The association of attachment style, postpartum PTSD and depression with bonding- A longitudinal path analysis model, from childbirth to six months.

BACKGROUND: There is substantial evidence that postpartum depression (PPD) is associated with a poor mother-infant bond, however, fewer studies have examined the role of other postpartum psychopathologies such as birth-related PTSD or relevant trait variables such as adult attachment styles in the quality of the mother-infant bond. METHODS: 210 postpartum women were sampled in a maternity ward of a tertiary health care center. Participants completed questionnaires at three-time points. Demographics questionnaire and the Adult Attachment style scale were administrated at 1-4 days postpartum, the City Birth Trauma Scale and the Edinburgh Postpartum Depression Scale two months postpartum and the Postpartum Bonding questionnaire at six months postpartum. RESULTS: The associations between adult attachment styles and postpartum bonding were fully mediated by postpartum psychopathology. Avoidant attachment had indirect effects on bonding through general PTSD symptoms (Beta=0.05, p=.019) and PPD (Beta=0.06, p=.010). Anxious attachment also had indirect effects on bonding through general PTSD symptoms (Beta=0.04, p=.044) and PPD (Beta=0.10, p=.001). In contrast, birth-related PTSD symptoms were not associated with bonding. The model presented a good fit. LIMITATIONS: Women sampled from one health-care center and self-report measures used. CONCLUSIONS: Our results suggest that although birth-related PTSD symptoms may cause difficulties, importantly they may not be associated with bonding difficulties six months postpartum. Therefore, women could be reassured that their birth-related PTSD symptoms, may not impact on bonding. Consequently, if interventions are specifically aimed at improving the mother-infant bond, the general-related PTSD, PPD symptoms and insecure attachment styles should be the focus of treatment

Ambulatory blood pressure adaptations to high-intensity interval training: a randomized controlled study

Objective: Hypertension remains the leading cause of cardiovascular disease and premature mortality globally. Although high-intensity interval training (HIIT) is an effective nonpharmacological intervention for the reduction of clinic blood pressure (BP), very little research exists regarding its effects on ambulatory BP. The aim of this study was to measure alterations in ambulatory and clinic BP following HIIT in physically inactive adults. Methods: Forty-one participants (22.8 \u10fc14 2.7 years) were randomly assigned to a 4-week HIIT intervention or control group. The HIIT protocol was performed on a cycle ergometer set against a resistance of 7.5% bodyweight and consisted of 3 \u10fc15 30-s maximal sprints separated with 2-min active recovery. Clinic and ambulatory BP was recorded pre and post the control period and HIIT intervention. Results: Following the HIIT intervention, 24-h ambulatory BP significantly decreased by 5.1 mmHg in sBP and 2.3 mmHg in dBP (P 1⁄4 0.011 and 0.012, respectively), compared with the control group. In addition, clinic sBP significantly decreased by 6.6 mmHg compared with the control group (P 1⁄4 0.021), with no significant changes in dBP and mean BP (mBP). Finally, 24-h ambulatory diastolic, daytime sBP, mBP and dBP, and night-time sBP and mBP variability significantly decreased post-HIIT compared with the control group. Conclusion: HIIT remains an effective intervention for the management of BP. Our findings support enduring BP reduction and improved BP variability, which are important independent risk factors for cardiovascular disease

High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men

Background: This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). Methods: Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7± 5.2 yrs) (LEX; n = 17, aged= 61.1 ± 5.4 yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6 weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. Results: The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each P b 0.05) in SED and increased MET capacity in both SED and LEX (P b 0.01) which was amplified by HIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (P b 0.05) and decrease to left ventricular internal dimension diastole (LVId) (P b 0.05) in LEX following HIIT. Conclusions: A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging

High-intensity interval training vs. moderate-intensity continuous training in the prevention/management of cardiovascular disease

Moderate-intensity continuous training (MICT) has long been considered the most effective exercise treatment modality for the prevention and management of cardiovascular disease, but more recently high-intensity interval training (HIIT) has emerged into the clinical environment has been viewed as a potential alternative to MICT in accruing such benefits. HIIT was initially found to induce significant improvements in numerous physiological and health-related indices, to a similar if not superior extent to MICT. Since then, many studies have attempted to explore the potential clinical utility of HIIT, relative to MICT, with respect to treating numerous cardiovascular conditions such as coronary artery disease, heart failure, stroke, and hypertension. Despite this, however, the efficacy of HIIT compared to MICT with respect to in reversing the specific symptoms and risk factors of these cardiovascular pathologies for improved health and wellbeing as well as reduced morbidity and mortality is not well understood. In addition, HIIT is often perceived as very strenuous, which could potentially render it unsafe for those at risk of or afflicted with cardiovascular disease, but these issues are also yet to be reviewed. Furthermore, the optimal HIIT protocol for each of the cardiovascular disease cohorts has not been established. Thus, the purpose of this review article is to (i) evaluate the efficacy of HIIT relative to MICT in the prevention and management of cardiovascular conditions, and (ii) explore any potential safety issues surrounding the suitability and/or tolerability of HIIT for patients with cardiovascular disease, as well as the potential optimal prescriptive variables of HIIT for application in the clinical environment

Aerobic training protects cardiac function during advancing age: a meta-analysis of four decades of controlled studies

In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. statistic. , 95% CI 0.05-1.86, p = 0.04). Meta-regression for chronological age identified that athlete-control differences, in the main, are maintained during advancing age. Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing

Age related vascular endothelial function following lifelong sedentariness: positive impact of cardiovascular conditioning without further improvement following low frequency high intensity interval training

Aging is associated with diffuse impairments in vascular endothelial function and traditional aerobic exercise is known to ameliorate these changes. High intensity interval training (HIIT) is effective at improving vascular function in aging men with existing disease, but its effectiveness remains to be demonstrated in otherwise healthy sedentary aging. However, the frequency of commonly used HIIT protocols may be poorly tolerated in older cohorts. Therefore, the present study investigated the effectiveness of lower frequency HIIT (LfHIIT) on vascular function in a cohort of lifelong sedentary (SED; n = 22, age 62.7 +/- 5.2 years) men compared with a positive control group of lifelong exercisers (LEX; n = 17, age 61.1 +/- 5.4 years). The study consisted of three assessment phases; enrolment to the study (Phase A), following 6 weeks of conditioning exercise in SED (Phase B) and following 6 weeks of low frequency HIIT in both SED and LEX (LfHIIT; Phase C). Conditioning exercise improved FMD in SED (3.4 +/- 1.5% to 4.9 +/- 1.1%; P < 0.01) such that the difference between groups on enrolment (3.4 +/- 1.5% vs. 5.3 +/- 1.4%; P < 0.01) was abrogated. This was maintained but not further improved following LfHIIT in SED whilst FMD remained unaffected by LfHIIT in LEX. In conclusion, LfHIIT is effective at maintaining improvements in vascular function achieved during conditioning exercise in SED. LfHIIT is a well-tolerated and effective exercise mode for reducing cardiovascular risk and maintaining but does not improve vascular function beyond that achieved by conditioning exercise in aging men, irrespective of fitness level

The associations between insecure attachment, rooming‐in, and postpartum depression: A 2 months’ longitudinal study

Postpartum depression (PPD) is the most common complication of childbearing, and recent studies have attempted to examine risk factors associated with it. The main study hypothesis was that a protective situational factor at a sensitive time period (full rooming‐in postpartum) would moderate the associations between insecure attachment dimensions and PPD. Three hundred twelve women, in either full or partial rooming‐in, participated in a longitudinal study at the maternity ward of a tertiary healthcare center. A Demographic questionnaire and the Experiences in Close Relationships Scale were administered at 1–4 days postpartum, and the Edinburgh Postnatal Depression scale at 2 months postpartum. PPD was significantly associated with both anxious and avoidant attachment dimensions, but not with rooming‐in conditions. In addition, women in partial rooming‐in showed a positive correlation between insecure attachment dimensions and PPD, whereas no such correlation was found for full rooming‐in women. A situational factor such as full rooming‐in, which occurs at a critical time point for the mother–infant relationship, can moderate the association between maternal avoidant or anxious attachment dimensions and the mother’s PPD levels. Postpartum practices, such as rooming‐in, can be personalized and thus beneficial in moderating personal risk factors for PPD.RESUMENLa depresión posterior al parto (PPD) es la complicación más común de dar a luz y estudios recientes han intentado examinar los factores de riesgo asociados con el parto. La hipótesis del principal estudio fue que un factor situacional de protección en un período temporal sensible (permitirle a la madre mantener a su bebé con ella en el mismo cuarto después del parto) moderaría las asociaciones entre las dimensiones de afectividad insegura y PPD. Trescientas doce mujeres, en situación completa o parcial de tener a su bebé en el mismo cuarto, participaron en un estudio longitudinal en la sala de partos de un centro terciario de cuidado de salud. Del primer al cuarto día después del parto, se administró un cuestionario demográfico y la Escala de Experiencias en Relaciones Cercanas; la Escala de Edimburgo de Depresión Postnatal se administró a los dos meses posteriores al parto. Significativamente se asoció la PPD tanto con las dimensiones de afectividad de tipo ansiosas como las evasivas, pero no con las condiciones de compartir el mismo cuarto. Adicionalmente, las mujeres en situaciones parciales de compartir el mismo cuarto mostraron una correlación positiva entre las dimensiones de afectividad insegura y PPD, mientras que tal correlación no se encontró en el caso de las mujeres en situaciones de compartir el cuarto completamente. Un factor situacional tal como el compartir el cuarto completamente, lo cual ocurre en un punto temporal crítico para la relación madre‐infante, puede moderar la asociación entre las dimensiones de afectividad maternas evasivas o ansiosas y los niveles de PPD de la madre. Las prácticas del período posterior al parto, tales como el compartir el cuarto, pueden ser personalizadas y por tanto beneficiosas en cuanto a moderar los factores personales de riesgo de PPD.RÉSUMÉLa dépression postpartum (DPP) est la complication la plus commune de la maternité et les études récentes ont essayé d’examiner les facteurs de risque qui y sont liés. L’hypothèse principale de cette étude était qu’un facteur protecteur situationnel à une période sensible (rooming‐in total postpartum) modérerait les liens entre les dimensions d’attachement insécure et la DPP. Trois cent douze femmes, soit en rooming‐in partiel ou total, ont participé à une étude longitudinale à la maternité d’un centre de santé tertiaire. Un questionnaire démographique et l’Echelle d’Expériences dans les Relations Proches ont été donnés à 1–4 jours postpartum, l’Echelle de Dépression Postnatale d’Edinbourg à deux mois postpartum. La DPP a été liée de manière importante à des dimensions d’attachement à la fois anxieux et évitant, mais pas avec les conditions de rooming‐in. De plus, les femmes en rooming‐in partiel ont fait preuve d’une corrélation positive entre les dimensions de l’attachement insécure et la DPP, alors qu’aucune corrélation n’a été trouvée pour les femmes du groupe rooming‐in. Un facteur situationnel telle que le rooming‐in total, qui se passe à un moment critique pour la relation mère‐bébé, peut modérer le lien entre les dimensions d’attachement évitant maternel et de l’attachement anxieux et les niveaux de DPP de la mère. Les pratiques postpartum, tel que le rooming‐in, peuvent être personnalisées et donc s’avérer être un bénéfice pour la modération de facteurs de risque personnel pour la DPP.ZUSAMMENFASSUNGDie Zusammenhänge zwischen unsicherer Bindung, Rooming‐in und postpartaler Depression: Eine zweimonatige LängsschnittstudiePostpartale Depression (PPD) ist die häufigste Komplikation, die im Zusammenhang mit Geburten von Kindern auftritt. Neuere Studien haben versucht, die damit verbundenen Risikofaktoren zu untersuchen. Die Hypothese der Hauptstudie war, dass ein protektiver Situationsfaktor innerhalb eines kritischen Zeitraums (vollständiges Rooming‐in, d.h. die Möglichkeit, das Neugeborene nach der Geburt im Zimmer zu haben) den Zusammenhang zwischen unsicheren Bindungsdimensionen und PPD abschwächen kann. 312 Frauen, mit einem entweder vollständigen oder teilweisen Rooming‐in, nahmen an einer Längsschnittstudie auf der Entbindungsstation eines tertiären Gesundheitszentrums teil. Ein bis vier Tage nach der Geburt wurde ein demografischer Fragebogen und die Skala für Erfahrungen in engen Beziehungen ausgeteilt. 2 Monate nach der Geburt erfolgte eine Befragung mit der Edinburgh Skala für postnatale Depression. PPD war sowohl mit ängstlichen als auch mit vermeidenden Bindungsdimensionen signifikant assoziiert, jedoch nicht mit Bedingungen des Rooming‐ins. Frauen mit teilweisem Rooming‐in zeigten eine positive Korrelation zwischen unsicheren Bindungsdimensionen und PPD, während für Frauen mit vollständigem Rooming‐in keine solche Korrelation gefunden wurde. Ein Situationsfaktor wie das vollständige Rooming‐in, der zu einem kritischen Zeitpunkt für die Mutter‐Kind‐Beziehung auftritt, kann den Zusammenhang zwischen mütterlichen vermeidenden oder ängstlichen Bindungsdimensionen und den PPD‐Werten der Mutter abschwächen. Postpartale Praktiken wie das Rooming‐In können personalisiert werden und somit zur Minderung persönlicher PPD‐Risikofaktoren beitragen.抄録不安定型アタッチメント、母子同室、産後うつ病の間の関連性:2ヶ月の縦断研 究産後うつ病(PPD)は、出産によって起こる最も一般的な合併症で、最近では、そ れに関連した危険因子を探究しようと試みている研究が複数ある。本研究の主な 仮説は、繊細な時期での1つの予防的状況要因 (産後の完全母子同室) は、不安 定型アタッチメントとPPD間の関連性を抑えるのではないかということである。 完全あるいは一部母子同室の312人の女性が、三次保健センターの産科病棟での 縦断研究に参加した。人口統計学的質問紙と成人アタッチメントスタイル尺度( ECR)を産後1～4日に行い、エジンバラ産後うつ病質問票を産後2か月に行なった。 PPDは、 不安型アタッチメントと回避型アタッチメントの両方と有意に関連があ ったが、母子同室の状況とは関連がなかった。さらに、一部母子同室の女性は、 不安定型アタッチメントとPPD間に正の相関がみられた。一方、完全母子同室の 女性にはそのような相関は見られなかった。母子関係にとって重要な時点で起こ る、完全母子同室のような状況要因は、母親の回避型あるいは不安型アタッチメ ントの程度と母親のPPDのレベルとの間の関連性を抑えることができる。母子同 室のような産後の実践は、個人対象にすることが可能であろう。そして、それは PPDに関する個人的な危険因子を抑えるのに有益であると思われる。摘要产后抑郁症 (PPD) 是最常见的分娩并发症, 最近的研究试图探讨与之相关的危险因素。主要的研究假设是在一个敏感的时间段 (完整产后同住) 的保护性情境因素会缓和不安全型依恋维度与PPD之间的关联。312名女性, 无论是完整还是部分同住, 都参加了在三级保健中心产科病房进行的纵向研究。产后1–4天使用“人口统计调查问卷”和“亲密关系经历量表”测量, 产后2个月使用“爱丁堡产后抑郁量表”测量。PPD与焦虑型、回避型依恋维度显著相关, 但与同住条件无关。此外, 部分同住的女性在不安全型依恋维度和PPD之间显示出正相关, 而完整同住的女性则没有这种相关性。在母婴关系的关键时间点发生的情境因素 (例如完整同住) 可以缓和母亲回避型或焦虑型依恋维度与母亲PPD水平之间的关联。产后的做法 (例如同住) 可以是个性化的, 从而有利于降低PPD的个人风险因素。ملخصالعلاقة بين التعلق الغير الآمن، والإقامة في غرفة الولادة والاكتئاب ما بعد الولادة: دراسة طولية لمدة شهرين.الاكتئاب بعد الولادة (PPD) يعتبر من المضاعفات الأكثر شيوعا لما بعد الإنجاب، وقد حاولت الدراسات الحديثة تناول عوامل الخطر المرتبطة به. كانت فرضية الدراسة الرئيسية هي أن عاملًا وقائيًا في فترة زمنية حساسة (الإقامة الكاملة في غرفة بعد الولادة) من شأنه أن يتوسط العلاقة بين أبعاد التعلق الغير آمن واكتئاب ما بعد الولادة. اشترك في الدراسة ثلاثمائة واثنتي عشرة امرأة، في إقامة كاملة أو جزئية، وأقيمت هذه الدراسة الطولية في جناح الأمومة في مركز فرعي للرعاية الصحية. تم إدارة استبيان ديموغرافي ومقياس التجارب في العلاقات الوثيقة عند 1–4 أيام بعد الولادة، ومقياس أدنبرة لاكتئاب ما بعد الولادة عند شهرين بعد الولادة. ارتبط اكتئاب ما بعد الولادة بشكل كبير مع كل من أبعاد التعلق القلق والمتجنب ، ولكن ليس مع ظروف إقامة الغرفة. وبالإضافة إلى ذلك، أظهرت النساء في الإقامة الجزئية وجود ارتباط إيجابي بين أبعاد التعلق غير الآمن واكتئاب ما بعد الولادة، في حين لم يتم إيجاد مثل هذا الارتباط للنساء في مجموعة الإقامة الكاملة. وبذلك فإن العوامل الظرفية مثل الإقامة الكاملة في فترة زمنية حرجة في العلاقة بين الأم والرضيع يمكن أن تتوسط الارتباط بين أبعاد التعلق الأمومي القلق أو المتجنب ومستويات اكتئاب ما بعد الولادة. ويمكن أن تتخذ ممارسات ما بعد الولادة، مثل الإقامة في غرفة الولادة، طابعا شخصيا وبالتالي تكون مفيدة في تخفيف عوامل المخاطرة الشخصية لاكتئاب ما بعد الولادة.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166287/1/imhj21895_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166287/2/imhj21895.pd