Prenatal Attachment in Twin Pregnancy

Twin births are associated with several medical, healthcare, socio-emotional, psychological and developmental consequences for families. Parents generally describe twin pregnancies as physically and emotionally difficult. Moreover, compared to singleton pregnancies, twin pregnancies are reported to carry higher maternal as well as perinatal morbidity and mortality. The aim of this chapter is to review literature on twin pregnancy and to give a comprehensive framework about parents’ experience of expecting twins. An important issue related to the psychological adjustment during twin pregnancies is prenatal attachment. During pregnancy, mothers use to think about their child-to-be, and they start to create representation of themselves as mothers. Prenatal attachment in twin pregnancies may differ from that in singleton ones. During a twin pregnancy, the mother-to-be has to deal with an identification process with two children at the same time and have to create a mental space that allow her to make representation of both children. The monitoring of these pregnancies is important for the creation and the consolidation of these maternal representations: ultrasound examinations revealed the fetal gender that facilitates naming the unborn twins and thinking to them as individuals and this is particularly important in the case of complicated twin pregnancies

Using the Transformative Storytelling Technique to Generate Empowering Narratives for Informal Caregivers:Semistructured Interviews, Thematic Analysis, and Method Demonstration

Background: The transformative storytelling technique is an innovative top-down approach to narrative therapy that aims to provide building blocks for creating flourishing narratives for target groups or populations. This approach acts as a facilitator for implementing the human-centered design in developing digital self-help tools for larger samples or target groups.Objective: This study applied the transformative storytelling technique, as a new approach in mental health, to develop empowering audio narratives for informal caregivers.Methods: A narrative inquiry was conducted with 17 informal caregivers (16 women and 1 man) who completed a semistructured interview, “Caregiver Life Story,” acquiring information about the beginning of the role, rising action, and critical point of the role. The participants' ages ranged from 41 to 84 years, with all participants providing care for at least a 6-month period. This inquiry was guided by the transformative storytelling technique, and aimed to collect data relevant to creating fictional stories based on real-life themes.Results: Twenty-five overall themes were distinguished across three a priori-set categories, providing narrative building blocks for the informal caregiver life stories. The final empowering caregiver life story was created as an example for this study, demonstrating the application of the transformative storytelling technique in an informal care context.Conclusions: The creation of empowering stories for populations or target groups in mental health care requires a unified and guided approach that will follow clear guidelines and storytelling principles. The transformative storytelling technique is a first of its kind in the mental health context, representing an initial step in enabling and supporting the creation of meaningful stories and the development of relatable, but productive, narratives. Such narratives have the potential to serve across media and digital platforms for supporting and improving well-being, and potentially triggering self-change in the target group or population.</p

An Italian Study

The literature provides some evidence that the use of violent video games increases the risk for young people to develop aggressive cognitions and even behaviors. We aimed to verify whether exposure to violent video games is linked to problems of aggression in a sample of Italian children. Four questionnaires were administered to 346 children between 7 and 14 years of age, attending primary and secondary schools in Northern Italy. Variables measured were externalization, quality of interpersonal relationships, aggression, quality of coping strategies, and parental stress. Participants who preferred violent games showed higher scores for externalization and aggression. The use of violent video games and age were linked to higher levels of aggression, coping strategies, and the habitual video game weekly consumption of participants. Our data confirm the role of violent video games as risk factors for problems of aggressive behavior and of externalization in childhood and early adolescence

Caring for twins during infancy: A systematic review of the literature on sleeping and feeding practices amongst parents of twins

Objective To better investigate how the parents of twins approach the care of their infants in terms of feeding and sleeping practices after birth by examining the sleeping and feeding behaviours of parents with twin babies. Methods Three electronic databases (PubMed, PsycINFO, and ScienceDirect) were searched, and studies published between 2006 and 2016 were included. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses (Moher et al., 2015) was adopted. Key findings were extracted and synthesised. Results Fourteen studies were included (three focused on sleeping, seven focused on feeding, and four focused on sleeping but considered feeding to be a secondary issue). Conclusion Caring for twins presents unique challenges that require specific choices to be made. The parents of twins could benefit from additional and specially developed advice from health professionals for considering and implementing adequate sleep and feeding practices that reduce parental fatigue and stress, as well as promote parent-twin relationships

Cancer and Pregnancy: becoming parents after an oncological diagnosis in women

The issue of cancer and pregnancy will be increasingly topical giving the rising trend of women diagnosed with cancer during childbearing period. Although oncological progress has allowed women who receive cancer diagnosis before or during pregnancy to satisfy their desire for maternity and to carry on gestation, there is still few awareness. In this chapter we present our research project and results carry out to date. The aim is to better understand challenges of women who experience pregnancy after or during cancer compared with non-oncological sample. We focus on the impact of cancer in the construction of prenatal attachment and related psychological aspects. We study resilience considered as a protective factor in the construction of mother-fetus relationship. Then, we present the results of a qualitative study conducted in order to have a deeper understanding of the psychological dynamics that help women with cancer diagnosis to develop their maternal identity. We explore the topic of breastfeeding in women with cancer history, investigating how the feeding method is related to mother’s mood states. Finally, we present the results about the cortisol concentration measurement during pregnancy. Our results show how it is very important to give women with oncological diagnosis the adequate support during puerperium

Monochorionic twins and the early mother-infant relationship: an exploratory observational study of mother-infant interaction in the post-partum period

The extraordinary increase in twin rates and specifically monochorionic twin pregnancies represents a major public health issue due to the associated increased risks for the mother, the child and their relationship. The aim of the present study was to examine the quality of mothers’ behaviour during mother–infant interaction in the early postpartum period by comparing mothers of twins and mothers of singletons during face-to-face interaction with their infants. Demographic and clinical information was collected by trained research psychologists from the mothers’ and the childrens’ clinical records and from interviews with the mothers. At three months (corrected for prematurity), the interactions of the dyads (11 mother-twin infant dyads and 11 mother-singleton dyads) were filmed at participants’ homes in accordance with the procedure of the Global Rating Scales. Maternal behaviour during interactions was assessed and rated by two trained research psychologists. With regard to the mothers’ interaction with each twin, no differences were found between mothers’ scores in every GRS subscale, indicating that mothers did not interact differently with their twins. Comparisons between mothers of MC twins and mothers of singletons showed that the quality of maternal sensitive behaviour during the interactions were lower in mothers of twins (0.35) Mothers of twins were also more distant during interactions with their babies and more likely to experience depression symptoms than mothers of singletons (0.05). Future research should examine mother-infant relationships following twin birth with larger samples. Such research will be especially useful in evaluating the potential benefits of interventions to promote positive mother-infant interactions

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 &lt; 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

The role of experience in parenting beliefs of British and Italian women during pregnancy

To understand the role of experience in parenting beliefs about caring for infants, we examined the parenting beliefs of pregnant women who were expecting their first child with those of pregnant women who already had at least one other child. A culturally diverse sample of 550 British and Italian women completed self-report measures evaluating their beliefs about the value of attunement and structure in caregiving, parenting self-efficacy, and home chaos. Psychometric evaluation confirmed the two-factor structure of the Baby Care Questionnaire (BCQ) for measuring attunement and structure but did not support configural invariance across the different samples. Beliefs about attunement and structure were related to parenting experience: pregnant women who already had at least one other child reported stronger beliefs in attunement, whereas pregnant women expecting their first child reported stronger beliefs in structure. Regression analyses revealed that the associations between parenting beliefs and experience remained when controlling for country, age, and education. Despite the limitations imposed by the lack of configural invariance, this cross-sectional, cross-cultural study constitutes an important first step in examining the relations between parenting experience and parenting beliefs during pregnancy

Protect, promote and support: a warm chain of breastfeeding for oncological women\u2014results from a survey of young Italian cancer mothers

The objective of this article was to analyse the experience of breastfeeding in new mothers with a history of cancer compared to women without a cancer diagnosis. First, we explored the impact of the cancer diagnosis on the breastfeeding choice. Second, we evaluated the relationship between different feeding methods and the mother\u2019s mood states in women with and without a history of cancer. The sample was composed of 74 mothers divided into two groups: 34 with a cancer history (clinical sample) and 40 without a cancer diagnosis (control group). Participants were requested to complete a questionnaire three months after childbirth which assessed: socio-demographic and clinical data, feeding modes (breastfeeding, formula and mixed feeding) and the profile of mood states (POMS). Results showed that women in the clinical group breastfeed significantly less and use formula more than those in the control group. Moreover, in the clinical group, women who breastfeed feel reported higher levels of confusion (according to POMS) than mothers who bottle-feed or use a mixed feeding method. On the contrary, in the control sample, women who breastfeed feel significantly more vigorous than puerperae who bottle-feed or use mixed methods according to POMS. Our findings suggest the need for a specific warm chain of support and the development of guidelines with clear and specific information for women with a cancer diagnosis in order to reduce their confusion around breastfeeding

The Impact of the COVID-19 Pandemic on Women's Perinatal Mental Health: Preliminary Data on the Risk of Perinatal Depression/Anxiety from a National Survey in Italy

Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18-52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women's mental health programs