Laura Vismara

A prevention and promotion intervention program in the field of mother–infant relationship

The purpose of the study was to analyze the efficacy of early home-visiting intervention in enhancing the quality of mother–infant interaction in psychosocial risk and depressive risk mother–infant dyads. Thirty depressive risk, 28 psychosocial risk, and 33 low-depressed and low-risk mothers were randomly distributed between the Home Visiting Program and control groups. Attachment (Adult Attachment Interview; Main & Goldwyn, 1997) and maternal representations during pregnancy (Interview of Maternal Representations During Pregnancy; Ammaniti, Candelori, Pola, & Tambelli, 1999) and after the birth of the infant (Interview of Maternal Representations After the Birth; Ammaniti et al., 1999) were evaluated as well as depressive symptoms (Center for Epidemiological Studies-Depression Scale; Radloff, 1977) during the first year. Ratings of sensitivity, interference, affective state of the mother, cooperation, and infant self-regulation during mother–infant interactions were assessed at 3, 6, and 12 months. Results showed the efficacy of the home-visiting program in improving sensitive maternal behaviors toward the child after 6 months of intervention.

Parenting stress, mental health, dyadic adjustment: A structural equation model

Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms), and dyadic adjustment among first-time parents. Method: We studied 268 parents (134 couples) of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment. Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers. Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study

Objective: Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers’ and mothers’ postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child’s birth; and 2) to explore how each parent’s parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. Method: The sample included 362 parents (181 couples; mothers’ MAge = 35.03, SD = 4.7; fathers’ MAge = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State-Trait Anxiety Inventory. Results: The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent’s own levels of anxiety and parenting stress and by the presence of depression in his/her partner. Discussion: This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents.

Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment

BACKGROUND The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia. AIMS The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women. METHODS Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth. FINDINGS Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth. CONCLUSIONS Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions.

Sostegno alla genitorialità nelle madri a rischio: valutazione di un modello di assistenza domiciliare sullo sviluppo della prima infanzia

RIASSUNTO: Obiettivo: Obiettivo del lavoro e stato quello di verificare l’efficacia dell’intervento precoce di Home Visiting diretto a rafforzare la qualita della relazione madre-bambino in diadi all’interno delle quali le madri presentano o un rischio depressivo, o un rischio psicosociale, o un rischio sia depressivo che psicosociale. Metodo: Sono state selezionate 38 donne a basso rischio, 39 donne a rischio psicosociale, 37 donne a rischio depressivo e 32 donne a doppio rischio, che sono state assegnate in modo casuale ad un programma di intervento o a un gruppo di controllo. Le donne hanno un’eta compresa tra i 20 e i 43 anni. Ad entrambi i gruppi sono state somministrate le seguenti interviste e questionari: l’AAI, l’IRMAG, l’IRMAN, il CES-D e l’SCL-90. Durante il primo anno di vita del bambino sono state effettuate delle videoriprese dell’interazione diadica madre-bambino a 3, 6 e 12 mesi. Risultati e conclusioni: i risultati hanno evidenziato una differente distribuzione delle rappresentazioni materne di se e del bambino nei quattro gruppi di donne, e l’efficacia dell’intervento precoce di Home Visiting in relazione ad un aumento di comportamenti materni sensibili, a partire dal 6° mese di vita, nel gruppo di donne che hanno ricevuto l’intervento. PAROLE CHIAVE: Gravidanza a rischio, Rappresentazioni materne, Home Visiting.

Stati mentali materni di ostilità e impotenza e qualità dell’interazione diadica in un gruppo di bambini a rischio di maltrattamento

La ricerca ha coinvolto 20 coppie madre-bambino a rischio di maltrattamento al fine di verificare se stati mentali materni ostili-impotenti influenzano la qualita dei pattern interattivi. Alle madri e stata somministrata l’AAI e ai trascritti e stato poi applicato il Sistema di Codifica degli Stati Mentali di Ostilita e Impotenza (HH); inoltre, e stata effettuata un’osservazione videoregistrata di scambi diadici. I risultati evidenziano una prevalenza di modelli insicuri (55%) e disorganizzati (35%). Il 40% delle madri presenta uno stato mentale ostile-impotente che influenza la qualita interattiva: nella relazione con il figlio, esse mostrano comportamenti intrusivi (t = 2,71; p < 0,01) e affetti negativi (t = 2,68; p < 0,01). I dati confermano che stati mentali ostili-impotenti compromettono la qualita dell’interazione diadica, con importanti implicazioni legate ad una genitorialita di tipo abusivo.

Stati mentali materni rispetto all’attaccamento e qualità dei pattern interattivi in un campione di bambini a rischio di maltrattamento

Obiettivo: L’obiettivo del lavoro e stato quello di valutare i modelli di attaccamento materni e la qualita dei pattern interattivi in un campione di bambini a rischio di maltrattamento. Metodo: Mediante un’apposita Scheda Anamnestica e Sociodemografica, sono state selezionate 20 coppie a rischio e 20 coppie di controllo. A tutte le madri del campione e stata preliminarmente somministrata l’AAI e contestualmente e stata effettuata un’osservazione videoregistrata di scambi diadici in un contesto naturale. Ai trascritti dell’AAI e stata successivamente applicata la Scala della Funzione Riflessiva. Risultati e Conclusioni: i risultati hanno evidenziato una differente distribuzione dei modelli operativi interni dell’attaccamento nei due gruppi di donne e modalita relazionali maggiormente problematiche nel gruppo a rischio di maltrattamento.