Sara Molgora

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.

Divorce and coparenting: A qualitative study on family mediation in Italy

This qualitative study intended to assess how intergenerational transformative family mediation is a resource in promoting and supporting coparenting during the transition of divorce. There were 2 goals: to assess parents’ perceptions of key topics of family mediation and to compare their perceptions concerning different moments of the intervention. Fifteen Italian parents were interviewed using an ad hoc semistructured interview. Data were analyzed using the textual analysis software T-LAB. Findings showed mediator, pragmatic aspects, and family relationships as the most salient aspects of mediation. Significant differences emerged among the beginning, the middle phase, and the end of this intervention.

Promoting Coparenting After Divorce: A Relational Perspective on Child Custody Evaluations in Italy

ABSTRACT This study intended to explore how child custody evaluations might help in supporting parents during the transition of divorce to continue to be parents together. Sixteen Italian divorced parents were interviewed using an ad hoc semistructured interview. Data were analyzed by T-LAB software. Findings indicated a shift from the structural aspects of the intervention to the dynamic ones, as well as from an individual vision of the child to a more relational one, from the problems and the conflicts to resources, mutual respect, and trust. Results are discussed in relation to practical implications for intervention.

Development and Evaluation of the Cancer Dyads Group Intervention: Preliminary Findings

Despite the fact that importance of primary relationships for cancer patients and their caregivers’ adaptation to illness is well recognized, only a paucity of studies report about clinical interventions for the patient–caregiver dyad. The article presents the Cancer Dyads Group Intervention (CDGI), a supportive group intervention for breast cancer patients and caregivers, and preliminary findings about its effectiveness. A correspondence analysis of the verbatim transcripts of the first three groups was conducted. Findings highlight the evolution of participants during the intervention and confirm the congruence between goals and the participants’ experience. Further investigation of the CDGI effectiveness is necessary.

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.

Italian women’s childbirth: a prospective longitudinal study of delivery predictors and subjective experience

Abstract Background: Previous research has demonstrated that negative childbirth expectations adversely influence perinatal outcomes. The current research builds on this with Italian mothers-to-be. Objective: The present study (1) explored the influence of cognitive and emotional variables on labour and delivery outcomes and (2) examined how individual characteristics, couple adjustment, and medical factors influence the childbirth experience. Method: 121 Italian primiparous women participated in a prospective longitudinal study where participants completed a set of questionnaires between the 32nd and 37th week of pregnancy and again 30–40 days post-delivery. Results: Binary logistic regression analyses revealed that women with negative childbirth expectations were three times more likely to experience an emergency C-section or an instrumental vaginal delivery. Furthermore, childbirth expectations predicted subjective birth experience. This relationship between expectations and delivery type and the subjective childbirth experience was weak while other variables (such as anxiety, depression, couple adjustment) did not significantly influence delivery type or the subjective childbirth experience. Conclusions: The weak relationship between childbirth expectations and perinatal outcomes renders it necessary to question the nature of the relationship found in previous research, especially considering inconsistencies of the literature on the subject. The current research makes it clear that further research is needed to understand better the relationship between expectations and perinatal outcomes in order to better improve the well-being of mothers-to-be during labour and delivery.

Promoting Patient and Caregiver Engagement to Care in Cancer

The positive outcomes associated with Patient Engagement (PE) have been strongly supported by the recent literature. However, this concept has been marginally addressed in the context of cancer. Limited attention has also received the role of informal caregivers in promoting physical and psychological well-being of patients, as well as the interdependence of dyads. The Cancer Dyads Group Intervention (CDGI) is a couple-based psychosocial intervention developed to promote engagement in management behaviors, positive health outcomes, and the quality of the relationship between cancer patients and their informal caregivers. The article examines the ability of the CDGI to promote adaptive coping behaviors and the perceived level of closeness by comparing cancer patients participating in the intervention and patients receiving psychosocial care at usual. Results indicate that individuals diagnosed with cancer attending the CDGI present significant increases in Fighting Spirit and Avoidance, while reporting also reduced levels of Fatalism and Anxious Preoccupation. Initial indications suggest that the intervention may contribute to strengthening the relationship with the primary support person.

Trajectories of Postpartum Depression in Italian First-Time Fathers:

Paternal postpartum depression (PPD) has received little attention compared with maternal prenatal and postpartum depression, despite research reporting that paternal PPD concerns a substantial number of fathers. History of depression and antenatal depression have been identified as important PPD’s risk factors, underlining the continuity of depressive symptoms during the transition to parenthood. However, only few studies have focused on the evolution of depressive symptoms with longitudinal research design. The present study aims at analyzing the longitudinal trajectories of depressive symptoms from the third trimester of pregnancy to 1 year after childbirth. One hundred and twenty-six first-time fathers completed the Edinburgh Postnatal Depression Scale at four time points (7-8 months of pregnancy, 40 days, 5-6 months, and 12 months after childbirth). Data were analyzed throughout latent growth mixture modeling. Latent growth mixture modeling analysis indicated a three-class model as the optimal solution. The three-class solution included a trajectory of low, stable depressive symptoms across the four time points (resilient, 52%); a trajectory of moderate, relatively stable depressive symptomatology (distress, 37%); and a trajectory of emergent clinical depression following a pattern of high depressive symptoms (emergent depression, 11%). This study allowed to identify different subpopulation within the sample, distinguishing among mental well-being, emotional distress, and high-risk conditions when—1 year after childbirth—fathers report the highest scores to the Edinburgh Postnatal Depression Scale. These results underline the importance to analyze fathers’ well-being over the time during the transition to fatherhood.

Group interventions for children having separated parents: a Systematic Narrative Review

ABSTRACT The aims of this article are to review the current body of knowledge on group interventions for children with separated or divorced parents and to provide new insights into the evaluation of their efficacy. This review draws on a method of systematic narrative review (SNR). We provide a narrative synthesis of evidence from 29 studies conducted between 1980 and 2014, which were included in the SNR consistently with the inclusion criteria established. Three dimensions were considered: intervention characteristics, study characteristics, and intervention outcomes (i.e., types of outcomes and efficacy). Our findings showed a general inconsistency among the studies, which was discussed in the light of some important methodological issues.