Mother-infant psychotherapy and perinatal psychiatry : Current clinical practice and future directions
- Authors: Galbally, Megan , Lewis, Andrew , Snellen, Martien , Paul, Campbell , Szego, Klara , Trauer, Tom
- Date: 2006
- Type: Text , Journal article
- Relation: Australasian Psychiatry Vol. 14, no. 4 (2006), p. 384-389
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- Description: Objective: To explore trends in the practice of mother-infant psychotherapy among perinatal psychiatry clinicians based in Melbourne. Methods: A cross-sectional survey with a purpose designed self-report questionnaire was used to assess the attitudes and practices of 47 perinatal and infant psychiatry clinicians in their use and understanding of mother-infant psychotherapy. Results: Seventy per cent of clinicians in this field of psychotherapy who responded to the questionnaire subscribe to a psychodynamic model, although cognitive behavioural models are also used. The interventions were mostly used in conjunction with other interventions, would be more accurately described as 'parent-infant psychotherapy', and non-psychiatrists in the area tended to be more likely to be formally trained in psychotherapy, but only 4% were formally trained in specific mother-infant psychotherapy. There was a unanimous request for further clinical training in this area. Conclusions: The emerging field of perinatal psychiatry needs to develop coherent therapeutic models and conduct outcome trials on specific interventions. Specific trainings in these models, in assessment and in diagnostic frameworks are required to enhance clinical efficacy, for research and service development purposes. © 2006 Royal Australian and New Zealand College of Psychiatrists.
- Description: C1
- Description: 2003001670
The self-concepts and possible selves of problem gamblers : A qualitative exploration
- Authors: Lewis, Andrew , Carnie, Kendall
- Date: 2006
- Type: Text , Conference paper
- Relation: Paper presented at the 2006 Annual Conference - National Association for Gambling Studies, Alphington, Australia : 10th November, 2005 p. 41-61
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- Description: The study investigated the self-concepts and possible selves of pathological gamblers. Six female egm users were recruited from a Victorian problem gambling counselling service. Three participants were currently gambling and three were not gambling. They were interviewed in-depth and using thematic analysis four dominant themes were identified. (1) Self-concepts tended to be consistent across all participants, (2) having a past self as being the dominant characteristics of possible selves coincided with greater possible selves clarity, (3) non-gambler's had more elaborate and specific plans for how to create change than did gambler's, and (4) non-gambler's had more plans to become possible selves which address goals of intrinsic meaning, rather than having a general goal to 'not gamble'. The findings are discussed in terms of implications for the cognitive theory of possible selves and suggestions for further research to investigate the utility of the constructs as a basis for a treatment modality.
- Description: E1
- Description: 2003002057
DFS based partial pathways in GA for protein structure prediction
- Authors: Hoque, Md Tamjidul , Chetty, Madhu , Lewis, Andrew , Sattar, Abdul
- Date: 2008
- Type: Text , Conference paper
- Relation: Third IAPR International Conference, PRIB 2008
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- Description: Nondeterministic conformational search techniques, such as Genetic Algorithms (GAs) are promising for solving protein structure prediction (PSP) problem. The crossover operator of a GA can underpin the formation of potential conformations by exchanging and sharing potential sub-conformations, which is promising for solving PSP. However, the usual nature of an optimum PSP conformation being compact can produce many invalid conformations (by having non-self-avoiding-walk) using crossover. While a crossover-based converging conformation suffers from limited pathways, combining it with depth-first search (DFS) can partially reveal potential pathways. DFS generates random conformations increasingly quickly with increasing length of the protein sequences compared to random-move-only-based conformation generation. Random conformations are frequently applied for maintaining diversity as well as for initialization in many GA variations.
Short-term psychodynamic psychotherapy : Review of recent process and outcome studies
- Authors: Lewis, Andrew , Dennerstein, M. , Gibbs, Petah
- Date: 2008
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 42, no. 6 (2008), p. 445-455
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- Description: Short-term psychodynamic psychotherapy (STPP) is a widely practised form of psychological intervention. Given that the Roth and Fonagy (1996) review concluded that there was a lack of confirming evidence for STPP, the current review is focused on studies published between 1996 and 2006 that evaluate the efficacy of STPP. As a result of a systematic literature review, 18 studies were found that met inclusion criteria consistent with those used by Roth and Fonagy (1996) for selection of studies, patient groupings and definition of therapeutic method. In general these studies add to an increasing body of evidence suggesting that STPP can be an effective psychological treatment for individuals experiencing mental health problems. Specifically, for depression STPP can be equal in effects to other psychological treatments and is significantly better than no treatment in the short term. Furthermore, emerging process data indicate that there is a significant relationship between the use of specific psychodynamic therapeutic techniques and the alleviation of depressive symptoms. Increasing evidence has emerged to support STPP as a treatment for generalized anxiety disorder, panic disorder and some personality disorders. There remains limited evidence for the use of STPP treatment for patients with anxiety disorders that relate more to stress. Very limited and inconclusive evidence currently exists to support STPP as a treatment for bipolar disorder, eating disorders and drug dependency. Future research needs to include broader assessment measures, long-term follow up, studies that maintain an identifiable focus, and research that includes a focus on psychotherapy process variables as they interact with outcomes.
- Description: C1
Brief report : The defense mechanisms of homophobic adolescent males : A descriptive discriminant analysis
- Authors: Lewis, Andrew , White, Jennifer
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Adolescence Vol. 32, no. 2 (2009), p. 435-441
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- Description: The study examined the role of defense mechanisms in homophobic attitudes of older male adolescents aged 17-18 years. A cross-sectional survey collected data from final year high school students (N = 86) attending an all male school in a regional centre in Victoria, Australia. The school was identified by teachers as having a problematic culture of homophobic intolerance. Participants were divided into homophobic and non-homophobic groups based on their scores on the Homophobia Scale Questionnaire. Discriminant analysis was conducted to identify the predictors that would best categorise students into those two groups on the basis of defense styles derived from the Defense Style Questionnaire-40 (DSQ-40). The strongest predictors of homophobia amongst defense styles were idealisation, denial, somatisation and devaluation accounting for 18.31%, 17.64%, 13.10% and 11.35% of the variance, respectively. Results generally supported the larger contribution of more immature defenses to higher levels of homophobia. © 2008 The Association for Professionals in Services for Adolescents.
Twin removal in genetic algorithms for protein structure prediction using low-resolution model
- Authors: Hoque, Md Tamjidul , Chetty, Madhu , Lewis, Andrew , Sattar, Abdul
- Date: 2011
- Type: Text , Journal article
- Relation: IEEE/ACM Transactions on Computational Biology and Bioinformatics Vol. 8, no. 1 (2011), p. 234-245
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- Description: This paper presents the impact of twins and the measures for their removal from the population of genetic algorithm (GA) when applied to effective conformational searching. It is conclusively shown that a twin removal strategy for a GA provides considerably enhanced performance when investigating solutions to complex ab initio protein structure prediction (PSP) problems in low-resolution model. Without twin removal, GA crossover and mutation operations can become ineffectual as generations lose their ability to produce significant differences, which can lead to the solution stalling. The paper relaxes the definition of chromosomal twins in the removal strategy to not only encompass identical, but also highly correlated chromosomes within the GA population, with empirical results consistently exhibiting significant improvements solving PSP problems.
Dimensions of religious/spiritual well-being in relation to personality and stress coping: Initial results from Bosnian young adults
- Authors: Malinovic, Alen , Fink, Andreas , Lewis, Andrew , Unterrainer, Human-Friedrich
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of spirituality in mental health Vol. 18, no. 1 (2016), p. 43-54
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- Description: The aim of this study was to examine possible relationships between religious/spiritual well-being (RSWB), the Big Five personality factors, and stress coping strategies among Bosnian young adults. Therefore, a first Bosnian translation of the Multidimensional Inventory of Religious/Spiritual Well-being was applied on a sample of 290 (181 females) Bosnian undergraduate students. RSWB dimensions such as hope, forgiveness, or general religiosity were found to be substantially related with more favorable personality dimensions as well as with more adequate stress coping. As a conclusion RSWB dimensions were confirmed as being an important resource for mental health for this sample of Bosnian adolescents.
Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: a systematic literature review
- Authors: Seth, Sunaina , Lewis, Andrew , Galbally, Megan
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Pregnancy Childbirth Vol. 16, no. 1 (2016), p. 124-124
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- Description: Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains unclear. This article provides a systematic review of studies examining the effects of maternal cortisol function on perinatal depression. A systematic search was conducted of six electronic databases for published research on the relationship between cortisol and perinatal depression. The databases included MEDLINE complete, PsychINFO, SCOPUS, Psychology and Behavioural Sciences, Science Direct and EBSCO, for the years 1960 to May 2015. Risk of bias was assessed and data extraction verified by two investigators. In total, 47 studies met criteria and studies showed considerable variation in terms of methodology including sample size, cortisol assays, cortisol substrates, sampling processes and outcome measures. Those studies identified as higher quality found that the cortisol awakening response is positively associated with momentary mood states but is blunted in cases of major maternal depression. Furthermore, results indicate that hypercortisolemia is linked to transient depressive states while hypocortisolemia is related to chronic postpartum depression. Future research should aim to improve the accuracy of cortisol measurement over time, obtain multiple cortisol samples in a day and utilise diagnostic measures of depression. Future studies should also consider both antenatal and postnatal depression and the differential impact of atypical versus melancholic depression on cortisol levels, as this can help to further clarify the relationship between perinatal depression and maternal cortisol function across pregnancy and the postpartum period.
Prenatal maternal mental health and fetal growth restriction: a systematic review
- Authors: Lewis, Andrew , Austin, Emma , Galbally, Megan
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Developmental origins of Health and Disease Vol. 7, no. 4 (2016), p. 416-428
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- Description: Maternal mental disorders during pregnancy are associated with a range of adverse health outcomes for offspring. This systematic review examines studies reporting on the relationship between maternal depression, anxiety or stress during pregnancy and fetal growth measured during pregnancy using ultrasound biometry. A systematic search of PsycINFO, Medline, Scopus, Web of Science and Embase was conducted and 1575 records were identified, with nine studies meeting inclusion criteria gathering data from over 7000 participants. All studies measured depression, six examined anxiety and depression, and five examined all three exposures. The majority measured symptoms rather than clinically diagnosable disorder. Studies consistently reported significant associations between maternal mental health, particularly anxiety symptoms, and reduced fetal head growth. Other fetal growth parameters showed inconsistent findings. A number of studies suggest that cortisol dysregulation associated with maternal mental health may play a role in fetal growth restriction. However, heterogeneity in the timing of growth measurement, assessment measures used for mental health and inconsistencies in adjustment for confounders, limits the synthesis and interpretation of findings. Future studies should consider differences in the timing, intensity and duration of mental health symptoms over pregnancy and should employ diagnostic assessment of mental disorders. Fetal growth should be repeatedly measured and further work is needed to establish the biological mechanisms involved.
Prenatal maternal mental health and fetal growth restriction: a systematic review
- Authors: Lewis, Andrew , Austin, Emma , Galbally, Megan
- Date: 2016
- Type: Journal article
- Relation: Journal of Developmental Origins of Health and Disease Vol. 7, no. 4 (2016), p. 416-428
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- Description: Maternal mental disorders during pregnancy are associated with a range of adverse health outcomes for offspring. This systematic review examines studies reporting on the relationship between maternal depression, anxiety or stress during pregnancy and fetal growth measured during pregnancy using ultrasound biometry. A systematic search of PsycINFO, Medline, Scopus, Web of Science and Embase was conducted and 1575 records were identified, with nine studies meeting inclusion criteria gathering data from over 7000 participants. All studies measured depression, six examined anxiety and depression, and five examined all three exposures. The majority measured symptoms rather than clinically diagnosable disorder. Studies consistently reported significant associations between maternal mental health, particularly anxiety symptoms, and reduced fetal head growth. Other fetal growth parameters showed inconsistent findings. A number of studies suggest that cortisol dysregulation associated with maternal mental health may play a role in fetal growth restriction. However, heterogeneity in the timing of growth measurement, assessment measures used for mental health and inconsistencies in adjustment for confounders, limits the synthesis and interpretation of findings. Future studies should consider differences in the timing, intensity and duration of mental health symptoms over pregnancy and should employ diagnostic assessment of mental disorders. Fetal growth should be repeatedly measured and further work is needed to establish the biological mechanisms involved.
The Validation of a Spanish version of the multidimensional inventory of religious/spiritual well-being in mexican college students
- Authors: Berger, Daniela , Fink, Andreas , Perez Gomez, Maria , Lewis, Andrew , Unterrainer, Human-Friedrich
- Date: 2016
- Type: Text , Journal article
- Relation: Spanish journal of psychology Vol. 19, no. (2016), p. E3-E3
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- Description: After the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was validated as a reliable instrument for the Western European context it is primarily intended in this study to translate the measure into Spanish and adapt it for the Mexican culture. Furthermore we investigate whether spirituality/religiosity has a similar impact on indicators of personality and subjective well-being in Mexico as it does in samples drawn from Western European cultures. 190 students (99 females) from public and private universities in Guadalajara, all Mexican citizens, were involved in this study. We found strong evidential support for the six factor solution of the Original MI-RSWB in this Mexican population. By mirroring previous research the measure showed a highly satisfying internal consistency (α = .91 for the total score and .75 or higher for all six sub dimensions). Furthermore the total RSWB score was observed to be related with Eysenck’s personality dimensions Extraversion (r = .24, p < .01), and Psychoticism (r = –.28, p < .001), although not with Neuroticism. There was also a positive correlation with Sense of Coherence (r = .31, p < .001). In conclusion, the dimensionality of RSWB and its associations with personality and subjective well-being was well supported in this first application within a Mexican cultural context.
Vulnerable dark triad personality facets are associated with religious fundamentalist tendencies
- Authors: Unterrainer, Human-Friedrich , Ruttinger, Johanna , Lewis, Andrew , Anglim, Jeromy , Fink, Andreas , Kapfhammer, Hans-Peter
- Date: 2016
- Type: Text , Journal article
- Relation: Psychopathology Vol. 49, no. 1 (2016), p. 47-52
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- Description: Background: This study explores the possibility that religious fundamentalism (RF) may be linked to deficits in personality structure, which is in contrast to the general assumption that religiosity and spirituality are positively related to mature personality development. Sampling andMethods: To test this hypothesis, 327 (232 female) college students completed the Multidimensional Inventory for Religious/Spiritual Well-Being together with the Innsbrucker Religious Fundamentalism Scale. In addition, the ‘vulnerable dark triad' of personality (‘vulnerable narcissism', subscale of the Pathological Narcissism Inventory ‘secondary psychopathy', subscale of Levenson's Self-Report Psychopathy Scale ‘borderline personality', of the Borderline Personality Inventory) was assessed. Results: In general, the relation between spirituality and healthy personality functioning was confirmed. In addition to greatly overlapping with ‘general religiosity' (p < 0.001), RF was also relevantly predicted by narcissistic (‘hiding the self') and borderline (‘primitive defenses') personality facets (p < 0.05 for both). Conclusions: Based on these preliminary data, we conclude that specific structural deficits in personality might lead to more rigorous variants of religious/spiritual beliefs such as RF. Further research in clinical surroundings as well as in religious extremist groups is recommended.
An Australian adaptation of the strengthening families program: Parent and child mental health outcomes from a pilot study
- Authors: Burn, Michele , Lewis, Andrew , McDonald, Louise , Toumbourou, John
- Date: 2019
- Type: Text , Journal article
- Relation: Australian psychologist Vol. 54, no. 4 (2019), p. 261-271
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- Description: This is the first pilot study to examine the Australian adaptation of the Strengthening Families Program (SFP), a manualised family intervention recommended internationally in evidence reviews to improve family functioning and child mental health. The study compared two versions (8 vs. 14-session) and longitudinally evaluated outcomes for child emotional and behavioural difficulties, and parental psychological distress. Fifty-eight families from disadvantaged primary schools in regional Victoria with children 8-12-years (80.6% of initially enrolled families, 62 parents and 74 children) completed the program and evaluation measures. Measures were repeated at pre-, post-, and 3-month follow-up and included the Kessler 6, the Strengths and Difficulties Questionnaire, and subscales adapted from the Longitudinal Study of Australian Children and Communities that Care Youth Survey. The program showed significant reductions in child difficulties and parental psychological distress from pre- to post-measurements that were sustained at follow-up. Reductions in parental psychological distress were significantly associated with reductions in child difficulties at follow-up. The 8- and 14-session formats were not found to be significantly different in reducing child difficulties or parental psychological distress. Effect sizes for the Australian version were similar to those reported in previous U.S. trials. Findings support the feasibility and effectiveness of an Australian adaptation of the SFP. The current study is unique in identifying similar outcomes for shorter and longer versions of the intervention. It is recommended that the 8-session Australian version is examined in a larger randomised controlled trial where children present with behavioural and emotional problems.
Breastfeeding, antidepressants, and depression in the mercy pregnancy and emotional well-being study
- Authors: Galbally, Megan , Watson, Stuart , Ball, Helen , Lewis, Andrew
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Human Lactation Vol. 35, no. 1 (2019), p. 127-136
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- Description: Background: Depression is consistently shown to predict lower rates of breastfeeding. In a handful of studies, breastfeeding has predicted lower depression symptoms. However, studies demonstrating the latter are limited in their measurement of both depression and breastfeeding and have not followed participants from pregnancy across the postpartum period. Research Aim: The primary aim of this study was to describe breastfeeding intentions and behaviors for the first 12 months postpartum among nonmedicated depressed, antidepressant-exposed, and control participants. The secondary aim was to examine group differences in the association between depressive symptoms and breastfeeding duration up to 12 months postpartum. Methods: First-trimester women (N = 212) were recruited into a prospective longitudinal study. Depressive disorders at baseline were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders, and depressive symptoms were measured at the first and second trimesters and 6 and 12 months postpartum using the Edinburgh Postnatal Depression Scale. Breastfeeding duration, support from family and employers, and perceptions of participants’ experience were measured. Results: Depressed women and antidepressant-exposed women reported a trend toward lower rates of intention, initiation, and duration, but this did not reach statistical significance. There was a statistically significant difference on depressive symptoms for women taking antidepressants during pregnancy, compared with controls, when they continued to breastfeed for 12 months postpartum. Conclusions: This study did not find a strong association between depression or antidepressant use and intention to breastfeed, partner breastfeeding support, or initiation or duration of breastfeeding. However, for women who took antidepressants, there was evidence that breastfeeding for 12 months was associated with lower depressive symptoms.
Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function
- Authors: Galbally, Megan , Watson, Stuart , Permezel, Michael , Lewis, Andrew
- Date: 2019
- Type: Text , Journal article
- Relation: Psychological Medcine Vol. 49, no. 9 (2019), p. 1490-1499
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- Description: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning. This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support. Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning. Pregnancy and the postpartum are a time of reduced sexual functioning for women however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.
Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort
- Authors: Porter, Elisa , Lewis, Andrew , Watson, Stuart , Galbally, Megan
- Date: 2019
- Type: Text , Journal article
- Relation: Infant behavior & development Vol. 57, no. (2019), p. 101336
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- Description: •This study uses longitudinal data from a prospective cohort study of Australian pregnant women and their children.•Perinatal maternal depression and anxiety positively predicted problems in offspring social-emotional development at 12 months.•Higher early pregnancy maternal depressive and anxiety symptoms predicted increased problems with children’s social-emotional development.•Also increasing symptoms during the perinatal period predicted increases in these same problems.•Results support the need to develop and evaluate perinatal interventions for mothers and infants impacted by depression and anxiety. Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.
The role of trauma and partner support in perinatal depression and parenting stress: An Australian pregnancy cohort study
- Authors: Galbally, Megan , Watson, Stuart , Boyce, Philip , Lewis, Andrew
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Social Psychiatry Vol. 65, no. 3 (2019), p. 225-234
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- Description: Background: Improving our understanding of the relationship between maternal depression and parenting stress is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress. Objectives: To examine the role of trauma and partner support, in understanding the relationship between perinatal depression and parenting stress. Methods: This study utilises data from 246 women in a pregnancy cohort study that followed women from early pregnancy until their infant was 12 months. Included were both women with a diagnosis of depression and those without depression. The measures included Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Edinburgh Postnatal Depression Scale, Childhood Trauma Questionnaire, Social Support Effectiveness Questionnaire and the Parenting Stress Index. Results: We found women with depression were more likely to report a history of childhood trauma. Depressive symptoms were positively associated with parenting stress while partner support was negatively associated with parenting stress. The protective role of partner support for parenting distress was observed in those with no history of childhood abuse and low depressive symptoms, but not in those with a trauma history and high depressive symptoms. Conclusions: These findings highlight the importance of early trauma in understanding the protective role of support on the relationship between parenting and depression. These findings can inform future studies and the refinement of future interventions aimed at both perinatal depression and parenting.
Trans-generational stress regulation: Mother-infant cortisol and maternal mental health across the perinatal period
- Authors: Galbally, Megan , van Rossum, Elisabeth , Watson, Stuart , de Kloet, Edo , Lewis, Andrew
- Date: 2019
- Type: Text , Journal article
- Relation: Psychoneuroendocrinology Vol. 109, no. (2019), p. 104374-104374
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- Description: •Antenatal depression and cortisol may be important for developing infant stress regulation.•Hair cortisol concentrations are useful for measuring cortisol in pregnancy and the postpartum.•Maternal hair cortisol concentration across pregnancy was not associated with maternal depression.•Antenatal maternal depressive symptoms were both associated with lower infant cortisol at 12 months of age.•Lower infant cortisol reactivity was associated with higher infant externalizing symptoms. Understanding maternal mental health and cortisol regulation across pregnancy and the relationship to the development of the offspring’s stress regulation is critical to a range of health outcomes. The aim of this study was to investigate infant and maternal cortisol in women with depression. Data were obtained from 241 pregnant women within the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a selected pregnancy cohort study. Depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) and repeat Edinburgh Postnatal Depression Scale (EPDS). Repeated measures of antidepressant use, stressful events, anxiety symptoms and maternal hair cortisol concentrations (HCC) and infant cortisol at 12 months postpartum in saliva and hair. Socio-emotional outcomes were measured at 12 months by maternal report on the Brief Infant and Toddler Socio-emotional Assessment (BITSEA). This study found that maternal depression was not associated with maternal HCC. Anxiety, stress and antidepressant use were not associated with maternal HCC. Independently, higher maternal 3rd trimester maternal depressive and anxiety symptoms were associated with lower infant cortisol response at 12 months of age. A higher number of postpartum stressful events was associated with lower infant cortisol response. Lower infant stress reactivity was associated with higher externalizing symptoms at 12 months of age. Future studies are required to understand implications for later mental health.
Maternal depression and the emotional availability of mothers at six months postpartum: Findings from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) pregnancy cohort
- Authors: MacMillan, Kelli , Lewis, Andrew , Watson, Stuart , Galbally, Megan
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 266, no. (2020), p. 678-685
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- Description: •Perinatal depression has been associated with poorer quality mother-infant interaction.•Emotional availability (EA) is an observable aspect of the mother-infant interaction.•Of the maternal depression and EA studies, few utilise both symptomatic and diagnostic measures.•Symptoms but not diagnosis of depression in early pregnancy were associated with lower EA.•Neither diagnosis of depression or late pregnancy or postnatal symptoms were linked to reduced EA. Existing research suggests maternal depression may reduce the quality of early mother-infant interaction and this might increase our understanding of how maternal mental health impacts on child development outcomes. However, most studies recruit from community samples and few include both a diagnostic measure of maternal depression together with an observational measure of the quality of the mother-infant relationship. Data was drawn from 210 women recruited in early pregnancy until 6 months postpartum within an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Those women who at six months postpartum were video recorded interacting with their infant for at least 40-minutes were included in this study, with the quality of those interactions assessed using the Emotional Availability Scales coding system. Depression was measured using the Structured Clinical Interview for the DSM-IV-TR Clinician Version and the Edinburgh Postnatal Depression Scale, and covariates included maternal age and education. Whilst results showed a small negative association between antenatal depressive symptoms in trimester one of pregnancy and maternal EA, there was no effect of maternal depression diagnosis or of maternal depressive symptoms in later pregnancy or postpartum. This study focuses exclusively on mothers and does not account for the role of partners. Maternal depression might have a smaller effect on maternal EA then some existing research implies, with that effect most prevalent in early pregnancy. Clinical intervention might not be necessary for all mother-infant dyads experiencing depressive symptomology, but instead be directed to those with additional risk factors.
Maternal perinatal depression, circulating oxytocin levels and childhood emotional disorders at 4 years of age: The importance of psychosocial context
- Authors: Galbally, Megan , Watson, Stuart , Keelan, Jeff , MacMillan, Kelli , Power, Josephine , Ijzendoorn, Marinus van , Lewis, Andrew
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Psychiatric Research Vol. 130, no. (2020), p. 247-253
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- Description: Oxytocin has been a hormone of interest in understanding both depression and parenting. Here, the role of oxytocin has been explored in understanding the interaction between perinatal depression, history of trauma and subsequent longer-term child socio-emotional outcomes. Data were obtained from 203 pregnant women from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a pregnancy cohort study with data collected across pregnancy, postpartum and until 4 years for mother and child. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) together with the Childhood Trauma Questionnaire to measure maternal trauma history. Maternal oxytocin levels were measured by enzyme immunoassay following extraction at four time points across pregnancy and the postpartum. The offspring consisted of 203 children followed up from birth until 4 years of age when they were assessed for DSM 5 depression and anxiety disorders (emotional disorders) using the Preschool Age Psychiatric Assessment. Maternal oxytocin levels increased over pregnancy and the postpartum in both control and depressed women with no difference between groups. Maternal childhood trauma and antenatal antidepressant use was also not associated with maternal oxytocin levels. Lower gestational age, maternal depression and early childhood trauma, and late pregnancy oxytocin concentrations were associated with later childhood emotional disorders together they predicted 10% of variance for emotional disorders. Oxytocin is a hormone whose role in understanding intergenerational risk from pregnancy to child emotional disorders is dependent on relational context. Future research can expand on understanding these important early predictors of childhood mental health.