Joëlle Darwiche

Anxiety and Psychological Stress Before Prenatal Screening in First-Time Mothers Who Conceived Through IVF/ICSI or Spontaneously

Mothers’ general anxiety, anxiety about the well-being of the child and psychological stress before prenatal testing was studied by comparing women who conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with women who conceived naturally. Before the first trimester screening test for Down’s syndrome, a group of 51 women who conceived through IVF/ICSI and a group of 54 women who conceived spontaneously completed the State Scale of the State-Trait Anxiety Inventory (S-Anxiety; Spielberger, 1983), the Fear of Bearing a Physically or Mentally Handicapped Child Subscale of the Pregnancy-related Anxiety Questionnaire (PRAQ-R; Huizink et al., 2004), the Psychological Stress Measure (PSM; Lemyre & Tessier, 1988), and the Prenatal Psychosocial Profile (PPP; Curry, Campbell, & Christian, 1994). Women who conceived through IVF/ICSI had more elevated levels of general anxiety and psychological stress than the women who conceived naturally; however, no difference was observed between the two groups for anxiety specifically related to the health of the child. These results underline the need to monitor women’s emotional state after conception via IVF/ICSI—when counseling usually ends—and around the time of the first trimester screening. Counseling might thus be extended.

Family interactions in IVF families: change over the transition to parenthood

Objective: This article presents a study of the change over time in the family interactions of couples who conceived through in-vitro fertilisation (IVF). Background: Observational methods are rarely used to study family interactions in families who used assisted reproductive techniques, but these methods are crucial for taking account of the communication that occurs in interactions with infants. Methods: Thirty-one couples expecting their first child were seen during the fifth month of pregnancy and when the child was nine months old. Family interactions were recorded in pre- and postnatal versions of the Lausanne Trilogue Play situation. Measures of marital satisfaction and parent-to-foetus/baby attachment or ‘bonding’ were also used to assess family relational dynamics. Results: Results showed that family alliance, marital satisfaction and parental attachment scores in the IVF sample were all similar to or higher than those in the reference sample during pregnancy. However, at nine months postnatally, the family alliance scores were lower. While marital satisfaction decreased over the period and parent–baby attachment increased, the family alliance scores were unstable, as no association was observed between the pre- and postnatal scores. In addition, neither prenatal marital satisfaction nor parent–foetus attachment predicted the postnatal family alliance. Conclusion: The change in the family alliance over the transition to parenthood appears to be specific to our IVF sample. Given that postnatal family functioning could not be predicted by prenatal family functioning, our observational data underline the importance of offering postnatal support to these families.

Mutual Smiling Episodes and Therapeutic Alliance in a Therapist-Couple Discussion Task

We observed mutual smiling episodes (MSEs) during therapist-couple triadic interaction as a key element of affective exchanges that serve to regulate the therapeutic relationship. Based on a functional perspective, we developed a new rating scale, the MSE Coding System (MSE-CS) that allows us to distinguish between four different MSEs, which correspond to four social functions: supporting mutual binding, sharing miseries, repairing, and confronting. MSEs were analyzed in a sample of eight therapist-couple triads. Therapeutic alliance and marital adjustment were also measured. The instrument (MSE-CS) demonstrated satisfactory inter-rater reliability, and initial indications of validity are promising. Results showed that number of MSEs was positively correlated with triadic therapeutic alliance. Types of MSEs were also distributed differently depending on the level of triadic therapeutic alliance.

Anxiety, depression, and attachment before and after the first-trimester screening for Down syndrome: comparing couples who undergo ART with those who conceive spontaneously

This studys aim was to describe the emotional status of parents to be before and after the first‐trimester combined prenatal screening test.

Partner support during the prenatal testing period after assisted conception

BACKGROUND Pregnancy after infertility is a challenging experience. The first-trimester screening test may add stress. Partner support reduces psychological distress in pregnant women after spontaneous conception. No data are available for women who conceive via assisted reproductive technology. AIM To assess whether there was a difference between couples who underwent assisted reproductive technology and couples who conceived spontaneously in the support they felt they provided to their partner and whether their perception of support received from their partner reduced their distress. METHODS This longitudinal prospective study included 52 women (spontaneous conception) and 53 women (assisted reproductive technology), as well as their partners. Participants completed the state scale of the State-Trait Anxiety Inventory, the Edinburgh Depression Scale, and two partner-support subscales of the Dyadic Coping Inventory: before prenatal testing (gestational age 12 weeks), immediately after receiving the results (gestational age of approximately 14 weeks), and once all the prenatal screenings had been completed (gestational age 22 weeks). FINDINGS Women who underwent assisted reproductive technology felt less able to help their partner cope with stress and felt their partner was less able to help them cope with stress than women with spontaneous pregnancy. This difference was not observed in men. Higher perceived partner support lowered the anxiety and depression of couples who conceived spontaneously, but did not benefit couples who followed fertility treatment. CONCLUSION These results add to our knowledge of the emotional state of women and their partners during pregnancy after infertility. This knowledge may allow prenatal care providers to offer specialized counselling to women and their partners in the transition from infertility to parenthood.

Adult Self-Esteem and Family Relationships

We conducted a literature review to examine the effects of self-esteem in the family context, selecting 40 studies exploring the associations between self-esteem, coparental relationship, parent-child relationship, and global family functioning. The research focused primarily on self-esteem and the parent-child relationship. The evidence indicates that parents with high self-esteem experience enhanced satisfaction with their children and exhibit more positive interactions with them. It was also found that parents’ high self-esteem is associated with less physical abuse and child neglect. Studies focusing on coparenting and family functioning are still rare, and more evidence is needed to establish robust conclusions.

Coparenting in Stepfamilies: A Cluster Analysis

ABSTRACT The aim of this study was to identify types of coparenting in stepfamilies based on observational data and to examine whether these types differed regarding marital satisfaction and child adjustment. Forty-five couples attended two videotaped discussion tasks on topics of agreement and disagreement regarding coparenting issues. An exploratory cluster analysis identified three main types of coparenting in stepfamilies: (1) Cooperative coparenting (n = 19), (2) Complementing coparenting (n = 16), and (3) Conflictual coparenting (n = 10). The Complementing coparenting type appeared as a new type of coparenting that had not been described in earlier studies and that might be specific to coparenting between non-biological parents. Comparison between the three clusters showed no differences for marital satisfaction and child adjustment. Each cluster is illustrated by a family case to provide a better understanding of coparenting dynamics in stepfamilies.

Prenatal Intuitive Coparenting Behaviors

Micro-analytic research on intuitive parenting behaviors has shed light on the temporal dynamics of parent and child interactions. Observations have shown that parents possess remarkable implicit communicative abilities allowing them to adapt to the clues infants give and therefore stimulate the development of many of the infants’ abilities, such as communication skills. This work focused on observing intuitive parenting behaviors that were synchronized and coordinated between the parents. We call them “prenatal intuitive coparenting behaviors” and used an observation task – the Prenatal Lausanne Trilogue Play procedure – to observe them. For this task, the parents role-play their first encounter with their future baby, represented by a doll. Two cases from a study on pregnancy after assisted reproductive technology are provided to illustrate how these behaviors manifest themselves. The observations from the first case suggest that expectant parents can offer the baby a coparental framework, whereas the observations from the second case show that opportunities for episodes of prenatal intuitive coparenting can be missed due to certain relationship dynamics. These kinds of observations deepen our knowledge of the prenatal emergence of the coparenting relationship and allow us to hone our strategies for intervening during pregnancy with couples who experience coparenting difficulties. Furthermore, these observations provide a novel and complementary perspective on prenatal intuitive parenting and coparenting behaviors.