Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study.

The parent-infant bond following childbirth is an important facilitator of optimal infant development. So far, research has mainly focused on mother-infant bonding. Data on fathers are still sparse. Parental mental health, such as posttraumatic stress symptoms (PTSD), may influence mother-infant relations and/or interactions. There is evidence that both parents can experience PTSD symptoms following childbirth (PTSD-CB). The aim of this study is to investigate the prospective relationship between parental PTSD-CB symptoms at 1 month postpartum and perceived parent-infant bonding at 3 months postpartum, while adjusting for antenatal confounders. A subsample was used for this study (n <sub>Totalsample</sub> 488, n <sub>mothers</sub> = 356, n <sub>fathers</sub> = 132) of an ongoing prospective cohort study. Future parents awaiting their third trimester antenatal appointments at a Swiss university hospital were recruited. Self-report questionnaires assessed PTSD-CB symptoms and psychological distress at 1 month postpartum, and parent-infant bonding at 3 months postpartum. Confounders included antenatal PTSD symptoms and social support measured via self-report questionnaires, and gestity and gestational age, extracted from medical records. Using structural equation modeling, the predictive ability of PTSD-CB symptoms at 1 month postpartum on parent-infant bonding at 3 months postpartum was assessed for both parents respectively. Maternal PTSD-CB symptoms at 1 month postpartum were found to be negatively prospectively associated with mother-infant bonding at 3 months postpartum; however, this effect disappeared after adjusting for psychological distress at 1 month postpartum. No such effects were found for fathers. There was no evidence of mediation of the relationship between parental PTSD-CB symptoms at 1 month postpartum and parental-infant bonding at 3 months postpartum via psychological distress at 1 month postpartum. However, such a mediation was found for maternal intrusion and hyperarousal symptom subscales. Results expand the current literature on the impact of PTSD-CB on parent-child relations to also include fathers, and to a community sample. Any adverse effects of mental health symptoms on parent-infant bonding were evidenced by 3 months postpartum only for mothers, not fathers. Our results may inform the development of prevention/intervention strategies

Look out captain, I hear an ambiguous alien! A study of interpretation bias and anxiety in young children

There is convincing evidence that anxious children and adolescents are biased to interpret ambiguity in a negative way (Stuijfzand, Creswell, Field, Pearcey, & Dodd, 2017). However, little research examines interpretation bias in children under eight years. This is due to existing measures of interpretation bias being inappropriate for young children. Consequently, we aimed to develop a new interpretation bias task for young children using tones. Children learnt to associate high tones with a ‘happy alien’ and low tones with an ‘angry alien’. They were then asked to classify tones from the middle of the frequency range (ambiguous tones) as ‘happy’ or ‘angry’. Corrugator muscle activity was recorded alongside behavioural responses. A community sample of 110 children aged 4 to 8 years, split into high and low anxious groups, completed the task. High anxious children were more likely to interpret the ambiguous tones as negative but this effect was small and only apparent after controlling for developmental factors. Corrugator activity aligned with behavioural responses for trained but not ambiguous tones. This is the first study to assess interpretation bias in young children using behavioural and physiological measures. Results indicate the task is developmentally appropriate and has potential utility for future research

Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

Epidemics or pandemics, such as the current Coronavirus Disease 2019 (COVID-19) crisis, pose unique challenges to healthcare professionals (HCPs). Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs. There is a lack of evidence-based advice on what would be effective in mitigating this impact. This rapid review synthesizes the evidence on the psychological impact of pandemics/epidemics on the mental health of HCPs, what factors predict this impact, and the evidence of prevention/intervention strategies to reduce this impact. According to rapid review guidelines, systematic searches were carried out in Embase.com , PubMed, APA PsycINFO-Ovid SP, and Web of Science (core collection). Searches were restricted to the years 2003 or later to ensure inclusion of the most recent epidemic/pandemics, such as Severe Acute Respiratory Syndrome (SARS). Papers written in French or English, published in peer-reviewed journals, and of quantitative design using validated measures of mental health outcomes were included. Of 1308 papers found, 50 were included. The full protocol for this rapid review was registered with Prospero (reg.no. CRD42020175985). Results show that exposed HCPs working with patients during an epidemic/pandemic are at heightened risk of mental health problems in the short and longer term, particularly: psychological distress, insomnia, alcohol/drug misuse, and symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, burnout, anger, and higher perceived stress. These mental health problems are predicted by organizational, social, personal, and psychological factors and may interfere with the quality of patient care. Few evidence-based early interventions exist so far. HCPs need to be provided with psychosocial support to protect their mental wellbeing if they are to continue to provide high quality patient care. Several recommendations relevant during and after an epidemic/pandemic, such as COVID-19, and in preparation for a future outbreak, are proposed

Setting the global research agenda in psychosocial aspects of women’s health – outcomes from ISPOG world conference at The Hague

The World Conference of the International Society of Psychosomatic Obstetrics and Gynecology held in The Hague, Netherlands in October 2019 ran a dedicated session debating the global research priorities for psychological and social aspects of women’s health. Member countries of ISPOG and individual members were invited to lodge abstracts arguing for topics that required, or would benefit from, a global effort to seek answers to important issues in clinical care. Using a deliberative decision-making approach, a debate was held after presentations, and the audience voted for the top-ranked topics (Table 1). The six identified topics, being three in gynecology and obstetrics respectively, reflected areas of common clinical concern and where gaps in knowledge were identified

Young children have social worries too: validation of a brief parent report measure of social worries in children aged 4–8 years

This study investigated the psychometric properties of the Social Worries Anxiety Index for Young children (SWAIY), adapted from the Social Worries Questionnaire—Parent version (SWQ-P; Spence, 1995), as a measure of social anxiety in young children. 169 parents of children aged four to eight years from a community sample completed the SWAIY and a standardized measure of anxiety; the SWAIY was completed again two weeks later. Parents deemed the items appropriate and relevant to children of this age. The SWAIY demonstrated excellent ( > 0.80) internal consistency and a one-factor model. Test-retest reliability was strong (r = 0.87) and evidence of convergent validity (r > .50) was found. The study provides initial evidence for the validation of SWAIY as a measure of social anxiety in children aged four to eight years old. This questionnaire is ideal for investigating social anxiety over early childhood and the relationship between early social worries and later anxiety disorders

Do clinically anxious children cluster according to their expression of factors that maintain child anxiety?

Background Cognitive Behaviour Therapy (CBT) is an effective treatment for childhood anxiety disorders, yet a significant proportion of children do not benefit from it. CBT for child anxiety disorders typically includes a range of strategies that may not all be applicable for all affected children. This study explored whether there are distinct subgroups of children with anxiety disorders who are characterized by their responses to measures of the key mechanisms that are targeted in CBT (i.e. interpretation bias, perceived control, avoidance, physiological arousal, and social communication). Methods 379 clinically anxious children (7–12 years) provided indices of threat interpretation, perceived control, expected negative emotions and avoidance and measures of heart rate recovery following a speech task. Parents also reported on their children's social communication difficulties using the Social Communication Questionnaire (SCQ). Results Latent profile analysis identified three groups, reflecting (i) ‘Typically anxious’ (the majority of the sample and more likely to have Generalized anxiety disorder); (ii) ‘social difficulties’ (characterized by high SCQ and more likely to have social anxiety disorder and be male); (iii) ‘Avoidant’ (characterized by low threat interpretation but high avoidance and low perceived control). Limitations Some measures may have been influenced by confounding variables (e.g. physical variability in heart rate recovery). Sample characteristics of the group may limit the generalizability of the results. Conclusions Clinically anxious children appear to fall in to subgroups that might benefit from more targeted treatments that focus on specific maintenance factors. Treatment studies are now required to establish whether this approach would lead to more effective and efficient treatments

Policy, service, and training provision for women following a traumatic birth: an international knowledge mapping exercise

Background: High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods: A survey was distributed as part of the COST Action "Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes". Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals