Attentional processing of infant emotion during late pregnancy and mother–infant relations after birth

The mother–infant relationship has an important influence on maternal mental health and infant development. Evidence suggests that this relationship is enhanced by a mother’s sensitive response towards her infant’s distress. We proposed that attentional processing of infant distress may indicate individual differences in this response. Research also suggests that maternal responses develop during pregnancy. We therefore hypothesised that more sensitive attentional processing of distressed infant stimuli during late pregnancy will be associated with more successful mother–infant relationships. Healthy pregnant women were recruited through community midwives. An established computerised paradigm measured women’s ability to disengage attention from distressed or non-distressed infant faces. From this paradigm, we derived an index of women’s attentional bias towards infant distress. Mother–infant relationships were measured using the postpartum bonding questionnaire (PBQ). A complete case sample of 49 women completed the attentional paradigm during late pregnancy and the PBQ 3–6 months after birth. We found that women who showed greater attentional bias towards infant distress during late pregnancy reported more successful mother–infant relationships. For every 50-ms increase on our measure of attentional bias towards infant distress during late pregnancy, the odds ratio for reporting a higher PBQ score, indicative of a weaker relationship, was 0.43 (95% confidence intervals 0.23–0.81, p = 0.01). The results suggest that women’s basic attentional processing of infant emotion during pregnancy influences their relationships with their infant. In the future, women’s attentional processing of infant emotion could inform early strategies to promote successful mother–infant relationships in vulnerable mothers to be.     

Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period

This pilot study explored the effects of an 8-week mindfulness-based cognitive therapy group on pregnant women. Participants reported a decline in measures of depression, stress and anxiety; with these improvements continuing into the postnatal period. Increases in mindfulness and self-compassion scores were also observed over time. Themes identified from interviews describing the experience of participants were: ‘stop and think’, ‘prior experience or expectations’, ‘embracing the present’, ‘acceptance’ and ‘shared experience’. Childbirth preparation classes might benefit from incorporating training in mindfulness.     

Reliability and accuracy of segmental bioelectrical impedance analysis for assessing muscle and fat mass in older Europeans: a comparison with dual-energy X-ray absorptiometry

Segmental determination of muscle and fat mass (MM, FM) attains growing importance for judging effects of training and malnutrition in older people. This study evaluated the reliability and accuracy of segmental bioelectrical impedance analysis (sBIA) for use in older people. In 72 (40 men, 32 women) healthy elderly (mean age 69.0 ± 4.8 years), the MM and FM of right and left arm (RA, LA), right and left leg (RL, LL), and trunk were determined by sBIA (BC-418-MA, Tanita) and dual-energy X-ray absorptiometry (DXA) as a reference method. The sBIA provided in both sexes reliable values for limb and truncal MM and FM, except for MM of RL in women. The accuracy of sBIA displayed sex-specific bias. For MM, accurate values were noted for men’s trunk and women’s limbs (except LA). By contrast, MM was significantly underestimated in men’s limbs by 6–18% and overestimated in women’s LA (13%) and trunk (14%). Estimates of FM were accurate for men’s arms as well as women’s legs and trunk. However, FM was significantly overestimated in men’s legs (34–37%) and trunk (60%), but underestimated in women’s arms (27–35%). The proportional deviations of sBIA estimates from DXA values for limbs and trunk were significantly related to the respective MM or FM. The sBIA tends to underestimate MM in men and to overestimate in women. The reverse occurs for FM. The actual equations of the Tanita device may not completely represent the European older population and should be partly revised.     

Eye movements during action preparation

Looking at actions of others activates representations of similar own actions, that is, the action resonates. This may facilitate or interfere with the actions that one intends to make. We asked whether people promote or block those effects by making eye movements to or away from the actions of others. We investigated gaze behavior with a cup-clinking task: An actor shown on a video grabbed a cup and moved it toward the participant who next grabbed his own cup in the ‘same’ or in a different, ‘complementary’, way. In the ‘same’ condition, participants mostly looked at the place where the actor held the cup. In the ‘complementary’ condition, gaze behavior was similar at the start of the actor’s action. To our surprise, as the action reached completion, participants started to look at the cup’s site that corresponded to the grabbing instruction for their own action. A second experiment showed that this effect grew with delay of the go-signal. This indicates that a reason for the effect may be to support memorizing the instructed action. The bottom line of the study is that passively viewed scenes (passive in the sense that nothing in the observed scene is manipulated by the viewer) are scanned to support preparation of actions that one intends to make. We discuss how this finding relates to action resonance and how it relates to links between representations of actions and objects.     

Impacts of early marriage and adolescent pregnancy on mental and somatic health: the role of partner violence

Archives of Women's Mental Health - Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women’s somatic, mental, and reproductive health, as...     

Symptoms of depression during pregnancy are associated with increased systolic blood pressure responses towards infant distress

A mother’s response towards her infant’s distress is important for the mother–infant relationship and infant development. There is evidence that maternal responses are impaired in depressed mothers. Further understanding of how depression disrupts maternal responses is important to direct treatment strategies. There is evidence that maternal responses develop during pregnancy. Further understanding of the relationship between depression and maternal responses during pregnancy is therefore important. We have previously found that depression during pregnancy is associated with reduced attentional engagement with infant distress but is unclear whether this is an insensitive or avoidance response. In the current study, we investigated the impact of anhedonic symptoms of depression on pregnant women’s autonomic response towards infant distress. We found that women experiencing anhedonic depressive symptoms during pregnancy had significantly larger systolic blood pressure responses towards infant distress (β, 1.6 mmHg, 95 % CI 0.5 to 2.6, p = 0.004) than non-depressed pregnant women. These results suggest that anhedonic symptoms during pregnancy may be associated with increased sympathetic sensitivity. This suggests that depression is not, at a sympathetic level at least, associated with insensitivity to infant distress and rather depression may be associated with an abnormally sensitive response.     

Age Differences in Genetic and Environmental Variations in Stress-Coping During Adulthood: A Study of Female Twins

The way people cope with stressors of day to day living has an important influence on health. The aim of the present study was to explore whether genetic and environmental variations in stress-coping differ over time during adulthood. The brief COPE was mailed to a large sample of the UK female twins (N = 4,736) having a wide range of age (20–87 years). Factor analyses of the items of the brief COPE yielded three coping scales: ‘Problem-Solving’, ‘Support Seeking’, and ‘Avoidance’. Monozygotic and dizygotic twin correlations tended to become lower with age for all three scales, suggesting that unique environmental factors may become more important with age during adulthood. Model-fitting results showed that relative influences of unique environmental factors increased from 60 % at age 20 years to 74% at age 87 years for ‘Problem-Solving’ and 56 % at age 20 years to 76% at age 87 years for ‘Avoidance’. During the same age period, genetic factors decreased from 40 to 26 % for ‘Problem-Solving’ and from 44 to 24 % for ‘Avoidance’. For ‘Seeking Support’, the magnitude of genetic and unique environmental factors was not significantly different across the adulthood. For all three scales, shared environmental effects were negligible. Overall, our findings implicate that the effects of environment that stem from idiosyncratic experience of stressful life events accumulate and become increasingly important in adulthood.     

Hip dysplasia following a case of olanzapine exposed pregnancy: a questionable association

Summary This is a case report of a 33 year old woman with a history of psychosis, who presented to the women’s mental health clinic for consultation at the 12^th week of gestation, having already received olanzapine throughout the first trimester. She was followed from that point on at our clinic and remained on small doses of olanzapine for the rest of her pregnancy, which was uncomplicated. She gave birth to a healthy female, which at the age of three months was diagnosed with developmental dysplasia of the hip and subsequently received appropriate treatment with favorable outcome. The possibility of the association of this congenital dysplasia with the use of olanzapine during pregnancy is further discussed in this paper.     

Anxiety and depression in women and men from early pregnancy to 3-months postpartum

To investigate high-anxiety and depression in women and men from early pregnancy to 3-months postpartum, 260 Portuguese couples (N = 520) filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the first, second, and third pregnancy trimesters, childbirth, and 3-months postpartum. Rates for high-anxiety (STAI-S ≥ 45) in women (13.1%; 12.2%; 18.2%; 18.6%; 4.7%) and men (10.1%; 8.0%, 7.8%; 8.5%; 4.4%) and for depression (EPDS ≥ 10) in women (20.0%, 19.6%, 17.4%, 17.6%; 11.1%) and men (11.3%; 6.6%; 5.5%; 7.5%; 7.2%) were high. Rates for depression were higher than rates for high-anxiety only in women during early pregnancy and the postpartum, but not at the third pregnancy trimester and childbirth. Rates for high-anxiety and depression were higher in women than in men during pregnancy/childbirth, but not at 3-months postpartum. Rates for high-anxiety but not rates for depression were higher during pregnancy/childbirth compared to 3-months postpartum and only in women. Considering that 15.9% of the parents-to-be were highly anxious and/or depressed during pregnancy—comparing to 9.3% at 3-months postpartum—particular attention should be drawn to both women’s and men’s mental health early in pregnancy.     

Satisfaction with pregnancy loss aftercare: are women getting what they want?

While there is increasing recognition that early miscarriage represents a significant loss experience that often provokes depression and anxiety, women’s dissatisfaction with some aspects of care received from healthcare professionals following a pregnancy loss and the potentially negative consequences of this are often less recognized. This review examines available literature to identify what comprises “treatment as usual,” how satisfied women are with the typical services they receive from healthcare personnel, and whether these services are consistent with women’s self-identified needs. Results are reviewed according to four major themes—patient satisfaction with: attitudes of healthcare providers, provision of information, interventions provided, and follow-up care. In general, women and families who have experienced a miscarriage report low levels of satisfaction in the presence of perceived negative attitudes from healthcare providers, insufficient provision of information, and inadequate follow-up care that did not focus on emotional well-being. Higher levels of satisfaction are reported among women whose providers were emotionally attuned to the magnitude of the loss, provided information, and involved women in treatment decisions when possible. Limitations of current research are reviewed and directions for future research, training, and practice are briefly discussed.     

The role of early post-implantation beta-HCG levels in the outcome of pregnancies following in-vitro fertilization

Daily plasma beta-HCG levels from days 11 to 18 after ovum retrieval(OR) were evaluated in a group of 73 women who became pregnantfollowing in-vitro fertilization and embryo replacement (IVF-ER).The 47 patients who had a normal ongoing pregnancy could bedistinguished from the 26 patients with a pathological pregnancy(pre-clinical abortion, clinical abortion and tubal pregnancy)by the mean daily beta-HCG levels, their mean daily increaseand the intercept and slope of the beta-HCG regression analysis.The mean daily beta-HCG levels of the normal pregnancies weresignificantly higher than: (i) pre-clinical abortions on days12–18 after OR; (ii) clinical abortions on days 12–16;and (iii) tubal pregnancies on days 12–17. Using quadraticdiscriminant analysis, normal and pathological pregnancies couldalso be distinguished by their absolute beta-HCG levels on day13 after OR with 27.6 mIU/ml being the cut-off point. Our resultsindicate that the outcome of pregnancy following IVF-ER couldbe predicted with a high degree of probability by monitoringdaily beta-HCG levels within the first 2 weeks following OR.     

The use of a ‘phantom scalp’ to assess the possible direct pickup of mobile phone handset emissions by electroencephalogram electrode leads

A ‘Phantom Scalp’ was constructed from a conducting foam mat to form a layer under a 62-electrode electroencephalogram cap closely approximating the electrical properties of a human scalp. The mat was placed over a polystyrene manikin head to preserve a correct anatomical arrangement. Electrical signals were recorded with a Global System for Mobile (GSM) communications mobile phone handset in place against the side of the ‘head’. Amplitude spectra were compared for three phone conditions: ‘off’, ‘standby’ and ‘transmit’. At 217 Hz, significant differences were obtained between ‘transmit’ and the other two conditions, but no significant differences were noted for the physiologically important range 0.5–30 Hz. An anomalous difference was noted for one electrode in the range 30–45 Hz.     

When are actively balanced biphasic (‘Lilly’) stimulating pulses necessary in a neurological prosthesis? I Historical background; Pt resting potential;Q studies

Actively balanced (‘Lilly’) stimulating current waveforms are generally considered to give very ‘safe’ stimulation. Although this is perfectly true, the specification of the necessary waveform generators in neurological prostheses demands additional complexity, and probably additional expense and development time as well. The paper and its companion enquire whether the use of simple, passively charge-balanced stimulating pulses is equally safe, provided the stimulation parameters and circuitry are designed with appropriate care. It is concluded that, in respect of safe deliverable charge density per pulse at the electrode, release of noxious products and stimulating effectiveness, simple pulses need give no worse performance; in some circumstances they may give better.     

When are actively balanced biphasic (‘Lilly’) stimulating pulses necessary in a neurological prosthesis? II pH changes; noxious products; electrode corrosion; discussion

Actively balanced (‘Lilly’) stimulating current waveforms are generally considered to give very ‘safe’ stimulation. Although this is perfectly true, the specification of the necessary waveform generators in neurological prostheses demands additional complexity, and probably additional expense and development time as well. The paper and its companion enquire whether the use of simple, passively charged-balanced stimulating pulses is equally safe, provided the stimulation parameters and circuitry are designed with appropriate care. It is concluded that, in respect of safe deliverable charge density per pulse at the electrode, release of noxious products and stimulating effectiveness, simple pulses need give no worse performance; in some circumstances they may give better.     

Decreased startle modulation during anticipation in the postpartum period in comparison to late pregnancy

Knowledge about healthy women’s psychophysiological adaptations during the large neuroendocrine changes of pregnancy and childbirth is essential in order to understand why these events have the potential to disrupt mental health in vulnerable individuals. This study aimed to compare startle response modulation, an objective psychophysiological measure demonstrated to be influenced by anxiety and depression, longitudinally across late pregnancy and the postpartum period. The acoustic startle response modulation was assessed during anticipation of affective images and during image viewing in 31 healthy women during gestational weeks 36–39 and again at 4 to 6 weeks postpartum. No startle modulation by affective images was observed at either time point. Significant modulation during anticipation stimuli was found at pregnancy assessment but was reduced in the postpartum period. The women rated the unpleasant images more negative and more arousing and the pleasant images more positive at the postpartum assessment. Self-reported anxiety and depressive symptoms did not change between assessments. The observed postpartum decrease in modulation of startle by anticipation suggests a relatively deactivated defense system in the postpartum period.     

Abortion clinic patients' opinions about obtaining abortions from general women's health care providers

Objective

Most U.S. women obtain abortions at specialty clinics. This qualitative study explores abortion clinic patients’ opinions about receiving abortions from general women's health care providers.

Methods

We conducted 20 h-long, semi-structured interviews with diverse women who had abortions in the U.S. Heartland. Each described her usual health care provider and how she accessed abortion care. We used qualitative analytic methods to organize and interpret the data.

Results

Despite having a general provider, most women sought clinic abortions. Some women offered reasons for preferring specialty care and others for preferring abortion from their general provider. Most women assumed their general provider did not “do abortion” and many believed those providers were opposed to abortion. Women who had delivered a baby were concerned with their image in their general provider's eyes. Two women were denied care by their general providers.

Conclusion

Women's preferences for abortion care centered on privacy, cost, empathy, ability to control their image, and desire for safe quality care. Two women who sought abortions through their general providers experienced negative repercussions.

Practice implications

General providers should proactively make patients aware of their positions on abortion and if supportive indicate that they can provide that care and/or a referral.     

Some problems with life event lists and health outcomes

Lists of life events are widely used in health outcomes research. As part of a large cohort study of women’s health in Australia, age- and gender-specific life events lists were developed and administered to women in different age groups over time. In this article, we provide empirical evidence that recall of life events is subject to telescoping (i.e., remote events are reported to have occurred more recently) and to mood (women with lower mental health scores report more life events, especially perceived rather than factual events). Nevertheless, even after adjustment for confounders, there is a clear association between poorer physical health and more life events. Therefore, these results demonstrate a continuing need for lists of life events in health research but also highlight the methodological challenges in using them.     

Risk behaviors for HCV- and HIV-seroprevalence among female crack users in Porto Alegre, Brazil

Several studies have shown a high prevalence of HIV-seropositive status among crack users, though most refer to North American populations. Few studies evaluate HCV prevalence among female crack users. In addition, there is a particular lack of data about risk behaviors and HIV/HCV prevalence in this population around the world. In order to ascertain the HIV/HCV serostatus and associated risk behaviors for infection of female crack users of Porto Alegre, Brazil. A cross-sectional study of a convenience sample of 73 current female crack users was conducted. Subjects answered NIDA’s Risk Behavior Assessment and an AIDS Information Questionnaire. In addition, blood was collected from subjects for HIV/HCV tests. The overall prevalence of HIV was 37.0%; HCV seroprevalence was 27.7%; of 15.1% the sample was co-infected with HIV and HCV. Four years of schooling or fewer (OR 4.72–CI 95%; 1.49–14.99) and having three or more HIV tests in one’s lifetime (OR 4.26–CI 95% (1.29–14.04)) were associated with HIV infection (after multivariate logistic regression). The single greatest risk factor for HCV infection was having 4 years of schooling or fewer (OR 4.51–CI 95%; 1.18–17.27). We found a very high prevalence of HIV and HCV infection among female crack users, and low education was the most significant risk factor associated with both infections.     

Novel electrode–skin interface for breast electrical impedance scanning

The high false-positive rate in clinical examinations limits the application of electrical impedance scanning (EIS) on breast cancer detection. One of the reasons is the non-uniform electrode–skin interface, which induces the ‘contact artifact’ in the results. To decrease the ‘contact artifact’, we designed a novel disposable electrode–skin interface [cotton fine grid thin layer (CFGTL)-interface], which is 0.2-mm thick and has a conductivity similar to that of normal breast tissue. The performance of the CFGTL-interface was evaluated by comparing it with the ultrasound gel interface generally used in EIS examinations. The test was conducted on 50 healthy female volunteers using two different interfaces separately, and a paired comparison method was used to analyze the effect of the CFGTL-interface on EIS measuring data. The results showed that the CFGTL-interface could effectively decrease the variation and the range of data fluctuation, which suggested that CFGTL-interface can decrease the ‘contact artifact’ and increase the accuracy of the examination. The CFGTL-interface appears to be an effective electrode–skin interface for breast EIS examination.     

Non-constraining sleep/wake monitoring system using bed actigraphy

This paper introduces a new method, bed actigraphy (BACT) for user-friendly sleep-wake monitoring. BACT provides a non-intrusive acquisition of activity data, and in particular does not require that sensors be attached to the subject’s body. The system consists of four load-sensing cells supporting the bed, an A/D converter, and a microcontroller with appropriate software. The performance of BACT was compared to that of standard polysomnography (PSG) recordings and wrist-worn actigraphy (ACT). Ten normal volunteers underwent overnight PSG recordings and were examined simultaneously with BACT and ACT. An automatic scoring algorithm scored each 30-s epoch of the BACT recordings for either ‘Wake’ or ‘Sleep.’ A sleep specialist manually scored the PSG recordings, and the results were divided into ‘Wake’ and ‘Sleep’ categories. The three methods showed a significant correlation when compared with in the contingency test. The mean epoch-by-epoch agreements between the BACT and PSG, ACT and PSG, and BACT and ACT recordings were 95.2, 92.9, and 94.3%, respectively. The mean absolute differences in sleep percentage (SP) between them were 1.8 ± 0.82, 3.4 ± 1.45, and 1.9 ± 1.16 %, respectively. BACT differentiation of the ‘Wake’ and ‘Sleep’ stages proved to be sufficiently robust, and its results were comparable to PSG analysis. This finding supports the experimental and clinical value of bed-activity monitoring during sleep.