Stacey Callahan

Frequency of borderline personality disorder in a sample of French high school students.

Objective: To estimate the frequency of borderline personality disorder (BPD) in French high school students. Method: A random sample of high school students (n = 1363) ranging in age from 13 to 20 years agreed to complete a questionnaire, the Screening Test for Comorbid Personality Disorders (STCPD); 107 of them volunteered to be interviewed. We assessed this group using the Revised Diagnostic Interview for Borderlines (DIB-R). We conducted a regression analysis to determine a cut-off for BPD diagnosis with the STCPD. Results: We estimated the overall frequency of BPD to be 10% for boys and 18% for girls. After a peak of frequency at age 14 years for both sexes, the frequency increased significantly again in late adolescence. Conclusion: This study found a high frequency of BPD in French adolescents, which adds to questions regarding the validity of diagnosing this disorder in adolescents.

Post-traumatic stress disorder related to birth: a prospective longitudinal study in a French population

The objective of the current study is to determine the prevalence of post‐traumatic stress disorder (PTSD) following birth in a French sample, as well as to examine predictive variables. This study collected data from women at four different times: 48 h, 1 month, 4 months and 9 months post‐partum. PTSD symptoms were measured using the Impact of Events Scale‐Revised (IES‐R). Predictive variables were examined with four questionnaires: the Labor Agentry Scale (LAS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS) and a researcher‐designed personal information form. PTSD rates varied from 5% (1 month post‐partum) to 2.9% (9 months post‐partum). Primiparity, birth preparation classes, transfer to a tertiary care centre, perception of external control, feeling of pain during birth and depressive symptoms were significant predictors of the global IES‐R score. Results provide a basis for considering changes in healthcare delivery and prevention programs within the French perinatal healthcare system.

Breast milk donors in France: a portrait of the typical donor and the utility of milk banking in the French breastfeeding context.

Although information regarding attitudes and characteristics of human blood donors has been researched, little is known about the motivations and demographic and personality characteristics of women who choose to donate their breast milk. Eight milk banks in France participated in a study examining donor characteristics, providing data on 103 women. The results showed that the donors were women of average childbearing age with strong support at home. Almost half did not work outside of the home, compared to the national average of 80% of women in this age group; similarly, a large number (currently working or not) were from the health and social services fields. Reasons for donation were largely altruistic, and a general optimistic attitude prevailed within the participants. The results of this study provide useful information for the recruitment of potential donors as well as information on how to facilitate and provide optimal service through milk donation. J Hum Lact. 19(2):199-202.

Support following miscarriage: what women want

Objective: Miscarriage is a frequent pregnancy complication often accompanied by psychological distress. The current study seeks to query women about their desire for support following miscarriage and specific aspects of content, type and timing of support. Method: An experimenter‐designed questionnaire was presented to Internet forums dealing with miscarriage or gynecological medical information. Three hundred and five women participated in the study. Results: The majority of women indicated that they would appreciate support following miscarriage. All proposed interventions appeared useful to women, particularly those dealing with the medical aspects of miscarriage. Women indicated that they felt poorly informed following miscarriage and had particular difficulty dealing with the emotional impact of their miscarriage. Conclusion: The results emphasise the need for providing more comprehensive care for women who have experienced miscarriage and provide information about how support could be best provided

Factors implicated in moderating the risk for depression and anxiety in high risk pregnancy

Objective: The aim of the study was to evaluate depressive and anxious symptoms while examining the impact of self-esteem, social support and coping strategies on these symptoms in women who have been hospitalised for high-risk pregnancies. Method: Fifty-five women from the south of France area hospitalised or on bed rest for high-risk pregnancy completed five scales: the Edinburgh Post-Natal Depression Scale (EPDS), the High Risk Pregnancy Stress Scale (HRPSS), the Revised Prenatal Coping Inventory (NuCPI), the ‘Questionnaire du Soutien Social Perçu’ (QSSP), and the Rosenberg Self-Esteem Scale (RSES). Results: The results show that over half of these women manifest symptoms characteristic of pre-natal depression and the entire sample showed high levels of anxiety symptoms. Predictive factors for depression included informational support and self-esteem; for anxiety, predictive factors were patient age and EPDS scores. Conclusion: This study underscores the importance of providing appropriate psychological support for women with high-risk pregnancies in order to avoid depressive disorders and any potential negative consequences on the perinatal period.

Prevention and treatment of postnatal depression

Postnatal depression is a common condition that may have a significant negative impact on both infant and mother, often remaining undiagnosed and untreated. Development of effective means of detection, prevention and treatment of postnatal depression is a major health challenge. The objective of this article is to critically review pharmacological, psychological and psychosocial approaches of prevention and treatment for postnatal depression. There is little evidence of short-term success for preventive interventions and some evidence of short-term success for treatment interventions. No preventive or therapeutic studies, however, have provided evidence for long-term success. There is a need for future research into the prevention and treatment of postnatal depression including the assessment of long-term effects on the child’s development as well as feasibility in relation to cost–effectiveness.

Attributions of Breastfeeding Determinants in a French Population

BACKGROUND The rates of initiation and duration of breastfeeding in France are low when compared with those in other European countries. The objective of this study was to determine attributions of breastfeeding determinants in a French population. METHODS A self-report survey listing 68 reasons for or against breastfeeding was developed. Nine hundred nine participants from the general population rated their level of agreement with each reason by means of a Likert-type scale. The survey explored gender, age, parenthood, decision to breastfeed, having friends who had breastfed, having family members who had breastfed, and having been breastfed themselves when younger. Exploratory factorial analyses extracted six factors for breastfeeding and five factors against breastfeeding. All the factors were entered in regression analyses to predict demographic variables that determined attributions for and against breastfeeding. Individuals were measured at two points in time to account for test-retest reliability (28.1 days +/- 6.95 day lapse). RESULTS Determinants varied significantly with respect to gender, age, parenthood, and breastfeeding history. High endorsement for breastfeeding involved breastfeeding to fulfill gender roles, to prevent health risks, and because of external encouragement; little endorsement was given for the physiological advantages for babies, pleasant sensations, and preference factors. In terms of not breastfeeding, high endorsement was observed in lack of support, negative attitudes, and infant formula reasoning factors; medical and physiological reasons for not breastfeeding showed low endorsement. CONCLUSIONS The results of this study showed a strong impact of society and cultural norms on feeding choice. If breastfeeding initiation and duration rates are to be increased, we suggest approaching the rest of the population in addition to pregnant women and mothers since society as a whole influences the decision to breastfeed.

Breast feeding initiation and duration: comparison of French and German mothers

BACKGROUND approximately 56% of babies in France are breast fed at birth compared with approximately 91% in Germany. Few studies have compared these neighbouring countries despite the similarities in their social systems. OBJECTIVES to compare breast-feeding initiation and duration from birth to 3 months post partum between French and German mothers, as well as reasons for breast-feeding cessation in the first 3 months. DESIGN mothers were contacted twice during the study: immediately after childbirth and at 3 months post partum. PARTICIPANTS 126 French mothers were recruited during their maternity stay in hospital, and 80 German women were recruited by their midwives and contacted via regular mail. All women were primiparous. METHODS breast-feeding rates at birth and 3 months post partum were collected and compared. In addition, reasons for breast-feeding cessation in the first 3 months were explored and analysed. RESULTS 96% of German women initiated breast feeding at birth and 83% were still breast feeding at 3 months post partum. In comparison, 67% of French women initiated breast feeding at birth and 34% were still breast feeding at 3 months post partum. CONCLUSION there is a need for postnatal follow-up care for French mothers who breast feed. Follow-up care available for German mothers shows encouraging results.

Fatigue and Breastfeeding: An Inevitable Partnership?

Postpartum fatigue is a normal condition that most women experience. Breastfeeding is often associated in women’s minds as contributing to the feeling of overall perceived fatigue, and many women indicate that they have ceased breastfeeding because of fatigue. However, the relationship between feeding choice and perceived fatigue has never been established. Two hundred and fifty-three women participated in a study examining whether perceived fatigue differed for bottle-feeding and breastfeeding women at 3 different times during the postpartum period (2-4 days, 6 weeks, and 12 weeks postpartum). Results showed no significant differences for these 2 groups, suggesting that perceived fatigue during the postpartum period is not dependent on feeding choice. Additional analyses examining other variables with a potential effect were nonsignificant. Because perceived physical fatigue does not appear to be dependent on feeding choice, women should be prepared for the feeling of perceived fatigue during the postpartum period while at the same time be reassured that feeding choice is not correlated.

The relationship between maternal self-esteem, maternal competence, infant temperament and post-partum blues

Background: Several studies emphasise the link between infant temperament and maternal cognitions, particularly in terms of maternal self-esteem and feelings of competence, and how this may affect the post-partum period. Objective: The aim of this study is to evaluate the link between infant temperament, maternal cognitions and post-partum blues. Methods: At 2 days post-partum, 69 women completed three questionnaires along with a form providing sociodemographic data: the Edinburgh Postnatal Depression Scale (EPDS), the Maternal Self-Report Inventory (MSI), and the Mother and Baby Scale (MABS) measuring post-partum blues symptoms, maternal self-esteem and perceptions of competency and infant temperament, respectively. Results: Correlation analyses showed a link between post-partum blues intensity and low maternal self-esteem, an impression of lacking competence in caretaking and feeding abilities, and the perception of the infant as ‘difficult’. A multiple regression analysis showed that the perception of the infant as difficult was predictive of post-partum blues intensity. Conclusion: The data demonstrate how some variables appear to influence post-partum blues and may provide insight into how to better organise both prevention and intervention strategies in this population.