Mental health symptom changes in pregnant individuals across the COVID-19 pandemic: a prospective longitudinal study

Abstract Background Initial studies found that mental health symptoms increased in pregnant and postpartum individuals during the COVID-19 pandemic. Less research has focused on if these putative increases persist over time and what factors influence these changes. We examined the longitudinal change in mental health symptoms in pregnant and postpartum individuals and investigated moderation by maternal emotion dysregulation and the incidence of coronavirus. Methods Pregnant and postpartum individuals at the University of Utah were invited to join the COVID-19 and Perinatal Experiences (COPE) Study. Beginning on April 23, 2020 participants were sent a survey comprised of demographics, medical and social history, pregnancy information and self-assessments (Time 1). Participants were contacted 90 days later and invited to participate in a follow-up questionnaire (Time 2). Daily coronavirus case counts were accessed from the state of Utah and a 7-day moving average calculated. Within-subject change in mental health symptom scores, as measured by the Brief Symptom Inventory, was calculated. Linear mixed effects regression modeling adjusted for history of substance abuse and mental health disorders. Results 270 individuals responded between April 23rd, 2020 and July 15th, 2021. Mental health symptom scores improved by 1.36 points (0.7-2.0 p < 0.001). The decrease in mental health symptoms was not moderated by the prevalence of COVID-19 cases (p = 0.19) but was moderated by emotion dysregulation (p = 0.001) as defined by the Difficulties in Emotion Regulation Scale short form. Participants with higher emotion dysregulation also had higher mental health symptom scores. Conclusion Mental health symptoms improved over the course of the pandemic in the same pregnant or postpartum participant. Our findings do not negate the importance of mental health care during the pandemic. Rather, we believe this identifies some aspect of resiliency and adaptability. Examining emotion dysregulation, or asking about a history of mental health, may be helpful in identifying persons at higher risk of heightened responses to stressors

Further Developments in the Panel of Psychological Inquiry Method of Case Study Research: The Case of "Ronan"

In 2011 our research group published a pilot study—the Case of "Anna"—employing the Panel of Psychological Inquiry (PPI) Clinical Case Study Method. The present study—the Case of "Ronan"—is a second example of the PPI method in action. The Case of Ronan has a number of modifications in method compared to the Case of Anna. First, the Case of Ronan involves the evaluation of a more complex and controversial written case study of a 20-month old boy who was diagnosed with moderate to severe autism spectrum disorder (ASD), and who was treated in a comprehensive therapeutic daycare center program where the core approach was based upon  Greenspan’s (2009) "Developmental, Individual-differences, Relationship-based" ("DIR"/ "Floortime") model. DIR/Floortime was originally developed for use by parents in their own homes, and the Case of Ronan demonstrates how a therapeutic pre-school environment can use DIR/Floortime as a model for most adult-child interactions in a pre-school therapeutic environment.  In addition to the application of the PPI model to a radically different clinical diagnosis, there were  modifications to the methodology itself including: (a) reduction in the number of judges from five to three; (b) having a key witness in the case testify remotely before the Panel; (c) the writing of a much more detailed judges’ opinion on the aspects of the case that most influenced their decisions; and (d) a further development of the logic of a quasi-judicial approach to clinical case studies in psychology. By examining how the civil law’s basic framework for proving causality in cases of personal injury (who did what harm to whom), the process by which knowledge claims that emerge out of clinical practice (who provided what benefit to whom) is further explicated

Association of Cannabis Use With Nausea and Vomiting of Pregnancy.

Our objective was to evaluate whether cannabis use was associated with nausea and vomiting in early pregnancy. Participants from nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) enrolled from October 2010 through September 2013 with a PUQE (Pregnancy-Unique Quantification of Emesis) questionnaire and an available stored urine sample from the first study visit (median gestational age 12 weeks) were included. Cannabis exposure was ascertained by urine immunoassay for 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH); positive results were confirmed with liquid chromatography tandem mass spectrometry. The primary outcome was moderate-to-severe nausea by the PUQE score. Overall, 9,250 participants were included, and 5.8% (95% CI 5.4-6.3%) had detectable urine THC-COOH. In adjusted analyses, higher THC-COOH levels were associated with greater odds of moderate-to-severe nausea (20.7% in the group with THC-COOH detected vs 15.5% in the group with THC-COOH not detected, adjusted odds ratio 1.6, 95% CI 1.1-2.2 for a 500 ng/mg Cr THC-COOH increment)