78 research outputs found
The child as held in the mind of the mother: The influence of prenatal maternal representations on parenting behaviors
Using a longitudinal design, this study examined the relationship of a motherâs prenatal representation of her child and her parenting behavior with that child at one-year-of-age in a sample of women who were either exposed or not exposed to intimate partner violence (IPV) (n = 164; mean child age = 1.1 years, sd = .11 years; 52% male). Controlling for prenatal IPV, a MANCOVA analysis revealed that prenatal representational typology was significantly related to parenting behavior one year post-partum. Mothers whose representations were affectively deactivated (disengaged) were more behaviorally controlling with their children. Mothers whose representations were affectively overactivated (distorted) were more hostile with their children. Mothers with balanced representations demonstrated more positive parenting. Exposure to IPV did not moderate this relationship. There was no direct association between pre-natal or post-natal IPV and parenting behavior. These findings suggest that prenatal representations influence postnatal parenting behavior in significant and theoretically consistent ways and that this relationship functions similarly for both abused and non-abused women. Results add to the growing literature that internal representations serve to guide behavior throughout development and suggest that maternal working models may be one important link in the intergenerational transmission of attachment relationships
Frailty Syndrome and Main Geriatric Syndromes in Surgical Clinical Picture
The paper represents an original research dedicated to one of the topical issues of the modern geriatrics - frailty syndrome. The rate of the syndrome incidence among the patient of the elderly and old age of the surgical profile has been specified; the increase in prevalence and degree of the frailty syndrome severity in the patients after surgical treatment has been confirme
Intimate Partner Violence, Mental Health, and HPA Axis Functioning
Research results are mixed as to whether stress exerts its damaging effects via under- or over-production of diurnal cortisol. Facets of the stressor itself as well as the mental health sequelae that follow have been put forward as important considerations in determining levels of cortisol secretion. We hypothesized that the contradictory findings in the literature were the result of variable-oriented methods masking the presence of distinctive subgroups of individuals. Using person-oriented methods, we explored whether there were classes of women who exhibited unique profiles of cortisol secretion, stress, and mental health by assessing 182 community women, many of whom had experienced intimate partner violence. The best fitting model in a latent profile analysis had 5 groups, each with distinct profiles of intimate partner violence stress (pregnancy and postpartum), cortisol secretion [cortisol awakening response (CAR) and diurnal slope], and mental health (posttraumatic stress, depressive, and anxiety symptoms). These were a Physiologically Under-Responsive group, a Healthy group, a Problematic CAR group, a Highest Stress/Normal Diurnal Slope group, and a Moderate Psychopathology/Normal Diurnal Slope group. Except for the Healthy group, the specific patterns of stress, mental health symptoms, and cortisol secretion identified in the literature were not found. The profiles were validated using variables that, in prior research, had shown relationships with the variables used to constitute the profilesâthree types of parenting (neglectful, sensitive, and harsh), antisocial behavior, and physical health. We concluded that there is heterogeneity in womenâs responses to stress. Current theories focused on the under- or over-production of diurnal cortisol in relation to stress and mental health symptoms are simplistic and fail to account for the significant subgroups of women who show unique biological and psychological responses.
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The quality of different types of child care at 10 and 18 months. A comparison between types and factors related to quality.
The quality of care offered in four different types of non-parental child care to 307 infants at 10 months old and 331 infants at 18 months old was compared and factors associated with higher quality were identified. Observed quality was lowest in nurseries at each age point, except that at 18 months they offered more learning activities. There were few differences in the observed quality of care by child-minders, grandparents and nannies, although grandparents had somewhat lower safety and health scores and offered children fewer activities. Cost was largely unrelated to quality of care except in child-minding, where higher cost was associated with higher quality. Observed ratios of children to adults had a significant impact on quality of nursery care; the more infants or toddlers each adult had to care for, the lower the quality of the care she gave them. Mothers' overall satisfaction with their child's care was positively associated with its quality for home-based care but not for nursery settings
Behavioral Coping Phenotypes and Associated Psychosocial Outcomes of Pregnant and Postpartum Women During the COVID-19 Pandemic
The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (Nâ=â2876) and postpartum women (Nâ=â1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic
Interventions targeting social isolation in older people: a systematic review
This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. METHODS: Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. RESULTS: Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. CONCLUSIONS: More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.National Institute for Health Researc
Person-Oriented and Variable-Oriented Research: Concepts, Results, and Development
Variable-oriented empirical research is based on the proposition that populations are homogeneous. Person-oriented research is based on the propositions that (1) distinct subgroups may exist and (2), if they exist, aggregate-level parameters may contradict parameters estimated for groups or individuals. This article first reviews the main tenets of person-oriented research with respect to developmental research. Three criteria of person-oriented research are proposed: (1) data are analyzed under the assumption that they were drawn from more than one population; (2) attempts are made to establish the external validity of groupings; and (3) groupings are interpreted based on theory. Illustrations use sample studies from the literature, for which both variable-oriented and person-oriented results are presented. Two groups of theorems and propositions of personoriented research are presented. The first group is method-centered and posits that parameter estimates can be group-specific. Thus, aggregation can lead to conclusions that describe none of the individuals or groups in a population validly. The second, new group posits that certain data situations are particularly prone to misleading conclusions after aggregation. Finally, the ecological fallacy is discussed as one of the chief reasons why person-oriented research is necessary. Conditions for proper variable- and person-oriented research are outlined
Women survivors of intimate partner violence and post-traumatic stress disorder: Prediction and prevention
A considerable body of research has demonstrated that women who are abused by their male romantic partners are at substantially elevated risk for the development of post-traumatic stress disorder (PTSD). This article reviews recent literature regarding intimate partner violence (IPV) and resultant PTSD symptoms. The article is intended to be an introduction to the topic rather than an exhaustive review of the extensive literature in this area. Factors that enhance and reduce the risk for PTSD, including social support, coping styles, and types of abusive behavior experienced, are described. In addition, the unique risks associated with IPV for women who have children are discussed. Prevention efforts and treatment are briefly reviewed
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