brownell et al., 1986). Women who cycle back into treatment for alcohol and other drug dependence after short periods of abstinence create a dilemma for addictions nurses and counselors. Often the addict encounters opposition by friends and family when entering treatment and delayed or misdirected treatment by professionals who fail to recognize symptoms and promote action in clinical practice (Finkelstein, 1994; Beckman and Amaro, 1986).