Katherine Pierce

Repetitive transcranial magnetic stimulation treats postpartum depression.

BACKGROUND Postpartum depression (PPD) is a prevalent illness, affecting 10-15% of new mothers. PPD is the most common complication of childbirth and is a significant public health concern. It is known to adversely impact maternal-infant bonding, childrearing practices, and can lead to suicide and infanticide. The current treatment approaches to PPD are suboptimal. Many mothers are reluctant to take medication because of concerns about side effects or exposure of their newborn infant through breastfeeding. The specific aims of this study were to (1) examine acute treatment effectiveness, (2) examine response durability, and (3) assess an effect of repetitive transcranial magnetic stimulation (rTMS) on maternal bonding. METHODS Nine antidepressant-free women with PPD were given 20 rTMS treatments over 4 weeks (10Hz, 120% motor threshold, left dorsolateral prefrontal cortex). Multiple characteristics were assessed at baseline and throughout treatment. Duration of effect was assessed at 30 days, 3 months and 6 months posttreatment. RESULTS Friedmans tests were conducted on Hamilton Rating Scale for Depression-24 item (HRSD-24), Edinburgh Postnatal Depression Scale (EPDS), Inventory of Depressive Symptomatology-Self-Report (IDS-SR) and Clinical Global Impressions-Severity (CGI-S) scores to compare performances at four time points (baseline, end of Week 2, end of Week 4, and 180-day follow-up). Overall, these results revealed a significant reduction in depressive symptoms by the end of Week 2 of treatment. Analyses yielded a medium effect size (r=0.68) on the primary outcome variable (HRSD-24). Of note, all nine patients remained in treatment for the complete 4 weeks, did not miss any treatment sessions and eight participants achieved remission of symptoms, defined as a HRSD<10 and a CGI-S=1. Analysis of follow-up data indicated robustness of the rTMS treatment over time. At 6-month follow-up, of the eight women that remitted, seven remained in remission without further psychiatric intervention, including the addition of medication and one was lost to follow-up. Results also indicated a significant improvement in bonding. CONCLUSIONS Our results demonstrate promising results for the use of rTMS in the treatment of PPD. Further randomized, sham-controlled studies need to be completed.

Effects of severe bothersome tinnitus on cognitive function measured with standardized tests

Neurocognitive tests compared abilities in people with bothersome tinnitus against an age-, gender-, and education-matched normative population. Participants between 18 and 60 years had subjective, unilateral or bilateral, nonpulsatile tinnitus for >6 months and a Tinnitus Handicap Inventory score of ≥38. Results from a first testing session showed deficits in learning, learning rates, immediate recall of heard words, and use of a serial order encoding strategy. Initial reliance on serial order encoding and, later, increased intrusion of incorrect words towards normal levels might indicate a less demanding strategy to compensate for weakness in associative memory for semantic categories.

Similarities in visual imagery ability in young and old women

Young (age 25 to 39 years, n = 50) and old (age 65 to 79 years, n = 50) women were administered both subjective and objective measures of imagery ability and imagery control. Little evidence of an age-related deficit in image vividness was observed. It would appear that imaginal ability does not vary with age. Alternatively, self-reports of images may not be accurate representations of images experienced.

Social Competence in Infants and Toddlers with Special Health Care Needs: The Roles of Parental Knowledge, Expectations, Attunement, and Attitudes toward Child Independence

Little research has empirically addressed the relationships among parental knowledge of child development, parental attunement, parental expectations, and child independence in predicting the social competence of infants and toddlers with special health care needs. We used baseline data from the Strengthening Families Project, a prevention intervention study that tested Bavolek’s Nurturing Program for Parents and Their Children with Health Challenges to explore the roles of these variables in predicting social competence in infants and toddlers with special health care needs. Bivariate relationships among the study variables were explored and used to develop and test a model for predicting social competence among these children. Study findings pointed to a combination of indirect and direct influences of parent variables in predicting social competence. Results indicated that parents who encouraged healthy behaviors for developing a sense of power/independence were more likely to have children with social competence developing on schedule. Elements related to parental expectations, however, did not have the hypothesized relationships to social competence. The present study provides preliminary data to support the development of knowledge based interventions. Within medical settings, such interventions may indeed maximize benefit while minimizing cost.