Interventions for postnatal depression assessing the mother–infant relationship and child developmental outcomes: a systematic review

Zoe-Lydia Tsivos,1 Rachel Calam,1 Matthew R Sanders,1,2 Anja Wittkowski1 1School of Psychological Sciences, University of Manchester, Manchester, UK; 2Parenting and Family Support Center, University of Queensland, Brisbane, Australia Abstract: Postnatal depression (PND) has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research. Keywords: postnatal depression, infant development, intervention, dyad, mother–infant relationship, systematic revie

Narrative review of interventions suitable for well-baby clinics to promote infant attachment security and parents' sensitivity

Aim The aim of this narrative review was to evaluate the evidence for interventions for children's secure attachment relationships and parents’ caregiving sensitivity that could potentially be implemented in the context of a well‐baby clinic. Methods Literature search on programmes for parental caregiving sensitivity and secure attachment for infants aged 0‐24 months. Randomised controlled trials (RCTs) published 1995‐2018 with interventions starting from one week postpartum, and with a maximum of 12 sessions (plus potential booster session) were included. Results We identified 25 studies, of which 22 studied effects of home‐based programmes using video feedback techniques. Positive effects of these interventions in families at risk were found on parental caregiving sensitivity and to a lesser extent also on children's secure or disorganised attachment. The effects of two of these programmes were supported by several RCTs. Three intervention studies based on group and individual psychotherapy showed no significant positive effects. Most of the interventions targeted mothers only. Conclusion The review found some evidence for positive effects of selective interventions with video feedback techniques for children's secure attachment and strong evidence for positive effects on parental caregiving sensitivity. Important knowledge gaps were identified for universal interventions and interventions for fathers and parents with a non‐Western background

Baby Triple P for Parents of a Very Preterm Infant: A Case Study

© 2016 Springer Science+Business Media New York. The objective was to examine one family’s experience with the parenting intervention Baby Triple P for parents of a very preterm infant. The family was in the intervention group of a large randomized controlled trial. At baseline, 6-weeks corrected-age and 12-months corrected-age, both parents were assessed for depression as measured by the Edinburgh Postnatal Depression Scale and subjective stress as measured by the Impact of Event Scale. At 6-weeks corrected-age and 12-months corrected-age, the mother was assessed for maternal self-efficacy as measured by the Maternal Self-Efficacy Scale, attachment as measured by the Maternal Postnatal Attachment Scale, responsiveness as measured by the Maternal Infant Responsiveness Instrument, and the quality of the mother-infant relationship as measured by the Emotional Availability Scales. Results at baseline showed the mother was at risk for depression and was experiencing a moderate level of subjective stress, while the father was experiencing a mild level of subjective stress. After the Baby Triple P intervention, the mother’s Edinburgh Postnatal Depression Scale and Impact of Event Scale scores and the father’s Impact of Event Scale score had dropped to within the normal range at 6-weeks corrected-age, and were maintained at 12-months corrected-age. The mother also indicated she experienced greater levels of self-efficacy, attachment, responsiveness, and the quality of the relationship with her infant. Both parents rated that they were very satisfied with the Baby Triple P program on the Client Satisfaction Questionnaire. This study indicated that the Baby Triple P intervention may be beneficial for some families with a very preterm infant