An exploration of men's experiences of depression during the postnatal period: An IPA study

Postnatal Depression (PND) is a construct that exists across time and culture, affecting both women and men at a ratio of 2:1 respectively. The dominant discourse focuses on women’s experiences of PND and the motherinfant relationship, presented within the framework of an overarching biomedical model that produced a plethora of studies underpinned by the positivist paradigm. In contrast, this research seeks to explore what it actually means for men, as fathers, to experience depression during the postnatal period. The literature to date highlights a threefold gap regarding approach to research into the phenomenon of PND: the epistemological underpinning, the methodological approaches chosen and the gender bias. To address this gap it is necessary for a paradigm shift regarding approach to research to embrace further qualitative methodology. Interpretive Phenomenological Analysis is the methodology identified for this research, as it provides the medium for consideration of the phenomenological and idiographic nature of the experience of PND, to include the role of the researcher and interpretation that reflects the central tenet of reflexivity within the discipline of Counselling Psychology. The overall gestalt presents a transitional adjustment process whereby the life event of the birth of a child initiated a process of deconstruction in preparation for adjusting to a new role within a changed family dynamic. The data revealed three super-ordinate and six sub-ordinate themes highlighting a complexity regarding how men made sense of their experience of depression during the postnatal period, including contemplation of past, present and possible future selves. Negative cognitive appraisal and attribution of meaning relating to childhood experiences, negative perceptions of fatherhood, masculinities, gender roles, the fatherchild relationship and socio-cultural contextual influences blocked the reconstructive process, resulting in increased stress and anxiety that led to depression. This study draws attention to risk factors, such as, childhood trauma, negative inter-generational relationships and differences in gendered expression of cognitive dissonance and anxiety. Conclusions consider implications for Counselling Psychology, highlighting the complex inter-subjective nature of men’s experiences and the value of an inter-disciplinary approach to future research, healthcare practice and intervention strategies to develop appropriate care and support for parents, particularly for men during the perinatal period

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis

Correlates of Mothers’ Perception of Their Communities’ Social Capital: A Community-Based Study

Psychosocial issues have been recognized as important factors in children’s health for decades. This study documents the relation among several important psychosocial variables (e.g., mothers’ depressive symptoms) and a new instrument that assesses parents’ perception of their communities’ social capital. Mothers were recruited from their children’s primary care (PC) pediatricians’ offices within the Southwestern Ohio Ambulatory Research Network or from a children’s hospital developmental clinic (DC). Mothers completed a questionnaire that included the Social Capital Scale (SCS), Children with Special Health Care Needs Screener (CSHCNS), Pediatric Quality of Life Inventory, Maternal Social Support Index and the Center for Epidemiologic Studies Depression Scale (CES-D). Mothers were sorted into three subgroups based on site of recruitment (PC or DC) and results of the CSHCNS. The sample (N = 620) was also sorted into terciles based on SCS scores. Mean SCS was about 73 for each of the three subgroups. Compared to mothers in the highest SCS tercile, mothers in the lowest SCS tercile reported lower education, lower income and higher CES-D median scores. The SCS subscale “sense of belonging” had an inverse correlation with CES-D scores (r = −.248, p \u3c 0.001). Mothers from primary care and sub-specialty clinics had similar perceptions about their communities’ social capital. Compared to mothers in the highest one third of SCS scores, mothers in the lowest one third were more likely to report less education and income as well as more depressive symptoms. A decreased sense of belonging in their communities was also correlated with more depressive symptoms. The SCS is a new useful tool for investigators and clinicians who work with children and their families

Mothers With Positive or Negative Depression Screens Evaluate a Maternal Resource Guide

Introduction Social isolation is common in mothers with high depressive symptoms. This study tested the hypothesis that a maternal resource guide that provided mothers with links to community human service agencies would be deemed more helpful by mothers with positive depression screens (PDS) compared with mothers with negative depression screens (NDS). Method This investigation was a cross-sectional survey study of a convenience sample from a primary care practice–based research network, the Southwestern Ohio Ambulatory Research Network (SOAR-Net). English-speaking mothers who took their child(ren) to SOAR-Net practices were eligible to participate in the study. Data were collected between May 2006 and March 2009. A total of 1048 mothers completed the survey, and 234 mothers refused to participate. Results Mothers were more likely to report that “This guide is helpful to me” if they were single (odds ratio [OR] = 4.05; 95% confidence interval [CI]: 2.77-5.94), their child had public health insurance (OR = 3.59; 95% CI: 2.39-5.40), or they had PDS (OR = 3.57; 95% CI: 2.13-5.98). After adjusting for a number of demographic variables, PDS continued to be significantly associated with “This guide is helpful to me” (adjusted OR = 2.68; 95% CI: 1.58-4.56). Discussion Mothers with PDS were more likely to report that the maternal resource guide would be personally helpful compared with mothers with NDS

Mothers With Positive or Negative Depression Screens Evaluate a Maternal Resource Guide

Introduction Social isolation is common in mothers with high depressive symptoms. This study tested the hypothesis that a maternal resource guide that provided mothers with links to community human service agencies would be deemed more helpful by mothers with positive depression screens (PDS) compared with mothers with negative depression screens (NDS). Method This investigation was a cross-sectional survey study of a convenience sample from a primary care practice–based research network, the Southwestern Ohio Ambulatory Research Network (SOAR-Net). English-speaking mothers who took their child(ren) to SOAR-Net practices were eligible to participate in the study. Data were collected between May 2006 and March 2009. A total of 1048 mothers completed the survey, and 234 mothers refused to participate. Results Mothers were more likely to report that “This guide is helpful to me” if they were single (odds ratio [OR] = 4.05; 95% confidence interval [CI]: 2.77-5.94), their child had public health insurance (OR = 3.59; 95% CI: 2.39-5.40), or they had PDS (OR = 3.57; 95% CI: 2.13-5.98). After adjusting for a number of demographic variables, PDS continued to be significantly associated with “This guide is helpful to me” (adjusted OR = 2.68; 95% CI: 1.58-4.56). Discussion Mothers with PDS were more likely to report that the maternal resource guide would be personally helpful compared with mothers with NDS

Cultural Views of Breastfeeding Among High-School Female Students in Japan and the United States: A Survey

This study compares the attitudes toward breastfeeding of high-school students in Japan and the United States. The study was conducted as a cross-sectional survey with a convenience sample (N=329). Data were collected in 1989 and 1990 at two private, girls-only high schools (Tokyo, Japan and Farmington, Michigan). Retrieval rates were 100 percent (Tokyo) and 78 percent (Michigan) respectively. Responses were compared by the chi-square (x2) test with Yate's correction and factor analyses. Tokyo students perceived that their mothers talked positively about breastfeeding (54 percent), while only 17 percent of Michigan students reported that their mothers did so (<.001). Less than five percent of the Tokyo students felt that breastfeeding disturbs family life, whereas nearly 98 percent of the Michigan students felt so (p<.001). Tokyo students scored significantly higher on the 'family' factor, while the Michigan students scored significantly higher on the 'self factor. Overall, this study indicates that high school students in Japan have more positive attitudes toward breastfeeding than students in the United States; however, teenagers in the United States are more interested than their Japanese age-mates in gaining information about breastfeeding.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68653/2/10.1177_089033449401000124.pd