Prenatal Attachment, Parental Confidence, and Mental Health in Expecting Parents: The Role of Childhood Trauma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154515/1/jmwh13034_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154515/2/jmwh13034.pd

Enhancing Breastfeeding Rates Among African American Women: A Systematic Review of Current Psychosocial Interventions

The goals of this article are to provide a review of key interventions and strategies that impact initiation and duration of breastfeeding with particular focus on low-income African American mothers' maternal psychological vulnerabilities during the early postpartum period using a social ecological perspective as a guiding framework. Although modest gains have been achieved in breastfeeding initiation rates in the United States, a projected gap remains between infant feeding practices and national Healthy People breastfeeding goals set for 2020, particularly among African Americans. These disparities raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes because of poorer mental health and increased vulnerability to chronic health conditions. Breastfeeding can be a protective factor, strengthening the relationship between mother and baby and increasing infant health and resilience. Evidence suggests that no single intervention can sufficiently address the multiple breastfeeding barriers faced by mothers. Effective intervention strategies require a multilevel approach. A social ecological perspective highlights that individual knowledge, behavior, and attitudes are shaped by interactions between the individual woman, her friends and family, and her wider historical, social, political, economic, institutional, and community contexts, and therefore effective breastfeeding interventions must reflect all these aspects. Current breastfeeding interventions are disjointed and inadequately meet all African American women's social and psychological breastfeeding needs. Poor outcomes indicate a need for an integrative approach to address the complexity of interrelated breastfeeding barriers mothers' experience across layers of the social ecological system.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140312/1/bfm.2014.0023.pd

Does Child Sex Moderate Vulnerability to Postpartum Risk among Infants of Mothers at Risk for Psychopathology?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110024/1/infa12065.pd

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

Strong, Safe, And Secure: Negotiating Early Fathering And Military Service Across The Deployment Cycle

Military fathers of young children often endure repeated separations from their children, and these may disrupt the early parent–child relationship. Postdeployment reunification also poses challenges; disruptions that have occurred must often be repaired in the context of heightened emotions on the part of each family member at a time when fathers are themselves readjusting to the routines and responsibilities of family life. The current study employed qualitative research with the central aim of informing a richer understanding of these experiences. Interviews were conducted with 14 military fathers of young children who had experienced separation from their families during deployment. Narratives were coded using principles of grounded theory, and common parenting themes were extracted. Fathers shared their hopes that their young children would develop qualities of strength, confidence, and self‐sufficiency. They also discussed difficulty in supporting the development of these qualities in their young children due to problems dealing with the negative emotions and difficult behaviors that their children exhibited. Reliance on their parenting partner was commonly cited as an effective strategy as fathers transitioned back to family life. Implications for intervention programs include the provision of parenting and self‐care skills and inclusion of the father's parenting partner in the intervention. RESUMEN Padres militares de niños pequeños a menudo enfrentan repetidas separaciones de sus hijos, las cuales pueden alterar las tempranas relaciones padre‐hijo. La reunificación posterior a la asignación militar también presenta retos; las interrupciones que han ocurrido muy a menudo se arreglan en el contexto de fuertes emociones por parte de cada miembro de la familia en un momento en que los papás están ellos mismos reajustándose a rutinas y responsabilidades de la vida familiar. La investigación cualitativa puede resultar en una mejor comprensión de estas experiencias. Para el presente estudio, se entrevistó a 14 militares, padres de niños pequeños, quienes habían experimentado la separación familiar durante sus asignaciones militares. Se codificaron las narrativas usando principios de teoría básica, y se extrajeron temas de crianza comunes. Los papás compartieron sus esperanzas de que sus pequeños niños desarrollaran su fortaleza, confianza y autosuficiencia. También discutieron la dificultad de apoyar el desarrollo de estas características en sus pequeños niños después de la separación por servicio militar debido a problemas relacionados con emociones negativas y conductas difíciles que sus hijos mostraban. Se citó reiteradamente el depender de la pareja en la crianza como estrategia efectiva en la transición de vuelta a la vida familiar. Las implicaciones para programas de intervención incluyen la incorporación de la pareja de quien dependen los papás para la crianza como parte de la intervención, así como la provisión de habilidades de crianza y autocuidado. RÉSUMÉ Les pères de jeunes enfants qui servent dans l’armée endurent souvent des séparations répétées d’avec leurs enfants, séparations qui peuvent perturber la relation précoce père‐enfant. La réunification après le déploiement peut également poser certains défis: les perturbations qui se sont passées doivent aussi être réparées dans le contexte d’émotions intensifiées de la part de chaque membre de la famille à un moment où les pères eux‐mêmes se réadaptent aux routines et aux responsabilités de la vie de famille. Des recherches qualitatives peuvent mener à une compréhension plus riche de ces expériences. Cette étude a interviewé 14 pères engagés dans l’armée, pères de jeunes enfants qui avaient tous fait l’expérience de la séparation de leurs familles durant le déploiement. Les récits ont été codés en utilisant les principes de la théorie ancrée et les thèmes de parentage commun ont été extraits. Les pères ont partagé leurs espoirs que leurs jeunes enfants feraient preuve de qualités de force, de confiance et d’auto‐suffisance en grandissant. Ils ont aussi discuté la difficulté qui existe à soutenir le développement de ces qualités chez leurs jeunes enfants après le déploiement à cause de problèmes liés aux émotions et aux comportements difficiles dont faisaient preuve leurs enfants. La dépendance envers le partenaire de parentage s’est trouvé fréquemment citée comme étant une stratégie efficace alors qu’ils transitionnaient dans le retour à la vie familiale. Les implications pour des programmes d’intervention comprennent l’inclusion du partenaire de parentage du père dans l’intervention et dans l’accumulation des précautions de parentage et des capacités à prendre soin de soi. ZUSAMMENFASSUNG Väter von Kleinkindern, die im Militär dienen, erfahren oft wiederholte Trennungen von ihren Kindern, welche die frühe Eltern‐Kind‐Beziehung stören können. Auch die Wiedervereinigung nach einem Einsatz beim Militär stellt eine Herausforderung dar: Brüche, die aufgetreten sind, müssen oft im Zusammenhang mit verstärkten Emotionen auf Seiten jedes Familienmitglieds wiedergutgemacht werden. Dies geschieht zu einer Zeit, in der sich die Väter wieder den Routinen und Aufgaben des Familienlebens anpassen. Qualitative Forschung kann zu einem umfangreicheren Verständnis dieser Erfahrungen beitragen. Die aktuelle Studie befragte 14 Väter von Kleinkindern, die beim Militär waren und Trennung von ihren Familien während eines Einsatzes erlebt hatten. Narrative wurden nach den Prinzipien der „Grounded Theory“ kodiert und allgemeine Themen zur Elternschaft wurden extrahiert. Die Väter teilten ihre Hoffnung mit, dass ihre Kinder Eigenschaften wie Stärke, Selbstvertrauen und Selbstständigkeit entwickeln. Sie diskutierten auch Schwierigkeiten bei der Unterstützung der Entwicklung dieser Eigenschaften bei ihren Kleinkindern nach einem Einsatz, aufgrund von Problemen im Umgang mit negativen Emotionen und schwierigen Verhaltensweisen, die ihre Kinder zeigten. Das Vertrauen in das andere Elternteil wurde allgemein als wirksame Strategie zitiert, wenn sie zurück ins Familienleben übergegangen sind. Implikationen für Interventionsprogramme umfassen die Einbeziehung des anderen Elternteils in die Intervention und die Bereitstellung von Erziehungs‐ und Selbstfürsorge‐Fähigkeiten. ABSTRACT 抄録：幼い子どものいる軍人の父親は、子どもとの別れを繰り返すことにしばしば耐えている。そして、これは、早期の親－子関係を中断するだろう。帰還後の家族の再統合もまた問題をはらんでいる。父親自身が家族生活のルーチンと責任に再適応している時に、家族メンバーそれぞれが高揚した感情というコンテクストの中で、生じていた中断がしばしば修復されなければならない。質的研究によりこれらの経験をより豊かに理解する情報をえることができる。この研究では、配備の間に家族との別れを体験した、14人の幼い子どものいる軍人の父親にインタビューした。談話はグランデット・セオリーの原則を用いてコード化され、共通の育児のテーマが抽出された。父親達は、幼い子どもが、強さ、自信、そして自給自足という素質を発達させるだろうという希望を共有していた。彼らはまた、子ども達が示す否定的な感情や難しい行動を扱う問題のために、帰還後に幼い子どものこれらの素質を発達させるように支援するのが難しいと議論した。養育パートナーへの信頼は、彼らが家族との生活に戻る移行における効果的な戦略として、共通して言及された。介入プログラムに対して持つ意味には、父親の養育パートナーを介入に含めること、そして養育スキルとセルフケアのスキルを提供することが、含まれるPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108646/1/imhj21465.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

Potential Neural Mediators of Mom Power Parenting Intervention Effects on Maternal Intersubjectivity and Stress Resilience

Stress resilience in parenting depends on the parent\u27s capacity to understand subjective experiences in self and child, namely intersubjectivity, which is intimately related to mimicking other\u27s affective expressions (i. e., mirroring). Stress can worsen parenting by potentiating problems that can impair intersubjectivity, e.g., problems of “over-mentalizing” (misattribution of the child\u27s behaviors) and “under-coupling” (inadequate child-oriented mirroring). Previously we have developed Mom Power (MP) parenting intervention to promote maternal intersubjectivity and reduce parenting stress. This study aimed to elucidate neural mechanisms underlying the effects of MP with a novel Child Face Mirroring Task (CFMT) in functional magnetic-resonance-imaging settings. In CFMT, the participants responded to own and other\u27s child\u27s facial pictures in three task conditions: (1) empathic mirroring (Join), (2) non-mirroring observing (Observe), and (3) voluntary responding (React). In each condition, each child\u27s neutral, ambiguous, distressed, and joyful expressions were repeatedly displayed. We examined the CFMT-related neural responses in a sample of healthy mothers (n = 45) in Study 1, and MP effects on CFMT with a pre-intervention (T1) and post-intervention (T2) design in two groups, MP (n = 19) and Control (n = 17), in Study 2. We found that, from T1 to T2, MP (vs. Control) decreased parenting stress, decreased dorsomedial prefrontal cortex (dmPFC) during own-child-specific voluntary responding (React to Own vs. Other\u27s Child), and increased activity in the frontoparietal cortices, midbrain, nucleus accumbens, and amygdala during own-child-specific empathic mirroring (Join vs. Observe of Own vs. Other\u27s Child). We identified that MP effects on parenting stress were potentially mediated by T1-to-T2 changes in: (1) the left superior-temporal-gyrus differential responses in the contrast of Join vs. Observe of own (vs. other\u27s) child, (2) the dmPFC-PAG (periaqueductal gray) differential functional connectivity in the same contrast, and (3) the left amygdala differential responses in the contrast of Join vs. Observe of own (vs. other\u27s) child\u27s joyful vs. distressed expressions. We discussed these results in support of the notion that MP reduces parenting stress via changing neural activities related to the problems of “over-mentalizing” and “under-coupling.” Additionally, we discussed theoretical relationships between parenting stress and intersubjectivity in a novel dyadic active inference framework in a two-agent system to guide future research

Associations Between Early Maternal Depressive Symptom Trajectories And Toddlers’ Felt Security At 18 Months: Are Boys And Girls At Differential Risk?

The goal of this study was to evaluate whether there are sex differences in children’s vulnerability to caregiving risk, as indexed by trajectories of maternal depressive symptoms assessed from 2 to 18 monthsâ postpartum, and children’s rated attachment security in toddlerhood, adjusting for maternal social support and demographic risk. Analyses utilized longitudinal data collected for 182 African American motherâ child dyads from economically diverse backgrounds. Participants were recruited at the time of the child’s birth and followed to 18 monthsâ postpartum. Results of conditional latent growth models indicated that an increasing rate of change in level of maternal depressive symptoms over time negatively predicted toddlersâ felt attachment security. Higher social support was associated with decreasing levels of maternal depressive symptoms over time whereas higher demographic risk was associated with increasing levels of maternal depressive symptoms. A subsequent multigroup conditional latent growth model revealed that child sex moderated these associations. For male (but not female) children, a rapid increase in maternal depressive symptoms was associated with lower felt attachment security at 18 months. These findings suggest that boys, as compared to girls, may be more vulnerable to early caregiving risks such as maternal depression, with negative consequences for motherâ child attachment security in toddlerhood.RESUMENEl objetivo de este estudio fue evaluar si hay diferencias de sexo en la vulnerabilidad de los niños al riesgo de prestación de cuidado, como han indicado las trayectorias de síntomas depresivos maternos evaluadas de 2 a 18 meses después del parto, y el puntaje de la seguridad de afectividad de los niños en su temprana infancia, con ajustes basados en el apoyo social materno y el riesgo demográfico. Los análisis utilizaron información longitudinal recogida de 182 díadas de madreâ niño afroâ americanas de niveles económicamente diversos. Los participantes fueron reclutados al nacer el niño y se les dio seguimiento hasta los 18 meses después del parto. Los resultados de modelos de modelos de crecimiento latente condicionales indicaron que un incremento en el puntaje de cambio en el nivel de síntomas depresivos maternos a través del tiempo negativamente predijo la seguridad afectiva que los infantes sentían. Se asoció un más alto apoyo social con decrecientes niveles de síntomas depresivos maternos a través del tiempo, mientras que más altos riesgos demográficos se asociaron con un incrementos en los niveles de síntomas depresivos maternos. Un subsecuente modelo de crecimiento latente condicional reveló que el sexo del niño moderaba estas asociaciones. En el caso de niños varones (no así las niñas), se asoció un rápido incremento en síntomas depresivos maternos con más bajos niveles, a los 18 meses, de seguridad en la afectividad sentida. Estos resultados sugieren que los niños varones, comparados con las niñas, pudieran ser más vulnerables a los riesgos de un cuidado temprano tal como la depresión materna, con consecuencias negativas para la seguridad en la afectividad madreâ niño en la más temprana infancia.Rà SUMà Le but de cette étude était dâ évaluer s’il existe des différences entre les sexes dans la vulnérabilité des enfants au risque de la personne prenant soin d’eux, telle qu’elle est indexée par les trajectoires des symptômes dépressifs maternels évalués de 2 à 18 mois après la naissance, et la sécurité de l’attachement telle qu’elle est évaluée chez les enfants durant la petite enfance, s’ajustant au soutien social maternel et au risque démographique. Les analyses ont utilisé des données longitudinales recueillies pour 182 dyades mèresâ enfants noires américaines issues de milieux socioéconomiques divers. Les participants ont été recrutés au moment de la naissance de l’enfant et ont été suivis jusquâ à 18 mois après la naissance. Les résultats de modèles de croissance latents conditionnels ont indiqué qu’un taux croissant de changement dans le niveau des symptômes dépressifs maternels au fil du temps prédisait de manière négative la sécurité de l’attachement ressentie des jeunes enfants. Un soutien social plus élevé était lié à des niveaux décroissants de symptômes dépressifs maternels au fil du temps, alors qu’un risque démographique élevé était lié à des niveaux plus élevés de symptômes dépressifs maternels. Un modèle de croissance latente conditionnelle subséquente et multiâ groupe a révélé que le sexe de l’enfant modérait ces associations. Pour les enfants mâles (mais pas les enfants femelles) une augmentation rapide des symptômes dépressifs maternels était liée à une sécurité perçue de l’attachement plus basse à 18 mois. Ces résultats suggèrent que les garçons, comparés aux filles, peuvent être plus vulnérables aux risques liés à la personne prenant soin d’eux comme la dépression maternelle, avec des conséquences négatives pour la sécurité de l’attachement mèreâ enfant dans la petite enfance.ZUSAMMENFASSUNGDas Ziel dieser Studie war es, Geschlechtsunterschiede bei Kindern im Hinblick auf ihre Vulnerabilität bei Fürsorgerisiken zu evaluieren. Die Fürsorgerisiken wurden durch den Verlauf der mütterlichen depressiven Symptome von 2 bis 18 Monaten nach der Geburt indiziert, sowie durch die bewertete Bindungssicherheit der Kleinkinder. Dabei wurde für mütterliche soziale Unterstützung und demografische Risiken kontrolliert. Für die Analysen wurden Längsschnittdaten von 182 afroâ amerikanischen Mutterâ Kindâ Dyaden mit verschiedenen ökonomischen Hintergründen genutzt. Die Teilnehmer wurden zum Zeitpunkt der Geburt des Kindes rekrutiert und nach der Geburt für 18 Monate begleitet. Die Ergebnisse der konditionalen latenten Wachstumsmodelle zeigten, dass im Verlauf ansteigende mütterliche depressive Symptome mit der gefühlten Bindungssicherheit der Kleinkinder in einem negativen Vorhersagezusammenhang standen. Höhere soziale Unterstützung war mit einer Abnahme der mütterlichen depressiven Symptome im Verlauf der Zeit assoziiert, während ein höheres demografisches Risiko mit dem Anstieg der mütterlichen depressive Symptome assoziiert war. Ein nachfolgendes konditionales latentes Wachstumsmodell für multiple Gruppen zeigte, dass das Geschlecht des Kindes diese Assoziationen moderierte. Bei Jungen (jedoch nicht bei Mädchen) war eine rasche Zunahme der mütterlichen depressiven Symptome mit einer niedrigeren gefühlten Bindungssicherheit 18 Monate nach der Geburt assoziiert. Diese Ergebnisse deuten darauf hin, dass Jungen, verglichen mit Mädchen, hinsichtlich früher Fürsorgerisiken wie mütterlicher Depression vulnerabler sind, was wiederum mit negativen Folgen für die Bindungssicherheit zwischen Mutter und Kind im Kleinkindalter einhergehen kann.æ é ²ã ã ®ç  ç©¶ã ®ç ®ç ã ¯ã é¤ è ²ã ®ã ªã ¹ã ¯ã ¸ã ®å­ ã ©ã ã ®è å¼±æ §ã «æ §å·®ã ã ã ã ã ©ã ã ã è© ä¾¡ã ã ã 㠨㠧ã ã ã ã ã ã ¯ã å ºç £å¾ 2â ¼18ã æ ã «è© ä¾¡ã ã ã æ¯ è¦ªã ®æ ã ã ¤ç ç ¶ã ®çµ é 㠨幼å æ ã «è© å® ã ã ã ã ã ©ã ã ®æ ç ã ®å® å® æ §ã æ æ¨ ã «ã ã ¦ã æ¯ è¦ªã ®ç¤¾ä¼ ç æ ¯æ ´ã ¨äººå £çµ±è¨ å­¦ç 㠪㠹㠯㠫㠤ã ã ¦é ©å ã ã ã ã å æ ã ¯ã çµ æ¸ ç ã «å¤ æ§ ã ªè æ ¯ã æ ã ¤182çµ ã ®ã ¢ã ã ªã «ç³»ã ¢ã ¡ã ªã «äººã ®æ¯ å­ ã ã é ã ã ã ã ç¸¦æ ­ç ã ªã 㠼㠿ã å ©ç ¨ã ã ã ç  ç©¶å å  è ã ¯å­ ã ©ã ã ®å ºç æ ã «é ã ã ã ã ç £å¾ 18ã æ é 追跡ã ã ã ã æ ¡ä»¶ä» ã æ½ å ¨æ é ·ã ¢ã ã «ã ®çµ æ ã ã ã æ é çµ é ã «ã ã æ¯ è¦ªã ®æ ã ã ¤ç ç ¶ã ¬ã ã «ã ®å¤ å ç ã ®å¢ å  ã ¯ã å¹¼å ã «æ ã ã ã ã æ ç ã ®å® å® æ §ã ã ã ¬ã ã £ã ã «äº æ¸¬ã ã ã ã ¨ã 示ã ã ã ã ã ã é« ã ç¤¾ä¼ æ ¯æ ´ã ¯ã æ é çµ é ã «ã ã æ¯ è¦ªã ®æ ã ã ¤ç ç ¶ã ¬ã ã «ã ®ä½ ä¸ ã «é ¢é £ã ã ã ã ã ã ®ä¸ æ ¹ã ã é« ã äººå £çµ±è¨ å­¦ç ã ªã ¹ã ¯ã ¯æ¯ è¦ªã ®æ ã ã ¤ç ç ¶ã ¬ã ã «ã ®å¢ å  ã ¨é ¢é £ã ã ã ã ã ã «ç¶ ã å¤ ç¾¤æ ¡ä»¶ä» ã æ½ å ¨æ é ·ã ¢ã ã «ã ã ã å­ ã ©ã ã ®æ §å ¥ã ã ã ã ã ®é ¢é £ã ç·©å ã ã ã ç ·å 㠧㠯 (ã ã ã 女å 㠧㠯㠪ã ) ã æ ¥é ã «å¢ å¤§ã ã æ¯ è¦ªã ®æ ã ã ¤ç ç ¶ã ¯ã 18ã æ ã §æ ã ã ã ã æ ç ã ®å® å® æ §ã ®ä½ ã ã ¨é ¢é £ã ã ã ã ã ã ã ®çµ æ ã ã ã 女å ã «æ¯ ã ¹ã ¦ç ·å ã ¯ã æ¯ è¦ªã ®æ ã 㠤㠮ã ã ã ªæ ©æ ã ®é¤ è ²ã ªã ¹ã ¯ã «å¯¾ã ã ¦ã ã è 弱㠧ã ã ã å¹¼å æ ã ®æ¯ å­ ã ®æ ç ã ®å® å® æ §ã «ã ã ¬ã ã £ã ã ªçµ æ ã ã ã ã ã ã ¦ã ã ã æ è¦ æ ¬ç  ç©¶ç ç ®ç æ ¯è© ä¼°å ç«¥ç §é¡§é¢¨é ªç è å¼±æ §æ ¯å ¦å­ å ¨æ §å ¥å·®ç °, ä½ è æ ¹æ ç ¢å¾ 2è ³18å æ ç ç ¢å©¦æ 鬱ç ç ç è» è·¡, å å ç«¥å ¨å¹¼å æ ç é¡ å® ä¾ é å® å ¨æ è© ä¼°, ä¸¦èª¿æ ´æ¯ è¦ªç 社æ æ ¯æ å äººå £é¢¨é ªã ç  ç©¶å æ ä½¿ç ¨å¾ 182å ä¾ è ªç¶ æ¿ å¤ æ¨£å è æ ¯ç ç¾ å é æ´²è£ æ¯ å­ äº äººçµ å ç 縱å æ ¸æ ã å è è å ¨å­©å­ å ºç æ æ å , ç ¶å¾ è· é ²å °ç ¢å¾ 18å æ ã æ¢ ä»¶æ½ å ¨ç é ·æ¨¡å ç çµ æ 表æ , é ¨è æ é ç æ ¨ç§», æ¯ è¦ªæ 鬱ç ç ç å¢ å  ç , è² é ¢å °é  æ¸¬å¹¼å ç ä¾ é å® å ¨æ ã è¼ é« ç 社æ æ ¯æ è æ¯ è¦ªæ 鬱ç ç ç é ä½ ç ¸é , è è¼ é« ç äººå £é¢¨é ªè æ¯ è¦ªæ 鬱ç ç ç å¢ å  ç ¸é ã é ¨å¾ ç å¤ çµ æ¢ ä»¶æ½ å ¨ç é ·æ¨¡å å æ 顯示, å ç«¥æ §å ¥ç·©å é é ä¿ ã å° æ ¼ç ·å­© (ä½ ä¸ æ ¯å¥³å­©) , æ¯ è¦ªæ 鬱ç ç ç å¿«é å¢ å  è 18å æ æ è¼ ä½ ç ä¾ é å® å ¨æ æ é ã é äº ç  ç©¶çµ æ 表æ , è å¥³å­©ç ¸æ¯ , ç ·å­©å ¯è ½æ ´å®¹æ å å °æ ©æ ç §é¡§é¢¨é ª, ä¾ å¦ ç ¢å©¦æ 鬱ç , å° å¹¼å æ æ¯ å­ ä¾ é å® å ¨æ å¸¶ä¾ ç è² é ¢å½±é ¿ãPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135990/1/imhj21617.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135990/2/imhj21617_am.pd

Ptsd Symptoms Across Pregnancy And Early Postpartum Among Women With Lifetime Ptsd Diagnosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/122410/1/da22465.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/122410/2/da22465_am.pd