Judy Ungerer

Paternal and maternal depressed mood during the transition to parenthood.

BACKGROUND The course of postnatal depression was examined in first-time mothers and fathers with emphasis on the role of personality and parental relationships as risk factors. METHOD 157 couples were assessed at four points: antenatally and at 6, 12 and 52 weeks postnatally. Various measures of mood and personality were administered at each of these assessment points. RESULTS Examination of the factors associated with depressed mood suggested that a womans relationship with her own mother was important in the early postpartum stage, and also her level of interpersonal sensitivity and neuroticism. For the father, his relationship with either his mother or father and his level of neuroticism were associated with his mood level early on. By the end of the first year couple morbidity increased, with rates of distress being at their highest for both parents, and factors associated with depressed mood being linked to partner relationship variables, at least for mothers. At most time points, antenatal mood and partner relationship were significant predictor variables for the postnatal mood of both mothers and fathers. LIMITATIONS The sample had a relatively high level of education and this should be taken into account when considering the generalisation of findings to less educated populations. At the time of conducting this study, the Edinburgh Postnatal Depression Scale (EPDS) had only been validated for use in the first few months postpartum, and thus we used another scale to measure the mothers mood at the other assessment points (the Beck Depression Inventory). Current research would suggest that the EPDS is valid both antenatally and at other times in the first year postpartum. CONCLUSION Whilst there was some consistency for mothers and fathers in the variables that predict their postpartum adjustment, these being antenatal mood and partner relationship, there is also evidence that adjustment to parenthood was related to different variables at different times. Early adjustment was related to the couples relationship with their own parents, as well as their own personality. Later adjustment was related to the couples functioning and relationship.

Psychosocial adjustment and the quality of the mother-child relationship at four months postpartum after conception by in vitro fertilization

OBJECTIVE To examine psychological adjustment to early motherhood at 4 months postpartum in mothers who conceived by IVF-ET. DESIGN Controlled clinical study. SETTING Healthy human volunteers in an academic research environment. PATIENT(S) Sixty-five primiparous women undergoing IVF-ET and 62 age-matched primiparous women with no history of infertility. INTERVENTION(S) Completion of questionnaires, interviews, and videotaped interaction. MAIN OUTCOME MEASURE(S) Maternal self-reports of psychosocial adjustment and behavioral ratings of quality of mother-infant interaction based on a videotaped observation scored blind to IVF-ET status. RESULT(S) Mothers who conceived by IVF-ET did not differ from control mothers on measures of anxiety, postnatal depression, marital satisfaction, or use of support services. However, they reported lower self-esteem and lower maternal self-efficacy, and they rated their infants as more temperamentally difficult. (Ratings of temperament difficulty for the infants of mothers who conceived by IVF-ET are within the normal range when compared with Australian normative data for this age group.) The videotapes revealed no group differences in maternal behaviors, but the infants of mothers who conceived by IVF-ET displayed more negative behaviors in response to an interactive stress. Group differences were accounted for largely by those mothers who underwent more than one treatment cycle and by their infants. CONCLUSION(S) Overall, the results are reassuring for parents who conceive by IVF-ET. However, specific adjustment measures reveal some minor difficulties and suggest that mothers who conceive by IVF-ET may benefit from increased support in the early postpartum months.

Attention Deficit Hyperactivity Disorder is Associated with Attachment Insecurity

The literature on attention deficit hyperactivity disorder (ADHD) and attachment is reviewed, and we describe an investigation of the relationship between attachment insecurity and ADHD. Nineteen boys, aged 5–10 years with DSM-IV diagnoses of ADHD were compared with 19 control children on three representational measures assessing internal working models of attachment and the self: the Separation Anxiety Test, the Self Interview, and a Family Drawing rated with an attachment-based scoring system. Consistent support was found for the hypothesis that ADHD is associated with insecurity of attachment, with the ADHD group obtaining poorer scores on all three measures. The nature of attachment insecurity in the ADHD group was one of heightened emotional expression characterized by strong, out of control affects, and was consistent with an anxious-ambivalent or disorganized attachment style. We argue that quality of attachment with primary caregivers should be assessed when children present with symptoms of ADHD, and that where insecure attachment relationships are found, treatment must incorporate relationship-building components.

Categorization Skills and Receptive Language Development in Autistic Children.

The category knowledge and receptive language skills of 16 autistic, mentally retarded, and normal children were assessed. The autistic childrens knowledge of function, form, and color categories was comparable to that of the mental- age- matched mentally retarded and normal comparison groups. Category knowledge and receptive language were more closely associated for mentally retarded and normal children than for autistic children. The findings indicate that category knowledge is not sufficient for the development of receptive language in autistic children.

The early development of empathy: Self-regulation and individual differences in the first year

A longitudinal study of 45 mothers and their first-born infants was conducted to identify developmentally meaningful, individual differences in childrens primitive empathic responding at 12 months of age, and to determine whether differences in self-regulatory skills assessed at 4 months might underlie any differences in empathic responding observed. Personal distress responses analogous to those observed in older children and adults were identified in one-third of the sample at 12 months of age. These distress responses were associated with indices of poorer self-regulatory skills in social contexts at 4 months of age. The results are interpreted within the broader framework of the development of self-regulatory strategies in the early childhood years.

The mother-child relationship following in vitro fertilisation (IVF): infant attachment, responsivity, and maternal sensitivity.

Infant attachment and mother-child interaction were evaluated for 65 primiparous women and their singleton infants conceived through in vitro fertilisation (IVF) and a control group of 61 women and their infants conceived naturally. The sample was enrolled during pregnancy as part of a longitudinal study. At 12 months postpartum, security of infant attachment was assessed using the Strange Situation procedure, and mother-child interaction was assessed in a free play context using the Emotional Availability Scales. IVF children demonstrated predominantly secure attachment relationships with their mothers (64.6% IVF, 55.9% controls), and there were no significant between-group differences in the proportion of IVF compared to control group children classified in any of the secure or insecure attachment groups. Furthermore, there were no significant group differences on maternal (sensitivity, structuring, hostility) or child (responsivity, involving) dimensions of interaction during play. The majority of IVF mothers (86%) were sensitive and their infants responsive (91%). Contrary to expectation, mothers ratings of greater anticipated infant difficultness assessed during pregnancy and higher ratings of infant temperament and behaviour difficulty assessed at 4 and 12 months postpartum were associated with secure attachment relationships and more optimal mother-child interaction in both the IVF and control groups.

‘Don't count your chickens’: A comparative study of the experience of pregnancy after IVF conception

Abstract The aim of this paper was to describe the personal experience of pregnancy for IVF mothers. Seventy in vitro fertilization (IVF) mothers were compared to a control group of 63 older first-time mothers using both questionnaire and interview measures of adjustment at 30 weeks of pregnancy. The IVF group was subdivided into women who had conceived on their first treatment cycle and repeat cycle mothers. Results showed that while there were no differences between the IVF and control group mothers on self-report measures of maternal role acquisition, the experience of pregnancy was different for the IVF mothers. Despite their higher levels of anxiety about the well-being of the baby, the repeat cycle IVF mothers were more likely to report positive, idealized attitudes to pregnancy than were the controls. The repeat cycle IVF mothers also differed from control group mothers in reporting expectations of a more difficult baby, and both 1 cycle and repeat cycle IVF mothers reported fewer conversations wit...

Implications of Resolving the Diagnosis of PKU for Parents and Children

OBJECTIVE To examine resolution of the diagnosis among parents of children with phenylketonuria (PKU) as a mechanism of adjustment for parents and children. METHODS Reaction to diagnosis interviews were conducted with 52 mothers and 47 fathers of 55 children with PKU aged 2-12 years. The parents also completed questionnaires assessing their personal adjustment (stress symptoms), their childs adjustment (behavior problems), and coping variables (personal hopefulness and coping strategies). RESULTS Most mothers (69%) and fathers (77%) were resolved to their childs diagnosis. Lower levels of parent stress were explained by higher personal hopefulness (14% of the variance for mothers and 21% for fathers) and resolution of the diagnosis (15% of the variance for mothers and 6% for fathers) after taking account of demographic variables and severity of the childs PKU. Parent resolution, however, did not contribute independently to the variance explained in child behavior problems after taking account of coping variables and severity of PKU. CONCLUSIONS Resolution of the diagnosis of PKU is a strong indicator of parent adjustment, and assessment of parent reactions should be considered an integral component of clinical care. Further research is warranted in relation to the implications of parent resolution for the childs response to PKU through different development stages and the effectiveness of interventions in aiding parent resolution.

Early development of children with major birth defects requiring newborn surgery

Aim:  To describe neurodevelopmental outcomes of neonates following cardiac or non‐cardiac surgery for major birth defects.

Psychosocial outcomes for parents and children after in vitro fertilization: A review

Abstract Descriptive writings and empirical research on the longterm effects of infertility and in vitro fertilization (IVF) on the psychosocial adjustment of parents and children are reviewed in three major areas: the experience of pregnancy, the quality of parenting, and the cognitive, social and emotional development of the children. Contrary to prior speculation, overall findings indicate that parents who conceive by IVF do not differ from comparison groups on adjustment to pregnancy, and they do not demonstrate dysfunctional parenting styles. Furthermore, there is no evidence that children conceived by IVF differ on either cognitive or social/emotional indices of development. However, the number of empirical studies is small and significant methodological shortcomings limit the conclusions which can be drawn from the research, More prospective empirical work is needed to clarify outcomes and to document the process of psychological adjustment over time in IVF families.