Prenatal attachment, distress symptoms and psychosocial variables in a sample of Italian first-time parents

Background. The term prenatal attachment refers to the bonding that parents develop towards the unborn baby. It is considered a precursor of the care-giving system and there is evidence that it could affect the parent-child relationship. Literature provides the knowledge of predictors of poor maternal prenatal attachment. However, paternal prenatal attachment is rarely studied and few studies have investigated prenatal attachment in couples. Aim: The study aims at evaluating the relationship between prenatal attachment, distress symptoms and selected psychosocial variables in couples in the third trimester of pregnancy. Methods: First-time parents attending public antenatal clinics were recruited into the study. A set of questionnaires investigated: sociodemographic, psychosocial and pregnancy related variables, depression and anxiety symptoms, distress and prenatal attachment. Results: Multiple linear regression showed that the woman\u2019s worries about pregnancy, her perceived social support, age and disappointment with the child\u2019s gender were independent predictors of maternal prenatal attachment. The degree of involvement toward the fetus by the father, his perception of the partner\u2019s attitude towards him during pregnancy and the impact of distress were independent predictors of paternal prenatal attachment. The results indicate several areas amenable to intervention by healthcare professionals to support couples in the transition of parenthood

Salute psichica e prevenzione nella perinatalità.

Riassunto Il periodo perinatale - definito nell’ambito della salute psichica come l’arco di tempo che si estende dal concepimento fino al primo anno successivo al parto - per le profonde trasformazioni biologiche, psichiche e sociali che comporta, rappresenta una fase di aumentato rischio per la salute psichica genitoriale con conseguenze che possono rivelarsi gravi e a volte drammatiche. Negli ultimi decenni la ricerca si è estesa dallo studio dei disturbi tipici del post partum a quelli del periodo prenatale evidenziando come i disturbi dell’umore e i disturbi d’ansia siano presenti in misura notevole anche nelle fasi della gravidanza e come il disagio psichico perinatale interessi anche i padri. Attualmente è disponibile una robusta conoscenza scientifica rispetto a fattori di rischio, prevalenza, ricadute e cronicità che i disturbi mentali perinatali presentano, così come sono ben conosciute le conseguenze che un disagio psichico perinatale comporta sullo sviluppo psicologico ed emotivo infantile. Tali evidenze sottolineano la necessità di predisporre programmi di prevenzione al fine di individuare precocemente le situazioni di disagio emotivo, assicurando un trattamento tempestivo e adeguato. La letteratura propone linee guida e modelli di prevenzione basati sulla formazione degli operatori in una visione integrata e multidisciplinare dell’assistenza nel periodo perinatale

Pre-natal Attachment and Parent-To-Infant Attachment: A Systematic Review

During the perinatal period, the establishment of the attachment relationship with the fetus and subsequently with the real child is crucial for the parents’ and the child’s well-being. Coherently with the assumption that the attachment relationship starts to develop during pregnancy, this systematic review aims to analyze and systematize studies focused on the association between pre-natal attachment and parent-to-infant attachment, in order to clarify the emerging results and provide useful information for clinical purposes. Nineteen studies were included. Sixteen researches identified a positive relationship between pre-natal attachment and parent-to-infant attachment, and three articles highlighted a negative association between antenatal attachment and post-partum bonding disorders. These results were found both in women and men, in normative and at-risk pregnancies, adopting different assessment approaches (i.e., self-report measures, observations, and projective measures). However, only small or moderate associations were found. Future studies are needed to further confirm these findings across different populations (e.g., male samples, non-normative samples or samples in disadvantaged conditions) and with different methodological approaches (e.g., observational measures). Moreover, studies would be needed in order to clarify mechanisms through which pre-natal attachment influences parent-to-infant attachment, as well as protective and risk factors which intervene between these two variables

The Walsh family resilience questionnaire: The Italian version

Background: Resilience focuses on strength under stress, in the context of adversity. Walsh\u2019s theoretical model identifies relational processes that allow families to tackle and overcome critical situations, dividing them into three domains of family function. The aim of this study was to assess resilience in families of patients with a chronic disease by adapting and validating the Italian version of the Walsh Family Resilience Questionnaire (Walsh-IT). Patients and methods: An Italian adult sample of 421 participants (patients and relatives) was collected with the aim to assess the reliability and validity of the Walsh-IT. Concurrent validity was carried out by comparing this instrument with the Family Adaptability and Cohesion Evaluation Scale III (FACES III) administered at the same time as the Walsh-IT. Results: Reliability showed high correlation between repeated measurements. The alpha coefficient was 0.946. Both parallel analysis and minimum average partial criteria suggested that the best number of domains is equal to 3, explaining 50.4% of the total variance. Based on the results obtained from the Rasch analysis, items 10, 11, 16, 22, and 23 have been removed resulting in a short-form questionnaire (Walsh-IT-R) of 26 items with three domains: shared beliefs and support (SBS, \u3b1=0.928); family organization and interaction (FOI, \u3b1=0.863); and utilization of social resources (USR, \u3b1=0.567). The total score of the Walsh-IT-R was strongly correlated with the total score of FACES III Real Family Scale (r=0.68; p,0.0001). Conclusion: Results support that the Walsh-IT-R is a valid instrument for the assessment of family resilience in Italy when contending with the challenges of chronic disease. It could be used in pre- and post-assessment in practice effectiveness research, offering a profile of family resilience processes at the start and end of interventions and follow-up

The Italian language postpartum specific anxiety scale [PSAS-IT]: translation, psychometric evaluation, and validation

IntroductionWhile often positive, the lifecourse transition to motherhood is susceptible to the risk for developing mood disorders. Postpartum anxiety has often been overshadowed by other perinatal-specific mental health disorders, such as postpartum depression, and therefore has not been at the forefront or center of as much empirical study. This has meant there is a lack of effective and reliable tools with which to measure it, despite growing evidence suggesting its detrimental impact on mothers, their babies, wider family and social contacts, and on healthcare systems. This current study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] into the Italian language, and to validate the tool for its use in detecting anxiety specific to motherhood.MethodsThe study (N = 457) comprised 4 stages: English-Italian translation and back-translation to obtain the Italian version [PSAS-IT]; a preliminary pilot study to adapt the PSAS to the characteristics of the Italian population; measurement invariance; and internal reliability of subscales.ResultsThe PSAS-IT demonstrates similar psychometric properties as the original English-language PSAS, with acceptable acceptability, construct and convergent validity, and internal consistency. Confirmatory factor analysis for multiple groups (Italy and United Kingdom) showed that the factor structure of the PSAS was valid for both groups [χ2 (2436) = 4679.481, p < 0.001, TLI = 0.969, CFI =0.972, RMSEA = 0.045, SRMR =0.064].DiscussionThe resulting findings offer a reliable measure of postpartum anxiety in Italian language up to six months after birth

Clinical Psychology of Aging: the Italian Manifesto

In the context of Italian aging population, clinical psychology can play a crucial role in enabling older adults to cope with the multiple challenges associated with the aging process and disease-related issues. This manifesto was  written by the 'Clinical Psychology of Aging' working group, which is part of the Italian Association of Psychology (AIP) consisting of academic experts in this field  who collaborated to elaborate the contents highlighting the most relevant dimensions of the clinical psychology of aging. Specifically, the aging process was addressed from multiple points of view (i.e., theoretical perspectives, multidimensional assessment, interventions), and the role of the clinical psychologists in the National Health System along with training issues were discussed in the attempt to specify  the unique contribution  of the clinical psychology in aging