Psychological impact of home apnea monitoring: temporal effects, family resources, and maternal coping style.

Mothers of 30 infants who had experienced an emergency apnea episode and were placed on a home apnea monitor were studied longitudinally, using measures of mood disturbance (anxiety, depression, hostility, fatigue, vigor and confusion). Mothers were assessed at the time of hospitalization immediately following the apnea episode, after approximately one month of home monitoring, and after three months of home monitoring. Measures of family resources, health locus of control, and coping style, involving preference for information under situations of threat, were obtained as predictor variables. A high level of mood disturbance was seen initially, but this was transient, diminishing significantly after the first month of monitoring. Level of family resources was highly predictive of mood disturbance throughout the study period, while health locus of control beliefs were predictive of changes in mood disturbance over time. These findings suggest a means for identifying families at higher risk for maladaptive responses, and in need of more intensive psychosocial support.

The surviving child in the SIDS family.

Children grieve, often very deeply. The unexpected loss of an infant elicits grieving from all family members and alters forever the family structure. What is the long-term impact of the death of a child in the family on the surviving sibling? What happens to children surviving this family catastrophe when they themselves become parents? In this report we present two accounts by children in the home when their siblings died. It reminds us that the effects of a sudden and unexpected loss of a child in the family can be long-lasting and return to us in childrearing practices of the next generation.

Supporting the SIDS family.

Pediatric health professionals are often uncomfortable following a sudden unexpected death in their practice. Anxiety and grief by the pediatrician can prevent the practitioner from using even the most basic grief counseling skills. However, the pediatrician, while deeply affected by the death, is in a unique position to meet the needs of parents and siblings. Often, the pediatrician is the only contact families have with the medical world. This report outlines the techniques we have used to support families during this period of loss. Alleviating guilt, by providing information in a sensitive manner, explaining autopsy results, providing guidance for surviving children, and understanding the effects of loss on a subsequent pregnancy are part of the role the pediatrician can assume. Parents have consistently reported how beneficial it was when pediatricians took the time to listen to their concerns and problems following a sudden and unexpected infant death.

Conditioned hyperventilation as a factor in animal, infant, and adult apnea: a theoretical analysis of experimental and clinical data.

An apnea hypothesis is proposed termed Conditioned Hyperventilation. An organism (animal, infant, or adult) can become conditioned to anticipate traumatic terminal breathing. The resulting hyperventilation produces excessive oxygen, which triggers apnea, allowing an increase in carbon dioxide. This apnea serves as an additional unconditioned stimulus (UCS) causing the hyperventilation (apnea) to increase. Organic blockage can also serve as the UCS. Apnea may be reduced or prevented by monitoring and extinguishing hyperventilation through the use of behavioral modification techniques, or biofeedback. Infant lung collapse during the first six months is suggested as one UCS in infants.

[Sudden infant death. An analysis of psychosocial conditions]. / Der plötzliche Kindstod. Eine Analyse psychosozialer Bedingungen.

The Sudden Infant Death Syndrome (SIDS) has been studied mainly in a medical-biological view. In this paper emphasis is put on the fact that SIDS is also a psychosocial phenomenon: As the infant exists in a continuous exchange with his environment, his death can be considered a reaction to extreme stress load including psychosocial factors. In proceeding from that concept, the social and psychological conditions of 94 mothers of SIDS cases have been analyzed and compared with 68 mothers of healthy infants of similar age, urban/rural relation, and social class distribution. Both groups differed considerably. The SIDS group was more "jeopardized" in any aspect. Probability to die seems to increase with the number of accumulated risk factors. The conclusions drawn can be utilized for prevention.

Psychosocial predictors of sudden death: a review and critique.

Research and selected case studies concerning psychosocial prediction of sudden death are evaluated under three categories: sudden cardiac, sudden infant and sudden traumatic death. The psychosocial predictors reviewed include novelty-pre-exposure, control-helplessness, restraint, Type A behavior, life change, bereavement, denial, social support and contact, voodoo, psychiatric illness, mother infant separation, submission-defeat, housing, handling and environmental enrichment. Four of these predictors, controllability-helplessness, pre-exposure-novelty, depressive affect and physical restraint are repeatedly cited in both human and animal studies and their importance is critically evaluated. Methodological and substantive recommendations for future research are made and a discussion of possible mechanisms is presented.

Developmental patterns of heart rate and heart rate variability during sleep and waking in normal infants and infants at risk for the sudden infant death syndrome.

The developmental sequence of heart rate and heart rate variability was examined during sleep and waking states in 22 normal infants, and 22 siblings of sudden infant death syndrome (SIDS) victims, using 12-h polygraphic recordings at 1 week and at 1, 2, 3, 4, and 6 months of age. Heart rate was higher in siblings of SIDS victims than in normal infants during quiet sleep over the first 6 months of life and was higher in the waking state at 3 months of age. The sibling group also had lower variability at 1 week during quiet sleep. Gender contributed no significant differences to heart rate, but females at risk for SIDS had lower waking cardiac variability than males.

The cry characteristics of an infant who died of the sudden infant death syndrome.

Fourteen cries of a four day old infant who subsequently died suddenly of unexplained causes were analyzed on nine acoustic characteristics including fo, duration, formant frequencies and sound pressure level. In comparison to a group of newborn controls, the Sudden Infant Death Syndrome (SIDS) victim's cries exhibited a lower fo, longer duration, lower formant frequencies and greater sound pressure level throughout the spectrum. Cry duration and sound pressure levels, however, deviated in excess on one standard deviation from the mean of the other newborns. Similar findings resulted when the SIDS infant was compared to a group of full term infants who were siblings of SIDS victims, although the magnitude of the differences was slightly less especially with respect to sound pressure level. Measurement of selected acoustic variables in a newborn's cry may be of value in our understanding of SIDS and for identifying infants at risk.

Grief intervention and sudden infant death syndrome.

A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) is described. Because parents of SIDS victims experience profound feelings of guilt and especially servere crisis reactions, programs relieving guilt and providing additional support to them are felt to have significant preventive potential. Data are presented tentatively supporting the conclusion that the SIDS grief intervention program had a beneficial impact on the participants. Implications for crisis theory and preventive programming in general are also discussed.