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1.
J Clin Psychiatry ; 82(4)2021 07 06.
Article in English | MEDLINE | ID: covidwho-1518675

ABSTRACT

Objective: The conditions created by the COVID-19 pandemic could negatively affect maternal mental health and the mother-infant relationship. The aim of this study is to determine the impact of the COVID-19 pandemic on depression, anxiety, and mother-infant bonding among women seeking treatment for postpartum depression (PPD).Methods: Baseline data collected in two separate randomized controlled trials of a psychoeducational intervention for PPD in the same geographic region, one prior to COVID-19 (March 2019-March 2020) and one during the COVID-19 pandemic (April-October 2020), were compared. Eligible participants had an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10, were ≥ 18 years of age, had an infant < 12 months old, and were fluent in English. Outcomes included PPD (EPDS), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and mother-infant relationship (Postpartum Bonding Questionnaire [PBQ]). All were measured continuously and dichotomized at accepted clinical cutoffs.Results: Of the 603 participants (305 pre-COVID-19; 298 during COVID-19), mothers enrolled during the COVID-19 pandemic reported higher levels of symptoms of PPD (B = 1.35; 95% CI, 0.64 to 2.06; Cohen d = 0.31) and anxiety (B = 1.52; 95% CI, 0.72 to 2.32; Cohen d = 0.30). During COVID-19, women had 65% higher odds of clinically significant levels of depression symptoms (OR = 1.65; 95% CI, 1.13 to 2.31) and 46% higher odds of clinically relevant anxiety symptoms (OR = 1.46; 95% CI, 1.05 to 2.05). However, there were no statistically significant differences in mother-infant bonding.Conclusions: The findings of this study suggest that rates and severity of PPD and anxiety symptoms among women seeking treatment for PPD have worsened in Canada during the COVID-19 pandemic. However, treatment-seeking mothers have consistently maintained good relationships with their infants. Considering the difficulties women with PPD face when accessing treatment, it is important that strategies are developed and disseminated to safely identify and manage PPD to mitigate potential long-term adverse consequences for mothers and their families.Trial Registration: ClinicalTrials.gov identifiers: NCT03654261 and NCT04485000.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression, Postpartum/etiology , Mother-Child Relations/psychology , Mothers/psychology , Object Attachment , Pandemics , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Humans , Infant , Infant, Newborn , Ontario/epidemiology , Risk Factors , Self Report , Severity of Illness Index , Young Adult
2.
J Dev Behav Pediatr ; 42(7): 532-539, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1406509

ABSTRACT

OBJECTIVE: To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown. METHOD: Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed. RESULTS: Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness. CONCLUSION: Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.


Subject(s)
Behavioral Symptoms/psychology , COVID-19 , Child Behavior/psychology , Parent-Child Relations , Parents/psychology , Psychosocial Functioning , COVID-19/prevention & control , Child , Female , Humans , Male , Object Attachment , Quebec
4.
JAMA Psychiatry ; 78(11): 1200-1207, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1396818

ABSTRACT

Importance: Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. Objective: To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. Design, Setting, and Participants: This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Interventions: Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). Main Outcomes and Measures: The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Results: Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83]; B = -4.82; P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15; 95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44; 95% CI, -5.47 to -3.38; P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09; 95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22; 95% CI, -4.72 to -1.71; P < .001), infant-focused anxiety (B = -1.64; 95% CI, -2.25 to 1.00; P < .001), social support (B = 3.31; 95% CI, 1.04 to 5.57; P < .001), and positive affectivity/surgency in infants (B = 0.31; 95% CI, 0.05 to 0.56; P < .001). Conclusions and Relevance: In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. Trial Registration: ClinicalTrials.gov Identifier: NCT04485000.


Subject(s)
Anxiety Disorders/therapy , COVID-19 , Cognitive Behavioral Therapy , Depression, Postpartum/therapy , Internet-Based Intervention , Mother-Child Relations , Psychotherapy, Brief , Social Support , Adult , Female , Humans , Infant , Infant Behavior/physiology , Object Attachment , Ontario , Outcome Assessment, Health Care , Psychiatric Status Rating Scales , Temperament/physiology
5.
Reprod Biomed Online ; 43(4): 756-764, 2021 10.
Article in English | MEDLINE | ID: covidwho-1366670

ABSTRACT

RESEARCH QUESTION: What are the psychological implications of the COVID-19 pandemic for father-child bonding and mental health among Italian gay fathers pursuing surrogacy in the USA or Canada? DESIGN: Between 20 March and 29 July 2020, this cross-sectional case-control study collected data on father-child bonding quality, depression, anxiety and somatization in 30 Italian gay fathers (n=15 families) who were having or successfully had a child through cross-border surrogacy during the COVID-19 pandemic. These fathers were compared with a sociodemographically similar group of 50 Italian gay fathers (n=25 families) who had children through cross-border surrogacy prior to the pandemic. RESULTS: Although father-child bonding quality and the mental health symptoms of fathers scored below the clinical cut-off points in both groups, fathers who had or were having a child during the COVID-19 pandemic reported poorer father-child bonding (estimate 3.04, SE 1.47, P=0.044) and more depressive (estimate -1.47, SE 0.49, P=0.005), anxious (estimate -1.96, SE 0.55, P<0.001) and somatic symptoms (estimate -2.48, SE 0.52, P<0.001). CONCLUSIONS: The findings call for the development of international guidelines for cross-border surrogacy and underline the need for tailored and ongoing psychological and legal support for intended gay fathers to ease their strain and anxiety related to having a child through cross-border surrogacy during the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Fathers/psychology , Homosexuality, Male/psychology , Object Attachment , Parenting/psychology , Adult , Anxiety/complications , Canada , Case-Control Studies , Depression/complications , Female , Humans , Italy , Male , Medically Unexplained Symptoms , Middle Aged , Pandemics , Surrogate Mothers , United States
7.
CMAJ Open ; 9(2): E556-E562, 2021.
Article in English | MEDLINE | ID: covidwho-1239171

ABSTRACT

BACKGROUND: The mental health of postpartum women has worsened during the COVID-19 pandemic; however, the experiences that underlie this remain unexplored. The purpose of this study was to examine how people in Canada who gave birth during the pandemic were affected by policies aimed at limiting interpersonal contact to reduce SARS-CoV-2 transmission in hospital and during the early weeks postpartum. METHODS: We took a social constructionist approach and used a qualitative descriptive methodology. Sampling methods were purposive and involved a mix of convenience and snowball sampling via social media and email. Study inclusion was extended to anyone aged 18 years or more who was located in Canada and was pregnant or had given birth during the COVID-19 pandemic. Data were obtained via semistructured qualitative telephone interviews conducted between June 2020 and January 2021, and were analyzed through thematic analysis. RESULTS: Sixty-five interviews were conducted; data from 57 women who had already delivered were included in our analysis. We identified the following 4 themes: negative postpartum experience in hospital owing to the absence of a support person(s); poor postpartum mental health, especially in women with preexisting mental health conditions and those who had had medically complicated deliveries; asking for help despite public health regulations that prohibited doing so; and problems with breastfeeding owing to limited in-person follow-up care and lack of in-person breastfeeding support. INTERPRETATION: Policies that restrict the presence of support persons in hospital and at home during the postpartum period appear to be causing harm. Measures to mitigate the consequences of these policies could include encouraging pregnant people to plan for additional postpartum support, allowing a support person to remain for the entire hospital stay and offering additional breastfeeding support.


Subject(s)
COVID-19/epidemiology , Mental Health , Pandemics , Patient Isolation/psychology , Postpartum Period/psychology , Adaptation, Psychological , Adult , Breast Feeding/psychology , COVID-19/prevention & control , Canada/epidemiology , Female , Health Policy , Humans , Object Attachment , Pregnancy , Qualitative Research , SARS-CoV-2 , Social Support , Young Adult
9.
Neonatal Netw ; 40(2): 117-120, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1160569

ABSTRACT

During the 2009 H1N1 pandemic, containment strategies aimed at limiting the spread of the virus were implemented but not to the extent as the current COVID-19 pandemic. Research is ongoing regarding disease symptomatology, transmission, and treatment for COVID-19. There are limited data regarding the effects of social distancing practices and restrictive hospital-visitation policies on the parent-infant dyad. The purpose of this commentary is to explore the implications of isolation practices on the parent-infant dyad during a pandemic.


Subject(s)
COVID-19/psychology , Object Attachment , Parent-Child Relations , Social Isolation/psychology , Awareness , COVID-19/prevention & control , Humans , Infant , Self Concept
10.
J Marital Fam Ther ; 47(2): 440-454, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1145315

ABSTRACT

The COVID-19 pandemic has transformed so many aspects of our lives. For psychotherapists, telehealth is likely a permanent part of the future mental health landscape. For family therapists using a manualized treatment, this brings unique challenges and creative opportunities. In this article, we describe the adaptation of attachment-based family therapy (ABFT) in the context of telehealth and COVID-19. ABFT is an empirically supported treatment model designed for adolescents and young adults struggling with depression, anxiety, trauma, and suicide. ABFT is a semi-structured, process-oriented, and trauma-informed family therapy model which presents its own unique challenges and benefits in telehealth environments. We present our adaptations based on years of telehealth clinical experience and address how this model supports the impact of COVID-19 on families.


Subject(s)
Couples Therapy/methods , Family Therapy/methods , Object Attachment , Telerehabilitation/methods , Adolescent , COVID-19/epidemiology , Female , Humans , Male , Models, Psychological , Professional-Family Relations , Young Adult
12.
J Pastoral Care Counsel ; 74(4): 292-293, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-968016

ABSTRACT

COVID-19 cannot rob us of our ability to perform our ministry for children. As adults and ministers, we can show our support for the spiritual growth of children. COVID-19 has not deprived us of our creativity in praise, telling of God's love, prayers, and support for all the children and parents. COVID-19 has not defeated our spiritual life.


Subject(s)
COVID-19/psychology , Child Welfare/psychology , Spirituality , Stress, Psychological/prevention & control , Adult , Child , Humans , Love , Object Attachment , Parenting/psychology , Pastoral Care/methods , Religion
13.
J Pastoral Care Counsel ; 74(4): 258-264, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-968978

ABSTRACT

Shifts in chaplain requests from patients and families and lack of engagement by staff in now traditional support forms in the COVID-19 context suggest that new insights and resourcing are needed. This exploratory translational study suggests that the evolutionary psychology of R. I. M. Dunbar and the social neuroscience of J. T. Cacioppo, his collaborators, and successors and their concerns for human loneliness have potential for use in development of effective healthcare chaplaincy practice in the COVID-19 context.


Subject(s)
COVID-19/psychology , Clergy/psychology , Loneliness/psychology , Pastoral Care/methods , Professional Role/psychology , Adaptation, Psychological , Humans , Interpersonal Relations , Object Attachment , Spirituality
14.
J Sex Marital Ther ; 46(8): 747-762, 2020.
Article in English | MEDLINE | ID: covidwho-744440

ABSTRACT

In early 2020, the novel coronavirus 2019 (COVID-19) spread across the United States and mitigation measures drastically affected the daily lives of Americans. In this study, we assessed the association between COVID-related relationship conflict and changes in intimate and sexual behaviors and experiences. Using data from an online nationally representative probability survey of 1,010 American adults in April 2020, we estimated the impact of coronavirus-related relationship conflict on changes in intimate and sexual behaviors among those in any type of romantic or sexual relationship (Nweighted=742). Further, we assessed the association between conflict and experience of orgasm and feeling emotionally close to partner. Among individuals in relationships, 34% reported some degree of conflict with their romantic partners due to the spread of COVID-19 and its related restrictions. Those experiencing frequent coronavirus-related conflict with their partner were significantly more likely to report decreased frequency of several solo and partnered intimate and sexual behaviors compared to those not experiencing any such conflict, exhibiting a dose-response trend among partnered sexual behaviors. Since the spread of coronavirus and associated social distancing measures in the United States, Americans have experienced escalations in conflict in their romantic partnerships, which was associated with changes to their intimate and sexual lives.


Subject(s)
Coronavirus Infections/psychology , Personal Satisfaction , Pneumonia, Viral/psychology , Sexual Behavior/psychology , Sexual Partners/psychology , Adult , COVID-19 , Female , Humans , Interpersonal Relations , Male , Object Attachment , Pandemics , Sexual Behavior/statistics & numerical data , Surveys and Questionnaires , United States
15.
Psychiatr Q ; 92(2): 675-682, 2021 06.
Article in English | MEDLINE | ID: covidwho-743745

ABSTRACT

We aimed to evaluate the postpartum depression rates and maternal-infant bonding status among immediate postpartum women, whose last trimester overlapped with the lockdowns and who gave birth in a tertiary care center which had strong hospital restrictions due to serving also for COVID-19 patients, in the capital of Turkey. The low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale (EPDS) and Maternal Attachment Inventory (MAI) within 48 h after birth. A total of 223 women were recruited. The median score obtained from the EPDS was 7 (7) and 33 (14.7%) of the women were determined to have a risk for postpartum depression. The median scores of the EPDS inventory of depressive women were 15 (3). The median MAI score of 223 women was 100 (26); and the MAI scores of women with depression were significantly lower than the controls [73 (39) vs. 101 (18) respectively, p < 0.001]. Evaluation of the factors that affect the psychological status of pregnant and postpartum women will lead the healthcare system to improve the implementations during the COVID-19 pandemic.


Subject(s)
COVID-19 , Depression, Postpartum/epidemiology , Object Attachment , Adult , COVID-19/prevention & control , Female , Humans , Tertiary Care Centers , Young Adult
16.
Int J Eat Disord ; 53(11): 1855-1862, 2020 11.
Article in English | MEDLINE | ID: covidwho-734194

ABSTRACT

OBJECTIVE: the aim of this longitudinal study was to evaluate the impact of COVID-19 epidemic on Eating Disorders (EDs) patients, considering the role of pre-existing vulnerabilities. METHOD: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID-19-related post-traumatic symptoms. RESULTS: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED-specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re-exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID-19-related post-traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. DISCUSSION: COVID-19 epidemic significantly impacted on EDs, both in terms of post-traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable.


Subject(s)
Coronavirus Infections/prevention & control , Feeding and Eating Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adolescent , Adult , COVID-19 , Case-Control Studies , Exercise/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Italy , Longitudinal Studies , Middle Aged , Object Attachment , Psychological Trauma/psychology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Young Adult
17.
Psychiatr Danub ; 32(2): 256-261, 2020.
Article in English | MEDLINE | ID: covidwho-717854

ABSTRACT

The novel coronavirus disease (COVID-19) pandemic has had a significant impact on the psychological health of individuals and societies. A theoretical framework is required in order to understand this impact and strategies to mitigate it. In this paper, individual and community responses to COVID-19 are discussed from the point of view of attachment theory, a psychological theory which examines the formation and disruption of attachment bonds across the life-span from an evolutionary perspective. The contributions of this perspective to individual psychological disorders such as anxiety, depression and post-traumatic stress, as well as to social responses such as interpersonal violence and stigmatization, are discussed in the light of findings from attachment research. Proposals for incorporating the knowledge derived from attachment theory into therapeutic strategies, as well as in developing community resilience in the face of COVID-19, are discussed based on the available evidence. It is hoped that this information will be of value to clinicians and researchers, as well as to those involved in planning health services and social policy.


Subject(s)
Coronavirus Infections/epidemiology , Object Attachment , Pandemics , Pneumonia, Viral/epidemiology , Psychological Theory , Stress, Psychological , COVID-19 , Humans
20.
Int Breastfeed J ; 15(1): 67, 2020 07 25.
Article in English | MEDLINE | ID: covidwho-670472

ABSTRACT

BACKGROUND: In an effort to prevent infants being infected with SARS-CoV-2, some governments, professional organisations, and health facilities are instituting policies that isolate newborns from their mothers and otherwise prevent or impede breastfeeding. WEIGHING OF RISKS IS NECESSARY IN POLICY DEVELOPMENT: Such policies are risky as was shown in the early response to the HIV pandemic where efforts to prevent mother to child transmission by replacing breastfeeding with infant formula feeding ultimately resulted in more infant deaths. In the COVID-19 pandemic, the risk of maternal SARS-CoV-2 transmission needs to be weighed against the protection skin-to-skin contact, maternal proximity, and breastfeeding affords infants. CONCLUSION: Policy makers and practitioners need to learn from the mistakes of the HIV pandemic and not undermine breastfeeding in the COVID-19 pandemic. It is clear that in order to maximise infant health and wellbeing, COVID-19 policies should support skin-to-skin contact, maternal proximity, and breastfeeding.


Subject(s)
Coronavirus Infections/transmission , HIV Infections/epidemiology , Health Policy , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Pneumonia, Viral/transmission , Betacoronavirus , Breast Feeding , COVID-19 , Coronavirus Infections/epidemiology , Humans , Mother-Child Relations , Object Attachment , Patient Isolation , Pneumonia, Viral/epidemiology , Risk Factors , SARS-CoV-2 , World Health Organization
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