Monique Seymour

Maternal anxiety, risk factors and parenting in the first post‐natal year

BACKGROUND The antecedents and consequences of maternal post-natal anxiety have received comparatively less attention than depression despite being one of the most frequently reported mental health difficulties experienced by parents following childbirth. The aim of this study was to extend emerging literature on post-natal anxiety by investigating the prevalence of maternal anxiety symptoms, and its relationship with parenting behaviours (i.e. warmth, hostility) and experiences (i.e. parenting efficacy and satisfaction) within the first post-natal year. The psychosocial risk factors for post-natal anxiety symptoms were also explored. METHODS A community sample of 224 Australian mothers of infants (aged 0-12 months) completed a self-report questionnaire. RESULTS Mothers in the current sample reported significantly more symptoms of anxiety compared with a normative sample. Approximately 18% of mothers reported mild to extremely severe symptoms of anxiety, with a high proportion experiencing co-morbid depressive symptoms. Maternal anxiety was associated with low parenting warmth, involvement, efficacy and satisfaction, and high parenting hostility. Yet, co-morbid depression and anxiety was more strongly associated with these parenting behaviours and experiences than anxiety alone. CONCLUSION A range of psychosocial risk factors (e.g. education, sleep, relationship quality) were associated with maternal post-natal anxiety symptoms, providing opportunities for early identification and targeted early intervention.

Wide Awake Parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue

BackgroundExhaustion and fatigue are commonly experienced by parents during the post-partum period, and can have implications for daily functioning, mental health and parenting practices. There is a need for the development of effective interventions to assist parents with the management of fatigue. This paper outlines the procedure for a randomised controlled study which aims to test the efficacy of Wide Awake Parenting, a program for the management of fatigue in the postnatal period.Methods/designParents with an infant less than 6 months of age, and from seven Local Government Areas in Melbourne, Australia were invited to participate in this study. Parents were randomised to receive the Wide Awake Parenting program (intervention groups) or usual care (control group) offered by health services. The Wide Awake Parenting program provides parents with psycho-education and information about fatigue, and strategies to reduce its effects either via a self-directed method, or professionally led with a home visit and telephone support. Baseline data will be collected prior to randomisation, and further data will be collected at 2- and 6-weeks post intervention.DiscussionTo our knowledge this is the first randomised controlled trial of a program which compares the efficacy of a self-management approach and health professional assistance for the management of fatigue in the early post-partum period. If effective, it could offer an important, universal public health management approach to this common health concern.Trial registration numberAustralian New Zealand Clinical Trials Registry, ACTRN12611000133932.

Acceptability of Wide Awake Parenting: A psycho-educational intervention to manage parental fatigue

Objective: This article reports on the pilot evaluation of Wide Awake Parenting (WAP), a novel intervention to assist parents of young children to manage fatigue. It was trialled with parents of infants and children (aged 0–4 years) with sleep and settling problems. Background: Fatigue is a common health concern for parents of young children that has the potential to impact upon daily functioning, mental health and parenting. Methods: Forty-nine parents attending a residential parenting programme for child sleep problems participated in a pre–post evaluation of a workshop targeting the management of fatigue. Results: High acceptability and satisfaction of the workshop content and delivery was reported. Following participation in the workshop, parents reported a significant increase in their perceived importance, self-efficacy and intention to engage in self-care behaviours to manage fatigue. Conclusions: The results of this pilot are encouraging and provide initial support for WAP, and scope for further development and rigorous evaluation.

Factors associated with the course of maternal fatigue across the early postpartum period

Background: Relatively little is known about the course and persistence of fatigue across the postpartum period, despite the potentially adverse effects fatigue has on maternal daily functioning, well-being, parenting behaviour and parent–child interactions. Objective: Using multi-wave data over a 4-month period in the postpartum, the present study sought to: (a) examine the course of maternal fatigue, and (b) identify a range of potentially modifiable individual and contextual factors associated with the course of fatigue over this time. Methods: Seventy mothers of infants aged between 0 and 7 months participated in the current study. To measure change over time and predictors of fatigue, latent growth curve analysis was used. Results: The results indicated that maternal fatigue at approximately three months postpartum was moderate to high, with little or no change in fatigue severity over time. Higher fatigue scores at three months postpartum were also significantly associated with younger maternal age, higher socioeconomic disadvantage, low self-efficacy to engage in health behaviours and poor sleep quality. Older maternal age and poor sleep quality were associated with stability of fatigue over time. Conclusions: Findings underscore the importance of identifying and supporting women experiencing high levels of fatigue in the first seven months postpartum. Additionally, findings highlight potential risk factors for initial and persistent fatigue, possibly allowing the identification of women who might be more vulnerable to fatigue. Implications for future research and practice are discussed.

Depression and anger in fathers of unsettled infants: A community cohort study

To examine the relationship between unsettled infant behaviour and fathers’ depressive symptoms, cognitions surrounding infant sleep (anger, doubt), and personal sleep, in a community cohort.

The prevalence and correlates of self-harm ideation trajectories in Australian women from pregnancy to 4-years postpartum

OBJECTIVES Women in the perinatal period are at increased risk of experiencing self-harm ideation. The current study longitudinally examines the prevalence, trajectories, and correlates of self-harm ideation in a population-based sample of Australian women from pregnancy through to the early years of parenting. METHODS Drawing on data from 1507 women participating in a prospective pregnancy cohort study, data were collected during pregnancy, at 3-, 6-, 12-, and 18-months postpartum, and 4-years postpartum. Longitudinal Latent Class Analysis was conducted to identify groups of women based on their responses to thoughts of self-harm at each time-point. Logistic regression analysis was used to identify factors associated with group membership. RESULTS Approximately 4-5% of women reported experiencing self-harm ideation at each time-point from pregnancy to 4-years postpartum. Cross-sectional analyses revealed that self-harm ideation was most frequently endorsed in the first 12-months postpartum (4.6%), and approximately 15% of women reported self-harm ideation at least once during the study period. Longitudinally, approximately 7% of women had an enduring pattern of self-harm ideation from pregnancy to 4-years postpartum. Women who had experienced a range of preconception and current social health issues and disadvantage were at increased risk of self-harm ideation over time. LIMITATIONS Limitations included use of brief measures, along with an underrepresentation of participants with particular socio-demographic characteristics. CONCLUSIONS A proportion of women are at increased risk of experiencing self-harm ideation during the perinatal period and in the early years of parenting, underscoring the need for early identification during pregnancy and early postpartum to facilitate timely early intervention.

Bio-ecological factors associated with the psychological distress of fathers of children with autism spectrum disorder: A population-based study of Australian families

Using a bio-ecological framework, the aim of this study was to examine factors associated with psychological distress experienced by fathers of children with autism spectrum disorder from a nationally representative sample of Australian children and their families. Individual (e.g. age and self-efficacy), interpersonal (e.g. partner distress, couple relationship, child behaviour and social support) and social environmental factors (e.g. job quality and financial hardship) were explored as potential predictors of fathers’ distress. Data were drawn from the Longitudinal Study of Australian Children, where 159 fathers of children with autism spectrum disorder were identified. As comparison, 6578 fathers of children without developmental disabilities were identified. Multiple regression analyses showed that experiencing depression within the past year, job quality (e.g. autonomy and access to parental leave) and social support were significant predictors for fathers of children with autism spectrum disorder. The importance of supporting the well-being of fathers of children with autism spectrum disorder is discussed.