Article

[Effect of paternity leave on maternal postpartum depression].

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Abstract

The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression. Fifty-one couples took part in the whole study. Between the second and the fifth day after the childbirth, the mother completed the Edinburgh Postnatal Depression Scale (EPDS), which measures the symptoms of depression and the Multidimensional Scale of Perceived Social Support (MSPSS) which measures the social support the mother has become. The father completed the EPDS. Two months and then the second time four months after the childbirth, the mother received the EPDS, the MSPSS, and questionnaires measuring the temperament of the baby, the maternal skills, the feeling of being a mother and the quality of life postpartum. In order to evaluate the paternal involvement, the father completed the EPDS and questions about paternal skills and involvement. The paternity leave seemed not to have any consequences on the results at the EPDS or other questionnaires. However, lack of paternal involvement was a significant predictor of the intensity of the depressive symptoms of the mothers. It is not the presence of the father wich seems important to take into account for detection and the traitement of postpatum depression but his participation in the care of the baby.

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... A review of 58 studies by Shorey, et al. [21] and enrolling 37,294 women in the postpartum period revealed that the PPD prevalence ranged from almost 1% to 42.7%, an average of about 17%, and the author partially attributed this variance to cultural factors, including variability in the definition and expression. For example, in Chinese society, after delivery, postpartum women are generally discharged within 1 week [22] but stay in confinement for at least 30 days [23]. PPD usually develops within the first few weeks after childbirth but may begin earlier or later, even up to a year after birth [16,23]. ...
... Sword, et al. [25] reported that relatives' and spouses' limited knowledge regarding PPD affects how women frame their experiences. PPD can cause many severe problems for family members and even affect children's education and family life [7,22]. Consequently, having understanding and knowledge of PPD is crucial for postpartum women and their family. ...
... The purpose of the questionnaire was to assess postpartum women's awareness of PPD and to examine the associations among knowledge, attitude, and prevention of PPD. The self-administered questionnaire consisting of four parts (16 questions) was developed after reviewing the literature and after conducting a qualitative study by using flexible semi-structured interviews of 10 postpartum mothers and their family members (five husbands, five mothersin-law, and five mothers of the postpartum woman) [3,5,7,8,17,19,22,24,25,[27][28][29][30]. The study obtained four main themes: (1) causes of PPD (family relationships, disease history, and the condition of the baby), (2) PPD prevention practices (self-confidence of the postpartum woman, health services, and activities), (3) viewpoints regarding to PPD (problems in daily life and while having a baby), and (4) selfevaluation (knowledge of PPD). ...
Article
Aim: Postpartum depression is a highly prevalent disorder, and it has been recognized as a public health problem. In Chinese culture, after childbirth, women must stay at home for postpartum confinement. However, more than 50% of postpartum women tend to experience depression symptoms 3–4 days after delivery. Although the prevention and causes of postpartum depression have been extensively studied, the assessment tools used are usually based on Western cultures. A Chinese-version assessment scale was necessary. The objective of this study was to develop a culturally sensitive questionnaire for assessing the knowledge, attitude, and prevention behaviors toward postpartum depression of Taiwanese women, and examined the associations among postpartum depression knowledge, attitude, and prevention. Methods: Two-phase study was conducted. First, a postpartum depression scale was developed and its reliability and validity were tested in 50 people. Second, 639 postpartum women from seven hospitals were asked to complete the questionnaire. Results: The questionnaire, which contained four subscales and 16 questions (Cronbach's α = .82–.84), was administered in the postpartum room and required 5–10 min for completion. This questionnaire showed face validity and high acceptance, the factor analysis showed that the questionnaire has acceptable structural reliability. High scores on the postpartum depression knowledge and attitude subscales were associated with higher prevention behavior subscale scores. Conclusion: The finding of this questionnaire is an effective tool for determining postpartum women’s understanding of postpartum depression. Understanding postpartum depression knowledge, attitude and prevention are essential to assess and promote the postnatal care
... negatively affect how fathers interact with their families and can affect the level of paternal involvement (Bielawska-Batorowicz & Kossakowska- Petrycka, 2006; Garfield & Isacco, 2009). Paternal involvement has many protective factors for families and has been linked to increased maternal wellbeing and better maternal attitudes toward motherhood (Sejourne, Vaslot, Beaume, Goutaudier, & Chabrol, 2012). Furthermore, high levels of paternal involvement during a child's infant and toddler stage is positively associated with children's emotional, cognitive, and social well-being (O'Brien, Brandth, & Kvande, 2007). ...
... Researchers have also found harmful effects of paternal PPD on infants' cognitive development and parent-infant interactions ( Sejourne et al., 2012). Prenatal and postnatal mental health of fathers plays an important role in children's development and executive functioning (Vänskä et al., 2017). ...
Article
Although postpartum depression is common and well-studied in mothers, many fathers also experience symptoms. This qualitative study investigated fathers’ experiences of postpartum depression. Data from secondary sources such as blogs, websites, forums, and chat rooms were analyzed using a combination of phenomenological and content analysis methods to understand father’s experiences of paternal postpartum depression. Six themes emerged from the data including fathers’ needing education, adhering to gender expectations, repressing feelings, being overwhelmed, resentment of baby, and the experience of neglect. These data provide useful information that can aid health care providers, researchers, clinicians, and families in understanding the experience of paternal postpartum depression and in better coping with the challenges these families face.
... Firstly, with the depressed mother the father activates protective behaviour, but with the passing of time it becomes difficult for him to continue in this and stand the sense of impotence and adapt to the sensation of being put aside and criticized, of not being certain of going back to normal sexual activity after the child's birth and the fear that care for the child will be solely his responsibility owing to the incapacity of the mother to deal with the child's needs [76][77][78][79]. ...
... According to Sèjournè the involvement of the father two months after birth correlates negatively with the maternal PPD [79]. ...
Article
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Background: Numerous studies have shown that postpartum depression is a phenomenon that develops in a family, social and economic context capable of influencing its course. A predominant role in the onset of the pathology is played by the relationship of the couple, but up to now few studies have been carried out on the role of the partner of the depressed mother and on the interactions between the two partners, that is, on how maternal depression influences the behaviour of the male partner and is in turn influenced, and how the depression of both parents, and not only that of the mother, influences the neuropsychic development of the child and the interactions between the child and the outside world. Objectives: The objectives are to examine the literature to arrive at an understanding of how the father figure develops during the pregnancy and how postpartum depression impacts on the couple's relationship and the care of the children by both partners. Materials and methods: This article presents a review of recent literature on the subject through a search for articles in Pubmed and Sciencedirect (keywords: men, postpartum depression, fathers, couple, prediction, detection), and by referring to classic texts in the fields of psychiatry and psychotherapy on the development of the parental figures. Conclusions: Although up to now the literature on the consequences of postpartum depression on the couple is scanty, the data collected allow us to affirm that it is not a problem that concerns only the mother, but one that has an impact on the entire family, on the child and the partner, triggering a chain reaction of maladjustment and distress that may lead to separation and destruction of the family unit with important repercussions on society as a whole.
... 30 Conversely, when paternity leave leads to increased paternal involvement (as it seems would naturally be the case), mothers are less depressed. 31 Studies have also observed higher PPD rates in countries where reproductive-aged women worked >40 h per week, noting that working full-time while caring for children can cause stress linked to PPD. 12 The US Preventive Services Task Force recently issued a recommendation that clinicians provide or refer pregnant and postpartum patients at increased risk for PPD to counseling interventions, perhaps reflecting increased recognition of the role of nonpharmacologic interventions in the prevention and treatment of PPD. 5 PPD is a common condition in the United States that causes harm to entire families. Brexanolone represents a mechanistically novel approach to the treatment of PPD that has shown initial efficacy data that are encouraging. ...
Article
Brexanolone recently became the first medication to be approved by the US Food and Drug Administration specifically for treating postpartum depression. In contrast to traditional antidepressants, however, brexanolone is a neurosteroid that is believed to mimic allopregnanolone, a product of endogenous progesterone. Although early clinical trials have shown success, the medication remains largely unavailable due to its extremely high cost and formulation (it must be given as a continuous intravenous infusion over 3 days in a monitored, inpatient setting). The efficacy data surrounding brexanolone are encouraging; there is also evidence, however, that postpartum depression may be mitigated by a number of social policies that provide support to new parents. We suggest a comprehensive approach to postpartum wellness that includes investing in evidence-based social interventions that may be much more accessible to the millions of Americans experiencing postpartum mood disturbance.
... In contrast, all forms of support from the father of the child reduce the chances of the mother developing depressive symptomatology, since there is an intimate relationship between marital satisfaction and positive psychological effects. 9 Besides the family and the spouse, the pregnant teenager may also seek support with her friendship contacts. However, many of them suffer from discrimination from friends and society. ...
Article
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Objective: to analyze family and social reactions to pregnancy in adolescence. Method: this is a qualitative, descriptive, and exploratory study with 21 mothers from 14 to 19 years old. The interviews were carried out in five Basic Health Units, recorded and later transcribed to enable content analysis in the Thematic Analysis modality. Results: four categories emerged: << Family reactions to adolescent pregnancy >>; << Reactions of the child´s father in the pregnancy of the adolescent >>; << Reactions of friends and society in the adolescent pregnancy >>; << Social discrimination experienced by adolescents >>. Conclusion: the revelation of pregnancy in adolescence can generate ambiguous feelings ranging from surprise, acceptance, and joy to negative reactions characterized by verbal aggression, abortion imposition, refusal of paternity and distance from friends. Some young women reported having suffered discrimination from health professionals and their mothers' friends, viewed as a bad influence. Descriptors: Pregnancy in Adolescence; Family Conflict; Social Support; Family Relations; Interpersonal Relations; Nursing.
... A cutoff was set to include scores of 65 or less, as such score was deemed indicative of a level of perceived social support sufficiently low to warrant intervention (Gallegos, 2007;Husain et al., 2006;Roman et al., 2007). The MSPSS has been used in clinical and nonclinical settings (Cecil, Stanley, Carrion, & Swann, 1995;Schneider & Chesky, 2011;Tripp, Nickel, & Katz, 2011;Uchino, Bowen, Carlisle, & Birmingham, 2012), in various age groups (Canty-Mitchell & Zimet, 2000;Golbasi & Erenel, 2012;Veselska et al., 2010), and in samples with various cultural backgrounds (Akhtar et al., 2010;Eker & Arkar, 1995;Karukivi et al., 2011;Sawant & Jethwani, 2010;Sejourne, Beaume, Vaslot, & Chabrol, 2012;Vaingankar, Abdin, & Chong, 2012). ...
Article
Background: Psychosocial well-being in the workplace may increase retention of oncology nurses, while a lack of social support has been a predictor of occupational stress in nurses. Purpose: To further explore this phenomenon by examining the psychometric properties of the Multidimensional Scale of Perceived Social Support in Greek nurses working in oncology and mental health settings. Methods: A cross-sectional design was used. The sample consisted of 150 nurses (70 oncology nurses and 80 mental health nurses) from the area of greater Athens who joined the study. The scale was translated to Greek using the "forward-backward" procedure. The Multidimensional Scale of Perceived Social Support's internal consistency reliability (Cronbach's α), stability (intraclass correlation coefficient), factor structure (factor analysis), and convergent validity (correlation with Ways of Coping Questionnaire) were examined. Results: A three-factor (significant others, family, and friends) model was confirmed. The subscales representing the three factors demonstrated excellent internal consistency reliability (Cronbach's αs > .90) and stability intraclass correlation coefficient (>.90). Conclusions: The measure is reliable and valid, and it can be used to assess nurses' social support; the results of such an assessment could be helpful when selecting strategies for assisting nurses.
... Un questionnaire a été créé pour la présente étude afin de mesurer l'implication maternelle dans les soins prodigués au bébé lors de la période d'hospitalisation en service de néonatalogie. Basée sur une revue critique de la littérature [45,46], cette échelle comporte 8 items reflétant des aspects spécifiques de l'implication maternelle concernant les soins dispensés au bébé lors de la période de couveuse (ex. : j'ai fait du « peau à peau » avec mon bébé). ...
Article
Objectives Empirical data regarding depressive, anxiety and posttraumatic stress disorder (PTSD) symptom profile following premature birth are lacking. The present study aims to: firstly, identify the typology of women who delivered prematurely based on anxiety, depressive and PTSD symptoms; and secondly, examine whether these profiles differ on maternal perception of infant temperament, mother–infant bond and maternal involvement in infant care during the hospitalization process. Participants and method Within four weeks of a preterm infant's hospital discharge, 110 French mothers (mean age [SD] = 29.5 [4.3] years) completed questionnaires assessing PTSD symptoms, depressive and anxiety symptoms, maternal involvement in infant care, maternal perception of infant temperament and mother–infant bound. Results Three profiles were highlighted: a first one labeled “resilient group” (n = 41, 37 % of the sample), a second one labeled “depressive group” (n = 23, 21 % of the sample), and a third one labeled “depressive-anxious-traumatized group” (n = 46, 42 % of the sample). Our findings also highlight a negative impact of postpartum depressive symptoms on mother–infant bond. Discussion Within four weeks of infant's hospital discharge, only a third of mothers exhibited a resilient profile, while depressive symptom severity seems to have a negative impact on mother–infant bond. Further research focusing on the impact of postpartum depression using direct observation and developing is warranted.
... This instrument is preferably short and has been found to be reliable and valid both in its original language [17] and in other language versions [18,19]. The instrument has been used in clinical and non-clinical settings [3,20,21], in various age groups [7,22,23] and in samples with various cultural backgrounds242526. Until today, there is no validated Swedish version of the MSPSS, a prerequisite for international communication and comparisons between studies. ...
Article
Full-text available
The Multidimensional Scale of Perceived Social Support (MSPSS) is a short instrument, developed to assess perceived social support. The original English version has been widely used. The original scale has demonstrated satisfactory psychometric properties in different settings, but no validated Swedish version has been available. The aim was therefore to translate, adapt and psychometrically evaluate the Multidimensional Scale of Perceived Social Support for use in a Swedish context. In total 281 participants accepted to join the study, a main sample of 127 women with hirsutism and a reference sample of 154 nursing students. The MSPSS was translated and culturally adapted according to the rigorous official process approved by WHO. The psychometric evaluation included item analysis, evaluation of factor structure, known-group validity, internal consistency and reproducibility. The original three-factor structure was reproduced in the main sample of women with hirsutism. An equivalent factor structure was demonstrated in a cross-validation, based on the reference sample of nursing students. Known-group validity was supported and internal consistency was good for all scales (alpha = 0.91-0.95). The test-retest showed acceptable to very good reproducibility for the items (kappaw = 0.58-0.85) and the scales (ICC = 0.89-0.92; CCC = 0.89-0.92). The Swedish version of the MSPSS is a multidimensional scale with sound psychometric properties in the present study sample. The simple and short format makes it a useful tool for measuring perceived social support.
Article
Résumé Introduction De par sa fréquence et ses nombreuses conséquences, la dépression du post-partum maternelle (DPPM) peut être considérée comme une problématique de santé publique. Or, le facteur de bon pronostic le plus puissant semble être le soutien social, et en particulier le soutien conjugal. Il faut donc être attentif aux conjoints dans les soins que nous pouvons dispenser. Nous proposons donc de faire l’état des lieux des dispositifs d’accompagnement prenant en compte les conjoints en cas de DPPM. Matériel et méthodes Nous avons réalisé une revue de la littérature en cherchant les études publiées sans limite temporelle dans les bases de données Pubmed, Cairn et Google Scholar. Les études sélectionnées s’intéressaient à des dispositifs d’accompagnement prenant en compte les conjoints dans le cas de dépression maternelle durant la grossesse ou le post-partum, avérée ou en prévention, et disposaient d’une évaluation de l’humeur maternelle et/ou de celle du conjoint. Résultats Seize études ont été incluses dans la revue de littérature. Les dispositifs ayant les résultats les plus probants semblent être ceux qui incluent les conjoints lors d’un traitement curatif d’une DPPM déjà installée. Peu de données existent concernant leur effet sur l’humeur paternelle. Conclusion Des études centrées spécifiquement sur les représentations et vécus des conjoints confrontés à la DPPM nous semblent indispensables à réaliser, dans le but de pouvoir imaginer des dispositifs d’accompagnement adaptés à l’ensemble des conjoints.
Article
The current article serves a dual purpose: to highlight the overlooked and recent concept of parenting-related exhaustion and to propose a specific methodology to test concurrent variations of the parent’s exhaustion with the partner’s exhaustion and her or his perceived and given support. Questionnaire data were collected from 97 mother–father couples over the course of 5 consecutive days. Results from multilevel model analyses revealed day-to-day dyadic variations as well as day-to-day regulation occurring in parental couples. The dyadic variations were shown by the fact that over the week, on the days when one parent felt more exhausted, the other parent’s exhaustion was also high. Dyadic regulation meant that greater exhaustion felt by one parent was associated with greater support from her or his partner. Partner’s extra support was both perceived by the exhausted parent and reported by the support provider (i.e., the partner).
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The majority of previous studies focused on mothers’ distress and considered partner support from the father to the mother. The current research studies the level and the course of distress and partner support in new mothers and fathers during the transition to parenthood and tests the protective role of partner support against distress. Data were collected in a two-wave longitudinal design from 53 heterosexual couples. Mothers and fathers completed questionnaires at two measurement occasions, that is, in the third trimester of pregnancy and 3 months after childbirth. The results provided arguments in favor of a dyadic perspective on distress during the transition to parenthood. No difference was displayed between mothers and fathers before and after childbirth. The level of distress decreased in mothers and also in fathers but only for those whose partner’s distress also decreased. The importance of partner support against postpartum distress was highlighted for mothers and fathers.
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Extensive evidence points to the importance of father-child relationship in the development and for the wellbeing of children, mothers and fathers. Father involvement is multidimensional and includes direct and indirect father-child involvements. In order to progress in this area, a valid measure of this construct, like the Inventory of Father Involvement (IFI), is needed in Brazil. The objective of this study was to investigate the structure of factors and internal reliability of the Brazilian version of IFI (IFI-BR). A sociodemographic questionnaire and the IFI-BR were filled in by 200 men who had five- to ten-year-old children. The results prove internal validity of the IFI-BR and confirms a structure of factors very similar to that of the original IFI, including eight of the nine original first-order factors and a general second-order factor, with indicators of internal reliability that were adequate for these eight factors.
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An ample body of scientific evidence exists, documenting the importance of the father-child relationship. The objective of this study was to develop a theoretical model of father involvement, organized according to the principles of Structural Equation Modeling, which require specification of the variables associated with the central construct, based on empirical data. In 2015, a systematic search was conducted in the databases APA PsycNET, Bireme, PEPSIC, Web of Science and IndexPsi Periódicos, using the descriptors "involvement" and "father", crossed with "measure", "scale", "tool" or "instrument", in both the English and Portuguese languages. There were no restrictions on the year of publication. In total, 39 complete texts were located, that included data on father involvement. The information in these texts was grouped into three categories: (a) dimensions of father involvement, (b) factors affecting father involvement and (c) impacts of father involvement on other variables. The model presented synthesizes the results of these studies, representing an advance in theory development in this area. This model increases the visibility of conceptual issues about father involvement and its correlates, and, following empirical testing, may contribute to the improvement of intervention programs for fathers.
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Full-text available
An ample body of scientific evidence exists, documenting the importance of the father-child relationship. The objective of this study was to develop a theoretical model of father involvement, organized according to the principles of Structural Equation Modeling, which require specification of the variables associated with the central construct, based on empirical data. In 2015, a systematic search was conducted in the databases APA PsycNET, Bireme, PEPSIC, Web of Science and IndexPsi Periódicos, using the descriptors "involvement" and "father", crossed with "measure", "scale", "tool" or "instrument", in both the English and Portuguese languages. There were no restrictions on the year of publication. In total, 39 complete texts were located, that included data on father involvement. The information in these texts was grouped into three categories: (a) dimensions of father involvement, (b) factors affecting father involvement and (c) impacts of father involvement on other variables. The model presented synthesizes the results of these studies, representing an advance in theory development in this area. This model increases the visibility of conceptual issues about father involvement and its correlates, and, following empirical testing, may contribute to the improvement of intervention programs for fathers.
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Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorized, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group. A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history. ACTRN 12605000567628.
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Postnatal depression commonly affects women after the birth of a child, and is associated with an increased risk of adverse outcomes for their children. A wide variety of measures have been used to screen for depression in the postnatal period but little research has investigated such measures with men. However depression can also affect men at this time, and this is associated with an independently increased risk of adverse child outcomes. The present study aimed to determine whether a reliable cut off point for the Edinburgh Postnatal Depression Scale (EPDS) can be established to screen fathers. A sample of fathers was sent the EPDS at 7 weeks after the birth of their child. A structured clinical interview was conducted with 192 men to determine whether they were suffering from depression. Fathers with depression scored significantly higher on the EPDS than non-depressed fathers. A score of greater than 10 was found to be the optimal cut off point for screening for depression, with a sensitivity of 89.5% and a specificity of 78.2%. The relatively modest participation rate means the results may not be fully generalisable to the whole population. The EPDS is shown to have reasonable sensitivity and specificity at a cut off score of over 10. The study shows that it is possible to screen fathers for depression in the postnatal period and it may be valuable to administer this measure to new fathers.
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This panel study examines changes in the psychological distress of 280 new mothers over a one-year period. Regression analyses show that when social support is indexed as the extent of the mother's social network, this variable has no impact on changes in psychological distress. However, the cognitive experience of social support and the degree of marital intimacy make significant independent contributions to changes in psychological distress. The results also provide no confirmation for the hypothesis that the elevated levels of psychological distress reported in recent community studies of young mothers can be accounted for by the inclusion of cases of postpartum depression.
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Objectives The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression.
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The expectant father has been traditionally left out from childbirth. His growing and current attendance in the delivery ward is reviewed in this article. In his case, how did we go from interdiction to a quasi-obligation? Upon what grounds is he in demand? Could his presence be dangerous? Is not his ritualised involvement in the antenatal stage, aiming to lead him at least to the labour room, synonymous with arbitrary prescriptions? How can we help him find his real place in accordance with his identity as a male? Facing the impossibility of his attendance in the delivery room, the author lays stress on the fact that the expectant fathers' words should be free within the couple. As a first step toward the knowledge of identity troubles specific to nascent fatherhood, in a developmental viewpoint, father groups help in accepting that impossibility of attendance. Moreover, the emergence of words facilitates a potential request for individual psychological support.
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Maternal postpartum depression (PPD) has been shown to negatively influence mother–infant interaction; however, little research has explored how fathers and father–infant interaction are affected when a mother is depressed. This study examined the influence of maternal PPD on fathers and identified maternal and paternal factors associated with father–infant interaction in families with depressed as compared with nondepressed mothers. A convenience sample of 128 mother–father–infant triads, approximately half of which included women with significant symptoms of PPD at screening, were recruited from a screening sample of 790 postpartum women. Mothers and fathers completed measures of depression, marital satisfaction, and parenting stress at 2 to 3 months' postpartum and were each videotaped interacting with their infants. Results indicate that maternal PPD is associated with increased paternal depression and higher paternal parenting stress. Partners of depressed women demonstrated less optimal interaction with their infants, indicating that fathers do not compensate for the negative effects of maternal depression on the child. Although mother–infant interaction did not influence father–infant interaction, how the mother felt about her relationship with the infant did, even more so than maternal depression. The links between maternal PPD, fathers, and father–infant interaction indicate a need for further understanding of the reciprocal influences between mothers, fathers, and infants.
Article
Current literature indicates that risk for maternal depression is substantial in low-income families. A large body of research also indicates that when mothers are depressed, children are at risk for a number of developmental difficulties. While mutual influence between child and parental difficulties has been noted, few studies examine risk factors for both depression and child aggression within ecological models. The present cross-site study examined the unique and additive contributions of contextual factors, including SES and family functioning, on maternal depression and child aggression in Early Head Start families. A multiethnic sample of parents and their children, between the ages of 12 and 43 months, participated in this study. Families came from five Early Head Start programs across the United States, representing both urban and rural areas. Structural equation models (SEM) demonstrate mutual links between depression and aggression, mediated at least in part by ecological factors. SEM indicated that 36.4% of the variance in child aggression is accounted for in a model linking aggressive behavior to parent depression, stress, and couple-level functioning, as well as other family interaction variables. A second model focusing on maternal depression revealed that 44.5% of the variance in maternal depression was accounted for through family factors, including couple-related support and satisfaction and parenting stress. In this second model, child aggression was indirectly linked to maternal depression. These data have important implications for programs serving at-risk families.
Article
This study compares the efficacy of two screening programs, of prevention and of treatment of postpartum depression on 450 mothers at an obstetrical clinic. On the third day postpartum, 450 mothers filled out the EPDS (Edinburgh Postnatal Depression Scale, Cox et al.,1987). All the mothers (N = 131) who had an EPDS score above or equal to nine were randomised into two groups: one group of 71 mothers benefited from a preventive “multidimensional” intervention, with the semi-directive intervention guide, and another group, composed of 60 mothers benefited from the preventive intervention, non-directive support intervention. Around the sixth week postpartum, the mothers responded again to the EPDS. The mothers who presented scores above or equal to 12 indicating depression, also filled out the 13-items Beck Depression Inventory (BDI, Beck, 1988) and the French version of the Williams structured intervention guide (1988) for the Hamilton Depression Rating Scale (HDRS). From these evaluations, 45 mothers presented a postpartum depression and taking into account the initial randomisation, 21 mothers benefited from the eight “multidimensional” home visit interventions, and 24 mothers benefited from the eight non-directive home visit interventions. The results of this study indicate that the “multidimensional interventions” in prevention but also in treatment, reduce in a significant manner the depressive symptomatology of postpartum depression compared to “non-directive interventions”.
Article
Developing a sense of competence and satisfaction in the maternal role enhances positive parenting and healthy development of the child. There is limited longitudinal research on the predictive factors influencing maternal role competence and satisfaction. The aim of this study was to determine the predictive and concurrent associations of prenatal perceived maternal role competence, learned resourcefulness, social support, stress, and depression to perceived maternal role competence and satisfaction at 6 weeks postpartum. A longitudinal, descriptive design was used. A convenience sample of 184 first-time pregnant women with a singleton and uneventful pregnancy were recruited from two regional public hospitals in Hong Kong. The Parenting Sense of Competence Scale, Self-control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, and Edinburgh Postnatal Depression Scale were used to assess maternal role competence and satisfaction, learned resourcefulness, social support, stress, and depressive symptoms, respectively. Data were collected during pregnancy and at 6 weeks postpartum. Multiple regression analysis showed that perceived maternal role competence and satisfaction at 6 weeks postpartum were predicted by prenatal perceived maternal role competence and learned resourcefulness and were associated with postnatal learned resourcefulness and depression. Social support and stress were not associated directly with perceived maternal role competence and satisfaction at 6 weeks postpartum. The present findings suggest that maternal learned resourcefulness and depression are important factors affecting perceived maternal role competence and satisfaction at postpartum. Culturally competent healthcare should be developed to promote the psychological well-being of women and to equip women with the learned resourcefulness skills to facilitate maternal role taking and enhance women's sense of competence and satisfaction in the maternal role.
Article
The validation of the French version of the Edinburgh Postnatal Depression Scale (EPDS), conducted on a sample of 87 women in the first 4 months of post-partum, is presented. The study of the sensitivity, specificity and predictive values versus research diagnosis criteria provide the cut-off score of 10.5 as the best (sensitivity: 0.80; specificity: 0.92). The EPDS as an index of severity of postnatal depression (PND) also had good criterion validity compared to the psychiatrist's assessment. Factor analysis shows that the internal structure of the EPDS is composed of two subscales which underline a more accurate description of PND. The reliability study confirms the good internal consistency of the global scale (Cronbach's alpha: 0.76) and its good short term test-retest reliability (0.98).
Article
Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.
Article
We examined the role of a number of psychosocial variables in the onset of postpartum depression and in recovery from depression that occurs during pregnancy. Women (N = 730) were recruited during pregnancy and were followed through 1 month postpartum. They were assessed on demographic variables and on measures of depressive symptomatology and diagnostic status, perceived stress, marital satisfaction, perceptions of their own parents, dysfunctional cognitions, and coping style. Onset of depression in the postpartum was predicted by the levels during pregnancy of depressive symptomatology and perceived maternal and paternal care during childhood. In contrast, recovery in the postpartum from depression during pregnancy was not predicted by the variables examined in this study. These results are discussed with reference to previous investigations that have examined depression that occurs outside the context of childbirth.
Article
The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
Article
A sample of 99 women was studied prospectively from the second trimester of pregnancy until nine weeks post partum. Depressed and nondepressed women identified at the second-trimester assessment and the postpartum assessment were compared on measures of stressful life events and social support provided by their spouses and close confidants. Nine percent of women during pregnancy and 12% of women after delivery were depressed. Women experiencing postpartum depression reported more stressful life events and less support from their spouses after delivery than the women not experiencing postpartum depression. Women experiencing depression during pregnancy reported somewhat less support from their spouses and more support from their confidants than nondepressed women. The results of the study suggest that different causes may be responsible for prepartum and postpartum depression.
Article
In the first study to systematically examine postnatal depression in fathers, we examined depression in 200 postnatal couples, using a two-stage design. The prevalence of depression ascertained by the 13-item Edinburgh Postnatal Depression Scale (EPDS), using a cut-off score for 'caseness' of 13 or more in an unselected postnatal sample, was 27.5% in mothers at six weeks postpartum, 25.7% in mothers at six months postpartum, 9.0% in fathers at six weeks postpartum, and 5.4% in fathers at six months postpartum. The prevalence did not differ significantly in either mothers or fathers from a control group of parents with children between three and five years of age. As expected, mothers had a significantly higher prevalence of psychiatric 'caseness' at both six weeks and six months postpartum than fathers. Fathers were significantly more likely to be cases if their partners were also cases. The hypothesis that different aetiological factors would be important in brief and persistent disorders in mothers was upheld.
Article
Interviews were carried out at 36 weeks antenatal with 63 married couples, in 36 of which the woman had a history of affective disorder and in 27 the woman had no previous psychiatric history. The men's attitudes to their wives were assessed using expressed emotion methodology. Also assessed were psychiatric history, neuroticism, satisfaction with the marital relationship and attitudes to sex, pregnancy and parenthood in both the woman and her partner. Women with psychiatric histories who did not relapse in the six months following delivery had partners who were more positive about them than partners of high-risk women who remained well and control women. This effect is explored further by examining which characteristics of the man and which of the woman contributed to his critical and positive comment score. Criticism of his wife was associated with each partner reporting less marital satisfaction and also with the man's psychiatric history. No characteristic of the woman contributed to her partner's criticism. In contrast, the men's positive comments about their wives were associated with the woman's satisfaction with key aspects of her femaleness. Positive husbands had wives were pleased to be pregnant, happy with their pregnant bodies and enjoying the sexual aspect of the marital relationship. In women with psychiatric histories the time which had elapsed since her last psychiatric admission also influenced his positive comments.
Article
This article describes the development of the Maternal Attitudes Questionnaire (MAQ), a 14-item self-report instrument measuring cognitions relating to role change, expectations of motherhood, and expectations of the self as a mother in postnatal women. This questionnaire was found to have good test-retest and internal reliability. In a large sample of women (n = 483) at 6-8 weeks postpartum, scores on the questionnaire were highly correlated with scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Revised Clinical Interview Schedule (CIS-R). Cluster analysis demonstrated that, among depressed women with similar symptom scores on the CIS-R, the MAQ discriminated a group with low MAQ scores and a group with high MAQ scores. This finding supports the hypothesis that women who are depressed postnatally are cognitively heterogeneous; such differences may be important in understanding the etiology and determining the treatment of postnatal depression.
Article
The adverse, short-term effects of postpartum depression on maternal-infant interaction have been repeatedly documented. Are there long-term sequelae for children whose mothers had experienced postpartum depression? The purpose of this meta-analysis was to determine the magnitude of the effect of postpartum depression on the cognitive and emotional development of children older than the age of 1 year. Nine studies which met the sample criteria were included in this meta-analysis. Results indicated that postpartum depression had a small but significant effect on children's cognitive and emotional development. The r indicator for effect size ranged from .18 to .22 whereas the d indicator ranged from .36 to .45. Implications for future research are addressed.
Article
A community sample of depressed and well mothers, recruited at 2 months postpartum and assessed through to 18 months, was followed up at 5 years. The quality of mother-child interactions was assessed, as was the children's behavioural and social adjustment, using maternal reports and observations of child behaviour during free play at school. Several aspects of child outcome were found to be associated with postnatal depression, even when taking account of current adverse circumstances (maternal depression and parental conflict). These included the child's behaviour with the mother, the presence of behavioural disturbance at home, and the content and social patterning of play at school. These associations with postnatal depression were independent of the child's gender. The child's relationship with the mother appeared to be mediated by the quality of infant attachment at 18 months. The mother's behaviour with her child was more affected by current difficulties, in particular by conflict with the child's father. Together these findings suggest that, while maternal behaviour varies with changing circumstances, exposure to maternal depression in the early postpartum months may have an enduring influence on child psychological adjustment.
Article
Postpartum depression (PPD) is known to have important negative effects on mother, infant and mother-child relationship. We present a case-control study of 35 mothers and their 18-month-old infants. These mothers suffered from postpartum depressive symptoms (PDS) when the infants were three months old, as rated with the Edinburgh Postnatal Depression Scale (EPDS, Cox 1987). A control group of 35 mothers without postpartum depressive symptoms (NPDS) with their 18-month-old infants was also evaluated. The infants were assessed using the Infant Behavior Record of the Bayley Scales of Infant Development, the Strange Situation and an object concept task. 15 months later, the PDS mothers were less affectionate and more anxious than the NPDS mothers. The PDS dyads demonstrated less verbal interaction and less playing interaction. 18-month-old infants of PDS mothers performed less well on object concept tasks, and were more often insecurely attached to their mothers. Only some results were linked to the mothers' depressive state (D-mothers) diagnosed at 18 months (e. g. responsiveness to persons). The important negative effects observed at 18 months on mother and infant of maternal PDS at 3 months confirm the need for early identification and therapeutic or preventive interventions.
Article
Pediatric anticipatory guidance has been associated with parenting behaviors that promote positive infant development. Maternal postpartum depression is known to negatively affect parenting and may prevent mothers from following anticipatory guidance. The effects of postpartum depression in fathers on parenting is understudied. Our purpose with this work was to examine the effects of maternal and paternal depression on parenting behaviors consistent with anticipatory guidance recommendations. The 9-month-old wave of data from a national study of children and their families, the Early Childhood Longitudinal Study, provided data on 5089 2-parent families. Depressive symptoms were measured with a short form of the Center for Epidemiologic Studies Depression Scale. Interviews with both parents provided data on parent health behaviors and parent-infant interactions. Logistic and linear regression models were used to estimate the association between depression in each parent and the parenting behaviors of interest. These models were adjusted for demographic and socioeconomic status indicators. In this national sample, 14% of mothers and 10% of fathers exhibited levels of depressive symptoms on the Center for Epidemiologic Studies Depression Scale that have been associated with clinical diagnoses, confirming other findings of a high prevalence of postpartum maternal depression but highlighting that postpartum depression is a significant issue for fathers as well. Mothers who were depressed were approximately 1.5 times more likely to engage in less healthy feeding and sleep practices with their infant. In both mothers and fathers, depressive symptoms were negatively associated with positive enrichment activity with the child (reading, singing songs, and telling stories). Postpartum depression is a significant problem in both mothers and fathers in the United States. It is associated with undesirable parent health behaviors and fewer positive parent-infant interactions.
Le congé de paternité (DREES, Études et résultats, n° 442) Retrieved from www
  • D Bauer
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Bauer, D. & Penet, D. (2005). Le congé de paternité (DREES, Études et résultats, n° 442). Retrieved from www.sante.gouv.fr/IMG/pdf/er442.pdf.
Psychopathologie de la périnatalité
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Dayan, J., Andro, G., & Dugnat, M. (2003). Psychopathologie de la périnatalité. Issy-Les- Moulineaux: Masson. Collection: Les âges de la vie.
Le rôle des facteurs liés au nourrisson dans la dépression maternelle
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