Strong Military Families Intervention Enhances Parenting Reflectivity And Representations In Families With Young Children

Military families face many challenges due to deployment and parental separation, and this can be especially difficult for families with young children. The Strong Military Families (SMF) intervention is for military families with young children, and consists of two versions: the Multifamily Group, and a Home‐based psychoeducational written materials program. The Multifamily Group was designed to enhance positive parenting through both educational components and in vivo feedback and support during separations and reunions between parents and children (n = 78 parents). In the present study, we examine parenting reflectivity and mental representations in mothers versus fathers in military families, service members versus civilian spouses/parenting partners, and before versus after participation in the SMF Multifamily Group and Home‐based interventions. Parenting reflectivity and mental representations were coded from the Working Model of the Child Interview (WMCI; C.H. Zeanah & D. Benoit, 1995). Results suggest that neither parenting reflectivity nor WMCI typology differs between mothers and fathers in military families, or between service members and civilian parenting partners. Furthermore, there was substantial stability in parenting reflectivity and WMCI typology from baseline to posttest, but participation in the Multifamily Group, relative to Home‐based, was associated with improvements in both parenting reflectivity and WMCI ratings from baseline to postintervention.RESUMENLas familias militares enfrentan muchos retos debido a las distantes asignaciones de servicio y la separación de los padres, lo cual puede ser específicamente difícil para familias con niños pequeños. La intervención Familias Militares Fuertes (SMF) es para familias militares con niños pequeños y consta de dos versiones: un Grupo Múltiple de Familias y un programa sicoeducativo de materiales escritos con base en casa. El Grupo Múltiple de Familias se diseñó para mejorar la crianza positiva tanto a través de componentes educativos como de reacciones y apoyo en vivo durante las separaciones y reuniones entre padres y niños (n = 78 padres). En el presente estudio, examinamos el poder de reflexión sobre la crianza y las representaciones mentales en mamás vs. papás en familias militares, miembros del servicio militar vs. cónyuges civiles/parejas conyugales en la crianza, y antes vs. después de la participación en el Grupo Múltiple de Familias SMF y en las intervenciones con base en casa. El poder de reflexión sobre la crianza y las representaciones mentales se codificaron usando el Modelo de Trabajo de la Entrevista del Niño –WMCI‐ (Zeanah y Benoit, 1995). Los resultados sugieren que ni el poder de reflexión ni la tipología del WMCI difieren entre mamás y papás en familias militares, o entre miembros del servicio militar y sus parejas conyugales civiles en la crianza. Es más, se dio una estabilidad de importancia en el poder de reflexión y la tipología WMCI entre el punto de referencia y la examinación posterior, pero la participación en el Grupo Múltiple de Familias, en relación con la intervención en casa, se asoció con mejoras tanto en el poder de reflexión como en los puntajes WMCI entre el punto de referencia y la intervención posterior.RÉSUMÉLes familles de militaires font face à de nombreux défis du fait des déploiements et de la séparation parentale, et cela peut s’avérer particulièrement difficile pour les familles avec de jeunes enfants. L’intervention Familles Militaires fortes (ici abrégé en français FMF, SMF en anglais, pour Strong Military Families) est destinée aux familles de militaires avec de jeunes enfants et consiste en deux versions: un Groupe Multifamilial, et une intervention à domicile avec programme de matériel psychoéducatif écrit. Le Groupe Multifamilial a été conçu afin de mettre en valeur le parentage positif à travers des composantes éducatives et du feedback in vivo et du soutien durant les séparations et les réunions entre les parents et les enfants (n = 78 parents). Dans cette étude nous examinons la réflectivité de parentage et les représentations mentales chez les mères et les pères de familles de militaires, les membres du service comparés aux épouses civiles et aux partenaires de parentage civils, et avant par rapport à après la participation au Groupe Multifamilial FMF et les interventions à domicile. La réflectivité de parentage et les représentations mentales ont été codées à partir du Modèle de Travail de l’Entretien de l’Enfant (Zeanah & Benoit, 1995). Les résultats suggèrent que ni la réflectivité de parentage ni le Modèle de Travail de l’Entretien de l’Enfant ne diffèrent entre les mères et les pères dans les familles militaires ou entre les membres du service et les partenaires de parentage civils. De plus il y avait une stabilité importante dans la réflectivité de parentage et la typologie du Modèle de Travail de l’Entretien de l’Enfant du niveau de référence jusqu’après le test, mais la participation au Groupe Multifamilial, par rapport à la participation à domicile, était liée à des améliorations dans à la fois la réflectivité de parentage et les scores du Modèle de Travail de l’Entretien de l’Enfant du niveau de référence à après l’intervention.ZUSAMMENFASSUNGMilitärische Familien stehen durch den Einsatz und die Trennung der Eltern vor vielen Herausforderungen, was besonders für Familien mit Kleinkindern schwierig sein kann. Die Intervention „Strong Military Families“ (SMF) richtet sich an Militärfamilien mit Kleinkindern und besteht aus zwei Versionen: Aus einer Mehrfamiliengruppe und einem psychoedukativen schriftlichen Materialprogramm für Zuhause. Die Mehrfamiliengruppe wurde entwickelt, um die positive Elternschaft sowohl durch pädagogische Komponenten als auch durch in vivo Feedback und Unterstützung bei Trennungen und Wiedervereinigungen zwischen Eltern und Kindern (n = 78 Eltern) zu fördern. In der vorliegenden Studie untersuchen wir die Reflektivität und mentalen Repräsentationen von Eltern bei Müttern vs. Vätern in militärischen Familien, Dienstmitgliedern vs. zivilen Ehepartnern/Erziehungspartnern und vor vs. nach der Teilnahme an der SMF Mehrfamiliengruppe und psychoedukativen Intervention Zuhause. Die elterliche Reflektivität und mentalen Repräsentationen wurden aus dem “Working Model of the Child Interview” (WMCI; Zeanah & Benoit, 1995) kodiert. Die Ergebnisse deuten darauf hin, dass sich weder die elterliche Reflektivität noch die Typologie der WMCI zwischen Müttern und Vätern in Militärfamilien oder zwischen Dienstmitgliedern und zivilen Ehepartnern unterscheiden. Außerdem gab es eine beträchtliche Stabilität in der elterlichen Reflektivität und WMCI‐Typologie vom Beginn der Untersuchungen bis zum Post‐Test, aber die Teilnahme an der Mehrfamiliengruppe, im Vergleich zur psychoedukativen Intervention Zuhause, war mit Verbesserungen sowohl in der elterlichen Reflektivität als auch in der WMCI‐Bewertung vom Untersuchungsbeginn zur Post‐Intervention verbunden.抄録強い軍人家族介入 The Strong Military Families が、 幼い子どものいる家族における育児の内省性 Reflectivity と表象を増強する軍人家族は配属や親との分離のために多くの困難に直面する。そしてこれは幼い子どものいる家族には特に困難になり得る。強い軍人家族The Strong Military Families (SMF)介入は、幼い子どものいる軍人家族のためのもので、2つの型がある。それらは、複数家族グループと資料を用いて家庭で行う心理教育的プログラムである。複数家族グループは、教育的な要素および親子の分離と再会のその場でのフィードバックと支援の両者を通して、ポジティブな育児を増強するようにデザインされた(n = 78人の親)。この研究では、私たちは、軍人家族の母親対父親、軍人対民間人の配偶者/養育パートナー、そしてSMF複数家族グループと家庭での介入に参加前対参加後において、育児の内省性と心的表象を調査した。育児の内省性と心的表象は、the Working Model of the Child Interview (Zeanah & Benoit, 1995) によってコード化された。結果から、軍人家族の母親と父親、あるいは軍人と民間人の養育パートナーの間に、育児の内省性あるいはWMCIタイプについて違いは示されなかった。さらに、基準線からテスト後にかけて、育児の内省性およびWMCIタイプにかなりの安定性があったが、家庭におけるプログラムに比べて、複数家族グループに参加することは、育児の内省性およびWMCI評価の両者の基準線から介入後への改善と関連していた。摘要強大軍人家庭干預增強在有子女家庭中的育兒反思能力和表現由於軍事部署和父母在不同地方居住, 軍人家庭面臨許多挑戰, 這些挑戰對於有小孩的家庭尤其嚴重。強大軍人家庭干預 (SMF) 是為有小孩的軍人家庭進行的干預, 包括兩個版本: 一個多家庭小組和一個家庭式的心理教育書面材料計劃。多家庭小組旨在通過教育丶反饋和支持, 在父母與子女 (78名父母) 的分離和團聚期間, 加強積極的父母教養。在本研究中, 我們考察在軍人家庭丶服務人員與平民配偶/養育夥伴的父母, 以及參與 SMF 多家庭小組和家庭式干預前後的父母反思和心理表徵。我們以兒童訪談的工作模式 (Zeanah&Benoit, 1995), 編碼父母反思能力和心理表徵。結果表明, 在軍人家庭父母之間, 或服務人員和平民養育夥伴之間, 父母反思能力和WMCI類型學並無不同。此外, 從基線到測試後, 父母反思能力和WMCI類型相當穩定, 但和家庭式干預相比, 多家庭小組的參與, 與從基線到干預後的父母反思能力和WMCI評分之改善相關。ملخصالتدخل القوى عند العائلات العسكرية يعزز الأداء التأملي الوالدي والتمثيلات الذهنية في الرعاية الوالدية للعائلات تجاه أطفالهم الصغارالعائلات العسكرية تواجه كثيرا من التحديات بسبب حركات التنقل العسكري والانفصال بين الوالدين وهذا يكون أشد صعوبة بالنسبة للعائلات ذوي الأطفال الصغار. التدخل القوي للعائلات العسكرية (SMF) هو برنامج يتكون من جانبين: مجموعة متعددة الأسر وبرنامج منزلي للمواد التعليمية النفسية المكتوبة. تم تشكيل المجموعة متعددة الأسر لتعزيز الرعاية الوالدية الإيجابية من خلال مكونات تعليمية وتغذية مرتدة ودعم أثناء فترات انفصال الأسر ولم الشمل بين الوالدين والأطفال (n = 78). في الدراسة الحالية نستخدم الأداء التأملي الوالدي والتمثيلات الذهنية عند الأمهات مقابل الآباء في الأسر العسكرية وأفراد الخدمة بالمقارنة مع الأزواج والوالدين المدنيين وكذلك المقارنة بين قبل وبعد المشاركة في برنامج (SMF). تم ترميز الأداء التأملي الوالدي والتمثيلات الذهنية من خلال النموذج العامل للمقابلة الشخصية مع الطفل (زينة وبينوا 1995). تشير النتائج إلى عدم اختلاف الأداء التأملي الوالدي ونمط النموذج العامل لمقابلة الطفل (WMCI) بين الآباء والأمهات في الأسر العسكرية أو بين أفراد الخدمة والأزواج والآباء المدنيين. بالإضافة إلى ذلك كان هناك استقرار جوهري في الأداء التأملي الوالدي ونمط النموذج العامل بين خط البداية والاختبار البعدي ولكن المشاركة في مجموعة متعددة الأسر بالمقارنة مع البرنامج المنزلي كانت مقترنة بتحسن في كل من الأداء التأملي الوالدي وتقييمات (WMCI) بين خط البداية وتدخل الاختبار البعدي.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141683/1/imhj21690_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141683/2/imhj21690.pd

Measurement of motherinfant interactions and the home environment in a European setting: preliminary results from a cross-cultural

Background: Infant development is adversely affected in the context of postnatal depression. This relationship may be mediated by both the nature of early motherinfant interactions and the quality of the home environment. Aim: To establish the usefulness of the Global Ratings Scales of MotherInfant Interaction and the InfantToddler version of the Home Observation for the Measurement of the Environment (ITHOME), and to test expected associations of the measures with characteristics of the social context and with major or minor depression. Method: Both assessments were administered postnatally in four European centres; 144 mothers were assessed with the Global Ratings Scales and 114 with the ITHOME. Affective disorder was assessed by means of the Structured Clinical Interview for DSMIV Disorders. Results: Analyses of motherinfant interaction indicated no main effect for depression but maternal sensitivity to infant behaviour was associated with better infant communication, especially for women who were not depressed. Poor overall emotional support also reduced sensitivity scores. Poor support was also related to poorer ITHOME scores, but there was no effect of depression. Conclusions: The Global Ratings Scales were effectively applied but there was lessCIHR184pub152

Depression during pregnancy: detection, comorbidity and treatment

Depression during pregnancy is common (∼15%). Routine prenatal depression screening coupled with the use of physician collaborators to assist in connecting women with care is critical to facilitate treatment engagement with appropriate providers. Providers should be aware of risk factors for depression – including a previous history of depression, life events, and interpersonal conflict – and should appropriately screen for such conditions. Depression during pregnancy has been associated with poor pregnancy outcomes including preeclampsia, insufficient weight gain, decreased compliance with prenatal care, and premature labor. Current research has questioned the overall benefit of treating depression during pregnancy with antidepressants when compared to the risk of untreated depression for mother and child. Published guidelines favor psychotherapy above medication as the first line treatment for prenatal depression. Poor neonatal adaptation or withdrawal symptoms in the neonate may occur with fetal exposure in late pregnancy, but the symptoms are mild to moderate and transient. The majority of mothers who decide to stop taking their antidepressants during pregnancy suffer relapsing symptoms. If depression continues postpartum, there is an increased risk of poor mother–infant attachment, delayed cognitive and linguistic skills in the infant, impaired emotional development, and behavioral problems in later life. Bipolar depression, anxiety and substance use disorders, and/or presence of severe psychosocial stress can lead to treatment-resistance. Modified and more complex treatment algorithms are then warranted. Psychiatric medications, interpersonal or cognitive-behavioral therapy, and adjunctive parent–infant/family treatment, as well as social work support, are modalities often required to comprehensively address all issues surrounding the illness.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79238/1/j.1758-5872.2010.00051.x.pd

Are commonly used self-report inventories suitable for screening postpartum depression and anxiety disorders?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66459/1/j.1600-0447.2000.102001071.x.pd

Inhibition of synaptic transmission by anandamide precursor 20:4-NAPE is mediated by TRPV1 receptors under inflammatory conditions.

Transient receptor potential ion channel, vanilloid subfamily, type 1 (TRPV1) cation channel, and cannabinoid receptor 1 (CB1) are essential in the modulation of nociceptive signaling in the spinal cord dorsal horn that underlies different pathological pain states. TRPV1 and CB1 receptors share the endogenous agonist anandamide (AEA), produced from N-arachidonoylphosphatidylethanolamine (20:4-NAPE). We investigated the effect of the anandamide precursor 20:4-NAPE on synaptic activity in naive and inflammatory conditions. Patch-clamp recordings of miniature excitatory postsynaptic currents (mEPSCs) from superficial dorsal horn neurons in rat acute spinal cord slices were used. Peripheral inflammation was induced by subcutaneous injection of carrageenan. Under naive conditions, mEPSCs frequency (0.96 ± 0.11 Hz) was significantly decreased after 20 μM 20:4-NAPE application (55.3 ± 7.4%). This 20:4-NAPE-induced inhibition was blocked by anandamide-synthesizing enzyme N-acyl phosphatidylethanolamine phospholipase D (NAPE-PLD) inhibitor LEI-401. In addition, the inhibition was prevented by the CB1 receptor antagonist PF 514273 (0.2 μM) but not by the TRPV1 receptor antagonist SB 366791 (10 μM). Under inflammatory conditions, 20:4-NAPE (20 μM) also exhibited a significant inhibitory effect (74.5 ± 8.9%) on the mEPSCs frequency that was prevented by the TRPV1 receptor antagonist SB 366791 but not by PF 514273 application. Our results show that 20:4-NAPE application has a significant modulatory effect on spinal cord nociceptive signaling that is mediated by both TRPV1 and CB1 presynaptic receptors, whereas peripheral inflammation changes the underlying mechanism. The switch between TRPV1 and CB1 receptor activation by the AEA precursor 20:4-NAPE during inflammation may play an important role in nociceptive processing, hence the development of pathological pain

Psychometric Characteristics of the Connor-Davidson Resilience Scale (CD-RISC) in Postpartum Mothers with Histories of Childhood Maltreatment

Background: There is increased awareness that resilience serves as a protective factor against adverse psychophysiological sequelae in the context of stress. However, there are few instruments to assess this construct in adult populations. The Connor-Davidson resilience scale (CD-RISC) has been developed to assess adaptation following stress exposure. While this instrument has previously demonstrated impressive reliability and construct validity, prior research has not supported the consistency of the originally described factor structure. There is also limited evidence regarding the measurement of resilience in the context of cumulative stress exposure. Objectives: This research explores the psychometric properties of the CD-RISC in mothers with childhood histories of maltreatment Materials and Methods: Postpartum women who endorsed a history of childhood abuse or neglect (N = 141) completed the CD-RISC, the childhood trauma questionnaire and other surveys measuring positive and negative health and functioning. We calculated descriptive statistics with percentage counts and means as appropriate. Internal reliability was evaluated by Cronbach’s alpha and the calculation of item-to-total score correlations. Parallel analysis (PA) was utilized to derive the number of retained factors. Results: A recent parenting transition concomitant with a history of maltreatment was associated with lower CD-RISC scores. Internal reliability and concurrent validity analyses were satisfactory and consistent with predicted hypotheses. Exploratory factor analysis (EFA) supported a four-factor model of resilience with this population. Conclusions: This research offers further evidence of the reliability and validity of the CD-RISC. Further, the results of the EFA with parallel analysis offer an empirically-driven derivation of factors for this population

Community- delivered infant- parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting

The current study evaluated the effectiveness of a home- based psychotherapeutic Infant Mental Health Home Visiting (IMH- HV) intervention for enhancing parenting sensitivity; a secondary aim was to evaluate whether the use of video feedback was associated with greater treatment response. Participants were N = 78 mothers and their children (age at entry ranged from prebirth to 24- month old (M = 9.8, SD = 8.4), who were initiating IMH- HV services with community mental health- based therapists (N = 51). Dyads were assessed during extended home visits via standardized interviews and observational and questionnaire methods within the first month of treatment (baseline), and again 6 and 12 months thereafter. Following each of these extended home visits, study evaluators completed a standard Q- sort to capture observations of maternal sensitivity during the visit. Therapists completed fidelity checklists used to derive the total number of IMH- HV sessions received (i.e., dosage) and frequency with which therapists provided video feedback. Results indicated a dose- response relationship between number of sessions and maternal sensitivity, and that video review with parents independently contributed to improved maternal sensitivity. Discussion focuses on the effectiveness of this community- based psychotherapeutic home visiting model for enhancing parenting, as well as the value of video feedback as a specific therapeutic strategy.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154891/1/imhj21840_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154891/2/imhj21840.pd

Gelatinase-A (MMP-2), gelatinase-B (MMP-9) and membrane type matrix metalloproteinase-1 (MT1-MMP) are involved in different aspects of the pathophysiology of malignant gliomas

Matrix metalloproteinases (MMPs) have been implicated as important factors in gliomas since they may both facilitate invasion into the surrounding brain and participate in neovascularization. We have tested the hypothesis that deregulated expression of gelatinase-A or B, or an activator of gelatinase-A, MT1-MMP, may contribute directly to human gliomas by quantifying the expression of these MMPs in 46 brain tumour specimens and seven control tissues. Quantitative RT-PCR and gelatin zymography showed that gelatinase-A in glioma specimens was higher than in normal tissue; these were significantly elevated in low grade gliomas and remained elevated in GBMs. Gelatinase-B transcript and activity levels were also higher than in normal brain and more strongly correlated with tumour grade. We did not see a close relationship between the levels of expression of MT1-MMP mRNA and amounts of activated gelatinase-A. In situ hybridization localized gelatinase-A and MT1-MMP transcripts to normal neuronal and glia, malignant glioma cells and blood vessels. In contrast, gelatinase-B showed a more restricted pattern of expression; it was strongly expressed in blood vessels at proliferating margins, as well as tumour cells in some cases. These data suggest that gelatinase-A, -B and MT1-MMP are important in the pathophysiology of human gliomas. The primary role of gelatinase-B may lie in remodelling associated with neovascularization, whereas gelatinase-A and MT1-MMP may be involved in both glial invasion and angiogenesis. © 1999 Cancer Research Campaig

Randomized pilot trial of the “Mom Power” trauma- and attachment-informed multi-family group intervention in treating and preventing postpartum symptoms of depression among a health disparity sample

IntroductionPerinatal depression, a common complication related to childbearing, impacts mothers, children, and families. Efficacious interventions reduce perinatal depression symptoms; effort is needed to prevent the onset of perinatal depression. To determine feasibility and preliminary efficacy in reducing perinatal depression, we conducted a community-based, randomized parallel open pilot trial of Mom Power, a group-based intervention to improve mental health and parenting in mothers with young children.MethodsMom Power consists of 10 group sessions, focused on parenting, child development and self-care and three individual sessions, to build rapport and provide personalized referrals. Control group participants received psychoeducational mailings. Computer-based urn randomization assigned mothers with experiences of interpersonal violence, depression, or other traumatic experiences to Mom Power (68) or control (54).ResultsAt 3-months post-treatment, the 31 retained women assigned to Mom Power were half as likely to meet criteria for probable depression (26%) as the 22 women retained in the control group (55%), with treatment predicting lower incidence of probable depression (OR = 0.13, p = 0.015). Moreover, among the 23 women who did not meet criteria for depression diagnosis at baseline, no women in the treatment group developed depression (n = 0, 0%) compared to control group women (n = 3, 30%). Logistic regression controlling for selective attrition confirmed the treatment effect on preventing new onset of depression (OR = 0.029, p = 0.012).ConclusionThese findings support the use of Mom Power for both treatment and prevention of perinatal depression.Clinical trial registrationhttps://classic.clinicaltrials.gov/ct2/show/NCT01554215, NCT01554215