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      Risk factors for the development of post-traumatic stress disorder and coping strategies in mothers and fathers following infant hospitalisation in the neonatal intensive care unit

      , , , ,
      Journal of Clinical Nursing
      Wiley-Blackwell

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          Prevalence and correlates of posttraumatic stress and postpartum depression in parents of infants in the Neonatal Intensive Care Unit (NICU).

          The purpose of this study was to assess the prevalence and correlates of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in mothers and fathers, and postpartum depression (PPD) in mothers, of infants in the Neonatal Intensive Care Unit (NICU). 86 mothers and 41 fathers completed measures of ASD and of parent perception of infant medical severity 3-5 days after the infant's NICU admission (T1), and measures of PTSD and PPD 30 days later (T2). 35% of mothers and 24% of fathers met ASD diagnostic criteria at T1, and 15% of mothers and 8% of fathers met PTSD diagnostic criteria at T2. PTSD symptom severity was correlated with concurrent stressors and family history of anxiety and depression. Rates of ASD/PTSD in parents of hospitalized infants are consistent with rates in other acute illness and injury populations, suggesting relevance of traumatic stress in characterizing parent experience during and after the NICU.
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            Prematurity, maternal posttraumatic stress and consequences on the mother-infant relationship.

            Premature birth is a stressful experience for parents. This study explores the links between maternal posttraumatic stress, maternal attachment representations of the infant and mother-infant dyadic interactions. The study enrols 47 preterm (GA<34 weeks) and 25 full-term infants. The Perinatal Posttraumatic Stress Disorder Questionnaire was administered to evaluate maternal posttraumatic stress symptoms. At 6 months of corrected age, maternal attachment representations of the infant were explored and coded with the Working Model of the Child Interview. Interactive characteristics were explored in a videotaped play session and coded with the Care Index. Full-term mothers were more likely to follow a "Cooperative" dyadic pattern of interaction with the infant and demonstrate Balanced representations of the infant. Preterm mothers with high posttraumatic stress symptoms were more likely to follow a "Controlling" dyadic pattern of interaction, with more Distorted representations. In contrast, preterm mothers with low posttraumatic stress symptoms were more likely to fall into a "Heterogeneous" group of patterns of dyadic interaction, with Disengaged representations. Interestingly, in Cooperative preterm dyads, only 23% of the mothers demonstrated Balanced representations, despite rates of 69% in full-term Cooperative dyads. Premature birth affects both mother-infant interaction characteristics and maternal representations of attachment with the infant. In particular, a "Controlling" dyadic pattern was associated with high maternal posttraumatic stress symptoms and Distorted maternal representations. It is important to examine the impact of maternal posttraumatic stress on the parent-infant relationship in order to plan supportive, preventive interventions in the neonatal period. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Helping parents cope with the trauma of premature birth: an evaluation of a trauma-preventive psychological intervention.

              To ascertain whether a trauma-preventive psychological intervention program for parents of premature infants during hospitalization in a level III NICU may reduce the severity of symptomatic response to the traumatic impact of premature birth. Mothers of premature infants were enrolled consecutively in a sequential control group design. Intervention group mothers received a structured psychological intervention in the first days after birth. Each mother could make use of additional psychological support if required and was actively approached at critical times during her infant's NICU stay. Control group mothers did not receive psychological intervention but could ask for counseling by the hospital minister. At discharge, mothers of both groups answered a questionnaire covering key outcome variables (symptoms of traumatization, emotions at discharge, and sample and control variables). At discharge, intervention group mothers (N = 25) showed significantly lower levels of symptomatic response to the traumatic stressor "premature birth" than those in the control group (N = 25; mean overall symptom level 25.2 [SD: 13.9] vs 37.5 [SD: 19.2]). This intervention program for parents after premature birth, combining early crisis intervention, psychological aid throughout the infant's hospitalization, and intense support at critical times, reduced the symptoms of traumatization relating to premature birth.
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                Author and article information

                Journal
                Journal of Clinical Nursing
                J Clin Nurs
                Wiley-Blackwell
                09621067
                December 2017
                December 20 2017
                : 26
                : 23-24
                : 4436-4445
                Article
                10.1111/jocn.13773
                28231614
                69b4e02a-a2ee-4250-86c1-09bb7c32fbdc
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1.1

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