Y. de Roten

Family interactions in IVF families: change over the transition to parenthood

Objective: This article presents a study of the change over time in the family interactions of couples who conceived through in-vitro fertilisation (IVF). Background: Observational methods are rarely used to study family interactions in families who used assisted reproductive techniques, but these methods are crucial for taking account of the communication that occurs in interactions with infants. Methods: Thirty-one couples expecting their first child were seen during the fifth month of pregnancy and when the child was nine months old. Family interactions were recorded in pre- and postnatal versions of the Lausanne Trilogue Play situation. Measures of marital satisfaction and parent-to-foetus/baby attachment or ‘bonding’ were also used to assess family relational dynamics. Results: Results showed that family alliance, marital satisfaction and parental attachment scores in the IVF sample were all similar to or higher than those in the reference sample during pregnancy. However, at nine months postnatally, the family alliance scores were lower. While marital satisfaction decreased over the period and parent–baby attachment increased, the family alliance scores were unstable, as no association was observed between the pre- and postnatal scores. In addition, neither prenatal marital satisfaction nor parent–foetus attachment predicted the postnatal family alliance. Conclusion: The change in the family alliance over the transition to parenthood appears to be specific to our IVF sample. Given that postnatal family functioning could not be predicted by prenatal family functioning, our observational data underline the importance of offering postnatal support to these families.

Brief Psychoanalytic Psychotherapy for Depressed Inpatient: Best Predictors of Response

Introduction A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. Our one-month randomized controlled trial of very brief psychotherapeutic treatment (12 sessions/4 weeks) showed especially medium to large between effect sizes (BES ranging from .53 to .89) at 3 months follow-up. Objectives This study aims at discovering the predictors of treatment response and remission at discharge and at 3 and 12 months follow-up. Methods The study was a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 167 consecutive adult inpatients with unipolar depression was recruited. Patients were randomly assigned to an adjunctive inpatient brief psychodynamic psychotherapy (IBPP) or psychiatric treatment-as-usual (TAU). The IBPP is a manualized very brief psychotherapeutic program in 12 sessions over 4 weeks. Response and remission were calculated on MADRS and QIDS-SR 16 . Variables included psychopathology (e.g., depression, symptom distress, diagnosis, comorbidity, suicidality, emotion regulation); history (e.g., childhood trauma, onset of the disorder); psychosocial role functioning (e.g., global functioning, social adjustment, Interpersonal functioning, quality of life); demographics ; and therapeutic alliance (with the therapist, with the clinical team). Results The two best predictors of response were (1) the treatment (psychotherapy) and (2) the alliance with the treatment team. Psychotherapy was the best predictor of remission. Conclusions Effective ways of treating depression in inpatient setting depend both on specific treatment programs and on general quality of the relationship with the clinical team.