Chiara Ionio

Post-traumatic stress symptoms after childbirth and early mother–child interactions: an exploratory study

Background: It is well known that mother–child relationships may be affected by maternal psychological disorders, but, at present, few experimental studies have investigated the negative impact of postpartum post-traumatic stress disorder (PTSD) symptoms on child behaviour using the Still Face paradigm. Objective: The aim of this exploratory work is to investigate whether postpartum stress symptoms may affect mother–child relationships. The underlying hypothesis is that the persistence of postpartum stress symptoms may have a negative outcome on the mother’s tuning with the child. Methods: A sample of 19 pregnant women (mean age = 31.31; SD = 4.50) attended the four phases of the research, from the seventh month of pregnancy. Maternal personality characteristics were assessed by MMPI-2. The Perinatal PTSD Questionnaire was used to assess PTSD symptoms two days and two months after delivery. Three months after childbirth the dyads attended the Still Face paradigm. Results: Data have shown that the persistence of PTSD symptoms has a different effect on early mother–child interactions than those of mothers who have not had postpartum stress symptoms. Conclusion: These data allow us to hypothesise that there are some baseline difficulties in women with PTSD symptoms in producing a positive interactive engagement, not only in relation to the break of interaction caused by the Still episode.

Mothers and Fathers in NICU: The Impact of Preterm Birth on Parental Distress.

Preterm birth is a stressful event for families. In particular, the unexpectedly early delivery may cause negative feelings in mothers and fathers. The aim of this study was to examine the relationship between preterm birth, parental stress and negative feelings, and the environmental setting of NICU. 21 mothers (age = 36.00 ± 6.85) and 19 fathers (age = 34.92 ± 4.58) of preterm infants (GA = 30.96 ± 2.97) and 20 mothers (age = 40.08 ± 4.76) and 20 fathers (age = 40.32 ± 6.77) of full-term infants (GA = 39.19 ± 1.42) were involved. All parents filled out the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact of Event Scale Revised, Profile of Mood States, the Multidimensional Scale of Perceived Social Support and the Post-Partum Bonding Questionnaire. Our data showed differences in emotional reactions between preterm and full-term parents. Results also revealed significant differences between mothers and fathers’ responses to preterm birth in terms of stress, negative feelings, and perceptions of social support. A correlation between negative conditions at birth (e.g., birth weight and Neonatal Intensive Care Unit stay) and higher scores in some scales of Impact of Event Scale Revised, Profile of Mood States and Post-Partum Bonding Questionnaire were found. Neonatal Intensive Care Unit may be a stressful place both for mothers and fathers. It might be useful to plan, as soon as possible, interventions to help parents through the experience of the premature birth of their child and to begin an immediately adaptive mode of care.

THE EFFECTS OF EXPRESSIVE WRITING ON POSTPARTUM DEPRESSION AND POSTTRAUMATIC STRESS SYMPTOMS

This study investigated whether an Expressive Writing intervention decreased depression and posttraumatic stress symptoms after childbirth. 113 women (M age = 31.26 yr., SD = 4.42) were assessed at Time 1 for depression (Beck Depression Inventory) and PTS (Perinatal PTSD Questionnaire) in the first days after childbirth, then randomized to either expressive writing or neutral writing conditions and reassessed at Time 2, 3 months later. The results (ANCOVAs, regression models) show that at 3 mo. depressive and posttraumatic symptoms were lower in women who performed the expressive writing task than in the neutral writing group. Moreover, the intervention condition was associated significantly with decreased depression at the high and at the mean levels of baseline depression at Time 1. Regarding PTSD, the results showed that the intervention condition was linked significantly to reductions of the symptoms at all levels of baseline PTSD. Mainly, these outcomes suggest that Expressive Writing can be a helpful early and low-cost universal intervention to prevent postpartum distress for women.

Paths of cognitive and language development in healthy preterm infants

OBJECTIVE Despite the presence of many studies on difficulties related to premature birth, findings on developmental outcomes are heterogeneous. This could be explained from a biological and environmental point of view, but also from a methodological one. The aims of this study were as follows: assess cognitive and linguistic performance using the BSID-III in a population of healthy preterm infants at 24 and 36 months (corrected age); analyze whether the correction for prematurity should be applied, decide when to stop using corrected age and evaluate possible improvements between 24 and 36 months. METHODS Developmental outcome was assessed at 24 and 36 months (corrected age) with the BSID-III in 75 healthy preterm (GA=32.5±1.97; BW=1631.55±453.92) and 69 term-born children (GA=39.77±1.00; BW=3298.95±457.27). RESULTS Preterm infants had significantly lower scores than those of term infants in Cognitive (COG) and Language (LANG REC, LANG EC) scales of the BSID-III at both 24 and 36 months, considering both corrected (CA) and chronological (UCA) age. At 24 months, significant differences between corrected and chronological scores were found for each BSID-III scale, while at 36 months, significant differences between corrected and chronological scores were found for LANG scales. Only the scores in the COG scale were statistically different between 24 and 36 months (F=4.894, P=0.009, η(2)=0.075). Considering only the preterm sample at 24 months, the differences between CA and UCA scores in the COG scale were significantly correlated to GA (p=0.000) and days in hospital (p=0.002;), while differences between CA and UCA scores in the LANG ESP scale were significantly correlated to GA (p=0.010), days in hospital (p=0.001), and birth weight (p=0.007). At 36 months, no significant correlations were found. CONCLUSIONS Preterm birth is followed by poorer cognitive and language outcomes during infancy than full-term birth. Age correction of prematurity is useful if the child is under 2 years of age; however, our findings raise concerns about the need for age correction, considering that at later ages, healthy preterm children have a higher rate of developmental delay compared with term infants. With regard to cognitive development, preterm children seem to recover from their initial disadvantage; however, with regard to linguistic development, data confirm that preterm infants are at risk for language difficulties.

L'impatto delle esperienze di vita negative della madre sul bambino

Nel tentativo di indagare l’impatto delle esperienze di vita negative materne su attaccamento e adattamento del bambino, e stato condotto uno studio che si e avvalso della somministrazione del Parenting Stress Index - Short Form (PSI-SF; Guarino et al., 2008), del Los Angeles Symptoms Checklist (LASC; King et al., 1995), del Vulnerable Attachment Style Questionnaire (VASQ; Bifulco et al., 2003), della Child Behavior Checklist 1½-5 (Achenbach & Rescorla, 2000) e dell’Attachment Q-Sort (AQS; Cassibba & D’Odorico, 2000). Lo studio, che ha coinvolto 54 mamme (27 inserite in comunita mamma-bambino) e i loro bambini (48.1% femmine, eta tra 1 e 5 anni, M = 2.78, SD = 1.14), ha messo in luce come l’aver vissuto esperienze di vita negative possa impattare sul benessere psicologico della madre, sulla percezione di se come genitore, sulle modalita di relazioni con il figlio e, di conseguenza, sul benessere del bambino in termini di adattamento e di attaccamento.

Eventi traumatici in adolescenza : risposte psicologiche e comportamentali

Gli adolescenti esposti a eventi di vita negativi possono sviluppare sintomi da stress post-traumatico e/o altri problemi psicologici e comportamentali. Questo lavoro si propone sia di indagare l’impatto degli eventi negativi o potenzialmente traumatici sulla comparsa dei sintomi di PTSD e sui comportamenti internalizzanti e/o esternalizzanti, sia di verificare se il modo in cui l’adolescente narra tali eventi sia in qualche misura influenzato dall’esperienza vissuta. 747 adolescenti (476 maschi e 271 femmine; eta media = 16.45; DS = 1.57) sono stati contattati presso alcune scuole secondarie. Ai ragazzi e stato chiesto di scrivere una narrazione di un evento di vita negativo esperito; in seguito e stato chiesto di compilare i seguenti strumenti: Impact of Event Scale-Revised (IES-R; Weiss & Marmar, 1997); Centrality of Event Scale (CES; Berntsen & Rubin, 2006) Youth Self-Report (YSR; Achenbach, 2001). I nostri dati sottolineano la presenza di numerose esperienze traumatiche anche in un gruppo normativo di adolescenti, di un effetto tra il tipo di evento e la risposta psicologica e comportamentale, e differenti modalita narrative a seconda delle risposte psicologiche e comportamentali suscitate dall’evento vissuto.

Italian psychologists’ and midwives’ perceptions of the pregnant teen: a qualitative study

Background: Although debate on adolescent pregnancies has continued for many years, only a few studies have paid attention to the attitudes of health workers and their perceptions of these teens. Objective: The main purpose of this study was to investigate and describe midwives’ and psychologists’ perceptions of the pregnant teens arriving at the health centres – either who wanted to become mothers or to interrupt pregnancy – analysing health workers’ reflections on their experiences of caring for these teens during pregnancy in the Italian context. Methods: Interviews were conducted with 22 health workers in order to describe their perceptions of Italian pregnant adolescents. Interviews were analysed using thematic analysis. Results: Data analysis identified three themes arising from health workers narrations: ‘teen identities’, with the subthemes confused teens, omnipotent teens and immigrant teens; ‘maternal bonding’, with the subthemes supportive mothers and self-centred mothers; and ‘social support demand’, with the subthemes support-seeking teens, self-excluded teens and unsupportive young partners. Conclusion: The results provide an interesting picture of health workers’ perceptions of Italian pregnant adolescents adding new knowledge that will be useful for better planning interventions with pregnant teenagers.

Premature birth: complexities and difficulties in building the mother–child relationship

Abstract Aim: This paper aims to investigate if the dyadic interactive behaviours were influenced by parental stress and feelings both in preterm and full-term mother–child dyads. Methods: 45 mothers (age = 35.29 ± 5.38) and fathers (age = 36.77 ± 6.89) of preterm infants (GA = 30.25 ± 2.95; BW = 1288.02 ± 488.76), and 36 mothers (age = 32.60 ± 4.56) and fathers (age = 35.54 ± 5.16) of full-term (GA = 39.88 ± 1.38; BW = 3156.39 ± 493.81) were involved. Parents filled out the Impact of Event Scale Revised (IES-R), Profile of Mood States (POMS) and Parenting Stress Index Short Form (PSI-SF) and interactive behaviours (Global Rating Scale) was videotaped after 3 months. Results: Mothers of preterm children showed higher level of Intrusiveness (Mpreterm = 4.07 ± .74, Mfullterm = 4.39 ± .51, t = 2.22, p = .029) and Remoteness (Mpreterm = 4.45 ± .83, Mfullterm = 4.79 ± .34, t = 2.51, p = .015) than mothers of term children. In preterm mothers’ lower levels of Sensitivity, higher levels of Intrusiveness, Remoteness and Depression are associated with the presence of negative feelings and parental stress in both parents. Moreover, higher children Distress is associated to parental negative feelings, paternal stress and post-traumatic symptoms. A higher score of parental negative feelings and parental stress predicted lower scores in Global RatingScale dimensions. Conclusions: Our results underline that preterm birth could be a risk factor for the co-construction of interactive exchanges between mother and premature baby. This study could help practitioners to better consider parental roles and to carry out specific supportive interventions for both parents and children.

Child abuse potential inventory in Italy: A comparative study of abusive and nonabusive parents

ABSTRACT The aim of this study was to explore the reliability and ability of the Child Abuse Potential (CAP) Inventory to discriminate parents in an Italian sample who are physically child abusive and physically nonabusive parents. The CAP Inventory and measures on parenting stress (PSI-SF) and parents’ attributions of child adjustment (CBCL) were administered in a sample of 37 abusive and 102 nonabusive parents in an Italian sample: Both groups of the respondents were similar in age, gender, marital status, and education. The Abuse scale showed adequate internal consistency (α = .86) and 52 items significantly discriminate between abusive and nonabusive parents. Moreover, the mean score of abusive parents (M = 194.5) was significantly higher than the mean score of nonabusive parents (M = 78) and the Abuse scale was correlated with parenting stress and parental perceptions of maladjustment in children (in terms of internalizing and externalizing symptoms). Finally, with the cut-off suggested in the original version of the CAP Inventory (Milner, 1986) when abusive and nonabusive groups are compared (166), the Abuse scale correctly classified 70.3% of the abusive group and 100% of the nonabusive group. These results showed adequate reliability and validity of the Abuse scale for Italy.

Mothers and fathers facing their children’s phenylketonuria

ABSTRACT The aim of this study is to understand the impact of children’s phenylketonuria (PKU) on mothers and fathers and to assess the mutual influence of the psychological functioning of one parent on the other. 33 mothers and 33 fathers of PKU-affected children and 43 mothers and 43 fathers of non-PKU-affected children were involved. All of the parents filled out the Los Angeles Symptoms Checklist, the Profile of Mood Scale, the Parenting Stress Index-Short Form, and the Coping Health Inventory for Parents. We performed parametric intergroup analysis and multiple regressions. Results pointed out that there is a link between maternal stress and maternal negative states of mind, trauma-related symptoms, and paternal coping strategies. As regards fathers, there is a link between paternal stress and maternal trauma-related symptoms. Our findings suggest it will be important to better investigate the role played by paternal response in supporting mothers of a chronically ill child, since they confirm the importance of taking into account the points of view of both mothers and fathers and their mutual influences in responding to PKU diagnosis.